THE EFFECTS OF COGNITIVE INFORMATIQN AND SUPERVISED PRACTICE upon THE: Acqmsmon 0751.5}; 2i}; CRISIS INTERVENTION SKILLS - ‘mssertatian for the Degreesfar Ph. D. MICHIGAN STATE UNIVERSITY- MICHAEL} BROWN 1974 . ‘ j . tatc thl‘l. 92m 5 ' Umvct’flt)’ -_r This is to certify that the ‘ thesis entitled . ' The Effects of Cognitive Information and Supervised Practice Upon the Acquisition of Crisis Intervention Skills presented by Michael J. Brown has been accepted towards fulfillment of the requirements for M—degeemm Personnel Services, and Mucational Psychology Majorpxofm' I’V ' '2 .n. i“. " .. ,liq ~ '1»? Date—lulLZ._127_lI_ fly ,. ‘ .. \ .. J _4 514'} .‘. 7' 1:. ~.; ‘ I A. ‘; 0—7539‘ ‘-' l I -" rid—4. fl; J ABSTRACT THE EFFECTS OF COGNITIVE INFORMATION AND SUPERVISED PRACTICE UPON THE ACQUISITION OF CRISIS INTERVENTION SKILLS By Michael J. Brown Statement of the Problem Crisis centers and hotlines have become solidly entrenched as part of our nation-wide response to mental health needs. Staffed primarily by non-professionals, situated conveniently in neighborhood communities, and offering a wide range of community services, these centers continue to grow in number, professional respect, and public acceptance. The advantages of crisis centers are many and varied, not the least of which lies in their ready accessibility and low cost. Unfortunately, herein lies also one of the greatest problems. Crisis center staffs, generally non-professional and often unpaid, must never- theless be equipped with certain intervention skills if they are to provide adequate service to their treatment populations. The use of unpaid personnel to man crisis centers severely limits availability of staff time. Selection and training of crisis Michael J. Brown (90 intervention agents must be designed to provide these agents with effective intervention strategies and skills in a relatively short period of time. Purpose of the Study The purpose of this study was to examine the impact of adding a unifying theory of personality structure and change, Transactional Analysis (TA), to the present crisis intervention skills of volunteers at the Open Door Crisis Center, Lansing, Michigan. Prior to this study, such a theory was not included in the training of volunteers. The addi- tion of such a component was designed to increase the volunteers' abilities to select and implement intervention strategies which are appropriate to specific situations. The Open Door's training program is designed to teach specific communication skills and cognitive information to prospective volunteers. These communication skills include Empathic Understanding, Attitude and Values Clarification, and Problem-Solving. The cognitive information consists of facts pertaining to community resources, as well as global strategies for dealing with specific types of problems. The Open Door's training model is based on a structured skills-building model. The philosophy underlying this approach is that crisis intervention skills can be taught by didactic instruction and practice, with no direct focus on changing the trainees' affective responses to stimuli. It was hypothesized that the addition of TA theory to the present training would eliminate three major weaknesses: (l) a communi- cation gap between trainers and trainees, caused by the lack of a Michael J. Brown common language; (2) a knowledge gap caused by the lack of a unifying theory of personality; and (3) the inability of trainees to generalize effective intervention strategies learned during training to the treat- ment setting. This study examines the effects of cognitive information, in the form of TA theory, and supervised practice, via a structured skills- building model, upon the acquisition of crisis intervention skills. Methodology Procedure At the time of the study, seventy (70) persons were active volunteers at the Open Door Crisis Center. Two of these persons, Senior Trainers, were selected to serve as trainers for this project. Of the remaining 68 volunteers, 56 agreed to participate in the study. During the course of the experiment, five (5) of the 56 became inactive and were deleted from the study, leaving a final sample of 5l subjects. These subjects were pre-tested on TA knowledge and leveled into six (6) groups as follows: Transactional Interpersonal Analysis Process Practice Recall Group Group Transactional (TAPI) (IPRI) Control Analysis Group Study Transactional Interpersonal (CG) Group Analysis Process (TAS) Practice Recall Group Group (TAPZ) (IPRZ) Michael J. Brown All subjects were also pre-tested with the Affective Sensitivity Scale and the Skills Ability Scale. Control group (CG) subjects received no further treatment. The TA Study group (TAS) was given a TA handbook for personal study. The TA Practice groups (TAP) received the TA hand- book, plus attended a two-day training workshop where TA theory was applied to crisis intervention skills. The Interpersonal Process Re- call groups (IPR) attended a two-day workshop on crisis intervention skills, without application of TA theory. Subjects assigned to non-TA oriented groups were instructed not to study TA for the duration of the experiment. All six groups were post-tested with all three instruments immediately following the workshops, and again five weeks later. All four training workshops were held during the same two- day period, and the TA study group received the handbook that same weekend. All four workshop leaders were experienced in Transactional Analysis, and two leaders (TAP1 and IPR1) were Senior Trainers at the Open Door. All four trainers attended a series of meetings to assure continuity of training methods, except for the addition or deletion of TA theory. The Affective Sensitivity Scale is a commercially available videotape and paper-and-pencil instrument designed to measure subjects' abilities to discriminate and label affect in another person (empathy). The TA Cognitive Tests (Forms 1, 2, 3) were designed for this study and measure subjects' knowledge of TA information. The Skills Ability Scale (SAS) was designed for this study and yields three subscale scores measuring subjects' abilities to select Michael J. Brown and implement crisis intervention strategies which are appropriate to specific situations. Design and Analysis A repeated measures analysis of variance was performed for each scale of each instrument, yielding five separate analyses to test for significance of group means across tests and within groups. The Scheffe method of post-hoc multiple comparisons was used to test the significance of differences between specific group means. Due to the exploratory nature of the study, the .10 level of significance was established as the critical level for accepting or rejecting differences. Conclusions The following results of the study are outlined according to the major assumptions, or predictions, previously stated: The follow- ing order of performance for improvement and retention of scores was predicted: TA Cognitive Tests: TAP > TAS > IPR = Control Skills Ability Scale: TAP > TAS > IPR > Control Affective Sensitivity Scale: TAP > IPR > TAS > Control TA Cognitive Tests: The research results tend to support the assumption that persons receiving TA information will improve on scores measuring TA knowledge. Subjects assigned to both the TA Study and TA Practice groups demonstrated significant improvement and retention of scores on this test. Subjects assigned to the TA Practice groups showed a trend toward greater improvement than those assigned to the TA Study Michael J. Brown group. Comparisons of gain scores between groups indicate that both the TA Study and TA Practice groups demonstrated significantly greater improvement in and retention of scores than did subjects assigned to the IPR or control groups. Skills Ability Scale: The research results clearly support the assumption that the addition of Transactional Analysis theory to the structured skills-building model, via cognitive information and_ supervised practice, results in improvement and retention of trainees' abilities to select and emit effective crisis intervention strategies, as defined by measures on the instruments used in this study. Signi- ficant improvement and retention of scores on all three subscales of the Skills Ability Scale were demonstrated by subjects assigned to the TA Practice group. Additionally, significant differences were found in improvement and retention of scores on all three subscales between subjects assigned to the TA Practice groups and those assigned to the control group (TAP-CG) or to the IPR groups (TAP-IPR). Subjects assigned to the TA Study group demonstrated no significant differences between pre- and post-test results on any of the SAS subscales. However, there was a significant difference for these subjects between pre- and delayed post-test results on subscale Type I (Information), indicating that scores on this subscale continued to climb for this group between these two testing periods. This same trend was demonstrated on subscale Type III (Long-Term Stress), although the results in this case were not significant. Additionally, signifi- cant differences were found in improvement and retention of scores on Michael J. Brown subscale Type I between subjects assigned to the TA Study group and those assigned to the control group (TAS-CG); and in improvement of scores on subscale Type II (Dangerous Emotions) between subjects assigned to these same two groups. On all three subscales, subjects assigned to the TA Practice groups demonstrated a trend toward superiority when compared with sub- jects assigned to the TA Study group (TAP-TAS). However, this trend was significant only for improvement and retention of scores on sub- scale Type III. Subjects assigned to the IPR groups demonstrated improvement in scores on subscale Type I only. No significant retention of scores was demonstrated for any of the subscales. Additionally, subjects assigned to the IPR groups demonstrated significantly greater improve- ment in scores on subscale Type I, when compared with subjects assigned to the control group (IPR-CG). No other significant differences in improvement or retention of scores were demonstrated by subjects assigned to the IPR groups. Affective Sensitivity Scale: No significant differences in improvement or retention of scores on the Affective Sensitivity Scale were demonstrated, nor were any significant differences found between subjects assigned to any pair of groups. This failure to show signifi- cant gains may be partially explained by (l) the extremely low validity of the Affective Sensitivity Scale; and/or (2) the fact that the subjects used in this study were already trained in empathy skills and had pre- viously demonstrated relatively high levels of achievement in these skills. It is important to note that scores on the Affective Sensiti- vity Scale did show an upward trend, where predicted, suggesting that Michael J. Brown trainees' abilities to determine affect in another person were main- tained or enhanced during the course of the experiment. In all, l2 of 34 hypotheses predicting significant differ- ences in improvement and retention of scores on three measures were accepted, in addition to one hypothesis which predicted null results. Five of the six hypotheses predicting improvement on the TA Cognitive Tests were accepted, and four of the five hypotheses predicting re- tention of scores on this test were also accepted. For the Skills Ability Scale, two of the six hypotheses predicting improvement and two of six predicting retention were accepted for all three subscales; and, a total of nine of twelve hypotheses predicting improvement or retention of scores were accepted for one or more subscales. None of the hypotheses predicting improvement or retention of scores on the Affective Sensitivity Scale were accepted. Discussion The general assumption of predicted comparative gains and retention of scores on the Transactional Analysis Cognitive Tests was as follows: TAP > TAS > IPR = Control. This assumption held true for both improvement and retention of scores, and was significant for all comparisons except TAP > TAS. The general assumption of predicted comparative gains and retention of scores on the Skills Ability Scale was as follows: TAP > TAS > IPR > Control. This assumption held true for improvement and retention of scores for subscales Type II (Dangerous Emotions) and Type III (Long-Term Stress). For subscale Type I (Information), Michael J. Brown subjects assigned to the IPR groups actually demonstrated higher scores on the post-test than did subjects assigned to the TA Study group. How- ever, this difference was very slight and was reversed to the expected direction on the delayed post-test. The general assumption of predicted comparative gains and re- tention of scores on the Affective Sensitivity Scale was as follows: TAP > IPR > TAS > Control. This assumption held true for improvement of scores. However, on delayed post-test scores, subjects assigned to the TA Study actually demonstrated slightly higher scores than did those assigned to the IPR groups. None of these gains were significant. The results of this study suggest that the addition of Trans- actional Analysis theory to a structured skills—building model for training crisis intervention agents, via cognitive information 93g_ supervised practice, does result in improvement in trainees' abilities to select and emit effective crisis intervention strategies, as defined by measures on the instruments used in this study. Furthermore, results indicate that once trainees have been trained in the basic communication skills of Empathic Understanding, Attitudes and Values Clarification, and Decision-Making, cognitive information regarding Transactional Analysis theory and practice, without additional supervised practice, is more helpful for increasing crisis intervention skills than is addi- tional supervised practice, without the cognitive information. Indica- tions are that most of these improved skills are maintained over time. THE EFFECTS OF COGNITIVE INFORMATION AND SUPERVISED PRACTICE UPON THE ACQUISITION 0F CRISIS INTERVENTION SKILLS By Michael J. Brown A DISSERTATION 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 I974 8) Copyright by MICHAEL JAMES BROWN l974 DEDICATION Dedicated to my wife, Susan, my daughter, Jennifer, and my friends. ii ACKNOWLEDGMENTS I am indebted to many people for helping me complete this dissertation, first and foremost my wife and family. I also wish to recognize and truly thank the following people for their assistance and direction given throughout the doctoral program and on the dissertation: Dr. James R. Engelkes, program and dissertation chairman, to whom I am especially grateful; and committee members Dr. Andrew M. Barclay, Dr. Alex J. Cade, and Dr. William A. Mehrens. I would also like to extend my appreciation to the follow- ing persons: Mr. Michael Swenson, director of the Open Door Crisis Center, who so ably served as a trainer and consultant to the project; Mr. Kowitt Pravalpruk, the research assistant, who spent many hours assisting in the design and analysis of the data; Mr. Rob Davis, Mr. William Griz, and Ms. Cher Swenson, who so capably served as trainers for the study; All of my friends and associates at the Open Door Crisis Center, who gave so freely of their time to make this study possible. TABLE OF CONTENTS LIST OF TABLES .......................... LIST OF APPENDICES ........................ Chapter INTRODUCTION ........................ Statement of the Problem ................ Purpose of the Study .................. Justification for the Study ............... Definitions ....................... Organization of the Thesis ............... REVIEW OF THE LITERATURE .................. Basic Learning Principles ................ Crisis Intervention Theory .............. Transactional Analysis in a Crisis Intervention Model . . Crisis Center Research ................ The Structured Skills- Building Training Model ...... Short— Term Training ................. Interpersonal Process Recall ............. Interpersonal Communication Skills .......... Counselor Education Programs ............. METHODOLOGY AND DESIGN OF THE STUDY ............ Population ....................... Sample .............. . ......... Instruments ....................... An Overview of the Affective Sensitivity Scale (Form C) ..................... Introduction and Test Development .......... Administration and Scoring . . . ........... An Overview of the Transactional Analysis (TA) Cognitive Tests (Forms #l, #2, #3) ........... Introduction ..................... Development ..................... Reliability Data ................... Administration and Scoring .............. iv Page vi xi Chapter Page An Overview of the Skills Ability Scale ........ 48 Introduction .................... 48 Development .................... 49 Administration ................... 50 Scoring ..................... . 51 Reliability .................. . . 51 Procedure ...................... 52 Hypotheses ...................... 58 Analysis of the Data ................. 63 IV. ANALYSIS OF THE DATA ................... 64 Organization of the Analysis of the Data ....... 64 Transactional Analysis Cognitive Tests Results . . . . 66 Improvement in Scores ............... 67 Retention of Scores ................ 69 Summary ...................... 7l Skills Ability Scale Results ........ . . . . . 71 Improvement in Scores ............... 75 Retention of Scores ................ 80 Summary ..................... 85 Affective Sensitivity Scale Results .......... 86 Improvement in Scores ....... . ....... 87 Retention of Scores ................ 88 Summary ...................... 90 Summary ....................... 90 V. SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS ........ 93 Summary ........................ 93 Purpose ...................... 93 Population and Sample ............... 94 Instrumentation .................. 94 Procedure ..................... 94 Design and Analysis ................ 95 Conclusions ...................... 96 Findings and Discussion .............. 96 Recommendations .................... lO3 APPENDICES ........................... lO7 BIBLIOGRAPHY .......................... 158 Table 03030100305 0501-wa LIST OF TABLES Crisis Calls Received during February l97l (227 Crisis Centers) ........... Services Most Frequently Offered (253 Crisis Centers) ................. Types of Calls Received (230 Crisis Centers) Results of Trainer Exposure to TA Theory and Practice ................. POPULATION SERIES Age Distribution of Active Volunteer Crisis Intervention Agents at Open Door Crisis Center (December, 1973) ......... Length of Service in Weeks: Active Volunteer Crisis Intervention Agents at Open Door Crisis Center (December, 1973) ...... Educational Background of Active Volunteer Crisis Intervention Agents at Open Door Crisis Center (December, l973) ...... SAMPLE SERIES Age Distribution: Original Sample ..... Length of Service in Weeks: Original Sample Educational Background: Original Sample Age Distribution: Final Sample ....... Length of Service in Weeks: Final Sample . . Educational Background: Final Sample . . . . vi 0 O O O C O O O O O Page 20 35 36 37 38 39 39 4o 41 41 Table Page TRANSACTIONAL ANALYSIS COGNITIVE TESTS SERIES 7.l. Transactional Analysis Cognitive Tests: Discrimination of Items with Naive and Sophisticated Groups ................ 45 7.2. Transactional Analysis Cognitive Tests: Content Validity ................ . . 46 7.3. Transactional Analysis Cognitive Tests: Reliability Data .................. 47 7.4. Transactional Analysis Cognitive Tests: Equivalence of Forms ............... . 47 TRANSACTIONAL ANALYSIS COGNITIVE TESTS RESULTS SERIES 8.l. Transactional Analysis Cognitive Tests: Number of Subjects, Mean Score, Sum of Scores, and Sum of Squared Scores ............... 66 8.2. Transactional Analysis Cognitive Tests: Repeated Measures Analysis of Variance Results for all Treatment Groups .......... . ....... 67 8.3. Transactional Analysis Cognitive Tests: Improve- ment in Test Scores by Scheffe Multiple Comparison Test for all Treatment Groups and all Pair-Wise Comparisons of Treatment Groups~~ Transactional Analysis Practice (TAP) Trans- actional Analysis Study (TAS), Interpersonal Process Recall (IPR), and Control (CG) ....... 68 8.4. Transactional Analysis Cognitive Tests: Retention of Test Scores by Scheffé Multiple Comparison Test for all Treatment Groups and all Pair-Wise Comparisons of Treatment Groups--Transactional Analysis Practice (TAP) Transactional Analysis Study (TAS), Interpersonal Process Recall (IPR), and Control (CG) ................. 70 SKILLS ABILITY SCALE RESULTS SERIES 9.l. Skills Ability Scale: Information: Number of Subjects, Mean Score, Sum of Scores, and Sum of Squared Scores ............... 72 Table Page 9.2. Skills Ability Scale: Dangerous Emotions: Number of Subjects, Mean Score, Sum of Scores, and Sum of Squared Scores .......... 72 9.3. Skills Ability Scale: Long-Term Stress: Number of Subjects, Mean Score, Sum of Scores, and Sum of Squared Scores .......... 73 9.4. Skills Ability Scale: Information: Repeated Measures Analysis of Variance Results for all Treatment Groups ................ 73 9.5. Skills Ability Scale: Dangerous Emotions: Repeated Measures Analysis of Variance Results for all Treatment Groups .......... 74 9.6. Skills Ability Scale: Long-Term Stress: Repeated Measures Analysis of Variance Results for all Treatment Groups . ..... . . . . 74 9.7. Skills Ability Scale: Information: Improvement in Test Scores by Scheffe Multiple Comparison Test for all Treatment Groups and all Pair-Wise Comparisons of Treatment Groups--Transactional Analysis Practice (TAP), Transactional Analysis Study (TAS), Interpersonal Process Recall (IPR), and Control (CG) ............ . ..... 77 9.8. Skills Ability Scale: Dangerous Emotions: Improvement in Test Scores by Scheffé Multiple Comparison Test for all Treatment Groups and all Pair-Wise Comparisons of Treatment Groups-~Transactional Analysis Practice (TAP), Transactional Analysis Study (TAS), Interpersonal Process Recall (IPR), and Control (CG) . . ................ 78 9.9. Skills Ability Scale: Long-Term Stress: Improve- ment in Test Scores by Scheffe Multiple Comparison Test for all Treatment Groups and all Pair-Wise Compa sons of Treatment Groups--Transactional Analysis Practice (TAP) Transactional Analysis Study (TAS), Interpersonal Process Recall (IPR), and Control (CG) .................. 79 Table Page 9.l0. Skills Ability Scale: Information: Retention of Test Scores by Scheffe Multiple Compari- son Test for all Treatment Groups and all Pair-Wise Comparisons of Treatment Groups-- Transactional Analysis Practice (TAP), Trans- actional Analysis Study (TAS), Interpersonal Process Recall (IPR), and Control (CG) ....... 8l 9.ll. Skills Ability Scale: Dangerous Emotions: Retention of Test Scores by Scheffé Multiple Comparison Test for all Treatment Groups and all Pair-Wise Comparisons of Treatment Groups-- Transactional Analysis Practice (TAP), Trans- actional Analysis Study (TAS), Interpersonal Process Recall (IPR), and Control (CG) ....... 82 9.l2. Skills Ability Scale: Long-Term Stress: Retention of Test Scores by Scheffe Multiple Comparison Test for all Treatment Groups and all Pair-Wise Comparisons of Treatment Groups--Transactional Analysis Practice (TAP), Transactional Analysis Study (TAS), Interpersonal Process Recall (IPR), and Control (CG) .............. . . . . 83 AFFECTIVE SENSITIVITY SCALE RESULTS SERIES lO.l. Affective Sensitivity Scale-~Number of Subjects, Mean Score, Sum of Scores, and Sum of Squared Scores . . . . . ................. 86 lO.2. Affective Sensitivity Scale: Repeated Measures Analysis of Variance Results for all Treat- ment Groups .................... 86 lO.3. Affective Sensitivity Scale: Improvement in Test Scores by Scheffe Multiple Comparison Test for all Treatment Groups and for all Pair-Wise Comparisons of Treatment Groups-- Transactional Analysis Practice (TAP), Trans- actional Analysis Study (TAS), Interpersonal Process Recall (IPR), and Control (CG) ....... 88 ix Table Page 10.4. Affective Sensitivity Scale: Retention of Test Scores by Scheffe Multiple Compari- son Test for all Treatment Groups and for all Pair-Wise Comparisons of Treatment Groups--Transactional Analysis Practice (TAP), Transactional Analysis Study (TAS), Interpersonal Process Recall (IPR), and Control (CG) .................... 90 II. Summary of Hypotheses and Significant Differences .................... 9l 12. Raw Scores of the Total Sample on Three Administrations of the Five Measures ........ l56 LIST OF APPENDICES Appendix Page A. TRANSACTIONAL ANALYSIS COGNITIVE TESTS (FORMS #l, #2, #3) ................. 107 B. SKILLS ABILITY SCALE: STIMULUS STATEMENTS ................ l34 C. SKILLS ABILITY SCALE: RATING SCALES ................... l4l D. LETTER AND QUESTIONNAIRE SENT TO VOLUNTEERS ................... 146 E. LISTENER PERFORMANCE SCALES .............. 150 F. RAW SCORES OF THE TOTAL SAMPLE 0N THREE ADMINISTRATIONS OF THE FIVE MEASURES ........ 156 xi CHAPTER I INTRODUCTION In the United States, crisis centers and hotlines are rela- tively new approaches to the growing concern for mental health. McCord and Packwood (1973) have defined a crisis center as "a community service organization whose primary function is telephone listening or counseling." Such centers have experienced phenomenal growth during the past several years. Thirteen known centers were in operation in 1966, 253 in 1971, and possibly triple that number by 1974 (Townley, 1974). Crisis centers are located in every state, with California having more centers than any other. Centers tend to cluster in metro- politan areas, the largest being Boston, Los Angeles, and San Francisco. There are currently six crisis centers in the greater Lansing area. College populations on campuses and in nearby towns are especially prone to utilize the services of crisis centers (Tucker, Megenty, and Vigil, 1970; McCarthy, 1970). Crisis center growth appears to be a result of increased drug usage and dissatisfaction with the operation of traditional counseling centers and mental health agencies. This dissatisfaction stems from the fact that most traditional agencies make services available only during the day, require persons seeking services to come to the office, emphasize maintenance of identifiable client records, and are not 1 equipped to handle bad drug experiences and other personal crises which require immediate attention. Stating these objections, a large percentage of crisis center service populations report an unwilling- ness to utilize more traditional services (Swenson, 1974). In the most recent survey of crisis centers in the United States, McCord and Packwood (1973) report their general characteris- tics. As illustrated in Table 1, there is a wide variation in the number of hours that crisis centers offer telephone services. *Table 1. Calls Received During February 1971 (227 Crisis Centers) Hours Open Number of Total Calls Calls Per Calls Per Per Day Centers Received Center Center Per Day 1-4 7 883 126 4.5 5-8 29 8,867 306 10.9 9-12 23 6,466 281 10.0 13-16 14 4,991 357 12.8 17-23 5 6,244 1,248 30.6 *from McCord and Packwood (1973) The fewest number of calls occur between 3:00 a.m. and 9:00 a.m., and the greatest number of calls is received between 6:00 p.m. and midnight. These centers reported an average of more than 113 calls per center per day, from one to 12 telephone lines available for calls (average 2.6), and the number of available listeners on duty ranging from 1.6 to 3.4. The number of full-time staff ranged from 2 to 200 per center, with a mean of 11.2. The number of part-time staff ranged from 2 to 150, with a mean of 26.3. Crisis centers typically offer a wide range of services other than telephone listening-counseling. These services may include emer- gency medical and free clinic services, rumor control, job placement, co-operative purchasing arrangements, birth control, pregnancy and abortion information, drug analysis, day-car for children, craft and other "free university" courses, speakers' bureaus, and rehabilitation programs. Most centers do not charge fees for any or some of their services. When fees are charged, they usually cover medical services, educational programs, speakers' bureaus, and ongoing counseling ser- vices. The services most frequently offered and the types of calls received are listed in Tables 2 and 3, respectively. Crisis centers are typically staffed by non-professional personnel. Backlogs in intake in counseling centers and mental health agencies, together with the high activity level of crisis centers, strongly suggest a continuing need for non- and para-professional staff to man these centers. According to the National Institute for Mental Health (1972), this rationale is further supported by the uniqueness of what non- and para-professionals have to offer, particularly in the areas of social competence training, continuity of care, and primary prevention. This argument is bolstered by the high incidence of cases in which crisis center clientele, when given opportunity for referral to traditional agency services, refuse to avail themselves of those services and state a preference for continued contact with the crisis center staff (Swenson, 1974). The utilization of non- and para- professionals in the mental health field has been widely acclaimed (Reiff and Riessman, 1965) and even called the "third revolution in the treatment of the emotionally disturbed" (Steisel, 1972). 'flable 2. Services Most Frequently Offered (253 Crisis Centers) S . Number of (a) erV1ces Centers Percent Telephone listening/counseling (by definition--1OO percent) 253 100 Referral services 252 99 Walk-in services 127 50 House-call services 127 50 Practicum setting for students in helping professions 114 45 Information services 109 43 Organizer for group counseling 94 37 Referral agent for academic tutors 62 25 Other 35 14 (aITotal exceeds 100 percent because centers generally offer a combina- tion of services *from McCord and Packwood (1973) Statement of the Problem Since crisis centers are almost always staffed primarily by non-professional personnel with little or no prior training, the issue of selection and training of staff becomes vital to their continued existence. McCord and Packwood (1973) found that 86 percent of the centers they surveyed used some variation of a formal (specific sequential steps) preservice training procedure, and that 74 percent of the centers used the training procedure itself as a screening device. Since the majority of crisis intervention agents are not paid for their time or services, including time spent in training, the issue of short- term training is a crucial one. Hence, a major goal of crisis center training is to devise a short-term training model which will adequately screen and prepare volunteer crisis intervention agents for work in the center. *Table 3. Types of Calls Received (230 Crisis Centers) Type of Call(a) Percent Drugs, except legal problems 20 Relationship: problems based on relationships with other people 13 Home life: problems based on life at home 11 Resources: need of outside resources not covered in other categories 10 Dating and Marriage 8 Feelings not specifically related to any category; general counseling 8 Suicide: contemplated, threatened, or attempted 6 Crank calls: cop-outs, no problems discussed 6 School 5 Legal and draft: includes arrest, legal problems, and draft information 4 (EIAll of the 230 centers were required to make their categories of types of calls received conform to the list of categories above. Since few centers use the same categories, the transference of percentages may result in some error. *from McCord and Packwood (l973) Purpose of the Study The purpose of this study was to examine the impact of adding unifying theory of personality structure and change, Transactional Analysis (TA), to the structured skills-building model currently being used to teach crisis intervention skills to crisis intervention agents at the Open Door Crisis Center, Lansing, Michigan. Prior to this study, such a unifying theory has not been included in the training of volun- teers. The addition of such a component was designed to increase the volunteers' abilities to select and implement intervention strategies which are appropriate to specific situations. The Open Door's training program is designed to teach specific communication skills and cognitive information to prospective volunteers. These communication skills include Empathic Understanding, Attitudes and Values Clarification, and Problem-Solving. The cognitive information consists of facts pertaining to community resources, as well as global strategies for dealing with specific types of problems, such as suicidal contacts, drug-related and other affective crises, and substance over- dose. The Open Door training model is based on the Interpersonal Process Recall technique (Kagan, 1972). Trainees take turns practicing the communication skills by listening to another trainee talk about some real concern, problem, or experience. The interaction is audio or video taped and then played back, with the trainer facilitating the trainee in self-discovery learning. The focus during the self-discovery learning is to help the listener to discover what personal factors played a part in determining the responses made during the interaction. At the end of the self-discovery learning period the trainer gives the trainee specific instructions on how to incorporate the new information into more appropriate behavior, in terms of the communication skills and strategies listed above. The philosophy underlying this approach is that the use of the communication skills can be taught by didactic instruction and practice, i.e., that the trainees can learn to use their own effective responses to aversive or emotion-laden stimuli to select appropriate responses, in terms of communication skills, without necessarily changing their own affective response. The philosophy does not deny that changes in affective responses take place through the exposure, practice, and didactic instruction. Nonetheless, there is no direct focus on changing the trainees' affective responses to stimuli. Justification for the Study Three major weaknesses of this training model were noted, all of which are related to the lack of a consistent theory of per- sonality structure and change. First, the lack of such a theory hampers the communication between the trainers and trainees regarding possible strategies for handling inappropriate behaviors (in terms of the communication skills) connected to the trainees' affective response. This communication gap interferes with the acquisition of the appro- priate behavior response. A second shortcoming stemming from the lack of a theory of personality structure and change is that the trainee is not given a model to be used in making decisions about which particular communication skill should be used in the interaction. This lack of knowledge further decreases the listener's effectiveness, commonly resulting in confusion and anxiety which is exhibited during training, and probably later when actually delivering services. . A third weakness is that the use of the communication skills may not generalize to situations other than the training en- vironment. Due to the lack of a model of personality structure, there is no framework present in the training that promotes generali- zations to people in all situations. Therefore appropriate behaviors on the part of the trainees may become cued to the training environ- ment, not to any internalized cues (or external cues) which would carry the behavior into other situations. In order to eliminate the weaknesses described above, a consistent theory of personality structure and change was incorporated into the existing training model. It was hypothesized that the in- clusion of this theory would (1) eliminate the communication gap between trainers and trainees by providing a common language for all partici- pants, (2) eliminate the knowledge gap by providing a model for making decisions regarding the "when“ and "why" of specific intervention strategies, and (3) allow for a greater generalization of effective intervention strategies and behaviors by providing thought patterns upon which those strategies and behaviors could be internally cued. The theory of personality structure and change chosen to be integrated into the training model was Transactional Analysis (TA). Transactional Analysis is a particularly appropriate theory for train- ing crisis intervention agents for at least three reasons. First, TA theory maintains that it is possible to teach a person more appropriate behavioral responses through verbal instructions without attempting to change the underlying affective responses (Berne, 1962; 1966). This position is compatible with the present training philosophy and there- fore supplements rather than changes the existing training model. Secondly, this approach uses a simple language, easily understood by non-professionals, which can be operationalized to permit a more accurate verbal communication between trainer and trainee. And, third, TA provides operationalized descriptions of cues which can be used to discern which communication skill would be most appropriate for a given situation. In sum, this study attempted to seek answers to the following questions: 1. Will the addition of the Transactional Analysis theory of personality structure and its implications for crisis intervention to the current training model result in im— provement in trainees' abilities to select and emit effective crisis intervention strategies, as defined by measures on the instruments used in this study? 2. Will supervised practice in Transactional Analysis theory and practice result in improvement in trainees' abilities to select and emit effective crisis intervention strategies, as defined by measures on the instruments used in this study? be used: 10 3. Will improvements in these abilities be maintained over time? Definitions For the purpose of this study, the following definitions will Crisis center: A community service organization whose primary function is telephone listening or counseling. Crisis intervention agent: Any person who utilizes the skills of a helping profession while work- ing in a crisis center. Structured skills-building model: A training model which uses a sequential series of structured exercises and techniques to teach specific skills, without emphasizing change of trainee affective response. Transactional Analysis (TA): A theory for predicting, describing, and changing human behavior, as defined by Eric Berne. Transactional Analysis terminology_(Berne, 1972): ‘Adglt: An ego state oriented toward objective, autonomous data-processing and probability- estimating. Chjlg: An archaic ego state. The Adapted Child follows parental directives. The Natural Child is autonomous. Contract: An explicit agreement between a patient and a therapist which states the goal of the treatment during each phase. 11 Decision: A childhood committment to a certain form of behavior, which later forms the basis of character. Drama triangle: A simple diagram showing the possible switches of roles in a game or script. The three major roles are Persecutor, Victim, and Rescuer. Ego state: A consistent pattern of feeling and experience directly related to a correspond- ing consistent pattern of behavior. Game: A series of transactions with a con, a gimmick, a switch, and a crossup, leading to a payoff. Lifegposition: A concept of O.K.ness and not O.K.ness which justifies a decision; a position from which games are played. Parent: An ego state borrowed from a parental figure. It may function as a directing influence (the Influencing Parent), or be directly ex- hibited as parental behavior (the Active Parent). It may be nurturing or controlling. Permission: (l) a parental license for autonomous behavior. (2) an intervention which gives the individual license to disobey a parental injunction if he is ready, willing, and able, or releases him from parental provocations. Potency: The strength with which a therapeutic inter- vention is delivered, relative to emphasis and timing. Protection: Support offered to the patient by the thera- pist throughout the treatment process. Racket: The sexualization and transactional seeking and exploitation of unpleasant feelings. Script: A life plan based on a decision made in childhood, reinforced by the parents, justi- fied by subsequent events, and culminating in a chosen alternative. Stamps: A feeling "collected" as the payoff in a game, cashed in later to justify a behavior. 12 Stroke: A unit of recognition, such as "Hello." Structural Analysis: Analysis of the personality, or of a series of transactions, according to Parent, Adult, and Child ego states. Time Structure: The six (6) possible ways in which a person may use his time at any given moment-- withdrawal, rituals, pastimes, activities, games, and intimacy. Transaction: A transactional stimulus from a certain ego state in the agent plus a transactional response from a certain ego state in the respondent. A transaction is the unit of social action. Volunteer: A non-professional crisis intervention agent. Organization of the Thesis Chapter I served as an introduction to the thesis. It de- lineated the purpose of the study, statement of the problem, object of the study, and the justification for the study. Also included in the first chapter was a brief description of the hypotheses, listed as questions to be tested, and a brief list of pertinent definitions. Chapter II consists of a review of the literature in the areas of crisis intervention and applicable training models. The general methodology and the design of the study are discussed in Chapter III. Chapter IV analyzes the data and results, while Chapter V includes summary material. discussion of the results, recommendations for further research, and con- clusions of the study. Other ancillary information pertinent to the study is found in the appendices. CHAPTER II REVIEW OF THE LITERATURE A review of the literature has been conducted in basic learning principles, crisis intervention theory, Transactional Analysis in a crisis intervention model, crisis center research, and the structured skills-building model as it pertains to crisis center training. Basic Learning Principles Davis, Alexander, and Yelon (l974) define learning as "a relatively permanent change in behavior as a function of practice or experience." These authors list several ways in which learning changes behavior: new responses are learned to stimuli; non- essentials are eliminated; and behavior becomes better integrated and more autonomous. Furthermore, these changes are often relatively permanent. Nine general principles of learning have been derived from psychological experimentation, and these principles can be applied in any learning system: 1. Meaningfulness: A student is likely to be motivated to learn things that are meaningful to him. Meaningfulness is a personal thing, relevant to individual experience. 13 l4 2. Prerequisites: A student is more likely to learn some- thing new if he has all the requisites. Sequential skills-building is based on this principle. 3. Modeling: A student is more likely to acquire new be- havior if he is presented with a model performance to watch and imitate. Good trainers show h9w_by providing an example. 4. Open Communication: A student is more likely to learn if the presentation is structured so that the instructor's messages are open to the student's inspection. Feedback is used to verify this openness. 5. Novelty: A student is more likely to learn if his attention is attracted by relatively novel presentations. 6. Active Appropriate Practice: The student is more likely to learn if he takes an active part in practice geared to reach an instructional objective. 7. Distributed Practice: A student is more likely to learn if his practice is scheduled in short periods distributed over time. Unfortunately, in this study this distribution is precluded by the structure of the existing model. 8. fading; A student is more likely to learn if instructional prompts are withdrawn gradually. 9. Pleasant Conditions and Consequences: A student is more likely to continue learning if instructional conditions are made pleasant. In addition to physical comfort, practice conditions can be made pleasant by setting challenging tasks, giving feedback, and re- warding students' efforts. 15 Three types of learning are of particular importance when training crisis intervention agents: concept learning, principle learn- ing, and problem-solving. A concept is an abstraction from an experience. Some writers treat concepts as external stimuli which a person acquires, while others treat concepts as "ideas" generated from within. In either case, a concept is "an abstract property which cuts across diverse events.... Concepts are used to organize and classify experience." (Davis, gt_al., 1974). Concepts are learned by differentiating between examples and non-examples (Carrol, 1964; Mechner, 1965). Prerequisite concepts are embedded in the definition of new concepts, and the new concept is derived by either an inductive or deductive approach. Practice and reinforcement solidify the learning process. Principles are used to predict, explain, and control phenomenon by stating relationships between two or more concepts (DeCecco, 1968). Although principles can generally be converted into "if-then" state- ments, a principle is not simply a number of concepts linked in the same sentence. A principle states a relationship between classes of events which enables us to (1) predict consequences; (2) explain events; (3) infer causes; (4) control situations; and (5) solve problems. A principle is learned most readily when a clear objective specifies which of the five applications is to be used. Once this is established and prerequisite knowledge is derived, the principle is received (usually by being told or by demonstration), practiced as per the objective, and reinforced. Since principles are functional and enable people to do things, using a principle is reinforcing (Gagné, 1966). I6 Problem-solving is needed when someone encounters a situation for which no appropriate response is immediately available, and can take place only after the person has learned concepts and principles in other contexts. Problem-solving is an advanced type of learning which includes a major element of discovery. In problem-solving a person integrates previously learned knowledge into new and more complex principles (Melton, 1964; Desse and Hulse, 1967). Psycholo- gists generally agree that the steps of problem-solving include pre- paring for the problem (organizing and understanding it); analyzing the problem, selecting and carrying out the plan, and testing to verify the appropriateness of the action (Davis, gt_gl,, 1974). Students may be taught how to solve specific types of problems or they may be taught general principles and strategies of problem-solving which will transfer to problems of many different types. Davis, gt_al, (l974) cite four major steps in teaching students to solve specific problems: (1) state an objective; (2) pretest and review the requisites; (3) arrange conditions for learning by providing many kinds of problems, modeling the problem-solving approach, and teaching specific algorithms; (4) use procedures to provide practice. There are many rules of thumb which can be used to promote learning how to solve problems, i.e. producing more than one solution, pro- gressive deepening; modeling; delaying choice of solution, stopping when stumped, trouble-shooting, etc. (Johnson, 1972). The structured skills-building model, as applied to most crisis intervention training programs, adheres to eight of the nine general principles of learning as described above: meaningfulness; l7 prerequisites; open communication; novelty; active appropriate practice; fading; and pleasant conditions and surroundings. The one general ex- ception is that of distributed practice. Due to the limited availability of volunteer trainer and trainee time, many crisis centers collapse the training program into a single intensive two- or three-day weekend ex- perience, sometimes supplemented by one or two brief (two to four hours) follow-up sessions after the volunteer has worked one or more shifts in the center. Crisis Intervention Theory Contemporary crisis theory sees a person who is in crisis as being at a turning point. The individual is facing a problem which he cannot solve in his usual way and, as his responses continue to meet with little success, his anxiety and tensions rise. He feels confused and helpless, overwhelmed by the situation, and feels that he needs help to resolve the problem (Paul, 1971). Crisis intervention at this point offers a person help in learning how to find a workable solution. Crisis intervention theory is a product of preceeding theories. It begins with Freud's principle of causality in psychic determinism, which states that all human behavior is a product of, or has as its source, the history and experience of the individual (Lowenstein, 1966). Hartman, Rado, and Erickson contributed work on ego psychology and adaptational dynamics, and further recognized the importance of the social environment of the individual (Rado and Daniels, 1956; Rappaport, 1959). Lindemann and Caplan then modified and applied these beginnings to their ideas on community-wide mental health and came up with an 18 equilibrium or homeostasis model of crisis and intervention (Lindemann, 1956). Crisis is defined by Caplan as occuring "when a person faces an obstacle to important life goals that is, for a time, insurmountable through the utilization of customary methods of problem-solving. A period of disorganization ensues, a period of upset, during which many abortive attempts at solution are made." (Caplan, 1961). After Caplan's work at the Harvard School of Public Health in the early 1960's, the crisis intervention approach became widely used in the mental health field. Crisis intervention is based on the concept that the indivi- dual strives to maintain a homeostatic balance in his life (O'Connell, 1971). When he is faced with a situation in which his usual responses do not work, he is thrown into a condition of uncertainty or disequili- brium. His perceptions of the situation become distorted and the probability of finding an adaptive response is decreased. The state of crisis is theorized to be a time-limited event lasting one to six weeks, since the individual cannot tolerate the extreme tension of crisis and uncertainty for more than a short period of time. During this time a solution is sought and one may be chosen which leads the individual to prior, more adequate, or less adequate levels of functioning. Crisis intervention can provide the help an individual needs to solve a personal crisis. Solving a crisis primarily involves the use of logical reasoning and five steps (Aguilera, Messick, and Farrell, 1970). l9 1. defining the problem 2. finding alternate solutions 3. testing the solutions 4. evaluating the results 5. redefining the problem when necessary Transactional Analysis in a Crisis Intervention Model Several different theoretical approaches have been used within the crisis intervention model (Aguilera , §p_pl., 1970; Parad, 1969). Unfortunately, these theoretical positions have not, for the most part, been supported by empirical research. Transactional Analysis has been theorized to be an efficient and versatile model for crisis counseling (Samuels, Teutsch, and Everts, 1968; Paul, 1971). Brown and Griz (1973) reported a study in which non-professional crisis intervention trainers were presented a 10-hour didactic presentation of Transactional Analysis theory applied to crisis intervention, followed by a marathon TA group and, finally, six months of ongoing personal growth groups. The trainers met with an experienced TA therapist in groups of eight for weekly two- hour sessions. Trainers reported an increase in their effectiveness as trainers, and Table 4 illustrates the results of the project. These authors indicate that it is important that the person in crisis be aware of and under- stand his feelings, and apply existing knowledge and information to the situation. TA provides the essentials that the individual and the crisis intervention agent need for successful intervention. For healthy crisis resolution, a person needs to use: 20 *Table 4. Results of Trainer Exposure to TA Theory and Practice Jan.-June July-Dec. Jan.-June Criterion 1972 1972 1973 Average contacts per month: 81 134 467 (Other crisis centers in the area reported a 10-30% decrease in con- tacts from July-Dec. '72 to Jan.- June '73) Average length of time with not contact: available 57.3 mins. 40.5 mins. Referrals to Mental Health Services: 5 8 29 Mean time before referral to other not agencies: chronic callers: available 11.5 months 6.2 months (Therapists follow-up reports indicate that since Jan. '73 referrals have been better prepared and more highly motivated for therapy.) Known suicides and/or attempts after contact with Center: 4 5 0 Trainee loss ratio (trainees who begin but do not successfully complete training): 42% 44% 18% (last training session--7%) Volunteers in therapy 5 5 28 (Consultation began in February, 1973. This project with the crisis center staff has been a rewarding and successful experience. Transactional Analysis has proven to be an effective and efficient model for the training of non-professional crisis intervention agents.) *from Brown and Griz (l973) 21 1. correct perceptions of the situation, which is furthered by seeking new knowledge and by keeping the problem in focus (Adult data input) 2. awareness of feelings and an ability to express them, which leads to a decrease in anxiety (Adult awareness of Child; catharsis) 3. development of patterns of seeking and using help with actual tasks and feelings by using interpersonal and institutional resources (Adult decision-making) A person in a crisis situation needs to have a cathected Adult ego state before contact with the worker is ended. The communication skills which the crisis intervention agent most commonly has at his disposal include Empathic Understanding, Attitudes and Values Clarifi- cation, and Problem-Solving. Empathic Understanding means to feed the "hurt" Child ego state, permitting free expression of feelings, or“ catharsis. Attitudes and Values Clarification means to ferret out the Parent messages, recognize their effects on the Adapted Child, and provide this as useable data to the Adult. Problem-Solving (perhaps this should be renamed Decision-Making to emphasize the positive aspects of change) requires Adult awareness and Child energy which is available only after the "hurt" Child has been cared for (catharsis followed by support) and the Parent decommissioned (protection plus permission to change). Thus, Transactional Analysis provides a conceptual framework for integrating the various skills necessary for effective crisis inter- vention (Brown, 1974). (For a more complete understanding of TA termin- ology, see glossary of definitions at end of Chapter I.) Crisis Center Reseapch Crisis intervention techniques have demonstrated effectiveness in dealing with a number of specific problem categories. Individual 22 counseling combined with environmental manipulation has been a success- ful approach to treatment with potential college dropouts. In a study by Garner (1970), 45 college freshmen who had been relatively poor achievers in high school and who were considered potential dropouts were exposed to crisis counseling (maximum 12 visits). All the coun- selors had at least a master's degree in counseling plus an additional 30 semester hours of study. When compared to a control group, this group of students had significantly fewer dropouts and improved academic performance. Immediate telephone intervention has recently been recognized as a valuable method of treating suicidal persons, substance overdose and/or withdrawal, and other emergency situations requiring immediate intervention (Schneidman, Farberow, and Litman, 1970; McCarthy and Berman, 1971; McCord and Packwood, 1973). And crisis intervention has been applied to even more complex intervention needs, like family therapy (Langsley and Kaplan, 1968). Rappaport (1965) has outlined numerous case studies supporting family crisis intervention as a primary prevention technique, and Parad and Caplan (1960) have used similar case studies to propagate a contemporary theory of family therapy. Additional applications of crisis theory have been reported with management of acute grief (Lindemann, 1944; Morrissey, 1964), parent— hood (Dyer, 1963; LeMasters, 1957), adolescents (Miller, 1959), and children (Klein and Ross, 1958; Irvine, 1964). In sum, the crisis intervention approach appears to be an effective model for dealing with emotional difficulties of various 23 sorts. This approach has demonstrated effectiveness over a 30-year period with persons of all ages and with a wide range of presenting problems. The Structured Skills-Buildigg Training_Model Short-Term Training The structured skills-building model for training crisis intervention agents in the skills of Empathic Understanding, Attitudes and Values Clarification, and Decision-Making has become commonplace. Short-term training programs have been described in detail in publi- cations by Truax, Carkhuff, and Douds (1964) and Truax and Carkhuff (1967). The central elements in this training approach can be summarized as (a) a therapeutic context in which the supervisor communicates high levels of empathy, warmth, and genuineness to trainees; (b) a didactic use of research scales for the measurement of empathy, warmth, and genuineness for "shaping" trainees' responses; and (c) a quasi-group therapy experience designed to aid trainees to achieve an integration of the didactic training with their personal values, goals, and life-styles. Truax (1970) offers the following description of the training sequence: ...The scales are used to identify tape-recorded samples of experienced therapists offering very high levels of therapeutic conditions, thus providing models for imitation. It should be remembered that even the best recordings of total sessions usually provide a number of examples of precisely what not to do. Secondly, the trainees are taught the use of the scales so that they will learn to identify high and low levels of empathy, warmth, and genuineness in their own therapy and that of others. Third, empathy training, warmth training, or genuineness train- ing, is provided by playing a tape recording of client interviews and then requiring trainees to make immediate therapeutic re- sponses. These responses are immediately rated on the research 24 scales to provide prompt feedback. As the trainee shapes his responses toward higher levels of empathy, warmth and genuine- ness, he begins role-playing which, in turn, is recorded, brought to class, and rated by a group of trainees on the research scales. Thus, the trainees compete among themselves in ability to communi- cate therapeutic conditions. Finally, they begin one-shot inter- views with real clients which are again tape-recorded and brought to class for rating. In all, the complete basic training program involves less than 100 hours of training. Truax and Lister (1971) measured the effects of this training upon accurate empathy and warmth. Twelve experienced counselors were pre-rated and placed in two groups. These counselors then engaged in an intensive 40-hour training program over a two-week period. Counse- lors initially high (N equals 6) and counselors initially low (N equals 6) made approximately equal gains on empathy, whereas no significant changes were made on warmth. Similar results have been obtained in numerous studies and replications cited by Carkhuff (1972). These results indicate the effectiveness of short-term training, using a structured skills-building model, for teaching basic communication skills to counselors at varying levels of functioning. Interpersonal Process Recall (IPR) Kagan (1972) has expanded the structured skills-building model into a systematic recall and evaluation process which implements third party intervention, audio or visual aids, and/or group feedback (IPR, or Interpersonal Process Recall). In an undated manuscript, Harris and Dendy have modified the IPR process to formulate a training model to teach crisis center volunteers the specific skills of Empathic Understanding, Attitudes and Values Clarification, and Decision-Making. This method has been widely used in the Midwest and is currently the most commonly used training model for crisis centers in the state of 25 Michigan. Further modification and expansion of this model by Hinds, James, Gieszer, and Jacobs (1972) has led to the publication of a handbook to be used as a training aid for crisis center volunteers. This handbook has been packaged and distributed by the Michigan Governor's Office of Drug Abuse and Alcoholism and is currently under- going modification for national distribution by the National Institute for Mental Health. A modified IPR model is currently being used to train volunteers at the Open Door Crisis Center, and was used to train crisis intervention agents for this study. This model is described more fully in Chapter III. Interpersonal Communication Skills Basic empathy skills provide the base for all three of these interpersonal skills (Empathic Understanding, Attitudes and Values Clarification, and Decision-Making) in all of the above models. The importance of empathy in counseling and psychotherapy has been es- poused by counseling theorists like Rogers (1957; 1961), Bordin (1968), Tyler (1969), and Krumboltz (1966). Truax and Carkhuff (1967) have theorized a positive correlation between interpersonal skills and psychotherapy outcomes. In a study by Dickenson and Truax (1966) 24 "essentially neurotic" underachieving college freshmen were divided into three eight-member counseling groups. The groups met twice weekly over a period of 12 weeks, for a total of 24 one-hour sessions. When compared to a group of 24 matched, non-counseled control subjects, the experimental students showed significantly greater improvement in grade point average. Some of this difference, however, may be attri- 26 buted to a "halo" effect. Moreover, those counseled subjects who received the “highest therapeutic conditions" tended to show the greatest improvement. Level of therapeutic conditions was determined by tape recording each session, randomly selecting one four-minute segment from the middle third of each hour, and rating these segments by two independent raters for measures of Accurate Empathy (Truax, 1961), Unconditional Positive Regard (Truax, 1962), and Therapist Genuineness (Truax and Dickenson, 1964). The authors conclude that "only therapists and counselors who provide relatively high levels of accurate empathy, warmth, and genuineness are helpful." Similar results were reported for therapists working with schizophrenics (Rogers, 1962) and neurotics (Truax, 1963). To demonstrate the appropriateness of these communication skills in a crisis center setting, Dilley, Lee, and Verrill (1971) compared the empathy scores of 15 trained and untrained counselors in a crisis center utilizing telephone intervention. Measurements were taken in three settings: face-to-face, telephone, and confessional (separated by a screen). As expected, trained counselors scored significantly higher Empathic Understanding scores than untrained counselors. _Moreover, there was little difference among the ratings for the three settings used, indicating the appropriateness of inter- personal skills for telephone intervention, the intervention modality most frequently used by crisis center personnel. In an elaborate explanation of his systematic Human Resources Development model, Carkhuff (1972) cites 27 experimental studies which 27 support the effectiveness of trainer interpersonal skills combined with a structured skills-building model for improving trainee function- ing. Systematic Human Resources Development emphasizes two primary factors of training effectiveness: the skills with which the helpers relate to other people (interpersonal skills), and the skills which they have in their specialty area (program skills). The trainees, or helpees, are taught specific interpersonal skills via didactic pre- sentation, demonstration, and supervised practice. These studies were conducted with professional and non-professional trainees in agencies, schools, hospitals, and correctional facilities. Many of these studies (23 of 27) involved non-professionals (parents, students, correctional officers and inmates, hospital personnel, patients, etc.) and all report significant increases in trainee effectiveness. Anthony and Carkhuff (1970) found similar results in a study which investigated change in measures of communication and discrimina- tion among Rehabilitation Counselor trainees. Brown and Schmidt (1973) trained 16 agency professionals using a structured Interpersonal Process Recall model and found significant improvement in trainee scores, when compared with a control group, on the Affective Sensitivity Scale (Danish and Kagan, 1971), as well as 10 sub-scales of the Personal Orientation Inventory (Shostrum, 1964): Other-Directed, Inner-Directed, Self-Actualizing Values, Feeling Reactivity, Spontaneity, Self-Regard, Self-Acceptance, Nature of Man, Acceptance of Aggression, Capacity for Intimate Contact. Research results demonstrate the effectiveness of the structured skills~building model for teaching interpersonal communication 28 skills to professional and non-professional workers in a wide variety of settings. No research is available which investigates the effects of adding theory to structured skills-building models, or to counsel- ing effectiveness in general. Counselor Education Program Recently, a number of different counselor education programs have stressed the integration of a combined didactic and experiential training program. Carkhuff and Truax (1965) applied such an approach to two separate but essentially identical training programs, one for advanced graduate students and the second for volunteer but otherwise unselected lay hospital personnel. Sessions lasted 16 weeks, meeting twice per week for two-hour periods. The students spent an additional two hours per week listening on their own to recorded therapy. First, the trainees were didactically taught the therapeutic conditions in- volved. Next, in order to obtain practice at discriminating levels of therapist and client conditions, they were exposed to tape recorded samples of counseling which had been previously rated at various levels of conditions and involvement. Then the trainees received empathy training, followed by role-playing, and finally their initial clinical interviews were recorded and rated so as to provide immediate and con- crete informational feedback on how well they were learning to put into operation the concepts involved. During the last week of the training period each trainee had a single taped clinical interview with each of three hospitalized patients. Six four-minute excerpts (two from each tape) were randomly selected and rated on four variables: Accurate 29 Empathy, Unconditional Positive Regard, Therapist Self-Congruence, and Client Depth of Self-Exploration. Ratings from the two groups were compared with each other and with an experienced group of prominent psychotherapists. Although the results showed consistent performance in the following descending rank order: (a) experienced psychotherapists; (b) graduate students; and (c) lay personnel, there was no significant difference between experienced therapists and graduate students, nor between graduate students and lay personnel on any of the measures. The only significant difference was between experienced therapists and lay personnel on the Therapist Self- Congruence dimension. These results suggest that "in a relatively short training period, i.e. approximately 100 hours, both graduate students and lay personnel can be brought to function at levels of therapy nearly commensurate with those of experienced therapists." Miller (1969) designed a counseling practicum program which moved trainees from non-counselor modes of behavior to more experienced counselor behavior. The 30 randomly selected trainees received didactic presentations regarding methods of intervention. Then, prior to their first counseling contact, they were exposed to different conditions: (a) no intervention; (b) practice responding to taped stimulus state- ments where a supervisor offered possible alternatives without a con- sistent model; and (c) practice responding to a tape where the super- visor offered only understanding responses as alternatives, with verbal reinforcement on a variable ratio schedule for making understanding responses. All subjects then had a ”counseling session” with an actor- client, which were then rated on four variables: Understanding Response, 30 Topic Changes, Number of Interactions, Number of Evaluations. Those trainees who were reinforced for using understanding responses during supervision responded that way significantly more often than the other students. They also changed the topic fewer times and had less total number of interactions with their clients. Results suggest the importance of combining didactic instruction with consistent super- vised practice to effect the learning of desirable counseling inter- vention skills. Truax (1970) outlines a lOO-hour training program for agency workers which not only involves experiential training in the form of supervised practice and structured skills-building, but emphasizes the didactic use of the rating scales themselves for training pro- fessional and non-professional counselors. The central elements and the procedural steps of this model are the same as those outlined earlier (Truax, 1970), with additional emphases being placed on periodic follow-up seminars to enhance retention of skills, and feed- back from client benefits to provide unit quality control and a con- tinuous influx of information regarding counseling effectiveness. Blocher and Wolleat (1972) developed and implemented a two- quarter training model within a two-year program leading to a master's degree in counseling. This program consisted of six quarterehour credits during each of the students' second and third quarters. This model again emphasized a combined didactic and experiential approach to counselor training, and added a third dimension of concurrent practical learning experiences in the form of supervised practicum. Eleven students each conducted twenty-minute video taped interviews 31 with a coached, actor-client on three occasions: (a) during the first week of the course; (b) during the last week of the course; and (c) eight months subsequent to completing the course. These three sets of interviews were then rated independently in random order by three pairs of trained judges on three outcome variables: Cognitive Flexi- bility (ability of the counselor to develop a consistent psychological framework for understanding the client and his concerns); Perceptual Sensitivity (ability of counselor to comprehend the total meaning of the client's communication); and Involvement with Client (the attitude of the counselor toward the client and the amount of counselor risk). The instrument used in making the ratings was the Burks Counselor Interview Rating Scales (CIRS). The students made significant gains (.05) during the training period on both Cognitive Flexibility and Perceptual Sensitivity, but not on Involvement with Client, the base- line for which was substantially higher than the other two. During the follow-up period, ratings increased on all three outcome variables. In the authors' words: ....Perhaps the most encouraging result of this evaluation was the evidence that a non-traditional training program with a combination of didactic, experiential, and practical instructional inputs contributes to substantial growth in counselor trainees. The candidates' counseling behavior not only improved considerably over the training period, but continued to change positively over the follow-up period. At the end of the evaluation, the findings lend support to those of Truax and Carkhuff, whose didactic- experiential training program has also been shown to contribute to the improvement, rather than the deterioration, of functioning on several facilitative conditions. In summary, it now appears that we can point to at least some reliable evidence that innovative counselor preparation programs which are not limited solely to the traditional didactic model have the potential to substantially improve the effectiveness of counselor trainees on several relevant dimensions. 32 Crisis intervention appears to be a viable treatment approach. Combined didactic and experiential training models have been effectively employed in the training of workers in a variety of settings. Whether or not the integration of didactic and experiential techniques within a consistent personality theory will provide a more effective vehicle for trainee acquisition of crisis intervention skills will be the issue upon which this author will concentrate his efforts in this study. CHAPTER III METHODOLOGY AND DESIGN OF THE STUDY The purpose of this chapter is to delineate a step-by-step narrative of the methodology involved in this study. It includes a description of how the population for the study was determined, and a description of each instrument used in the study. The procedure used in the study is discussed, the research hypotheses are listed, and the methods used for statistical analyses are summarized. Population The population of subjects for the study consisted of the active volunteer crisis intervention agents at the Open Door Crisis Center, located at 1320 S. Washington Avenue, Lansing, Michigan. The Open Door is a three-year old non-profit corporation, staffed totally by volunteers, offering telephone and walk-in crisis abatement, re- ferral services, and some long-term counseling. At the time of the study the center was handling an average of 500 contacts per month. Each volunteer used as a subject for this study had successfully completed a 40-hour training program in communication and crisis intervention skills prior to the experiment. Seventeen volunteers had completed necessary additional training requirements to become a trainer of new volunteers. Furthermore, each volunteer 33 34 was working at least one four-hour shift per week, which qualified the person for "active" status at the center. The following demographic information is provided as a description of the volunteers at the center during the time of the study. (Refer to Table 5.1, Age Distribution; Table 5.2, Length of Services; and Table 5.3, Educational Background.) A general summary statement describing the center's staff is "white, middle-class, and young." Sample The subjects for the study were selected as follows: First, approximately three months prior to the experiment, the project was presented to the entire staff and approved. Care was taken at this time not to spell out the specifics of the experiment in such a way as to contaminate the study. Second, approximately two months before the pre-tests, a letter was sent to each volunteer explaining more fully the purpose of the study. Included with this letter was a scheduling questionnaire, requesting volunteers to participate in the experiment and to submit a schedule for testing. Those volunteers who did not immediately respond were contacted by phone. Two volunteers were not included in this procedure, but instead were selected to lead two of the training groups during the experiential weekend. In this manner, one of each of the different practice groups was led by a Senior Trainer who was intimately familiar with the traditional training model used at the Open Door. 35 Table 5.1. Distribution of Active Volunteer Crisis Intervention Agents at Open Door Crisis Center (December, 1973) Male Female Age in Years Single Married Single Married Total 15 l O l O 2 l7 0 O 1 O l 18 0 O 1 O 1 19 O O 1 0 1 20 3 O 2 l 6 21 O 5 O 8 22 3 2 2 2 9 23 O l 2 1 4 24 3 O I 3 7 25 l 2 3 2 8 26 2 l O l 4 27 1 2 l 2 6 28 l O O 0 l 29 O 0 2 1 3 30 1 l 1 2 5 32 O 2 O l 3 35 0 0 0 l 1 Total 19 11 23 17 70 Mean 23.1 26.5 22.1 26.2 24.1 Median 22 25 21 24 24 36 Table 5.2. Length of Service in Weeks: Active Volunteer Crisis Inter- vention Agents at Open Door Crisis Center (December, 1973) Length of Service Male Female in Weeks Single Married Single Married Total 0 to 9 l 4 5 3 13 10 to 19 1 1 3 4 9 20 to 29 2 l 3 l 7 30 to 39 l l O 2 4 40 to 49 4 l 5 2 12 50 to 59 2 1 l 0 4 60 to 69 l O O 0 1 70 to 79 0 l 3 0 4 80 to 89 O O O 0 0 90 to 99 2 0 2 4 8 100 to 109 2 l 0 l 4 130 to 139 O O l O 0 150 to 159 3 0 0 O 3 Total 19 ll 23 17 70 Mean 69.7 34.0 42.4 43.8 49.0 Median 50 to 59 20 to 29 30 to 39 30 to 39 40 to 49 37 Table 5.3. Educational Background of Active Volunteer Crisis Inter- vention Agents at Open Door Crisis Center (December, 1973) Educational Male Female Background Single Married Single Married Total In High School 1 O 3 O 4 In undergraduate 10 3 12 6 31 B.A. or 8.5. 4 2 7 5 18 In graduate school 4 5 l 5 15 M.A. or M.S.W. 0 l 0 1 2 Total 19 ll 23 17 7O Attending School 15 6 13 7 4| Not Attending School 4 5 10 10 29 Total 19 ll 23 17 7O Of the remaining 68 volunteers, 56 agreed to participate in the experiment. As can be seen from Tables 6.1, 6.2, and 6.3, there were no apparent demographic differences between the population and the original sample. These 56 subjects were leveled into six groups on the basis of pre-test scores on the Transactional Analysis Cognitive Test. Between the pre—test and the delayed post-test, five (5) sub- jects became "inactive" and therefore inaccessible. Tables 6.4, 6.5, and 6.6 show the demographic information for the 51 subjects completing the experiment. Instruments This study employed three instruments--the Affective Sensitivity Scale (Form C), Transactional Analysis (TA) Cognitive Tests (Forms 1, 2, 3), and the Skills Ability Scale (Subscales: Information, Dangerous Affect, Long-Term Stress). The Affective Sensitivity Scale is commercially avail- able and is described as per existing reliability and validity data. The 38 Table 6.1 Age Distribution--Original Sample Male Female Age in Years Single Married Single Marriedfi‘ Total 15 l - l - 2 17 - - - - - 18 - - l - l 19 - - 1 - 1 20 2 - 2 1 5 21 3 - 4 - 7 22 3 l 2 - 6 23 - l 2 1 4 24 2 - l 2 5 25 l 2 3 2 8 26 2 l - l 4 27 - l 1 l 3 28 l - - - 1 29 - - 2 - 2 30 l - 1 2 4 32 - l l 2 4 35 - - - l 1 Total 16 7 21 12 56 Mean 22.9 25.1 22.4 26.8 23.9 Median 22 25 22 26 24 39 Table 6.2. Length of Service in Weeks: Original Sample Length of Service Male Female ‘__ in Weeks Single Married Single Married Total 0 to 9 l 3 5 2 ll 10 to 19 1 1 3 3 8 20 to 29 2 0 3 l 6 30 to 39 l 0 0 l 2 40 to 49 4 l 4 l 10 50 to 59 O 1 1 O 2 60 to 69 l 0 O O 1 70 to 79 0 1 3 O 4 80 to 89 0 O 0 O 0 90 to 99 2 O 2 3 7 100 to 109 l O O l 2 130 to 139 O O O O 0 150 to 159 3 O 0 O 3 Total 16 7 21 12 56 Mean 69.4 29.3 37 9 45.8 47 5 Median 45 15 25 3O 45 Table 6.3. Educational Background: Original Sample Educational Male Female Background Single Married Single Married2 ‘TotaT In High School 1 O 2 O 3 In undergraduate 8 2 ll 6 28 B.A. or 8.5. 3 1 7 4 14 In graduate school 4 3 1 l 9 M.A. or M.S.W. O l O l 2 Total 16 7 21 12 56 Attending School 13 4 ll 5 33 Not Attending School 3 3 10 7 23 Total 16 7 21 12 56 40 Table 6.4. Age Distribution: Final Sample Male Female Age in Years Single Married Single Married1 Total 15 l - 1 _ 2 17 - - - - _ 18 - - l - l 19 - — 1 - 1 20 2 - 2 - 4 21 3 - 3 - 6 22 3 - 2 - 5 23 - - 2 l 3 24 2 - l 1 4 25 l 2 3 2 8 26 2 l - 1 4 27 ' - l l l 3 28 l - - - 1 29 - - 2 - 2 3O 1 - l 2 4 32 - 1 - l 2 35 - - - l 1 Total 16 5 20 10 51 Mean 22.9 26.7 22.5 27.8 24.1 Median 22 26 23 27 24 41 Table 6.5. Length of Services in Weeks: Final Sample Length of Service Male Female in Weeks Single Married Single Married Total 0 to 9 l l 5 l 8 10 to 19 1 l 3 2 7 20 to 29 2 O 3 l 6 30 to 39 1 O O l 2 40 to 49 4 l 3 l 9 50 to 59 O l l O 2 60 to 69 l 0 O 0 1 70 to 79 0 l 3 O 4 80 to 89 O 0 O O O 90 to 99 2 0 2 3 7 100 to 109 l 0 O l 2 130 to 139 O O O O O 150 to 159 3 O 0 O 3 Total 16 5 20 10 51 Mean 69.4 39.0 37 6 53.0 50 Median 45 45 25 40 45 Table 6.6. Educational Background: Final Sample Educational Male Female Background Single Married Single Married Total In High School 1 O 2 O 3 In undergraduate 8 0 10 5 23 B.A. or 8.5. 3 1 7 3 13 In graduate school 4 3 l l 9 M.A. or M.S.W. O l O l 2 Total 16 5 20 10 51 Attending School 13 4 ll 4 32 Not Attending School 3 1 9 6 19 Total 16 5 20 10 51 42 TA Cognitive Tests and the Skills Ability Scale were developed for this experiment and are described in more detail. An Overview of the Affective Sensitivity Scale (Form C)' Introduction and Test Development Affective sensitivity can be conceptualized as "the ability to detect and describe the immediate affective state of another, or in terms of communication, the ability to receive and decode affective communication." (Kagan, Krathwohl, and Farquahr, 1965). The Affective Sensitivity Scale was developed to measure subjects' abilities to identify affect in this manner, thereby providing a measure of what is termed generically as empathy (Danish and Kagan, 1971). The scale operationalizes this concept through a videotape situational test containing 66 scenes involving 11 different clients and counselors, both male and female. These scenes are taken from actual counseling sessions of clients, representing typical counseling situations which vary in emotional depth and content of client concern. Each showing of a videotaped sequence is followed by the subjects' answering of several multiple-choice paper-and-pencil items, each of which contains three responses, or foils, which define what the client may be feeling about the counselor. The subject is to choose the foil which he thinks most clearly describes the client's feelings. The reliability of the scale has been assessed using internal consistency and test-retest coefficients. Internal consistency co- efficients range between .58 and .77 with the majority of coefficents 43 in the .70's (Danish and Kagan, 1971). A test-retest coefficient of correlation was .75 over a two-week period (Campbell, 1967; Kagan, Krathwohl, Goldberg, Campbell, Schaubel, Greenberg, Danish, Resnikoff, Bowes, and Bondy, 1967). Campbell, Kagan, and Krathwohl (1971) report a series of concurrent validation studies which compared scores on the Affective Sensitivity Scale with therapist and peer rankings of counseling effectiveness. The average correlation across all studies reported was .26, with rho values ranging from .42 to .17. "These concurrent validity studies suggest that a low, positive relationship exists between scale scores and judgments of counseling affectiveness." Although the validity data for the Affective Sensitivity Scale is so low as to render its usefulness as doubtful, it was chosen for the study for two reasons: (1) it provides a standardized measure of empathy which had been used in numerous counselor prepara- tion programs; and (2) it therefore provided a method to observe change in scores of empathy while new crisis intervention techniques were being introduced to the subjects. Administration and Scoring This scale was administered using computer scoring sheets according to standardized instructions. Subjects were instructed to fill in the answer sheet requests for "student number," the date, and sex of subjects. Answer sheets were computer-scored at the Office of Evaluation Services, Michigan State University. 44 An Overview of the Transactional Analysis (TA) Cognitive Tests_(Forms 1, 2L 3) Introduction The TA Cognitive Tests were developed and implemented in order to provide a measure of subjects' knowledge of Transactional Analysis theory and practice. These scores were used to level groups at the onset of the experiment, as well as to measure changes in sub- jects' knowledge of TA throughout the study. Each form of the test consists of 55 multiple-choice, paper- and—pencil questions, each with four foils. The subject is requested to choose the most correct answer for each question. Credit is re- ceived only when the correct answer is chosen. Development An initial question pool of 200 items was developed from the materials presented in a Transactional Analysis handbook. This hand- book was used during the experiment to acquaint subjects with TA theory. Each item in the pool was also cross-referenced to Born to Nip-(James and Jongeward, 1971), a popular TA textbook. Each item consisted of a multiple-choice question with four foils, one of which provided a correct answer. These 200 questions were then written as two tests, one of 168 items and the other of 32 items, so that they could be scored by the Office of Evaluation Services, Michigan State University. These tests were administered to two different populations in order to de- termine the ability of the individual items to discriminate between 45 individuals who were naive and those who were sophisticated in terms of TA theory and practice. The naive population was selected from one undergraduate and one graduate class at Oakland University. The mem- bers of these classes reported little or no prior knowledge of TA theory and practice, that being one reason why they had taken the class. The sophisticated population were members of Transactional Analysis Clinical Training programs who had been exposed to at least one intro- ductory TA workshop, supplemented by individual readings and varying amounts of TA training and personal treatment. Table 7.1 illustrates the results of these administrations, indicating that the test items did discriminate between naive and sophisticated populations. Table 7.1. Transactional Analysis Cognitive Tests: Discrimination of Items with Naive (N) and Sophisticated (S) Groups No. of Signifi- Test N0. of Kuder-ZO Std. Error Mean Score cance of Items Subjects Reliability of Measure Score Variance Mean Diff. 50 0.912 5.739 82.92 374.83 N: '58 s = 37 0.922 4.667 125.89 279.54 p ('005 N = 50 0.647 2.614 13.63 19.42 32 s = 37 0.836 2.275 22.32 31.56 p ('005 Using the information gained from the item analysis, three tests were developed of equal length (55 items each). The following is a content validity table used to develop the three tests: 46 Table 7.2. Transactional Analysis Cognitive Tests: Content Validity Points for Each Area Subject Area Pom 1 Form 2 Form 3 1. Structural Analysis--ego states and content l4 l4 l4 2. Time Structuring--definition and ways 8 7 8 3. Strokes--definition, types, and need for 10 ll 10 4. Life Positions--definitions 4 4 4 5. Transactional Analysis--types of transactions 4 4 4 6. Rackets and Stamps--definition and recognition of 6 6 6 7. Games--definiti0n and recognition of 6 6 6 8. Scripts--definition 3 3 3 These three forms were used in the experiment as pre-, post-, and delayed post-tests, respectively. Copies of the three forms can be found in Appendix A. Reliability Data Reliability data was gathered from administering the various forms of the TA Cognitive Tests during the experiment. These three forms were also administered to students at Oakland University as a single final examination for a course in Transactional Analysis. Table 7.3 illustrates the data obtained. 47 Table 7.3. Transactional Analysis Cognitive Tests: Reliability Data Kuder-20 Std. Error Form Number When Given Reliability of Measure Pre-test 0.78 3.00 l Post-test 0.84 2.85 Oakland U. 0.79 2.93 Post-test 0.88 2.75 2 Delayed Post- 0.87 2.70 Oakland U. 0.78 2.76 ‘— Delayed Post- 0.84 2.90 3 Oakland U. 0.82 2.89 Kuder-Richardson-ZO estimates range from .78 to .88, a high reliability for a 55-item test. Furthermore, results from the tests given to the Oakland University students were used to compute test-equivalences, the correlation between individual test scores. These correlations are given in Table 7.4. Table 7.4. Transactional Analysis Cognitive Tests: Equivalence of Forms Form #1 Form #2 Form #3 Form #1 1.00 Form #2 0.67 1.00 Form #3 0.87 0.55 1.00 As illustrated in Table 5.4, the correlations between the three forms are adequate, especially since the experiment uses only the comparisons 48 of Forms 2 and 3 to Form 1. Form #1 correlates with Form #2 at 0.67; and Form #1 correlates with Form #3 at 0.87. Administration and Scoripg The tests were administered using computer scoring sheets. The person administering the tests was instructed to say: I am not allowed to answer any questions about the test. Please read the test instructions carefully, take the test, and return the test booklet and answer sheet to me when you are finished. Each test had the following verbal instructions. There is no time limit to this test, so take as much time as you need. There is only one correct answer for each question. You will not lose points for an incorrect answer. Please do not mark on the test booklet. Instead, mark your answers on the answer sheet, using a #2 pencil. Also, mark your experimental code number in the space for "student number," the date, your sex, and the Form # of this test. The tests were computer-scored by the Office of Evaluation Services, Michigan State University. An Overview of the Skills Ability Scale Introduction The Skills Ability Scale (SAS) was developed following the concept that calls coming into crisis centers can be sorted into categories along the dimensions of (1) the need presented by the caller; and (2) the degree of emotion present in the caller. Three categories have been identified from a history of the contacts taking place at the Open Door. These categories were used to develop three Subscales of the Skills Ability Scale, as described below: 49 Type 1: Information. The caller makes a request for information. The information requested may be about general knowledge, or for the location of appropriate community resources. There are no indications of a strong affective component accompanying the request for information, and there are no indications that the caller will not be capable of hearing and using the in- formation. Type II: Dangerous Emotions. The caller is apparently overwhelmed by the affective component of the problem. There are strong indications that the caller will not be able to begin appro- priate coping behavior until the affective component is brought under control. Type III: Long:Term Stress. The caller is presenting material about some "long-term" stress. Although affective material is a crucial component, the caller is still able to employ exist- ing coping mechanisms. The caller is usually requesting aid in clarifying the various aspects of the problem and develop- ing alternative courses of action. Development Most of the contacts made at the Open Door are made via tele- phone, which eliminates the use of visual cues in selecting intervention strategies and skills. For this reason, audio tape was selected as the appropriate vehicle for measuring crisis intervention skills. Also, the use of audio tape would result in the development of a measurement instrument which would continue to be used by the Open Door in subse- quent training programs. Sixty (60) typical caller statements, twenty (20) for each of the three categories, were first written and then audio taped. The caller statements were written and recorded by persons experienced in crisis intervention, but who were not subjects in the experiment. The resulting sixty statements were sorted into the above categories by two groups of raters. One group was composed of three experienced crisis 50 intervention agents who had read the above description of the cate- gories just prior to hearing the audio tape. The second group was composed of 22 student nurses at Lansing Community College who had just listened to a one-hour lecture on crisis intervention strategies and techniques which included a discussion of the above categories. Caller statements receiving .80 agreement on category assign- ment were identified. This figure (.80) was arbitrarily chosen as one which would provide a reasonably good assurance that intention of call could be readily identified. Ten (10) caller statements from each category were selected and re-taped in random order. Each caller state- ment was immediately followed by a 30-second silence. This constituted the final form of the Skills Ability Tape. (See Appendix B for stimulus statements). Administration The Skills Ability Scale was administered to a maximum of seven subjects at a time, this upper limit being dictated by the number of tape recorders available. The following instructions were given: You will be listening to speaker statements on the reel-to-reel tape recorder and recording your responses on the casette re- corder in front of you. To do this you will turn your recorder on and off with the switch on the microphone. It should be done this way....turn your recorder on, say 'number one,‘ and turn your recorder 0ff....d0 that now. Fine, now you will listen to the first speaker statement, turn your recorder on, pause for a second so your casette will be ready to record, make your re- sponse, say 'number two,‘ turn your cassette off, and wait for the next speaker statement. There will be thirty seconds after each statement for you to make your response. Are there any questions about how you are to take this test? After questions on the mechanics were answered, the subjects were given the following instructions: 51 I cannot answer any questions about this part of the instructions, so listen carefully. You are to fantasize that the speaker state- ment is the first thing you hear after you answer the phone at the center. You are to make the best response you know how. We will begin now. Scoring A five-point scale for each category was developed, based on the existing intervention procedures adopted by the Open Door (refer to Appendix C). These procedures were based on both the theory of crisis intervention and the cumulative experience of the staff. These procedures have been established by majority vote of the staff over a two-year period. It was determined that each scale could be made behaviorally specific. In this manner, the rater had only to determine if certain sets were present in order to arrive at the rating of the response. Furthermore, in developing the scales it was found that TA provided a ready explanation of why each procedure was adopted. However, it should be stressed that these procedures were developed prior to the intro- duction of TA concepts to the training model. Reliability During the practice sessions with the three raters it was intended to develop an inter-rater reliability of at least 0.60. How- ever, the simplicity of the rating scales allowed for almost perfect agreement by the raters after rating 150 responses. Furthermore, Hoyt reliability for all ratings of responses of the subjects made during the pre-, post-, and delayed post-tests was computed (a total of 4,590 responses), and was found to be 0.97. 52 Procedure 1. Two months before the training workshop, a letter ex- plaining the nature and purpose of the study was mailed to each active crisis intervention agent at the Open Door. This letter was accompanied by a questionnaire requesting demographic information and what times the person could be available for testing and the weekend training workshop. 2. Starting one month before the pre-test, each crisis intervention agent was contacted by telephone to verify his response to the letter and questionnaire. At this time the crisis intervention agent was again informed of the importance of the study, but was not otherwise pressured into participating in the experiment. Each person's decision was recorded and no attempt was made to determine why an indi- vidual chose not to participate. By the end of this activity, a list of the crisis intervention agents who had made the committment to participate in the study was developed. 3. Starting one month before the post-test, one two-hour session per week was held with the group leaders, for a total of eight hours. During this time the training procedures and goals were dis- cussed and practiced until all the group leaders were able to con- sistently follow the same training model. All four of the leaders were attending Transactional Analysis Clinical Training Programs throughout the duration of the experiment. Two of the group leaders were certified as Senior Trainers of the Open Door. Senior Trainer certification is achieved by successfully completing 120 hours of training and then 53 receiving recommendation for Senior status by two observers during three consecutive trainings. This certification is maintained as long as the trainer continues to receive Senior status recommendations dur- ing subsequent trainings. 4. Due to the scheduling requirements of the subjects and limitations in equipment and space, the pre-tests were conducted over a four-day period, Monday through Thursday. The Skills Ability Scale could only be administered to seven subjects at a time, due to the requirement of each subject having to use a tape recorder. Two groups of subjects were tested each evening. The following testing schedule was followed in administering the instruments: Group I: 7:00 P. M. to 8:00 P.M.--Affective Sensitivity Scale 8: 00 P. M. to 8:45 P.M.--TA Cognitive Test; Form #1 8: 45 P. M. to 9:30 P.M.--Skills Ability Scale Group II: 7:00 P. M. to 7:45 P.M.--TA Cognitive Test; Form #1 7: 45 P. M. to 8:30 P.M.--Skills Ability Scale 8: 30 P. M. to 9:30 P.M.--Affective Sensitivity Scale 5. Each evening after the pre-tests were administered, the TA Cognitive Test was hand-scored. These scores were rank ordered in terms of magnitude of score. After all scores were rank ordered on Thursday evening, subjects were assigned to groups of six on the basis of magnitude of test score. Subjects were assigned to the experimental groups by random assignment from each group of TA test scores. In this manner an attempt was made to level each group in terms of know- ledge about Transactional Analysis prior to the beginning of the various treatments. Subjects were notified of their assignments on Friday morning. 54 6. The following chart shows the six experimental groups to which the subjects were assigned. All subjects received pre-, post-, and delayed post-tests on all three measures. TA Practice IPR Group] Group1 Control TA Study . . Group Group Sr. Tra1ner Sr. Tra1ner TA Practice IPR GTOUPZ Group2 The Control Group (CG) received no further treatment. On Friday, the subjects assigned to the Transactional Analysis Study Groups (TAS) were given a handbook covering an introduction to TA theory, and were in- structed to study the handbook over the weekend until they felt comfortable with their knowledge level. Handbooks were turned into the center on the following Monday, and these subjects were instructed not to study any TA material again until the conclusion of the study. Two Interpersonal Process Recall Groups (IPR) were established. These groups repeated the traditional training model used by the Open Door to teach communication skills to new volunteers. Subjects assigned to these groups were not given TA handbooks, the group leaders were in- structed not to use TA concepts or terminology during the training, and the group members were instructed not to read or discuss material about TA for the duration of the study. The group labeled IPR1 was led by a trainer who was an Open Door Senior Trainer, while the group leader of IPR2 was not an Open Door Trainer. Two Transactional Analysis Practice Groups (TAP) were estab- lished. Subjects assigned to these groups were given the same handbook 55 on Transactional Analysis that was given to the TAS group. The TAP groups repeated the traditional training model used by the Open Door, with TA concepts and terminology added. The TAP1 group was led by an Open Door Senior Trainer, while TAP2 had a group leader who was not an Open Door trainer. 7. The following is a condensation of the training given to both the IPR and the TAP groups. This model is derived from the Open Door's Training Manual for Trainers. a. The group leader selects a subject to be a Speaker, who talks about some real concern, problem, or experience; and a subject to be a Listener, who practices the communication skills. The group leader is responsible for making sure that each subject speaks and listens five times, and that the subjects do not listen to the same speaker more than once. b. The Speaker and Listener proceed to have an interaction that lasts from 5 to 10 minutes, and which is audio taped. During the interaction the group leader takes notes on the behavior of the Listener, rates the interaction on five performance scales (refer to Appendix E), and develops specific feedback for the Listener. The group leader is responsible for terminating the interaction. c. The audio tape is played back while the group leader facilitates a discussion between the Listener and Speaker about the dynamics of the interaction. During this "non- directive recall" the group leader offers the Listener an opportunity for self-discovery learning through the use of "open-ended questions." During this period the group leader does not give specific instructions or comments about the appropriateness of the Listener's behavior. Generally this process lasts approximately 15 minutes, with the group leader selecting two or three points in the inter- action for further inspection and discussion. d. At the end of the non-directive recall, the group leader gives specific instructions about behaviors that the Listener should change or retain. In many cases this con- sists of reinforcing the information gained by the Listener during the preceding non-directive recall. 56 e. The Listener then summarizes the instructions given by the group leader and makes a contract on what behavioral changes the subject will be making in subsequent interactions. f. The last step consists of providing an opportunity for "group process." During this time questions from the sub- jects are answered, and, if necessary, feelings of the subjects are dealt with. The objectives of the group process are to provide new information and to facilitate the subjects' maintaining an emotional set conducive to learning. At the end of group process, another interaction is begun. The average cycle takes between 25 and 30 minutes. The training workshop for this experiment took place from 7:00 P.M. to 11:00 P.M. Friday, and from 9:00 A.M. to 6:00 P.M. Saturday, with a one-hour lunch break on Saturday. This is a total of 12 hours training, which the subjects received in addition to the 28 hours of training which they had previously received during initial volunteer training. At the end of this period the subjects were re- quested not to discuss the study with any other subject. Furthermore, subjects in all the groups were requested not to study TA until the conclusion of the experiment. Verbal agreement to these requests were received from all subjects. 8. Again, due to scheduling requirements of the subjects and limitations in equipment and space, the post-tests were conducted over a five-day period, Sunday through Thursday evenings. The following testing schedule was used: Group I: 7:00 P.M. to 8: 00 P. M. --Affective Sensitivity Scale 8:00 P.M. to 8: 45 P. M. --TA Cognitive Test, Form #2 8:45 P.M. to 9: 30 P. M. --Skills Ability Scale 9:30 P.M. to 10: 15 P. M. -TA Cognitive Test, Form #1 Group II: 7:00 P.M. to 7: 45 P.M.--TA Cognitive Test, Form #2 7:45 P.M. to 8: 30 P. M. --Skills Ability Scale 8:30 P.M. to 9: 30 P. M. --Affective Sensitivity Scale 9:30 P.M. to 10: 15 P. M. -TA Cognitive Test, Form #1 57 At the beginning and end of the testing the subjects were reminded of their agreement not to study TA material until the end of the experi- ment, nor to discuss the experiment with each other. 9. Four weeks after the end of the post-tests each subject was contacted by telephone to schedule the delayed post-test. At this point it was determined that five subjects had become inactive at the Open Door, and could not be located. These subjects were deleted from the study. 10. Four weeks after the post-tests, a meeting was held for the three raters who would be used to rate the Skills Ability Scale. These three raters were also participating in the TA Clinical Train- ing Program. During this meeting the Skills Ability Scale was dis- cussed, and the tapes generated by the five subjects who had dropped out of the experiment were used to develop a high degree of agreement on rating responses. 11. Five weeks after the conclusion of the post-tests, the delayed post-tests were administered to the subjects. Again the test- ing was spread over a five-day period, Sunday through Thursday evenings. The following testing schedule was used: Group I: 7:00 P.M. to 8:00 P.M.--Affective Sensitivity Scale 8:00 P.M. to 8:45 P.M.-~TA Cognitive Test, Form #3 8:45 P.M. to 9:30 P.M.--Skills Ability Scale 9:30 P.M. to 10:15 P.M.-TA Cognitive Test, Form #2 Group II: 7:00 P.M. to 7:45 P.M.--TA Cognitive Test, Form #3 7:45 P.M. to 8:30 P.M.--Skills Ability Scale 8:30 P.M. to 9:30 P.M.-~Affective Sensitivity Scale 9:30 P.M. to 10:15 P.M.-TA Cognitive Test, Form #2 58 12. Immediately after the conclusion of the delayed post- tests, the individual responses to the Skills Ability Scale were re- recorded from cassette to 7“ reel tape in random order. In this manner, the raters were kept from knowing which test the recorded responses were from. The SAS responses were rated simultaneously by the three raters. However, precautions were taken to prevent discussion of the responses, once the rating had begun. Raters were instructed not to communicate their responses to each other, and the rating was monitored by a proctor. 13. Once all the data had been compiled in raw form, i.e. computerized answer sheets, the subjects were thanked for their cooperation with a party. During the party, questions about the experiment were answered. Hypothesgs The primary questions toward which this study was directed were: (1) Will the addition of the Transactional Analysis theory of personality structure and its implications for crisis inter- vention to the current training model result in improvement in trainees' abilities to select and emit effective crisis intervention strategies, as defined by measures on the instruments used in this study? (2) Will supervised practice in Transactional Analysis theory and practice result in improvement in trainees' abilities . to select and emit effective crisis intervention strategies, as defined by measures on the instruments used in this study? (3) Will improvements in these abilities be maintained over time? The following general trends were predicted: 59 (1) Subjects assigned to the TA PractiCe groups, given new cognitive information in addition to receiving supervised practice in the application of this information, will improve and retain scores on all three measures to a higher degree than will subjects assigned to any of the other groups; (2) Subjects assigned to the TA Study group, given new cognitive information, will improve and retain scores on the TA Cogni- tive Tests and the Skills Ability Scale to a higher degree than will subjects assigned to the Interpersonal Process Recall (IPR) or control groups; and (3) Subjects assigned to the Interpersonal Process Recall (IPR) groups, given additional supervised practice in communication skills, will improve and retain scores on the Affective Sensitivity Scale to a higher degree than will subjects assigned to the TA Study (TAS) or control groups. In sum, the following order of performance for improvement and retention of scores was predicted: TA Cognitive Tests: TAP > TAS > IPR Control Skills Ability Scale: TAP > TAS > IPR > Control Affective Sensitivity Scale: TAP > IPR > TAS > Control To answer the primary questions toward which this study was directed, the following research hypotheses were tested: Hypothesis 1: Subjects assigned to the control group (CG) and to the IPR groups will not demonstrate a significant improve- ment in scores on the TA Cognitive Tests. Hypothesis 2: Subjects assigned to the TAS group will demonstrate significantly greater improvement in scores on the TA Cognitive Tests, when compared with subjects assigned to the control group. Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis 60 Subjects assigned to the TAS group will demonstrate significantly greater improvement in scores on the TA Cognitive Tests, when compared with subjects assigned to the IPR groups. Subjects assigned to the TAP groups will demonstrate significantly greater improvement in scores on the TA Cognitive Tests, when compared with subjects assigned to the control group. Subjects assigned to the TAP groups will demonstrate significantly greater improvement in scores on the TA Cognitive Tests, when compared with subjects assigned to the IPR group. Subjects assigned to the TAP group will demonstrate significantly greater improvement in scores on the TA Cognitive Tests, when compared with subjects assigned to the TAS group. Subjects assigned to the TAS group will demonstrate a significantly greater retention of scores on the TA Cognitive Tests, when compared with subjects assigned to the control group. Subjects assigned to the TAS group will demonstrate a significantly greater retention of scores on the TA Cognitive Tests, when compared with subjects assigned to the IPR groups. Subjects assigned to the TAP groups will demonstrate a significantly greater retention of scores on the TA Cognitive Tests, when compared with subjects assigned to the control group. : Subjects assigned to the TAP groups will demonstrate a significantly greater retention of scores on the TA Cognitive Tests, when compared with subjects assigned to the IPR groups. : Subjects assigned to the TAP groups will demonstrate a significantly greater retention of scores on the TA Cognitive Tests, when compared with subjects assigned to the TAS group. : Subjects assigned to the TAS group will demonstrate a significantly greater improvement in scores on the Skills Ability Scale, when compared with subjects assigned to the control group. 61 Hypothesis 13: Subjects assigned to the TAS group will demonstrate a significantly greater improvement in scores on the Skills Ability Scale, when compared with subjects assigned to the IPR group. Hypothesis 14: Subjects assigned to the TAP groups will demonstrate a significantly greater improvement in scores on the Skills Ability Scale, when compared with subjects assigned to the control group. Hypothesis 15: Subjects assigned to the TAP groups will demonstrate a significantly greater improvement in scores on the Skills Ability Scale, when compared with subjects assigned to the IPR groups. Hypothesis 16: Subjects assigned to the TAP groups will demonstrate a significantly greater improvement in scores on the Skills Ability Scale, when compared with subjects assigned to the TAS group. Hypothesis 17: Subjects assigned to the IPR groups will demonstrate a significantly greater improvement in scores on the Skills Ability Scale, when compared with subjects assigned to the control group. Hypothesis 18: Subjects assigned to the TAS group will demonstrate a significantly greater retention of scores on the Skills Ability Scale, when compared with subjects assigned to the control group. Hypothesis 19: Subjects assigned to the TAS group will demonstrate a significantly greater retention of scores on the Skills Ability Scale, when compared with subjects assigned to the IPR groups. Hypothesis 20: Subjects assigned to the TAP groups will demonstrate a significantly greater retention of scores on the Skills Ability Scale, when compared with subjects assigned to the control group. Hypothesis 21: Subjects assigned to the TAP groups will demonstrate a significantly greater retention of scores on the Skills Ability Scale, when compared with subjects assigned to the IPR groups. Hypothesis 22: Subjects assigned to the TAP groups will demonstrate a significantly greater retention of scores on the Skills Ability Scale, when compared with subjects assigned to the TAS group. Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis 23: 24: 25: 26: 27: 28: 29: 30: 31: 32: 62 Subjects assigned to the IPR groups will demonstrate a significantly greater retention of scores on the Skills Ability Scale, when compared with subjects assigned to the control group. Subjects assigned to the TAS groups will demonstrate a significantly greater improvement in scores on the Affective Sensitivity Scale, when compared with subjects assigned to the control group. Subjects assigned to the IPR groups will demonstrate a significantly greater improvement in scores on the Affective Sensitivity Scale, when compared with subjects assigned to the control group. Subjects assigned to the IPR groups will demonstrate a significantly greater improvement in scores on the. Affective Sensitivity Scale, when compared with subjects assigned to the TAS group. Subjects assigned to the TAP groups will demonstrate a significantly greater improvement in scores on the Affective Sensitivity Scale, when compared with subjects assigned to the control group. Subjects assigned to the TAP groups will demonstrate a significantly greater improvement in scores on the Affective Sensitivity Scale, when compared with subjects assigned to the TAS group. Subjects assigned to the TAP groups will demonstrate a significantly greater improvement in scores on the Affective Sensitivity Scale, when compared with subjects assigned to the IPR groups. Subjects assigned to the TAS group will demonstrate a significantly greater retention of scores on the Affective Sensitivity Scale, when compared with subjects assigned to the control group. Subjects assigned to the IPR groups will demonstrate a significantly greater retention of scores on the Affective Sensitivity Scale, when compared with subjects assigned to the control group. Subjects assigned to the IPR groups will demonstrate a significantly greater retention of scores on the Affective Sensitivity Scale, when compared with subjects assigned to the TAS group. 63 Hypothesis 33: Subjects assigned to the TAP groups will demonstrate a significantly greater retention of scores on the Affective Sensitivity Scale, when compared with subjects assigned to the control group. Hypothesis 34: Subjects assigned to the TAP groups will demonstrate a significantly greater retention of scores on the Affective Sensitivity Scale, when compared with subjects assigned to the TAS group. Hypothesis 35: Subjects assigned to the TAP groups will demonstrate a significantly greater retention of scores on the Affective Sensitivity Scale, when compared with subjects assigned to the IPR groups. Analysis of the Data The 6500 CDC computer at the Michigan State University computer center was used to process the data and perform the following statistical analyses: A repeated measures analysis of variance was performed for each subscale of each instrument, yielding five (5) separate analyses: (1) TA Cognitive Tests; (2) Affective Sensitivity Scale; (3) Skills Ability Scale: Information; (4) Skills Ability Scale: Dangerous Emotions; and (5) Skills Ability Scale: Long-Term Stress. The results of these analyses are found in Chapter IV; The Scheffé method of multiple comparisons was performed to test the significance of differences between specific group means, the results of which are also found in Chapter IV. Due to the exploratory nature of the study, the .10 level of significance was established as the critical level for accepting or re- jecting differences. CHAPTER IV ANALYSIS OF THE DATA The purpose of this study was to investigate the effects of adding a unifying theory of personality structure and change, Trans- actional Analysis (TA), to a structured skills-building model for teaching crisis intervention skills. This chapter presents the statistical analysis of the data in order to examine the hypotheses stated in Chapter III. To implement this study, 51 volunteer crisis intervention agents were selected and assigned to six groups-—one control group, one Transactional Analysis study group, two Interpersonal Process Recall (IPR) groups, and two Transactional Analysis practice groups. (Review the selected population, p. 33, the sample, p. 34, and assign- ment chart, p. 54, for a detailed description of the population and sample.) These subjects received pre-, immediate post-, and delayed post-tests on five measures: (1) Transactional Analysis Cognitive Tests; (2) Skills Ability Scale: Information; (3) Skills Ability Scale: Dangerous Emotions; (4) Skills Ability Scale: Long-Term Stress; and (5) Affective Sensitivity Scale. nganization of the Analysis of the Data To facilitate the investigative process, 35 separate 64 65 hypotheses were generated under six general assumptions. The six assumptions represent predictions of improvement in and retention of scores on three instruments. Five separate analyses of variance pro- cedures were performed to test for main effects. The Scheffe method of multiple comparisons was used to test the hypotheses. The .10 level of significance was established as the critical level for accepting or rejecting differences. Data will be presented in the following order: (1) Transactional Analysis Cognitive Tests a. Improvement in scores b. Retention of scores (2) Skills Ability Scale a. Improvement in scores b. Retention of scores (3) Affective Sensitivity Scale a. Improvement in scores b. Retention of scores Each section will begin with a table which presents the number of subjects, mean score, sum of scores, and sum of squared scores for each group on the three administrations of the instrument. This will be followed by a table presenting the analysis of variance results, a statement of the general assumption and related hypotheses, and, finally, the results of the Scheffe comparisons. The analysis of variance procedure is robust to the slight variations in cell sizes; therefore, no correction factor was used or reported. The interaction 66 effects of Tests x Groups will be discussed in full along with the Scheffé tables. The two TA Practice groups (TAH and the two Inter- personal Process Recall groups (IPR) were each collapsed into a single group for the Scheffé comparisons. This procedure yielded a slightly more conservative measure than would be reported if they had not been collapsed, enhancing test integrity. Transactional Analysis Cognitive Tests The number of subjects, mean score, sum of scores, and sum of squared scores for each group on the three administrations of the Transactional Analysis Cognitive Tests are presented in Table 8.1 Table 8.1. Transactional Analysis Cognitive Tests: Number of Subjects, Mean Score, Sum of Scores, and Sum of Squared Scores Pre-test Post-test Delayed Post-test Group n 7 XX 2x2 7 2x 2x2 11' 2x 2x2 CG 8 28.500 228 6,728 29.375 235 7,157 28.000 224 6,538 TAS 10 27.400 274 7,696 41.500 415 17,281 38.300 383 14,825 IPR 8 29.000 232 7,302 31.000 248 8,372 30.500 244 7 IPR 8 31.625 253 8,225 33.250 266 8.952 34.125 273 9 TAP 9 30,000 270 8,280 43.444 391 17,049 41.111 370 15 TAP; 8 28,750 230 6,684 42.375 339 14,427 41.000 328 13 'Total 51 29.157 1,487 44,915 37.137 1,894 73,238 35.725 1,822 67 Nun—l A repeated measures analysis of variance test was performed to test fo r differences across test means (blocks) and across group means (treatments). The results of this test are presented in Table 8.2. As Table 8.2 ill trates, a significant difference exists across both test and group mea and a significant Tests x Groups Interaction. US- 115, 67 Table 8.2. Transactional Analysis Cognitive Tests: Repeated Measures Analysis of Variance Results Source of Sum of Mean Signi- Variance Squares d.f. Square F ficance Groups 1,906.469 5 381.294 5.203 .0008 S: Groups 3,297.857 45 73.286 Tests 1.850.052 2 925.026 125.427 .0001 Tests x Groups Tests x S: Groups Total 1,122.286 10 112.286 15.225 .0001 663.754 90 7.375 8,840.993 152 Improvement in Scores Assumption: Hypothesis 1: Hypothesis 2: Hypothesis 3: Hypothesis 4: Hypothesis 5: Significant differences in improvement in scores on the TA Cognitive Tests will be found between each pair of groups in the following direction. TAP > TAS > IPR = Control Subjects assigned to the control group (CG) and to the IPR groups will not demonstrate any improve- ment in scores on the TA Cognitive Tests. Subjects assigned to the TAS group will demonstrate significantly greater improvement in scores on the TA Cognitive Tests, when compared with subjects assigned to the control group. Subjects assigned to the TAS group will demonstrate significantly greater improvement in scores on the TA Cognitive Tests, when compared with subjects assigned to the IPR groups. Subjects assigned to the TAP groups will demonstrate significantly greater improvement in scores on the TA Cognitive Tests, when compared with subjects assigned to the control group. Subjects assigned to the TAP groups will demonstrate significantly greater improvement in scores on the TA Cognitive Tests, when compared with subjects assigned to the IPR groups. 68 Hypothesis 6: Subjects assigned to the TAP groups will demonstrate significantly greater improvement in scores on the TA Cognitive Tests, when compared with subjects assigned to the TAS group. The Scheffe method of multiple comparisons was used to test the research hypotheses. Table 8.3 presents the results of these analyses. Table 8.3. Transactional Analysis Cognitive Tests: Improvement in Test Scores by Scheffe Multiple Comparison Test for all Treatment Groups and all Pair-Wise Comparisons of Treat- ment Groups--Transactional Analysis Practice (TAP); Trans- actional Analysis Study (TAS); Interpersonal Process Recall (IPR); and Control (CG) Ratio of Sample Statistic Mean Sample to Expected Signi- Contrast Square Statistic Mean Square ficant CG 4.2804 0.880 0.2056 TAS 3.8285 14.100 3.6829 * TAP 2.9414 13.535 4.6016 * IPR 3.0267 1.810 0.5980 TAP-CG 1.6475 12.655 7.6811 * TAP-IPR 1.3389 11.725 8.7575 * TAP-TAS 1.5316 0.565 0.3689 TAS-CG 1.8217 13.220 7.2568 * TAS-IPR 1.5482 12.290 7.9383 * IPR-CG 1.6630 0.930 0.5592 As illustrated in Table 8.3, significant differences exist be- tween pre- and post-test results of subjects assigned to the TA Practice and TA Study groups. Significant differences in improvement of scores exists: (1) between subjects assigned to the TA Practice groups and those assigned to the control group (TAP-CG): (2) between subjects assigned to the TA Practice groups and those assigned to the IPR groups (TAP-IPR): (3) between subjects assigned to the TA Study group and those 69 assigned to the control group (TAS-CG); and (4) between subjects assigned to the TA Study group and those assigned to the IPR groups (TAS-IPR). No significant differences exist between pre- and post- test scores of subjects assigned to the IPR or control groups, nor do any significant differences exist: (1) between subjects assigned to the TA Practice groups and those assigned to the TA Study group; nor (2) between subjects assigned to the IPR groups and those assigned to the control group. Retention of Scores Assumption: Significant differences in retention of scores on the TA Cognitive Tests, when compared with subjects assigned to the control group. TAP > TAS > IPR = ContrOI Hypothesis 7: Subjects assigned to the TAS group will demonstrate a significantly greater retention of scores on the TA Cognitive Tests, when compared with subjects assigned to the control group. Hypothesis 8: Subjects assigned to the TAS group will demonstrate a significantly greater retention of scores on the TA Cognitive Tests, when compared with subjects assigned to the IPR groups. Hypothesis 9: Subjects assigned to the TAP groups will demonstrate a significantly greater retention of scores on the TA Cognitive Tests, when compared with subjects assigned to the control group. Hypothesis 10: Subjects assigned to the TAP groups will demonstrate a significantly greater retention of scores on the TA Cognitive Tests, when compared with subjects assigned to the IPR groups. Hypothesis 11: Subjects assigned to the TAP groups will demonstrate a significantly greater retention of scores on the TA Cognitive Tests, when compared with subjects assigned to the TAS group. 70 Again, the Scheffe method of multiple comparisons was used to test the research hypotheses. The results of these analyses are presented in Table 8.4. Table 8.4. Transactional Analysis Cognitive Tests: Retention of Test Scores by Scheffé Multiple Comparison Test for all Treatment Groups and all Pair-Wise Comparisons of Treat- ment Groups--Transactional Analysis Practice (TAP), Transactional Analysis Study (TAS), Interpersonal Process Recall (IPR), and Control (CG) Ratio of Sample Statistic Mean Sample to Expected Signi- Contrast Square Statistic Mean Square ficant CG 4.2804 -0.500 0.1168 TAS 3.8285 10.900 2.8471 * TAP 2.9414 11.680 3.9709 * IPR 3.0267 2.000 0.6608 TAP-CG 1.6475 12.180 7.3928 * TAP-IPR 1.3389 9.680 7.2301 * TAP-TAS 1.5316 0.780 0.5093 TAS-CG 1.8217 11.400 6.2577 * TAS-IPR 1.5482 8.900 5.7487 * IPR-CG 1.6630 2.500 1.5033 As illustrated in Table 8.4, significant retention of scores exists for subjects assigned to the TA Practice and TA Study groups. Significant differences in retention of scores exists: (1) between subjects assigned to the TA Practice groups and those assigned to the control group (TAP-CG); (2) between subjects assigned to the TA Practice groups and those assigned to the IPR groups (TAP-IPR); (3) between sub- jects assigned to the TA Study group and those assigned to the control group (TAS-CG); and (4) between subjects assigned to the TA Study group 71 and those assigned to the IPR groups (TAS-IPR). No significant differences exist: (1) between subjects assigned to the TA Practice groups and those assigned to the TA Study group; nor (2) between sub— jects assigned to the IPR groups and those assigned to the control group. Summar Hypotheses #l, #2, #3, #4, #5, #7, #8, #9, and #10 are accepted. Hypotheses #6 and #11 are not accepted. Subjects assigned to each of the TA Practice and TA Study groups demonstrated signifi- cantly greater improvement and retention of scores than subjects assigned to either the IPR or control group. There are no significant differences between subjects assigned to the TA Practice group and those assigned to the TA Study group, nor between subjects assigned to the IPR groups and those assigned to the control group. (Refer to Table ll--Summary of Hypotheses and Significant Differences, p. 91.) Skills Ability Scale Results Since the Skills Ability Scale is designed to yield three subscale scores, rather than a single global score, these subscales will be examined separately. The number of subjects, mean score, sum of scores, and sum of squared scores for each group on the three administrations of each of the three subscales are presented in Tables 9.1, 9.2, and 9.3, respectively. A repeated measures analysis of variance test was performed on each subscale to test for differences across test means (blocks) and across group means (treatments). The results of these tests are presented in Tables 9.4, 9.5, and 9.6, respectively. 72 Table 9.1. Skills Ability Scale: Information: Number of Subjects, Mean Score, Sum of Scores, and Sum of Squared Scores Pre-test Post-test Delayed Post-test 2 Group n X 2X 2X 7' 2X 2X 7' XX XX CG 8 27.250 218 6,076 26.875 215 5,889 28.125 225 6,445 TAS 10 21.900 219 4,967 28.700 287 8.319 29.300 293 8.733 IPR1 8 24.000 192 4,658 28.250 226 6,484 27.250 218 6.014 IPR2 8 24.125 193 4,705 31.000 248 7.816 30.375 243 7.539 TAP 9 23.000 207 4,789 34.111 307 10.517 35.556 320 11.548 TAP; 823.000 184 4,266 34.000 272 9,284 32.500 260 8,504 Total 51 23.784 1,213 29,461 30.490 1,555 448,309 30.569 1,559 48,783 Table 9.2. Skills Ability Scale: Dangerous Emotions: Number of Subjects, Mean Score, Sum of Scores, and Sum of Squared Scores Pre-Test Post-Test Delayed Post-test Group x 2x xx ‘x' 2x 2x2 7 xx 2x2 CG 8 15.000 120 1,858 14.500 116 1.710 14.750 118 1,850 TAS 10 12.700 127 1,675 17.700 177 3,171 15,000 150 2.362 IPR1 8 14.500 116 1,720 15.375 123 1,905 16.000 128 2,096 IPR2 8 14.625 117 1,787 16.375 131 2.229 15.625 125 2.129 TAP 9 15.222 137 2,153 20.889 188 4,045 21.556 194 4,426 TAP2 8 14.250 114 1,772 20.875 167 3,521 20.125 161 3,251 Total 51 14.333 731 10,965 17,686 902 16.581 17.176 876 16,114 73 Table 9.3. Skills Ability Scale: Long-Term Stress: Number of Subjects, Mean Score, Sum of Scores. and Sum of Squared Scores Pre-test Post-test Delayed Post-test Group n 'x‘ 2x 2x2 '71 Ex 2x2 7 2x 2x2 CG 8 22.625 181 4,160 23.000 184 4,382 22.750 182 4.206 TAS 10 18.600 186 3,514 22.300 223 5,059 21.900 219 4,820 IPR1 8 19.250 154 2,984 21.000 168 3,538 21.000 168 3,556 IPR2 8 21.250 170 3.720 21.125 169 3.589 21.875 175 3.855 TAP1 9 19.778 178 3,592 29.889 269 8,147 30.333 273 8.527 TAP2 8 20.375 163 3.551 29.000 232 6.770 27.500 220 6,138 Total 51 20.235 1,032 21,521 24.412 1,245 31,475 24.255 1,237 31,111 Table 9.4. Skills Ability Scale: Information: Repeated Measures Analysis of Variance Results Source of Sum of Mean F Signi- Variance Squares d.f. Square ficance Groups 418.115 5 83.623 3.414 .0107 S: Groups 1.102.133 45 24.492 Tests 1.547.033 2 773.516 118.581 .0001 Tests x Groups 526.556 10 52.666 8.072 .0001 Tests x 5: Groups 587.078 90 6.523 Total 4.180.915 152 74 Table 9.5. Skills Ability Scale: Dangerous Emotions: Repeated Measures Analysis of Variance Results Source of Sum of Mean Signi- Variance Squares d.f. Square F ficance Groups 473.296 5 94.659 5.383 .0006 S: Groups 791.383 45 17.586 Tests 332.954 2 166.477 26.578 .0001 Tests x Groups 243.312 10 24.331 3.884 .0001 Tests x S: Groups 563.733 90 6.264 Total 2.404.678 152 Table 9.6. Skills Ability Scale: Long-Term Stress: Repeated Measures Analysis of Variance Results Source of Sum of Mean Signi- Variance Squares d.f. Square F ficance Groups 877.720 5 175.544 7.736 .0001 5: Groups 1.021.117 45 22.691 Tests 571.621 2 285.810 49.780 .0001 Tests x Groups 511.651 10 51.165 8.912 .0001 Tests x S: Groups 516.728 90 5.741 Total 3.498.837 152 75 As illustrated in Tables 9.4. 9.5. and 9.6. significant differences exist across test and group means on each of the three subscales. There is also a significant Tests x Groups interaction for each subscale. Improvement in Scores Assumption: Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis 12: 13: 14: 15: l6: 17: Significant differences in improvement of scores on the Skills Ability Scale will be found between each pair of groups in the following direction: TAP > TAS > IPR > Control Subjects assigned to the TAS group will demon-. strate a significantly greater improvement in scores on the Skills Ability Scale, when com- pared with subjects assigned to the control group. Subjects assigned to the TAS group will demon- strate a significantly greater improvement in scores on the Skills Ability Scale, when com- pared with subjects assigned to the IPR groups. Subjects assigned to the TAP groups will demon- strate a significantly greater improvement in scores on the Skills Ability Scale, when com- pared with subjects assigned to the control group. Subjects assigned to the TAP groups will demon- strate a significantly greater improvement in scores on the Skills Ability Scale, when com- pared with subjects assigned to the IPR groups. Subjects assigned to the TAP groups will demon- strate a significantly greater improvement in scores on the Skills Ability Scale, when com- pared with subjects assigned to the TAS grOUp. Subjects assigned to the IPR groups will demon- strate a significantly greater improvement in scores on the Skills Ability Scale, when com- pared with subjects assigned to the control group. Again, the Scheffe method of multiple comparisons was used to test the research hypotheses. Tables 9.7, 9.8 and 9.9 present the results of these analyses for each of the subscales. To facilitate examination, 76 these subscales will be reported one at a time. Skills Ability Scale: Type I: Information: As illustrated in Table 9.7, significant differences exist between pre- and post-test results of subjects assigned to the TA Practice and IPR groups. Signi— ficant differences in improvement of scores exist: (1) between subjects assigned to the TA Practice groups and those assigned to the control group (TAP-CG); (2) between subjects assigned to the TA Study group and those assigned to the control group (TAS-CG); (3) between subjects assigned to the TA Practice groups and those assigned to the IPR groups (TAP-IPR); and (4) between subjects assigned to the IPR groups and those assigned to the control group (IPR-CG). Skills Ability Scale: Type II: Dangerous Emotions: As illus- trated in Table 9.8, significant differences exist between pre-and post- test results of subjects assigned to the TA Practice and TA Study groups. Significant differences in improvement of scores exist: (1) between subjects assigned to the TA Practice groups and those assigned to the control group (TAP-CG); and (2) between subjects assigned to the TA Practice groups and those assigned to the IPR groups (TAP-IPR); and (3) between subjects assigned to the TA Study group and those assigned to the control group (TAS-CG). Skills Ability_Scale: Type III: Long-Term Stress: As illus- trated in Table 9.9, significant differences exist between pre- and post- test scores of subjects assigned to the TA Practice groups. Significant differences in improvement of scores exist: (1) between subjects assigned to the TA Practice group and those assigned to the control group (TAP-CG); 77 (2) between subjects assigned to the TA Practice groups and those assigned to the IPR groups (TAP-IPR); and (3) between subjects assigned to the TA Practice groups and those assigned to the TA Study groups (TAP-TAS). No other significant differences were discovered. Table 9.7. Skills Ability Scale: Information: Improvement in Test Scores by Scheffé Multiple Comparison Test for all Treat- ment Groups and all Pair-Wise Comparisons of Treatment Groups--Transactiona1 Analysis Practice (TAP), Trans- actional Analysis Study (TAS), Interpersonal Process Re— call (IPR), and Control (CG) Ratio of Sample Statistic Mean Sample to Expected Signi- Contrast Square Statistic Mean Square ficant CG 2.4745 -0.370 0.1495 TAS 2.2132 6.800 3.0724 TAP 1.7004 11.055 6.5013 * IPR 1.7497 5.560 3.1770 * TAP-CG 1.5495 11.425 7.3735 * TAP-IPR 1.2591 5.495 4.3641 * TAP-TAS 1.4404 4.255 2.9541 TAS-CG 1.7133 7.170 4.1849 * TAS-IPR 1.4560 1.240 0.8516 IPR-CG 1.5640 5.930 3.7915 * 78 Table 9.8. Skills Ability Scale: Dangerous Emotions: Improvement in Test Scores by Scheffe Multiple Comparison Test for all Treatment Groups and all Pair-Wise Comparisons of Treatment Groups--Transactional Analysis Practice (TAP), Transactional Analysis Study (TAS), Interpersonal Process Recall (IPR), and Control (CG) Ratio of Sample Statistic Mean Sample to Expected Signi- Contrast Square Statistic Mean Square ficant CG 2.0968 -0.500 0.2385 TAS 1.8754 5.000 2.6661 TAP 1.4409 6.150 4.2682 * IPR 1.4826 1.315 0.8869 TAP-CG 1.5184 6.650 4.3796 * TAP-IPR 1.2339 4.835 3.9185 * TAP-TAS 1.4115 1.150 0.8147 TAS-CG 1.6789 5.500 3.2759 * TAS-IPR 1.4268 3.685 2.5827 IPR-CG 1.5326 1.815 1.1842 79 Table 9.9. Skills Ability Scale: Long-Term Stress: Improvement in Test Scores by Scheffé Multiple Comparison Test for all Treatment Groups and all Pair-Wise Comparisons of Treat- ment Groups--Transactional Analysis Practice (TAP), Transactional Analysis Study (TAS), Interpersonal Process Recall (IPR), and Control (CG) Ratio of Sample Statistic Mean Sample to Expected Signi- Contrast Square Statistic Mean Square ficant CG 2.3818 0.370 0.1553 TAS 2.1303 3.700 1.7368 TAP 1.6367 9.365 5.7219 * IPR 1.6842 0.815 0.4839 TAP-CG 1.4536 8.995 6.1880 * TAP-IPR 1.1813 8.550 7.2380 * TAP-TAS 1.3513 5.665 4.1923 * TAS-CG 1.6073 3.330 2.0718 TAS-IPR 1.3660 2.885 2.1121 IPR-CG 1.4673 0.445 0.3033 Retention of Scores Assumption: Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis 18: 19: 20: 21: 22: 23: 80 Significant differences in retention of scores on the Skills Ability Scale will be found be- tween each pair of groups in the following direction: TAP > TAS > IPR > Control Subjects assigned to the TAS group will demon- strate a significantly greater retention of scores on the Skills Ability Scale, when com- pared with subjects assigned to the control group. Subjects assigned to the TAS group will demon- strate a significantly greater retention of scores on the Skills Ability Scale, when com- pared with subjects assigned to the IPR groups. Subjects assigned to the TAP groups will demon- strate a significantly greater retention of scores on the Skills Ability Scale, when com- pared with subjects assigned to the control group. Subjects assigned to the TAP groups will demon- strate a significantly greater retention of scores on the Skills Ability Scale. when com- pared with subjects assigned to the IPR groups. Subjects assigned to the TAP groups will demon- strate a significantly greater retention of scores on the Skills Ability Scale, when com- pared with subjects assigned to the TAS group. Subjects assigned to the IPR groups will demon- strate a significantly greater retention of scores on the Skills Ability Scale. when com- pared with subjects assigned to the control group. Again, the Scheffe method of multiple comparisons was used to test the research hypotheses. The results of these analyses are presented in Tables 9.10, 9.11. and 9.12 (one for each subscale). To facilitate examination, these subscales will be reported one at a time. 81 Table 9.10. Skills Ability Scale: Information: Retention of Test Scores by Scheffe Multiple Comparison Test for all Treatment Groups and all Pair-Wise Comparisons of Treat- ment Groups-~Transactiona1 Analysis Practice (TAP), Trans- actional Analysis Study (TAS), Interpersonal Process Recall (IPR), and Control (CG) Ratio of Sample Statistic Mean Sample to Expected Signi- Contrast Square Statistic Mean Square ficant CG 2.4745 0.880 0.3556 TAS 2.2132 7.400 3.3435 * TAP 1.7004 11.030 6.4866 * IPR 1.7497 4.750 2.7147 TAP-CG 1.5495 10.150 6.5507 * TAP-IPR 1.2591 6.280 4.9875 * TAP-TAS 1.4404 3.630 2.5202 TAS-CG 1.7133 6.520 3.8056 * TAS-IPR 1.4560 2.650 1.8200 IPR-CG 1.5640 3.870 2.4744 82 Table 9.11. Skills Ability Scale: Dangerous Emotions: Retention of Test Scores by Scheffe Multiple Comparison Test for all Treatment Groups and all Pair-Wise Comparisons of Treatment Groups--Transactional Analysis Practice (TAP), Transactional Analysis Study (TAS), Interpersonal Process Recall (IPR). and Control (CG) Ratio of Sample Statistic Mean Sample to Expected Signi- Contrast Square Statistic Mean Square ficant CG 2.0968 -0.250 0.1192 TAS 1.8754 2.300 1.2264 TAP 1.4409 6.110 4.2405 * IPR 1.4826 1.250 0.8431 TAP-CG 1.5184 6.360 4.1887 * TAP-IPR 1.2339 4.860 3.9387 * TAP-TAS 1.4115 3.810 2.6993 TAS-CG 1.6789 2.550 1.5188 TAS-IPR 1.4268 1.050 0.7359 IPR-CG 1.5326 1.500 0.9787 Table 9.12. Skills Ability Scale: of Test Scores by Scheffe Multiple Comparison Test for all Treatment Groups and all Pair-Wise Compari- sons of Treatment Groups--Transactional Analysis Practice (TAP), Transactional Analysis Study (TAS), Interpersonal Process Recall (IPR), and Control (CG) Long-Term Stress: Retention Ratio of Sample Statistic Mean Sample to Expected Signi- Contrast Square Statistic Mean Square ficant CG 2.3818 0.120 0.0504 TAS 2.1303 3.300 2.1303 TAP 1.6367 8.835 5.3980 * IPR 1.6842 1.190 0.7066 TAP-CG 1.4536 8.715 5.9954 * TAP-IPR 1.1813 7.645 6.4719 * TAP-TAS 1.3513 5.535 4.0961 * TAS-CG 1.6073 3.180 1.9785 TAS-IPR 1.3660 2.110 1.3660 IPR-CG 1.4673 1.070 0.7292 84 Skills Ability Scale: Type I: Information: As illustrated in Table 9.10, significant differences exist between pre-and delayed post-test results of subjects assigned to the TA Practice and TA Study groups. Significant differences in the retentions of scores exist: (1) between subjects assigned to the TA Practice groups and those assigned to the control group (TAP-CG); (2) between subjects assigned to the TA Practice Groups and those assigned to the IPR Groups (TAP-IPR); and (3) between subjects assigned to the TA Study Group and those assigned to the control group (TAS-CG). Skills Ability Scale: Type II: Dangerous Emotions: As illustrated in Table 9.11, a significant difference exists between pre- and delayed post-results for subjects assigned to the TA Practice groups. A significant difference in retention of scores exists: (1) between subjects assigned to the TA Practice groups and those assigned to the control group (TAP-CG); and (2) between subjects assigned to the TA Practice groups and those assigned to the IPR groups (TAP-IPR). Skills Ability Scale: Iype III: Long-Term Stress: As illustrated in Table 9.12, a significant difference exists between 'pre- and delayed post-test results of subjects assigned to the TA Practice groups. Significant differences in retention of scores exists: (1) between subjects assigned to the TA Practice groups and those assigned to the control group (TAP-CG); (2) between subjects assigned to the TA Practice groups and those assigned to the IPR groups (TAP-IPR); and (3) between subjects assigned to the TA Practice 85 groups and those assigned to the TA Study group (TAP-TAS). No other significant differences were discovered. Summar Hypotheses #14 (TAP > CG) and #15 (TAP > IPR) are accepted for all three subscales of the Skills Ability Scale, indicating a significantly greater improvement in scores from pre- to post-test. Hypotheses #20 (TAP > CG) and #21 (TAP > IPR) are also accepted for all three subscales of the Skills Ability Scale. indicating a signifi- cantly greater retention of scores from pre- to delayed post-test. Hypothesis #12 (TAS > C0) is accepted for subscales Type I (Information) and Type II (Dangerous Emotions), indicating a signifi- cantly greater improvement from pre- to post-test. Further, hypotheses #17 (IPR > CG) and #18 (TAS > CG) are accepted for subscale I (Informa- tion), and hypotheses #16 (TAP > TAS) and #22 (TAP > TAS) are accepted for subscale III (Long-Term Stress). The only consistently significant differences in improvement and retention of scores on all three subscales are found in the sub- jects assigned to the TA Practice groups. The only consistent signi- ficant differences in comparisons of improvement and retention of scores on all three subscales are found between subjects assigned to the TA Practice groups and subjects assigned to the control group or to the IPR groups: (TAP-CG) or (TAP-IPR). (Refer to Table ll—— Summary of Hypotheses and Significant Differences. p. 91). The number of subjects, mean score, sum of scores. and sum of 86 Affective Sensitivity Scale Results squared scores for each group on the three administrations of the Affective Sensitivity Scale are presented in Table 10.1. Table 10.1. Affective Sensitivity Scale-—Number of Subjects. Mean Score, Sum of Scores, and Sum of Squared Scores Pre-test Post-test Delayed Post-test Group n 7' 2X 2X2 7' XX 2X2 7' XX 2X2 CG 8 39.625 317 12.833 39.500 316 13.092 41.250 330 13.900 TAS 10 34.100 341 12.147 34.900 349 12.617 37.000 370 14.124 IPR1 8 43.000 344 14.926 39.625 317 12.901 41.375 331 14.005 IPR2 8 39.750 318 13.510 48.625 389 19.113 45.125 361 16.813 TAP1 9 38.667 348 13.652 46.667 420 19.712 44.667 402 18.036 TAP2 8 38.250 306 12.010 45.625 365 16.795 44.375 355 15,805 Total 51 38.706 1.974 79.078 42.275 2.156 94.230 42.137 2.149 92,683 A repeated measures analysis of variance test was used to measure differ- ences across test means (blocks) and across group means (treatments). results of this test are presented in Table 10.2. The Table 10.2. Affective Sensitivity Scale: Repeated Measures Analysis of Variance Results Source of Sum of Mean F Signi- Var1ance Squares d.f. Square ficance Groups 1.498.640 5 299.728 3.185 .0152 S: Groups 4.235.125 45 94.114 Tests 416.980 2 208.490 11.703 .0001 Tests x Groups 569.720 10 56.972 3.198 .0001 Tests x 5: Groups 1.603.300 90 17.814 Total 8.323.765 152 87 As Table 10.2 illustrates, a significant difference exists across both test and group means. There is also a significant Tests x Groups interaction. Improvement in Scores Assumption: Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis 24: 25: 26: 27: 28: 29: Significant differences in improvement in scores on the Affective Sensitivity Scale will be found between each pair of groups in the following direction: TAP > IPR > TAS > Control Subjects assigned to the TAS groups will demon- strate a significantly greater improvement in scores on the Affective Sensitivity Scale. when compared with subjects assigned to the control group. Subjects assigned to the IPR groups will demon- strate a significantly greater improvement in scores on the Affective Sensitivity Scale, when compared with subjects assigned to the control group. Subjects assigned to the IPR groups will demon- strate a significantly greater improvement in scores on the Affective Sensitivity Scale, when compared with subjects assigned to the TAS group. Subjects assigned to the TAP groups will demon- strate a significantly greater improvement in scores on the Affective Sensitivity Scale. when compared with subjects assigned to the control group. Subjects assigned to the TAP groups will demon- strate a significantly greater improvement in scores on the Affective Sensitivity Scale. when compared with subjects assigned to the TAS group. Subjects assigned to the TAP groups will demon- strate a significantly greater improvement in scores on the Affective Sensitivity Scale. when compared with subjects assigned to the IPR groups. The Scheffe method of multiple comparisons was used to test the hypotheses. Table 10.3 presents the results of these analyses. 88 Table 10.3. Affective Sensitivity Scale: Improvement in Test Scores by Scheffé Multiple Comparison Test for all Treatment Groups and for all Pair-Wise Comparisons of Treatment Groups--Transactiona1 Analysis Practice (TAP), Trans- actional Analysis Study (TAS), Interpersonal Process Recall (IPR), and Control (CG) Ratio of Sample Statistic Mean Sample to Expected Signi- Contrast Square Statistic Mean Square ficant CG 4.8506 -0.130 0.0268 TAS 4.3385 0.800 0.1844 TAP 3.3333 7.690 2.3070 IPR 3.4299 2.755 0.8032 TAP-CG 2.5606 7.820 3.0540 TAP-IPR 2.0808 4.935 2.3717 TAP-TAS 2.3803 6.890 2.8946 TAS-CG 2.8313 0.930 0.3285 TAS-IPR 2.4061 -1.955 0.8125 IPR-CG 2.5846 2.885 1.1162 As illustrated in Table 10.3. no significant differences were found between pre- and post-test results. Also. no significant differences were found in improvement of scores between subjects assigned to any group, when compared with subjects assigned to any other group. Retention of Scores Assumption: Significant differences in retention of scores on the Affective Sensitivity Scale will be found between each pair of groups in the following direction: TAP > IPR > TAS > Control Hypothesis 30: Subjects assigned to the TAS group will demon- strate a significantly greater retention of scores on the Affective Sensitivity Scale. when compared with subjects assigned to the control group. Hypothesis Hypothesis Hypothesis Hypothesis Hypothesis 31: 32: 33: 34: 35: 89 Subjects assigned to the IPR groups will demon- strate a significantly greater retention of scores on the Affective Sensitivity Scale, when compared with subjects assigned to the control group. Subjects assigned to the IPR groups will demon- strate a significantly greater retention of scores on the Affective Sensitivity Scale, when compared with subjects assigned to the TAS group. Subjects assigned to the TAP groups will demon- strate a significantly greater retention of scores on the Affective Sensitivity Scale, when compared with subjects assigned to the control group. Subjects assigned to the TAP groups will demon- strate significantly greater retention of scores on the Affective Sensitivity Scale, when compared with subjects assigned to the TAS group. Subjects assigned to the TAP groups will demon- strate a significantly greater retention of scores on the Affective Sensitivity Scale, when compared with subjects assigned to the IPR groups. Again, the Scheffe method of multiple comparisons was used to test the research hypotheses. The results of these analyses are presented in Table 10.4. As illustrated in Table 10.4. no significant differences were found between pre- and delayed post-test scores. Also, no signi- ficant differences were found in retention of scores between subjects assigned to any group, when compared with subjects assigned to any other group. 90 Table 10.4. Affective Sensitivity Scale: Retention of Test Scores by Scheffe Multiple Comparison Test for all Treatment Groups and for all Pair-Wise Comparisons of Treatment Groups--Transactiona1 Analysis Practice (TAP), Trans- actional Analysis Study, (TAS), Interpersonal Process Recall (IPR), and Control (CG). Ratio of Sample Statistic Mean Sample to Expected Signi- Contrast Square Statistic Mean Square ficant CG 4.8506 1.620 0.3340 TAS 4.3385 2.900 0.6684 TAP 3.3333 6.065 1.8195 IPR 3.4299 1.880 0.5481 TAP-CG 2.5606 4.445 1.7359 TAP-IPR 2.0808 4.185 2.0112 TAP-TAS 2.3803 3.165 1.3297 TAS-CG 2.8313 1.280 0.4520 TAS-IPR 2.4061 1.020 0.4239 IPR-CG 2.5846 0.260 0.1006 Summar None of the hypotheses #24 through #35 for the Affective Sensitivity Scale are accepted. (Refer to Table 11 - Summary of Hypotheses and Significant Differences, p. 91). Summar The analysis of data in Chapter IV presented the hypotheses under investigation; the analysis of variance tables; and the results of the Scheffé comparisons for each of the five instruments: Trans- actional Analysis Cognitive Tests; Skills Ability Scale: Information; Skills Ability Scale: Dangerous Emotions; Skills Ability Scale: Long— Term Stress; and the Affective Sensitivity Scale. 91 Table 11 illustrates a summary of the hypotheses and the significant results. Table 11. Summary of Hypotheses and Significant Differences Signi— Instrument Measure Hypothesis Assumption ficant TA Cognitive Improvement Tests of Scores #1 IPR = CG Null #2 TAS > CG * #3 TAS > IPR * #4 TAP > CG * #5 TAP > IPR * #6 TAP > TAS TA Cognitive Retention Tests of Scores #7 TAS > CG * #8 TAS > IPR * #9 TAP > CG * #10 TAP > IPR * #11 TAP > TAS Skills Ability Improvement Scale of Scores #12 TAS > CG #13 TAS > IPR #14 TAP > CG * #15 TAP > IPR * #16 TAP > TAS #17 IPR > CG Skills Ability Retention Scale of Scores #18 TAS > CG #19 TAS > IPR #20 TAP > CG * #21 TAP > IPR * #22 TAP > TAS #23 IPR > CG Affective Improvement Sensitivity of Scores #24 TAS > CG Scale #25 IPR > CG #26 IPR > TAS #27 TAP > CG #28 TAP > TAS #29 TAP > IPR Affective Retention Sensitivity of Scores #30 TAS > CG Scale #31 IPR > CG #32 IPR > TAS #33 TAP > CG #34 TAP > TAS #35 TAP > IPR 92 Five of the six research hypotheses predicting improvement of scores on the TA Cognitive Tests were accepted at the .10 level of confidence. Four of the five research hypotheses predicting differences in retention of scores on the TA Cognitive Tests were also accepted. Hypotheses predicting significant differences in improvement and retention of scores on the Skills Ability Scale were accepted for subjects assigned to TA Practice groups, when compared with those assigned to either the control group (TAP-CG) or to the IPR groups (TAP-IPR). In all, nine of the twelve hypotheses predicting differences in improvement and retention of scores on the Skills Ability Scale were accepted for one or more subscales; three were not accepted for any of the subscales. Hypotheses predicting significant differences in improvement and retention of scores on the Affective Sensitivity Scale were not accepted in any case. CHAPTER V SUMMARY, CONCLUSIONS, AND RECOMMENDATIONS This final chapter is devoted to a summary of the study, a discussion of the conclusions drawn from the data and their analyses, and recommendations and implications for future research. Purpose Summary The purpose of this study was to examine the impact of add- ing a unifying theory of personality structure and change, Transactional Analysis (TA), to a structured skills-building model for teaching crisis intervention skills. The primary questions toward which this study was directed were: (1) Will the addition of the Transactional Analysis theory of (2) (3) personality structure and its implications for crisis intervention to the current training model result in improve- ment in trainees' abilities to select and emit effective crisis intervention strategies, as defined by measures on instruments used in this study? Nill supervised practice in Transactional Analysis theory and practice result in improvement in trainees' abilities to select and emit effective crisis intervention strategies, as defined by measures on instruments used in this study? Nill improvements in these abilities be maintained over time? The present study was the first research (known to the re- searcher) performed to date, testing the results of adding a cognitive structure to a structured skills-building model, or to counseling 93 94 effectiveness in general, Population and Sample The selected population was the active volunteer crisis inter- vention staff at the Open Door Crisis Center. Lansing, Michigan. 0f 70 active volunteers, 56 agreed to participate in the study and were leveled into the following six groups on the basis of knowledge of TA theory and practice: one control group, one TA Study group, two TA Practice groups. and two groups who received the traditional structured skills-building training program, without TA structure. Five subjects were lost during the course of the experiment, leaving a final sample of 51 subjects. Instrumentation Five instruments were used to measure crisis intervention skills, all of which were used as pre-, post-, and delayed post-tests; Transactional Analysis Cognitive Tests; Skills Ability Scale: Informa- tion; Skills Ability Scale: Dangerous Emotions; Skills Ability Scale: Long-Term Stress; and Affective Sensitivity Scale. Procedure All subjects received pre-tests on all of the above instru- ments. The TA Cognitive Tests were scored immediately and used to level subjects into blocks. Control group subjects received no further treat- ment. The TA Study group was given a TA handbook for personal study. The TA Practice groups received the TA handbook, plus attended a two- day training workshop where TA theory was applied to crisis intervention skills. The Interpersonal Process Recall (IPR) groups attended a 95 two-day workshop on crisis intervention skills, without application of TA theory. Subjects assigned to non-TA oriented groups were in- structed not to study TA for the duration of the experiment. All six groups were post-tested with all three instruments immediately follow- ing the workshops, and again five weeks later. All four training workshops were held during the same two- day period, and the TA study group received the handbook that same weekend. All four workshop leaders were experienced in Transactional Analysis, and two leaders were Senior Trainers at the Open Door Crisis Center. All four trainers attended a series of meetings to assure continuity of training methods, except for the addition or deletion of TA theory. The Affective Sensitivity Scale is a commercially available videotape and paper-and-pencil instrument designed to measure subjects' abilities to discriminate and label affect in another person (empathy). The TA Cognitive Tests were designed for this study and measures subjects' abilities to select and implement crisis inter- vention strategies which are appropriate to specific situations. Design and Analysis A repeated measures analysis of variance test was performed for each scale of each instrument, yielding five separate analyses to test for significance of group means across tests and within groups. The Scheffe method of post-hoc multiple comparisons was used to test the significance of differences between specific group means . 96 Due to the exploratory nature of the study, the .10 level of significance was established as the critical level for accepting or rejecting differences. Conclusions Finding§_and Discussion The following results of the study are outlined according to the major assumptions, or predictions, previously stated: The following order of performance for improvement and retention of scores was predicted: TA Cognitive Tests: TAP > TAS > IPR = Control Skills Ability Scale: TAP > TAS > IPR > Control Affective Sensitivity Scale: TAP > IPR > TAS > Control TA Cognitive Tests: The research results tend to support the assumption that persons receiving TA information will improve on scores measuring TA knowledge. Subjects assigned to both the TA Study and TA Practice groups demonstrated significant improvement and reten- tion of scores on this test. Subjects assigned to the TA Practice groups showed a trend toward greater improvement than those assigned to the TA Study group. Comparisons of gain scores between groups indicate that both the TA Study and TA Practice groups demonstrated significantly greater improvement in and retention of scores than did subjects assigned to the IPR or control groups. Skills Ability Scale: The research results clearly support the assumption that the addition of Transactional Analysis theory to the structured skills-building model, via cognitive information 33g_ 97 supervised practice, results in improvement and retention of trainees' abilities to select and emit effective crisis intervention strategies. Significant improvement and retention of scores on all three subscales of the Skills Ability Scale were demonstrated by subjects assigned to the TA Practice group. Additionally, significant differences were found in improvement and retention of scores on all three subscales between subjects assigned to the TA Practice groups and those assigned to the control group (TAP-CG) or to the IPR groups (TAP-IPR). Subjects assigned to the TA Study group demonstrated no significant differences between pre- and post-test results on any of the SAS subscales. However, there was a significant difference for these subjects between pre- and delayed post-test results on subscale Type I (Information), indicating that scores on this subscale continued to climb for this group between these two testing periods. This same trend was demonstrated on subscale Type III (Long-Term Stress), although the results in this case were not significant. Additionally. significant differences were found in improvement and retention of scores on sub- scale Type I between subjects assigned to the TA Study group and those assigned to the control group (TAS-CG); and in improvement of scores on subscale Type II (Dangerous Emotions) between subjects assigned to these same two groups. On all three subscales, subjects assigned to the TA Practice groups demonstrated a trend toward superiority when compared with sub- jects assigned to the TA Study group (TAP-TAS). However, this trend was significant only for improvement and retention of scores on subscale Type III. 98 Subjects assigned to the IPR groups demonstrated improvement in scores on subscale Type I only. IPR subjects demonstrated no signi- ficant retention of scores for any of the subscales. Additionally, subjects assigned to the IPR groups demonstrated significantly greater improvement in scores on subscale Type I, when compared with subjects assigned to the control group (IPR-CG). No other significant differences in improvement or retention of scores were demonstrated by subjects assigned to the IPR groups. Affective Sensitivity Scale: No significant differences in improvement or retention of scores on the Affective Sensitivity Scale were demonstrated, nor were any significant differences found between subjects assigned to any pair of groups. This failure to show signi- ficant gains may be partially explained by (l) the extremely low validity of the Affective Sensitivity Scale: and/or (2) the fact that the subjects used in this study were already trained in empathy skills and had previously demonstrated relatively high levels of achievement in these skills. It is important to note that scores on the Affective Sensitivity Scale did show an upward trend, where predicted, suggesting that trainees' abilities to determine affect in another person were maintained or enhanced during the course of the experiment. In all, 12 of 34 hypotheses predicting significant differences in improvement and retention of scores on three measures were accepted, in addition to one hypothesis which predicted null results. Five of the six hypotheses predicting improvement on the TA Cognitive Tests were accepted, and four of the five hypotheses predicting retention of 99 scores on this test were also accepted. For the Skills Ability Scale, two of the six hypotheses predicting improvement and two of six pre- dicting retention were accepted for all three subscales; and, a total of nine of twelve hypotheses predicting improvement or retention of scores were accepted for one or more subscales. None of the hypotheses predicting improvement or retention of scores on the Affective Sensi- tivity Scale were accepted. The general assumption of predicted comparative gains and retention of scores on the Transactional Analysis Cognitive Tests was as follows: TAP > TAS > IPR = Control. This assumption held true for both improvement and retention of scores, and was significant for all comparisons except TAP > TAS. The general assumption of predicted comparative gains and retention of scores on the Skills Ability Scale was as follows: TAP > TAS > IPR > Control. This assumption held true for improvement and retention of scores for subscales Type II (Dangerous Emotions) and Type III (Long-Term Stress). For subscale Type I (Information), sub- jects assigned to the IPR groups actually demonstrated higher scores on the post-test than did subjects assigned to the TA Study group. However, this difference was very slight and was reversed to the ex- pected direction on the delayed post-test. The general assumption of predicted comparative gains and retention of scores on the Affective Sensitivity Scale was as follows: TAP > IPR > TAS > Control. This assumption held true for improvement of scores. However, on delayed post-test scores, subjects assigned 100 to the TA Study actually demonstrated slightly higher scores than did those assigned to the IPR groups. None of these gains were significant. The results of this study suggest that the addition of Trans- actional Analysis theory to a structured skills-building model for training crisis intervention agents, via cognitive information and supervised practice, does result in improvement in trainees' abilities to select and emit effective crisis intervention strategies, as defined by measures on the instruments used in this study. Furthermore, results indicate that once trainees have been trained in the basic communication skills of Empathic Understanding, Attitudes and Values Clarification, I and Decision-Making, cognitive information regarding Taansactional 1 Analysis theory and practice, without additional supervised practice, is more helpful for increasing crisis intervention skills than is addi- tional supervised practice, without the cognitive information. Indi- cations are that most of these improved skills are maintained over time. For each of the instruments significant differences in im- provement and retention of scores were predicted between each pair of groups in a hierarchical order: Transactional Analysis Cognitive Tests: TAP > TAS > IPR = Control Skills Ability Scale: TAP > TAS > IPR > Control Affective Sensitivity Scale: TAP > IPR > TAS > Control (Note that for the TA Cognitive Tests, it was hypothesized that IPR and Control subjects would show no significant differences.) The differences between each pair of groups, although not significant in some cases, were almost always in the expected direction. The lack of significance in 101 these findings may be attributed to: (l) the relatively short duration of the training workshops and the brevity of the TA handbook; or (2) the fact that subjects employed in this study had previously been ex- posed to training and experience in crisis intervention skills. These questions can be answered by repeating the study with more naive sub- jects and a longer training workshop, i.e. a full 28-hour program, rather than a 12-hour version. There were two instances in which groups did not demonstrate differences in the expected hierarchical order. On Skills Ability Scale Type I (Information), IPR subjects demonstrated more improvement between pre- and post-test scores than did subjects assigned to the TA Study group. This difference was very slight and was not retained over the follow-up period. It appears that cognitive information and supervised practice are about equally effective in training subjects to respond to calls requesting information. On the Affective Sensitivity Scale, subjects assigned to the IPR groups improved more than those assigned to the TA Study group dur- ing the training period. However, IPR subjects did not retain this difference during the follow-up period, and TAS subjects actually demonstrated greater scores on the delayed post-test than those assigned to the IPR groups. It appears that the supervised practice, without cognitive information, causes immediate improvement in trainees' abilities to determine affect, but that this improvement rapidly decreases over time. Cognitive information, without supervised practice. causes less immediate improvement than supervised practice alone, but this improve- ment is more likely to be maintained over time. 102 In sum, it appears that cognitive information is a useful model for training crisis intervention agents, especially when com- bined with supervised practice. The cognitive structure appears to enhance trainees' abilities to select and emit effective crisis intervention strategies. Once trainees have acquired basic communi- cation skills, cognitive information alone appears to be more benefi- cial for improving crisis intervention skills than supervised practice alone. Limitations: A possible contamination of the study may have resulted from the fact that all volunteers engaged in the study were aware of its intent prior to the onset of the experiment, i.e. that its purpose was to measure the effects of adding TA theory to the IPR model. Subjects assigned to the TA groups may have experienced added incentive as a result of this knowledge, responding to an expecta- tion that they would perform better as a result of participating in a newer training model. Subjects assigned to the IPR groups, on the other hand, were aware of the fact that they were receiving the tradi- tional training program, rather than a newer model. This may have re— sulted in IPR subjects responding to an expectation that they would not perform as well as those subjects assigned to the revised model. There is no way to measure the effects this knowledge had upon changes in test scores. This limitation may be further amplified by the fact that the subjects were aware of the skills and interests of the experimenter, who had been consulting with the crisis center for over a year prior to the study. Knowing that the experimenter had an interest in Transactional 103 Analysis may have caused a bias in mental set, possibly resulting in change in test scores in one direction or the other. Results of these effects remain unknown. Another limitation of the validity of the results reported in this study stems from the lack of reliability and validity data for the Transactional Analysis Cognitive Tests and the Skills Ability Scale, both of which were designed for this study. To this date, no standardized measures are known to the author which accurately measure trainees' skills in crisis intervention. The Skills Ability Scale shows promise of meeting this need, but much more data needs to be accumulated before this instrument can be employed with any great deal of confidence. The Affective Sensitivity Scale, while being supported by reliability and validity studies, has not demonstrated sufficient validity to gain the confidence of this author. This instrument was employed in this study to provide some measure of trainees' abilities to determine the affective state of another person while learning to select and emit effective crisis intervention strategies. Results indicate that improvement and retention of abilities to select and emit effective crisis intervention strategies are not necessarily correlated with improvement and retention of abilities to determine affect, as measured by the Affective Sensitivity Scale. Recommendations Crisis centers and hotlines continue to grow in numbers, types of services offered, and public and professional acceptance. The trend 104 toward non-professional staffing of these centers, as well as increased utilization of non-professionals in traditional mental health agencies, has created a large demand for short-term training models which ade- quately prepare volunteers and other untrained personnel for working with the public. Further studies involving the effectiveness of short- term training, structured skills-building models, and cognitive informa- tion upon the acquisition of crisis intervention skills are badly needed, in addition to more reliable and valid instruments to measure the effectiveness of these programs. Further reliability and validity studies should be conducted for all three subscales of the Skills Ability Scale. These studies will be conducted at the Open Door Crisis Center, and other places, in the near future, and will be made public upon their completion. Additionally, investigations will be conducted into the feasibility of developing a more standardized paper-and-pencil instrument modeled after the Skills Ability Scale, which would render it more accessible to centers and agencies with limited availability of financial resources and rater time. This study has demonstrated that Transactional Analysis theory. applied to a structured skills-building model via cognitive information and supervised practice, effectively increases trainees' acquisition of crisis intervention, as defined by measures on instruments used in this study. Trainees used in this study were already practicing crisis intervention agents, previously trained in basic crisis intervention skills. Future studies are planned at the Open Door in which new volun- teers. without previous training, will be exposed to the TA Practice model as their initial training experience. These subjects will be 105 compared with other subjects who will receive training via the structured skills-building model, without the addition of Transactional Analysis theory. The purpose of this future study will be to examine the impact of adding TA theory to the training model for new volunteers, and the .05 level of confidence will be used to determine significance. Should these results demonstrate that the additional component of TA theory to the model is effective for new volunteers, TA theory will be installed as a regular component to the program, i.e. all new volun- teers will receive training via the TA Practice model used in this study. Replications of this study should be repeated in other set- tings to insure its effectiveness. Such replications are planned for two locations in the near future, one at another crisis center in a different city, and one as part of a clinical training program for professionals. Additional studies should be conducted with theoretical approaches other than Transactional Analysis. Some of the more modern approaches to human personality seem particularly suitable for appli- cation to short-term training models, e.g. behavior modification, Rational-Emotive Therapy, Reality Therapy. These approaches can be applied to a variety of training models to devise the most effective combination of cognitive information and supervised practice. Additional studies should also be conducted with counselors and other helping professionals at various levels of competence and training, i.e. B.A., M.A., M.S.W., Ph.D., M.D., etc. to determine the effectiveness of cognitive information and supervised practice upon the acquisition of skills pertinent to their many applications. This 106 issue could be pursued throughout the social sciences and into ancillary fields such as teaching, administration, child-rearing, etc. Finally, no training model is useful unless it can be demon- strated to be effective in preparing trainees to function in their set- ting. The effectiveness of crisis agents trained in this program will be ascertained by continued examination of the application of their skills with the treatment population. Records will be maintained and examined regarding number of types of contacts, length of time spent with contacts, number and preparation of referrals to other agencies, known suicides, and client satisfaction with services. Results of these examinations will provide a measure of effectiveness regarding application of skills with the treatment population, a practical and more direct evidence supporting the utilization of any particular training model. APPENDICES APPENDIX A TRANSACTIONAL ANALYSIS COGNITIVE TESTS (FORMS #1. #2. #3) APPENDIX A TRANSACTIONAL ANALYSIS COGNITIVE TEST FORM #1 Instructions Please do not write or make any marks on this test. Instead a compu- tor answer sheet should be used to record your answer to each ques- tion. Please make sure to record your code number, the date and the Form #1 on the computer answer sheet with a #2 pencil. If you decide to change an answer to a question make sure that you completely erase the first answer. If you cannot completely erase the answer ask for another answer sheet. Each question has one b§§t_answer that you should select. Remember that all questions should be answered from within the framework of Transactional Analysis. There is no time limit to this test. 1. An ego boundry lesion is: A. an Adult contamination. B. an interference in adequate functioning. C. a critical remark. D. a psyche sore spot. 2. "I never do anything right as far as you're concerned" is an example of: A. banal scripting. B. the Victim role. C. a negative conditional stroke. 0. the Parent ego state. 107 108 The Child initiates a game intending to: A. redeem some gold stamps. B. persecute others. C. "hook" the Child or Parent of another person. 0. feel rejected. When we use the term "Racket" in TA, we mean: A. an existential position. B. a delusion. C. a pay—off 0. chronic lousy feelings that lead to no useful action. Positive strokes convey: A. positive feedback about behavior. B. "OK" feelings. C. a desire for reciprocal strokes. 0. positive aspects of the giver. Which is a function of the Little Professor? A. Agression. B. Rebellion. C. Intuition. D. Affection. A woman who always calls her mother-in-law even though she always feels depressed afterwards is: A. playing Persecutor. B. structuring time with a pastime. C. playing a game. 0. too stupid to know any better. Of the occupations listed below, a person with an excluded Parent and Child (constant Adult) would probably do best as: A. youth counselor. B. teacher. C. computer programmer. D. therapist. Which of these terms has to do with the need to structure time? A. Decisions. B. Experiences. C. Games. 0. Deprivations. 10. 11. 12. 13. 14. ’15. 16. 109 Which statement is Qgt_true about why people play Games? A. They have a need to structure time. B. They play games to avoid boredom C. Games are the first step to intimacy. 0. Games are played to reach a payoff. A positive conditional stroke is: A. detriment to the giver. B. a discount. C. dependent on being earned. D. the deepest form of recognition. A couple seeking a marriage counselor may be seeing the counselor as a: A. Persecutor. B. Nurturing Parent. C. Rescuer. D. Victim. People who collect stamps seem to be wasting time and energy because: A. people don't need excuses for what they feel. B. their rationalizations are generally ridiculous. C. they prefer to make war not love. 0. they should get them free. An ulterior transaction is: A. never justifiable because there's a hidden motive. B. outside the awareness of the Adult. C. within Child awareness of both persons. 0. involving more than two ego states. In a crossed transaction the one who initiates it: A. feels discounted. B. had an ulterior motive. C. collects stamps. D. switches roles in the Game Drama Triangle. According to TA of the people have Scripts: . about 50%. . about 90%. . about 20% . all coon): 17. 18. 19. 20. 21. 22. 23. 110 An example of a positive stroke is: . "My parents never listen to me." . "Boy I'm a lousy teacher!" . I'Well you finally did something right." . "Having you around is nice." DOW) In TA terms spontaneity refers to: A. the freedom to choose from the three ego states. B. recapturing your childhood. C. letting things come naturally. D. expressing warmth. The Natural Child is: A. determined by a person's age. B. selfish and sensuous. C. docile. D. learned behavior. "Don't kiss me in front of the children" is an example of: A. a positive stroke. B. a discount. C. an Adult evaluation of a sensitive situation. 0. a Natural Child fear. In TA terms a person who is a "winner" would be expected to have which Life Position? A. I'm OK; You're OK. B. I'm 0K; You're not-OK. C. I'm not-0K; You're OK. 0. I'm not-OK: You're not-OK. Early childhood decisions are frequently unwise because the person making them: A. hasn't learned to cathect his Adult. 8. does so only after a traumatic experience. C. has plenty of data but doesn't know how to interpret it. D. perceives life through the small peekhole of his existence, which can create distortions. person who sets himself up to feel lonely, depressed, or afraid 5: do) . immature and unstable. . suicidal. . severely depressed and needs hospitalization. . getting ready for his racket feeling. DOW) 24. 25. 26. 27. 28. 29. 30. 111 When exposing a game, a good rule of thumb is to: A. make the players see how deliberately dishonest they are. B. wait until the player gets his pay-off and then ask him what he's feeling. C. make sure that the players' Adults are aware of what they have done. 0. punish them enough so that they won't do it again. A complementary transaction is one in which: A. both people are on good terms with each other. B. the content is socially acceptable. C. a message gets an expected response. 0. a positive stroke is given. People who collect stamps: A. need a reason to have fun. B. usually look for pay-offs they haven't earned. C. seem to prefer negative to positive strokes. D. are probably more use to conditional then unconditional strokes. "Who am I? What am I doing here? and "Who are all the others?" is the basis for: A. choosing rackets. B. being Victim. C. stroking yourself. 0. a person's script. A woman who plays "If It Weren't For You" with her husband just as her mother did is an example of: A. an outward expression of the Parent. B. a defense mechanism. C. banal scripting. 0. following her script. "I can't help it if I'm crabby. It's not my fault", is what type of discount? A. denying that a problem exists. B. denying that the situation is important. C. denying that anything can be done. 0. denying the ability to do anything about the problem. "You're great!" is a stroke. A. unconditional positive. B. conditional positive. C. unconditional negative. 0. conditional negative. \ 31. 32. 33. 34. 35. 36. 37. 112 The first ego state to develop is: A. Parent. B. Child. C. Adult. 0. Parent and Child develop simultaneously. When you act as your parents acted you are most likely in which ego state? A. Adapted Child. B. Adult. C. Little Professor. 0. Parent. People with full books of stamps: A. can turn them in for a prize of suicide or homocide. B. are more easily managed because their books are full. C. are undoubtedly in their anger racket. D. have rightfully earned them. According to TA the Adult ego state is all but: A. the executive of the personality. B. a computer gathering data. . contains genuine responses to an actual situation happening now. . inborn. person's Adult can be contaminated by: C D A A. his Parent. B. an incomplete Parent. C. both his Child and Parent. 0. his Child. The term "ego state" means: A. a way of classifying Parental, Adult and Childish behaviors. B. the parts of a person's ego. C. the ego, superego and id. 0. a system of feelings and related behaviors. Psychological Games are: A. like board games or cards. B. alternative stereotype transactions leading to withdrawal. C. complementary ulterior transactions leading to a pay-off. D. ulterior transactions brought-into Adult awareness. 38. 39. 40. 41. 42. 43. 44. 113 An adult at a football game is really excited. jumping up and down, and screaming. Which ego state has executive control? A. Child. 8. Adult. C. Parent. 0. two of the above. Which statement is most true about withdrawal as a way of structuring time? A. the only source of strokes is the person stroking himself. B. withdrawal is unhealthy because there are no strokes. C. it is difficult to withdraw because there are too many people. 0. withdrawal is totally learned behavior. Negative strokes are strokes that: . make the receiver feel not-OK. . convey negative feedback about behavior. . are conditional. . . are given negative value by the recipient. A B C D A person who illegitimately feels victimized by society would probably be coming from a Life Position of: A. B. C. D. I'm OK; You're OK. I'm 0K; You're not-OK. I'm not-OK: You're OK. I'm not-OK; You're not-0K. People who totally lose interest in living are most likely taking the position: m 0K; You're 0K. m OK; You're not-OK. m m not-OK; You're OK. not-0K; You're not-OK. A I B. I C. I' D. I A stroke is not: A. a unit of recognition. B. a physical touch. C. a spoken "Hello". D. a discount. Framing a picture on a Sunday afternoon is an example of a: A. pastime. B. withdrawal. C. activity. 0. ritual. 45. 46. 47. 48. 49. 50. 51. 114 A person's sense of real self: A. is firmly lodged in the Natural Child. B. doesn't crystalize until he reaches 12 years old. C. can be experienced in any ego state. 0. is only felt when all three ego states are fully cathected. Stroke hunger is: A. a theoretical concept. B. conditioned by heredity. C. the inborn need for touch. 0. conditioned culturally. A person who bases his decisions on prejudiced data is said to have a: A. dysfunctional Adult. B. Critical Parent. C. gallows transaction. 0. contaminated Adult. Procrastination becomes a common pattern of the Adapted Child because: A. the Parent is too restrictive. B. the Natural Child wants to rebel and the Adapted Child doesn't so the Little Professor stalls. C. it satisfied the Adapted Child's need to rebel. . he holds being late as a positive value learned from his parents. ritual is: D A A. a simple and stereotyped complementary transaction. B. not a source of important strokes. C. a type of pastime. D. something you do to fill time when you belong to an organization. Self indulgence in feelings of guilt and inadequacy is an example of: A. a decathected Parent. B. adapted feelings. C. racket feelings. D. a suicide script. A person can give up playing games by: A. recognizing and avoiding them. B. collecting stamps instead. C. blowing off steam. 0. starting a stamp collection. 52. 53. 54. 55. 115 People most fear intimacy because: A. B. C. D. they are inately suspicious. they aren't in the habit of being open. intimacy is an expression of the future. it involves giving up Activities and Pastimes. Which statement is most true about Life Positions? OW) > CO D. . They are relative to each other. . Each of us spends time in each position but one is our most favorite. . They are learned after we begin to speak. . They are relatively unimportant. complementary transaction is one in which: both people are on good terms with one another. people exchange Adult-Adult strokes. the person starting the exchange gets an expected response from the person's ego state to the ego state that started the transaction. everything is exactly even. Talking about the book "Games People Play" is an example of: DOW) the game "Psychiatry". a pastime. . an activity. . cathecting the Adult ego state. 116 TRANSACTIONAL ANALYSIS COGNITIVE TEST FORM #2 Instructions Please do not write or make marks on this test. Instead a computer answer sheet should be used to record your answer to each question. Please make sure to record your code number, the date, and the Form #2 on the computer answer sheet with a #2 pencil. If you decide to change an answer to a question make sure that you completely erase the first answer. Each question has one bg§t_answer that you should select. Remember that all questions should be answered from within the framework of Transactional Analysis. There is no time limit to this test. 1. An act, word or gesture that says "I know you're there" is an example of: A. Reality testing. B. Ego functioning. C. a stroke. 0. a Nurturing Parent statement. 2. "I like you" is an example of: A. an unconditional stroke- B. the beginning of "Rapo". C. stroke hunger. D. a ritual. 3. Life Positions are: . relative to others. . decisions made at an early age about others and one's self. . decisions made to keep others away. . the cause of psychological games. onw> 10. 117 Ulterior transactions are: A. not necessarily dishonest. B. characteristically dishonest. C. always gamey. D. duplex rather than angular. The hunger for structured time is: A. conditioned culturally. B. to avoid the pain of boredom. C. a sexual need. 0. a ritual. The position "I'm OK; You're OK", is best described as: A. an unrealistic goal. B. a potentially mentally healthy position. C. a position of people who feel victimized. D. a homicidal position. A e person is extremely upset and crying. Which ego state has xecutive control? A. Child. 8. Adult. C. Parent. 0. two of the above. Which of these ways of structuring time best illustrates withdrawal? A. sleeping. B. fantasizing. C. reading a book. 0. answering the mail. People who collect trading stamps are wasting time and energy because: they usually can be beaten at their own game. they are "re-proving" an incorrect childhood decision. . usually they collect more than they really need. . usually they can't keep track of their collection and how they can cash it in. UCW> If a chairperson of a meeting presents a problem and then shoots down all suggestions (without good reasons) he is: . crossing transactions. in his rebellious Natural Child. . playing a game. . probably doing it for the member's own good. DOW) 11. 12. 13. 14. 15. 16. 17. 118 When calling a game, a good rule of thumb is to: A. come on Persecutor to protect yourself. B. not pay any attention to the player's payoff feeling. C. make sure that you have "hooked" the player's Adult first. 0. laugh at the person as that probably isn't the payoff they are after. Awareness in TA terms refers to: A. sensitivity to others. B. reality testing. C. knowing what's happening now. D. wearing rose-colored glasses. An example of the Nurturing Parent is: A. I'Be sure to take the trash out before you leave." B. "Don't get into cars with strangers." C. "Boys shouldn't wear long hair." 0. "I don't think he'd be good for the job." The position of "I'm OK; You're notvOK" is best described as: A. a winner position. 8. Victim position. C. suicidal position. 0. a powerless position. 0f the categories of time structuring, playing football is an example of: A. intimacy. B. ritual. C. pastime. D. activity. Unwise Child decision can be: A. reversed because they are self determined. B. best blotted out by drug therapy. C. ignored. but not completely changed. . D. reversed at the risk of incurring psychosomatic reactions. Games and Rackets come mainly from: A. siblings and peers. B. television soap operas. C. learned adapted behavior. 0. Parent ego state. 18. 19. 20. 21. 22. 23. 119 Select the positive conditional stroke: A. (Father to Son) "You did a good job on the lawn." B. (Daughter to Mother) "Gee you're pretty, mommy." C. (Brother to Sister) "Smooth move, ex-lax." D. (Husband to Wife) I'You look tired. Why don't you take it easy?" A A good example of a crossed transaction is: . A student says, "You doubler crosser" and the second student answers I'And you're another. " . A nice boy says to his mother, "I' m hungry" and she responds crossly "I' m too upset to fix dinner. " . A boy says "I've lost your crossword puzzle," and the teacher answers "Where did you last see it?" D. The chaplain says "You've torn down my cross" and the revolutionary answers "Yes, I want it for a demonstration." 0CD "I really like you,‘I "I like you too" is an example of: . Child-Child complementary transactions. . Natural Child-Adult cross transactions. . Ulterior transactions. . Data exchanged by an Adult-Adult transaction. DOUG) Which of these statements about Rackets is not true: . it's a lousy feeling. . it leads to no action. . it is chronic. . it is a genuine feeling. A B C D A "Victim" is: A. a game player. B. someone who collects stamps. C. a position in the Game Drama Triangle. D. the only loser in the Game Drama Triangle. Which of the following is not a classification for transactions? . ulterior. . crossed. . congruent. . complementary. DOW) 24. 25. 26. 27. 28. 29. 30. 120 When a child learns to say "Thank you" to Someone he is in which ego state? A. Little Professor part of the Child ego state. B. Nurturing Parent part of the Parent ego state. C. Adult ego state. 0. Adapted Child part of the Child ego state. Which of the following is g9t_a way of stopping a game? A. reinforcing old decisions. B. giving up discounting. C. crossing transactions. D. withholding a payoff. People who turn down positive strokes: A. are commonly considered easy to manage. B. usually know phoniness when they see it. C. probably had overly loving mothers. D. are probably in a not-OK position. Ignoring the obvious signs that a person needs to cry is what type of discount? A. denying that a problem exists. B. denying that the situation is important. C. denying that anything can be done. 0. denying the ability to do anything. “It was really nice of you to cook dinner," is a stroke? A. unconditional positive. B. conditional positive. C. unconditional negative. 0. conditional negative. When behavior fluctuates between compliance to parental interference and rebellion against it, the conflict is between: A. Adapted Child and Adult. . Natural Child and Parent. . Parent and Adapted Child. . Adapted Child and Natural Child. discount is harmful because: . it is always painful. . it can't be avoided. B C D A A. it is a sign of neurosis. B C D. it is scripted. 31. 32. 33. 34. 35. 36. 37. 121 A person who expands his capacities for awareness, spontaneity and intimacy is: A B C D A A B C D. . developing an integrated Adult in moving toward autonomy. . decathecting the Parent. . dysfunctional. . in his Child most of the time. person who hugs others easily and genuinely is an example of: . expressing intimacy. . an integrated Adult. . a third degree Game Player. a Rescuer. The part of the Child that is innately intuitive, creative, and manipulative is the: DOW) > COW) . Critical Child. . Natural Child. . Adapted Child. . Little Professor. TA, "Hi, how are you?" would most likely be the beginning of a: Racket. . Game . Angular Transaction. Ritual. depressed person might be taking the position: I'm 0K; You're OK. I'm not-OK; You're OK. I'm OK; You're not-OK. I'm not-OK; You're not-OK. The bad feeling one is left with at the end of a Game is called: A. B. C. D. an anger stamp. an expression of the Critical Parent. an ulterior transaction. a Racket feeling. Prejudiced statements of a contaminated Adult are usually voiced as: DOW) . discounts. . negative strokes. . facts. . Critical Parent expressions. 38. 39. 40. 41. 42. 43. 44. 122 The Natural Child can be: . nurturing and warm. . informative. . selfish. . a Victim. A B C D A person whose behavior is unpredictable and often irrational is: A. in his Natural Child a lot. B. someone with lax ego boundaries. C. in need of reparenting. 0. playing Victim. False flattery and compliments are examples of: A. a conditional stroke. B. cultural scripting. C. Critical Parent subversion. D. a negative stroke. Game analysis deals with: A. ulterior transactions leading to an unexpected payoff. B. motivations of people who play psychological games. C. competitive motivations in sports and how they relate to life. 0. ulterior transactions which lead to an exchange of strokes. People play games because: A. it's fun and avoids pain. B. they lead to a predictable payoff. C. they do not yearn for intimacy. 0. they have much unresolved hostility. If someone is deprived of the opportunity to exchange strokes: . he learns his lesson. . . he hungers for strokes, even negative ones. . he loses interest in wanting to socialize. . he gets angry. . helps people who aren't functioning adequately to stand on their own. . creates crisis situations to look good in. . cashes in a lot of stamps. A B C D A Rescuer is someone who: A B C D. keeps others dependent on him 45. 46. 47. 48. 49. 50. 51. 123 In TA terms, a psychological script is: . the plan of the transactions of a Game. . a compulsively followed life plan. . the structure of a ritual. . the identity of the individual. A B C D A person who has ego boundry lesions: A. fixates in one ego state. B. cannot use his Adult. C. has a hysterical Parent. 0. exhibits uncontrollable behavior when touched in a "sore point". Which statement is an example of the Adult? > . "I wish I dared talk like that." B. "I'm really angry with you!" C. “That music makes me want to dance!" 0. "These socks are both brown." When people manipulate others to re-experience and collect old feelings they are: A. using their Little Professor. B. scripted to fail. C. indulging themselves in a Racket. 0. coming from "I'm not-0K; You're not-OK". "You swim like a champion" is an example of: A. maintenance stroking. B. a positive stroke. C. a discount. 0. recognition hunger. Religious beliefs come from: A. the Parent. B. national scripting. C. the Adult. D. magical thinking. When an infant seeks to avoid painful experiences and responds at the feeling level, this is an example of: A. an emerging Adult ego state. B. the Little Professor. C. an emerging Parent ego state. 0. the Adult ego state being in executive control. 52. 53. 54. 55. 124 In which of the occupations listed below would you most likely find a person with an excluded Child? A. Judge. B. youth counselor. C. disc jockey. D. stunt driver. Magical thinking is a function of: A. Little Professor. B. Critical Parent. C. Adapted Child. 0. a contaminated Adult. Which statement is an example of an unconditional positive stroke? "Thanks for doing the dishes. I really appreciate it." "Janet never listens to me." . "You've worked hard this week. Yes, you may have the car tonight." . "I really enjoy knowing you." DOW) People who save archaic feelings and later feel bad about themselves are: . cashing in stamps. . playing Persecutor. . using social control. . being in their Child. DOW) 125 TRANSACTIONAL ANALYSIS COGNITIVE TEST FORM #3 Instructions Please do not write or make any marks on this test. Instead a computer answer sheet should be used to record your answer to each question. Please make sure to record your code number, the date and the Form #3 on the computer answer sheet with a #2 pencil. If you decide to change an answer to a question, make sure that you completely erase the first answer. If you cannot completely erase the answer, ask for another answer sheet. Each question has one bg§t_answer that you should select. Remember that all questions should be answered from within the framework of Transactional Analysis. There is no time limit to this test. 1. In TA terms, withdrawal means: A. Going off addictive drugs. B. Rejecting strokes. C. Not exchanging strokes. 0. Not giving strokes. 2. Pastimes are: A. Relatively safe since you don't see the people again. 8. Necessary steps to intimacy. C. Safe ways of getting to know people. 0. Self-defeating because you don't get enough strokes. 3. Transactional Analysis proper is the study of: A. Whether the therapist is performing properly. B. What people do and say to each other. C. Appropriate situations for using TA. 0. Correct clinical usage of TA terms. 10. 126 "A consistent pattern of feeling and experience directly related to a corresponding consistent pattern of behavior" is the defini- tion of: A. A transaction. B. A racket feeling C. A rubber band feeling. 0. An ego state. Child battering is an extreme form of: A. Natural Child rebellion. B. Adapted Child fear. C. Game playing 0. Discounting. The reason that a person plays games is: A. Well within the Adult awareness of the player. 8. Probably not within the Adult awareness of any player, at least when he makes his first move. . That people are basically not-OK. . That it usually is the only way to get strokes. . Is carried by Winner scripts. . A familiar feeling that leads to no action. C. Is the result of genuine misbehavior. D. Leads to a change of status quo. C D A "Racket" feeling is one that: A B Flunking a test by not studying and partying instead can be an example of: A. Stupidity. B. Cashing in stamps. C. Gold stamps redemption. 0. Little Professor. The Drama triangle refers to: A. Conflicts between the three ego states. B. Three Games being played at the same time. C. Basic roles in a Game. 0. Manipulative "hooks" in a game. Activities are: . Ways of structuring time that deals with reality. . Something you must do. . Found in everyone's lives. . Found only in organizations. DOW> 11. 12. 13. 14. 15. 16. 17. 127 "You take it all too seriously," is what type of discount? A. Denying that a problem exists. B. Denying that the situation is important. C. Denying that anything can be done. 0. Denying the ability to do anything. A a Game played from which ego state reinforces a life position nd advances a script? . Parent. . Contaminated Adult. . Child. . Critical Parent. . m not-OK; You're OK. m OK; Your're OK. 'm OK; You're not-OK m A B C D A realistic, mentally healthy position is: A B C D not-OK; You're not-OK. In TA terms "stamps" refer to: S & H green stamps. Psychological suicide. C. A collection of old feelings. D. Beating up the Child from the Parent. A. B. If the Adult is in executive control, then: A. Stimuli is received through it before a person responds or acts. B. Autonomous decisions are more difficult. C. A person will be more spontaneous. D. The Parent ego state is de-cathected. "Stop crying, it doesn't help" is a stroke. A. Unconditional positive. B. Conditional positive. C. Unconditional negative. 0. Conditional negative. The Parent ego state is: . The manipulator of the personality. . The executive of the personality. . Discounted in TA. . The second ego state to develop. DOW) 18. 19. 20. 21. 22. 23. 24. 128 Strokes for "being" rather than "doing": A. Should be avoided if the giver is uncomfortable. B. Are unconditional reinforcers of an I'm 0K position. C. May hinder actions toward autonomy. 0. Are best left to professionals to deal with. All but one of these statements about Games is true. Which is incorrect: A. The players must know the game in order to play. B. All games have a beginning and a given set of rules. C. They are ongoing series of complementary transactions which are plausible at the social level. 0. Pay-offs are usually unpredictable and a surprise to the players. A person who says, "I've tried and tried for years and can't get anywhere" is involved in: A. Rituals. B. Banal scripting. C. Integrating his Child and Parent with his Adult. 0. Reluctance to look at the total situation to avoid the obvious. "What time is it?" "You're always in such a hurry!", is an example of: A. Nagging. B. Discounting. C. Teasing. D. Crossed transaction. The Nurturing Parent contains: A. Moralizing punitive messages. 8. An evaluation process. C. Protective limits. 0. Opinions on how to behave. The Adapted Child is: A. Inborn. B. Learned from Parent figures. C. Creative. 0. A believer of magic. Which ego state would cover stress by acting cheerful? A. Natural Child. B. Adult. C. Critical Parent. 0. Adapted Child. 25. 26. 27. 28. 29. 30. 31. 129 The definition of a positive stroke is: A. A sincere compliment. 8. Positive recognition. C. A modified physical touch. 0. A script message activated by a situation. "Wouldn't you like to come up to see my etchings?" is an old cliche’ illustrating: . Complementary transactions. . Superficial transactions. . Indirect transaction. . Ulterior transactions. A B C D A "racket" feeling is: A. A necessary step to action. B. A pay-off to a Game. C. Usually real. 0. Not based on any experience. People play psychological games to: A. Support their existential position. 8. Have a good time. C. Strengthen their Adult ego state. 0. Protect their Child ego state. The decisions we made during our childhood: A. Can't be changed. B. Were usually right because kids don't fool themselves. C. Didn't have anything to do with reality. 0. Were usually wrong but can be changed. According to TA, all games start with: A. A discount. B. Someone taking one of the game roles. C. A crossed transaction. 0. Someone cashing in a stamp. Counter-injunctions are usually: A. Created by the person to off-set injunctions they got from their parents. Given non-verbally. . Given verbally. . Telling the person how their life should end up. DOW 32. 33. 34. 35. 36. 37. 38. 130 The Natural Child part of the Child ego state: A. B. C. D. Decreases in importance as a person gets older. Is the source of empathy. Is expressed when a student is engrossed in studying. Is indifferent to hurting others. According to TA, a person who is highly effective: COW) . Is always in their Adult and therefore is very logical. . Uses their Adult to decide if their needs are OK. . Can change ego states readily in response to changing situations. . Is usually in their Child and therefore is doing what they need to do. The need to structure time is: A. B. C. D. Conditioned culturally. A sexual need. Inborn. A ritual. Feeling lonely instead of finding someone to be with is an example of: A. B. C. D. In A B. C D Being in your "racket". Rubber band feelings. "Blemish" Time structuring. TA terms, a delusion is caused by: . "Adult" contamination of "Child". Traumatic childhood trauma which results in crazy "Parent tapes". . "Parent" contamination of "Adult". . "Child" contamination of I'Adult". TA, the phenomenon of exclusion is related to: . Rigid ego boundaries. . Lax ego boundaries. . Group dynamics. . Social control of individuals. Script instructions are programmed into: DOWZD The "Adult" ego state. . The natural "Child" ego state. . The adapted "Child" ego state. . The “Parent" ego state. 39. 40. 41. 42. 43. 44. 45. 131 TA advocates which Life Position for people to work towards? A. I'm OK; You're OK. B. I'm OK; You're not-OK. C. I'm not-OK; You're OK. 0. I'm not-OK; You're not-OK. The position of "I'm not-OK; You're OK" would most likely be held by a: A. Paranoid. B. Delinquent. C. Someone who usually is withdrawn. 0. Truck driver. Intimacy in TA terms refers to: A. Being together. B. Expressing the Natural Child feelings of warmth and tenderness. C. Risking growth. 0. Having Child-Child interactions with someone you like. Select the positive, unconditional stroke: A. You look good today. B. I like you when you're so sweet. C. You have great taste in clothes. 0. I enjoy being with you. Which of these is an example of intimacy: A. Doing someone's chores because you want to help. B. A mother singing to her baby. C. A husband bringing his wife flowers and candy. 0. Husband and wife share their feelings about the wife's new job. The definition of stroke in TA terms is: . Any act implying recognition of another's presence. . A biological deficiency that needs to be eradicated. . Physical touching. . A response to a need. . Die. . Feel I'm OK; You're not-OK. . Provoke negative strokes. A B C D A person who is insufficiently positively stroked will often: A B C 0. Become a "Now I've got you, you son of a bitch" player. 46. 47. 48. 49. 50. 51. 52. 132 When an initial "Adult" to "Adult" stimulus provokes a "Parent" to "Child" response, the transaction is: A. Angular. B. Ulterior. C. Complementary. D. Crossed. "Teasing" a child is, in TA terms: A. A "Warm Fuzzy". B. A conditional stroke. C. A negative stroke. 0. A ritual. The position I'm not-0K; You're not-OK is best described as: . Schizoid. . Paranoid. . Healthy. . Depressed. A B C D A contaminated Adult is: A. Experienced as withdrawal. B. Hard to cathect. C. Can be delusions and hallucinations in extreme cases. 0. Emancipated and can make its own autonomous decisions. "Hellos" and "goodbyes" are examples of: A. Rituals. B. Child-Child dialogue. C. Transactions. 0. Intimacy. Which statement about positive strokes is not true: A. Sometimes they are compliments. B. They are often an expression of affection. C. They are usually complementary transactions. 0. They create stroke hunger by stimulating the need. Someone who sets unnecessarily strict limits on behavior or is charged with enforcing rules sadistically is a: A. Karpman dramatist. B. Kick Me player. C. An Adult out of control. 0. Persecutor. 53. 54. 55. 133 The ego state part which "psyches out'I the best move in the situation is the: . Adapted Child. . Natural Child. . Adult. . Little Professor. person with a Lax Ego Boundary is said to: . be low-energy. . Be able to change ego states readily. . Exceptional in functioning. . Lacks identity. COED) 3> COW) "Don't feel bad, Doc, I can take the truth," is an example of: A. Contract. B. Winner script. C. Kick Me player. 0. Nurturing Parent. APPENDIX B SKILLS ABILITY SCALE: STIMULUS STATEMENTS APPENDIX B SKILLS ABILITY SCALE: STIMULUS STATEMENTS #1 (Male). "She did it again! Just walked out leaving the dishes in the sink....That woman is driving me crazy....Twenty years of..." #2 (Female, young). "My girlfriend asked me to call. She..ah.. felt kinda funny calling. Well, she thinks she's pregnant. But she's afraid to go to her family doctor. You know. he's known her since she was a kid. Anyway, I said I'd call for her. She's my best friend. I just heard your thing on the radio about referrals and stuff. 00 you know of a doctor she could go to for a test?‘I #3 (Female, scared). "Hello! Is someone there? Jesus! I heard the noise again. Some guys are outside fooling with my door. I called the police and they said they'd be right over. But I'm all alone. Oh, no! They're shaking the door know again. Hello! Hello!" #4 (Male). "I don't have any money and I need to see a doctor about this rash I got. Someone at work said there's free clinics somewhere. But I couldn't find them in the phone book." #5 (Female). "Boy, I'm really pissed! I was at a party tonight and I got to talking with this guy. He seemed really nice. We talked about sports and found out that we both like to ski and I thought maye be I'd finally found a guy I could have some fun with. Boy was I 134 135 wrong! He offered to take me home and I thought he was just being polite. So I invited him in and offered him a drink. Well, that did it. He wouldn't keep his hands off me. I told him I wasn't that kind of girl and he got mad. He said I was leading him on wearing sexy clothes and inviting him in! And I wasn't! I was just trying to be nice. It seems like every date I've been on ends that way. You just can't trust men. They're all alike!" #6 (Male). "Hi! How ya doin'? I'm doin' fine. My buddy's been with me all afternoon. This is a bomb trip, man! Great acid. Anyway. Chuck's going out to get us some food and he doesn't want me to be alone. So you get elected to be my guide for twenty minutes. Doesn't pizza sound great!" #7 (Male). "I've got a gun here. It's loaded and I know how to use it. I was in Nam ya know. Saw lots of things....but what's it matter now? (sigh) No one cares. I lost my legs and I can't get a job. And this is real funny. You're gonna get a kick out of this! My fiancee is marrying someone else tomorrow." #8 (Female). "Someone told me that using contraceptive foam is just as good as using birth control pills. I've been on pills a couple of years and haven't tried anything else. I thought I'd check it out, though, first. Do you have any information?" #9 (Female). "My fiancee thinks I'm a virgin, but I'm not. Is there any way he can tell?‘I #10 (Female). "I'm thinking about ending it all. I've had it. Everything's gone wrong. There's nothing I can do about it. And I've got a bunch of pills here that'll help me." 136 #11 (Female). "I don't like being a nosey neighbor, but some- thing's got to be done. The father next door is an alcoholic and comes home and beats up his children. It just makes me sick. This morning Sarah came over to play with my Linda and she had a swollen wrist. I don't know much about medicine, but I think it's broken. Can I take the child to the doctor or call the police? I'm not sure what's legal." #12 (Female). "Some smart ass guy in my class says that it's OK to drink alcohol and take downers. He says it's a great trip and I should try it. I told him I was going to call you first and find out if he's telling the truth. Is he?" #13 (Female). "Boy am I going to get my boss! I'm so mad at him! All year long my boss has loaded me with more work than the other secretaries. He thinks I'm such a good worker! Well, I've had it! He left yesterday for vacation and he expects me to run every- thing. I'm twice as busy doing his work too! Well, I'm just going to let everything pile on his desk. I'm just going to sit there and drink coffee and read magazines and he can go to hell! When he gets back and opens his door...Man...will he be surprised! Don't you think that's a good trick?" #14 (Female). "1 want to know what my rights are. My husband says he doesn't have to pay child support 'cause I'M the one who left with the kids. Is he right?" #15 (Female). "I was going to this therapist and I really trusted him and was willing to work in the group. But just because I never had 137 anything to work on when I got there he said I didn't really want to work. It wasn't true! I just didn't trust the other people in the group. Mrs. James would laugh all the time and make an ass of herself and that funny looking Mr. Carlson never said anything, but he made these funny noises. I got stuck with a bunch of creeps. I didn't be- long there. And then I found out that the therapist was a draft dodger! Can you beat that! I'm not going to trust anybody who doesn't believe in his country! And here all the time I thought he was a good person.... Good thing I found out about that in time." #16 (Male, scared). "Can you help me? My friend just passed out on the floor. There's just the two of us in the house and I don't know what to do." #17 (Female). "I found some red capsules in my daughter's purse. If I describe them can you tell me what they are?" #18 (Male). "I'm afraid to go home to my wife. I got fired to- day and I feel really stupid. I've been having a lot of trouble at work. My boss and I have a personality clash. And he warned me that I was calling in sick too much. The next time I better bring in a doctor's excuse or I'd be fired. Well, I didn't think he'd do that. And I really wanted to go hunting Friday so I took the day off. Well, when I walked in the office without a doctor's excuse this morning, he blew his stack. Um...I don't know what I'm going to tell my wife. This is the fourth job I lost this year. I can't figure out how come I always end up a loser...I guess I always pick on the wrong bosses." 138 #19 (Female). "Hey....I need some help. My bedroom is scaring me. The walls keep weaving in and out and my bed won't stop moving. I'm afraid to sit on it. Mag and I dropped some window pane about three hours ago, but I never saw this stuff before. Can you come over?" #20 (Male, angry). "I warned her! I said if I caught her going out on me again I'd kill her. And I will! I came home from work and she's not here. So I'm just waiting. She better have a good excuse." #21 (Male, hesitant). "Ah...I'm just here for a...for ah... construction job for the summer. I don't know any...anybody except the guys at work...wonder how I can meet some chicks." #22 (Male). "1 don't know what to do. I feel numb. Diane and I went together all through high school. We were planning on getting married when I got done with college, but that isn't going to happen. We just had a big fight and she gave me back her diamond. I can't be- lieve this is happening to me." #23 (Female). "Is this a volunteer place I'm calling? I have three children in school during the day and I'd really like to get in— volved in something. The only organization I know about is the Red Cross. but I'm not the nursing type. I used to be a bookkeeper before I was married. Is there any place that I could use my skills part time?" #24 (Male). "I just can't get to sleep tonight. I've tried read- ing and warm milk. Nothing helps. I just keep thinking about the funeral today. I thought maybe if I talked it out I could get some rest." #25 (Female). "I'm a sensitive person and sometimes people can't understand that I take things to heart. I seem to always be around 139 people who hurt my feelings. I don't understand how they can be so cruel. My second husband was especially mean to me. It took me a long time to realize he wouldn't change. Why, just yesterday I offered Rosemary-~she's my cousin--a recipe for my special fruitcake: And she said she didn't bake much and probably wouldn't ever use it, so I shouldn't go to the bother and write it down for her. That's what really hurt my feelings. I don't offer my recipe to everyone!" #26 (Female). "Nobody appreciates what I do. (sigh) I work so hard to do everything right. I want to be a good mother you know. I make breakfast in the morning for everyone, drive the kids to school. My house is always open for the kids to bring their friends home to. I bake special desserts that I know they'll like. I've always tried to please Jack-~that's my husband. But it seems like they never notice. I feel like I'm being taken for granted. I don't understand what I'm doing wrong." #27 (Male). "My mother is really mad at me. She asked me to stop at the dry cleaners after class to pick up the coat she wanted to wear to a party tonight. I forgot. And now it's closed. She said it's the last straw. I guess she's right. I'm always forgetting things. (sigh) Last month I forgot to send in the insurance money for my car and now it's cancelled. My dad just says it figures. He thinks I'm stupid any- way. I guess I am." #28 (Female). "1 want to go to college but I'm not going. My parents are divorced and my mother supports us. I had a rough time growing up, taking care of the younger kids while Mom worked. My teachers say I have 140 a high 1.0. and I should get better grades. They expect too much of me. I'd like to do better, but I just can't. I wish I could, though. No one in our family's been to college. I'd like to be the first one. If I'd been born in another family I'd be able to go. How come I_had to have it so rough?° #29 (Female). "My parents won't let me do anything I want. I could be a great guitar player...they won't give me money for lessons. It's not as if we're poor. They're just selfish. They know how much I want to play. They just like to see me miserable. I could do a lot of things if it weren't for them. They just enjoy having all the power over me. I can't wait until I'm 18. Then I'll be happy!" #30 (Male). "Ever since I was a kid people have been picking on me. People expect too much of me. They don't understand that I've had a rough life and I don't get sympathy from anyone. They tell me 'Do this, John', '00 that, John', but I can't do everything! I wish people would just leave me alone." APPENDIX C SKILLS ABILITY SCALE: RATING SCALES APPENDIX C SKILLS ABILITY SCALE: RATING SCALES GENERAL DISCUSSION: Underlying the Skills Ability Scale (SAS) is the concept that calls coming into a crisis center can be sorted into categories along the dimensions of presented need of the caller and the degree of emotion present. Three cate- gories were identified from a history of the contacts taking place at the Open Door. The categories are as follows: Type I: Information: The caller is making a request for information. The in- formation requested can be about general knowledge or for the location of appropriate community resources. There are little or no indications of a strong affective component accompanying the request for information. And there are no indications that the caller will not be able to hear and use the information. II: Dangerous Emotions: The caller is apparently overwhelmed by the affective component of the situation. There are strong indica- tions that the caller will not be able to begin appro- priate coping behavior until the affective component is brought under control. Also applies to trippers or other drug users having a good time. III: Long:Term Stress: The caller is presenting material about some long-term stress or pattern in his or her life. Although affective material may be a crucial component. the caller is still able to use existing coping mechanisms. It is assumed that the caller is requesting aid in clarifying the various aspects of his/her problem and developing alterna- tive courses of action. 141 Type I: 142 Information: Level 1. Level 2. Level 3. Level 4. Level 5. Responses at this level are judged to be "turn offs." The response is judgmental, in a negative sense, of the caller and/or the request. Or the response gives information that does not correctly respond to the request. Examples: a. "I'm sorry but answering that question con- flicts with my values systems. You'll have to talk with my shift partner." b. (In response to a request to identify some capsules) "Why don't you bring the tabs of acid in and we will analyze it for you." Responses at this level do not answer the caller's question. However, the response does not turn off the caller. The most common example is an empathic response to the question. Or the Crisis Intervention Agent does not indicate his limitations in giving information. For example, giving legal or medical information without telling the caller he is not an expert and advising the caller to contact a pro- fessional. Responses at this level indicate that the question can be answered. The limits of the Crisis Inter- vention Agent in giving legal or medical informa- tion is clearly communicated to the caller. However. the information given is incomplete or indicates another source of information that must be contacted before the caller's questions can.be answered (Crisis Intervention Agents are expected to be able to pro- vide a complete, accurate answer to each speaker statement.) Responses at this level give an accurate answer to the caller's question while clearly communicating the limits of the Crisis Intervention Agent's ex- pertise. Responses at this level give an accurate answer to the caller's question while clearly communicating the limits of the Crisis Intervention Agent's ex- pertise. The response may also indicate the existence of further resources. And all responses at this level contain an invitation to the caller to continue talk- ing about his/her concern. Type II: 143 Dangerous Emotions: General: Level 1. Level 2. Level 3. Level 4. Level 5. In life-threatening situations or when the caller requests a Flying Squad, the response must include a request for the caller's location. If this is not done, the response should receive a rating one level lower than it normally would. Responses at this level tend to keep the caller overwhelmed by emotions. The most common example of this level is making an empathic response. Responses at this level tend to move the caller into a cognitive process. However, the response does not offer reassurance, new information, or suggestions for appropriate action. The most common example of this level is a response which requests more informa- tion from the caller. Responses at this level contain 2 out of the 3 following elements: (a) reassurance to the caller, (b) a tendency to move the caller into a cognitive process, (c) giving new information or correcting false information. Responses at this level contain all three of the following elements: (a) reassurance to the caller, (b) a tendency to move the caller into a cognitive process. (c) giving new information or correcting false in- formation. Response at this level contains all three of the elements listed in Level 4. In addition, the res- ponse contains instructions to the caller which aid in coping with the immediate crisis. Examples of instructions. a. Bad Trip: "Open and close your hand. See, you control that!" b. Suicide: "Let's make a contract to talk to each other for the next hour before you do anything." Type III: 144 Long-Term Stress: General: Level 1. Level 2. Level 3. Level 4. This category of contacts is typically made up of people playing what Transactional Analysts call “games." The general expectation of responses is that they will be nonjudgmental, show "positive regard" for the caller, demonstrate that the Crisis Intervention Agent hears/understands what the caller is saying, and does not reinforce the caller's game or racket feeling. Responses at this level tend to reinforce the caller's game or racket feeling. There may be evidence that the Crisis Intervention Agent is setting up or parti- cipating in a series of Ulterior Transactions. Examples: a. Instead of "You feel stupid," the response is "You're stupid." b. The Crisis Intervention Agent explains how the caller probably misunderstood the situation or somehow acted in the wrong manner. Responses at this level still tend to reinforce the caller's game or racket feeling. However, the Crisis Intervention Agent is not participating in Ulterior Transactions. The most common response of this type is empathy, focusing on the racket feeling. Examples: a. (Stupid) "You really feel stupid." b. (NIGYSOB) "You're really angry." Responses at this level do not reinforce the caller's game or racket. The response (a) shows that the caller's feelings (still racket) are heard and accepted, but (b) tends to move the caller into his/ her Adult by requesting more information. Examples: a. (RAPO) "You're really angry at men because they all seem to be after sex. Have you ever met a man who wasn't?" b. Stupid) "You really feel stupid because you forgot to pick up your mother's coat. It seems that you end up feeling stupid a lot of the time." Responses at this level (A) are directed at feelings underlying the caller's racket and (b) introduce the idea that changes are possible without making the change the caller's responsibility. Level 5. 145 Examples: a. b. (RAPO) “I hear that you're angry and hurt. How could those things change for the better?" (NIGYSOB) "You're really angry because you don't feel that your boss is fair to you. But it sounds like what you're doing could get you into trouble." (If It Weren't For You) "You are really dis- appointed because you don't feel able to go to college. Have you thought about other ways to finance your education?" Responses at this level (a) are directed to feelings underlying the caller's racket, (b) tend to hook the caller's Adult, and (c) put the responsibility for change on the caller. Examples: a. b. (RAPO) "You're angry and hurt. What do you think you can do differently next time?" (Stupid) "You're feeling worthless because you always seem to be making mistakes. How can you change things so you'll feel better?" APPENDIX D LETTER AND QUESTIONNAIRE SENT TO VOLUNTEERS APPENDIX D LETTER SENT TO VOLUNTEERS Dear Volunteer: Several months ago it was decided at a staff meeting that the Open Door would perform an experiment to determine if certain changes should be made in our training package. This experiment will also be Mike Brown's doctoral thesis. This letter is to let you know more about that experi- ment. The basic question that is being asked is whether or not adding Trans- actional Analysis (TA) will improve the training in Empathy, Value Clarification and Decision Making. This will be done by giving each volunteer at the Open Door some pre-tests and then randomly assigning you to different groups. These groups are (a) a Control Group that doesn't do anything except take some tests, (b) a TA Study Group that only reads a handbook and takes the same tests, (c) a TA Practice Group that reads the handbook and then goes through our regular IPR training, and (d) a group that just repeats our regular IPR training. Because of the nature of the experiment, some of you will be asked to put in more time than the others. But each group is equally important for the experiment to really be meaningful. The experiment will take an effort from each of us. When it is done we will have the necessary information to decide if we want to include TA in our training program. And we will have an excellent justification for our decision which is important in the present move by the State for greater control of crisis centers. I should also mention that the results of the study will not be used to evaluate your skills. The tests that you take will not identify you as a person. To facilitate this lack of identification, please select for yourself a four digit number (perhaps the last four digits of your Social Security Number) for you to use in identifying the various tests. Please keep your code number to yourself because the lack of identity is necessary for the experiment to be valid. However, I need to know what code number you selected so that I can make sure that there is no duplication. 146 147 Enclosed with this letter is a questionnaire that will be used to set up the schedule for the whole experiment. It also requests some demographic information so we can describe the Open Door's volunteer staff. Please fill it out and return it to my folder the next time you are working a shift. Thank you, Mike Swenson 148 SCHEDULING QUESTIONNAIRE TRAINING EXPERIMENT Name Experiment Code No. Marital Status Age Highest school grade completed Major Employment Full time ____ Half time _____ I. Pre-tests: Please check all the times that you could attend. Feb. 11th 7:00 pm to 11:00 pm ___Feb. 13th 7:00 pm to 11:00 pm___ Feb. 12th 7:00 pm to 11:00 pm ___Feb. 14th 7:00 pm to 11:00 pm____ However, you will only be asked to come to one session. II. The experiment will take place at the following dates: Feb 15th (Friday) 7:00 pm to 11:00 pm Can Come Feb 16th (Sat.) 9:00 am to 6:00 pm Feb 17th (Sun.) 9:00 am to 6:00 pm Can't Come III. Post-test: Please check all the times you could attend. It would be preferred if you could come the 17th. Feb. 17th 7:00 pm to 11:00 pm ____Feb. 20th 7:00 pm to 11:00 pm ____ Feb. 18th 7:00 pm to 11:00 pm ___ Feb. let 7:00 pm to 11:00 pm ____ Feb. 19th 7:00 pm to 11:00 pm ____Feb. 22nd 7:00 pm to 11:00 pm ___ 149 IV. Follow-up test: Please check all the times that you could attend. March 25th 7:00 pm to 11:00 pm _____ 26th 7:00 pm to 11:00 pm 27th 7:00 pm to 11:00 pm 28th 7:00 pm to 11:00 pm 29th 7:00 pm to 11:00 pm 30th :00 am to 1:00 pm :00 pm to 6:00 pm :00 pm to 11:00 pm Blst :00 am to 1:00 pm NKOVNKD :00 pm to 6:00 pm \1 :00 pm to 11:00 pm APPENDIX E LISTENER PERFORMANCE SCALES Level 1. Level 2. Level 3. APPENDIX E LISTENER PERFORMANCE SCALES Empathic Response Scale At this level the verbal and behavioral expressions of the listener do not attend to the feelings, attitudes or values of the speaker. The listener is either ignoring or unaware of the speaker's present and obvious feelings. The listener: a. points out conflicts in the speaker's presented material in a judgemental way; b. reacts to the material presented by the speaker in a negative manner; c. uses personal examples or personal feelings that take the focus away from the speaker. The listener may be sensitive to the obvious material pre- sented by the speaker and yet misunderstands much of what the speaker has communicated. The listener blocks off or misdirects the speaker. At this level the listener: a. responds with platitudes or simple solutions; b. responds using abstract and general terms; c. identifies the speaker's feelings, attitudes or values but uses examples outside of the speaker's here-and-now experience: d. responds using questions about the.speaker's experience or responds by only "summarizing“ the presented situa- tional material; e. identifies a feeling, attitude or value and "hammers" at the speaker preventing the speaker from moving to other material. The responses at this level show understanding and reflect present, obvious feelings, attitudes or values. _But the listener does not respond accurately to how the speaker feels beneath the expressed material. The listener: 150 Level 4. Level 5. Level 1. Level 2. 151 a. consistently reflects the speaker's stated feelings, attitudes or values in a non-judgemental way; b. aids the speaker in exploring the depth of feelings but allows the speaker freedom to move to new material. The listener consistently uses straight reflective state- ments and is also able to add to the speaker's self-under- standing by identifying underlying feelings, attitudes and values not named by the speaker. The listener: a. is able to focus on those feelings, values and attitudes that are central to the speaker's problem; b. responds to contradictions with examples out of the speaker's stated experience; C. is able to show the relationship between the speaker's feelings, attitudes and values; "You're really angry about your son smoking grass because you feel that it is dangerous and you're afraid he will get hurt." At this level the listener can consistently use straight reflective statements in conjunction with consistently identifying underlying feelings, attitudes and values. The listener communicates a full awareness of what the speaker is experiencing. ‘ Listener's Genuineness Scale The listener is clearly defensive. There is consistent overt evidence of a very considerable discrepancy between what is said by the listener and what the listener admits to experiencing. Examples are: a. the listener who says in a strained voice that he is not bothered by the speaker's presented material; b. the listener who does not admit to confusion about what the speaker is presenting. There is evidence of defensiveness or presence of a facade in the listener's responses. The listener may respond in a contrived or rehearsed way rather than in a personal manner. The listener consistently avoids reflecting or exploring the depth of certain emotions. The listener who: a. identifies "hurt" without exploring the need to cry; b. uses a monotone voice when speaking and fails to match tone with the speaker; c. avoids obvious verbal and non-verbal signs of anger. Level 3. Level 4. Level 5. Level 1. Level 2. Level 3. 152 There is no evidence of defensiveness or presence of a facade in the listener's response. a. the listener admits to being confused in order to clarify the presented material. b. there is minimum appropriate physical contact, i.e. hold- ing the speaker's hand while the speaker cries. c. the listener reveals his feelings when they are inter- fering with his ability to listen to the speaker. The listener is open to experiences of all types, both pleasant and unpleasant. The listener is able to reflect and explore the depth of all emotions. However, extensive interaction with deeper feelings is tiring to the listener because the listener is uncomfortable experiencing the depth of the emotions. a. there is appropriate physical contact, i.e. holding and/ or stroking the speaker when the speaker cries. b. the listener is able to control his innate uneasiness in dealing with the speaker's presented material. The listener is freely and deeply himself without retarding the growth of the speaker. The listener need not express personal feelings but whether he is clarifying or sharing experience, it is clear that he is being himself so that his verbalizations match his inner self. Listener's Nonpossessive Warmth Scale At this level the listener is offering advice or giving negative regard. The listener actively approves or dis- approves of the speaker's behavior. Through such action the listener is making himself, not the speaker, the center of attention. The listener communicates to the speaker that his behavior matters in the sense that the listener is concerned about the outcome of the speaker's problem. There is little evaluation of the thoughts and feelings of the speaker. How- ever, the listener may communicate that he wants the speaker to be more mature, not quite so emotional or that he wants the speaker to confine the conversation to feelings. The listener communicates to the speaker that his behavior matters in the sense that the listener is concerned about the speaker. There is no overt negative evaluation and very little positive evaluation of the presented material. However, the listener still communicates a desire that the Level Level Level Level Level Level 153 speaker talk only about feelings, attitudes or values. a. the listener does not smile or nod when the speaker gives what the listener considers to be a correct answer; b. the listener does not show skeptism or approval when the speaker advances a tentative solution to their problem. . The listener communicates warmth and respect for the speaker. The listener may communicate a desire for less sustained heavy emotionalism. There is neither negative or positive approval of the speaker's presented material. However, the listener may communicate the desire that the speaker pre- sent only personally relevant material. . The listener communicates warmth without restriction. There is a deep respect for the speaker as a person and his rights as a free individual. At this level the speaker is free to be himself even if it means regressing or even disliking the listener. Receiving and Using Feedback . The receiver is clearly defensive. Feedback is consistently met with explanations as to "why" they did what they did. The receiver is unable to summarize and identify major themes of feedback. Further interactions reveal no learning from the feedback. . The receiver is sometimes defensive. Questions and discussions often stem from the receiver attempting to find some instance where their behavior would have been correct. Often the person uses self-criticism to avoid negative feedback from others. Further interactions reveal that some feedback is being used to improve their performance. . The receiver may still be apprehensive (as indicated by their hearing only the negative feedback) but questions and dis- cussion stem from a need to clarify the feedback not to "prove" they were right. The receiver is able to summarize and identify major themes of feedback. However, their acceptance of feedback is based either on their understanding of theory or the authority of the giver. Further interactions reveal that most feedback is being used to improve their performance. The receiver is most often comfortable in receiving feedback and is able to hear both positive and negative feedback. The re- ceiver often can understand the feedback as it relates to their Level 5. Level 1. Level 2. Level 3. 154 own emotional experience. (They can recall the experience of being hindered in speaking by the listener asking questions.) Also, the receiver has some insight into their values, attitudes and feelings that have resulted.in the behavior for which they are receiving feedback. Almost all feedback is used to improve their performance. The listener is clearly at ease and eager for feedback as a method of improving their performance. Questions and dis- cussion are used to clarify feedback with the receiver owning feelings of confusion or disagreement. The receiver is able to summarize and identify major themes of feedback. Further, the receiver is able to identify his values, attitudes or emotions that are producing his behavior. Further inter- actions show a progressive use of feedback. Ability to Give Feedback Gives general feedback that does not communicate things that the receiver might be expected to be able to do something about. Often uses feedback as a method.of satisfying emotions that are not being openly expressed (such as "beat- ing up" the receiver). Conveys the feeling that the feed- back is about what the person is as a person, not about specific behavior of the person. There is some general feedback but the giver also talks about some specific behavior that the receiver might.be expected to be able to do something about. Some typical behavior at this level is: a. not speaking directly to the person receiving the feedback; b. using feedback to show how clever they are, i.e. ''I got that he was feeling...."; c. giving only positive feedback when negative feedback was clearly called for. Gives specific feedback about things that the receiver might be expected to be able to do something about. .Never gives general feedback. However, feedback is based on theory and does not reveal the emotions of the giver. Clearly communi- cates that the feedback is about the person's behavior not what the person is as a person.. Gives both positive and negative feedback although there might still be a tendency to cushion the negative feedback. Checks to make sure that the feedback has been clearly communicated and understood. Level 4. Level 5. 155 Begins to include examples of possible changes in behavior. Sometimes the feedback is based on the giver's emotions and experience. .Begins to determine the emotional impact of the feedback on the receiver. Gives specific feedback about specific behavior that is based on the feelings of the giver. Readily supplies helpful ex- amples of possible change. Gives negative feedback in a non- threatening manner. Consistently checks to make sure that the feedback has been communicated and the nature of the emotional impact of the feedback. APPENDIX F RAW SCORES OF THE TOTAL SAMPLE ON THREE ADMINISTRATIONS OF THE FIVE MEASURES 156 om me me am Nm mm _N om mp mp op mp KN mN Pm mmmm mm mm cc mm mm mm om pm pm up mp mp mm mm mm mmmm mm em he mm em um om cu m_ mp up .mp mm mm mm mm¢_ pm we ea mm mm Fe mm NN _N up mF mp mm on em mmpo pimam ma ow mm mm ca KN mm o~ mp mp mp op om mm 5— Room me mm me mm mm mm mm _N mp Np NP ep mm mm mm mmow om mm om mm ca mm om mm mp pp mp op pm Fm mm mpmk um um mu Fe mm mm mm mp w— FF _N ¢_ —m em on mmmx ow mm mm Fa Na Fm Fm mm mp NP om up an mm mm _FNN me me me me “a om KN am am mm mp ep Rm Fm mm Nemm Fm mm mm mm ma Fm Fm mm mp NP wp op mm mm mm _mmm me we ow mm Fe mm Fm _N «F m. mF OF mm mm mp emmP _m mm wN _a me mm mm «N om up mp _F om RN m_ «mm, mm mm mm _a we mm _N mm mp o_ o_ F_ om RN _N emop m

wpwcmou HHH maxw .m.<.m HH waxy .m.<.m H waaw .m.<.m L3:52 aaoco xuw>wpwmcom mwmxpmc< _mcowuummcmgh muou m>wyomme< mmgzmmmz m>wm mgp mo mcomumgumwcwau< awash co mFQEmm Page» msp do mucoum 3mm .Np anmp m x~ozmma< 157 _Nwm onem nmmm mmwm _NNN mmym ammo _omo ommw mmmn ammm mmom nmmw mmnm mmmp mmop Femo wmxm wemw mmmm nmpw eapm mama ommp mum— Fomm mums ammo mmme N1¢