ABSTRACT.

STIMULATED RECALL WITH VIDEOTAPE AND SIMULATION
IN COUNSELING AND PSYCHOTHERAPY: A COMPARISON
OF EFFECTS OF TWO METHODOLOGIES WITH
UNDERGRADUATE STUDENT CLIENTS

. By

Robert William Van Noord

This research represented an attempt to evaluate an
integrated videotape/stimulated recall/affect simulation
method of personal counseling and psychotherapy. In the
evaluation of this method, a comparison was made between
rated, self-reported, and peer-observed behaviors of under-
graduate student clients who received the experimental
therapy procedures and behaviors of clients who had received
a second program consisting of traditional, dyadic therapy.
The basic question underlying the study was whether an
integrated affect simulation/Interpersonal Process Recall
(IPR) procedure with videotape could effect more client
growth in therapy over a six-week period of time than a
traditional therapeutic approach.

The therapy model used in this study was derived
largely from Kagan's (1967) IPR and and affect simulation
methods. The sequential steps in the experimental therapy

model included the following: (1) Regular counseling

Robert William Van Noord

sessions; (2) Affect Simulation Viewing-Client and Counselor
discussion of client's reactions to filmed affective stimuli;
(3) Video Recall of Affect Simulation (VRAS)--Client review
of his videotaped reactions to affect simulation; (4) Client
Recall-client review and exploration, with assistance from
"inquirer," of thoughts, feelings and reactions during
previously conducted and videotaped therapy session; (5)
Mutual Recall-~client and counselor together review videotape
of just-completed session and explore feelings, thoughts and
reactions. The traditional therapy model consisted of
dyadic, relationship-oriented counseling and therapy,

equated for time with the IPR model.

Students requesting personal counseling or therapy
were randomly assigned to treatment groups and to counselors
(employed by university counseling centers) within treat-
ment groups and post-treatment comparisons were made between
the two groups. Measures of client in-therapy verbal
behaviors, client satisfaction with therapy, client self-
concept change and peer reports of client behavior outside
of therapy were employed with hypotheses predicting that
clients who received IPR therapy would obtain higher
in-therapy behavior ratings, satisfaction reports, and peer
ratings, and lower self-concept discrepancy scores than
clients who received traditional therapy.

Data were analyzed by a multivariate analysis of
covariance procedure, with one covariable (rated empathic

understanding of therapist) and five dependent variables

Robert William Van Noord

(a composite client growth scale, client self exploration,
client satisfaction with therapy, client self concept dis-
crepancy and peer reports). Two independent 3 tests were
also performed as post hoc exploratory analyses of peer
ratings results and covariable to dependent variable
correlations and dependent variable intercorrelations were
examined. Finally, subjective written comments of the
client-participants in the study were obtained.

Results of the multivariate analysis on the five
dependent variables taken together indicated no significant
treatment effect. Results of univariate analyses carried
out in the same procedure also indicated no significant
treatment effects for the dependent variables taken
separately. POSt hoc analyses of frequencies of strong
positive and negative peer responses indicated that, although
peers of clients who received traditional therapy tended to
respond with more strongly negative responses than peers of
, IPR group clients, the difference was nonsignificant.l

Written comments of participating clients indicated
that those who responded were pleased with their therapy
experience, regardless of their group. Client statements
appeared to indicate that individuals who received IPR
therapy thought of videotape use as beneficial for self-
exploration. Comments also seemed to demonstrate more
awareness by IPR group members of client defensive dynamics
land of an interactive client-counselor relationship than by

traditionally counseled clients.

Robert William Van Noord

Conclusions from the results of the research were
that the therapy model used for this study did not result
in more client growth in therapy on the variables examined,
but that affect simulation and IPR with videotape is seen
by clients as beneficial and conducive to self exploration
and exploration of the client-counselor relationship in

personal therapy.

STIMULATED RECALL WITH VIDEOTAPE AND SIMULATION
IN COUNSELING AND PSYCHOTHERAPY: A COMPARISON
OF EFFECTS OF TWO METHODOLOGIES WITH

UNDERGRADUATE STUDENT CLIENTS

BY

Robert William Van Noord

A THESIS

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

DOCTOR OF PHILOSOPHY

Department of Counseling, Personnel Services
and Educational Psychology

1973

' n DEDICATION

To my parents, who provided the impetus for it all.

They would be pleased and proud.

ii

ACKNOWLE DGEMEN TS

Acknowledgement is gratefully made to the many
individuals who contributed directly and indirectly to the
planning and completion of this project.

Norm Kagan, my committee chairman and dissertation
advisor provided encouragement, support and advice through-
out the project. I am very appreciative of these as well
as the personal and professional curiosity, interest and
friendship he shared with me.

Andy Porter provided invaluable advice and education
during the research, not just relative to statistics and
design. His clear thinking and helpful suggestions are much
appreciated.

Gregory Miller had confidence in me from the begin-
ning of my graduate program. I am grateful to him for
getting me started and for his support throughout it.

Sam Plyler, who became a real friend and colleague,
shared and took and gave, thus enriching, eXpanding and
validating my experiences and growth.

And Bill Kell knew what it all meant to me, and let
me know that he knew and understood. He generously gave

of--through being--himself, a person through whom I

iii

understood myself first, and-through that, the clients and
others with whom I worked.

I am also deeply grateful to those who were willing
to help and contribute to the research and the researcher
by participating in various roles within the project.
Dianne Singleton, my research assistant, and the therapists
for the project, Miriam Burke, Dale Cook, Bob Dendy, Tom
Fiester, Dave Groves, Ken Hall, June Jacobson, Norm Kagan,
Liz Monroe, H. Mike Peter, Karen Rowe, Ken Salzman and
Allan Scholom all contributed immensely through their com-
petence and interest in the project. Similarly, the assis-
tance given by Pam Bakeman, Roger Landvoy, Sarah Schendel
and Tom Spierling, who ably acted as inquirers, is grate-
fully acknowledged. And I am grateful to the clients, who
were willing to search and explore, and who were the focal
point of the entire study.

Jim Archer and Kathy Scharf acted as raters for the
audiotapes and Roy Gabriel and F. Robert Wilson provided
valuable consultative assistance with statistical and
Computer-related portions of the research” I am very
appreciative of these contributions and those of Nancy
Bossenbroek, who did much of the initial typing of the
dissertation.

Finally, the direct and indirect support received
from the staff members of the MSU and the University of
Delaware Counseling Centers during the progress and the

reporting of this research was felt and appreciated.

iv

Some of these already mentioned and others, equally
important, shared in my development at MSU. For them and
their participation in my growth as a person and a thera-
pist, I am particularly grateful:

To Norm Kagan, who constantly stimulated and
encouraged me, while impreSSing upon me the fact that being
helped and being independent are not incompatible.

To my individual supervisors, Joan Hamachek and
Norm Abeles, who allowed me to experience and learn, and
Bill Kell, who was there when I was most ready for him.

The importance of those searches, insights and pleasures
is well known to both of us.

To the interns, who cared and shared with each
other and with me, which was so important, and to Dinny
Kell, with whom I know "it really happened," which means
that it can happen again.

To Bob Dendy, whose friendship is valued so highly,
who shared from the start and throughout, and with whom
the closeness will continue.

To Ken Hall and Kathy Scharf, who became so impor-
tant through our sharing and warmth.

And finally, but most importantly, I am thankful to
and for my wife, Sally, who knew and understood more than
anyone. Our love and understanding will only continue to
grow as we share throughout our lives together, and Rob

will come to know that too.

TABLE

DEDICATION . . . . .

ACKNOWLEDGEMENTS . . .

LIST OF TABLES . . . .

LIST OF FIGURES . . . .

LIST OF APPENDICES . . .

Chapter

I.

II.

III.

INTRODUCTION . .

Purpose . .
The Problem .

Definition of Terms
Need for the Study
General Hypotheses
Basic Assumptions .

Theory . .
Overview . .

OF

REVIEW OF LITERATURE

Introduction
Client Movement

Problems of Assessment of Client Movement
Acceleration of Client Movement -. . .

CONTENTS

Page

0 I I O O O O O 0 iii

0 o o o o o o o oViii

. . . . . . . . . 39
. . . . . . . 39
. 40
. 48

Conclusions and Implications of

the Literatur
Summary . .

DESIGN AND METHODOLOGY

Experimental Design . .

Sample . .

Description of Treatments

Instrumentation
Hypotheses .
Analysis of Dat
Delimitations
Summary . .

e

a

o o 0 o o o o ‘0 o 72
. . . . . . . . . 74

O C O O O O O O 76

115
118
119
120

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vi

Chapter

IV.

V. DISCUSSION AND CONCLUSIONS

BIBLIOGRAPHY

Introduction

ANALYSIS OF RESULTS

Covariable Ratings

Multivariate and Univariate Findings
The Peer Information Questionnaire--

Independent t Tests Results .

Dependent Variable to Covariable

Correlations
Dependent Variable Intercorrelations
Client Written Comments
Summary

Summary
Conclusions
Discussion
Implications for Further Research

vii

Page
122

122
122
124

128

130
132
134
138

140
140
145
147
156

159

Table

3.1

3.2

3.3

3.4
3.5

3.6

3.7

LIST OF TABLES

Distribution and Description of Sample by
Age, Class and Sex within Groups . . .

Final Subject and Counselor Distribution
Within Treatment Groups . . . . . .

Description of Therapist Sample by Position,
IPR Experience and Sex . . . . . . .

Summary of the Experimental Procedures . .

Frequency of Conducted Inquiries by
Inquirers . . . . . . . . . . .

Correlations between the MSGO GRT(15) Scale
and 13 MMPI Subscales . . . . . . .

Reliability Coefficients for Judges' Average
Ratings of Each Client Dimension and
Counselor Empathic Understanding _. . .

Rated Level of Empathic Understanding of
Counselors by Rater and Treatment Group .

F Ratio for Multivariate Test of Equality
of Mean Vectors . . . . . . . . .

ANCOVA for COGS Ratings . . . . . . .

Grand Means for Dependent Variables
(Raw Scores) . . . . . . . .. . .

ANCOVA for DX Ratings . . . . . . . .
ANCOVA for TSR Scores . . . . . . . .
ANCOVA for MSGO Scores . . . . . . .
ANCOVA for PIQ Scores . . . . . . . .

3 Test Table for Frequency of "One" and
"Six" PIQ Responses . . . . . . . .

viii

Page

82

85

86
87

93

106

115

123

124
125

126
126
127
127
128

130

Table

4.10

4.11

5.1

Page

Correlations Between Covariable and
Dependent Variables (pooled within
grOupS) o o o o o o o o o o o o o 131

Correlation Matrix--Dependent Variable
Intercorrelation Coefficient (pooled .
with groups) . . . . . . . . . . . 133

Summary of Therapy Procedures . . . . . . 143

ix

LIST OF FIGURES
Figure Page

1. Pictorial Representation of the Design . . . 77

LIST OF APPENDICES

Appendix page
A. Subject Consent Form . . . . . . . . . 171
B. Standard Letters of Explanation to

Student Clients . . . . . . . . . . 173

C. Memos to Counselors Regarding
Participation . . . . . . . . . . . 178

D. Therapy Session Report Items . . . . . . 181
E. Peer Data Form . . . . . . . . . . . 185
F. Sample Questions for Use with Affect

Simulation Films . . . . . . . . . . 187
G. Week-By-Week Memos Regarding Procedures

for Group A Counselors . . . . . . . . 189
H. Procedural Memos for Group 3 Clients . . . . 198
I. Characteristics of Client Growth Scales . . . 201
J. Degree of Self Exploration Scale . . . . . 208
K. Miskimins Self-Goal-Other Discrepancy Scale

Hand Scoring Summary Sheet and Profile
smary O O O O O O O O O O O O O 211

L. Cover Letter to Peer-Informants . . . . . 214

M. Response Sheet for Peer Information
Questionnaire . . . . . . . . . . . 216

N. The Peer Information Questionnaire . . . . 218
0. Client Written Comments Sheet . . . . . . 221
P. The Empathic Understanding Scale . . . . . 223

xi

CHAPTER I

INTRODUCTION

Purpose

The purpose of this study is to assess the effective-
ness of a client therapy program which combines the use of
Interpersonal Process Recall (IPR) and affect simulation
films. The study is a modified replication of an earlier
investigation (Schauble, 1970) and represents a further
examination of a relatively new treatment program for
clients. In this program IPR and affect simulation are
incorporated into an ordered treatment program and the
results of that treatment compared with the results of a

more traditional college counseling program.

The Problem

 

Individuals in the field of counseling and psycho-
therapy have as one of their mandates the constant evaluation
and upgrading of the effectiveness of their work, as well
as the possession of a committment to provide helping services
to those who come to them for assistance. In this study, an
attempt is made to obtain a reliable assessment of the
effectiveness of a recently developed method of helping
peOple who have sought assistance with personality and/or

adjustment problems from professional counselors. In this

1

way, an evaluation and possible upgrading of a way of
providing mental health services to college age clients
may be provided.

Traditionally practitioners have carried out
counseling and therapy with college clients in an indi-
vidual or group setting, and in this sense the present
investigation does not depart significantly from the more

typical method of therapeutic intervention. It does differ,

however, in the specific technique of intervention. In

 

this study a relatively new process and technology is used
with the basic concept that therapeutic progress can occur
more rapidly when specific behavior dimensions are isolated
and promoted within the context of therapy.

Consideration of the notion of accelerating therapy
is a step forward given the types of questions which have
been asked about the field in the past. The issue of
whether or not counseling or therapy is effective at all
has undergone extensive debate as recently as the 1960's.
Eysenck's (1952) report in which the claim was made that
psychotherapy had no more effect than no treatment at all,
provided the stimulus for many additional opinions and much
further discussion (e.g., Sanford, 1953; Rosenzweig, 1954;
DeSharmes, Levy and Wertheimer, 1954; Levitt, 1957). More
recent investigations, however, have indicated that studies
which reveal no effects as a result of therapeutic inter-

vention may have had some shortcomings (Spielberger, Weitz

and Denny, 1962; Baymurr and Patterson, 1960; Draspa, 1959;
Bergin, 1963; Kiesler, 1966). That is, while earlier
investigators claimed that psychotherapy had no more
effect than no treatment at all, later studies have
revealed that there may be effects of therapy which are
not observed because of the averaging of differences; the
averaging of positive and negative effects produced a
gross observation which led to the conclusion that

there were no effects at all. Further evidence has
indicated that when related to therapist functioning

variables and specific interpersonal behavior dimensions,
therapy may have positive effects which influence client
change (Truax and Carkhuff, 1967; Carkhuff and Berenson,
1967). The significance of these later findings lies in
the observation that therapy has been found to be £2;
better or £2£_29£§2_(Traux and Carkhuff, 1967).

Given then, the possibility that therapy can be
either beneficial or detrimental, it behooves the indi-
viduals in the profession to make every effort to insure
that the effect will_be beneficial and that the client
can have a satisfying experience.

An effort is made in this study to evaluate a
method designed to accelerate the positive impact of
counseling and therapy. While there are many methods

being tested and used to this end by various practitioners,

this investigation is focused on the use of a specific
method of video technology (Interpersonal Process Recall)
as an intervention in the counseling process. Interpersonal
Process Recall (IPR), which uses videotape replay of the
counseling session to stimulate recall (Kagan, Schauble,
Resnikoff, Danish and Krathwohl, 1969), has been shown to
have significant potential for accelerating growth in
therapy with prison inmates (Kagan, Krathwohl, et a1.,
1967), with disabled adults (Schauble, 1968; Kagan,
Krathwohl and Miller, 1963), and can be used in conjunction
with hypnosis (Woody, Kagan, Krathwohl and Farquhar, 1956).
IPR has also been demonstrated to be an effective method
of training helpers to deal with various populations
(Spivack, 1970; Archer, 1971; Dendy, 1971; Grzegorek,

1971; Heiserman, 1971; Scharf, 1971). Only one controlled
study has been carried out, however, which assessed the
effectiveness of IPR as a therapeutic mode with college
student clients (Schauble, 1970). The aim of this project
is to further examine the effectiveness and efficiency of
the use of IPR and affect simulation as a therapeutic tool
with college students.

IPR in general is the heart of this treatment program,
but specific parts of the process are expanded and emphasized
as elements contributory to therapy acceleration. The use
of affect simulation films and of the "inquirer" role are

two particularly important aspects of the experimental

counseling experience. The theory and a description of
these portions of the treatment program.will be described
and expanded upon later in this and subsequent chapters.
In this study, no distinction is made between
counseling and therapy. This position is based on the
conclusion that ". . . there are no essential differences
between counseling and therapy in the nature of the
relationships, in the process, in the methods or tech-
niques, in goals or outcomes (broadly conceived), or even

in the kinds of clients involved" (Patterson, 1966, p. 3).

Definition of Terms

 

Special terms used in this study are defined as
" ’follows:

1. Interpersonal Process Recall (IPR): The term

 

used to describe the process of recording on videotape an
interpersonal interaction (e.g., the counseling relation-
ship) and playing back the videotape, thus enabling either
or both of the participants to stOp the videotape to
examine and verbalize the interpersonal dynamics of the
original experience. A person in the role of "inquirer"
(see below) is included in this process.

2. Recall Session: The phase of the IPR process

 

where the videotape of a counseling interview is played
back and an "inquirer" helps to stimulate examination by

either or both of the participants of the underlying

dynamics of their interaction during the recorded counseling
session.

3. Inquirer: The designation given to the third
person whose function is to facilitate the client or
counselor's self-analysis of thoughts, feelings, images,
and general pattern of interaction with the other. Since
this person's clinical function is limited to actively
probing the immediate past (contained on the videotape),
the name "interrogator" was initially selected, then
changed to "inquirer" to more accurately describe his
role.1

4. Affect Simulation: A technique using films
which simulate various kinds and intensities of emotional
stress. The films are structured so that a filmed actor
looks at the client and confronts him with various inter-
personal stress situations. Client reactions to such
situations can thus be studied with the counselor in order
to develop understanding and new and more satisfying ways
of responding to the kinds of stress simulated by the films.

5. Video Recall of Affect Simulation (VRAS): Clients
are videotaped while viewing the Affect Simulation Films,
and the client's videotaped behavior while watching the

films becomes the focus of a personal counseling session.

 

1In previous literature, the terms "interrogator,"
"recaller" and "inquirer" have been used to designate the
same person. In this study, the terms, "inquirer" and
"recaller" are used synonomously.

6. Traditional Counseling: Counseling of the type
generally carried out at the MSU Counseling Center and
characterized in this study by the following: (1) It is
dyadic in that the client and the counselor are the only
two individuals in the setting and the relationship;

(2) It is relationship oriented. That is, it is con-
siderate of the ongoing relationships of the client,
including that with his therapist; (3) It is developmentally
oriented in that developmental antecedents of the client's
present psychic situation are often considered; and (4) It
is immediate in the sense that immediate events in the
client's life are typically the focus of concern and con-

sideration.

Need for the Study

The increasing use made by students of college
counseling centers across the country may be indicative
of more than a lessening of the stigma attached to seeking
help for a personal or interpersonal concern. Another
reason professional counselors are finding increasing
, demands for their services may be because many people in
distress are unable to find facilitative agents in their
everyday lives. Carkhuff and Berenson (1967) note that
individuals in the general pepulation, when asked to act
as helpers for another, function considerably below the

minimum level of facilitative helpfulness. This implies

that the general populace is quite oblivious to the feelings
and experiences of the people with whom they relate--they
are essentially immune to constructive human encounters.
Psychological literature abounds with evidence that people
are in need of help, but also mirrors the fact that the
field of counseling and therapy is lacking many answers to
the problems presented to its professionals. Still, people
continue to come for professional help, seeking answers to
problems of everyday living and desiring to c0pe effectively
with the ever increasing stress of society. These people
reflect, to some extent, the state of our society described
by Carkhuff and Berenson (1967):

An unhealthy society is one in which only 20 per cent

of its people are free of signs of emotional distress.

An unhealthy society is one in which one third of its

~ members demonstrate distressing psychiatric sympto-

matology. An unhealthy society is one in which half

of the hospital beds are occupied by mental patients,

and in which one third of these are second admissions.

American society, in which all of these conditions

exist, is not healthy (p. 3).

Unfortunately, however, many professionals are
unable to provide for the needs of clients in counseling
and therapy. Carkhuff and Berenson (1967) continue:

If counselors and psychotherapists functioned in real
life the way they do in the therapeutic hour, they
would be patients. The professional helpers to whom
we turn because human sustenance is not available in
the general environment are themselves functioning

at ineffectual levels of those dimensions related to
constructive change or gain (p. 11).

Yet, it has been acknowledged that counseling and therapy
can have a positive effect (Truax and Carkhuff, 1966;
Carkhuff and Berenson, 1967) and with this acknowledgement
comes the mandate that the counseling profession constantly
evaluate and upgrade its theory and methodology in order
to ensure that the client is able to have a valuable
experience.

The need for upgrading of both theory and methodology

is obvious. The tasks facing counselors are to determine

how this may be done and to carry it through. Examination
of counselor and client variables in an attempt to
determine those which foster client growth has been one
productive activity aimed at upgrading the therapy
process. Another has been the development and testing of
therapeutic methodologies which may be used to assist
those in distress. It is with this latter activity that
this study is concerned.

In this study an attempt is made to assess the
usefulness of a methodology which is thought to benefit
clients in therapy. Through the use of a specific tech-
nology, clients may be helped to exPand and clarify their
experiences; by viewing themselves as both object and subject
in this treatment program, clients may be able to expand
their consciousness and gain contact with more effective
ways of living and relating. In this way individuals may
be able to rise above the dilemma and attain the goal to

which May (1967) refers.

10

. . . I have described the human dilemma as the capacity
of man to view himself as object and as subject. My
point is that both are necessary--necessary for
psychological science, for effective therapy; and for
meaningful living. I am also prOposing that in the
dialectical rocess between these two oles lIes-tfie
development, and the deepening aggfafdenIng, g§_hfifign
consciousness-TpI-IU).

 

 

General Hypotheses

General hypotheses proposed for this investigation
are stated here. Specific research hypotheses will be
outlined in Chapter III.

1. Clients who receive counseling with IPR and
affect simulation will evidence more growth on rated process
dimensions of Owning of Feelings, Differentation of
Stimuli, Committment to Change and Degree of Self Explo-
ration than will clients who receive traditional counseling.

2. Clients who are counseled with IPR and affect
simulation will be more satisfied with their therapy
sessions than will clients who are counseled with tradi-
tional methods.

3. Clients who receive counseling with IPR and
affect simulation will reveal less discrepancies between
their self concept, their goal self concept and the way
they think others see them than will clients who receive
traditional counseling.

4. Peers of clients will report more positive

behavior changes for clients who receive counseling with

IPR and affect simulation than for clients who receive

traditional counseling.

11

Basic Assumptions

This investigation of therapy acceleration through

a specific treatment program is carried out under a set

of assumptions which are briefly outlined here:

1.

Clients who seek assistance and are counseled

at the Michigan State University Counseling
Center do not differ from clients who seek help
and are counseled at other university counseling
centers in their ability to increase their
interpersonal functioning.

Clients are capable of achieving insights into
their own behavior and of consequently changing
their intra- and interpersonal behaviors.

Client within-interview behavior can be adequately
judged from listening to only audiotaped samples
of a total interview. Further, measures which
use ratings of clients' within-interview verbal
behavior are valid and capable of determining
changes in that behavior.

Client's subjective reports are valid measures
of client satisfaction.

While some therapeutic change may occur exclu-

‘sively intraindividually, some changes in client

behavior as a result of therapy are capable of
being observed by the individuals with whom

clients interact outside of the therapy setting.

12

Theory
The theory underlying the treatment program developed

for this study grew primarily from observations, inferences,
and investigations of what constitutes and promotes positive
client movement in counseling. General theoretical founda-
tions described by Kell and his associates (1966, 1970) are
used and the therapeutic model is based on Kagan's (1967)
Work with IPR and affect simulation. In addition some of
'Carkhuff's (1967 a,b) techniques of tape rating (with
revisions» have been included in the criterion instruments.
In this section, these theoretical formulations are reviewed
and a description of the theoretical model of treatment is
given.

The general theoretical base for the procedures
used in this study stems from a relationship_theory of
counseling. It is closer to the views of neo-analysts
(eg. Sullivan) than of classical Freudianism, and more,
akin to the views of Bruner (learning by discovery) than
to more "behavioristic" approaches such as those of
B. F. Skinner (operant conditioning) (Dendy, 1971). The
approach being taken here, therefore, considers the client
as a positive force in the resolution of his own concerns,
and capable of achieving insights which will lead to more
appropriate behaviors and to more positive mental health.

The task of the counselor is to facilitate this process.

13

The counseling situation, and the relationship with-
in it, is further seen as a microcosm, and thus representa-
tive of the client's life in general, including the rela-
tionships in which he engages. In his interactions with
significant (and sometimes nonsignificant) others in his
life, the client has learned ways of COping and behaving.

He carries these modus operandi with him into therapy and
uses them with his counselor, who becomes a significant
figure in the life of the client. Given that these inter-
personal behaviors are to some extent maladaptive and
productive of the dissatisfaction in life which brought

the client to counseling, one of the tasks of the counselor
is to assist the client in examining these interactive
behaviors.

In spite of counselor efforts to assistthe client,
however, the client may continue in attempts to elicit
responses from his counselor in order to effect certain
goals. These eliciting behaviors which seem to be maladaptive
in the client's present life are interpersonal methods that
the client has developed as ways of c0ping with anxiety.

As Kell and Mueller (1966) say:
The purpose for which the behaviors were learned and
the reasons that the client still clings tenaciously
to them is to ward off anxiety. Anxiety, therefore,
is the emotionally motivating force that runs through
all of the eliciting behaviors. Although anxiety
can be an experience related to many different conflicts,

basically it arises out of the meaning that establishing
and breaking human relationships has for a person. The

14

motivation for the genesis and utility of the
eliciting behaviors stems from a person's needs
to manipulate and maintain interpersonal contacts
and to avoid pain (p. 47).

It is necessary that these eliciting behaviors be
examined by the counselor and the client in terms of what
purposes they serve for the client and how they are
operational in the client-counselor relationship. In
addition, an examination of these behaviors is necessary
in order for the counselor to grasp the particular concern
of the client, since the eliciting behaviors are the
behavioral manifestations of the client's interpersonal
conflicts (Kell and Mueller, 1966).

Through the use of stimulated recall and affect
simulation with clients in therapy, it was hypothesized
that clients could be more effectively helped to examine
their own behaviors and underlying conflicts than through
the use of traditional counseling techniques, especially
in the initial stages of counseling. Consequently, Inter-
personal Process Recall methods and affect simulation
films were used in an attempt to accelerate the process
of client self-examination and discovery.‘ 4

But why do clients persist in carrying out these
maladaptive behaviors both with the counselor and with
significant others in everyday life? A review of some

obstacles to client growth may be pertinent at this point.

15

Obstacles to Client Growth

A number of obstacles can be present in the therapy
situation which make the task of the counselor and client
more difficult. Some of these obstacles are the client's
defensive dynamics, client subjectivity, the compression
of prior client experiences and fears of psychological
closeness to the counselor.

Client anxiety often results in client defensive-
ness. The client attempts to defend against the counselor,
making it extremely difficult for the client to react
spontaneously to the therapist and for the therapist to
completely understand the experiences of client in the
same way the client experienced them. A "strong wall" is
erected (Brammer and Shostrom, 1960) which may inhibit
therapeutic progress.

This situation is compounded because participation
in an emotional experience makes it extremely difficult for
a person to make precise, objective, unbiased observations
(Kubie, 1958). Because of the very nature of his involve-
ment in the experience and his closeness to it, the client
is unable to label what he feels easily, much less identify
it precisely. He cannot identify the precipitating condi—
tions of his condition easily and finds it difficult to
communicate these to the counselor. Kubie elaborates on
this in referring to the counselor trainee supervision
process; his comments seem to have relevance to counselor

and client alike.

16

. . . So much of our raw data consists of brief

impressions of evanescent, fleeting moments of

behavior. They are here and gone in a flash, never

to recur, never to be reenacted or relived in

exactly the same way. . . . It is this fleeting

moment which must be studied. For this purpose it

would have to be perceived and recorded and recalled

with precision. Yet, we know that during the whole

experience the observer himself is emotionally

involved. . . . When we are involved emotionally,

we are hardly free to make precise, objective

observations, to record them accurately, or to

recall them without bias. . . . Parents and

teachers and psychiatrists have all been dependent

for their basic data upon these imperfect and

fallible memories of visual and auditory perceptions

which are themselves subject to distortion (p. 84).

As possible solutions to the dilemma described by

Kubie, two new developments reported by Goldberg (1967)
have promise: "(1) The advent of videotape which provides
an immediate, accurate, and undistorted recreation of a
previously experienced interaction, and (2) the adaptation
of stimulated recall methodology, designed to activate a
person's ability to introspect about his inner experiences,
to the process of . . . therapy. . . ." (p. 2). Both of
these developments are used in this study in an attempt

to promote client growth.

Kell and Mueller (1966) point out another obstacle
to client growth in counseling. Very early in his therapeutic
encounters with a counselor, a client presents a picture which
is a synthesis of his whole life history expressed in terms
of the significant content of his life. The many experiences
of the client have been compressed into a few ways in which

the client thinks about himself. That is, the client tends

17

to represent himself in terms of only a few feelings or
characteristics about himself. He has, in fact, lost
awareness of important distinctions between prior events
and perceives them in a global, undifferentiated manner.
The client's perception of these events as being similar

in character may further lead him to believe that these many
different events all influence him in the same manner and
that his way of responding to them is the same in every
similar circumstance. He loses sight of distinctions
between differing events and between his reactions to these
events.

Attached to each of these compressed client experi-
ences is a particular affect which has also been compressed.
The affect, as well as the experiences, are difficult for
the client to regain awareness of. Searching for and grasp-
ing thesecognitive and affective experiences and expanding
them accounts for considerable time in therapy, particularly
in the initial stages. Without contact with these experi-
ences, the client's attempts to convey prior emotional.
experiences to the counselor may take on entirely different
meanings-~distorted further by lapses of time, client
defensive behaviors, and numerous other factors related
to client, counselor, or relationship variables. This
treatment program was intended not only to assist the
client and counselor in regaining contact with eXperiences,

but also to cut through these possible distortions.

18

Fear of psychological closeness may also contribute
a hindrance to client growth in therapy. An approach-
avoidance dynamic has been reported in previous investi-
.gations, both during the initial stages of therapy (Kell
and Mueller, 1966) and throughout the therapeutic process.
Past research with the IPR method showed frequent occurrences
of the dynamic--the client seemed to both approach and
retreat from psychological closeness with his counselor
(Kagan, Krathwohl, et al., 1967). The observation was
made that while the client and counselor were talking about
events external to the counseling relationship they were
also having conflicting feelings about the relationship
itself. In varying intensities across different client-
counselor interactions, four basic affective client experi-
ences seemed nearly universal: hostility, affection, fear
of hostility, and fear of affection.‘ Given these fears of
closeness, continued expression and exploration of emotion
by the client and the counselor in the therapeutic relation-
Shiptseems quite unlikely without some other assistive
technique; previous investigations indicate that simulation
films and IPR.may be potentially helpful to individuals in

.dealing with and overcoming these fears.

Basic Client Needs
A similarity between client in-therapy needs and
the obstacles to client growth discussed above may be

seen. Obstacles to client growth are particularly relevant

19

for consideration at initial stages of therapy but may
deserve attention at later points in the therapeutic
process as well. Client needs permeate the entire pro-
cess of therapy and can be looked at from a number of
different perspectives. In this section, they will first
be examined as stemming from the obstacles to growth dis-
cussed previously. Client needs which are more general
and which are referred to in theoretical formulations by
Carkhuff, Truax and Berenson will then be briefly des-
cribed in relation to the purposes of this study.

In order for a client to begin the process of self-
exploration and to examine his situation so that a change
process can begin, his anxiety about entering counseling
needs to be dealt with. This can be done within the context
of the client-counselor relationship which begins to be
established at the onset of counseling. One counselor set
(among others) is proposed by Kell and Borow (1970) as
necessary for this relationship to be established:

. . . As human beings we need to be understood
phenomenologically, or subjectively. . . . The need
to be understood in this way is heightened in the
person seeking help with his emotional problems.

At such times he has frightening feelings of
apartness which stem from past and present conflict
with significant others. Fears of abandonment and
isolation are common. . . . Careful listening and
sensitive responses by us to these thoughts and
feelings of the client help him to feel there is

someone who can know and share with him something
of how he feels within himself (pp. 11 a 12).

20

The need to be phenomenologically understood is
basic to the establishment of a relationship, and conse-
quently, to the success of counseling. This is
not to say that counselor understanding and empathy neces-
sarily resolves the client's concern. It does howeVer,
help alleviate some of the client's feelings of helpless-
ness and aloneness, and rouses in him some feelings of
hopefulness, of being with someone who understands, and
possible thoughts of coping and mastery, rather than
despair (Kell and Borow, 1970). From this point, the
counselor and the client can continue in attempts to
alleviate the client's discomfort and resolve his concern.

The term accurate empathy has been coined by Truax
and Carkhuff to describe what is necessary at
this and later stages of the counseling relationship. From
theoretical formulations of Rogers (1957) and Studies by
Truax and Carkhuff, accurate empathy has been presumed to
be a facilitative dimension in therapeutic relationships
(Truax and Carkhuff, 1969 a,b).

According to Truax and Carkhuff (1967):

Accurate empathy involves more thanjust the ability
of the therapist to sense the client or patient's
'private world' as if it were his own. It also
involves more than just his ability to know what

the patient means. Accurate empathy involves both

the therapist's sensitivity to current feelings and
his verbal facility to communicate this understanding

21

in a language attuned to the client's current
feelings. . . . His responses not only indicate

his sensitive understanding of the obvious feelings,
but also serve to clarify and eXpand the client's
awareness of his own feelings or experiences (p. 46).

Accurate empathy on the part of the counselor is
therefore seen as necessary to client growth and is needed
by the client upon entering therapy.

It was mentioned earlier that an obstacle to client
growth is the fact that many of the client's prior experi-
ences have been compressed, or compacted, and that the
affect associated with each of these experiences has been
compressed similarly (Kell and Mueller, 1966). It may be
helpful in order for the client and counselor to examine
these general and affective experiences, that they be
expanded, and in a sense, relived in the therapeutic experi-
ence. By perceiving and responding at the most general level
possible to the dynamic meaning of the client's previous
experiences, the counselor may be able to find the recurring
affective theme that pervades the client's verbal material.

The client then has the most freedom.possible to
expand his experiences and feelings in the ways that
have the most significance to him. ‘As the client
begins to expand the associated feelings, the
counselor can follow the course of the client's

lead as to which experiences have the most meaning
for him, the counselor can more effectively track
the development of the client's conflicts (Kell

and Mueller, 1966, p. 36).

Through this expansion process, the client also
is encouraged to undergo a process of self-discovery. The

client leads himself to see that the way in which he views

22

himself within the presenting content represents very
basic attitudes that he has toward himself. When the
client can perceive these attitudes which he possesses
toward himself, he may be able to isolate areas of conflict
which produce the discomfort and concerns of the present.
The client has a need to expand these compressed experi-
ences in order to look at them as factors contributing to
his current concern. One of the tasks of the counselor,
therefore, is to assist in this expansion process. The
specific methodology used in this treatment program was
intended to assist the counselor in helping the client
regain contact with the totality of his prior experiences.
By reliving, through videotape technology, previously
undergone counseling experiences, the client is able to
expand and examine his own awareness of that experience.
In this way he is able to see how he has c0ped and dealt
with situations in the past and how feelings about events
may influence his behavior within a particular experience.
A third obstacle to client growth discussed above
was the subjectivity about his concern and himself with
which the client enters therapy. The client, in order to
accurately examine himself and his problem has need of an
"unbiased objectifier," a person who can view the situation
relatively objectively (that is, without the client's self-
defeating needs) and assist the client in observing,

identifying, and labeling the affective components of prior

23

and present events without bias. With the help of the
counselor, an inquirer, and the videotape, the client may
be able to see precipitating conditions, reactions to
experiences and modes of operation more clearly. This
need of a means to help the client in being able to
objectively observe and evaluate his situation is ful-
filled in this project through the use of videotape and
the IPR procedure.

A fourth need which a client brings to therapy and
which may prove to be an obstacle if not overcome is that
of at least recognition, if not resolution, of the fear
of psychological closeness to the counselor. The theory
underlying this program of study is a relationship theory
of counseling. In this framework the client-counselor
relationship is considered a medium in which client con-
cerns can be examined and worked through as well as a
potent force in getting at the true concerns with relation-
ships which many college students have. This approach
adheres to the concept of a dynamic, interactional process
in counseling which is more fully described by Kell and
Mueller (1966):

We have developed our ideas about the ways that
clients change in terms of the dynamic conse-
quences of the client-counselor interaction in

the relationship. Our constructs reflect both the
reciprocal impact of their communication on each
other and the lengths to which both participants

may go to keep the communication intact so that
the counselor may be helpful.

24

Thus the relationship between client and counselor
is important. A part of this relationship is the affective
bases from which the participants Operate. Clients, as has
been observed earlier, come to the counseling setting with
basic fears, four of which have been found to be nearly
universal: fear of being hostile, fear of being affection-
ate, fear of receiving hostility and fear of receiving
affection. All of these fears in moderation are relatively
"normal" and to be expected within the therapeutic situation.
The client needs, however, to be able to gain contact with
these emotions and not allow them to Operate outside the
realm of his awareness. The client needs assistance in
getting in touch with these fears and in recognizing and
dealing with them, for the fear of closeness makes continued
expression and exploration of emotion unlikely in the early
stages of the counseling relationship (Schauble, 1970).

In this treatment program, it was expected that
the methodology outlined would assist both the client and
the counselor in discovering and dealing with the above
mentioned fears. The so-called "process of approximation”
in approaching these interpersonal threats will be described
in a subsequent discussion (see page 32).

More generally, however, client needs can also be
viewed from the standpoint of what accounts for and what
can predict constructive personality change. Many

orientations to counseling and therapy have emphasized

25

the critical nature of counselor and client process
variables. Rogers (1957) has proposed six conditions

as being "necessary to initiate constructive personality
change."

1. Two persons are in psychological contact.

2. The first . . .., the client, is in a state of
incongruence, being vulnerable or anxious.

3. The second . . . , the therapist, is congruent or
integrated in the relationship.

4. The therapist experiences unconditional positive
regard for the client.

5. _The therapist experiences an empathic under-
standing of the client's internal frame of
reference and endeavors to communicate this
experience to the client.

6. The communication to the client of the therapist's
empathic understanding is to a minimal degree
achieved (pp. 95-96).

From these necessary conditions have evolved further
theoretical formulations which have since gathered some
evidence as being descriptive of factors which can be
facilitative of positive client growth in therapy. Though
given different labels at times, counselor variables have
included: (1) empathic understanding, (2) positive regard
or warmth, (3) genuineness, (4) self-disclosure, (5) Specifi-
city of emotional experience, (6) concreteness in problem
solving, (7) apprOpriate confrontation, and (8) interpreta-
tion of the immediate helping experience (Carkhuff, 1969 b).
Client variables have included: (1) self exploration
(Truax and Carkhuff, 1967), (2) owning of feelings,

(3) committment to change, (4) differentiation of stimuli,

and (5) changing behavior with the helper (Kagan, et al.,

26

1967, 1969). Constructive client change has been reported
when these variables are present at facilitative levels

in the counseling setting, and it appears that improved
mental health can be facilitated through helping the client
and counselor carry out the above behaviors. Of the above
client variables, the following are examined in this
project: (1) self exploration, (2) owning of feelings,

(3) commitment to change, and (4) differentiation of
stimuli. As Schauble (1970) states, "Most theoretical
schools in counseling and psychotherapy agree that client
behaviors which reflect owning of feelings, or discomfort
. . . , motivation and committment to change, delineation
and clarification of problem areas, and self-exploration
are essential ingredients to client progress in a therapy
relationship" (pp. 150-151). In this study, another
attempt is made to fulfill these client needs and thus

facilitate client progress in therapy.

Client Growth

 

The above discussion serves to illustrate what
recent literature in counseling and therapy postulates--
that clients typically enter therapy without having access
to many basic emotions. Because of client subjective bias,
compression of experiences, lapses of time, and other
client, counselor, and relationship variables, the client's

attempt to convey prior emotional experiences to the

27

counselor may take on entirely different meanings than those
of the original experience (Schauble, 1970). Because of the
client's inability to recognize and deal with feelings, the
client is anxious and has difficulty c0ping. He cannot

identify and/or experience his feelings nor can he know and

understand them. As a result, the client cannot change the

behavior they cause--behavior that is dissatisfying to
him and which he wishes to change.

There is little disagreement about the statement
that the purpose of counseling is to change people's
behavior (Kell and Mueller, 1966). In insight therapy
behavior change is assumed to come about as a result of
client exploration of anxiety laden areas with the counselor.
The counseling progresses from a more superficial level of
relationship and experience to a deeper level; it moves
from a point at which the client and counselor are exploring
relatively non-threatening areas to a point where they are
dealing with areas of thought and feelings which are
frightening to the client. The client becomes progres-
sively more able to deal with these threatening areas.

This process of gradual movement to a more in-depth
relationship and experience is often referred to in the
vernacular as "getting down to gut level."

In his description of the change process which
occurs in seven stages, Rogers (1958) pictures the goal of

therapy which is reached in the final stage as when

28

New feelings are experienced with immediacy and
richness of detail, both in the therapeutic
relationship and outside. . . . The situation
is experienced and interpreted in its newness,
not as in the past. .

Client growth in counseling, then, is defined as
an increasing capacity to gain access to, communicate and
fully experience feelings (Schauble, 1970). When the client
is able to accomplish this, he is able to see more clearly
the behaviors he wishes to change and can be helped to
resolve his concerns. Thus the principal task of the
counselor is to increase client insight and understanding
and help the client experience his feelings in an appro-
priate way (Howard, Orlinsky and Hill, 1968). The treatment
program used here has this as its primary goal.

Basic Experimental Method:
Description and Theogy»

In this section Interpersonal Process Recall and
affect simulation are further described and the theory
underlying their use is discussed.

Interpersonal Process Recall.--Interpersonal Process
Recall (IPR) was developed at Michigan State University by
Norman Kagan and his associates as a means of assisting a
counselor-in-training to better examine his feelings about
himself and his interactions with his clients and thus look
at the dynamics Of his relationships with his clients

(Kagan, Krathwohl, et al., 1967). It has since been used

not only with counselor trainees, but also with teachers,

29

social workers, medical students and clients in therapy
The actual use of IPR with a client is as follows. The
interaction of a counseling interview is videotaped by

a partially hidden or revealed camera of which both the
client and counselor are aware. At the conclusion of the
interview, an "inquirer" meets with the same client and
the videotape of the just completed counseling interview
is replayed. Either the client or the inquirer may stOp
the playback, especially at times when the client recalls
specific events occurring at that point in the counseling
session. The inquirer then assists the client, through a
specific kind of probing, from a relatively neutral frame
of reference (see Kagan, Krathwohl, et al., 1967, p. 11),
to recall, examine and explore the feelings, thoughts and
reactions he was having during the counseling session.

The use of the IPR method provides a maximum of
cues, both verbal and non-verbal, to the individual so
that the likelihood of a complete reliving of the original
experience is increased. The heart of the methodology
lies in two dimensions. The first is the immediate video-
taped replay of the totality of the counseling session which
provides the client with an Opportunity to see and hear
the entire prior interaction. Second is the introduction
of a person especially trained and experienced in helping
a subject concentrate and relate his own recalled thoughts

and feelings.

30

While there is some evidence to indicate that the
basic IPR method can be a potent tool to accelerate therapy,
there is need for a reliable, stringent examination of the
method as a therapeutic tool. Many recent studies have
examined the effectiveness of IPR as a tool in the training
of professional and paraprofessional counselors; some initial
investigations were undertaken to examine the impact of IPR
on client progress and a more recent study also examined
client movement as a result of IPR intervention in the therapy
process. In this later study Schauble (1970) evaluated the
potency of IPR used in conjunction with another potential
method of producing accelerative effects in therapy, affect
simulation films. He found significant accelerative effects
from the use of IPR and affect simulation films for a group
of experimental subject-clients compared with the effects of
"traditional" therapy with a group of control subjects. In
his conclusions, Schauble states, "With an indication of the
initial value of the program, ongoing studies should be
initiated which would provide more substantial evidence as to
whether or not the technique results in accelerated movement
in therapy" (Schauble, 1970). In this study the effects of
the application of simulation and IPR to the therapy process
are further examined.

Affect Simulation.--Affect simulation was developed
out of the observation that the potency of the IPR method for
client learning and growth hinged at least partly on the

quality of the counseling session (Kagan, Krathwohl, et al.,

31

1967). The recall of the counseling session seemed to have
more effect if the counseling session contained intense
client-counselor interaction over matters of concern to the
client than if the session consisted of bland exchanges.
Recognition of this limitation led to the reasoning that if
a client could be helped to focus on his reaction to a
series of planned threatening behaviors of another person,
he would be better able to know about his own dynamics in
the face of these behaviors and obtain valuable feedback
about himself which would be useful for both himself and
his counselor.

As a result, a series of filmed vignettes was created,
and later reproduced on videotape. The vignettes incorporate
four dimensions of the approach-avoidance dynamic which
seems characteristic of clients, especially at entry into
counseling (Kagan, Krathwohl, g£_§l., 1967; Kell and
Mueller, 1966). The four emotions portrayed in varying
degrees of intensity are hostility, affection, fear of
hostility and fear of affection. By examining their reac-
tions to these types of affect, both client and counselor
(particularly the client, for purposes of this study) can
better know the ways in which they might react to the
behaviors, feelings, and actions Of the other person in the
lcounseling relationship and everyday interactions. These
feelings are typically evidenced by client concerns such

as: (l) The counselor might hurt or reject him; (2) The

32

counselor might make an affectionate, dependent or
seductive approach toward him; (3) the client's own
hostile impulses toward the counselor might emerge; or

(4) The client's own affectionate, dependent or seductive
impulses toward the counselor might be expressed or acted
out. Unless these feelings are brought out and dealt with,
or at least recognized for what they are, the general fear
of closeness will not be overcome and continued expression
and exploration of emotion is unlikely. As a result, the
client's progress in therapy will be limited.

In an effort to accelerate the progress of a client
through therapy then, affect simulation films were also
used as a means of assisting the individual in examining
his own intra- and interpersonal dynamics. The client
watched the films and explored his feelings, thoughts
and reactions to them with his counselor.

Organization of Treatments:
Successive ApproXimation

The treatment program formulated for this study was
designed to accelerate client growth in counseling by
taking the client through a series of therapeutic tasks,
thereby "successively apprOximating" the desired goal of
client self-exploration and eventually, positive mental
health. This series of tasks takes the client from a

position of relatively more interpersonal safety (from

33

the client's perception) to a position of more risk. It
moves the client from participation in a simulated, "low
key" activity (film simulation) in which his feelings and
emotions are stimulated but he is clearly safe to a point
where the client is an active participant in the process
of dealing with himself and his world in the immediacy of
its occurrence.

The program of therapy used in this study represents
an attempt to replicate the acceleration of therapy study
carried out by Schauble in 1970; it will be seen that the
four stages of treatment are similar to the three used
previously by Schauble. The following general stages are
comprised in the treatment program developed for this study:

1. Simulation Viewing

2. Simulation Video Recall (SVR)

3. Client Recall (ClR)

4. Mutual Recall (MuR)

In the £i£§5_pha§§f-Simulation Viewing--the client
and the counselor watched a series of filmed vignettes
together, without being videotaped. The films were designed
to simulate various interpersonal stress situations and were
intended to provide a beginning means cf assisting the
client to gain contact with and examine the feelings he
was having as he watched the film. During and after the
viewing of the vignettes, the counselor and client dis-

cussed and explored further the client's reactions to the

34

vignettes. The counselor, in this phase, made use of
some of the questions used by the inquirer (see Appendix F),
but was not strictly limited to the inquirer role.

In the second phasgf-Simulation Video Recall-—each
client was shown a similar film to that of phase one, but
which had a different content. The client was videotaped
as he watched the film. The videotape of the client, with
the accompanying audio portion of the simulation film,
was played back immediately to provide the client and his
counselor with what was assumed to be a sample of the
client's reactive behavior in an actual emotional stress
situation. The examination of this videotape served as
the focal point for the ensuing counseling session. In
this phase, it was expected that the client would become
increasingly more able to identify and deal with simulated
emotional confrontation and would become more at ease with
his own feelings and behavior. He would become more aware
that he and the counselor are both capable of dealing with
his emotional stress, and Openness and access to feelings
would be defined as desirable and attainable goals of the
counseling experience (Schauble, 1970). The client is in
a relatively "safe" position at this point; he is allowed
to look at his reactions without having to be responsible
for their impact or comsequences. He is dealing with inter-

personal threat, but from a position of relative safety.

35

In the thigd.ph2§g§-Client Recall-~the counselor
and the client were videotaped while engaged in a regular
counseling session. Immediately after completion of the
session, the counselor left the room and a third person—-
the inquirer-~conducted a recall session with the client.
At this stage, the role of the recall worker, or inquirer,
was strictly adhered to, and considered crucial.

During the client recall the inquirer can be very
instrumental in the process of assisting the client with
self-exploration and examination. Most clients in recall
cannot tell certain feelings which they had during the
interview (e.g., affection or hostility) directly to their
counselor, since he was and still is the object of those
feelings. That is, at this stage, many clients would tend
to avoid in recall (with their counselors) the very areas
they avoided in the counseling interview. A second counselor
in the role of inquirer may help the client overcome this
behavior by keeping the client's attention focused on the
videotape and by limiting discussion to that which had
transpired in the counseling session. Clients typically
find it easier to tell the second person about their
feelings and behaviors with the first person than to tell
the first person directly. By trying to remain neutral
the inquirer avoids establishing another client-counselor
relationship; instead, he keeps the client focused on the

feelings or content of the original relationship. In this

36

way the inquirer seems to help the client move one step
closer to achieving concurrent, “here and now" awareness
of his affect.

This inquirer-client interaction in the recall
process is structured to enable the client to become aware
of his behavior in relating to the counselor. The client
is provided the opportunity to learn how his feelings
originate and develop. He can learn what he likes and
dislikes about himself in the counseling interaction. He
can also learn to recognize the feelings he has about the
counselor and the ways he expects or hOpes the counselor
will feel and act toward him. Because the client is still
not confronting the counselor in this stage (the counselor
is observing, with the client's knowledge and consent, from
another room, but is not participating) and thus still has
minimal responsibility for the consequences of his feelings,
the anxiety which normally attends recognizing and examin-
ing these feelings is reduced.

In the fourth phaggf-Mutual Recall--a regular
counseling session was again videotaped (as in phase three)
and the inquirer entered to conduct a mutual recall with
both the counselor and client. The videotape of the just-
completed counseling session was replayed, with the
counselor remaining in the background initially. As
the client began to identify affective material in the
videotaped session, the inquirer involved the counselor

by inviting him to comment on what he thought was occurring.

37

As the counselor and the client communicated their reactions
more and more during the recall session, the inquirer played
a less active role. When, near the end of the recall
session, the interaction between the client and the
counselor began to move from the "there and then" of
the videotaped session to the "here and now" of the recall
session, the inquirer found an appropriate time to quite
literally withdraw from the session. The client, hopefully,
was thus engaged with the counselor in honest, open communi-
cation about feelings and reactions. He was starting to
experience and label immediate in-relationship feelings and
had reached the "working through" stage (Brammer and Shostrom,
1960) where the greatest gains can be made and consolidated.
Thus in the experimental treatment program, it was
expected that clients would be taken through a series of
four stages designed to successively approximate some types
of client behaviors thought to be representative of and

conducive to positive mental health.

Overview

 

In this chapter an introduction to the study was
given. The purpose and problem were presented, terms were
defined, the need for the study was outlined and general
hypotheses and basic assumptions were stated. The theory
underlying the approach, including discussion of obstacles
to client growth, client needs and how client growth occurs
was discussed. The theoretical base for the basic experi-
mental method and organization of treatments was also des-

cribed.

38

In Chapter II a review of pertinent literature and
research dealing with client movement, problems of assess-
ment of client movement and acceleration of client movement
through self-confrontation, use of videotape, stimulated
recall and affect simulation will be presented.

The design and methodology of the study, including
specific descriptions of treatments and instrumentation
will be given in Chapter III and the resulting data will
be presented in Chapter IV.

In Chapter V the results, conclusions and implica—
tions of the study will be discussed, along with directions

for further research.

CHAPTER II

REVIEW OF LITERATURE

Introduction

 

The review of literature in this chapter will be
focused on the following areas relevant to the present
study: (1) Client movement; (2) Problems of assessment
of client movement; (3) Acceleration of client movement,
including the use of self confrontation in general and
use of videotape, stimulated recall and affect simulation
in particular, and (4) Conclusions and implications of

the literature.

Client Movement
Prior to examination of attempts to accelerate

client movement in therapy, it is necessary to consider

if positive client movement can be brought about at all.
Since Eysenck's (1952) classic paper, investigation of the
efficacy of counseling has been a major activity of many
theorists and practitioners. In spite of these efforts

to determine an answer to the question of whether coun-
seling works, the issue has not been entirely resolved.

.Findings of studies relevant to the problem lend slightly

39

40

more support to the conclusion that counseling produces
no change in a positive direction (Schauble, 1970).
However, the difficulty in evaluating the effects
of therapy is an important factor in the consideration of
whether therapy is or is not effective. The two most
frequently reported obstacles to Satisfactory evaluation
of therapy are; (l) the inability of various schools of
counseling and psychotherapy to agree clearly upon processes
and specific goals, and (2) the inability to put such
definitions as exist into Operation so as to measure
adequately and reliably, whether the goals have been
obtained (Stollak, Guerney and Rothberg, 1966). The
difficulty of evaluation of therapy, coupled with a lack
of agreement of what constitutes adequate examination of
therapeutic movement results in the state of relative

unknowing experienced by the profession now.

Problems of Assessment of Client Movement

 

There are two types of criteria by which the impact
of therapy on client behavior can be evaluated. They are

external criteria, or client behavior outside of the therapy

 

interaction (in situ) and internal criteria, or client

 

behavior within the therapy setting. The use of these
two differing types of criteria has typically represented
the dichotomy which has resulted from two differing types
(pf interests: examination of how changes took place in

'therapy, with focus on the interchange between client and

41

therapist (i.e., the process), and examination of the end
point of therapy, with focus on what change took place
(i.e., the outcome) (Luborsky, 1959, pp. 320-321).

The client's behavior in his everyday life is
typically that which brings him to therapy, and positive
change in this behavior is, of course, the purpose of
the therapy process. External criteria are therefore
important in measuring the effects of therapy. A measure-
ment problem becomes evident when external criteria
are used however. The development of sufficiently
‘broad criteria which are at the same time delineated is a
difficult task. Criteria should be of "sufficient breadth
that they are meaningful and representative of a wide
range of functioning and yet, at the same time, circum-
scribed enough to be measured with reliability" (Zax and
Klein, 1960, p. 445). One way of attempting to get around
the problem of having limited criteria to use has been to
develop implications for wide ranges of functioning from
the observations obtained from narrow criteria. An example
of this type of research is that done by Tuebor and Powers
(1953). Using the number of court appearances following
treatment, Tuebor and Powers compared a group of potential
juvenile delinquents who had received treatment with a
Hatched control group who had not received treatment. The

use of the number of court appearances is certainly a

42

meaningful criterion for therapy with juvenile delinquents,
but a broader range of criteria in this study may have
revealed differences obscured by the use of this one
criterion measure. Since Tuebor and Powers found no
significant differences in their study, the reader is

left with the question of whether the treatment, the
criterion, or both were ineffective. And when comparisons
between results of different studies, where different
pOpulations, treatments and designs may have been used

are desired, issues of criteria become even more important.

The above mentioned study serves to point out
another problem-—that of the insufficiency of an individual
criterion for attempts to assess the effectiveness of
therapy which can be done with a variety of populations.
That is, the criterion used in the Tuebor and Powers
study, for example, would not be relevant for assessment
of therapy done with other groups, such as undergraduate
students or married couples.

Attempts to measure broader areas of functioning
have been made primarily in institutional settings, where
the subject's range of behavior is limited. In these
settings multiple, but individually meaningful criteria
can be applied. Such dependent variables as the number
of times hospitalized patients received electroconvulsive
shock, discharge from the hospital (Cowden, Zax, Hague

and Tinney, 1956), reports from the prison chaplain, and

43

return to prison as a parole violator (Fox, 1954) have

been used. The lack of a unifying framework in which to
integrate these observations for comparisons across dif-
ferent populations results in fragmented results. A
variety of behavioral changes are reported, but different
changes, usually singular, appear in many different studies.
Possible valid measures are reported, but only for specific
purposes. It can only be concluded that a satisfactory
criterion, set of criteria, or even a conceptual framework
in which to evaluate different forms of therapy with
different populations has not yet been found.

The notion of using internal criteria, or those
based upon a client's in-counseling behavior stems largely
from the client-centered approach to therapy. Since the
first use of internal criteria, many researchers have
refined and specified these criteria, to a point where
much recent literature reports their use as measures of
client change.

Data provided by Rogers and Dymond in 1954 indicated
that the primary changes occurring during client-centered
therapy consisted of changes in client self concept rather
than changes in overt or visible behavior. This raises
the question of whether therapy can be justified by the
argument that in spite of lack of observable behavior change,
therapy results in a more realistic and self-satisfying

self concept. The issue is further complicated by the

44

fact that Rogers' and Dymond's statements are not sub-
stantiated by the results of their research. No signifi-
cant differences between behavior before and after therapy
for the treatment group were found when observations and
reports by friends of the clients were examined, nor were
differences found in change in self concept between patients
receiving therapy and those who did not. Although Dymond
(1955) later stated that positive adjustment changes are
not identical to changes which took place in therapy, and
are characterized by "a strengthening of neurotic defenses
and a denial of the need for help," neither the statement
that changes in self concept occur nor the statement that
changes which do occur in untreated clients are different
than those for treated clients are substantiated yet and
still deserve further attention.

Although the Q-sort instrument has been widely used
for the type of studies done by Rogers and Dymond (e.g.,
Butler and Haigh, 1954; Cartwright, 1959; Rosenthal, 1955;
Dymond, 1953; Cartwright and Roth, 1957; Butler, 1960;
and Lesser, 1961) a number of other instruments have been
developed which were intended to serve as outcome criteria
through client feedback. Such instruments as the Client
Post-Therapy Scale (Tucker, 1953), the Therapy Session
Report (Orlinsky and Howard, 1968), a self-rating scale
(Fiedler, 1949) and a Personal Orientation Inventory

(Shostrom, 1968) purport to provide criteria by which to

45

assess client progress in therapy. This type of measure
does have shortcomings, however, since the extent to which
evaluative approaches depend on client feedback may deter-
mine the reliability of the assessment (Schauble, 1970).
Cowen and Combs (1950) further state that when a client
enters treatment he feels bound to justify seeking help
and when terminating counseling he feels obligated to
prove to himself and to the therapist that he has indeed
made movement. This "hello-goodbye" effect (Hathaway,
1948) may be reflected in any report of reduction in dis-
comfort or of positive growth. The limitations of the
use of client reports of therapeutic outcome are aptly
summarized by Zax and Klein (1960) in the following
statement:
Unfortunately, on close analysis, this deceptively
simple procedure is seen to be fraught with serious
pitfalls. Standards for such assessments will vary
both among clients and between client and researcher;
clients will vary in the extent to which they can
report what they feel; the reports of many clients
will be subject to many distortions; finally, the
client's evaluation of his condition may be affected
by conscious or semi-conscious motives (p. 443).
In addition, this type of measure may produce spurious
results since, when an active control group is used,
reporting individuals may be insensitive to treatment
differences and rate higher than what their actual
experiences warrant (Porter, 1972).

It can be seen that another, or additional method

of assessment is necessary. One promising approach to the

46

evaluation of change in behavior in counseling and therapy
is the rating of behavior, usually verbal, by outside
observers. This method has been shown to be potentially
effective, especially in the assessment of therapist be-
havior considered essential to effective counseling and
therapy; considerable research has shown, for example,
that variables such as therapist empathy, positive regard,
genuineness and concreteness can be reliably rated and
consistently related to positive change in the client
(Truax and Carkhuff, 1967; Carkhuff and Berenson, 1967).
The concept of self exploration has been the most
used of the many dimensions upon which ratings of client
behavior are made. One reason for this seems to be the
fact that a number of research studies tend to verify the
significance for outcome of the concept of self exploration.
Wagstaff, Rice and Butler (1960), for example, reported
that patients with successful outcomes in therapy (client-
centered) tended to explore themselves more in the course
of therapy than did patients who could be classified as
therapeutic failures. Several other examinations of the
degree of client self exploration in client-centered
therapy further indicated that more successful clients
increasingly eXplored their problems as therapy proceeded,
while less successful ones tended to decrease in the
exploration of their problems (Steele, 1948; Seeman,

1949). ‘

47

The Depth of Intrapersonal Exploration Scale,
developed by Truax and Carkhuff (1964) and later revised
(Carkhuff and Berenson, 1967) has been found to be a
reliable and promising research instrument. However,
it still remains somewhat crude and has been criticized
on the grounds that it is a global measure of behavior,
derived from a single (client-centered) therapeutic
approach; it has also been used primarily by researchers
disposed toward client-centered techniques.

Kagan et a1. (1967) have proposed a possible solu-

tion to the problem of shortcomings of the Depth of Intra-

 

personal Exploration Scale by devising a set of outcome
criteria to be used in the ongoing counseling process.
These criteria possess the following characteristics:

1. They are not identified with a particular
counseling theory.

2. They are operationally definable and thus have
research utility.

3. They do not necessarily represent discreet entities,
i.e., a client may display two or more of the
characteristics at a given moment.

4. They are not intended to describe everythipg
that goes on in the counseling relationship.

 

The intent behind this approach was to develop a
set of criteria for client change which was acceptable to
most theoretical positions without defining all client
change. Representative of some of the most obvious tasks
a client experiences in successfully moving through the

counseling process, component elements are:

48

l. The client owns his discomfort.

2. The client commits himself to change.

3. The client differentiates stimuli.

4. The client behaves differently.

Kagan and his associates operationalized these criteria

in a rating scale-—The Characteristics of Client Growth
Scales (Kagan, Krathwohl, et al., l967)--on which independ-
ent judges rate client behavior in taped sessions. The
scale has been found useful in scanning client movement

in a variety of individual counseling situations (Resnikoff,
Schauble and Kagan, 1969; Schauble, 1968; Kagan, Krathwohl,
et al., 1967).

Since it is reasonable to assert that the client
establishes a relationship with his therapist which is
similar to those which he forms with other people in his
environment (in that he makes use of the same dynamics), it
would follow that observable behavior change in therapy
would be a valuable source of information for evaluating
the success of the therapy process. In spite of the
ambiguity surrounding research findings resulting from the
use of external criteria, it would seem that both internal
or "process" measures and external criterion measures have
value for an attempt to evaluate the influence of counseling

(or therapy on client movement.

Acceleration of Client Movement
The following consideration of the literature is

<ievoted to ways of accelerating client movement through

49

specific techniques. The concept of self confrontation is
considered and uses of videotape techniques, specifically
Kagan's Interpersonal Process Recall (Kagan, Krathwohl,

et al., 1967) method are reviewed. Consideration is also
given to previous uses of stimulated recall and affect
simulation, and conclusions and implications of the litera-

ture are cited.

Self'Confrontation

 

The use of recording as a medium for client self
examination and confrontation is certainly not new. Rogers
used recordings to analyze and teach non—directive psycho-
therapy as early as 1942 and Covner (1942a, 1942b, 1944a,
1944b) also reported the use of self confrontation tech-
niques in counseling practice and research.

Freed (1948) however, seems to have been the first
American therapist to report the use of sound recordings
as an integral part of the therapy process. By playing
each recording to the client immediately after they were
made, a discussion of the client's reaCtion to this self
confrontation was initiated. This technique was found to
be particularly effective in play therapy with children
and in the treatment of character disorders. The particular
advantage of this type of self confrontation technique for
treating the latter (character disorders) seemed to be

loecause of the difficulty the therapist often encounters

50

with usual techniques in verbalizing back to the client
the subtle nuances of the manner in which the client behaves
and relates, rather than the content of the material.

In 1958, Cameron also reported success in long-
term group psychotherapy through the use of repeated audio-
tape playback. He noted that both patients and therapists
were better able to perceive and understand meanings in
communications which they could not detect during the first
playback of the material. One apparent result of this
process was that group members were unable to defend
against repeated self confrontation experiences.

Subsequent to initial uses of audiotapes in therapy,
some uses of visual images were also made. Miskimins and
Braucht (1971) report that Carrere (1954, 1955) made the
initial use of self confrontation techniques in the treat-
ment of alcoholics. They further state that a significant
increase in the rate of success over standard methods was
shown by Carrere (1958). "Self image experiences" by
psychotic patients and changes in their psychotic states
are also reported by Cornelison and Arsenian (1960), who
photographed patients and then observed and discussed
their responses with them. Improvement on a variety of
measures, including personal appearance and projective
techniques was noted. In spite of obvious shortcomings
in control and design, the authors were optimistic about

the possibilities of the use of this technique in therapy.

51

Cornelison (1966), in commenting on his further use of
self confrontive techniques with alcoholics, psychotics,
and individuals with psychosomatic disorders, states,
"Without any qualification I would say that in nearly
every instance there has been some positive response,
perhaps as great or greater than you usually get in one-
to-one therapy."

The advent of videotape provided an even more
potentially effective means of using self investigation
and confrontation in counseling and therapy, but its
appearance raises a question of whether seeing one's own
behavior in therapy via the videotape would evoke feelings
of threat or extreme anxiety in the client. This result
may be something akin to the "psychic shock" reactions
observed by Cornelison and Arsenian (1960) when their
hOSpitalized patients were confronted with motion pictures
and still photographs of themselves. A few practitioners
have noted increases in the level of anxiety of patients
on viewing a tape of themselves. Moore, et al., (1965)
noted this with psychiatric patients and Geertsma and
Reivich (1965) with a psychiatric outpatient. Poling
(1968), however, did not find this to be the case. He
investigated the impact of videotaping under three dif-
ferent conditions, finding that while counselors who par-
ticipated.in the project did not perceive much difference

in the three interview environments used for videotaping,

52

the clients involved actually viewed the environments as
less threatening and more conducive to counseling than did
their counselors.
. . . For each of the situations, counselees rated
the interview environments more positively than did
the counselors. Statistical significance was observed
in each of the comparisOns which tended to support
the conclusion that counselees appeared to have been
less threatened by the videotaping of counseling
interviews than counselors (p. 352).
While the different environments were not compared with a
no-videotape control in the Poling study, the results of
the study seem to confirm the author's conclusion that
when counseling was conducted "in a professional manner"
the physical environment had little effect on the degree
of success of the interview. Further support for this
conclusion is given by the research conducted by Kagan,
Krathwohl, et al. (1967), in which little difference has
been observed in the behavior or anxiety level of clients
in sessions in which they are videotaped as compared to
sessions in which they are not. Thus, it appears that
environments containing videotape equipment are not per-
ceived as particularly threatening or anxiety-provoking

to clients and that clients are, in fact, eager to view

their videotapes (Ryan, 1969).

Use of Videotape

 

In the majority of studies of videotape media as an
accelerative therapeutic tool, the client has been unable

to View the videotape immediately after the completion of

53

the counseling session. In the few studies in which clients
were able to see themselves on the videotape after the
counseling session (e.g., Schmeding, 1962; Pascal, 1967

and Walz and Johnston, 1963) with one exception (Schauble,
1970), the effects of this practice were not examined; the
writers did not look at the influence which the viewing of
the videotapes had on client behavior. Ryan (1969), how-
ever, does indicate that clients are eager to view their
videotapes and that the client, counselor-in-training and
supervisor should work together as a team in analyzing the
session. Yet, he does not explore the possibility of
various roles or behaviors for each of the participants in
this type of experience, nor does he speak to the potential

impact of this procedure on client behavior.

One structured approach to the use of all of the
participants in the counselor training process was taken
by Goldberg (1967). He used the approach develOped by
Kagan, Krathwohl, et al. (1967), in which the counselor-
trainee was able to observe the client's "stimulated recall"
of the completed counseling session and thus maximize his
feedback about the client's perceptions of the therapy
session. At a later session, the client, counselor and
supervisor engaged in a "mutual recall" where the client
and counselor were able to share their perceptions more
directly. Goldberg found that his training program
resulted in a significantly improved performance for

(counselor trainees when compared with a control group of

54

trainees who received intensive traditional supervision.
Although trainees in both groups were rated as more -
affective, understanding, specific, eXploratory and
effective as a result of the project, treatment group
trainees evidenced significantly greater positive be-
havior change than control group counselors.

Other counselor training programs in which video-
tape methods were used have shown similarly positive
results. In a series of related research projects (Dendy,
1971; Scharf, 1971; Archer, 1971), evidence favoring the
use of videotape and Kagan's Interpersonal Process Recall

technique for the training of residence hall advisors as

paraprofessional helpers was found. Similarly, some studies
conducted on the use of IPR as a training tool for master's
level counseling students (Spivack, 1970) and for prison
counselors (Grzegorek, 1971) indicated that the IPR method
with videotape usage produced significantly higher per-
formance than more traditional types of training which
taught similar subject matter in a more didactic manner.
However, in a study conducted by Heiserman (1971) in which
juvenile court workers were trained in interpersonal com-
munication skills, results favoring an experiential-videotape
training program over a cognitive-classroom program were not
found.

Many studies of counselor training techniques have
dealt specifically with the supervision process. Suess

(1966) and Schiff and Reivich (1964) indicate the apparent

55

value of videotape for understanding counselor and client
dynamics. The record of non-verbal communication within
the interview was especially important for supervisors,
since this is not available through the traditional techniques
of notes or audiotapes. Another advantage to the use of
videotapes is pointed out by Gruenberg, Liston and Wayne
(1969), viz., supervision becomes more complete and honest,
providing the necessary feedback with which to determine the
progress of the patient and therapist. They go on to cite
specific advantages to the use of videotape over traditional
supervisory techniques: (1) The supervisor has a genuine
source of encounter with the patient. He is able to obtain
specific, first-hand knowledge of the client; and (2) The
therapist trainee need not concern himself with taking notes,
since the videotape provides a complete record of the ses-
sion for supervision. The authors claim a twofold advantage
to this. Both the therapist's concern over completeness of
notes, and the client's concern (brought on by the thera-
pist's notetaking) over the amount of interest the therapist
has in him are alleviated. Finally, Gruenberg, §£_31. indi-
cate that the pace of therapy is increased with the use of
videotape.

The cessation and resumption of videotaping were

clearly related to the effectiveness of therapeutic

activity. Succinctly stated, when one is under

intense scrutiny, whether it be in doing psycho-

therapy or surgery, it is reasonable to expect a

more intense investment of attention to the problem
at hand (p. 104).

56

It could be expected that this statement holds true for
the client as well as the therapist. That is, if the client
were aware that he were under "intense scrutiny," his

"performance" as a client might be improved.

It also appears that clients may experience other
gains in therapy, just as counselors appear to do as a
result of videotape application. Two separate studies
(Landsman and Lane, 1963; Walz and Johnston, 1963) have
suggested that counselors-in-training gained new insights
and greater self-awareness as a result of viewing a video-
tape replay of their counseling behavior, although no
evidence was provided supporting the notion that these
insights were translated into new or effective counseling
behaviors. However, it seems logical to expect that if
counselors can gain insight and self awareness from watching
their sessions on videotape, clients would be able to obtain
similar gains.

Yet, only a few studies have examined directly the
therapeutic potential of videotape on client movement in
therapy. Moore, Chenell and West (1965) found that patients
who were allowed to see themselves on videotapes made of
counseling sessions over a period of several weeks made
more rapid changes in the "direction of health" than did
patients who were videotaped but who did not see themselves.
Similarly, Paul (1965) and Geertsma and Reivich (1965)
report on the technique of eXposing the patient to video-

tapes of previous behavior. These studies seem to lack

57

adequate controls, however, and did not make maximum use
of the videotape as a therapeutic tool. In most cases

videotapes have been made and provided to the client merely

for him to view. Few attempts have been made to use video-
tape methods as a way to assist a client examine the dynamics

underlying his behavior.

 

In a series of studies by Kagan, et al., however,
there were some indications that by applying a structured
approach to the examination of the videotape, accelerated
movement in therapy could occur (Kagan, Krathwohl, et al.,
1967; Kagan, Krathwohl and Miller, 1963; Resnikoff, Kagan
and Schauble, 1970). In these studies and in a subsequent
investigation by Schauble (1970), a structured method of
stimulation of client recall of events in an immediately
preceding counseling session was found to increase positive
client movement in therapy.

Stimulated Recall in Counseling and
Therapy--Kagan's IPR

 

 

The Interpersonal Process Recall (IPR) method
developed by Kagan et a1. (1963, 1967, 1969) makes use
of the technique of stimulated recall by videotape within
a structured approach. The IPR technique was derived from
Bloom's (1954) use of stimulated recall as a means of
examining the thought processes of students via audiotapes,
as well as from Nielson's (1962) investigation of perceptual

change through self-confrontation.

58

The actual use of IPR is as follows: During a
counseling interview the interaction is videotaped by a
partially hidden camera of which both the client and
counselor are aware. At the conclusion of the interview a
"recaller" meets with the same client and replays the video-
tape of the just completed counseling session. Either the
recaller or the client may stop the playback by means of
a remote switch at points which seem pertinent. The recall
worker then assists the client, through gentle probing
from a relatively neutral frame of reference, to recall,
examine and explore the feelings, thoughts and reactions
he was having during the counseling session.

The use of the IPR method allows for the provision
of maximum cues, both verbal and non-verbal, to the indi-
vidual so that the likelihood of a complete reliving of
the original experience will be increased. The heart of
the methodology lies in two dimenSions: the immediate
videotape replay and a persOn especially trained and
experienced in helping a person concentrate and relate his
recalled thoughts and feelings (Archer, et al., 1971).

A Special value of the IPR technique seems to be
that it contains a clear formulation of an approach in
which the videotape of the client's own in-therapy behavior
serves as the stimulus for client investigation of the
dynamics underlying that behavior (Schauble, 1970). Through
the recall process, both client and counselor seem to gain
a great deal of understanding of the nature of the client's

{problems and of the client's interpersonal relationships,

59

the latter in particular through the observation of the
kind of interpersonal relationship the client has estab-
lished with the counselor. The counselor is able to
observe the client's projections, fears and aspirations
about him (the counselor), thus better understanding the
client's interpersonal behavior and some of the more
central qualities of the client's presenting problem.
Similarly, the client begins to understand his own general
perceptions and reactions to people by observing the way
in which he interacted with the counselor.

Kagan and his associates conducted intensive case
studies using the IPR approach, but also carried out
controlled studies (Kagan, Krathwohl, et al., 1967) which
led them to two general conclusions:

1. When IPR is introduced as an intervention in
the counseling process, client growth can be accelerated,
but only when the counselor is actively involved in the
recall process. In two studies examining the effect of
IPR on counseling with prison inmates, it was observed
that unless the counselor was a participant in the recall
process through a "mutual recall" method, clients did not
evidence growth in therapy in spite of there being much
apparent productivity in the sessions.

2. Different variations of IPR intervention may
be apprOpriate, based on the functioning level of the
therapist. In a study comparing the regular IPR session

for two counselors, the results indicated that the higher

6O

functioning counselor (who was more effective than the
other on all criteria for each method of treatment)
benefitted more from the regular IPR than the mutual
IPR. For the lower functioning counselor these results
were reversed. The writers concluded:
The IPR procedure provides the client with insights
into his interpersonal behavior but it is necessary
that the counselor be able to integrate these
insights into his ongoing relationship with the
client if growth is to be accelerated. It would
appear that the more competent counselors under
such conditions, gain new understanding from studying
the session between the interrogator and his client,
and gain less from taking part in the interrogation.
The less competent therapist, on the other hand,
may either not understand the dynamics uncovered in
recall or may not be able to implement them, thus
frustrating the client's new understandings--perhaps
even retarding client growth (pp. 319-320).

Kagan et a1. go on to state that the less competent
counselor becomes more effective with his client by par-
ticipating directly in the recall session, where the
presence of the recaller may serve to reduce the anxiety
of the counselor so that he becomes more comfortable in
dealing directly with the interpersonal dynamics and
conflicts between his client and himself.

Other research has supported this conclusion.
Piaget, Berenson and Carkhuff (1967) have indicated that
counselors functioning at low levels of facilitation have
a negative effect on well motivated clients. That is,

clients who attempt to deal with interpersonal dynamics

within the therapy relationship receive negative

61

reinforcement from low functioning counselors to the extent
that such positive client activity in therapy eventually
disappears. '

Taking counselor involvement and functioning level
of counselors into account, preliminary evidence indicates
that the use of stimulated recall with videotape can be an
effective influence in accelerating client growth in
therapy. There is further evidence for this statement.

Schauble (1970) has carried out a major study of
the use of IPR and affect simulation as an accelerative
technique for client growth in therapy, the purpose of
which was to investigate the effects of affect simulation
films together with stimulated recall on client movement
in counseling. He compared the effects of IPR and affect
simulation treatment with more traditional counseling
methods for two groups on a variety of measures including
audiotape ratings of client in—therapy behavior, the
Tennessee Self Concept Scale, the Wisconsin Relationship
Orientation Scale and the Therapy Session Report. Since
the Schauble study is being replicated with modifications
in the present study, it will be discussed in some detail
here.

In the Schauble study, a treatment program similar
to that used in the present study was used, namely a three-
stage treatment program in which both affect simulation and

Interpersonal Process Recall were incorporated as a method

62

to accelerate client movement in therapy. In the first
phase, the client was videotaped while watching an affect
simulation film—-a film designed to stimulate and elicit
emotional reactions from the client. This videotape was
played back and the client's videotaped behavior served

as the focus for the ensuing counseling session. In this
way the client could look at his emotional reactions from

a position of relative personal safety. That is, he did
not have to be responsible for the impact and consequences
of his reactions. In the second phase, client and counselor
were videotaped while conducting a counseling session, and
during its replay, a trained recall worker conducted an

IPR session with the client while the counselor observed
through a one-way mirror. After the recall session the
client and counselor resumed their counseling session,
incorporating insights gained from the recall. In the

third phase of the Schauble study, both client and coun-
selor viewed a replay of the counseling session together,
while the recall worker encouraged them to share their
feelings as they occurred in the original counseling
session. As counselor and client communication about

their feelings and reactions increased, the recaller

played a progressively less active role. When the inter-4
action between the client and counselor shifted from a focus
on the videotape to the immediacy of the recall session, the

recaller left the room and counselor and client continued

63

in the therapy session. While both treatment and control
group therapy focused on effective client/counselor inter-
action and communication, no IPR interventions were used for
the control group. In this control, or traditional coun-
seling group, the therapists concentrated on client/
counselor interaction in an attempt to help the client
achieve greater self awareness and understanding of his

own dynamics.

Twelve female undergraduates were used as clients
for the Schauble study. All had requested personal
counseling from the university counseling center and
had agreed to participate in the research. The two
therapists were pre-doctoral interns at the counseling
center, both of whom had had training in both IPR tech-
niques and in traditional counseling methods. Both
therapists were also rated on scales measuring facili-
tative behavior in therapy and found to be functioning
above or near the 3.0 level across dimensions on a five
point scale where a rating of 3.0 is considered the minimum
level of counselor performance for client growth to occur.

Clients were randomly assigned to therapist and
treatment groups and each interview for both groups was
audiorecorded for subsequent rating by judges. Ratings
of the initial counseling sessions served as a pre-measure
in Schauble's design, and analysis ofthese initial ratings

indicated no significant differences between groups on any

64

of the rated dimensions, suggesting that the treatment
groups were equivalent in their initial level of functioning
as rated by judges.

The judges rated client functioning on four dimen-
sions of client behavior in therapy which were considered
to be characteristic of client growth: Owning of Feelings
(OF), Committment to Change (CH), Differentiation of
Stimuli (DS) and Depth of Self Exploration (DX). Ratings
of the sixth and final session served as a post measure
of client functioning on these criteria.

In addition to the ratings, the Tennessee Self
Concept Scale and the Wisconsin Relationship Orientation
Scale were used as pre-to post-treatment measures of
client growth (applied before and after treatment), and
both clients and therapists completed a shortened form
of the Therapy Session Report (TSR) immediately after
each session.

Analyses of pre-to post-therapy changes in client
behavior during therapy were carried out on each of the
Characteristics of Client Growth Scales dimensions. Change
scores for the two groups were significantly different at
the .05 level in favor of the IPR group. After treatment
the clients in the IPR treatment group were rated higher
on the OF, CH, D5, and DX dimensions than at the beginning

of treatment. No differences were found for the traditional

65

treatment group, pre- to post—treatment. Analysis of vari-
ance of change scores between groups also indicated signi-
ficant differences (.05 level) in the hypothesized direction

on each of the client growth dimensions.

No significant differences were found on the WROS
through analyses of pre to post changes in the Schauble
study, but change scores between groups were found to be
significant and favored the experimental (IPR) treatment.
Differences in client perceptions of treatment as measured
by the TSR were found on only two of the six dimensiOns when
pre to post changes were analyzed. Significant changes were

noted on the dimensions of client feelings about coming

 

 

39 the session and client feelings about ppogress made in

 

the session. In both cases, changes were noted only for

 

the IPR treatment group, with significant between group
differences on change scores. With regard to therapist
perception of treatment, a change score difference was

found on only one dimension: therapist lookipg forward

 

£2 coming Eg_the session. Finally, a descriptive analysis

 

of Tennessee Self Concept Scale scores provided little
indication of any meaningful change in self concept;
change score differences on all dimensions were evenly
divided between groups.
Schauble concludes as follows:
The analysis of data suggests that the IPR treatment
had a significant accelerating effect on client

movement in therapy, as rated by independent judges.
Clients in the IPR group had a greater positive

66

difference in the degree to which they felt able to
relate to their therapist, when compared with the
traditional counseling group. Clients in the IPR
group had more positive feelings about coming to
their treatment sessions and about the progress that
was made within these sessions. Therapists also were
found to look forward more positively to the IPR
treatment sessions than the traditional treatment
sessions (abstract).

It is apparent that significant accelerative effects
in therapy were produced by the application of the IPR and
affect simulation techniques in the Schauble study. Most
therapeutic changes, however, were observed on process
dimensions and only a few effects were noted on the Therapy
Session Report. The Schauble study provided implications
for the directions which need to be taken in the develOpment
of adequate criteria by which to measure the effects of
therapy, and further research on the use of IPR as an
accelerative tool in therapy is needed.

Another study was conducted by Hartson (1971) who
used IPR in group work as a training method for three
specific group communication skills, namely, self intro-
spection, self disclosure and adequate responding. Hartson
compared the IPR process with a traditional T-group model
in an attempt to determine the relative effectiveness of
each in reaching these goals for the group members. Two
groups each of two different types were compared: (1) IPR
groups consisting of four two-hour sessions of IPR replay

and interrogation followed by two two-hour sessions of Open

group communication which were video- and audiotaped for

67

assessment, and (2) growth and develOpment groups consisting
of four two-hour sessions of T-group interaction focusing on
here-and-now communication, with two two-hour sessions of Open
communication which were video- and audiotaped for assessment.
Each treatment program consisted of two types of subjects--
those randomly assigned from a YMCA population requesting a
group experience and those randomly assigned from a college
student population who had requested a group experience.

Two assessment procedures were used: (1) Individual
tests of self-disclosure, acceptance of self, self-rated
social behavior, group readiness, satisfaction with the
group experience and self-disclosure in the group process,
and (2) total group communication assessments using a
panel of judges who rated videotaped samples of group
communication, and Hill's Interaction Matrix Technique
used to analyze the frequencies of verbal statements in
interaction categories. 1

Using an Analysis of Variance Technique for pre-
and post tests, difference scores, and rating of partici-
pant's behavior, and a Chi Square procedure for analysis
of the Hill's Interaction Matrix Technique which was used
to assess the frequencies of verbal statements in various
categories of interactions, Hartson found the IPR groups
to be significantly higher on the variables of self dis-
closure and group readiness. He also found members in the
IPR group to be judged significantly higher on the video-

taped samples on communication skills and on group assessment

68

of therapeutic verbal communication. It was observed that
a group leader who is enthusiastic about the use of video-
tape as a group technique will have a greater impact upon
the group members. The study seemed to support the use

of IPR as a pre-group training process for group communica-
tion skills and for enhancement of group members' readiness
to enter into various categories of group communication.

It also seemed to indicate that the IPR method, when used
in a group situation, can be an effective technique for
enhancing the group process, especially when specific

goals for the group process are defined.

Simulation in Counseling

 

Simulation has been used successfully aS'a training
technique for many years, especially in industry and the
armed forces (Kersh, 1965). A distinct advantage to its
use in these fields has been to avoid damage to equipment
or danger to human lives. It has not been until recently,
however, that simulation has been considered and adopted
as a technique for education and the social sciences.

Greenlaw, Herron and Randon (1962) have spoken
about the general benefits of simulation, indicating that
through its use time is condensed, understanding of
decision-making processes is enhanced, and analytic skills
are sharpened through immediate observation by the partici-

pants of the results of their decision. Since both clients

69

and counselors make crucial decisions which are loaded
with implications for the future, these benefits would
seem to apply to individual needs in counseling and
therapy as well. If it is assumed that at least part of
a client's COping difficulty has to do with his lack of
ability to make apprOpriate decisions and to take action
on them, or with his lack of confidence in his ability,
the use of a simulated situation wherein a client can
make and examine various behavioral responses without
fear of potential disastrous consequences would appear
beneficial.

Simulation research has been carried out in
the field of teacher education. Simulation has been used
to train teachers to more correctly assess each child's
functioning level (Utsey, Wallen and Beldin, 1966), to
develOp referential categories in which to View different
behaviors (Wallen, 1966) and to evaluate the impact of
individual or innovative approaches on the teaching process
(Fattus, 1965). The fact that each of these aims is
interchangeable with those of counselor educators is
exemplified in the adOption by Delaney (1969) of a proposal
for developing the simulation approach in counselor edu-
cation. He indicates that a number of conclusions are
justified on the basis of research to date:

1. Simulation is justified as an instructional

technique.

70

2. The use of a television monitor for stimulus
presentation is apprOpriate.

3. Realism is not a primary requirement for
transfer of learning.

4. Simulation positively affects actual performance.

5. Simulation provides economy of time and reduces
long term expense.

6. The application of simulation techniques to
counselor education has been shown to be
feasible and effective.

Delaney's conclusions are derived from the notion that what
is effective in teacher education applies to counselor
education as well. And while the rationale for the use

of simulation in counseling and therapy training programs
is present, research into the development and use of
simulation techniques for the profession is quite sparse.

In one of the few attempts to provide research

evidence, Bierd and Standish (1964) found encouraging
results from a project in which audio recordings as
simulation stimuli were used. The writers used a simulated
environment to train practicum student counselors to dis-
criminate between cognitive and affective responses and
then to use counselor response leads to facilitate more
affective behavior in clients. The results indicated

that the experimental groups demonstrated a significant

71

performance gain over the control group, as well as
differences between the experimental and control groups
in post-training interview performance.

If the use of audio simulation evidences positive
results, a further question might involve what the application
of film or other video techniques could add. Logui, Zenner
and Gohman (1968) attempted to evaluate the influence of
videotape on the job interview situation, but obtained
confusing results. Using a programmed materials group,

a programmed materials with videotape group and a control
group, each composed of neuropsychiatric in-patients, the
authors found results which did not substantiate their
hypotheses. The results did not indicate that the pro-
grammed materials or materials with videotape facilitated
performance in the job interview situation. In fact, the
non-significant trend favored the control group. One of
the methodological weaknesses of this study was the failure
of the researchers to provide more than one simulated
interview and viewing of the videotape for the subjects;
the single video session in this study may have done more
harm than good because, suggest the authors, the self-
confronting nature of the videotape produces anxiety.

There is little doubt that simulated situations can
produce anxiety in some clients. Earlier in this chapter it
was observed that while there is concern among some writers

as to whether exposure to the self image can have a

72

deleterious effect on the client in therapy, this seldom
seems to be the case. Client anxiety gap be raised by self
confrontation, but there is some evidence to suggest that
this can be of positive value; client behavior that relates
to the client's problem area is stimulated and can thus

be dealt with in the therapy situation (Danish and Kagan,
1969; Schauble, 1970).

Conclusions and Implications of
the Literature

 

Despite a lack of controlled, definitive research
in many areas of counseling and therapy, a number of
implications emerge from a review of those areas related
to the acceleration of client growth.

It appears that there are few appropriate or
satisfactory criteria or dimensions which accurately
reveal the effect of techniques designed to accelerate
client growth in therapy. Rogers' work has precipitated
the use and investigation of some internal or "process"
dimensions which seem to have some value for counseling
and therapy research. While there are three potential
sources of this process data, the client, the counselor,
or an independent observer, the most promising source
appears to be the independent observer (Truax and
Carkhuff, 1967; Carkhuff and Berenson, 1967). Reliable
and useful scales have been developed from several

dimensions of desirable in-therapy behavior including

73

client self exPloration (Truax and Carkhuff, 1967), owning
of discomfort, committment to change and differentiation

of stimuli (Kagan, Krathwohl, et al., 1967; Schauble,

1967, 1970). While this type of process criterion seems
more stable and generalizable, its development is rather
recent, and it has not been used with any great consistency
to date.

One promising way to enhance client growth seems
to be by applying videotape and simulation techniques to
the therapy process. While these techniques have been
used primarily for counselor or helper training since
their develOpment, preliminary research evidence indicates
that some benefits may accrue to clients in therapy as a
result of the application of videotape methodologies and
affect simulation (Kagan, Krathwohl, et al., 1967;
Schauble, 1970). A technique which clearly maximizes
client participation and feedback has been develOped
(Kagan, Krathwohl, et al., 1967; Resnikoff, Kagan and
Schauble, 1970; Schauble, 1970) and has been shown, albeit
on a small scale, to result in significantly accelerated
client growth (Schauble, 1970).

If the IPR method with videotape increases feed?
back to the client about his behavior in an interaction,
and if simulation experiences provide an Opportunity for
stimulating a variety of emotional reactions in the client

(Cornelison and Arsenian, 1960; Small, 1967), both of

74

which appear likely (Schauble, 1970), can the use of these
procedures when incorporated into a therapeutic inter-
action, result in a significantly greater benefit to clients
than the use of more traditional methods? Preliminary
evidence suggests that there is an affirmative answer to

this question.

Summary

Primarily because of the lack of development of
adequate criteria, there is little controlled research in
the area of evaluation of counseling and therapy. When
external criteria have been used, difficulties with
comparisons of results across different studies have
been encountered,at least in part because of an inadequate
system of comparison. Although some internal criteria
have been used in previous research, they are still in
the process of being further develOped. Definitions of
processes and goals are still being sought, and operation-
alization of those that have been formulated has been
difficult. Some rating scales have been develOped,
however, which appear to have value for examining dimensions
of client behavior which seem essential to client change in
therapy. They include the client behaviors of owning of
feelings, differentiation of stimuli, committment to
change and self exploration.

A variety of approaches have been adopted in attempts

to accelerate the influence of therapy on client growth,

75

each with a seemingly sound theoretical rationale. Little
consistent or conclusive empirical support has been seen,
however, for the statement that the new approach is any
more effective than the usual one-to-one therapy. Video-
tape and simulation appear to have considerable potential
for positively influencing client growth, but most relevant
research with these methods has been on their use in
counselor education. The one method that has been found
to have direct application for counseling and therapy is
Interpersonal Process Recall (Kagan, Krathwohl, et al.,
1967; Resnikoff, Kagan and Schauble, 1970; Kagan,
Krathwohl and Miller, 1963; Schauble, 1970).

In this study scales of client in-therapy behavior,
client reports and external criteria have been used to
examine the effects of an IPR and affect simulation tech-
nique in counseling and therapy. Previous research has
indicated that this intervention technique has potential
.for accelerating growth in therapy, but further validation

is needed.

CHAPTER III

DESIGN AND METHODOLOGY

Experimental Design

 

An experimental research design was used for this
study to test the hypotheses posited earlier, namely that:
(1) Clients who receive counseling with IPR and affect
simulation will evidence higher ratings on dimensions of
OF, DS, CCh and DX than will clients who receive tradi-
tional counseling, (2) Clients who are counseled with IPR
and affect simulation will be more satisfied with their
therapy sessions than clients who are counseled with
traditional methods, (3) Clients who receive counseling
with IPR and affect simulation will reveal less discrep-
ancies between their self concept, goal self concept and
the way they think others see them than clients who receive
traditional counseling, and (4) Peers of clients will
report more positive behavior changes for clients who
receive IPR counseling than for clients who receive
counseling without IPR. Comparisons between groups on
client interview behavior, self reports, self concept
assessment and peer reports are permitted by the design,

which is presented pictorially in Figure l.

76

77

 

 

 

 

 

 

 

 

 

13

 

 

 

 

 

 

 

 

 

Figure l.--Pictorial Representation of the Multivariate

Analysis of Covariance Design*

*Rated level of Emphatic Understanding of therapists con-
stitutes the Covariable.

H

2 3:3:: 3+3 vauaw
haw

Random Assignment

Subject

Experimental treatment group (individual counseling with
IPR and Affect Simulation)

Treatment-control group (Individual counseling)

Level of client functioning -- Characteristics of Client
Growth Scales

Level of client functioning -- Depth of Self Exploration
Therapy Session Report -- Total Score

Miskimins Self-Goal-Other Discrepancy Scale -- "Total"
scale score

Peer Information Questionnaire -- Total Score

78

An elaboration of the "postest only control group
design" described by Campbell and Stanley (1963) was used
in this experiment. No pretests were considered necessary
for the treatment groups in this study since it was assumed
that randomization (random assignment of clients and thera-
pists to groups) would fulfill the assumption that any
differences between the two groups were a result of
chance, rather than any consistent variations. Campbell
and Stanley further indicate that the design used in this
study is amenable to "covariance analysis . . . , thus
providing an increase in the power of the significance
test very similar to that provided by a pretest" (p. 26).
It should be noted also that the gain in precision obtained
by the use of a covariate corresponds directly to the
degree of covariance. The use of a covariate, in this
case ratings of therapist functioning level, avoids an
experimenter-introduced pretest session, thus providing
less posttest reactivity to the pretesting than would be

the case with a pretest-posttest design.

Sample

Because of the nature of this research project and
the fact that the participants volunteered for the project,
it was not possible to obtain a truly random sample of
clients. For this reason, the sampling and assignment

procedures will be described in detail, allowing the reader

79

to judge whether this sample is appropriate for the popu-

lation to which he wiShes to generalize.

Clients

The clients who participated in this study were
undergraduate college students who had come voluntarily
to their respective college counseling centers for assist-
ance with personal-social concerns. Twelve of these clients
were Michigan State University students; one was a student
at the University of Wisconsin at Milwaukee. At MSU, clients
who fulfilled the selection criteria for participation in
the study were taken in order from a waiting list (necessi-
tated by heavy demands for services). At UWM, the client
was asked in a screening interview whether he was willing
to participate in the project. Therefore, the initial and
subsequent contacts with this client were made in person.
For the MSU clients, however, because they had been
previously screened, a telephone procedure was used.

At the Michigan State University Counseling Center
a client is seen immediately by a screening counselor when
a request for services is made by a student. The screening
counselor attempts to assess the client's needs and make
a determination of how the services of the Center can best
be used in meeting those needs. This procedure resulted
in a list of clients waiting for counseling. From this
list were selected (in order from the list) clients who:

(1) had primarily a personal-social concern (rather than

80

an educational-vocational one), (2) were not considered
potentially suicidal or in an extreme crisis situation,
and (3) were interested in more than a brief contact with
a counselor. These determinations were made on the basis
of notes written by the screening counselors. A total of
seventeen clients were thus selected for contact about
participation in the project.

Each of the clients selected from the M.S.U. list
was contacted by telephone by the investigator or his
assistant. This contact served a two-fold purpose. It
provided an opportunity to explain the research aspects
of the project to each prOSpective client-subject. It
also gave each of these individuals an opportunity to
give or withhold his preliminary agreement to participate
and his consent for the data gathered to be used, in
confidence, for research purposes.(Written permission was
obtained at the first meeting between the client and his
counselor. See Appendix A for consent form.)

Prior to being contacted, all potential subjects
were randomly assigned to either the experimental or
control group. They were then contacted and asked about
their willingness to participate. This telephone conver-
sation typically lasted approximately ten minutes. The
standard form letter which would be given to clients in
each group (see Appendix B) was used as the outline for

the explanation of the project to each prospective

81

client—participant. Following this contact, clients were
assigned to counselors (who had also been randomly assigned
to either an experimental or a control group) according to
scheduling and case load practicalities.

From the seventeen clients who met the criteria
for participation in the project, thirteen agreed to
participate when contacted by telephone. Of the remaining
four, two individuals had decided against counseling between
the time of their screening interview and the telephone
contact, one had been able to enter a group counseling
experience, and one was out of the area for a week and
unable to be contacted. Two of these individuals had been
assigned to group A and two to group B. A summary and
deseription of the resulting sample is presented in Table
3.1, and discussion of subject mortality during the pro~

ject follows.

Subject‘Mortalipy

As indicated, thirteen volunteer clients.had agreed
to participate in the study as part Of their therapy experi—
ence. These thirteen individuals thus began their respective
therapy programs; the IPR group consisted of seven clients
and the traditional counseling group was cOmpriSed of six
clients. Only one client terminated prior to the completion
of the treatment program. For several reasons this client

was unable to participate in the total experimental treatment.

82

TABLE 3.l.--Distribution and Description of Sample by Age,
Class and Sex within Groups.

1 --_--.-._.-_ _.._. _
_...._.._...-_-._._.__. ,--_.:==-_'-.

 

— : mam—.1332 m 2:!

 

 

 

 

Counselors Number of Subject Description
Subjects
Age Class Sex
Group A
(IPR)

l l 20 Junior Female

2 1 20 Sophomore Male

3 1 l9 SOphomore Male

4 l 20 Sophomore Male
5 l 21 Senior Female

6 l 24 Junior Male
7* 1* 21 Junior Female

Total: 7
Group B
(Traditional)

8 l 21 Junior Female
9 l 19 Fresh. Female

10 1 18 Fresh. Male
11 l 21 Junior Female

12 l 23 Junior Male
13 _l_ 21 Senior Female

Total 6

 

*Deleted during project.

Her counselor was notified in advance that she was unable

to meet during the week of session 3, so arrangements were
Inade to resume the program the following week. The appoint-
nmnit for session 5 was also subsequently cancelled by the
CliEfllt, and she was leaving the area the following week.
Whilxa the fifth session was able to be scheduled, adequate
tinma to schedule the sixth session for this client was not
avaiflLable. In addition, some resistance to the recall during
time fifth session was encountered. As a result, the decision

was numde to allow the client and therapist to examine and

83

resolve the dynamics of their relationship instead of
requesting that the client undergo the recall. In essence,
the judgement was made by the researcher and the therapist
that the time which would ordinarily be used for a client
recall should be spent in resolution of the conflict by

the client and therapist together. While the question of
client motivation and readiness for therapy was thought to
be a legitimate one, there were also practical factors
relating to client time and scheduling possibilities which
influenced the termination of this client.

Because of the premature termination of this single
client, her therapist was also eliminated from the study.
The mortality of these individuals thus left a total sample
of twelve clients and twelve therapists, with six clients
and six therapists in each treatment group. The final

client and counselor distribution is summarized in Table 3.2.

Therapists

 

The therapists used for this study were senior
staff nenbers, counseling interns (predoctoral candidates
111<slinical or counseling psychology) and practicum
.studenis (beginning or intermediate level doctoral candi-
dates ichflinical or counseling psychology) at one of two
nuxhwestern universities-~Michigan State University and The
Unixnarsity of Wisconsin at Milwaukee. Twelve therapists
were employed at MSU and one at UWM. The senior staff

members were regular employees of the university, having

84

TABLE 3.2.--Final Subject and Counselor Distribution Within
Treatment Groups.

 

Counselors Number of Subject Description

 

 

Subjects
Age Class Sex
Group A
(IPR)
1 1 l9 Sophomore Male
2 1 2O Sophomore Male
3 l 20 Sophomore Male
4 1 20 Junior Female
5 l 21 Senior Female
6 l 24 Junior Male
Total: —6_
Group B
(Traditional)
8 1 l8 Freshman Male
9 l 19 Freshman Female
10 l 21 Junior Female
11 l 21 Junior Female
12 l 21 Senior Female
13 l 23 Junior Male
Total: —6_

 

had the bulk of their training in the "traditional" form of

counseling and therapy. Counseling interns are employees
of the MSU Counseling Center while in a doctoral level pro-
gram in clinical or counseling psychology. They have typi—
cally completed all but the dissertation for the Ph. D.
degree. Practicum students are also doctoral students who
are typically beginning practical, supervised experience
xvith counseling and therapy. The interns and practicum
Students who participated in this investigation also had
thezlaulk of their training in traditional forms of counseling

Eflui therapy. In terms of their general theoretical

85

orientation, all of the counselors placed some emphasis upon

interpersonal dynamics and their developmental antecedents;
none of the counselors identified primarily with a behavior
modification model.

The therapists used for the study volunteered to
participate in response to memos issued at the beginning
of Spring term, 1972 (see Appendix C). After volunteers
were obtained, therapists were randomly assigned to either
the experimental or the control group. To reduce the
possibility of a therapist-treatment interaction, each
therapist saw only one client who was participating in
the study. That is, each client—subject for the study
had a different therapist who had been randomly assigned
to one of the two groups.

Although most of the therapists in each group had
had some experience with Interpersonal Process Recall
and/or affect simulation films as a training methodology,
only one had used IPR previously as a therapeutic tool.
All therapists in the IPR group viewed a videotape (Kagan,
1972) explaining the use of affect simulation films prior
to seeing their clients and were given a typescript of
the videotaped lecture for any further reference. A

description of the therapist sample is given in Table 3.3.

Description of Treatments

 

The introductory contact and first treatment session

were the same for clients in Group A (counseling with IPR

86

TABLE 3.3.--Description of Therapist Sample by Position, IPR
Experience and Sex.

 

Position IPR Experience Sex

 

 

Sr.Staff Intern Practicum Yes No Male Female

 

Group A (IPR)
2 2 3 5 2 5 2

Group B (Traditional)

1 3 2 4 2 4 2

 

and affect simulation) and Group B (traditional counseling).
The introductory contact by telephone with each client was
necessary in order to ensure that each participant-client
was fully informed of the research aspects of the treatment,
and that he was willing to engage in the various data
gathering activities. 4

The initial one and one-half hour session for
clients in both groups served the purpose of allowing the
client and counselor to meet each other and begin identifying
the client's concern. It also provided an opportunity to
obtain an audiotape recording of the session for subsequent

rating by judges of the counselor's functioning level.

Counseling with IPR and Affect Simulation
As outlined in Table 3.4, the experimental treatment
fell into four distinct and sequential phases. In phase 1

(session 2), affect simulation films were used without

87

TABLE 3.4.--Summary of the Experimental Procedures.

 

introductory Contact: A soiopnono conssrsasion o! spproaioosoiy tivo so too lioness duration was bold nos-son tho inconticosos
and oach cl ant.

s. The initial contact by tsiopnom provided was opportunity to orient tho participating clients to tho spooioi circuotonooo
of tho rososrch projoct and obtsin choir preliminary vorbsl sgroonont to participato. it was onplainod to each client that
no/ono would no involved in s study which was designod to hoip dotino what goos on in thorapy, iron both tho cliont's and
tho thorapists‘s point of viow. To do thil. it was nocosssry for the client to cooporato by: (1) Making a coo-dttlont
to ass a counselor ono and one-half nours par wock for at least six wants: (2) Supply tho nooos and addrosoos of at loaot
two poopis whos wo may contact sitar six weeks in rogard to tho client's bohsvior which thoy had obsorvod: (3) Convicts two
trio! (5 hour) inventories altar tho client's sixth session: (0) Parole the first and sixth sessions to ho audiosspod (or
subsequent rating by judges.

b. In addition. clients in tho IPR group were told that some of thoir sessions would to vidootaood and opociaily downlopod
fills would be usod as part of their rrostncnt during tho first six wooks of counsoling.

Trostmont A Troatnont I
Counseling with IPR Traditional Counooiing (no it!)
acre—M
a. Ciiont asked to road latter (soc Appondrx a: outlrnrng n. Ciron! asked to road lottor (soo Appondia I) outlining
rsguosts for particrpstron. provido names of peers lsoc requosts {or participation, provido naoos of poors (so.
Appondir E) and sign consent {ore (soc Appondil A). Appondis t) and sign consoni ferns (soo Appondin A).
b. Ninety ninuro initial counseling sossion with each client. b. ninoty ninuio initial counseling oossion with soon
This intorvxow sorvod to provide audictapo raring o: ciiont. This interview oorvod to prowido audios-Os
counselor functioning iovol. rating of counselor functioning iowoi.

Session 02
a. Thirty sunuto counseling interview with once client. Sineiy ninut. counseling intarviow with oacn ciiont.

b. forty ninuto sossion in which a!!ect IiRuldtion Irina were
shown to osch client. During this tins counselor and client
use sinuistion film as focal porn: for diICJIIion of client's
rooctions to filmed vignottos.

c. Twonty ninuts counssiing intCrVieU conducth wzznout use of .
widoosapo or filo.

Session I]

s. Thirty ninura counseling intervrvw with each clivnt. ninety ninuto counseling session with each ciiant.
b. Forty minute segment during which affect srru2.:xcn {:lrn
woro shown to clisnt. Videotape o! clrort 'ndr. and rare

playod back for Client and counselor to our in drscussina
ciiont reaction to filmed stiruzr. Cruhsnlnr attorpts on
uso videotape to holp clionr cxplntr his rsncvxcns.

c. Twsnty minute counseling intorvrow ranductnd without nor of
vidootspo or film.

{neuron 04
———-—*

o. Thirty ninuro crunssirng intdxvxewl with each Cir-n1. srnoty ninuto counseling sossion with each client.
vidoctspod.

b. forty ninuto ciisnr rscsll or vidootspc node c: first
thirty minutes.

a. Twenty minute counseling interviow conducted without
use or vrdoo.

Session 05
s. Thirty ninuto counseling interviow with each client. :inoty ninuto counseling soosion with osch ciiong
vidootapod.
b. forty Minuto client rocall of vidootspo node of first
thirty ninutos.
c. Twonty minute counseling incsrviow conducted without
tho uso oi vidoo.

 

Session 06
a. Thirty minute counseling interview with osch ciiont a. Ninety minute counsoiing sossion with each client.
which was Vidoorapod.
b. forty ninuts ciisnr and counselor (Mutual) rocsii b. Client oonpioros invsntoriss--T8l and I000.

02 vidootapo nods of YIrsE [EirEy ninutos.

c. Twonty ninuto counsoling interview conducted without
tho non of vidoo.

d. Client cosplotos invsntorios--TSI and M500.

88

videotape and in phase 2 (session 3), affect simulation
films and video-recall were combined (VRAS). In phase 3
(sessions 4 and S), the client underwent a stimulated
recall of his own in-counseling interaction with his
therapist which had been recorded on videotape (i.e., a
traditional IPR recall session, conducted by a trained
inquirer). In phase 4 (session 6), the therapist remained
with his client as a mutual recall was conducted by an

inquirer.

Phase 1

During session 2, the first thirty minutes of the
counseling interaction were conducted by the counselor as
a "standard" personal counseling session. The next forty
minutes included use of the simulation films. As in the
Schauble (1970) study, not more than five vignettes were
shown to a client in any one session, and none of the
scenes were longer than two minutes in length.

During this forty-minute segment in which affect
simulation was used as a stimulus for discussion, no video-
tape procedures were used. Each IPR group counselor was
asked to use a modified inquirer role during this session,
and to follow the type of questioning found in Appendix F,
"Sample Questions for Use with Affect Simulation Films."
Counselors were not limited to this role; however, they

were asked to use the films as a stimulus for exploration

89

by the client within the context of the client's concern.
That is, they were not asked to refrain from interpreta-
tion or reflection of client statements, nor to attempt
to keep from engaging in a counseling relationship with
the client, as the inquirer typically does. Thus, the
client's reactive behavior was used as a means of
exploring the nature of, and feelings about actual and‘
existing interpersonal relationships. When the forty
minutes had passed, the client and counselor returned to

a traditional counseling interaction.

Phase 2

For session 3, the first thirty minutes of the
total hour and one-half were again conducted as a traditional
personal counseling session. The next forty minutes were
spent with the use of affect simulation films and VRAS--
video recall of affect simulation. During these forty
minutes the client was videotaped while watching a total
of five affect simulation vignettes. The tape, containing
an image of the client and the accompanying audio portion
of the simulation vignettes, was played back for a "recall"
of the client's reactions to the film (VRAS session). During
this segment of the meeting, the counselor again made use
of, but was not limited to, the type of questions found in

Appendix F. The VRAS session was intended to assist the

9O

client in examining his reactions to the films through the
use of the videotape. The videotaped sample of the client's
reactive behavior was kept to a maximum of ten minutes, and
the sample served as the focus for a personal counseling
session. After the forty minute time segment was over,

the counselor and client again returned to a traditional

counseling interaction for the remaining twenty minutes.

Phase 3

For sessions four and five, which comprised the
third phase of the experimental treatment, the first thirty
minutes of the session were conducted again as a traditional
counseling session. This thirty-minute session was video-
taped for the subsequent client recall session, producing
an image, with accompanying audio, of the counselor and
client. At the conclusion of this thirty-minute session
another counselor (trained in recall or "inquiry" techniques)
entered the room to conduct a recall of the videotaped
counseling session. At this point the counselor left the
room to observe the recall session, with the client's know-
ledge, from an adjacent room. A television monitor with
accompanying audio arrangements had been set up to enable
the counselor to observe and hear the recall session.

During the recall session, the task of the inquirer
was to encourage the client to explore his behavior in the

counseling relationship. The inquirer attempted to keep

 

91

the client's attention and concentration on the "there—and-
rthen" of the counseling relationship, rather than enter

into another counseling relationship with the client.
Through his observation of the recall session, the counselor
could observe the client's exploration of his own behavior
and incorporate this information into that which he already
had about the client. He could also obtain the client's
preceptions of the counselor, if that too was discussed
during the recall session. This "client recall" procedure

was used for both the fourth and fifth IPR treatment session.

Phase 4

Session 6, the final phase of the IPR and affect
simulation treatment program, again began with thirty
minutes of standard counseling. This session was also
videotaped for playback to both the client and the
counselor. That is, during the recall session in this
phase, the counselor not only remained in the room during
the inquiry session, but participated in the recall of
the previously completed counseling session. The inquirer
conducted a "mutual recall," in which the client and
counselor were encouraged to share their thoughts and
feelings about the counseling interaction contained on
the videotape (the "then—and-there" of the just completed
session). It was expected that this interaction would
then develop into a more direct communication between

the client and the counselor about the immediate client

92

counselor relationship. Within this forty-minute process,
the inquirer became progressively less active in the recall
session, until he was able to leave the client and counselor
to continue the counseling session, hopefully engaged in
immediate, face-to-face communication about ongoing thoughts,
feelings and reactions. A week-by-week outline of the
experimental procedures followed by weekly procedural

memos to eXperimental group counselors may be found in

Appendix G.

Inquiry (Recall) Procedures

Each IPR group client underwent three formal recall
sessions during the course of his counseling treatment.
The fourth and fifth counseling sessions for IPR group
clients included a client recall process, during which
the counselor left the room and an inquirer conducted a
recall session with the client. The sixth session for
IPR group clients included a mutual recall, in which the
client and counselor were joined by an inquirer for
exandnation of the videotaped counseling session and of
client and counselor reactions, impressions, thoughts
and feelings.

Recall sessions were conducted by either the
investigator, another second-year counseling intern at
tjua.MSU Counseling Center, or one of four doctoral

Primiticum students in counseling. Attempts were made

 

 

 

Ill .llllrlfidl-IIJII
alfllllllll

93

to vary the schedules for each lPR group client so that
each would experience recall with at least two different
inquirers.

A total of nineteen recall sessions were conducted,
three for each IPR-counseled client, with the exception
of one client who terminated the project prior to the
fifth-session recall (see page 81). Frequencies of

conducted inquiries by inquirers are found in Table 3.5.

TABLE 3.5.--Frequency of Conducted Inquiries by Inquirers.

 

 

Recaller Recaller Number of
Sex Inquiries
Conducted

1 Male 10

2 Male 3

3 Female 2

4 Female 2

5 Male 1

6 Male 1

 

Traditional Counseling (without IPR)

Clients receiving traditional counseling were seen
for six counseling sessions of one and one—half hours each,
the same amount of time as that spent with each client in
the experimental group. Typical traditional sessions last
about one hour. The additional time not only equated the

time for each group, but provided the traditional group

94

counselors and clients with a "special," somewhat luxurious
treatment situation. The goals of counseling for this group
were the same as those for the IPR and affect simulation
group, namely, concentration on the client-counselor inter-
action in an attempt to help the client in self-exploration,
leading to greater self-awareness and understanding of his
own dynamics. It was expected that these counseling sessions
would be responsive to individual client needs, as were the
eXperimental treatment sessions, and that they would be as
intensive as possible. Counselors for the traditional
counseling group were instructed to meet their clients
weekly for one and one-half hours and to audiorecord their
first and sixth sessions. No other instructions as to
type of counseling approach were given. Instructional
memos to control group counselors are contained in
Appendix H.

A comparative summary of the experimental procedures

is found in Table 3.4.

Physical Environments

 

All counseling sessions for both the IPR and tradi-
tional counseling groups were held in rooms in the Michigan
State University Counseling Center. Because of space
limitations and lack of availability of videotape recording
equipment, it was necessary that different types of rooms

be used for each treatment group. While all first sessions

m. &g%.&~—._

 

 

 

95

for both groups were held in regular offices of the
Counseling Center, subsequent sessions for the IPR group
clients were conducted in a research room of the Center
in order to apply the affect simulation and IPR—videotape
techniques. All sessions for4traditional group clients
were conducted in regular offices of the Center.

The research room in which experimental counseling
sessions were held contained a desk, two comfortable chairs,
a 35 millimeter projector and screen for showing of simula-
tion films, an unconcealed microphone and television camera,
and a television monitor which was used for viewing the
recorded videotapes. A videotape recorder was contained
in an adjacent room during recording of sessions, then
wheeled into the interview room for playback. The adjacent
room also contained an audio console for routing of audio
impulses to the videotape recorder and for audio recording
of the sixth session for IPR clients.

A typical office used for traditional group clients
contained a desk, two comfortable chairs, a small table,
and an unconcealed audiorecorder and micrOphone.

While the physical environments were slightly
different for the two groups, in that the offices used
for control clients did not contain video recording or
playback equipment, it was apparent that control clients
were very much aware that they were involved in a project

of a "special" nature, primarily because they were meeting

96

for one-half hour more than the customary one hour session.
Traditional group counselors indicated that their clients
often commented to this effect over the course of the six-
week program. It was assumed that a difference in effects
due to slightly different environments for the groups was
minimal, since clients in both groups felt the "special"

nature of their treatment.

Instrumentation

 

Five measures were used as criteria for this study:
(1) The Characteristics of Client Growth Scales (COGS,
defined by Kagan, Krathwohl, et al., 1967; revised into
a five-point scale by Schauble and Pierce, 1969), (2) The
Degree of Self Exploration Scales (DX, Truax and Carkhuff,
1966; Carkhuff and Berenson, 1967), (3) Selected items
from the Therapy Session Report (TSR, Orlinsky and Howard,
1968), (4) Selected scales from the Miskimins Self—Goal-
Other Discrepancy Scale (MSGO, Miskimins and Braucht, 1971)
and (5) A peer information questionnaire (PIQ) develOped
for this study by which the opinions of clients' peers
could be obtained.

The Characteristics of Client
Growth Scales (COGS)

 

The COGS consist of three separate scales (Owning
of Feelings, Committment to Change and Differentiation of

Stimuli) which characterize productive client growth in

97

*
counseling. Each of these scales is operationalized into
a five-point scale with 1.0 being the lowest possible
rating and 5.0 the highest rating. 3.0 is defined as being

the minimal level at which constructive change can occur.

Owning of Feelings Scale (OF)

The Owning of Feelings scale of the COGS is the
dimension on which a rating of the extent to which a client
admits and ”owns" his feelings as coming from himself is
given. While some clients in therapy are quite aware of
the affective levels of their experiences, others have
only vague feelings which pervade their perspective of
life and which are not tied to specific behaviors or
interactions. It is purported that progress can occur
in therapy when the client is able to identify his feelings
and tie them to their source.

At level one of the owning of feelings scale the

 

client seems to avoid any acceptance of his feelings. His
in-therapy behavior is usually characterized by a denial
of his having any feelings or by silence. He may appear
to believe he is not part of the world of feelings. At

level two the client's feelings are eXpressed in a vague

 

manner which makes them seem intellectualized and distant.

At level three feelings are identified by the client and

 

he can usually tie them to their source but does so in an

intellectual manner. At level four he almost always

 

 

*
See Appendix I for complete COGS.

98

acknowledges his feelings and expresses them with emotional
proximity but at times has difficulty connecting the
feelings to their source. The client clearly expresses

his feelings with emotional proximity at level five. At

 

the same time he demonstrates awareness of the fact that

i

they are tied to specific behaviors of his own and others.

Committment to Change Scale (CCh)

The committment to change scale of the COGS is
that on which the client is rated according to his decision
that he wants to change and his willingness to deal with
his problems and face the consequences of his changing.
This willingness is evidenced by increased c00peration
with his therapist. Purportedly, when the client evidences
a maintainence of his motivation to change, progress can
occur.

At level one of the committment to change scale

 

the client shows no motivation to change and is resistive
to the counselor's attempts to promote change. Client
behavior at this level may take the form of complete

passivity or defensive hostility. At level two the

 

client's committment to changing is noticeably question-
able, even though he may be somewhat passive or evasive,
or he may seem more interested in rationalizing his be-

havior than in changing it. At level three the client

 

may deal with feelings which are centrally involved with

99

his problem but has a tendency to rationalize or move from
tOpic to tOpic. He vascillates between an overt desire

to change and the desire to resist change.* In sum, the
client varies in his motivation to change. The client
expresses a clear desire to change at level four, and while
he may be reluctant to experience painful feelings at
times, he almost actively cooperates with the change
process. When the client actively c00perates in the
counseling process and continually engages in the process

of confronting his problems and feelings directly, he is

functioning at level five of the committment to change

 

scale.

Differentiation of Stimuli Scale (DS)

The third Characteristics of Client Growth scale
is that which indicates the level at which the client's
in-counseling behavior is characterized by differentiation
of stimuli. When clients progress in counseling they
typically learn to perceive more of the stimuli in their
environment and react to those stimuli as discrete,
individual factors rather than stereotyped, similar ones.
It is purported that, as a result, clients are better able
to identify and differentiate their emotions and reactions

to these stimuli.

 

*
See also Kell and Mueller (1966) for a discussion
of client ambivalence.

100

At level one of the differentiation of stimuli scale

 

the client tends to use stereotyped categories in lumping

differentiable stimuli, e.g., all girls, all professors, all
roommates, all adults etc. He seems unable to differentiate
his problems, feelings or congerns, and is unwilling to make

attempts to do so. At level two the client may talk about

 

different feelings and problems, but does so without an
apparent realization of any differences between them or
their effect on him as an individual. He talks about his
feelings and problems in an intellectualized, global way.
Level three typically indicates a vascillation by the
client between discussing different stimuli and their
effect on him as a person and responding in a general,
unclear fashion. That is, he may start out making clear
differentiations but is unable to persist, lapsing back

into hazy generalizations. At level four the client

 

actively attempts to become more aware of his various
emotions and their sources. He is almost always aware of
the differences between stimuli in his world and responds

to them differentially. At level five the client seems

 

always to perceive the different stimuli in his world
and reacts to them in a variety of differential manners.
He shows immediate awareness of his own unique character-

istics and the reactions he stimulates in others.

101

The Depth of Client Self Exploration
Scale (DX)

 

The DX Scale in its most recent form consists of
five levels, with level one being the lowest possible score
and level five being the highest possible score.* Within
the scale are incorporated seVeral dimensions of client
in-therapy behavior, including intrapersonal probing of
matters of personal relevance, accompanied by the immediate,
or spontaneous expression of feelings. Some findings of
Rogers and Truax (1961) suggest that this scale may be
one which measures something akin to readiness for help.
That is, low levels of rating on the scale may describe
clients who are relatively rigid and unready for help
while high levels may describe clients with a readiness
to change.

On the DX scale, level one indicates that the

 

client's behavior shows no evidence of self-exploration.

At level two the client may respond to the introduction

of personally relevant material by the counselor but

does so in a remote and mechanical manner. At layal

thlaa the client may be found to introduce personally
relevant material but does so with no spontaneity or inward
probing to discover new feelings or experiences. The
client introduces personally relevant material at lazal

four, but does so without a distinct tendency toward

 

*
See Appendix J for the complete DX scale.

102

self—exploration to discover new feelings and experiences.
At level five the client is actively focusing on himself

and exploring himself and his world.

The Therapy Session Report (TSR)

In an attempt to obtain information from an often
neglected source, the participants in the therapy session,
items from the Therapy Session Report (TSR) were also as
evaluation instruments in this investigation.

The Psychotherapy Session Project (Orlinsky and
Howard, 1968), as a way of surveying various aspects of
the therapy experience, devised two parallel questionnaires,
one for patients and one for therapists. The question-
naires are completed independently by each client (patient)
and therapist and have resulted in a useful structure with
which to examine the therapy relationship and experiences
for each participant. Each form of the TSR consists of
simple descriptions and evaluations covering various
dimensions of experience. The form of the TSR to be used
in this study (see Appendix D) is modification of the
original instrument and represents an attempt to evaluate
the influence of the two types of treatment as seen by

the client.

103

The Miskimins Self-Goal-Other
Discrepancy Scale (MSGO)*

The use of the term "self concept" has become a
pOpular way of studying and understanding human behavior,
and seems to have applicability to this investigation for
assessment of movement and change in therapy. As Schauble
(1970) states:

People who see themselves as being undesirable,
inadequate or inferior often act accordingly; and
those whose concept of self is unrealistic tend to
deal with life in unrealistic ways. Thus a know-
ledge of how an individual perceives himself
should be useful in evaluating or helping that
individual (p. 74).
Consequently, a measure of self concept change was applied
in this study.

The Miskimins Self-Goal-Other Discrepancy Scale
(MSGO) was used in this study to assess changes in dis-
crepancies between subjects' actual self concepts, the
ways they think others view their behaviors, and the ways
they would actually like to be (their "goal self concept").
The reasoning behind the use of a self concept discrepancy
measure rather than a measure of magnitude of self concept
or "strength" of self concept relates to the very core of

the treatment program intended, i.e., the notion of in-

creasing self awareness in order to examine the dynamics

 

*

COpyright 1971 by R. W. Miskimins and George N.
Braucht. All Rights reserved. The author is appreciative
to R. W. Miskimins for his permission to use the scale.

104

underlying a person's maladaptive behavior. By examining
the discrepancy between the way a person actually behaves
and the way others see him as behaving, for example,
differences should become obvious between treatment group
subjects and control group subjects if, in fact, the IPR
treatment is more effective than traditional counseling.
It was assumed that by becoming aware of differences
between his actual self concept and the perceived responses
of others, a client would revise his own concept of self
toward more similarity to the way others see him.

The MSGO is a twenty item questionnaire which
"serves to systematize observation of three . . . aspects
of self . . . (SC, GSC, and PRO)" (Miskimins and Braucht,
1971, pp. 66-67). That is, it is a means of assessing the
self concept, the goal self concept, and the perceived
response of others, in order to calculate congruency among
the three. The 20 items consist of polar constructs (e.g.,
Relaxed-Tense) on a nine point scale. The client is asked
to indicate his rating of his own position for all three
concepts--SC,GSC,and PRO-~thus transferring his "perceived"
discrepancies onto the polar construct pair (Miskimins and
Braucht, 1971). The final form of the scale contains four
categories, general, social, emotional and personal, with
each category containing five test items. The general,
social and emotional categories are standardized in the
test booklet; for the personal category, the test-taker

is asked to formulate his own list of five constructs.

105

Correlative validation studies have been done on
the MSGO through a number of different approaches. Coef-
ficients were obtained between MSGO scores and established
psychological measurements (Taylor Manifest Anxiety Scale
and Minnesota Multiphasic Personality Inventory), clinical
judgments and objective behavioral criteria.

When the 20 item MSGO was correlated with the
Taylor Manifest Anxiety Scale (TMAS) using scores of 63
college students, coefficients ranging from -.06 to +.72
were obtained for the various MSGO scores. For the two
MSGO scales which measure total discrepancies (GRT [15] and
GRT [20]) validity coefficients of +.67 and +.7l, respec—
tively, were noted. The scale which indicates the total
discrepancies for the first 15 items (GRT [15]) is the
one of interest in the formal analysis used for this study.

In an attempt to assess the relationship of MSGO
scores to various psychological disturbances, the MMPI was
administered to the same group of 63 college students on
the same day that the MSGO was administered. The analysis
of the relationship between MSGO and MMPI scores were
reflected in 738 individual correlations (13 MMPI sub-
scales X 56 MSGO scores). Correlation coefficients obtained
between the 13 MMPI subscales and the MSGO score used in
this study are presented in Table 3.6.

Further validity assessment was carried out by

the MSGO authors to test the ability of the MSGO to

106

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i

 

 

 

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107

distinguish "normal" from "abnormal psychological states.

A group of subjects (N=29) which had no history of
psychiatric treatment was compared with a group of sub-
jects who were undergoing psychiatric treatment (N=29).

With a matched pairs design, three MSGO values, including
the one used for this study, were found to demonstrate
exceptional ability to differentiate normals from psychiatric
patients: GRT (15), SC--PRO, T (15), and SC--PRO, GT. A11
scales showed differences in the predicted direction between
the two groups, with 19 of the 28 variables employed being
found to differentiate the two groups at statistically
significant levels. The mean score for patients was found
to be 56.07 compared with 29.31 on the GRT (15) variable,

a difference which was statistically significant at the

.001 level. And in a similar study designed to assess the
ability of the MSGO to differentiate between varying degrees
of psychopathology, similarly favorable results were
observed for the GRT (15) scale. The mean for 47 subjects
judged to be "severely" pathological was found to be
significantly higher than the mean for a matched group

of individuals judged as being of "moderate" pathology

(p < .05). When an operational definition of psycho-
pathology (length of stay in the hospital and form of
discharge) was used for 94 patients in another study, mean
score differences between groups were in the predicted

direction, but not statistically significant.

108

The MSGO was also subjected to test-retest relia-
bility studies. A group of 51 college students completed
the scale on two different occasions separated by a 14
day time span. Test-retest reliability coefficients
ranging from +.87 to +.24 were obtained for 28 summary
MSGO variables. Test-retest a for the GRT (15) variable
was found to be .80.

The MSGO scoring profile allows comparison of
individual scores_with means and standard deviation units
for a sample of 63 non-student "normals" (see Appendix K
for MSGO Hand Scoring Summary Sheet and Profile Summary).
For this study, the scale which reflects all discrepancies
for the first 15 items (the Total Scale) will be used for

comparison of experimental and control group scores.

The Peer Information Questionnaire

In an attempt to obtain information about each
client's observed behavior outside of the therapy session
a Peer Information Questionnaire was formulated. 15 items
consisting of statements about inter-and intra-personal
behaviors was constructed. Added to these 15 items was
a sixteenth item which related to the informant's
confidence in his ratings. An attempt was made to
structure these items so that a variety of behaviors
was assessed, including those also examined through the
use of judges' ratings of client's in-therapy verbal

behavior.

109

Peer-informants were asked to indicate their
responses to each item on the PIQ with a number between
one and six; a rating of one represented strong disagree-
ment with the statement, six represented strong agreement
and intervening numbers ranged between these opinions.

A questionnaire and explanatory cover letter (see
Appendix L) was mailed to each of the peers whose name
the participating clients had provided earlier. It was
thought that with the approaching termrend and final
exams week, a higher percentage of responses could be
obtained through personal telephone contacts than through
reliance on the peer-informants to return their responses
by mail. Each informant, therefore, was asked to provide
his/her responses to the written form mailed to him when
called by telephone. An independent assistant who had no
knowledge of each client's experimental or control status
telephoned each informant for his reaponses during the
week following the last of the six treatment sessidns
(before the client had met again with his counselor, if
further meetings had been arranged). The telephone
assistant recorded each response on a data sheet as it
was given to her by the informant (see Appendix M for
Response Sheet). Thus, responses were obtained from.two
peer-informants for each client in each group. The Peer
Information Questionnaire to which each informant

responded is contained in Appendix N.

110

Client Written Comments

The above instruments were used to obtain data
for formal analysis. In order to obtain information of
a more subjective nature which was not amenable to analysis
but nevertheless valuable, subjective reactions, impres-
sions and opinions about the treatment programs were
solicited from each client when he completed the TSR and
MSGO. This provision of a page for client subjective
comments also provided an opportunity for the researcher
to give final instructions to each client and express
appreciation for their participation in the project. The
subjective comments form is found in Appendix 0.
Ratings of Counselor Functioning-~The
Empathic Understanding Scale

While random assignment of clients and therapists
to groups was used in this study in an attempt to equate
the two treatment groups, it was also thought that dif-
ferential functioning levels of therapists may be a factor
requiring control in the experimental design. Because
therapists with three different levels of experience and
expertise could logically be expected to function at dif-
ferent levels, and because of recent literature (Carkhuff,
1969a) describing the importance of helper functioning
level for client growth, therapist level of functioning
was used as a covariate in the analysis of data for this

study. The particular dimension upon which therapist

111

functioning level was assessed was the Empathic Under-
standing in Interpersonal Processes Scale (Carkhuff,
1969a).* This scale was selected because of indications
that empathy is perhaps the most critical of all helping
dimensions for counselor effectiveness in facilitating
client growth (Carkhuff, 1969a; Berenson and Carkhuff,
1967; Truax and Carkhuff, 1967).

A functional definition of empathic understanding
is given in the scale itself, which consists of five

levels. At level one, the behavioral eXpressions of the

 

therapist detract significantly from the communications
of the client. They do not indicate that the counselor
is listening, understanding or being sensitive to the

feelings of the client. At level two on the EU scale,

 

the counselor may respond to the expressed feelings of
the client, but does so in a way which detracts from
those feelings, distorts their meanings or evidences
incongruence between the client's eXpression and the
counselor's idea of that expression. The expressions of
the therapist are essentially interchangeable with those
of the client at level three. That is, they express
essentially the same affect and meaning, without an accu-
rate response to feelings which may be below the surface

expression of affect. At level four, the expressions of

 

the counselor add noticeably to the eXpressions of the

 

*
See Appendix P for complete EU Scale.

112

client; they add deeper feeling and meaning to the client's

expressions of affect. A level five rating indicates that

 

the counselor is responding with full awareness and under-
standing of the deep feelings of the client. The counselor‘s
responses add significantly to the feelings and meanings
of the expressions of the client.

Segments of the audiotapes made of Session 1 for
all therapists were presented to judges for rating on
levels of therapist empathic understanding. These ratings
were then used for a covariate analysis of the dependent

variables in an attempt to assess client growth in therapy.

Rating of Criterion Tapes

Two independent raters were used as judges for the
scales used as criterion measures for this study. Both
judges held the Ph.D. degree in Counseling Psychology,
were employed at an eastern university counseling center
and were experienced in the use of behavior rating scales.
In addition, both judges were functioning themselves at
high levels (above 3.0) of facilitative counselor behavior
as measured by the Truax and Carkhuff (1967) scales.

A training session of three hours was conducted for
the judges (45 minutes for each of the scales), during which
a description and review of each of the scales was provided.
Practice ratings on therapy tapes were also made during

this training session. The practice tapes were stopped

113

at various points and the ratings of the judges were
compared and discussed, until there was apparent close
interjudge agreement.

In rating the tapes, neither judge had knowledge
of the differences in experimental procedure for each
group, nor was he aware of the group to which each client
or counselor was assigned. Each judge made an independent
rating of client functioning for all sixth-session tapes
and of counselor empathic understanding for all first-
session tapes.

Selection of Segments and Rating of
Client Functioning Levels

From each of the audiotapes made of the sixth
(final) therapy session, segments were excerpted for
presentation to the judges. In order to obtain a repre-
sentative sample of the interaction during the session,
and to obscure the differences in experimental treatment
between the two groups, segments were taken from the first
thirty minutes and the last twenty minutes of each sixth .
session (the presence of the inquirer for experimental
group clients would have been obvious to the judges had
the intervening forty minutes been used for rating). A
seven-minute segment was thus randomly excerpted from the
first thirty and the last twenty minutes of each final
session. This resulted in a fourteen-minute excerpt for

each client. gAll segments were then randomly ordered and

114

dubbed onto a master tape for rating by the judges. Ratings
of each client statement within the fourteen-minute segment
(up to a maximum of twenty statements) were made on the
dimensions of OF, DS, CCh and DX.
Selection of Segments and Rating of
Counselor Functioning Level

Counselor level of empathic understanding was chosen
as a covariate in this study because of the apparent
importance of differential levels of counselor functioning
for client growth. To obtain this rating, excerpts con-
taining client-counselor interactions were selected from
the audiotapes made by all counselors of their initial
session. Since the initial session was the same for both
eXperimental and control groups, excerpts could be selected
from any portion of the 90-minute tapes.‘ From each first-
session tape, therefore, three segments were taken; a
three-minute excerpt was randomly drawn from the first,
middle and last thirty minutes of each audiotape, resulting
in a total of nine minutes for each tape. The three three-
minute segments for each counselor were then dubbed in random
order onto a master tape for rating by the judges. Each of
the three-minute segments was then given one global rating
on empathic understanding by each of the same two judges

who rated the dependent variable tapes.

115

Reliability of Ratings

 

Reliability estimates for the total audiotape sample
(12 posttapes for client ratings and 12 pretapes for
counselor ratings) were established on each rated dimension
(OF, DS, CCh, DX and EU)’, Coefficients were obtained
through the use of a two-way analysis of variance tech-
nique described by Hoyt (1967) and a program developed
by Jennrich (1961) for the CDC 6500 computer was used
for the analysis of data. Reliabilities of average ratings
for each rated dimension are reported in Table 3.7.
TABLE 3.7.--Reliability Coefficients for Judges' Average

Ratings of Each Client Dimension and Counselor
Empathic Understanding.

 

 

 

 

Dimension COGS
OF DS CCh DX EU
Correlation .8325 .8990 .9445 .9782 .8433
Hypotheses

 

The specific hypotheses are presented here in
research form. They will be designated with the letter H,
numbered one through five.

If the theory and methodology of this study are
sound, it can be expected that clients who are counseled

with affect simulation and IPR (Group 1) will be rated at

116

higher levels of OF, DS and CCh than traditionally counseled
clients (Group 2). Since ratings on these three client
dimensions will be added to yield a composite score for
each client, the above prediction implies the examination
of the following hypothesis:
H1: The composite posttest ratings for OF, DS and
CCh Wlll be higher for the treatment group
receiving personal counseling with IPR inter-
vention than for a traditionally counseled
group that receives personal counseling alone.

Similarly, it can be expected that IPR-treatment
clients will evidence higher DX ratings than clients who
receive traditional therapy.

H2: The posttreatment level of DH ratings for clients
in the IPR treatment group W111 be higher than
the posttreatment level of DX ratings of clients
who receive traditional counseling.

It is also predicted that clients who receive the
experimental (IPR) treatment will eXpress more satisfaction
with the counseling process and relationship than will
clients who receive traditional treatment.

The twelve items selected from the TSR by Schauble
(1970) to measure client and therapist change in perception
of treatment processes would yield an additional twelve
hypotheses if considered separately. Since only client
variables and a more global client Opinion about the therapy
than that obtained by Schauble is of formal interest in
this study, a shortened form of the TSR was applied (see
Appendix D for items used). Client feelings about the

therapy process were obtained on four dimensions:

117

l. The client's feelings about the six sessions

just completed.

2. The client's feelings about progress made in

the session.

3. The client's perception of therapist under-

standing.

4. The client's perception of therapist helpfulness.

These four dimensions were again added to yield a
composite score for purposes of the formal analysis, and
the application of this measure implies the examination of
a third hypothesis:

H3: Clients who are counseled with IPR and affect
simulation will evidence more satisfaction with
counseling than will clients who receive tradi-
tional counseling.

The MSGO was also administered to all clients in
an effort to assess the degree of discrepancy between
clients' self concept, goal self concept and their per-
ceived responses of others toward them (SC, GSC and PRO,
respectively). Only the MSGO TOTAL scale was used for
this purpose. The TOTAL scale of the MSGO is eXplained
as follows:

. . . labeled GRT (15), this dimension refers to the

sum of the discrepancies between SC and GSC and

between SC and PRO, thereby indicating the total
discrepancy for the first 15 test items (Miskimins

and Braucht, 1971).

While the use of the TOTAL scale only does not permit

diagnostic differentiation or provide as much information

118

about a client as would be the case were all of the MSGO
scales used, the TOTAL scale does incorporate most of the
discrepancy areas measured by the scale.

The fourth hypothesis, then, derived from the
prediction that IPR treatment will result in less self
concept-related discrepancies than traditional treatment,
is as follows:

H4: Clients who receive traditional counseling will
reveal higher self concept-related discrepanCies
on the MSGO than will clients who receive
counseling with IPR and affect simulation.

In an effort to determine whether changes in clients'
behavior as a result of therapy intervention were notice-
able outside of the therapy setting, a Peer Information
Questionnaire (PIQ) was devised and sent to two pe0p1e
whom each client had indicated would be willing to comment
on his/her behavior at the end of the six-week counseling
program (see Appendix E). It was expected that the following
hypothesis would be confirmed on the basis of the informa-
tion gathered through this questionnaire:

H5: Peers of clients who receive the IPR counseling
treatment Will report more pOSitive behaVior
changes for their peers on the PIQ than will

peers of clients who receive traditional
counseling.

Analysis of Data

 

The data resulting from this investigation were
analyzed by a multivariate analysis of covariance technique.

A program developed by Finn and modified by Wright (1968)

119

for the CDC 3600 computer was used for the analysis of
each of the five dependent variables (COGS, DX, TSR, MSGO,
and PIQ), and independent sample t-tests were further
performed to test for between group differences in fre-
quency of one and six ratings by peers on the PIQ. The
subjective comments provided by most clients were also
examined in an effort to obtain an informal observation

of reactions to the treatment programs.

Delimitations

 

Because of the nature of this study, there are
certain delimitations to it which are discussed briefly
here.

The subjects used for this investigation were
students enrolled at two major midwestern universities.
These subjects were clients who had requested assistance
with personal concerns from the staffs of their respective_
counseling centers. Consequently, they were characterized
not only by age level but also by the types of concerns
presented. This study is addressed only to an investigation
of a way of assisting the college age group and has no
direct generalizability for therapy with any other age
group.

Also by reason of the population used, it was
expected that certain types of maladjustments or concerns

would rarely, if ever, be encountered in the study, since

120

they are not concerns usually related to the mental health
of the college population. These are concerns or problems
such as those associated with old age, mental retardation,
alcoholism, active psychosis, and the like. Therefore,
the results of this investigation are not intended to
apply to these types of situations.

Neither was this study intended to allow for
examination of differential effects of the treatment
program on different types of problems. That is, no
investigation was made of the varying waystfluatreatment
may affect individuals with differing diagnoses. The
only stipulation made in this regard was that the sub-
jects have a personal-social type of concern which they
were interested in resolving or attempting to'resolve.l
Further description of the sample was found under that
heading.

Finally, formal measures of client functioning
subsequent to termination of the treatment program were
not included in the research design, although informal

post-post measures may be taken in the future.

Summary

The sample for this study consisted of volunteer
clients who had requested assistance with personal concerns
from the staffs of the Michigan State and the University

of Wisconsin-Milwaukee Counseling Centers. Therapists

121

used for the study were also volunteers from the staffs
and practicum groups at the two counseling centers. A
posttest only design was used with therapists and clients
randomly assigned to one of two groups. Group A received
counseling in which videotape, affect simulation and IPR
procedures were used; group B received traditional
counseling. Comparisons were made between the groups

on measures of client in-therapy verbal behavior, client
satisfaction with therapy, reports of clients' peers and
self concept discrepancy. Hypotheses predicting higher
scores for group A on rated client behavior, satisfaction
with therapy and peer reports, and lower scores for group
A on the self concept discrepancy measure were posited.
Clients in each group met for six sessions of one and one-
half hours each during Spring term, 1972. The IPR-
videotape clients underwent specific procedures, using
simulation and stimulated recall, while the traditional
group clients received counseling without videotape
procedures. The time spent in therapy was equated for
both groups. Results were analyzed using a multivariate
analysis of covariance on five dependent variables, with
counselor functioning level as the covariable. Independent
sample E tests were also performed to test for differences
between the groups in frequency of extreme scores on the
PIQ. Finally, subjective comments of clients about the

counseling programs were informally examined.

CHAPTER IV

ANALYSIS OF RESULTS

Introduction

 

The results of analysis and observation of the data
are presented in this chapter. Covariable ratings results
are given and the results of the analysis of covariance
are presented. The results of an additional analysis pro—
cedure for the Peer Information Questionnaire results are
also evaluated and dependent variable to covariable corre-
lations and dependent variable intercorrelations are
presented. Subjective comments of client-participants are

also provided.

Covariable Ratings

 

Level of empathic understanding (EU), the covariable
used in the analysis of data for this study, has been
claimed to be one of the most crucial counselor character-
istics relative to client progress in therapy (Carkhuff,
1969a). It was thought that the addition of this covari-
able in the analysis of data might not only control for
the counselor functioning level variable, but assist in

the interpretation of the data after analysis.

122

123

The mean score for group A counselors (3.11) was
observed to be slightly higher than the mean score for
group B counselors (2.97). The raw scores by rater,

counselor and treatment group are reported in Table 4.1.

TABLE 4.1.--Rated Level of Empathic Understanding*
of Counselors by Rater and Treatment Group.

 

 

 

Ratings
Counselor Rater l Rater 2
Group A l 3.33 3.00
(IPR)

2 3.00 3.00
3 2.67 2.00
4 3.33 4.00
5 3.33 3.33
6 3.33 3.00

XA = 3.11
Group B 7 3.00 3.00

(Traditional)

8 2.33 2.67
9 3.00 3.00
10 3.00 3.00
11 3.00 3.33
12 3.00 3.33

XB = 2.97

 

*Raw Scores

124

Multivariate and Univariate Findings

A multivariate analysis of covariance with five
dependent variables and one covariable was used for the
major analysis of data for this study. Multivariate and
univariate analysis results are presented in this section.
Significance testing was carried out at the .05 level for
each analysis.

In the multivariate analysis of covariance, no dif-
ference between groups A and B was noted. As indicated in
Table 4.2., the computed F ratio of 1.8126 was not found to
be significant at the .05 level with 5 and 5 degrees of

freedom.

TABLE 4.2.--F Ratio for Multivariate Test of Equality of
Mean Vectors.

 

df F pg

 

5,5 1.8126 .2649*

 

*Not Significant.

Since the proposed hypotheses deal with the treat-
ment effects on each dependent variable taken separately,
the hypotheses are restated here, and accompanied by the
results of the univariate analysis of data relative to each
hypothesis. It must be noted that for the overall alpha
level of .05 in this analysis, each separate level must be

set at .01. Also, since directional significance tests are

125

desired but the F statistic is non directional, the critical
values used are for alpha equal to .02. That is, results
would be significant if p < .02 in each of the cases to
follow. Tables 4.3 and 4.5 through 4.8 contain abbreviated
analysis of covariance tables (information printed out
through computer analysis) for each one-way analysis.
H1: Clients who receive counseling with IPR
and affect simulation will evidence
higher scores on a composite COGS rating
than will clients who receive traditional
counseling.
Results: No significant difference in treatment

effect between group A and group B was found. Therefore,

the null hypothesis is not rejected.

TABLE 4.3.--ANCOVA for COGS Ratings.

 

Source df MS F p<

 

Between 1 3.0873 1.5004 .2517*
Within 9 2.0577

 

*Not significant.

Since significance was not found in the analyses,
the grand means of groups A and B on each dependent variable

in this covariate analysis are presented in Table 4.4.

126

TABLE 4.4.--Grand Means for Dependent Variables (Raw Scores).*

 

 

R1 R2 R3 R4 R5
(COGS) (DX) (TSR) (MSGO) (PIQ)
284.70 f 91.15 14.41 55.08 110.89

 

*For the COGS and BK ratings the ranges of possible means
would be 120-600 and 40-200, respectively (raters x
statements x dimensions x 5). It is interesting to note
that the average rating was below the 3.0 level for clients
in both groups (COGS = 2.37, 0x = 2.28).

H Clients who receive counseling with IPR and
affect simulation will evidence higher
ratings of DX than clients who receive

traditional counseling.

2:

Results: No significant difference in treatment
effect between group A and group B was found. Therefore,

the null hypothesis is not rejected.

TABLE 4.5.--ANCOVA for DX Ratings.

 

 

Source df MS F pf
Between 1 1.8808 1.2359 .2951*
Within 9 1.5218

 

*Not significant.

H3: Clients who are counseled with IPR and
affect simulation will be more satisfied
with their therapy sessions than clients
who are counseled with traditional methods.

Results: No significant difference in treatment

effect between group A and group B was found. Therefore,

the null hypothesis is not rejected.

127

TABLE 4.6.--ANCOVA for TSR Scores.

 

 

Source df MS F p<
Between 1 .1134 .1092 .7486*
Within 9 1.0382

 

*Not significant.

H4: Clients who receive counseling with IPR
and affect simulation will reveal less
discrepancy between their self concepts,
their goal self concepts and the way they
think others see them than clients who
receive traditional counseling.

Results: No significant difference in treatment
effect between group A and group B was found. Therefore,

the null hypothesis is not rejected.

TABLE 4.7.--ANCOVA for MSGO Scores.

 

 

Source df MS F p<
Between 1 .7377 3.1272 .1109*
Within 9 .2359

 

*Not significant.

5: Peers of clients will report more positive
behavior changes after the treatment period
for clients who receive IPR counseling than
for chants who receive counseling without
IPR.

Results:

effect between group A and

128

No significant difference in treatment

group B was found. Therefore,

 

 

the null hypothesis is not rejected.

TABLE 4.8.-—ANCOVA for PIQ Scores.

Source df MS F p<
Between 1 .9532 .5267 .4865*
Within 9 1.6200

 

*Not significant.

For this last hypothesis, further analyses were

performed. The results of these analyses will be found
in the following section of this chapter.
The Peer Information Questionnaire-—
Independentlngests Results

In a further effort to ascertain whether differences
existed between the ways peers of group A clients and peers
of group B clients responded to the PIQ, two independent
one-tailed E tests were performed. Since "one" and "six"
responses on the PIQ represented extremes of "strongly feel
it is not true" and "strongly feel it is true," respectively,
for each PIQ statement, it was assumed that these options
would be used by peers only when they felt intensely about
their client-peer (relative to a particular item on the

PIQ). It was further thought that behaviors of clients of

129

a particular treatment group may have influenced peers to
respond more strongly, positively or negatively, to items
on the PIQ when evaluating that peer, this despite the
earlier finding that on the average there was no between
groups difference.

Two informal hypotheses were formulated. It was

expected that peers of group A clients would express more

 

"strongly agree" (six) ratings than peers of group B cli-
ents and that peers of group A clients would express laaa
"strongly disagree" (one)responses than peers of group B
clients. Comparisons of the frequency of "one“ responses
between groups A and B and the frequency of "six" responses
between groups A and B were thus made.

A significance level of .05 was selected for the
two E tests taken together; however, since the assumption
of independence could not be met for the PIQ results in
this case, the .05 level was split, and a E distribution
score at the .025 level with 10 degrees of freedom was
used. For the first E test the number of "six" reSponses
across all items on the questionnaire and across the two
peers for each client constituted the dependent variable.
For the second test the dependent variable consisted of
the number of "one" responses across items and peers.

As noted in Table 4.9, the frequency of "one"
(negative) responses was not found to be significantly
greater for group B than for group A. Neither was the

frequency of "six" (positive) responses found to be

130

significantly greater for group A than for group B. Had

a .l confidence level been selected, however, the frequency

of "one responses would have been found to be significantly

greater for group B than for group A, but the frequency of

Six" responses would not have been found to be significantly

different.

TABLE 4.9.--E Test Table for Frequency of "One" and "Six"
PIQ Responses.

 

 

Group A Group B t _
(IPR) (Traditional) nAan 2
Frequency
of -
Ones 2 8 -1.686*
Mean .34 1.33
SOD. .47 1037
Frequency
of ~
Sixes 41 28 1.250*
Mean 6.83 4 67
S.D. 3.02 2 92

 

*Not significant.

Dependent Variable to Covariable Correlations

Correlation coefficients between the EU covariable
and each dependent variable were computed and varied rela-
tionships were noted. As seen in Table 4.10, both positive
and negative correlations were found, with one coefficient

significant at the .01 confidence level.

131

TABLE 4.lO.--Corre1ations Between Covariable and Dependent
Variables (pooled within groups).

 

R R4 R

 

l 2 3 5
(COGS) (DX) (TSR) (MSGO) (PIQ)
Cov .562 .401 ‘ - -.258 -.888* .235

(EU)

 

*Significant at the .01 level (d.f. = 10)

A coefficient of .562 was noted between the EU
covariable ratings and the COGS ratings. A rather strong,
but non-significant (.05 level) positive relationship
between the two variables is indicated by this coefficient,
suggesting that the level of counselor empathic understand-
ing may be directly related to client in-therapy behaviors
(OF, DS, and CCh) as measured by the COGS.

Similarly, a positive correlation of .401 was
obtained between the covariable and DX ratings, suggesting
that clients of therapists rated higher on EU may engage in
the self exploration process more or to a deeper level than
clients of therapists who are rated at lower levels of EU.
This correlation, however, while relatively high, is non-
significant, and caution must be used in its interpretation.

A relatively low negative correlation was found
between EU ratings and TSR results. The -.258 coefficient
may indicate a slight inverse relationship between counselor
empathic understanding and client reported satisfactiOn with

therapy, but the relationship between counselor EU and

132

client satisfaction on the basis of the data from this study
does not appear to be sufficiently strong to warrant a
definitive statement.

A significantly high correlation was found, however,
between counselor EU and MSGO results. A correlation of
-.888 (significant at the .01 level) was obtained, indicat-
ing a strong inverse relationship between self concept dis-
crepancies and counselor EU for the data resulting from this
study. One conclusion which may be justified on the basis
of the coefficient is that higher levels of counselor EU are
related to lower self concept discrepancies as reported by
clients after therapy on the MSGO. Conversely, lower levels
of counselor EU may be related to higher discrepancies
between self concept elements on the MSGO.

Little relationship was found between the EU
covariable and peer reports of client behavior outside of
the therapy setting. A low positive correlation of .235
between EU and PIQ results was noted. This coefficient is
not sufficiently high to be found significant at the .05
level and statements of EU to PIQ relationships must be
made with great caution on the basis of this correlation.
Further discussion of these results will be found in the

subsequent chapter.

Dependent Variable Intercorrelations
Correlation coefficients between dependent variables
were also computed for the data resulting from this study

(see Table 4.11). Both positive and negative dependent

133

variable intercorrelations were found, with three correla-

tions being significant beyond the .05 level.

TABLE 4.ll.--Correlation Matrix--Dependent Variable Inter-
correlation Coefficient (pooled with groups).

 

 

COGS DX TSR MSGO PIQ
COGS 1.000
DX .920** 1.000
TSR - .121 .026 1.000
MSGO - .577* - .579* .072 1.000
PIQ - .001 - .041 .193 - .272 1.000

 

* Significant at .05 level.
**Significant at .01 level.

The highest indication of relationship between
dependent variables was found to exist for the COGS and DX
scales (.920), a correlation significant beyond the .01
confidence level. The results of the COGS and UK ratings
for this study were therefore highly related in a positive
direction. The COGS correlated negatively with the other
three dependent variables; coefficients descriptive of the
relationship between the COGS ratings and TSR, MSGO and PIQ
results were found to be -.121, -.577 and -.001, respec-
tively. The COGS to MSGO correlation coefficient was fur-

ther found to be significant at the .05 level.

134

Although the DX ratings correlated highly with
COGS ratings for these data, low correlations were found
between DX and TSR results and between DX and PIQ results.
Coefficients for these two relationships were found to be
.026 and -.041, respectively. A significant (.05 level)
negative relationship was observed between DX ratings and
MSGO results, however, indicating a relatively strong
inverse relationship between these two variables. That is,
DX and MSGO data were found to be related in a way which
suggests that higher levels of client self exploration were
associated with low self concept discrepancy scores, and
low levels of client self exploration were associated with
higher self concept discrepancy indices.

Low but non-significant correlations (.072 and .193)
were found between TSR scores and MSGO scores and PIQ
ratings, respectively, indicating little relationship
between TSR results and either MSGO or PIQ results.
Similarly, little relationship was noted to exist between
MSGO and PIQ results; a coefficient of -.272 was obtained

for this relationship.

Client Written Comments
As a means of obtaining an informal client evalua-
tion of the treatment programs, a "Comments" page was
provided for each participating client at the time of post-
testing. Clients were asked to indicate, if they desired,
any of their impressions, reactions to, or opinions about

the six-week program they had just completed.

135

Nine of the twelve clients who completed the therapy
programs chose to respond with comments about their program
or about themselves in the program. Clients in both groups
tended to "accentuate the positive;" all comments made about
the treatment programs were of a positive nature. Clients
in group A (IPR) tended to speak of the benefits of the
videotape and the examination of it for their particular
experience in therapy while clients in group B (no IPR)
typically commented about the importance of their deciding
to enter therapy and the beginning benefits of their
therapy experience. Many clients from both groups indicated
that their six week experience was only the beginning of a
new process of self-exploration and examination for them.
Observation of the client comments suggests that group A
clients tended to speak more about the relationship between
them and their therapists in the context of a particular
concern than group B clients; group B clients spoke more
about their individual feelings about the therapy without
referring to their relationship with the therapist. As an
example, an IPR group client commented as follows:

"Working with the video provided an easy path to
help the client and therapist get together and
understand just exactly how the other person was
feeling. At times I felt that I was so wrapped
up in trying to say my feelings that I couldn't
feel them. The video brought these back and
provided us a chance to interact at an even more
basic level . . . . The action on the video pro-
vided an opportunity to analyze what was happen-
ing on the tape which gave us both another chance

to look at what we really wanted to say to each
other. Thus we were able to be more truthful."

136

A comment more representative of group B clients, however,
does not refer to the client-therapist relationship:

"I think it has been very good in ways of going

over experiences in the past and letting myself

feel things that I was unable to recognize in

myself then. I think I am a bit more able to

accept myself now and to see where some of my

feelings originate. Overall, the sessions have
been quite helpful to me."

Clients also commented on the length of the sessions,
revealing an opinion that the longer sessions were benefi-
cial to them. In this context, however, IPR group clients
seemed to indicate more awareness of their own defensive
dynamics than traditionally counseled clients. For example,
in the following comment, the IPR group client seems to
demonstrate an awareness of not only a defense against the
counselor's approaches toward him, but also the importance
of an interactive relationship between himself and his
counselor:

"The 18 hour sessions worked well for me. It took
me time to get past my opening bullshit. In the
early stages I would have wasted most of 50 minute
sessions. The use of videotape was very signifi-
cant for me. Not only did I get the chance to view
how I react but by discussing how I thought my
therapist was reacting (while he was in the other
room) facilitated our relationship. I feel this
is a very good method for building up a trust
between client and therapist . . . I was very
pleased with the project and the therapy."
The following example, however, from a member of the tradi-
tionally counseled group, seems to connote more passivity

on the client's part, with little awareness of a mutual

effort toward problem resolution:

137

"My counselor . . . wasn't alwa s able to grasp
exactly what I was feeling--a1t§ough he was
usually on the right track. His basic purpose
was to give me feedback on what I was saying--
how it made him feel--what patterns he saw--where
I was coming from. He helped me to become aware
of the sources of my problems, and made sugges-
tions as to how to deal with them--which will
always be up to me."

Many of the twelve clients made some reference to
the importance of entering therapy, and many IPR clients
commented on their wish that the program had been longer.
For example, "It really seemed like we were just starting
to scratch the top of my head," or:

"I felt good about how the sessions went but it's

hard to feel very good with much more to do . . .

Over the short period of six sessions I had some

difficulty accepting the relationship with the

therapist making progress somewhat retarded,

cutting down on the effectiveness of the therapist."
A general impression evident was that, since more IPR
clients made reference to having more to do, or a clearer
notion of what directions they wanted to grow in, the video
and IPR may have enhanced the process of clarifying and
setting goals for the IPR group over the treatment period.

Finally, in addition to the observation that most
clients (regardless of group) saw their therapy experience
as a very positive one, IPR group clients seemed to find
the video review of their own behavior "interesting" and
profitable for their own personal growth; however, differ-
ences between the groups with regard to this impression

were not found to be reflected in the satisfaction (TSR)

reports.

138

Summary

Five areas of data were examined in this study. A
comparison of covariable ratings was made, an analysis of
covariance on each of the five dependent variables was
carried out, two independent E tests were performed in
order to compare frequency of extreme responses to client
behavior by peers, and dependent variable to covariable
correlations and dependent variable intercorrelations were
examined.

When comparisons were made between groups on the
covariable (counselor empathic understanding), group B
counselors (no IPR) were found to be functioning at a
slightly, but not significantly higher level than group A
counselors. Relationships between the covariable and the
dependent variables were observed through examination of
correlation coefficients. Correlations between the covari-
able ratings and each dependent variable ranged from -.888
to +.562; one correlation--that between Empathic Under-
standing and Miskimins Self-Goal-Other Discrepancy Scale
results-~was found to be significant (.01 level).

Hypotheses one through five were analyzed and
appropriate statistical evidence was presented. No dif-
ferences between groups A and B were found to_exist on the
criterion measures when data were examined by analysis of
covariance. No differences were noted on Characteristics
of Client Growth or Client Degree of Self Exploration

dimensions, Therapy Session Report results, Miskimins

139

Self-Goal-Other Discrepancy Scale scores or Peer Informa—
tion Questionnaire ratings. Neither did counselor empathic
understanding mask possible treatment effects between groups,
since this factor was controlled for by the use of counselor
EU as the covariable.

When Peer Information Questionnaire results were
further examined by the application of two independent E
tests to the frequencies of extreme scores on the PIQ,
numerical differences favoring the IPR group were observed,
but were not found to be significant.

Varying intercorrelations were noted among the
dependent variables. Correlations ranging from +.920 to
-.579 were observed for each dependent variable to depen-
dent variable intercorrelation. Finally, subjective com-

ments of client-participants were noted and reported.

CHAPTER V

DISCUSSION AND CONCLUSIONS

Summary

This research represented an attempt to evaluate a
relatively recently developed methOd for accelerating
client growth in counseling and psychotherapy. The specific
purpose of the study was to compare the results of the
application of two different methods of therapy with college
students. One method included an affect simulation/video-
tape technique; the other consisted of a traditional dyadic
approach.

The basic question underlying the research project
was whether an integrated affect simulation/Interpersonal
Process Recall procedure with videotape could produce a
more accelerative effect on client growth in therapy over
a six week period of time than a traditional therapeutic
approach. In a previous study (Schauble, 1970), in which
similar methods were used in a different design, significant
results were noted; clients with whom the experimental pro-
cedures were used were found to have evidenced greater
gains on therapy process variables than clients who under-
went traditional therapy.

140

141

The therapy model used in this study was derived
largely from Kagan's (1967) Interpersonal Process Recall
and affect simulation methods. Studies showing applica-
tions of these methods in a variety of settings were
examined and these, in addition to those in which more
general simulation and videotape techniques were used,
provided some evidence that the methods could be adapted to
the therapy situation and provide a viable approach to the
acceleration of client growth in therapy.

The therapy program for the experimental group
clients was begun with a regular counseling session. To
apply a successively approximative method of assisting
clients to move toward confronting and examining their
fears and dynamics, additional tasks were then introduced
in subsequent sessions. Clients moved next into the use
of affect simulation, whereby they could examine their
affective reactions to emotional situations and respond to
affect within a relatively non-threatening situation.
Clients then were videotaped during their affect simulation
viewing, and examined their reactions to the simulated
experience by reviewing the videotape of themselves as they
watched the simulation films. Following this, they were
videotaped during their counseling sessions and given an
opportunity to review and recall their own behaviors and
feelings as they occurred in the client-counselor relation-
ship. Two sessions were spent with only an inquirer (a

third person trained to help the client recall and explore

142

his original thoughts and feelings during the videotape
replay of the interaction) and the client present, and
another session was spent with the inquirer and both the
client and counselor present. A summary of procedures
for the IPR group and the comparison treatment group is
presented in Table 5.1.

The final sample for this study consisted of under-
graduate students who had sought assistance with personal
concerns from the staff at the Michigan State University
and the University of Wisconsin at Milwaukee Counseling
Centers. Therapists used for the study were staff members,
doctoral interns, and doctoral level practicum students,
all of whom regularly counseled clients at the counseling
center offices. A posttest only design was used with
therapists and clients randomly assigned to treatments.
Clients who received therapy within the IPR/affect simula-
tion model were compared with clients who received a more
traditional therapy treatment and who did not use video-
tape methods. Measures of client in-therapy verbal
behaviors (owning of feelings, differentiation of stimuli,
commitment to change and self exploration), client reports
(a therapy session report and a self concept discrepancy
measure) and reports of peers were used as criterion
measures. Hypotheses were presented which predicted that
the IPR/videotape group would obtain higher in-therapy

behavior ratings,satisfaction with therapy ratings and peer

143

 

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144

ratings and lower self concept discrepancy scores than the
traditional group.

Following random assignment of names taken from a
waiting list of clients, each prospective client was called
by telephone for assessment of willingness to participate
in the project. Of those called, all who were able to be
contacted and who had not arranged some other therapy
experience agreed to participate. A sample of 13 clients
and 13 therapists was thus gathered (one client was unable
to complete the entire project, resulting in a total final
sample of twelve clients). Because of different levels of
experience and expertise of the therapists, results were
analyzed by a multivariate analysis of covariance. Five
dependent variables and one covariable were used in the
analysis, with rated empathic understanding of therapists
constituting the covariable. Significance testing was
carried out at the .05 level for each hypothesis.

No significant differences were noted between group
A (IPR/videotape treatment) and group B (traditional treat-
ment) on the variables of interest. Hypotheses predicting
higher posttreatment scores for group A clients on a com-
posite Characteristics of Client Growth Scales (COGS, Kagan,
1967) rating (consisting of combined scores for client
Owning of Feelings, Differentiation of Stimuli and Commit-
ment to Change), a client Depth of Self Exploration rating
(DX, Truax and Carkhuff, 1966; Carkhuff and Berenson, 1967),

a Therapy Session Report (TSR, Orlinsky and Howard, 1968)

145

and a Peer Information Questionnaire (PIQ, developed for
this study) were not confirmed. Neither was an hypothesis
predicting lower scores for group A clients on the Miskimins
Self-Goal-Other Discrepancy Scale (MSGO, Miskimins and
Braucht, 1971) supported by the data. Correlation coeffi-
cients between covariable ratings and the dependent variables
were computed, as well as intercorrelations of dependent
variables. Covariable to dependent variable correlations
ranged from -.888 to +.562; dependent variable intercorre—
lations ranged from -.579 to +.920. Two independent one—
tailed E tests were also performed on the PIQ results in

an attempt to ascertain whether differences in the frequency
of extreme responses existed between the two groups. No
significant differences were evident when these tests were
applied. Finally, comments of participating clients were

gathered and examined.

Conclusions

 

1. The application of a series of successively
approximative therapeutic tasks in which affect simulation
films and videotape replay and review through Interpersonal
Process Recall (IPR) were used did not result in more
accelerated client growth in therapy as measured on
in-therapy process variables than did the application of
traditional therapeutic methods.

2. The application of affect simulation and Inter-

personal Process Recall with videotape to the personal

146

therapy experience did not result in greater satisfaction
with the therapy experience than the application of tradi-
tional therapeutic techniques.

3. The application of affect simulation and Inter-
personal Process Recall methods in personal therapy did not
result in less self concept-related discrepancies than the
application of traditional therapeutic methods without
affect simulation and IPR.

4. The application of affect simulation and IPR
methods to personal therapy did not result in increased
reports of positive behavior change for clients by their
peers than the application of traditional therapy methods
without IPR and affect simulation.

5. The use of affect simulation and Interpersonal
Process Recall with videotape is seen by clients as bene-,
ficial and conducive to self exploration and exploration
of the client-counselor relationship in personal therapy.

Conclusions one through four are derived from
examination of data resulting from this study. Conclusion
five is not related to formal questions asked in the study
and therefore do not stem from analysis of the data.
Rather, it is derived from comments made by client-parti-

cipants after the conclusion of the therapy program.

147

DiscuSsion

 

Implications and Observations

The primary observation stemming from the results
of the present study is that of the difference in outcome
between this study and that of Schauble in 1970. An impor-
tant implication of the fact that effects of IPR/affect
simulation treatment were noted in the Schauble study but
not in the present experiment is that those previous results
must be looked upon with more skepticism than would be the
case were this study not conducted. That is, while the
results of either of these projects may be valid, the fact
that differences between treatment groups were noted in the
original project but not in the present one to some extent
weakens the positive implications of results obtained in
the Schauble study.

Reference to another recent study (Hartson, 1971)
of IPR use in a therapeutic setting is also pertinent here.
The general conclusion that IPR use does not result in more
therapeutic progress than traditional methods is not shared
by Hartson on the basis of his results, since it was found
in that study that the use of IPR resulted in significantly
more self disclosure and group readiness and higher judge-
ments of communication skills and therapeutic verbal communi-
cation. While the use of the IPR methodology for the Hartson
study and for this study was dissimilar, and the therapeutic
milieu was different in each case, in the differing results

lies the implication that the IPR procedure as a therapeutic

148

methodology appears to be viable, but deserves further
investigation.

A third implication comes from comparing the struc-
tured IPR/affect simulation therapy experience with the
less structured traditional therapy received by the compari-
son group clients. This comparison raises the issue of the
effect of structure imposed by someone other than the
primary therapist to the therapy situation. Each experi-
mental treatment session was organized in this project to
facilitate measurement as well as progress by clients
through the various stages. While the organization of the
progressive movement was done on a logical basis, possibly
there were negative effects resulting from not using
specific techniques at differing points in the therapy
process according to individual client needs as determined
by each therapist.

There were also great differences in competency
among the therapists used for this study; yet, it is impor-
tant to note that all of the therapists came from a rela-
tively select group. The selection process for staff
members, interns and students at the primary university
'used for the study is rigorous. The implication here is
.that a more diverse therapist sample, in which therapists
from a number of different institutions were used, for
example, may have affected client progress in a different

way.

149

Treatment and Methodological Considerations

A number of factors deserve to be considered in
the interpretation of the results of this study. It must
be remembered that the length of treatment consisted of
only six therapy sessions for a total of nine hours of
therapeutic encounter. The issue of whether this amount
of time is enough to produce evident change for either
group could be raised. That is, six weeks may not have
been sufficient for either treatment to realize its full
impact, and because of this factor, differences were not
apparent. Yet, it must also be remembered that in the
1970 Schauble study, some differences were noted after the
same length of treatment. One difference between the two
studies that is worthy of note however, is the fact that
the physical facility for this study was different than
that for the Schauble study. In the present study, the
videotape equipment was more visible and contained in the
room, while for the previous study the camera and VTR were
partially concealed and contained in an adjacent room behind
a partition. While clients' self reports do not seem to
indicate this, it is possible that the presence of some of
the equipment in the counseling room detracted from the
experimental clients' ability to concentrate fully on
themselves, thus reducing the potency and effectiveness
of the method.

Other methodological differences between the Schauble

study and the present one deserve consideration.. While

150

clients for the Schauble study were also randomly selected
and assigned, the entire sample consisted of female clients,
while the sample for the present study was composed of both
male and female individuals.

Another difference between the two studies is in the
assignment of therapists to treatment groups. While each of
the two therapists in the Schauble study used both IPR and
traditional methods with different clients, none of the
therapists in the present study worked with more than one
subject in the study, and consequently used only one of the
two treatment methodologies. The effects of sex differences
in the client sample or possible therapist bias toward or
against a particular treatment approach as a result of one
therapist using both treatments may be cause for speculation
as to the different results. Similarly, the fact that one
inquirer conducted a majority of the recalls should be con-
sidered a possible influence in the present study.

A final consideration relates to the affect simula-
tion portion of the experimental treatment. The use of
affect simulation has been thought to be particularly
effective for counselors in training, especially for assist-
ing them in exploration of their own reactions to affective
stimuli. Training of this sort is typically carried out by
persons quite experienced in helping counselors-in-training
to use the affect simulation films or videotape to best
advantage. The counselors used for this study, however,

were not all versed in the use of the affect simulation

151

films prior to their training for the study. Hence, their
training may not have been sufficient to help their clients
realize the full benefits of the films for self explora-
tion. Yet, reports of experimental group therapists about
these sessions would indicate that the films certainly did
have some impact on some clients. The specific effects of
affect simulation for direct use in therapy with clients

would seem to warrant further investigation.

Statistical Analysis

 

While a different analysis procedure was used for
the results of this study than was used for those of the
former study (Schauble, 1970), it would not appear that
this modification can be used to account for the differing
results of the two experiments. The covariate analysis
procedure used here essentially equated all Ss on the
covariable criterion so that differential growth could be
observed. The use of a covariable in this manner accom-
plishes essentially the same purpose as the use of a pre-
test, provided the covariable correlates sufficiently high
with the dependent variables. It is therefore prOper to
speak of client growth from beginning to end of the treat-
ment period, rather than only of higher or lower post-
treatment scores on the criterion measures. And on the
basis of analysis of data, it is evident that significantly
more growth in therapy did not occur for experimental

clients than for comparison-treatment clients.

152

The degree of covariance must be considered in the
interpretation of these results, however, since the
precision of the statistic used corresponds directly to
the degree of covariance between the covariate and the
dependent variable(s) (Campbell and Stanley, 1963). While
correlation coefficients between the empathic understanding
covariate and the dependent variables used for this study
were generally sufficiently high to use the EU covariate,
the use of another, or additional covariates might have
increased the precision of the analysis. Correlation coef-
ficients ranging from -.888 (significant at .01 level) to
+.562 were noted for the covariable to dependent variable
relationships. The additional use of the Degree of Self
Exploration Scale as a covariable, for example, may have

increased the precision of the covariate analysis statistic.

Limitations

 

Basic methodological limitations exist in this
study. The most obvious, and probably most basic weakness
is the size of the N. Although a larger sample size would
certainly have been preferable, the availability and will-
ingness of therapists at the time the study was undertaken
was prohibitive of obtaining a larger sample. The necessity
of controlling for a therapist-treatment interaction or
bias was obvious; assignment of each client to a different
therapist seemed crucial in order to control for this

possible contaminating effect. The number of observations

153

was thus limited to twelve, and this small sample size
would have required sizable differences for statistical
significance.

A second limitation of the study is the imprecision
of measurement. As discussed in Chapter II, certain prob~
1ems are inherent in the assessment of inter- and intra-
personal behavior. Attempts were made in this study to
circumvent some of these problems but the development of
adequate measurement techniques for human behavior remains
in initial stages. Research has shown that verbal behavior
rating scales can be reliable and valid measures of therapy
processes, but these need further refinement and specifica-
tion. The fact that one of the measures used dealt with
clients' behavior in real social situations (clients' peer
relationships) rather than only the therapy setting, sug-
gests relevance. Yet the reliability and validity of the
Peer Information Questionnaire in particular is certainly
questionable. A follow-up reliability study of the PIQ
results, in which a Hoyt (1967) two-way analysis of
variance technique was used, revealed a coefficient of .123.
On the basis of this reliability coefficient it can be
concluded that the peers so disagreed in their ratings of
their client-peers that the observation of differences
between the two treatment groups would have been impossible
to observe. Essentially, nothing was measured by the PIQ
in this study. Yet, the use of peer-informants seems a

logical and relevant way to measure real behavior change

154

in individuals undergoing therapy. More specific studies
of the effectiveness and appropriateness of this means of
measuring human behavior are needed and are continuing.
Specifically relevant to the above discussion is
the issue of whether any single criterion should be used
to assess individual behavior change as a result of thera-
peutic intervention. In the present study, both internal
and external criteria were used; an attempt was made to
measure change both in the therapy situation and outside
the therapy setting, in the clients' day-to-day relation-
ships with peers. The rationale for the use of these
multiple criteria stems from the concept of a directional,
progressive sequence of events which may be more valid
when considered in one direction but not necessarily when
viewed in the opposite sequence. If it is assumed that
counselor behavior, if appropriately acted out, will change
a client's behavior (therapist empathy, for example, being
conducive to self exploration by the client) in the therapy
situation, can it automatically be assumed that the clients'
behavior will also be changed outside of the therapy set-
ting? Further, can it therefore be assumed that if the
clients' behavior outside of therapy is changed, then that
change will be observed by others? Not necessarily, it
seems, especially when the possibility of change occurring
exclusively intraindividually is considered. Rather, a
reverse series of assumptions would appear to be more valid:

If an individuals' behavior is observed to have changed in

155

his everyday living and relationships, it probably has,

in fact, changed. If it has changed outside of the therapy
milieu it has likely changed in therapy also. And the
change is likely related in some way to the behaviors of

the therapist in his work with the client. In attempts to
assess real, observed behavior change in clients, therefore,
the use of external criteria seems crucial and relevant.

Another consideration specifically relevant to the
use of the Peer Information Questionnaire has to do with
the way in which peers were asked to judge the client-
peers. Asking peers to review and remember the clients'
behavior "over the past six weeks" may be less accurate and
more susceptible to inaccuracies and distortions than keep-
ing a daily observation log, for example, or informing the
peers prior to the start of the clients' treatment programs
that they will be asked to comment about the behavior of
their peer.

While the other instruments may also be criticized
for their general lack of sensitivity, an additional factor
may have compounded or accentuated the insensitivity of
two of these instruments. Composite scores were used for
the Characteristics of Client Growth Scales in that the
summed total of ratings on Owning of Feelings, Differentia-
tion of Stimuli and Commitment to Change for each client
was used. Similarly, only the Total scale of the Miskimins

Self-Goal-Other Discrepancy Scale, which incorporates all

factors into one score, was used as a criterion. The

156

decision to use the composite COGS score and only the MSGO
Total scale score may have resulted in less sensitivity to

subtle differences across clients or groups of clients.

Implications for Further Research

1. Because contradictory results have been obtained
from the two in-depth studies conducted to date on the
effectiveness of the affect simulation/IPR therapy program,
further investigation of the viability of the model for
therapeutic use is indicated. Further research concentrat-
ing on investigation of the differences between the previous
(Schauble, 1970) and the present study may reveal factors
which are important in determining the potency of the affect
simulation/IPR method in counseling and psychotherapy.

2. The necessity versus economy of videotape equip—
ment as an integral part of the therapy experience should
be carefully considered and evaluated. While clients report
that they benefitted from the videotape experience, objec-
tive assessment does not support the conclusions that
therapeutic benefits occur to clients with whom it is used.

3. Studies which investigate the effects of the
treatment model used here over longer periods of time should
be initiated. Attention should be focused on the impact of
a similar successively approximative treatment program on
client behavior over a longer period of time. Possibly a.
more extended therapy program would allow for the impact

of the films and/or videotape to be more fully realized.

157

4. The use of specific parts of the IPR/affect
simulation therapy model remains a possibility which
requires further investigation. Research in which various
stages (e.g., Video Recall of Affect Simulation, Client
Recall) of the model are applied individually would be
appropriate for determining the individual potency of
each stage for specific purposes in therapy.

5. In addition to evaluation of individual stages
as therapeutic tools, an assessment of various combinations
of stages in various sequences is necessary. That is, the
content and sequence of the therapy model should be fur-
ther scrutinized. It may be found that some parts of the
model should be enhanced or lengthened in order for the
treatment to have its maximum effect. The mutual recall
stage, for example, seems to be a particularly helpful
stage for clients, according to their reports, and may be
particularly suited to extension or emphasis in a therapy
program of the sort examined in this study.

6. The imposition of structure, particularly time
limits of the type imposed in this study, on clients and
therapists seems to deserve further investigation. Study
of the effects of moving to a new task or stage on a
scheduled basis rather than on a basis considerate of
individual differences and needs is required. Implications
for training therapists to use simulation and videotape
independently and without supervision or structure may also

be found in this type of investigation. With appropriate

158

training in the use and appropriateness of videotape and
simulation methodologies (the forty-hour training program
currently being given many counselors and paraprofessionals,
for example), therapists could use those which are most

capable of assisting their clients learn and grow.

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159

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Covner, B. J. The use of phonographic recordings in
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Covner, B. J. The completeness and accuracy of counseling
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Cowen, E. L. and Combs, A. W. Follow up study of 32 cases
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Cowden, E. L., Zax, M., Hague, J. R. and Tinney, R. C.
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Danish, S. J. and Kagan, N. Emotional simulation in coun-
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Goldberg, Alan David. A sequential program for supervision
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Grzegorek, A. E. A study of the effects of two types of
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164

Hathaway, 8. R. Some considerations relative to non-direc-
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Hays, William L. Statistics. New York: Holt, Rinehart and
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Heiserman, M. S. The effect of experiential-videotape
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1971.

Howard, K. I., Orlinsky, D. E. and Hill, J. A. The patient's
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Hoyt, Cyril J. Test reliability estimated by analysis of
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Kagan, N. Influencing Human Interaction. Instructional
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Kagan, N., Krathwohl, D. R., et al. Studies in Human
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Kagan, N., Krathwohl, D. R. and Miller, R. M. Stimulated
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Kagan, N., Schauble, P. G., Resnikoff, A., Danish, S. and
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Kell, B. L. and Borow, J. M. Developmental Counseling and
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Kell, B. L. and Mueller, W. J. Impact and Change: A Study
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165

Kersh, B. Y. Classroom simulation: Further studies on
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Levitt, B. E. The results of psychotherapy with children:
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Luborsky, L. Psychotherapy. Annual Review of Psycholpgy,
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Magoon, T. Innovations in counseling. Journal of Counsel-
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May, Rollo. Psychology and the human dilemma. Princeton,
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Miskimins, R. W. and Braucht, G. N. Description of the
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Moore, F. J., Chernell, E. and West, M. J. Television as

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Nielson, G. Studies in Self-Confrontation: Viewing a
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Schmeding, R. W. The use of playback in the counseling
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168

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169

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APPENDICES

170

APPENDIX A

SUBJECT CONSENT FORM

171

SUBJECT CONSENT FORM

MICHIGAN STATE UNIVERSITY East Lansing, Michigan 48823

 

Counseling Center Student Services Building

CONSENT FORM

I, , student number

, agree that the information obtained

 

during the course of my counseling and testing sessions may
be used for scientific purposes. This permission covers

the use of test results, counselor reports, video and/or
sound recordings, and behavior ratings given by the
individuals I have identified for that purpose. This per-
mission is given with the understanding that all information
will be treated in a professional manner and that adequate

safeguards will be taken to insure anonymity.

Signed

 

Date

 

Witness

 

172

APPENDIX B

STANDARD LETTERS OF EXPLANATION

TO STUDENT CLIENTS

173

STANDARD LETTERS OF EXPLANATION

TO STUDENT CLIENTS

MICHIGAN STATE UNIVERSITY East Lansing, Michigan 48823

 

Counseling Center

(1) April 10, 1972
Dear Student:

We at the Counseling Center believe that one of
the ways we have of becoming increasingly helpful to
students like yourself is through careful study of your
concerns and of our effectiveness in helping you with them.
We are presently in the process of evaluating the use of
videotape in counseling with students as a possible means
of facilitating "growth" in counseling. We would like you
to consider participating in this project.

As a participant, you will be assigned to a counselor
whose primary concern is helping you. You will be asked to
make a commitment to meeting for six weeks with your coun-
selor, for 1% hours per week (instead of one hour per ses-
sion). Portions of your counseling sessions would be
recorded on videotape and the additional time is needed to
allow you to view a playback of the videotape. You would
also be asked to complete some brief inventories after your
sixth session and provide us with the names of two individ-
uals whom you know and who are in a position to observe
your behavior over Spring Term. After you have had six
sessions with your counselor the two individuals you named
will be asked to respond to a brief checklist in which they
will indicate their perceptions of your behavior.

The research period will be for the next six weeks
of Spring Term. After this period you may continue on a
regular basis with your counselor if you both agree it is
appropriate.

In summary, your participation consists of: (1)
making a commitment to see your counselor 1% hours a week
,for at least six weeks, (2) supplying the names of two
peOple we may contact in regard to your behavior which
they may have observed, and (3) completing two brief
(about % hour) inventories after your sixth session.

174

175

We want to emphasize that your willingness to par-
ticipate in no way affects your seeing a counselor at the
Center and that all information will be used for scientific
purposes only, with adequate safeguards to insure anonymity.
Our most important consideration is to assist you with the
resolution of the concerns that stimulated you to seek our
help. We do want you to know, however, that through the
participation of students like yourself we are able to
improve our effectiveness.

Sincerely,

Robert Van Noord
Counseling Intern

Dr. Ralph Kron
Assistant Director for
Research

176

MICHIGAN STATE UNIVERSITY East Lansing, Michigan 48823

 

Counseling Center

(2) April 10, 1972

Dear Student:

We at the Counseling Center believe that one of the
ways we have of becoming increasingly helpful to students
like yourself is through careful study of your concerns and
our effectiveness in helping you with them. We are pre-
sently in the process of evaluating the use of a different
approach consisting of longer contact sessions with students
as a possible means of facilitating "growth" in counseling.
We would like you to consider participating.

As a participant, you will be assigned to a coun-
selor whose primary concern is helping you. You will be
asked to make a commitment to meeting for six weeks with
your counselor, for 1% hours per week (instead of one hour
per session). Your counseling sessions would be recorded
on audiotape and you will be asked to complete some brief
inventories after your first six sessions. We will also
ask you for the names and addresses of two individuals
whom you know and who are in a position to observe your
behavior over Spring Term. After you have had six sessions
with your counselor the two individuals you named will be
asked to respond to a brief checklist on which they will
indicate their perceptions of your behavior.

The research period will be for the next six weeks
of Spring Term. After this period you may continue on a
regular basis with your counselor if you both agree it is
appropriate.

In summary, your participation consists of: (1)
making a commitment to see your counselor 1% hours a week
for at least six weeks, (2) supplying the names and
addresses of two people we may contact in regard to your
behavior which they have observed, and (3) completing two
brief (about 8 hour) inventories after your sixth session.

177

We want to emphasize that your willingness to
participate in no way affects your seeing a counselor at
the Center and that all information is used for scientific
purposes only, with adequate safeguards to insure anony-
mith. Our most important consideration is to assist you
with the resolution of the concerns that stimulated you to
seek our help. We do want you to know however, that
through the participation of students like yourself we are
able to improve our effectiveness.

Sincerely,

Robert W. Van Noord
Counseling Intern

Dr. Ralph Kron
Assistant Director for
Research

APPENDIX C

MEMOS TO COUNSELORS REGARDING PARTICIPATION

178

MEMOS TO COUNSELORS REGARDING PARTICIPATION

To: Senior Staff and Interns
From: Bob Van Noord
Subj: Participation in Research Project

Date: March 27, 1972

I'm planning to run some dissertation research during
Spring term, preferably here at the Student Services Branch,
but possibly at the Fee Branch Center as well.

I'd be interested in knowing if any of you who will
be picking up new P-S clients early Spring Term from the
waiting list would be willing to spend an extra half-hour
per week with one new client, at least audiotaping your
sessions, and possibly videotaping them and using some
Interpersonal Process Recall techniques in them, within the
context of the concern that a particular client has presented.

That is, I'm asking for a half-hour of your time per
week for six weeks during Spring Term, in addition to the
usual hour that is typically spent in a continuation of your
regular session with the client or in examination of some of
the dynamics of the relationship between you and your client.

If you think you might be able to spring loose some
time for this, and would be interested, would you please
check the appropriate places below and return this to my
box by the end of the week? As an after thought, please
check the appropriate place(s) and return in either case.
Thanks.

I will be picking up one or more new clients.

 

I'm willing to participate

 

I'm unwilling or unable to participate.

 

Name

 

Note: If this isn't clear or if you have some questions,
please feel free to stop by and ask.

179

180

To: Practicum Students
From: Bob Van Noord
Subj: Participation in Research Project

Date: March 27, 1972

I'm planning to run Some dissertation research during
Spring term here at the Student Services Branch of the
Center.

I'd be interested in knowing if any of you who will
be picking up new P-S clients early Spring Term would be
willing to spend an extra half-hour per week with one new
client, at least audiotaping your sessions and possibly
videotaping them and using some Interpersonal Process Recall
techniques in them, within the context of the concern that a
particular client has presented.

That is, I'm asking for a half-hour of your time per
week for six weeks during Spring Term, in addition to the
usual hour that is typically spent per week with most clients.
The additional half-hour will be spent in a continuation of
your regular session with the client or in examination of
some of the dynamics of the relationship between you and your
client.

If you think you might be able to spring loose some
time for this, and would be interested, would you please check
the appropriate places below and return this to Nancy Bossen-
broek? As an afterthought, please check the appropriate
place(s) and return it to her in either case. Thanks.

I will be picking up one or more new clients.

 

I'm willing to participate.

 

I'm unwilling or unable to participate.

 

Name

 

Note: If this isn't clear or if you have some questions,
please feel free to stOp by and ask.

APPENDIX D

THERAPY SESSION REPORT ITEMS

181

182

THERAPY SESSION REPORT ITEMS*

This booklet contains four questions about the ther-
apy sessions which yOu have just completed. These questions
have been designed to make the description of your experi-
ences in the session simple and quick.

The questions have a series of numbered statements
under them. You should read each of these statements and
select the ana which comes closest to describing your
answer to that question. Then circle the number in front
of your answer.

BE SURE TO ANSWER EACH QUESTION

Client Code

 

Date

 

*These items were selected from the Therapy Session
Report, Copyright by Psychotherapy Session Project, 1966.
All property rights reserved by the Psychotherapy Session
Project, 907 South Walcott Avenue, Chicago, Illinois, U.S.A.

183

Therapy Session Report Items

In general, how do you feel about the previous six
sessions which you have just completed?

1. Very poor

2. Pretty poor

3. Fair

4. Pretty good

5. Very good

6. Excellent

7. Perfect

How much proqress do you feel you made in dealing with
your problems over these six sessions?
1. In some ways my problems seem to have gotten worse.

2. Didn't get anywhere over the period of the six
sessions.

3. Some progress.
4. Moderate progress.
5. Considerable progress.

6. A great deal of progress.

184

How well did your therapist seem to understand what
you were feeling and thinking during your session?

1. Misunderstood how I thought and felt.

2. Didn't understand too well how I thought and felt.

3. Understood pretty well, but there were some things
he (she) didn't seem to grasp.

4. Understood very well how I thought and felt.

5. Understood exactly how I thought and felt.

How helpful do you feel your therapist was to you
during your sessions?

1. Not at all helpful.

2. Slightly helpful.

3. Somewhat helpful.

4. Pretty helpful.

5. Very helpful.

6. Completely helpful.

APPENDIX E

PEER DATA FORM

185

PEER DATA FORM

Names of people whom we may contact in about six weeks:

Name

 

Address

 

Telephone

 

Name

 

Address

 

Telephone

 

*Name

 

Address

 

Telephone

 

*If you are doubtful as to the availability or willingness
of one of the above, please give us an alternate. It is
important to receive responses from two individuals.

Again, we thank you for your cooperation!

186

APPENDIX F

SAMPLE QUESTIONS FOR USE WITH AFFECT

SIMULATION FILMS

187

SAMPLE QUESTIONS FOR USE WITH AFFECT

SIMULATION FILMS

1. Focus on what the actor/actress is communicating.

What was he/she saying?

What was he thinking?

What was he feeling?

. Can you separate the content of what he was
saying (the actual words) from the meaning
(intent or feeling) behind what he was saying?

COED?”

2. Focus on how the client reacted.

A. What kind of reaction did you Lava?
B. What were you thinking?

C. If there was more than one fgtling 01 moticn
aroused in you can you sort them ou:, i.e.,
recognize, identify, and 1;Lcl the Ta;ling?

D. Can you tell where the feeling was Coming from,
i.e., identify the source?
E. How would you respond to that person?

The first session in which affect simulation is used
will probably make use more of the types of questions
found under 1 above. The second session in which affect
simulation is used (i.e., Session 3) should be spent
more in getting into the client's reactions to the films;
consequently, the type of questions found under 2 above
would be in reviewing the videotape of the client as he
was watching the films.

188

APPENDIX G

WEEK-BY-WEEK MEMOS REGARDING PROCEDURES

FOR GROUP A COUNSELOMS

189

WEEK-BY-WEEK MEMOS REGARDING PROCEDURES

FOR GROUP A COUNSELORS

To: Group A Counselors
From: Bob Van Noord
Subj: Procedures

Date: April 14, 1972

The following is an outline of tee SOQJIHCQ of events
for the next six weeks as you're seeing your client within
my research project. You will be meeting your client for
six weeks, for 1% hours a session. l‘d like you to audio-
tape your first and last sessions and I'll previde the
materials for this.

Session 1 (Week 1)
A 90 minute seSSion with the cl; 2t whtck is audiotaped

Session 2 (Week 2)

a) a 30 minute counseling session with the client

b) a 40 minute session in which simulation vignettes
will be shown to the client and counselor will use
films as focal point for discuSSion of client
reactions to the filmed stimuli.

c) a 20 minute counseling interview conducted without
the use of film or videotape.

Session 3 (Week 3)

a) a 30 minute counseling session with the client

b) a 40 minute session in which affect simulation films
will be shown to the client, videotape of client
will be made as he watches and tape replayed for
client and counselor to use in discussion of client
reactions to the filmed vignettes. In this session,
the counselor focueses more on assisting the client
in exploration of his own behavior.

c) a 20 minute session conducted without the use of
films or videotape.

Session 4 (Week 4)
a) a 30 minute counseling interview which is videotaped
b) 40 minutes for a client recall of the videotape of
the first 30 minute session. A trained "inquirer"
will assist the client in this process while the
counselor listens and observes through a one way
mirror.

190

191

c) a 20 minute counseling interview conducted without
videotaping.

Session 5 (Week 5)
a) a 30 minute counseling interview which is videotaped
(same as week 4)
b) a 40 minute client recall of videotape made of first
30 minutes (same as week 4)

c) a 20 minute counseling interview conducted without
videotape.

Session 6 (Week 6)
a) a 30 minute counseling session with the client
which will be videotaped.
b) a 40 minute client ang counselor recall (review of
videotape of the first 30 minutes). A trained
"inquirer" will enter and assist in this process.

c) a 20 minute counseling interview conducted without
the use of videotape or IPR.

Your clients will be taking two inventories follow-
ing their 6th session in the testing office. Your work
with them after this 6th session, if you continue, would
be on a regular basis.

This is intended only to provide an overview for

you. I'll be getting more details to you week by week.
Thanks!

192
Session 2

Hopefully, in Session 1 you have had a chance to
establish a beginning relationship with your client and in
some ways define the parameters of his concern. Possibly
you have already formulated some notions about how you
would like to proceed with that client--what his needs,
desires, defenses might be and how you would like to con-
sider these. '

The essential purpose of the use of affect simulation
films in Session 2 is to assist the client in getting more
in touch with his affective domain--how he perceives inter-
personal threat, for example, how he hears it, and how he
reacts to it. While your client may already have some
realization of what is "fair game" to talk about with you,
and some awareness that talking about feelings and emotions
is all right and appropriate, the films are intended to
help him experience these feelings. In a sense, the films
legitimize, stimulate and define your willingness to deal
with affect in depth as well. They are also an initial
step in a successively approximative process of bringing the
client from a position of relative threat, from his percep-
tion, namely, dealing face-to-face with you and himself
about his immediate, in-therapy reactions and emotions, to
a point where he is able to do this without perceiving it
as a major threat to himself.

 

Over the course of the six sessions, using the films
and videotape as aids, the client will be brought through a
gradual process of approaching and dealing with himself and
you--the result being an ability to deal immediately and
honestly with oneself and others. The use of affect simula-
tion films is one of the initial steps in this process.

This may all be clearer if it is pointed out that in
the process of viewing the films and reacting and talking
about his reactions to them, the client has begun the pro-
cess of self-exploration and examination, but is doing so
from a position of relative interpersonal safety. While
he has been asked to imagine himself in a situation with the
person on film, the client still knows that the filmed other
is on film, and is not a real person. Out of this position,
he can begin to look at his feelings and reactions without
having to be responsible for their impact or consequences.
Session 3 will also assist in this process and will include
the use of videotape in the client's examination of himself.
Session 2, however, will not make use of videotape replay.

193

In Session 2, please use the first 30 minutes to
conduct a regular session with your client. After 30
minutes, move into using the films for the next 40 minutes
with the client. You may want to view a vignette, then
stop and talk about your client's reactions to the stimulus
situation, using the type of questions found on the
attached sheet entitled "Sample Question for Use with Affect
Simulation Films." Please take your time in using the films.
Try not to rush through the vignettes and do not hurry the
process of discussing reactions to them. Typically, only a
few vignettes stimulate as much or more than an hour of
reactive discussion. Allow the client to tell you about his
reactions and internal experiences in his own words.

After spending 40 minutes with the films and exami-
nation of client reactions to them, return to your regular
counseling session for the last 20 minutes.

194

Session 3

Session 3 will be conducted in essentially the same
way as was Session 2, except that the use of videotape will
be added. The intent of both sessions is the same: to
provide an entry into the client's examination of himself,
particularly his affective domain.

The first 30 minutes of your 1 and H hour session
will be spent as a regular counseling interview, without
the use of films or videotape. After these 30 minutes,
please move into using the films once again with the client.
Have the client view 5 vignettes in sequence, with no
interruptions for discussion between them. At this point,
the use of the stimulus films is over, except for the dis-
cussion and examination of client reactions. The resulting
videotape will then be used as the focal point for the
remainder of the 40 minute time segment allotted to this.
The videotape which you will be viewing with your client
will contain an image of him or her accompanied by the
audio of the stimulus vignette.

As the client views himself on the videotape, he
will be able to recall the feelings and reactions he was
having at the time of his watching the actor on film.
Assist him in exploring these feelings by using the type
of questioning contained on the attached sheet entitled
"Sample Questions for Use with Affect Simulation Films."
Allow the client to tell you about his experience in his
own words. At times you may want to help him get clearer
about what he is saying to you--go ahead. Feel free to
probe deeper, when appropriate, if you have some hunch
or lead you may want to follow up on, doing so within
the perspective of the client as the chief explorer. The
overall intent is to allow the client to self-discover,
to arrive at his own insights about himself, with you and
the videotape as helpers to him.

It is very possible that you will not have time to
review the entire videotape made of the client as he was
watching the film because of the time taken in discussion
and exploration. No problem. Please don't rush through
the review of client reactions to the vignettes. If you
only cover his reactions to one vignette, fine. If more,
that's fine too.

After these 40 minutes have elapsed, please return to
a regular counseling session for the remaining 20 minutes.

195

Session 4

The fourth session with the client whom you are
seeing as part of this project will make use of a third
person, called an "inquirer" who will assist your client
in a review of videotape in your counseling session while
you observe from another room via a television monitor.
The 90 minute session will be spent as follows: For the
first 30 minutes, you and the client will conduct a
counseling session which will be videotaped. At the
conclusion of this 30 minute session, you will leave the
room, the inquirer will enter and after explaining the
reasoning behind this process and instructing the client,
will conduct a recall session with the client for the next
40 minutes. During this time, the inquirer will assist
the client in exploring and examining himself and his
reactions and feelings as they operated and occurred in
the just completed counseling session. You will be able
to see and hear this process in the adjoining room on a
television monitor.

This next step is intended to assist the client in
looking closer at himself as his relationship with you.
While he will be aware that you are observing and hearing
what he is saying, he is not yet dealing with your rela-
tionship face-to-face with you. In a sense, this brings
him a step closer to dealing with his feelings in an
immediate way, but he does not have to explain them or
account for thim to you as yet.

Following the 40 minute recall, you will rejoint your
client and continue for another 20 minutes without being
videotaped.

To summarize, the 90 minute session, then, will be
carried out as follows:

1. A 30 minute counseling session which is
videotaped.

2. A 40 minute client recall by a third-person
inquirer.

3. A 20 minute counseling session without the
use of videotape.

196

To: Group A Counselors
From: Bob Van Noord
Subj: Procedures for Session 5

Date: May 22, 1972

Session 5 will be conducted in the same way as was
Session 4 last week.

You will meet with your client for an initial 30
minute counseling session which will be videotaped. Follow-
ing this 30 minute session, an inquirer will enter and
conduct a 40 minute recall session with the client, which
you will observe and hear via a TV monitor in the adjoining
room. After the recall session, you will again enter the
counseling room and continue with the client for another 20
minutes without being recorded. The sequence, then, for
the 90 minute period:

a. 30 minute counseling session--videotaped
b. 40 minute client recall

c. 20 minute counseling session

197

To: Group A Counselors
From: Bob Van Noord
Subj: Procedures for Session 6

Date: May 22, 1972

Session 6 will make use of a mutual recall process,
wherein both you and your client will review the videotape
of your counseling session with the help of a trained
Inquirer. The outline for the 90 minutes is as follows.

You and your client will meet together for a 30
minute counseling session which will be videotaped.
Following this session, an Inquirer will join the two of
you and conduct a mutual recall, assisting both of you
in recalling the events, thoughts and feelings occurring
during the previously recorded interaction. After 40
minutes of recall (possibly less), the Inquirer will
leave the two of you to continue a dyadic interaction.
The sequence for the 90 minute session:

a. 30 minute counseling session-~videotaped
b. 40 minute mutual recall
c. 20 minute counseling interaction

When Session 6 is finished, I'd like you to have
your client go to the Testing Office for a brief (8 hour)
battery of inventories. If they are not able to take these
immediately after Session 6, please have them come in within
the next few days following for this. It is only necessary
that they give their name to the person in the office. The
girls there know which inventories the clients will be
taking. When this is completed, the research aspects of
your meetings with your client are finished. Further meet-
ings, if arranged by the two of you would be on a regular
basis, unless you've made other arrangements.

Thanks much for your cooperation and assistance!

APPENDIX H

PROCEDURAL MEMOS FOR GROUP B CLIENTS

198

PROCEDURAL MEMOS FOR GROUP B CLIENTS

To: Group B Counselors
From: Bob Van Noord
Subj: Procedures for Research Client

Date: April 14, 1972

This is to clarify the procedures regarding your work
with the client that you're seeing as part of my research
project this term. I'd like you to meet with that client
for an hour and a half weekly, rather than an hour session,
and audiotape your first and sixth session with that client.

After the sixth session, the client will go to the
testing office and take a couple of inventories which should
require no more than about a half-hour.

It's important that your first and sixth sessions be
audiotaped. I'll get 1800 foot tapes to you Before your
sessions--they should go for 18 hours and 3 3/4 IPS. Again,
Thanks!

199

200

To: Group B Counselors
From: Bob Van Noord
Subj: Procedures for Session 6

Date: May 22, 1972

I will get an audiotape to you prior to your sixth
meeting with the client whom you're seeing as part of my
research project. Please record this sixth session on the
side of the tape which is indicated for Session 6 on the
leader of the tape (ready to use as you get it), and return
the tape to me as soon as possible.

Following your sixth session, your client will take
a brief (about one-half hour) battery of inventories. If
the client has time to take these right after your session,
please escort him/her to the testing office for this. If
not, he/she should take them within a few days after your
sixth session--at least before any subsequent sessions if
you are continuing to meet.

Any further meetings between the two of you, if
planned, will be on the regular basis, unless the two of
you have made other arrangements.

Thanks very much for your aSSistance and cooperation!

APPENDIX I

CHARACTERISTICS OF CLIENT GROWTH SCALES

201

CHARACTERISTICS OF CLIENT GROWTH SCALES

Owning of Feelings in Interpersonal
Processes: A Scale for Measurement

Level 1

The client avoids accepting any of his feelings. When feel-
ings are expressed, they are always seen as belonging to
others, or entirely situational and outside of himself.

Example: The client avoids identifying or admitting to any
feelings by either remaining silent or denying he feels any-
thing at all.

In summary, the client seems to believe he is not a part of
the world of feelings.

Level 2

The client may express feelings vaguely, but they are not
really accepted as coming from within. Feelings are not
tied to himself or to specific interactions but seem to
pervade his life. In general he shows little involvement
with his feelings.

Example: The client discusses or intellectualizes about
feeling in a detached, abstract manner and gives little
evidence of knowing the origin of his feeling.

In summary, any expression of feeling appears intellec-
tualized, distant and vague.

Level 3

The client can usually identify his specific feelings and
their source but tends to express what he feels in an
intellectualized manner.

Example: The client seems to have an intellectual grasp of
his feelings and their origin but has little emotional
proximity to them.

In summary, the client usually ties down and owns his feel-

ings in an intellectual manner. Level 3 constitutes the
minimum level for gain.

202

203

Level 4

The client almost always acknowledges his feelings and can
express them with emotional proximity but at times he has
difficulty in connecting the feelings to their source.

Example: The client shows immediate and free access to his
feelings but has some difficulty in understanding these
feelings or their connection to people or concerns in his
life. ' '

In summary, the client owns his feelings fully but seems to
have some difficulty in linking them to specific things in
his life.

Level 5

The client clearly embraces his feelings with emotional
proximity, and at the same time shows awareness that his

feelings are tied to specific behaviors of his own and
others.

Example: The client is completely in tune with his feelings,
expresses them in a genuine way, and is able to identify
their origin.

In summary, the client clearly owns his feelings and
accurately specifies their source.

204

Commitment to Change in Interpersonal
Processes: A Scale for Measurement

Level 1

The client shows no motivation for change. He is resistive
to attempts by the second person to accomplish change or
explore the desirability of change. This may take either
the form of complete passivity or defensive hostile behavior.

Example: The client may question the efficacy of the helping
process and the helpfulness of the second person to an
inappropriate degree, i.e., he seems to be attacking the
change process, or he is totally unreceptive and unc00pera-
tive to the efforts of the second person.

In summary, the client gives no verbal or behavioral evidence
of a desire to change.

Level 2

While the client expresses the desire to change, his commit-
ment is noticeably questionable. The client seems to resist
the impact of the helping process, and is passive or evasive
in his interaction with the second person.

Example: The client seems more involved in rationalizing or
defending his behavior than he is in working on changing it.
He may communicate the importance or necessity of change,
but there is little behavioral evidence of cooperation or
real commitment to the change process.

In summary, there is some verbal commitment to change but no
behavioral evidence of that commitment.

Level 3

The client vacillates between an overt desire and/or commit-
ment to change, and the desire to resist or evade change in
order to avoid pain. He may express the desire to change
and attempt to confront his feelings but varies in his
maintenance of motivation to change.

Example: The first person deals with the feelings which
are centrally involved with his problem, but there is some
tendency to rationalize his behavior or move from topic to
topic.

In summary, the client expresses the desire to change, but
vacillates his commitment to change and cooperation with
the second person. Level 3 is the minimal level for change
to take place.

205

Level 4

The client expresses a desire to change, and while at times
is reluctant to experience painful feelings involved in
exploring his behavior, actively tries to c00perate with
rather than resist the second person's efforts.

Example: The client continually returns to the task of
understanding his behavior and his role in it, although he
experiences (and may overtly express) hesitancy in dealing
with his painful feelings.

In summary, the client wants to change, and he cooperates
with the change process in a verbal and behavioral manner.

Level 5

The client expresses a clear desire to change. He actively
cooperates with the second person in the counseling process,
even to the point of accepting painful feelings accompanying
the exploration of his problem. The client is deeply
involved in confronting his problems directly, and makes no
attempt to evade or resist the experiencing of feelings and
behaviors.

Example: The client pursues the exploration of his feelings
and behavior, attempting to gain a better understanding of
his behavior in order to change. He faces his problem
directly rather than avoiding it or changing the subject.

In summary, the client clearly expresses verbally and
behaviorally a desire and commitment to change his behavior.

206

Differentiation of Stimuli in Interpersonal
Processes: A Scale for Measurement

Level 1

The client seems unable to identify or differentiate his
problems, feelings, or concerns and is unwilling or unable
to move in this direction.

Example: The client may show either no grasp of his feel-
ings or problems or he seems to respond to everything in
very much the same way.

In summary, the client seems totally unable or unwilling to
make discriminations between his feelings or the peOple and
events in his life.

Level 2

The client may talk about different feelings and problems
but he shows little grasp of real differences among them
or of their effect on him as an individual.

Example: The client may respond in a rehearsed manner to
people and events as if his reactions were pre-determined
by stereotyped expectations.

In summary, the client seems to differentiate between his
feelings, people, or events at only a superficial level.

Level 3

The client vacillates between discussing different stimuli
and their effect on him (as a unique person) and responding
in a general unclear fashion.

Example: The client may initially make clear differentiations
about his world, but he is unable to productively maintain
this behavior and lapses into hazy generalizations which do
not seem to have immediate meaning to him.

In summary, the client clearly differentiates between dis-
crete stimuli, but is unable to develOp his perceptions or
use them effectively. Level 3 constitutes the minimal
level of differentiation for growth.

Level 4

The client is almost always aware of the differences between
stimuli in his world, and he responds to them in a

207

differential manner. He actively attempts to become more
aware of his various emotions and their sources.

Example: The first person may show a strong desire to
understand himself as a unique and complex person and he
attempts to differentiate and identify the distinct people
and events in his world.

In summary, the first person is actively involved in a
successive differentiation of his feelings and events in
his world.

Level 5

The client always perceives the different stimuli in his
world and reacts to them in a variety of differential ways.
He is fully aware of his own unique effect on the discrete
stimuli around him.

Example: The client may clearly differentiate among his
characteristics and those of others. He shows immediate
awareness of his own unique characteristics, and the
reactions he stimulates in others.

In summary, the first person recognizes individuality in
himself and in others, and responds in an appropriate
manner.

APPENDIX J

DEGREE OF SELF EXPLORATION SCALE

208

DEGREE OF SELF EXPLORATION SCALE

Helpee Self-Exploration in Interpersonal
Processes: A Scale for Measurement1

Level 1

The second person does not discuss personally relevant
material, either because he has had no opportunity to do
such or because he is actively evading the discussion even
when it is introduced by the first person.

Example: The second person avoids any self-descriptions or
self-exploration or direct expression of feelings that would
lead him to reveal himself to the first person.

In summary, for a variety of possible reasons the second
person does not give any evidence of self-exploration.

Level 2

The second person responds with discussion to the introduc-
tion of personally relevant material by the first person
but does so in a mechanical manner and without the demon-
stration of emotional feelings.

Example: The second person simply discrsses the material
without exploring the significance or the meaning of the
material or attempting further exploration of that feeling
in an effort to uncover related feelings or material.

In summary, the second person responds mechanically and
remotely to the introduction of personally relevant
material by the first person.

 

1This scale is derived in part from "The Measurement
of Depth of Intrapersonal Exploration" (Truax & Carkhuff,
1967), which has been validated in extensive process and
outcome research on counseling and psychotherapy (Carkhuff,
1963; Carkhuff & Berenson, 1967; Truax & Carkhuff, 1967,
1963, 1964, 1965). In addition, similar measures of
similar constructs have received extensive support in the
literature of counseling and therapy. The present scale
represents a systematic attempt to reduce ambiguity and
increase relability. In the process, many important
delineations and additions have been made. For comparative,

209

210

Level 3

The second person voluntarily introduces discussions of
personally relevant material but does so in a mechanical
manner and without the demonstration of emotional feeling.

Example: The emotional remoteness and mechanical manner
of the discussion give the discussion a quality of being
rehearsed. ‘

In summary, the second person introduces personally rele-
vant material but does so without spontaneity or emotional
proximity and without an inward probing to discover new
feelings and experiences.

Level 4

The second person voluntarily introduces discussions of
personally relevant material with both spontaneity and
emotional proximity.

Example: The voice quality and other characteristics of
the second person are very much "with" the feelings and
other personal materials that are being verbalized.

In summary, the second person introduces personally rele-
vant discussions with spontaneity and emotional proximity
but without a distinct tendency toward inward probing to
discover new feelings and experiences.

Level 5

The second person actively and spontaneously engages in an
inward probing to discover new feelings and experiences
about himself and his world.

Example: The second person is searching to discover new
feelings concerning himself and his world even though at
the moment he may perhaps be doing so fearfully and
tentatively.

In summary, the second person is fully and actively focus-
ing upon himself and exploring himself and his world.

 

purposes, level 1 of the present scale is approximately
equal to stage 1 of the earlier scale. The remaining
levels are approximately correspondent: level 2 and
stages 2 and 3; level 3 and stages 4 and 5; level 4 and
stage 6; level 5 and stages 7, 8, and 9.

APPENDIX K

MISKIMINS SELF-GOAL-OTHER DISCREPANCY SCALE
HAND SCORING SUMMARY SHEET AND

PROFILE SUMMARY

211

212

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EXAMINER USE ONLY
MSGO DISCREPANCY SCALE
HAND SCORING SUMMARY SHEET Exomlner
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All RIGHTS RESERVED 0 COPYRIGHT I967 BY R. W. MISKIMINS

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APPENDIX L

COVER LETTER TO PEER-INFORMANTS

214

COVER LETTER TO PEER-INFORMANTS

Room 207
Student Services Building
Michigan State University

Dear

Your name was given to us several weeks ago by
who has been a participant this past term in a social
science research project on campus.
believed you would be willing to cooperate by responding
to the items on the enclosed form. The form is being
sent to you by mail so that you have a chance to look it
over. A person will be calling you by telephone sometime
in the next week in order to obtain your responses. We
will be making every effort to get in touch with you;
however, in the event that for some reason we are unable
to reach you, we would like to ask that you contact us
before you leave the area for the summer. Someone can
be reached at 355-0722 (on campus) or 351-9428 (off
campus).

Your responses will be kept confidential and used
for research purposes only. will not
see your responses nor will he/she know how you marked
them unless you choose to discuss it with him/her.

Quite frankly, the number of subjects in this
project is relatively few, which makes every response
vital to its success. We will be in touch with you
by telephone shortly. Thank you for your cooperation!

Sincerely,

Robert W. Van Noord
and

Dr. Bill L. Kell,
Research Sponsor

215

APPENDIX M

RESPONSE SHEET FOR PEER INFORMATION

QUESTIONNAIRE

216

10.
ll.
12.
l3.
14.

15.

16.

RESPONSE SHEET FOR PEER INFORMATION

QUESTIONNAIRE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

217

Client Code

APPENDIX N

THE PEER INFORMATION QUESTIONNAIRE

218

THE PEER INFORMATION QUESTIONNAIRE

On the attached form are a number of statements that
can describe a person's behavior. Many of them focus on
how a person may act or feel toward others, some may not
directly involve others.

Consider the changes in the behavior of
over the past six weeks. Your best reference of course is
his/her behavior in relation to you, but this need not be
your only consideration. When you are contacted by tele-
phone, you will be asked to respond to each statement using
the scale 1-6 as indicated.

 

When you are called, please indicate your reSponse
by using the number which best represents your response to
each statement.

1. I strongly feel that it is not true.

2. I feel that it is not true.

3. I feel that it is probably not true, or more
untrue than true.

4. I feel that it is probably true, or more true
than untrue.

5. I feel that it is true.

6. I strongly feel that it is true.

It is important that your responses to these items
be obtained before you leave for the summer. If you do
not hear from us because we haven't been able to reach you,

would you please call as indicated in the enclosed letter?

355-0722 (on campus)
351-9428 (off campus)

Again, thanks very much for your cooperation!

219

220

 

 

l. Strongly feel it is not true.
2. Feel it is not true.
3. Probably not true, or more untrue than true.
4. Probably true, or more true than untrue.
5. Feel it is true.
6. Strongly feel it is true.
1. I believe he/she has feelings he/she does not tell me
about, that are causing difficulty in our relationship.
2. He/she willing to express his/her feelings about
himself/herself to me.
3. He/she is willing to express his/her feelings about me
to me.
4. He/she seems to be in the process of changing or trying
to change.
5. He/she gets along better with members of the opposite
sex lately. I
6. He/she gets along better with members of the same sex
lately.
7. He/she worries less now than he/she used to.
8. He/she perceives the different stimuli in his/her
experiences and reacts to them in different ways.
9. He/she engages in more introspection and self exploration.
10. When he's/she's working (e.g., schoolwork), he/she is
more involved.
11. When he's/she's at play (e.g., sports, leisure time
activities), he/she is more involved.
12. I like him/her better than I used to.
13. I respect him/her more.
14. He/she respects himself/herself more.
15. I think the directions in which he/she is changing, or
trying to change, are for the better for him/her.
16. I consider myself in as good a position to make the

above responses as most of his/her other acquaintances.

 

APPENDIX O

CLIENT WRITTEN COMMENTS SHEET

221

CLIENT WRITTEN COMMENTS SHEET

Comments

Sometimes multiple-choice inventories don't provide
an opportunity to express opinions or comments in exactly
the way that a person would like to express them. Please
feel free to use this space to indicate any impressions,
reactions, or opinions you may have had to the six week
project which you have completed. Your comments are
welcome.

Any further meetings with your counselor, if planned
by the two of you, will be on the one hour per week basis,
unless other arrangements have been made between you and
your counselor.

Your coOperation and participation in this project
is very much appreciated. Thank you!

222

APPENDIX P

THE EMPATHIC UNDERSTANDING SCALE

223

THE EMPATHIC UNDERSTANDING SCALE

Scale 1

Empathic Understanding in_Interpersonal
Processes. II

A Scale for Measurement1

Robert R. Carkhuff

Level 1

The verbal and behavioral expressions of the first person
either do not attend to or detract significantly from the
verbal and behavioral expressions of the second person(s)
in that they communicate significantly less of the second
person's feelings than the second person has communicated
himself.

Examples: The first person communicates no awareness of
even the most obvious, expressed surface
feelings of the second person. The first
person may be bored or disinterested or simply
Operating from a preconceived frame of refer-
ence which totally excludes that of the other
person(s).

In summary, the first person does everything but express

that he is listening, understanding or being sensitive to

even the feelings of the other person in such a way as to
detract significantly from the communications of the
second person.

 

f

 

_ .— -

1The present scale ”Empathic understanding in
interpersonal procesSes" has been derived in part from "A
Scale for the measurement of accurate empathy" by C. B.
Truax which has been validated in extensive process and
outcome research on counseling and psychotherapy (sum-
marized in Truax and Carkhuff, 1967) and in part from an
earlier version which has been validated in extensive pro-
cess and outcome research on counseling and psychotherapy
(summarized in Carkhuff and Berenson, 1967). In addition,
similar measures of similar constructs have received
extensive support in the literature of counseling and
therapy and education. The present scale was written to
apply to all interpersonal processes and represent a
systematic attempt to reduce the ambiguity and increase

224

225

Scale l--p. 2
(Rev. 7/67b)

Level 2

While the first person responds to the expressed feelings
of the second person(s), he does so in such a way that he
subtracts noticeable affect from the communications of the
second person. '

Examples: The first person may communicate some awareness
of obvious surface feelings of the second per-
son but his communications drain off a level of
the affect and distort the level of meaning.

The first person may communicate his own ideas
of what may be going on but these are not con-
gruent with the expressions of the second person.

In summary, the first person tends to respond to other than

what the second person is expressing or indicating.

Level 3

The expressions of the first person in response to the
expressed feelings of the second person(s) are essentially
interchangeable with those of the second person in that
they express essentially the same affect and meaning.
Examples: The first person responds with accurate under-
standing of the surface feelings of the second
person but may not respond to or may misinter-
pret the deeper feelings.
The summary, the first person is responding so as to
neither subtract from nor add to the expressions of the
second person; but he does not respond accurately to how
that person really feels beneath the surface feelings.
Level 3 constitutes the minimal level of facilitative
interpersonal functioning.

 

the reliability of the scale. In the process many impor-
tant delineations and additions have been made, including
in particular the change to a systematic focus upon the
additive, subtractive or interchangeable aspects of the
levels of communication of understanding. For comparative
purposes. Level 1 of the present scale is approximately
equal to Stage 1 of the Truax scale. The remaining
levels.are approximately correspondent: Level 2 and
Stages 2 and 3 of the earlier version; Level 3 and Stages
4 and 5; Level 4 and Stages 6 and 7; Level 5 and Stages

8 and 9. The levels of the present scale are approximately
equal to the levels of the earlier version of this scale.

226

Scale l--p. 3
(Rev. 7/67b)

Level 4

The responses of the first person add noticeably to the
expressions of the second person(s) in such a way as to
express feelings a level deeper than the second person
was able to express himself.

Examples: The facilitator communicates his understanding
of the expressions of the second person at a
level deeper than they were expressed, and
thus enables the second person to experience
and/or express feelings which he was unable
to express previously.

In summary, the facilitator's responses add deeper feeling

and meaning to the expressions of the second person.

 

Level 5

The first person's responses add significantly_to the feeling
and meaning of the expressions of the second person(s) in ’
such a way as to (l) accurately express feelings levels
below what the person himself was able to express or (2) in
the event of ongoing deep self-exploration on the second
person's part to be fully with him in his deepest moments.
Examples: The facilitator responds with accuracy to all
of the person's deeper as well as surface
feelings. He is "together" with the second
person or "tuned in" on his wavelength. The
facilitator and the other person might proceed
together to explore previously unexplored areas
of human existence.
In summary, the facilitator is responding with a full aware-
ness of who the other person is and a comprehensive and
accurate empathic understanding of his most deep feelings.