A 50-HOUR INTENSIFlED IPR TRAINING PROGRAM FOR COUNSELORS Thesis for the Degree of 'Ph. D. MlCHlGAN STATE UNIVERSITY KAREN KAY ROWE 1972 LIBRARY 4,331 Michigan State U . . This is to certify that the thesis entitled A 50 Hour Intensified IPR Training Program for Counselors presented by Karen Kay Rowe has been accepted towards fulfillment 5 of the requirements for Pth. degree in College Counseling Major professor Dike July 28, 1972 V BIN—DING av ‘ HMS & 80 um um: . h mlmon mama; ’ :;-_,.\.-( Iflllllllflzllfllfllullljlnflllhjll ilillwlfllflll 6% r2. , é—wV ‘76 _.,_~.,._._. ,____‘..—.— ____ ABSTRACT A SO-HOUR INTENSIFIED IPR TRAINING PROGRAM FOR COUNSELORS BY Karen Kay Rowe Interpersonal Process Recall (Kagan, gg‘gi-p 196” is a video tape training technique designed to maximize the amount of feedback available to the partici- pants of a counseling interview. Originally deve10ped flnruse in counselor education and psychotherapy, the IPR model has been successfully applied to many training situations where the goal has been to teach interpersonal mmmmnication skills. The technique has been used to accelerate client growth in psychotherapy (Woody, 1965; Resnikoff, E 11:, 1970; Schauble, 1970; Hartson, 1971): Ubtxain lay mental health workers (Dendy, 1971; Scharf, 1371;‘Archer, 1971) and to train professional counselors “kfldberg, 1967; Spivack, 1970; Grzegorek, 1971: Heiser- man, 1971). The IPR research to date has been primarily con- Cerned with two basic issues: (1) establishing Inter- Personal Process Recall as a valid and effective training Karen Kay Rowe technique, and (2) exploring the range of pOpulations to whnflmthe training model is applicable. The purpose of fins study was to expand the basic IPR procedure into a MFhour intensified IPR training program for counselors amithen evaluate the model in terms of both statistical and meaningful significance. Recognition of the limitations of present IPR models was primarily the result of feedback provided by members of the IPR staff and their trainees. From this feedback, three types of learning were identified as Emmential areas for expansion--cognitive, affective, and the integration of these two dimensions. Additions to cognitive learning included: (1) luoviding a conceptual framework from which the trainees mnfld.understand the process of growth and change; (2) ctfering specific information, in the form of lectures émd written handouts, about client dynamics, and (3) SUQQESting alternative approaches to understanding the Cflient's experiential world. Additions to affective learning included: (1) lfimgthening the time available for training, (2) making were requesting a group experience to help develop 441 n v“ 28 their interpersonal skills. Eight groups of eight members were formed and then assigned to one of the treatments. In addition, there were four no treatment control groups. The groups met weekly for eight sessions. The encounter-developmental groups were relatively unstruc- tured. Group exercises were suggested for the first three weeks after which the leaders were instructed to let the group develOp on its own. All meetings for the IPR groups were structured with specific tasks for each session. The first four meetings included use of the affect simulation films and audio tape rating. The second half of the training was exclusively IPR, providing speaker, listener, and mutual recall experience as well as inquirer training for the group members. Posttest data were obtained on four criteria: the Affective Sensitivity Scale, the Personal Orientation Inventory, the Wisconsin Relationship Orientation Survey and the Barrett-Lennard. Analysis of the results indi- cated that students trained in the Integrated IPR groups had significantly greater interpersonal skills than those in the no treatment or the encounter-developmental groups. Analyzed separately, only one of the dependent variables, the WROS, showed a significant treatment effect. Specifically, the depth of typical peer relation- ships was greater for students in the IPR groups than for -. .1. 29 those in the encounter-develOpmental or no treatment control groups. From the results, Archer concluded that under- graduate paraprofessionals using an IPR training model could help other undergraduates improve their interpersonal skills. In addition, the paraprofessionals seemed to be more effective when using a structured IPR model than an encounter-developmental approach. In this section, three interrelated studies that dealt with the training and use of paraprofessional helpers were reviewed. Scharf and Dendy proposed models for the training of undergraduates, while Archer used those trainees to determine whether lay mental health workers could in turn train their peers. While Scharf's data was inconclusive, the results from the Dendy and Archer research suggest that students can be taught to communicate effectively in the helping role and are capable of transmitting those skills to other students. IPR in Counselor Education Grzegorek (1971) compared two similar models of counselor education in the training of 44 prison counselors. The purpose was to determine the effects of an Experiential-Accepting (E-A) approach as compared to a Cognitive-Intellectual (C-I) model. The investigator defined four tasks applicable ‘to both treatment groups. The first was training in the .. .m— ‘v u..v «g;- anc '4 0‘ .0 30 elements of effective communication as a context for understanding the helping relationship. The second was viewer recall following simulated confrontation, using the IPR stimulus films. The third phase was Inter- personal Process Recall, encompassing client, counselor, and mutual inquiry. The final task was group review of the individual client contacts of the trainees. Both treatments involved the use of affect simu- lation and stimulated recall. The difference was in the emphasis of training. The C-I program used the tasks to focus on client dynamics and counseling techniques. The E-A group emphasized the counselor's personal growth and his feelings about the client and the counseling inter- action. The training consisted of ten, eight-hour days over a period of two weeks. Pre and post measures were taken on the Affective Sensitivity Scale, four dimensions of the CVRS, and on empathic understanding. Combining all six measures, the Experiential- Accepting group showed significant pre to post change while the Cognitive-Intellectual group did not. A between groups comparison revealed significant differences in favor of the E-A group on the understanding, Specific and exploratory subscales of the CVRS and on the Empathic Understanding scale. 31 These results indicate that the Experiential- Accepting treatment had a significant positive effect on actual counselor performance. However, the two treatments did not seem to differ in regard to the trainee's ability to perceive client feelings as measured by the Affective Sensitivity Scale. Grzegorek discussed the results in terms of the importance of the experiential component in counselor education. The outcome of the study suggests that cog- nitive learning alone is not sufficient to increase the effectiveness of counselor behavior. Working with court caseworkers, Heiserman (1971) studied the effects of two different methods of teaching interpersonal communication skills. A 16-hour experi- ential-video tape training program was compared to a cognitive-classroom teaching approach of the same length. All subjects were given 32 hours of training. Each treatment lasted 16 hours, after which they were reversed -—all subjects received training under both approaches, but in differing order. The cognitive treatment consisted of discrimination training focused on various dimensions of Carkhuff's Scales of Facilitative Functioning and Kagan's Elements of Effective Communication. This framework also allowed for discussion of how these skills could be applied to the court setting. The IPR model involved training and 32 practice in the use of the elements of effective communi- cation, exercises using affect simulation, and IPR inter— views with role-played and coached clients. Pre, mid, and post measures were obtained on six variables: The A, U, S, and E subscales of the CVRS, Carkhuff's Empathic Understanding, and the Wisconsin Relationship Orientation Survey. Pre and post measures were also obtained in the form of case reports which were subsequently rated by two juvenile court judges as to their helpfulness in the disposition of cases. Analysis of the data revealed significant change on only one variable, the WROS. Specifically, clients of IPR trained caseworkers evaluated the counseling relation- ship more positively than did clients of more cognitively trained caseworkers. In that no differences were obtained on the remaining six measures (five dealing with actual counseling behavior), the author concluded that the experiential-IPR treatment was not more effective than the cognitive—classroom approach in teaching communi- cation skills. While the Grzegorek and Heiserman studies were concerned with on-the-job training for relatively un- sephisticated subjects, the following two counselor education models were applied in a university setting twith graduate student trainees. 33 In one such effort, Goldberg (1967) compared the use of IPR techniques in counselor supervision to a more traditional approach. He defined four developmental tasks which served as goals for both treatment models: 1. The trainee becomes increasingly aware of the elements of good counseling. 2. The counselor candidate becomes sensitive to and understands a greater amount of client communication. 3. The counselor candidate becomes aware of and sensitive to his own feelings during the counsel- ing session. 4. The counselor candidate becomes sensitive to the bilateral nature of the counseling inter- action (pp. 14-6). The traditional approach involved one hour of individual supervision immediately following each of the six client contacts. The focus of these supervisory sessions was to help the counselor understand himself, his own dynamics, and his relationship to his client. The experimental group was given supervision based on an adaptation of the IPR procedure. The first session involved teaching the elements of effective communication, using a videotaped counseling interview as a basis for discussion. The second and third sessions involved a 30-minute counseling interview followed by 15 minutes of client and 45 minutes of counselor recall. The next two meetings were followed by a one-hour client recall, with another trainee serv- ing as inquirer. The sixth counseling session was 34 followed by a one-hour mutual recall experience with the supervisor as inquirer. Thirty-six master's level students in counseling were used as subjects. Pre and post measures were taken on the five dimensions of the CVRS and the Wisconsin Relationship Orientation Scale (WROS). An analysis of the data indicated that both‘groups improved signifi- cantly on each of the six measures. A between group com- parison revealed that the IPR supervised counselors were rated as being more affective, understanding, specific, exploratory, and effective than the traditionally super- vised group. The experimental group also scored signifi- cantly higher on the WROS. In a more recent project, Spivack (1970) compared a traditional classroom approach to counselor education to an IPR model utilizing video tape procedures and affect simulation. Similar to the present study, the 20 subjects were graduate students enrolled in the ten-week course, "Processes in Counseling." Both counselor training programs were based on the four developmental tasks cited in the Goldberg review. The traditional approach consisted of lectures, demon- strations, and discussions in a classroom setting. The students met three hours weekly for the first five weeks, after which the treatments were reversed. 35 The experiential-IPR model included viewing and reacting to the affect simulation films, the rating of pre—recorded audio tapes, and counseling under both role- played and coached client conditions using IPR procedures. Advanced doctoral students conducted the counselor and mutual recall sessions for the trainees. A pre—mid-post design was used to analyze the data. In a pre to mid comparison, significant differences favoring the IPR model were found on the understanding, specific and exploratory subscales of the CVRS in an interview situation with a coached client. Under role- played client conditions, the IPR group scored signifi- cantly higher than the traditional group on all dimensions of the CVRS. No differences were found between groups on empathic understanding or on the Affective Sensitivity Scale. The author concluded that video recall techniques can be successfully implemented in a formal counselor training program. In summary, three of the four studies reviewed provided support for the use of IPR in counselor edu- cation. The Heiserman training program did not effect change on five of the six variables examined. However, Grzegorek, working in a similar setting with prison counselors, obtained significant results in favor of the IPR.method. In addition, Goldberg and Spivack both 36 successfully employed IPR models in the graduate train- ing of professional counselors. Summary The task of training counselors to be effective therapeutic agents is a difficult and complex one. The literature reviewed in this chapter represents only a small sample of the research being done in the field of counselor education-~namely, that associated with the application of the Interpersonal Process Recall methodology. The studies presented provide strong empirical evidence in support of IPR. Its effectiveness has been demonstrated in counselor education, the training of paraprofessionals, and in the acceleration of client growth in psychotherapy. Theoretically, it seems feasible that IPR could be applied to any situation where the goal is to improve interpersonal communi- cation. ‘. CHAPTER I I I THEORY Introduction In Chapter I, a conceptual framework was offered as a foundation for the prOposed IPR training model. Chapter II provided the research base from which the present study develOped. The purpose of this chapter is to bring both of these components together in the context of psychological theory. Two levels of theory will be presented. The first will be a discussion of personality theory as it relates to the IPR process. The focus here will be on the contri- butions of Sullivan and Kell and Mueller. The second level will be a consideration of some of the more concrete implications of a relationship-oriented therapy. Here the concern will be with process dynamics and how this infor- mation influenced the choice and sequencing of the developmental tasks in the present model. Personality Theory Harry Stack Sullivan Sullivan, like Freud, viewed the relationship between the client and therapist as reminescent of 37 .1 u - 38 earlier significant interactions, most probably parental. Unlike Freud, however, Sullivan considered the therapist to be not only an observer, but an active participant as well--the nature of that participation being of crucial importance to therapy outcome. The therapist role as "participant observer" appears to be a logical extension of the way Sullivan conceptualized personality develop— ment and behavior change. Sullivan viewed anxiety as both the core of emotional disturbance and the consequence of an inter- personal situation. He considered the first instance of anxiety to be the infant's reaction to his security being threatened. This occurs, according to Sullivan, in the maternal relationship where the infant's needs are not met because of an anxious mother. As the infant experiences the anxiety accompanying unmet needs, he adapts by learning certain "response pat- terns“ to cope with his state of relative discomfort. Developmentally, as the child comes into other signifi— cant relationships, early coping patterns are tested and nmflified to keep his anxiety at a tolerable level. Thus, beginning at an early age, response patterns, both adaptive and maladaptive, are learned and reinforced as the child adjusts to his social environment. Important to his conceptualization of the therapy process, Sullivan regarded the individual's particular 4. .II UH v I 39 and unique response patterns as socially learned behavior. Further, those patterns which impede the individual's ability to function effectively must be unlearned or modi- fied in the same context in which they originated-~that is, interpersonally. Sullivan viewed the therapy interaction as a sample of the client's interpersonal style. As the therapist be- comes a significant other, the same interpersonal anxie- ties the client meets outside are brought into the therapist-client interaction. Change takes place when the therapist intervenes in a way that breaks up the self-defeating patterns and frees the client to learn more appropriate ways of responding. Sullivan described the therapist as a "participant observer," a term that implies a dual role. First, the therapist is a participant in a social interaction. He has interpersonal stimulus value and therefore directly experiences the client's mode of relating to others. Secondly, he is a professional with a conceptual under- standing of personality theory. He is an analyst of the client's behavior, maintaining a distance which allows him to recognize and respond to maladaptive response patterns. There are two aspects of Sullivan's theory which are directly relevant to the IPR process. The first is Iris acknowledgment of the importance of the interpersonal pl.» '0' b. I . ‘e'- ‘v on. "O. L‘.. ." I" u .I 'v \ .- ,- xv 40 nature of the counseling experience. The implication this notion has for therapist behavior is aptly summarized by Ford and Urban (1963): To the extent that the therapist is unaware of or unwitting about his participation in the interview, he does not know what is happening (p. 574). One of the premises underlying the IPR technique is that to understand the client's life style, the counse- lor must be aware of his own interpersonal impact. This notion is consistent with Sullivanian therapy style and has the strength of being rooted in a comprehensive theory of personality development. A second contribution of Sullivan to the IPR process is his clarity about the dual function of the therapist. In a fundamental way, the IPR roles of “counselor" and "inquirer" parallel Sullivan's under- standing of the therapist as both a participant and an analyst. Especially in the initial stages of IPR train- ing, the primary task of the "counselor" is to become aware of and responsive to the client's affective com- munication--the participating function. On the other hand, the task of the inquirer is to focus on the inter- personal dynamics or the cognitive aspects of the on- going relationship--the analyzing function. One goal of the present training program is to have the roles of counselor and inquirer merge together 1111a way that complements the trainee's own therapeutic 1. 1"! nu: » 41 style. The issue of experiential and conceptual inte- gration leads appropriately to a discussion of Kell and Mueller's interpersonal theory of therapy. gill L. Kell and William J. Mueller While there are many similarities between the developmental theories of Sullivan and Kell and Mueller, there are some important differences in the way they implement their knowledge in the therapy relationship. The differences that have had a direct bearing on the present training program will be discussed after looking at the way Kell and Mueller conceptualize personality development. Emotional disturbance is caused by painful experiences, the affect of which has been partially or totally blocked from expression. Full expression of the feeling at the time of occurrence did not happen because of either perceived or actual threat of even greater pain. The result is that the internalized affect remains with the individual in compressed form--perhaps most frequently retained as a memory devoid of the emotion surrounding ‘the event. If a number of truncated experiences within the Same general theme occur, they become affectively com- pressed together, emerging as an assumption the indi- "i43ual makes about himself. The person becomes threatened, 42 then, when he is confronted by a similar situation where he anticipates experiencing the same kind of pain. The threat is that the interpersonal consequence will be the same as it was in the original learning situation--and previously, the feelings were overwhelming. Dynamically, the threat of feeling the same over- whelming pain is experienced as anxiety. The anxiety, in turn, serves as the motivating stimulus for eliciting behaviors--interpersonal attempts to c0pe with the anxiousness. The specific nature of the eliciting be- haviors depends on how the individual learned to ward off anxiety in previous interactions with significant others. Emotional difficulties emerge when the eliciting behaviors apprOpriate to an earlier develOpmental period are no longer sufficient to contain the anxiety or when the behavior is no longer acceptable. The task of the therapist is to facilitate expansion, with the consequent experiencing of emotion, to complete the develOpmental task and free the indi- vidual emotionally to continue his growth process. Kell and Mueller describe the process as follows (1966): Only by experiencing conflicted feelings that have been hidden away and by reawakening the affect that has been compressed can the client hepe to change. The critical dimension here is that the experience of the conflicted feelings must occur under differ- ent learning conditions than the earlier experi- ences in which the client learned the inapprOpriate behaviors (p. 138). 43 Perhaps the greatest contribution Kell and Mueller make to understanding the purpose of IPR lies in the deeply personal manner with which they regard the therapy process. Whereas Sullivan placed limitations on therapist involve- ment and went so far as to say that certain feelings (i.e., anger) were not legitimate for the therapist to experience or share, Kell and Mueller take the view that not only are they appropriate, but can serve as powerful cues for 'understanding the client's experiential world. One of the focal points of the basic IPR technique is to facilitate the trainee's awareness of what hp experiences during the counseling interview. This is the purpose of "counselor recall." Once identified and labeled, these thoughts and feelings gain in meaning as the trainee listens to what the client was experiencing at the same moment in time. This is the intent of both ”client" and "mutual" recall. It is assumed that over time and continued access to feedback, the trainee will come to understand his own reactions as they relate to what the client is thinking and feeling. As the trainee discovers the nature of the reciprocal impact of the relationship, he has begun the process labeled earlier as the integration of the affective and cognitive dimensions. The present training model includes two additions tn: the traditional IPR treatment which were designed to 44 facilitate this integrative process. The first was to structure the later stages of training to focus on specific aSpects of the counseling relationship. While the subject of focus is important in its own right, the experience of exploring and the subsequent understanding of the process of exploration seem to be more crucial learning tasks. The second addition was to provide cognitive input in the form of lectures and written handouts. These served to facilitate the trainee's conceptual understand- ing of the eXperiential portion of the training program. Both additions were designed to promote a fusion of the experiencing and understanding components of therapy--that the counselor feel the impact of the relationship as well as comprehend the meaning it has for both participants. The Training Model The purpose of this section is to provide an overview of each step in the training model.* This will be followed by a discussion of the various themes which served as the basis for the selection and sequencing of the developmental tasks. *The reader is referred to Appendix A for a come plete description of each phase of training, including instructions for each participant. 45 Three issues need to be clarified before intro- ducing the training model. First, with the exception of the lecture sessions, the trainees met in their permanently assigned triads throughout the entire 50 hours. Secondly, during the first 40 hours of training, an IPR staff member was present at all triad meetings. And thirdly, the time block assigned for each task was divided into thirds, so on a rotating basis, each trainee functioned in each of the assigned roles (counselor, client, and inquirer). A 50-Hour Intensified IPR Training Program for Counselors 1. Lecture: Elements of Effective Communication and Introduction to Interpersonal Process Recall (IPR). Handout: IPR Counselor Verbal Response Scale Time: 2 hours While a brief description of the IPR process was presented, the main emphasis of this session was to introduce Kagan's four elements of effective com- munication. Illustrated by video taped examples, the helping role was defined as one in which the counse- lor's responses (1) reflect the affective rather than the cognitive message, (2) communicate understanding of the client's message, (3) accurately and specifi- cally label the feelings heard, and (4) encourage the client to further explore his concern. 2. Audio Tapes A. Identification of client feelings B. Responding to client feelings Handout: Empathic Understanding in Interpersonal Processes (revised) Time: 2 hours The purpose of this meeting was to provide practice in hearing and responding to feelings, using audio taped client statements as stimulus material. The trainee's first task was to differentiate the affective from the cognitive component and to identify the feelings expressed. 46 Given the labels, the second stage was to create a response that communicated that the counselor had heard what the client was feeling. Counselor Recall-~recall conducted by staff member Handout: Explanation of Recall Time: 2 hours This meeting served as the first exposure to the IPR video taping technique. During the interview, the counselor was instructed to respond to his client's concern using the elements of effective communication. He then reviewed the video tape with a staff inquirer to explore the thoughts and feelings as they occurred during the interview. Client Recall-~recall conducted by staff member Time: 2 hours The same format was used (#3 above), except that the focus was shifted from counselor to client recall. The intent was to provide the counselor with feedback about how the client was experiencing the interview. Inquirer Training (Kagan's video tape, 1 hour) Handout: Role and Function of the Inquirer Time: 3 hours In this session, the trainees were formally introduced to the role of inquirer. After viewing a video recorded demonstration, they functioned as inquirers for each other, using the staff member as a consultant. Mutual Recall--recall conducted by student Time: 2 hours While still allowing for individual exploration, mutual recall was designed to focus on the reciprocal impact of the counseling relationship. The goal, with the aid of the inquirer, is that the participants talk with each other about what they experienced during the interview. Stimulus Films Handout: Establishing Ownership of Feelings—-Part I Time: 2 hours The stimulus films are short vignettes of an actor (or actress) talking directly to the viewer. The particular sequence used portrayed varying degrees 10. 11. 47 of hostility and rejection. The purpose was to help the trainees become more aware of their own reactions and feelings to situations that typically pose an interpersonal threat. The trainees were instructed to let the actor talk directly to them. Following each vignette, they were encouraged to identify and explore the feelings that were aroused. Interview--Client Recall--Interview Time: 3 hours The purpose of this session was to provide additional practice in the roles of counselor and inquirer. The second interview (following the recall) allowed the trainees the Opportunity to make use of the information gained during recall by immediately reentering the counseling relationship. Interview--Mutual Recall--Interview Handout: Establishing Ownership of Feelings--Part II Time: 3 hours Same as above (#8), but with more emphasis on exploring the feelings between the client and counselor. Stimulus Films Time: 2 hours The client was asked to watch a vignette of an actor (or actress) expressing varying degrees of affection. He was then joined by a counselor whose task it was to understand the client's reaction to the film. This exercise served two purposes. First, it enabled the trainee to explore his own feelings in relation to the vignette. Secondly, the interviewing task of the counselor was designed to incorporate some basic elements of the inquirer role. Mutual Recall--Assertiveness Handout: Feelings Touched, Now What? Time: 3 hours The purpose of this meeting was to focus attention on a specific aspect of counselor behavior that often gives trainees difficulty, namely, assertiveness. The interview was structured to have the counselor be more assertive and then receive immediate feedback as to its impact. In addition, the role of inquirer was expanded to include more sophisticated lines of questioning. 12. 13. 14. 150 48 Lecture: How Clients Run from Counselors--Inter- personal Defenses Time: 1 hour Interpersonal defenses were discussed from the context of behavioral typologies--a modification of Horney's classification scheme. The lecturer focused on response patterns which lead to psychological distance--withdrawa1, attack and conformity. These modes were then discussed in terms of their impli- cations for counseling. Client Recall--Role-played client Handout: Identification of Client Needs The: maus This session was designed to provide addi- tional experience in the counselor and inquirer roles. To offer fresh input, a role-played client (high school student) was interviewed by each trainee. The client was then joined by an inquirer who explained the IPR process and reviewed the video tape with him. The counselor was present to receive feedback via client recall. Conceptualization of Client Dynamics--video taped counseling session Handout: Use of Fantasy Time: 2 hours A one-hour video tape of an actual counseling session was used as a springboard for discussion of the client's concern, his interpersonal style of relating, and possible directions a counselor might pursue. The purpose of this didactic meeting was to facilitate integration of the conceptual input with the experiential base of the training program. Further, it was designed to stimulate creative think- ing about how the counselor's intervention could lead to behavior change. Mutual Recall-~Existential Relationship Time: 3 hours The purpose of this meeting was to encourage the trainees to be aware of and use their own feelings as they occur in the counseling interview. Instead of the client-counselor format, two trainees were instructed to talk with each other about the meaning of their relationship. The inquirer's role was also expanded to stimulate a deeper level of self- exploration during the mutual recall. 16. 17. 18. 49 Stimulus Films Time: 3 hours This series of stimulus vignettes had junior high school students in both verbal and non-verbal sequences. The trainees were asked to discuss their understanding of the student and to specify the clues that contributed to that understanding. Further, they were prompted to hypothesize about how they might proceed if this student were his counselee. Preparation for IPR Counseling Time: 2 hours This meeting was devoted to clarifying the mechanics of scheduling, use of video equipment, room assignments, etc., in preparation for the IPR counsel- ing experience. IPR Counseling--Actua1 Client Time: 10 hours lst day 30-minute interview 15-minute client recall (counselor absent) 45-minute counselor recall (client absent) 2nd day 30-minute interview 60-minute client recall (counselor present) 30-minute interview 3rd day 30-minute interview 30-minute mutual recall 30-minute interview The purpose behind having the trainees see an actual client was to give them the opportunity to use the knowledge and experience they acquired during the first 40 hours of training. Having extended contact with one client demanded that the trainees draw on their own resources and mobilize their ideas into counseling behavior. It also provided them with the opportunity to serve as inquirers in a clinical setting and importantly, to make their own assessment of the potential of Interpersonal Process Recall. op:u a... t.- 'h I .,. ,. noon. (:5 r o. I ‘I . "v. a..‘ (‘9 . 'on... i 3.71 In.“ u. U) r f 5., 9. '76 51a; ‘ . 4. n H“ 4 “.L 50 As mentioned earlier, there are several basic themes that underlie the structure of this particular training program. The tasks were chosen, structured, and sequenced in a way that was consistent with and that en- hanced the development of these three themes. The first theme was a progression from situations of minimal threat to those involving increased risk taking. During the initial phases, the trainees functioned in simulated counseling experiences-—"audio taped clients" and stimulus films. They then used each other as clients as they practiced their interview skills within the rela- tive safety of their own triad. Finally, during the last stage of training they entered an actual counseling situ- ation to test out their own potential for interpersonal impact. The second thread involved the shifting of attention from the experiential to the conceptual to the integration of both affective and cognitive learning. The emphasis during the earlier stages of training was on recognizing and labeling both client and counselor feelings. At the midpoint, the focus was shifted to include both cognitive input and exercises aimed at conceptualization of client dynamics. During the later stages, experiences were structured to demand that attention be given to both dimensions simultaneously to facilitate the integrative process. QI- nu 51 The final theme was develOpment of the inquirer role such that the learning could be appropriately trans- ferred into effective counseling behavior. The addition of more sephisticated lines of questioning during recall provided new perspectives from which the counselor could understand the client's experiential world. From the less threatening position of inquirer, the trainee can focus on perceiving rather than responding. He can then validate or modify his ideas during recall by having the client teach him the meaning behind his responses (verbal and nonverbal). As the trainee learns to trust his per- ceptiveness as a recaller, he has the data to recognize and respond to similar cues as they occur with his own clients. Summary This chapter dealt with two basic issues. The first was to provide an understanding of IPR that ranged beyond the technique itself to the wider perSpective of psychological theory. The interpersonal approaches of Sullivan and Kell and Mueller were shown to be consistent with and relevant to the goals of IPR. The second issue was to present and discuss the training model designed for the present study. The next chapter will deal with the implemen- tation and evaluation of this 50-hour IPR training pro- gram for counselors. CHAPTER IV DESIGN AND METHODOLOGY Introduction The previous chapters have provided the rationale, the research base, and the theoretical structure for the present study. The purpose of this chapter is to outline the experimental procedures used to evaluate the 50-Hour Intensified IPR Training Program. Population The population for the study is comprised of a rather heterogeneous group of graduate students eligible for training in the helping professions. Most of the participants were aware of the nature of the course in advance and enrollment was voluntary, so the pepulation is composed largely of students desirous of the kind of experiential training afforded by IPR. Sample The sample consisted of 21 students enrolled in Education 816 D, "Processes in Counseling." This graduate level course (3 credits) was offered during the five-week summer term at Michigan State University, 1971. 52 53 The educational background of the subjects varied greatly--ranging from the beginning graduate to the post- doctoral level. Twelve students were working toward a Masters in Education, a majority majoring in counseling. Five others were at the Ph.D. level in counseling or counseling related fields. Two participants were non- degree students taking post-graduate courses to supple- ment their M.A. in counseling. The remaining two subjects were practicing M.D.'s, one of whom was earning a Masters in Educational Psychology. The average age of the trainees was 33.7, ranging from 23 to 55 years. There were 10 males and 11 females. The students were informed at the initial class meeting that they would receive a grade of 4.0 (A), con- tingent only on completing the 50 hours of training and participating in the research aspects of this project. The trainees were also told that other alternatives for obtaining credit would be available, should they decide not to complete the IPR program. At the outset of training, each participant was assigned to a triad. Because only two video facilities were available for 70 hours of training per week (seven groups, ten hours each), it was necessary to make the assignments permanent and on the basis of compatible schedules. 54 Personnel The IPR Staff The staff members were selected on the basis of their previously demonstrated competency in using the IPR procedure. Each of the eight trainers had between one and two years prior experience with the IPR technique. All in the field of counseling psychology, the staff in- cluded one Ph.D., three Counseling Interns at the advanced doctoral level, and four beginning doctoral candidates. An IPR staff member was present at all triad meetings, excluding the final ten-hour counseling experi- ence. Limited only by scheduling conflicts, an attempt was made to have the staff work with as many different triads as possible. This was done to expose the trainees to a number of different styles as well as to distribute the "trainer" effect evenly across groups. The staff members worked anywhere from three to 35 hours per week, depending on their availability. Prior to the beginning of training, the staff attended a three-hour work session in which the entire program was presented in detail. They were briefed on 'the mechanics of Operation, the immediate goals of each 'training session, and the overall design of the training program. In addition, the staff as well as the trainees received a complete written description of each task before each session. .1 .- it ‘ I as. '- I-' “I 55 Clients The final ten hours of training involved three counseling contacts with an actual client. With the ex- ception of four (who were recruited because of cancel- lations), the clients were first-term college freshmen volunteers. They were given a brief overview of the training program and were told they would be using the IPR video tape technique to better understand their interpersonal behavior. Before their initial interview, they were given a letter of explanation (see Appendix B). Each of the 21 student-clients was assigned to a trainee on the basis of compatible scheduling. Followingthe counseling experience, the trainees were asked to write a brief summary of their three inter- views (see Appendix C). The primary purpose was to identify students who might be in need of further counsel- ing, thus necessitating a referral. The write-up also provided an Opportunity for the trainees to integrate their observations and experience with their conceptual understanding of the client's concern. Interviewegp for the Criterion Tapgs The interviewees for the pre and post tapes were Obtained from a graduate level "Curriculum Improvement" class and an advanced undergraduate course, "School and Society." A majority of the 42 interviewees were 56 Obtained from the two classes prior to the pretest. A later recruiting effort was made in the undergraduate course to insure a sufficient number of volunteers for the posttest. Each interviewee was assigned to a trainee on the basis of similar schedules. In recruiting volunteers, the following intro- duction was given: There is a group of graduate students in Edu- cation who are about to go through (or have gone through) an intensive training program to learn interview skills. We would like them to have the experience of conducting a one-hour interview, which would be audio taped and used for research purposes. Here would be an opportunity for you to sit down in a one-to-one situation and let yourself be known. The interview is loosely structured in terms of what you want to talk about. The 21 trainees were given the following in- structions for both the pre and post interview: For the next hour, you are asked to get to know this person as another human being. Try to under- stand how this person thinks and feels about the things that are important to him. Each group (trainees and interviewees) was aware of the instructions given to the other. Instrumentation The Affective Sensitivity ScaIe (ASS) This scale was designed to measure affective sensitivity as a standardized test of empathy.* The *A c0py of the test booklet for the Affective Sensitivity Scale is contained in Appendix D. 57 instrument requires the testee to identify client feelings in video taped segments of actual counseling interviews. The items focus on two dimensions of the interaction, namely, the client's feelings about himself or his con- cern, and the client's feelings about the counselor. The 66-item scale follows a multiple choice for- mat, providing a correct response and two distractors for each question. The correct answers to the individual items were obtained from three sources: (1) clinical judges' determination of what the client and counselor were feeling, (2) evaluations of clinical judges with a case history of the client, and (3) protocols from IPR recall sessions in which the client described how he was feeling. The Affective Sensitivity Scale was develOped to assess ability to perceive client feelings as an indi- cator of counselor effectiveness. To establish the con- current validity, Kagan, pp 31. (1967) reported a study with M.A. counselor training groups in which an average .53 correlation was obtained between therapist ratings of affective sensitivity and ASS scores. In another study with eight small NDEA groups, Kagan, pp 31. (1967) cited correlations of .46 to -.10 between the A88 and peer ratings of affective sensitivity. The authors also reported coefficients ranging from .42 to .16 between subjective supervisor ratings and the ASS. 58 Reliability figures for the NDEA groups ranged from .53 to .77, with the majority of scores falling above .70. Kagan predicts reliabilities above .70 with reasonably heterogeneous groups. The test does not appear to be subject to a prac- tice effect. Scharf (1971) reported identical post and delayed-post (eight weeks) means of 46.03 for a no treat- ment comparison group of professional counselors. The ASS does appear to be sensitive to treatment effects. Recently, the instrument has recorded significant pre to post training differences in the studies of Spivack (1970) and Grzegorek (1971). The Counselor Verbal Response ScaIe (CVRS) The Counselor Verbal Response Scale (Kagan, pp 31., 1967) is an instrument designed to differentiate effective from non-effective counselor responses. The original scale was composed of five dichotomous dimensions: (1) affective and cognitive, (2) understanding and non- understanding, (3) specific and non-specific, (4) explora- tory and non-exploratory, and (5) effective and non- effective.* The first four subscales were used in the present research. *A cepy of the Counselor Verbal Response Scale is contained in Appendix A. 59 The usual procedure for the use of the CVRS is to provide judges with audio recorded samples from the first, middle, and final thirds of each interview under consideration. The raters, then, are required to evalu- ate 20 consecutive counselor responses on each of the subscales. This format allows for a maximum score of 20 and a minimum of 0 for each dimension. In a validity study, Kagan, pp 31. (1967) reported that significant differences were found between the re- sponses of M.A. and Ph.D. candidates. With the Ph.D. group scoring higher on the affective, understanding, specific, exploratory, and effective dimensions, signifi- cance at the .01 level was obtained for each subscale of the CVRS. The scale has since been used in several studies (Goldberg, 1967; Spivack, 1970; Grzegorek, 1971; Scharf, 1971; Dendy, 1971) and appears to be sensitive to training. Concerning interjudge agreement, Kagan's (1967) initial research yielded interrater reliabilities ranging from .80 to .96. Goldberg (1967) reported correlations varying from .81 to .96. More recently, interrater reliabilities of .93 to .99 were obtained by Spivack, from .93 to .99 by Grzegorek (1971), and an average of .747 by Scharf (1971). 60 The Empathic_gpderstandingin Inter ersonal Processes Sca e EU) Carkhuff (1969, v. II) derived this instrument from Truax's "A Scale for the Measurement of Accurate Empathy."* It is a five-point scale used to assess the level of empathic understanding in helping relationships. According to Truax and Carkhuff (1967), "accurate empathy involves both the therapist's sensitivity to current feelingp and his verbal facility to communicate this understanding in a language attuned to the client's current feelings” (p. 46). From this definition, five levels of empathic understanding were operationally de- fined in the following manner. At Level 1, the counselor's response does not attend to or detracts significantly from the client's statement. At Level 2, the counselor's re- sponse subtracts noticeably from the client's affect. At Level 3, the minimal level of facilitative functioning, the counselor's response is interchangeable in both mean- ing and intensity of affect with the client's message. At Level 4, the counselor adds noticeably, while at Level 5, the counselor's response represents a signifi- cant addition to the client's affective experiencing (Carkhuff, 1969, v. II). The EU scale was designed for use in both train- ing and research. As a training method, potential helpers .3 *A copy of the Empathic Understanding in Inter- personal Processes Scale is contained in Appendix E. 61 are taught to discriminate among levels of empathic under- standing by rating audio taped counselor responses. In research, the scale is used by trained raters to determine a counselor's level of facilitative functioning on the EU dimension. Generally, a team of independent judges rate either individual counselor responses or assign an overall EU score to an interview segment. The second procedure was used in the present study. Carkhuff, Kratochvil, and Friel (1968) reported interrater reliabilities of .88, .87, and .85 for three experienced raters. Berenson, pp 31. employed two teams of two raters each, obtaining interjudge agreements of .80 and .45. In IPR research, Spivack (1970) reported interrater reliabilities of .90, .96, .99, .90, .93, and .91 on the EU scale, Scharf (1971) obtained a .479 re- liability of average ratings, and Grzegorek (1971) re- ported an interrater reliability coefficient of .98. Evaluation Form A fourth instrument* was designed for the present study to obtain subjective, diary-like feedback from the trainees. It required a ranking of and reaction to each session, an evaluation of the written handouts, and the trainee's assessment of the program's strengths and weaknesses. *A copy of the Evaluation Form is contained in Append ix F . 62 The Evaluation Form was not used in the empirical analysis of results, but the subjective feedback will be presented and discussed in Chapter VI. Selection of Raters Three judges were selected to independently assess pre and post interview behavior on the CVRS and EU scale. The raters included a Ph.D. Counseling Psychologist, a Counseling Intern, and an advanced doctoral candidate in counseling psychology. While all judges had previous experience with both instruments, two hours of individual training was provided to insure agreement as to the use and interpretation of the scales. Reliability of the Tape Ratings To insure uniformity of the responses being rated, a set of master tapes was prepared for each judge. First, all 42 tapes (21 pre, 21 post) were pooled, coded, and randomly assigned a sequence number correSponding to a position on the master tape. Then, three minutes from the first third of the interview, five minutes from the middle third, and three minutes from the final third of the interview were randomly selected and rerecorded onto the master tape. This method was chosen to provide a more balanced sampling of interview behavior. From the three segments combined, the judges were instructed to rate the first 20 counselor responses on the 1 5'": 1 App 1" '10 CI. .'A O.“ A tn UV . “in ‘I ._. 0“: (‘1‘. ‘ I 63 CVRS dimensions. In cases where 20 responses were not obtained, a total was extrapolated from the data avail- able. The judges were also asked to give an independent rating to each segment on the Empathic Understanding Scale. The three partial scores were then averaged to provide an overall EU rating. Hoyt's formula (in Mehrens & Ebel, 1967) was used to compute the reliability of the average ratings across judges. The procedure, based on an analysis of variance, is as follows: MS - MS where: r the reliability coefficient MSS the Mean Square for subjects MSSR - the Mean Square for subjects by raters 1nteraction. Table 4.1 presents the reliabilities of the average ratings for times and measures. These coefficients are within the range of reliabilities reported earlier, and indicate that there was sufficient interjudge agree- ment to proceed with the data analysis. 64 TABLE 4.1 Reliabilities of the Average Ratings across Judges on the EU and CVRS Measure Pre Post CVRS-Affective .818 .824 CVRS-Understanding .789 .884 CVRS-Specific .733 .804 CVRS-Exploratory .760 .910 Empathic Understanding .746 .834 Predetermined Criterion Levels of Facilitative FunctiOning One purpose of the present study is to evaluate the meaningfulness of any change in terms of counselor effectiveness. The issue appears to be that of comparing the actual scores (posttest) to a known comparison group. For purposes of the present study, it is assumed that psychologists employed at a major university counsel- ing center, and assigned supervisory responsibilities for doctoral students and interns, are functioning at an effective professional level and therefore, constitute an appropriate comparison group. Scharf (1971) and Dendy (1971) obtained scores on the six criterion measures used in the present study for a group of nine professional counselors. Table 4.2 contains the means and range of scores from this sample. 65 TABLE 4.2 Predetermined Criterion Levels: Overall Means and Range of Scores for Nine Professional Counselors on the ASS, EU, and CVRS (Scharf, 1971, un- published data) Measure Mean Range Affective Sensitivity Scale 46.000 38--56 CVRS-Affective 5.556 0--l7 CVRS-Understanding 17.222 10--20 CVRS-Specific 14.889 4--20 CVRS-Exploratory 13.222 5--20 Empathic Understanding 2.444 l.83--3.l7 These figures are defined as the predetermined criterion levels against which the posttest scores in the present study will be compared. Design The present study addresses itself to two basic issues: (1) whether there are significant pre to post changes in dimensions of facilitative functioning for students exposed to the IPR training program, and (2) whether the trainees' posttest scores reached the pre- determined criterion levels. In order to answer these <1uestions, a one-group pretest-posttest design, presented in Figure 4.1, was employed. 66 : :72; ”~3- ——_-_ _.-._. —_..._. .11: where, 0 indicates Observation, and X indicates treatment FIGURE 4.1 A Schematic Representation of the Experimental Design (Campbell and Stanley, 1969, p. 7) While this design, according to Campbell and Stanley (1969), poses a number of threats to both internal and external validity, other considerations, especially previous studies using the IPR procedure, suggest that these threats are not serious. While it is acknowledged that there is no empirical basis for refuting the possible sources of invalidity, the degree and probability of threat to this particular study will be discussed in Chapter VI. Hypotheses The following hypotheses, stated in research form, will be tested: H01: There will be no pre to post difference in means on the combined measures of facilitative functioning (ASS, CVRS, and EU) for groups exposed to the Intensified IPR Training Program. HO 2. 67 There will be no Times by Measures Inter- action. If Hypothesis 2 is rejected, the following hypotheses will be tested: HO HO 3: There will be no pre to post differences in means on the Affective Sensitivity Scale for groups exposed to the Intensified IPR Training Program. There will be no pre to post differences in means on the Affective dimension of the CVRS for groups exposed to the Intensified IPR Training Program. There will be no pre to post differences in means on the Understanding dimension of the CVRS for groups exposed to the Intensified IPR Training Program. There will be no pre to post differences in means on the Specific dimension of the CVRS for groups exposed to the Intensified IPR Training Program. There will be no pre to post differences in means on the Exploratory dimension of the CVRS for groups exposed to the Intensified IPR Training Program. There will be no pre to post differences in means on the Empathic Understanding Scale for groups exposed to the Intensified IPR Training Program. In addition, the following hypotheses will be tested: HO 9. The posttest scores for the combined groups exposed to the Intensified IPR Training Pro- gram will not be different from the combined scores of professional counselors on the Affective Sensitivity Scale. 68 Ho The posttest scores for the combined groups exposed to the Intensified IPR Training Pro- gram will not be different from the combined scores of professional counselors on the Affective dimension of the CVRS. 10‘ H011: The posttest scores for the combined groups exposed to the Intensified IPR Training Pro- gram will not be different from the combined scores of professional counselors on the Understanding dimension of the CVRS. H012: The posttest scores for the combined groups exposed to the Intensified IPR Training Pro- gram will not be different from the combined scores of professional counselors on the Specific dimension of the CVRS. H013: The posttest scores for the combined groups exposed to the Intensified IPR Training Pro- gram will not be different from the combined scores of professional counselors on the Exploratory dimension of the CVRS. H014: The posttest scores for the combined groups exposed to the Intensified IPR Training Pro- gram will not be different from the combined scores of professional counselors on the Empathic Understanding Scale. Analysis A 2x6x7 repeated measures analysis of variance (with both time and the dependent variables as the re- peated measures) will be used to test for an overall treatment effect (times) and a times by measures inter- action. If a significant times by measures interaction is found, matched pairs t-tests, with the overall a split into as many equal parts as there are measures, will be used to determine differences on the individual measures. This method of post hoc analysis affords the greatest power, since only six comparisons are of interest. v1... Dip. - on“ ' I l ‘to: -“A. . .v. '1 F ‘ l V In ~ 5 t“ . th. | fl uzl h. 5 U\ '.‘ 3i.» ‘ A. 5~=‘ H .I‘ -‘~“l ‘ \ \iif\ H h;‘ 69 The second set of hypotheses will be tested by comparing the overall posttest mean on each dependent variable to the predetermined criterion score. Multiple t-tests for the comparison of means will be used in this analysis. Rejection of the null hypothesis in favor of the treatment would, of course, represent a significant finding. In addition, failure to reject the null hypothesis would suggest that the trainees were function- ing at a level comparable to professional counselors on that particular dimension. Thus, a non-significant difference will also be considered a positive outcome. Summary The sample for this study consisted of 21 graduate students enrolled in "Processes in Counseling," summer quarter, Michigan State University, 1971. The course involved 50 hours of intensive exposure to Interpersonal Process Recall--a program designed to facilitate experi- ential, cognitive, and integrative learning. The subjects were assigned to triads, with these groups being defined as the experimental units. A one-group pretest-posttest design was employed. Pre and post data were collected on the Affective Sensitivity Scale, four subscales of the Counselor Verbal Response Scale, and the Empathic lJnderstanding in Interpersonal Processes Scale. In addition, feedback from the trainees was obtained by Ineans of an subjective questionnaire. 70 A repeated measures analysis of variance will be used to test for main treatment effects and a times by measures interaction. If a significant times by measures interaction is found, matched pairs t-tests will be used to test for pre to post differences on the six dependent variables. The comparison of posttest means to the cri- terion scores will be done through a series of t-tests. The data and results are presented in Chapter V. CHAPTER V ANALYSIS OF RESULTS Introduction In this chapter, the data relevant to the hypotheses under investigation is presented. Each hypothesis is restated, the statistical procedures described, and the results of the analysis presented. Hypotheses Related to Pre-Post Differences Ho - There will be no pre to post difference in means on the combined measures of facilitative functioning (ASS, CVRS, and EU) for groups exposed to the Intensified IPR Training Program. Ho - There will be no Times by Measures Inter— action. A repeated measures analysis of variance was used to test these hypotheses. Because the instruments are scaled differently, the raw data were transformed to a common metric to obtain additivity across measures. This ‘was accomplished by dividing each raw score on a particu- lar variable by the standard deviation of the pooled ‘variances across times for that variable. The raw data 71 72 for the pre and post group means are shown in Tables 5.1 and 5.2. The transformed values are presented in Tables 5.3 and 5.4. The ANOVA model requires that several assumptions be satisfied. When the independent variables are fixed, as in the present case, the F statistic is robust with respect to the assumption of normality (Hays, 1963). When there are an equal number of observations per cell, as in the present case, the F statistic is robust in re— gard to the assumption of equal variances (Hays, 1963). The assumption of independence was met by defining groups rather than subjects as the experimental unit. In addi- tion, the repeated measures design requires that the correlations between the repeated measures be equal. Since it was likely that this assumption was violated, the Geisser-Greenhouse Conservative F test was used. This procedure reduces the degrees of freedom by elimi- nating those attributable to the repeated measures. Table 5.5 presents the critical values of F(.05) for both the Liberal and Conservative tests. Table 5.6 contains the results of the analysis of variance. The results contained in Table 5.6 show that the two null hypotheses of interest were rejected in the conservative analysis. This significance (a i .05), made the use of the liberal test unnecessary. 73 TABLE 5.1 Raw Data--Pretest Group Means Group ASS CVRS-A CVRS-U CVRS-S CVRS-E EU 1 35.00 1.889 6.555 5.000 8.000 1.611 2 36.67 3.778 12.111 8.111 8.889 1.722 3 43.67 5.444 9.889 7.888 8.555 2.000 4 33.67 1.888 8.555 6.777 8.444 1.499 5 30.67 3.666 9.444 7.333 10.444 1.722 6 37.33 2.777 8.111 5.777 9.222 1.611 7 38.00 2.888 4.444 2.332 5.111 1.222 E 36.43 3.190 8.444 6.175 8.381 1.627 TABLE 5.2 Raw Data--Posttest Group Means Group ASS CVRS-A CVRS-U CVRS-S CVRS-E EU 1 44.33 5.778 9.777 6.444 9.888 1.777 2 43.00 6.555 12.666 10.222 10.666 2.444 3 47.00 5.555 9.889 7.222 7.555 2.000 4 44.33 6.777 11.777 9.111 9.777 2.055 5 40.67 7.444 14.222 11.888 14.667 2.555 6 43.00 3.444 8.666 7.000 7.888 1.722 7 48.00 3.444 9.000 5.777 7.111 1.611 E 44.33 5.571 10.857 8.238 9.667 2.024 74 TABLE 5.3 Transformed Data--Pretest Group Means 0—...— -—,—1— _.. Group ass CVRS-A CVRS-U CVRS-S CVRS-E EU 1 11.225 1.431 3.114 2.532 3.990 5.733 2 11.760 2.862 5.753 4.108 4.433 6.128 3 14.005 4.124 4.697 3.995 4.266 7.117 4 10.798 1.430 4.064 3.433 4.211 5.334 5 9.836 2.777 4.486 3.714 5.208 6.128 6 11.972 2.103 3.853 2.926 4.599 5.733 7 12.187 2.187 2.111 1.127 2.549 4.348 E 11.683 2.416 4.011 3.127 4.179 5.789 TABLE 5.4 Transformed Data—-Posttest Group Means Group ass CVRS-A CVRS-U CVRS-S CVRS-E EU 1 14.217 4.377 4.644 3.264 4.931 6.323 2 13.790 4.965 6.017 5.178 5.319 8.697 3 15.073 4.208 4.697 3.658 3.768 7.117 4 14.217 5.134 5.594 4.615 4.876 7.313 5 13.043 5.639 6.757 6.022 7.315 9.092 6 13.790 2.609 4.116 3.546 3.934 6.128 7 15.394 2.609 4.275 2.926 3.546 5.733 '2 14.281 4.220 5.157 4.173 4.813 7.200 75 TABLE 5.5 Critical Limits of Liberal and Conservative F Tests* Liberal Conservative Source F Ratio F df F df MS _ T fis-T— 5.99 1.6 5.99 1,6 GT MS TM MST“ 2.53 5,30 5.99 1,6 GTM *a < .05 Code: G = Groups; T = Times; M = Measures TABLE 5.6 ANOVA Table for Repeated Measures with Transformed Scores -_—~ ._.._-_ .__.—. -__.h __ Source 88 df MS F G Groups 31.729 6 5.288 T Times 42.891 1 42.891 18.261* GT Groups x Times 14.126 6 2.354 M Measures 916.903 5 183.381 GM Groups x Measures 32.199 30 1.073 TM Times x Measures 7.781 5 1.556 7.665** GTM Groups x Times x Measures 6.100 30 .203 *Decision: Reject H01, 0 i .05 for the conser- vative F test. **Decision: Reject H02, 0 i .05 for the conser- vative F test. 76 More specifically, the analysis revealed a sig- nificant pre to post change on the combined measures and a significant times by measures interaction. The TM interaction indicates that the treatment effect was re- flected differentially across the six measures. A graphic representation of the times by measures interaction is presented in Figure 5.1. The rank order of times is the same across all measures, indicating that the interaction is ordinal rather than disordinal. Thus, even in the cases where the difference is not statistically significant, the trend is toward an increase in means pre to post. To test for significant differences on the indi- vidual measures, Hypotheses 3 through 8, generated from Hypothesis 2, were examined. Specific Hypotheses H03: There will be no pre to post differences in means on the Affective Sensitivity Scale for groups exposed to the Intensified IPR Training Program. H04: There will be no pre to post differences in means on the Affective dimension of the CVRS for groups exposed to the Intensified IPR Training Program. Hos: There will be no pre to post differences in means on the Understanding dimension of the CVRS for groups exposed to the Intensified IPR Training Program. 45- 44— 431 42. 41‘ 40‘ €—-Posttest means 394 38. 37« 3 4.... 6:33 Pretest means 12— 11- 12: i\ \ ./°. / l I F l l I ASS CVRS-A CVRS-U CVRS-S CVRS-E EU Figure 5.1 Graph of the Times by Measures Interaction Raw Data 78 H06: There will be no pre to post differences in means on the Specific dimension of the CVRS for groups exposed to the Intensified IPR Training Program. H07: There will be no pre to post differences in means on the Exploratory dimension of the CVRS for groups exposed to the Intensified IPR Training Program. H08: There will be no pre to post differences in means on the Empathic Understanding Scale for groups exposed to the Intensified IPR Training Program. The notation in symbol form for the null and alternative hypotheses is as follows: where ”l = pretest “2 posttest Matched pairs t-tests were used to examine the difference in means on each of the dependent variables. Procedures for using this approach require dividing the overall alpha level (.05) by the number of comparisons being made, such that the total does not exceed the overall alpha limit. Thus, the alpha level for each post hoc com- parison was set at .0083. Since there has been no evi- dence to suggest that the levels of facilitative function- ing would significantly decrease pre to post (see Chapter II), the decision was made to use a one-tailed test. The 79 critical value for a one-tailed t-test with six degrees of freedom at a i .0083 was 3.269. The raw score mean differences are presented in Table 5.7. The results of the t-test comparisons are contained in Table 5.8. The results of the matched pairs analyses indi— cate that Hypotheses 3, 4, 6, and 8 were rejected. Thus, the treatment main effect was attributed to significant pre to post gains on the Affective Sensitivity Scale, the Affective and Specific subscales of the Counselor Verbal Response Scale, and the Empathic Understanding in Inter- personal Processes Scale. TABLE 5.7 Raw Score Mean Differences Measure Pretest Posttest Difference ASS 36.43 44.33 7.90 CVRS-A 3.190 5.571 2.381 CVRS-U 8.444 10.857 2.413 CVRS-S 6.175 8.238 2.063 CVRS-E 8.381 9.667 1.286 EU 1.627 2.024 .397 80 TABLE 5.8 Results of the Matched Pairs t Tests with Transformed Data Measure t ASS 7.497* CVRS-A 3.284* CVRS-U 3.174 CVRS-S 3.269* CVRS-E 1.763 EU 3.273* *Decision: Reject Ho, t significant at a < .05. Hypotheses Related to Predetermined Criterion Levels* H09: The posttest scores for the combined groups exposed to the Intensified IPR Training Pro- gram will not be different from the combined scores of professional counselors on the Affective Sensitivity Scale. H09: “2 = 46.000 Hag: “2 # 46.000 H010: The posttest scores for the combined groups exposed to the Intensified IPR Training Pro- gram will not be different from the combined scores of professional counselors on the Affective dimension of the CVRS. HO : = 5.556 10 “2 Halo: “2 ¢ 5.556 *The predetermined levels were ASS, 46.000; CVRS-A, 5.556; CVRS-U, 17.222; CVRS-S, 14.889; CVRS-E, 13.222; EU, 2.444. See Chapter IV, p. 65. 81 H011: The posttest scores for the combined groups exposed to the Intensified IPR Training Pro- gram will not be different from the combined scores of professional counselors on the Understanding dimension of the CVRS. Holl: “2 = 17.222 Hall: “2 # 17.222 H012: The posttest scores for the combined groups exposed to the Intensified IPR Training Pro- gram will not be different from the combined scores of professional counselors on the Specific dimension of the CVRS. Ho : = 14.889 12 “2 Halz: “2 # 14.889 H013: The posttest scores for the combined groups exposed to the Intensified IPR Training Pro- gram will not be different from the combined scores of professional counselors on the Exploratory dimension of the CVRS. Ho = 13.222 13‘ u2 Hal3: 02 ¢ 13.222 H014: The posttest scores for the combined groups exposed to the Intensified IPR Training Pro- gram will not be different from the combined scores of professional counselors on the Empathic Understanding Scale. H014: = 2.444 “2 Ha14: “2 # 2.444 Separate t-tests for the comparison of means were used to examine Hypotheses 9 through 14. Again to pre- serve an overall alpha level of .05, the probability of making a Type I error was split among the six tests. 82 Therefore, the alpha level for each non-directional com- parison was set at .0083. The critical value for t with six degrees of freedom (tn-l) was i 3.898. The analysis of data required rejection of Hypotheses 11 and 12. These results suggest that at the end of training, the IPR groups were functioning signifi- cantly lower than the professional counselor group on the Understanding and Specific subscales of the CVRS. TABLE 5.9 Results of the t Tests between Posttest Means and the Predetermined Criterion Levels ‘ —_ _.— —_ Measure t ASS -l.767 CVRS-A .025 CVRS-U -8.128* CVRS-S -7.890* CVRS-E -3.634 EU -3.088 *Decision: Reject Ho, t significant at a i .05. The analysis also indicated that Hypotheses 9, 10, 13, and 14 were not rejected. Of particular rele- vance to the present study, the IPR trainees were functioning at levels not significantly different from professional counselors on four of the six measures. 83 That is, no significant differences were observed between IPR posttest scores and the predetermined criterion levels on the Affective Sensitivity Scale, the Affective and EXploratory subscales of the Counselor Verbal ReSponse Scale, and the Empathic Understanding in Interpersonal Processes Scale. Confidence Interval Comparisons The t-tests identified those measures for which there was no statistically significant difference between the posttest and criterion scores. This procedure, how- ever, does not speak to the issue of whether there were meaningful differences in terms of effective counseling behavior. Thus, posttest and criterion scores that were statistically comparable may, nonetheless, reflect im- portant differences in counselor behavior. Conversely, differences obtained in the statistical analysis may have little meaning in regard to counselor effectiveness. Therefore, a confidence interval procedure was used to further explore the relationship between posttest scores and the predetermined criterion levels. For each of the six measures, t-test confidence intervals were computed for the posttest means, defining the range of sampling error around that mean. The alpha level for each test was .0083 to preserve an overall alpha of .05. Therefore, the probability is Z .95 that all the population means for the IPR group fall within 84 their respective ranges. The confidence limits for the IPR group are presented in Table 5.10. TABLE 5.10 Confidence Intervals for the IPR Group Measure Confidence Interval ASS 44.33 i 3.68 CVRS-A 5.571 1 2.327 CVRS-U 10.857 i 3.052 CVRS-S 8.238 1 3.286 CVRS-E 9.667 1 3.812 EU 2.024 t .530 A second procedure was used to determine the intervals for the six criterion levels. These limits were established to define a range, such that scores falling outside that range would represent meaningful deviations from the predetermined criterion levels and would, therefore represent meaningful differences in behavior. The following procedure was used to define the interval. First, the range of scores for the nine pro- fessional counselors was obtained for each measure. Then, the actual distance between the upper and lower limits of the range was calculated. This provided an estimate 85 of where professional counselors could be expected to score. This distance was then divided in half to provide a conservative estimate of the range of scores to be defined as effective counseling behavior. These limits are shown in Table 5.11. TABLE 5.11 Intervals for the Professional Counselor Criterion Levels Measure Mean Range Confidence Interval ASS 46.00 38 - 56 46.00 + 4.50 CVRS-A 5.556 0 - 17 5.556 t 4.250 CVRS-U 17.222 10 — 20 17.222 : 2.250 CVRS-S 14.889 4 - 20 14.889 i 4.000 CVRS-E 13.222 5 - 20 13.222 1 3.750 EU 2.444 1.83 - 3.17 2.444 t .335 The confidence intervals for the IPR group were then compared graphically to the intervals established for the professional counselor group. These are pre- sented in Figures 5.2, 5.3, and 5.4. The degree to which the IPR range coincides with the professional counselor interval represents the range of chance differences of the IPR mean also included in the range defined as not meaningfully different from the professional counselors. 86 CVRS-A SASS Scores fires 10 .4 PC 50-- 9__ 49—4 8-n IPR IPR ’ 48—q 7.3 47-# -—1 6— 46— 7 a S— 45_4 . .4 4.— 44- _ - 3—4 43-— 4 2_1 42-— J 1.. 41-— 40 — 0._ Figure 5.2 Professional Counselor and IPR Intervals for the A88 and CVRS-A Scores CVRS-U 20 —7 Scores _ 20-—1 PC PC 19 —— 19-—4 18 __ n J 18— 174 4 _ 16 __ 17.._ ‘ 15 -_. 16-—— .7 14”-”. 15-—~ .. l3— IPR _ l4-—— _‘ 12‘ IPR l3 ‘— 1.1—“ J a a T 9.. 11 —~ __J 8 —_‘ lO‘- 4 _ 7__ 9 _—4 .— 6.— ._J 8 — 5_ 7 _. 4__ Figure 5.3 Professional Counselor and IPR Intervals for the CVRS-U and CVRS-S 88 CVRS'E EU Scores PC Scores 17—— 3.0"“ 16—— _ -* IPR lS—A 2.5"“ 14“ ' IPR 13" 2.0 — 12-— ‘ 11— 1. 5 — 10—— 3 9—— 1.0-—— 8-— _ 7“ .5 __ 6 __ —4 5__r 0 __ Figure 5.4 Professional Counselor and IPR Intervals for the CVRS-E and EU 89 A comparison of the A58 confidence intervals reveals a high degree of overlap, suggesting that the IPR group was functioning well within the acceptable range. This result is consistent with the statistical analysis. On the CVRS-A, the IPR interval falls completely within the professional counselor range. This comparison indicates that the IPR group was functioning well within the acceptable limits of effective counseling behavior. The t-test comparison also indicated that the two groups were not significantly different. On the CVRS-U and CVRS-S, there was virtually no overlapping of intervals, with the IPR group having the lower range. These were also the two cases where the- statistical analysis revealed that the IPR mean was sig- nificantly lower than the predetermined criterion level. While no significant pre to post gain was found on the CVRS-U, there was a significant pre to post increase on the CVRS-S. This suggests that the gain on the Specific dimension, while statistically significant, was not sufficient to reach an effective level of functioning. The graph reveals a moderate overlap on the CVRS-E. It is interesting to note that while there was no statistically significant pre to post gain on this measure, the final level of functioning appears to be well within the range of effective counseling behavior. 90 While the IPR range on the EU scale includes most of the professional counselor interval, over half of the IPR distribution falls below the criterion range. This comparison suggests that while some of the trainees were functioning at an effective level, many others scored under the lower confidence limit. While the gain appears to be meaningful, nevertheless, this result should be interpreted cautiously-~noting that statistically the IPR means were not different from the criterion level. In summary, there were meaningful gains on four of the six dependent variables. The IPR groups were functioning at levels comparable to selected Ph.D. level professional counselors on the ASS, CVRS-A, CVRS-E, and EU measures. The IPR group performance on the CVRS-U and CVRS-S was lower than the range defined as acceptable by the confidence interval procedure. Summary A repeated measures analysis of variance was used to test for an overall difference in means across testing times. The null hypothesis was rejected, indicating sig- nificant and positive gains on the combined measures. The ANOVA also yielded a significant interaction between times and measures, indicating that the overall change was reflected differentially across the six measures. Matched pairs t-tests revealed that the treatment effect 91 was due to significant increases on the ASS, CVRS-A, CVRS-S, and EU measures. Multiple t-tests were used to compare posttest scores to the pre-established criterion levels. The indi- vidual comparisons revealed that the trainees were functioning at a significantly lower level on the CVRS-U and CVRS-S. However, no significant differences were detected on the ASS, CVRS-A, CVRS-E, and EU scales. The statistical analysis indicated that on these four measures, the IPR trainees were functioning at levels comparable to professional counselors. To assess the meaningfulness of these results, a confidence interval procedure was employed to determine whether the posttest scores fell within a range defined as effective counseling behavior. Results of these com- parisons indicated that in those cases where the groups were statistically comparable they were also meaningfully comparable to (not significantly different from) pro- fessional counselor levels of facilitative functioning. Table 5.12 summarizes the results. A discussion of the results, the conclusions, and the implications of this investigation are contained in Chapter VI. 92 TABLE 5.12 Summary of Hypotheses and Results Hypothesis Test Decision Ho1 Repeated Measures ANOVA .05 Reject H02 Repeated Measures ANOVA .05 Reject Ho3 Matched Pairs t Test .0167 Reject Ho4 Matched Pairs t Test .0167 Reject Ho5 Matched Pairs t Test .0167 Do Not Reject H06 Matched Pairs t Test .0167 Reject Ho7 Matched Pairs t Test .0167 Do Not Reject H08 Matched Pairs t Test .0167 Reject H09 t Test Comparison of Means .0083 Do Not Reject* H010 t Test Comparison of Means .0083 Do Not Reject* Ho11 t Test Comparison of Means .0083 Reject* Ho12 t Test Comparison of Means .0083 Reject* H013 t Test Comparison of Means .0083 Do Not Reject* Hol4 t Test Comparison of Means .0083 Do Not Reject* *In these cases, failure to reject Ho represented the outcome favorable to the effectiveness of the training program. CHAPTER VI SUMMARY AND CONCLUSIONS Summary Interpersonal Process Recall (Kagan, gg‘al., 1967) is a video tape training technique designed to maximize the amount of feedback available to the participants of a counseling interview. Originally develOped for use in counselor education and psychotherapy, the IPR model has been successfully applied to many training situations where the goal has been to teach interpersonal communi- cation skills. The technique has been used to accelerate client growth in psychotherapy (Woody, 1965; Resnikoff, <_e_t_ 31.; 1970; Schauble, 1970; Hartson, 1971), to train lay mental health workers (Dendy, 1971; Scharf, 1971; Archer, 1971), and to train professional counselors (Goldberg, 1967; Spivack, 1970; Grzegorek, 1971; Heiserman, 1971). The IPR research to date has been primarily con- cerned with two basic issues: (1) establishing Inter- personal Process Recall as a valid and effective training technique, and (2) exploring the range of populations to vflxich the training model is applicable. The purpose of this study was to expand the basic IPR procedure into a 93 94 SO-hour intensified IPR training program for counselors and then evaluate the model in terms of both statistical and meaningful significance. Recognition of the limitations of present IPR models was primarily the result of feedback provided by members of the IPR staff and their trainees. From this feedback, three types of learning were identified as potential areas for expansion--cognitive, affective, and the integration of these two dimensions. Additions to cognitive learning included: (1) providing a conceptual framework from which the trainees could understand the process of growth and change; (2) offering specific information, in the form of lectures and written handouts, about client dynamics; and (3) suggesting alternative approaches to understanding the client's experiential world. Additions to affective learning included: (1) lengthening the time available for training, (2) making qualitative changes in the inquirer role to facilitate and expand counselor self-awareness, and (3) emphasizing specific behaviors that often give beginning counselors difficulty. To facilitate the integration of cognitive and affective learning, the program included the following: (1) the cognitive input dealt with process dynamics rather than abstract theoretical constructs, (2) the cognitive 95 sessions were sequenced to complement the experiential portions of the training program, (3) a deliberate effort was made to integrate the skills learned as inquirer into the counselor role, and (4) the trainees spent ten hours using the IPR technique in a counseling situation with an actual client. Thus, the goal underlying the expansion of the basic IPR model was to facilitate the trainee's under- standing of the process of therapy--an area that has previously been neglected in IPR training programs. The counseling behaviors to be learned included: (1) increasing the trainee's ability to perceive feelings that are being experienced by the client but that are not being directly expressed, (2) that while responding to the client's concern, the trainees become sensitive to and aware of the dynamics of the problem--such as how and why the maladaptive behavior was learned, what main- tains the behavior and what risks would be in- volved for the client if he were to change the behavior, (3) learning ways the counselor can use his own feelings, thoughts, and fantasies in the on- going interview to facilitate client movement and growth, (4) using the client-counselor interaction to more fully understand the client's interpersonal style, and (5) increasing the trainee's ability to choose the most appropriate response from a number of alternatives. The sample for the study consisted of 21 students enrolled in Education 816 D, "Processes in Counseling." 96 This was a graduate level course offered during the five- week summer term at Michigan State University, 1971. Each participant was permanently assigned to a triad at the beginning of the training program. These groups were defined as the experimental units for the study. A one-group pretest-posttest design was employed. Two samples of behavior were collected prior to and immediately following the 50 hours of training. The Affective Sensitivity Scale was administered to evaluate the trainee's ability to perceive client feelings in video taped segments excerpted from actual counseling interviews. The trainees also conducted pre and post counseling interviews with student volunteers. Segments of these interviews were subsequently rated by three independent judges on the Affective, Understanding, Specific, and Exploratory subscales of the Counselor Verbal Response Scale and the Empathic Understanding in Interpersonal Processes Scale. The study was designed to answer two basic questions: (1) whether there would be significant pre to post changes in the level of facilitative functioning for students exposed to the intensified IPR training program, and (2) whether the trainee's posttest level of function- ing would reach a predetermined criterion level, the scores of professional counselors. To answer the first question, the following hypotheses were formulated: HO HO 2: 97 There will be no pre to post difference in means on the combined measures of facilitative functioning (ASS, CVRS, and EU) for groups exposed to the Intensified IPR Training Program. There will be no Times by Measures Inter- action. A repeated measures analysis of variance revealed a significant treatment effect on the combined measures and a significant times by measures interaction (a i .05). The rejection of Hypothesis 2 indicated that the pre to post gains were reflected differentially across the six measures. HO HO 3: Therefore, the following hypotheses were tested: There will be no pre to post differences in means on the Affective Sensitivity Scale for groups exposed to the Intensified IPR Training Program. There will be no pre to post differences in means on the Affective dimension of the CVRS for groups exposed to the Intensified IPR Training Program. There will be no pre to post differences in means on the Understanding dimension of the CVRS for groups exposed to the Intensified IPR Training Program. There will be no pre to post differences in means on the Specific dimension of the CVRS for groups exposed to the Intensified IPR Training Program. There will be no pre to post differences in means on the Exploratory dimension of the CVRS for groups exposed to the Intensified IPR Training Program. O I I (1) L1 .., . in... in: ‘n._, 'f-. .‘V~ i... ‘I- ‘c 98 H08: There will be no pre to post differences in means on the Empathic Understanding Scale for groups exposed to the Intensified IPR Training Program. Matched pairs t-tests were used to compare the pre and post means on the individual measures. An overall alpha level of .05 was preserved by dividing the proba— bility of a Type I error among the six one-tailed tests. The matched pairs analyses revealed statistically signifi- cant differences on four of the six dependent variables. Thus, the treatment main effect was attributed to pre to post gains on the Affective Sensitivity Scale, the Affec- tive and Specific subscales of the Counselor Verbal Re- sponse Scale, and the Empathic Understanding in Inter- personal Processes Scale. No significant differences were found on the Understanding and Exploratory dimensions of the CVRS. . A second basic question in this investigation was whether the posttest scores represented an effective level of functioning. To answer this question, the IPR post- test mean on each measure was compared to a predetermined criterion level. This level was the mean for a group of selected Ph.D. level professional counselors who had been tested on the ASS, CVRS, and EU measures (Scharf, 1971) .* These psychologists were among those employed at a major university counseling center who were permitted to *Raw data used in Scharf dissertation obtained directly from the author. 99 supervise Ph.D. candidates in practicum and were therefore assumed to be functioning at effective professional levels. The criteria were: ASS, 46.00; CVRS-A, 5.556; CVRS-U, 17.222; CVRS-S, 14.889; CVRS-E, 13.222; EU, 2.444. The following hypotheses were tested: H09: The posttest scores for the combined groups exposed to the Intensified IPR Training Pro- gram will not be different from the combined scores of professional counselors on the Affective Sensitivity Scale. H010: The posttest scores for the combined groups exposed to the Intensified IPR Training Pro- gram will not be different from the combined scores of professional counselors on the Affective dimension of the CVRS. Holl: The posttest scores for the combined groups exposed to the Intensified IPR Training Pro- gram will not be different from the combined scores of professional counselors on the Understanding dimension of the CVRS. H012: The posttest scores for the combined groups exposed to the intensified IPR Training Pro- gram will not be different from the combined scores of professional counselors on the Specific dimension of the CVRS. H013: The posttest scores for the combined groups exposed to the Intensified IPR Training Pro- gram will not be different from the combined scores of professional counselors on the Exploratory dimension of the CVRS. H014: The posttest scores for the combined groups exposed to the Intensified IPR Training Pro- gram will not be different from the combined scores of professional counselors on the Empathic Understanding Scale. Separate t-tests for the comparison of means were used to examine these hypotheses. The results indicated that, at the end of training, the IPR group was 100 functioning significantly lower than the criterion level on the Understanding and Specific subscales of the CVRS. It was also found that at the end of training, the IPR group was functioning at levels not significantly different from professional counselors on the Affective Sensitivity Scale, the Affective and Exploratory subscales of the Counselor Verbal Response Scale and the Empathic Under- standing in Interpersonal Processes Scale. Following the statistical analysis, a confidence interval procedure was employed to determine whether the posttest scores fell within a range defined as effective counseling behavior, thus providing a basis for a meaning- ful comparison. For each of the six measures, a t-test confidence interval was established around the IPR mean. The intervals for the criterion levels were set up to define the range of scores that could be meaningfully regarded as not different from the professional counselor level of functioning. The confidence intervals for the IPR group were then compared graphically to the intervals established for the professional counselor group. It appeared that in those cases where the groups were not statistically differ- ent, neither were they meaningfully different from the levels of professional counselors, i.e., on the ASS, CVRS-A, CVRS-E, and EU. The results of this training program are con- trasted with earlier IPR studies in Table 6.1. An ].()]. gnu-sauna. undo: m uncounsao> oucouaum vwo.~ n~o.u no».m amn.u on~.o mad.» ann.oa vvv.a «nm.m oo~.n an.vv nv.wn mam vowuunGOuaH \uuuon on uaovnum ouoauauo 030x nde) on nunuwau nunlusam om.a oa.a m~.~H oo.m oa.o« mo.v oo.o~ ma.v cm.n on. m wv h.nv zmnnlaacowuuvauk \uuson on QOAUIOU shoved! uua>wmm axOO! ca uuaduau lucouaum hN.H vH.H mm.n on.n oo.m ma.n oo.n mu.n mo.~ mm. o.~v ~.on uncouuuvuuknaumn \uunoa o~ 6030000 Inca-d! uon>wam nova: unaau usaalaun on. anus: o nun-«Ho nan-usum na.- Ho.n nn.o mn.n no.na oo.o av.“ on.n newuubuooamuuamn \uusoa an nozocoo anon-n: nuanvaoo oxooz ea uuoxuosoncu oo.~ no.d wo.n no. no.n nn.u .9.H do. Ouuuooaauuxmu \nuaon an nanoawaudon vusoo aIIu0I«CI undo: on ouoxuosiuau no." no A pa.~ pa.“ -.v as." va.~ ~o. mauunoauu-oin \ouso: an nuuuaucaaoa ausou guano-so: ocauaooo< once) a cucuocnsoo o.~ ~.H oo.«a o.v oo.~a o.v o.- o.v v.m o.~ «.0. ~.nn aauaucluuoaxu can \ouso: on nuonoowum coouum cxouooouuo causal o \ooodna u nuooaasaob .4: no.“ no.“ on.v~ -.n« p~.ma a~.o sn.mv no.on nun opqoaouun \uuson on unicsuu canon-uhuovno mason .uou: nlauu usaslauu o>av m undounsuo> ed: pp.« aw.» nv.oa pv.on «o.« oo.on on. «An o>uoa0uan \uuson ov uniuaum ou-suauuuoosa «xenon anon cum anon cum anon Cum anon cum doom out uoOh on; ~38. unaware 3330 8332.2 -«muwunu an unm¢>u mumflbu almm>u ¢umx>u and alluoOum oaasdouh man no :o-«udmaoo 4 H.o udntfi “V p. H. (I) 102 examination of these data suggest that previous IPR pro- grams, notably the Dendy and Goldberg research, evidenced higher posttest scores and greater pre to post gains on all measures. The possible reasons why greater increases were not recorded in this study will be discussed in a later section. Results of the Analysis The findings of this study indicate that graduate students who were exposed to a five week, 50-hour intensi- fied IPR training program for counselors experienced sig- nificant pre to post increases in levels of facilitative functioning. Statistically significant gains were ob- served in the trainee's ability to perceive client feel- ings (ASS), to respond to the client's Affective message (CVRS-A), to label the client's feelings Specifically (CVRS-S), and in their level of Empathic Understanding (EU). The findings further suggest that on certain dimensions, the trainees were functioning at levels that were both statistically and "meaningfully" comparable to a select group of professional counselors at or near the I1h.D. level. These dimensions included ability to per- ceive client feelings (ASS), to respond to the client's Affective message (CVRS-A) , to encourage the client to ftzrther Explore his concern (CVRS-E), and in their level of Empathic Understanding (EU). 103 Before discussing the results of this study, the subjective feedback obtained through the Evaluation Form will be presented. Results of the Evaluation Form Following the 50 hours of training, each par- ticipant was asked to describe his reactions to the experi- ence by completing the Evaluation Form (see Appendix F). In this section, the questions will be restated, followed by a summary of the responses. The response to the training experience was over- whelmingly positive. This is not to imply that the train- ees offered no criticism, but that the general reactions were favorable and the suggestions were constructive. 1. Rank these sessions in the order that they were helpful to you (each session was listed). 2. Please share your reactions to each of the above sessions. The rankings were quite diverse, suggesting either that the reactions to the different phases of training were highly individualized, or that the trainees were being asked to rank sessions that were nearly equal. .However, several trends emerged. Among the most highly :ranked sessions were IPR Counseling--Actual Client, Client EIecall--Role-played Client, and Mutual Recall--Assertive- riess. At the other end of the continuum, the three Shessions involving use of the Affect Simulation Films and 104 the lecture on Interpersonal Defenses were among the least preferred. 3. What is your reaction to the following handouts: A. Establishing Ownership of Feelings--Part I B. Establishing Ownership of Feelings-—Part II C. Feelings Touched, Now What? D. Identification of Client Needs E. Use of Fantasy Feedback from the trainees indicated that all five handouts were valuable and directly relevant to the train- ing experience. The two that received the most positive response were "Use of Fantasy" and "Feelings Touched, Now What?” This method of introducing cognitive input into a basically experiential program was apparently highly successful. The trainees reported that the ideas not only stimulated their thinking about the therapy process, but that the practical implications were clear enough to be translated into counseling behavior. In the later stages of the program, many trainees requested more input of a similar nature as well as an expansion of the ideas already presented. 4. Did you see each step as important to later steps, or did some seem irrelevant to you (please be specific)? The following comments were typical: The training program was well planned. At first I had difficulty seeing how things would fall into place, but as time passed, they did fall into place. 105 All steps seemed important if you can accept the view that each was a step in a hierarchy of skills. I was quite restless and at times bored in the early stages, but the later stages were more challenging and added variety. There were no jarring inconsistencies. Only problem came when there seemed too little time to make sense out of the progression. The progression was tremendous. Personally, I could feel confidence increasing because of awareness of responsibilities, etc. Each step seemed to add something (and not too much so we were lost), and still conceptualize the earlier stages. In terms of my own major area (curriculum), it seemed as if you had done a superb task analysis. Each step seemed to me to lead to the next--transi- tions were well-timed and natural. I saw three threads interwoven throughout--the develOpment of the group as an entity, the development of self and self-awareness, etc., and the development of each of us as a counselor. At any one time it was impossible to separate the three strands. They merged beauti- fully throughout. Only one trainee reported feeling lost and unable to grasp the scheme of the program. The majority of re- actions were similar to the fourth and fifth above, sug- gesting that the developmental sequencing of tasks was extremely effective. 5. What was the one most important thing you learned throughout this training program? To use my own hunches to draw the client out, to be less qualifying and verbal. I was never so aware of the unbelievable impact and power of a relationship. The amount accomplished in my client sessions astonished me. Feelings are much more important than the words exchanged between two people. When working with a client, to be honest with my thoughts and feelings. 106 What to do with feelings once they are identi- fied. To be able to listen to other peOple in an affective, feeling manner; and to be able to evalu- ate some of my own feelings about myself and others. In my earlier training, I was taught that re- flection of feelings was E23 prOper response. How- ever, I learned here that leading questions help the client to bring up, recognize, and identify basic feelings. To be aware of my own feelings and not be threat- ened or afraid of dealing with myself and others in the affective domain. I think the most important thing I have learned is not to give advice and not to try to solve other people's problems but to help them explore their feelings and by doing so, allow them to be more in touch with ways they can solve their own problems. 6. What one change would you make? This 50 hours was too intensive . . . think I could have enjoyed it more (not necessarily got more out of it) over a lO-week period. I learned much and was stimulated by the in- tensity of the daily exposure and practice. Try for a greater feeling of availability of staff to student for individual help and feedback. Not change leaders so much. It is difficult to adjust so much to new peOple who don't know how far you've come, what you've been through, or what still needs to be worked out. More patient-client contact with less "client role-playing" by the students. I would like to see clients brought in that have real problems and concerns which they want help with. Fewer or better stimulus films. Perhaps a short summary of what really occurred after each session to help us understand the feelings that took place within ourselves and others. 107 7. General feedback: The course was tremendous. It has been one of the greatest learning experiences I've had in my college career. I liked the process of "doing" rather than "reading about" these experiences. The entire experience was fantastic. As a result of this experience, I feel I will be better able to communicate with my students and deal honestly with them. Excellent course. Well thought out, tremendous amount of planning, yet well done. All in all, definitely a turning point in my life. I grew tremendously and am terribly happy about the whole thing. The wealth of knowledge learned about myself and my effect on others will probably never be fully measured. This program should be required of all people who are going to work professionally, in any capacity, dealing with peOple in a helping relation- ship. It put pressure on me to interact with others and to evaluate my strengths and weaknesses; and it was a great experience--I needed the pressure and the interaction. I liked the feeling that the course, though very well planned and executed, still leaves me with the feeling that it is open-ended. The course is finished; excitement in it continues. Discussion This SO-hour IPR training program was designed to provide a much more intensive training experience than been offered by existing IPR models. The counselor's feelings about himself, his client, and the counseling relationship were emphasized to help the trainee more fully understand his own interpersonal behavior. Cog- has nitive input in the form of lectures and written handouts, 108 not used in previous IPR studies, was included to expand the trainee's understanding of the counseling process. Because of these modifications, it was anticipated that rather large pre to post increases would be recorded on all six measures. The results of the analysis, however, suggest that this was not the case. While there were statistically significant increases on four of the six dependent vari- ables, the only measure that registered a large pre to post gain was the Affective Sensitivity Scale. On the other hand, subjective data from the Evaluation Form sug- gests the possibility that greater gains were experienced by the trainees than were recorded by the research instru- ments. Therefore, before drawing conclusions about the effects of the 50-hour training program, it is necessary to consider those factors which may have confounded the results. Why were greater pre to post gains not obtained on the CVRS and EU measures? Why was there the apparent discrepancy between the empirical and subjective results? One possible reason that the scores on the be- havioral measures (CVRS and EU) were not as high as anticipated may be that while the trainees learned to perceive and identify client feelings (as measured by the .ASS), this knowledge was not translated into effective counseling behavior. This possibility seems unlikely, 109 however, because the trainees reported that their effec- tiveness with clients increased considerably, and these reports were substantiated by the clinical observations of the IPR staff. An interesting observation is that the CVRS and EU scores were obtained from the same source, the audio taped interview. It may be that factors confounding the interview situation itself lead to a biased measure of the trainee's level of facilitative functioning. Because of ethical considerations, clients with personal-social concerns could not be used for the cri- terion interviews. Therefore, the trainees were not given an opportunity to demonstrate their skills with the client population for which they were trained. Reports from the trainees revealed that most of the student-interviewees desired a mutual sharing of ideas rather than help with a problem or concern. It may have been highly inappro- priate for the counselor trainee to respond as though a problem existed when no problem.was being expressed, or to respond affectively when the interviewee asks a legitimate informational question, i.e., "What classes do I need for a social science major?" Therefore, it is possible that the trainees responded quite apprOpriately, but this fact was reflected negatively on the criterion measures . 0‘ .1 ‘ v4 .tu 110 Similarly, the fact that the criterion tape was a "one time only“ interview may not have allowed the trainee to demonstrate the kind of learning intended through the intensification of the basic IPR model. One emphasis throughout the training was an understanding of the BER? EEEE of therapy and the nature of the client-counselor interaction over time. It takes time to build a relation- ship such that the client trusts the counselor's inquiries into sensitive emotional areas. If the probing is done prematurely, the client may respond with mistrust and defensiveness, especially if he is not actively seeking help with a specific concern. Thus, it seems likely that a number of interviews with the same client would have been necessary to determine whether the trainee could build and maintain a relationship which would have appropriately allowed him to demonstrate his competency. There is yet another factor related to the inter- view that may have confounded the results. At the time the final interview was scheduled, the trainees reported being emotionally exhausted from the intensive training, drained by the humid, 95 degree weather, and under the pressure of final exams. Several trainees stated they were packed and ready to leave town as soon as they com- pleted the interview. Therefore, it is possible that a fatigue factor affected the trainee's motivation and per- haps even their immediate ability to function at their most effective levels. 111 Another factor that may have influenced the out- come was that many of the student volunteers for the posttest criterion interview were obtained through a second recruiting effort. In that both pre- and post- interviewees were drawn from the same population, it is difficult to speculate what effect the difference in time (4 weeks) may have had on the clients, and hence, on the results. Another possible explanation for the final scores being lower than anticipated might be related to the nature of the trainee sample. No screening procedure was used for admittance into the training program. Five or six of the students might have been more suited for a slower- paced, less intensive training program. Not all of the participants were interested in becoming professional counselors and this seemed to have an effect on their motivation to understand the complexities of the helping relationship. Another explanation, however, is that none of these possible confounding variables effected the results of the study. It could be that the modifications of the basic IPR model did not result in the training of more effec- tive counselors than previous IPR programs. 112 Observations Logistical Problems In the course of five weeks, a total of 350 hours (7 triads, 50 hours each) of IPR training was given. The scheduling of triads at a time when both video equipment and staff were available was a time consuming and diffi- cult, but not insurmountable task. About 15 hours of staff time per week was needed to solve the logistical problems necessary to maintain Operation of the program. Staffing_Demands Seventy hours of staff time per week is a heavy demand. However, almost all of the IPR training was con— ducted by doctoral students, requiring very little commit- ment from the university in terms of faculty time. The staff, all volunteers, were excited by the training pro- gram and their reactions suggested that it was an im- portant learning experience for them as well as the trainees. If such a program were to be implemented on a continuing basis, a pyramid structure could be set up ‘whereby former trainees are given much of the staffing responsibilities for future programs. This creates an efficient, self-perpetuating model which provides a 'valuable learning experience for both staff and trainees, and which requires a minimal outlay of faculty resources. 113 Suggested Modifications of the SO-Hour Intensified IPR Training Model Feedback from the IPR staff and the trainees indi- cated that the following modifications might be appropri- ate for future training programs employing the model used in this study. 1. Extend the SO-hour training program over a period of ten weeks. This would not only alleviate many of the scheduling problems, but would also provide addi— tional time between sessions for the trainees to think about and integrate their experience. 2. Employ a screening procedure in the selection of trainees. Because this training is intensive and de— manding, factors such as readiness for training, moti- vation, and general ability to relate on an interpersonal level should be considered. In addition, it seems imr portant to determine whether the prospective student values the kind of interpersonal learning emphasized in Interpersonal Process Recall. 3. Eliminate or modify the use of stimulus films. Trainee feedback indicated that the sessions involving use of the stimulus films were the least productive of all the training experiences. The students commented that the films tended to communicate an "acted" quality which made them difficult to relate to. They suggested increasing the number of actors (from two) and widening 114 the range of emotions portrayed. (The investigator has also observed that discussions tend to be more spontaneous in slightly larger groups of six to ten, rather than three, trainees.) 4. Provide more interviewing experience with actual students. In the later stages of the program, the trainees seemed to become saturated by the continued ex- posure to members of their own triad. This problem could be minimized by providing additional interviewing experi- ence with student volunteers. Another solution might be to change the membership of the triads several times throughout the 50-hour program. 5. Provide more cognitive input during the later stages of training. The handouts apparently stimulated a good deal of thinking about the process of therapy. Several trainees requested more input of this nature, reporting that the ideas presented helped them integrate the experiences provided by the training program. Some Additional Notes While the purpose of the 50-hour program was to train effective helpers, the participants reported personal as well as professional growth. In addition to greater self-awareness, many trainees indicated that the quality of their day-to-day relationships (including marriages) improved as a result of this training experience. 115 The actual training time consumed 700 man hours (50 hours, 21 students) in a span of five weeks. At times, scheduling conflicts necessitated early morning and late evening sessions, often at the trainee's in- convenience. Perhaps a testimony to the student's in- volvement and commitment, only 11 man hours were missed. A number of the participants have since accepted teaching positions where their responsibilities include providing IPR training for students. Several others have been active on the Michigan State campus, working with undergraduates who have requested training in inter- personal communication skills. Since the summer of 1971, several aspects of this model have been incorporated into newer training programs. This suggests that peOple working closely with IPR felt that the modifications contributed to the training experi- ence. Two of the handouts, "Use of Fantasy" and "Feelings Touched, Now What?" were published in Influencing Human Interaction (Kagan, 1972). Conclusions The results of the analysis indicated that sta- tistically significant increases were found on four of the six measures of facilitative functioning. Pre to post gains were obtained on the A88, CVRS—A, CVRS-S, and EU measures. q '1 . \ :5 “-04 ‘s 116 The results also indicated that the trainees were functioning at levels not significantly different from professional counselors on the A88, CVRS-A, CVRS-E, and EU scales. It also appeared that there were no meaningful differences between the IPR trainees and the professional counselors on these four measures. The data obtained from the Evaluation Form and the clinical observations of the IPR staff, however, suggested the possibility that greater gains were experienced by the trainees than were recorded by the research instruments. Several factors--actual clients were not used for the criterion interviews, a one-hour interview may not have been sufficient for a relationship to develOp such that the trainee could appropriately demonstrate his competency, and the reported and observed fatigue at the end of train- ing--were cited as possible confounding variables which may have served to depress the results of the study. Considering both the empirical and subjective evi- dence, it is tentatively concluded that this 50-hour intensified IPR training program resulted in substantial increases in the trainee's ability to function effectively in the counseling relationship, and may be the most effec- tive IPR model to date. A replication of this study, employing a more stringent experimental design which con- trols for or eliminates the possible confounding vari- ables in this study, is needed to further examine the effects of the training program. 117 Implications for Future Research This program was designed to provide an intense, short-term learning experience. It may be that a substantial amount of learning and integration takes place after the training is completed. Therefore, this program needs to be evaluated in both short-term (6 weeks) and long-term (6 months) follow-up studies. Further research is needed to determine the optimal length and intensity of training, i.e., a rate of training which provides enough time for the participants to integrate the experience, yet sufficient intensity to stimulate growth and exploration. It may be that IPR training is most effective dur- ing specific stages in the counselor's pro- fessional development. This approach needs to be compared with sensitivity group experiences, other structured training methods (Ivey's micro- counseling, Carkhuff's discrimination training) and individual supervision, in the beginning, middle, and final stages of the trainee's gradu- ate study. None of the studies using IPR in counselor edu- cation (including this one) have measured client 118 growth as a direct indicator of the effectiveness of training. In future research, indicators of client change as well as counselor behaviors need to be considered. The results of this study suggested that on several measures, the IPR trainees were function- ing at levels not significantly different from a selected group of professional counselors. How- ever, comparable levels of facilitative function- ing do 22; indicate comparable levels of com- petence. Further research is needed to identify those skills or attributes that differentiate between the competent psychologist and the minimally effective counselor. 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Chicago: Aldine Publishing Company, 196 . 123 Truax, C. B. Refocus of counseling research. In J. M. Whitely, Research in counseling: Evaluation and refocus. Columbus, Ohio: Charles E. Merrill Pub- lishing Co., 1967. Whiteley, J. M. Counselor education. Review of Edu- cational Research, 1969, 39, 173-187. Woody, R. H., 33 El. Stimulated recall in psychotherapy using hypnosis and video tape. The American Journal of Clinical Hypnosis, 1965, 1, 234-241. APPENDICES APPENDIX A A 50 HOUR INTENSIFlED IPR TRAINING PROGRAM FOR COUNSELORS Time Reguired 2 hours 2 hours 2 hours 2 hours 3 hours 2 hours 2 hours 3 hours 3 hours 2 hours 3 hours 1 hour 10. 11. 12. Outline of the Training Program Task Lecture: Elements of Effective Communication and Introduction to Interpersonal Process Recall (IPR) Handout: IPR Counselor Verbal Response Scale. Audio Tapes A. Identification of client feelings B. Responding to client feelings Handout: Empathic Understanding in Inter- personal Processes (revised) Counselor Recall--recall conducted by staff member Handout: Explanation of Recall Client Recall--recall conducted by staff member Inquirer Training A. Kagan's video tape (1 hour) Handout: Role and Function of the Inquirer Mutual Reca11--recall conducted by student Stimulus Films Handout: Establishing Ownership of Feelings--Part I Interview--Client Recall--Interview Interview--Mutual Recall--Interview Handout: Establishing Ownership of Feelings--Part II Stimulus Films Mutual Recall--Assertiveness Handout: Feelings Touched, Now What? Lecture: How Clients Run from Counselors: Interpersonal Defenses 124 Time Reguired 3 N N 10 hours hours hours hours hours hours 14. 15. 16. 17. 18. 125 Task Client Recall-Role-played Client Handout: Identification of Client Needs Conceptualization of Client Dynamics A. Video tape of counseling session Handout: Use of Fantasy Mutual Recall--Existential Relationship Stimulus Films Lecture: IPR Counseling and Summary Overview IPR Counseling--Actual Client lst day 30 minute interview 15 minute client recall 45 minute counselor recall 2nd day 30 minute interview 60 minute client recall 30 minute interview 3rd day 30 minute interview 30 minute mutual recall 30 minute interview 126 SESSION 1 Lecture: Elements of Effective Communication and Introduction to Interpersonal Process Recall Handout: IPR Counselor Verbal Response Scale The purpose of this lecture is to provide a brief overview of what counseling is. This particular conceptual framework introduces four dimensions of communication. While these elements are not the end all and be all of effective interviewing, they do represent an appropriate place to begin learning about the helping relationship. The elements of effective communication are some specific behaviors which were exhibited by expert inter- viewers. Not only were these "experts" judged effective by their colleagues, but their clients reported such things as, "I felt I could talk to this person about anything" and "This person really helped me to see things more clearly." 1. Exploratory--NoneXploratory Talk about the tentativeness of the counselor's per- ceptions and how he can use these to facilitate client exploration. 2. Cognitive--Affective Talk about the difference between the cognitive (story- line) and the affective (feeling). 3. Specific--Nonspecific Talk about labeling feelings clearly, honestly and specifically. 4. Understanding--Nonunderstanding Talk about how you let the client know that you under- stand or are trying to understand how he feels. (If you hear his feelings, does the client know that you hear?) 127 IPR COUNSELOR VERBAL RESPONSE SCALE The scale was developed as a part of a project supported by a grant from the U.S. Department of Health, Education and Welfare, Office of Education, "EXploration of the Potential Value of Interpersonal Process Recall Technique (IPR) for the Study of Selected Educational Problems" (Project Nos. 7-32-0410-216 and 7-32-0410-270). 128 IPR COUNSELOR VERBAL RESPONSE SCALE The Counselor Verbal Response Scale is an attempt to describe a counselor's response to client communication in terms of four dichotomized dimensions: (a) affect-- cognitive; (b) understanding--nonunderstanding; (c) specific--nonspecific; (d) exploratory--noneXploratory. These dimensions have been selected because they seem to represent aspects of counselor behavior which seem to make theoretical sense and contribute to client progress. A fifth dimension--effective-noneffective--provides a global rating of the adequacy of each response which is made independently of the four descriptive ratings. The unit for analysis is the verbal interaction between counselor and client represented by a client statement and counselor response. A counselor response is rated on each of the five dimensions of the rating scale, with every client-counselor interaction being judged independently of preceding units. In judging an individual response the primary focus is on describing how the coun- selor responded to the verbal and nonverbal elements of the client's communication. Description of Rating Dimensions I. Affect--cognitive dimension The affective-cognitive dimension indicates whether a counselor's response refers to any affective component of 129 a client's communication or concerns itself primarily with the cognitive component of that communication. A. Affective responses--Affective responses gen- erally make reference to emotions, feelings, fears, etc. The judge's rating is solely by the content and/or intent of the counselor's response, regardless of whether it be reflection, clarification, interpretation. These responses attempt to maintain the focus on the affective component of a client's communication. Thus they may: (a) Refer directly to an explicit or implicit reference to affect (either verbal or nonverbal) on the part of the client. Example: "It sounds like you were really angry at him. (b) Encourage an expression of affect on the part of the client. Example: "How does it make you feel when your parents argue? (c) Approve of an expression of affect on the part of the client. Example: "It doesn't hurt to let your feelings out once in a while, does it?" (d) Presents a model for the use of affect by the client. Example: "If somebody treated me like that I'd really be mad." Special care must be taken in rating responses which use the word "feel." For example, in the statement "Do you feel that your student teaching experience is helping you get the idea of teaching?", the phrase "Do you feel that" really means "do you think that." Similarly the expression "How are you feeling?" is often used in a matter-of-fact, conversation manner. Thus, although the verb "to feel" is y;- D v5.1» 5 b“‘ :‘J‘a '5‘ unstru- 130 used in both these examples, these statements do not represent responses which would be judged "affective." B. Cognitive Responses--Cognitive responses deal primarily with the cognitive element of a client's communi- cation. Frequently such responses seek information of a factual nature. They generally maintain the interaction on the cognitive level. Such responses may: (a) Refer directly to the cognitive component of the client's statement. Example: "So then you're thinking about switching your major to chemistry?" (b) Seeks further information of a factual nature from the client. Example: "What were your grades last term?" (c) Encourage the client to continue to respond at the cognitive level. Example: "How did you get interested in art?" II. Understanding--nonunderstanding dimension The understanding--nonunderstanding dimension indicates whether a counselor's response communicates to the client that the counselor understands or is seeking to understand the client's basic communication, thereby encouraging the client to continue to gain insight into the nature of his concerns. A. Understanding responses--Understanding responses communicate to the client that the counselor understands the client's communication--the counselor makes appropriate reference to what the client is expressing or trying to ex- press both verbally and nonverbally--or the counselor is Clearly seeking enough information of either a cognitive 131 or affective nature to gain such understanding. Such responses: (a) Directly communicate an understanding of the client's communication. Example: "In other words, you really want to be treated like a man." (b) Seek further information from the client in such a way as to facilitate both the counselor's and the client's understanding of the basic problems. Example: "What does being a man mean to you?" (c) Reinforce or give approval of client communications which exhibit understanding. Example: CL: "I guess then when people criticize me, I'm afraid they'll leave me." CO: "I see you're beginning to make some connection between your behavior and your feelings." B. Nonunderstanding responses--Nonunderstanding responses are those in which the counselor fails to under- stand the client's basic communication or makes no attempt to obtain appropriate information from the client. In essence, nonunderstanding implies misunderstanding. Such responses: (a) Communicate misunderstanding of the client's basic concern. Example: CL: "When he said that, I just turned red and clenched my fists." CO: "Some people don't say nice things." (b) Seek information which may be irrelevant to the client's communication. Example: CL: "I seem to have a hard time getting along with my brothers." CO: "Do all your brothers live at home with you?" (c) Squelch client understanding or move the focus to another irrelevant area. Example: CL: "I guess I'm really afraid that other people will laugh at me." CO: "We're the butt of other peOple's jokes sometimes." 132 Example: CL: "Sometimes I really hate my aunt." CO: "Will things be better when you go to college?" III. Specific--nonspecific dimension The specific-nonspecific dimension indicates whether the counselor's response delineates the client's problems and is central to the client's communication or whether the response does not specify the client's concern. In essence, it describes whether the counselor deals with the client's communication in a general, vague, or peripheral manner, or "zeros in" on the core of the client's communication. NB: A response judged to be nonunderstanding must also be nonspecific since it would, by definition, misunderstand the client's communication and not help the client to de- lineate his concerns. Responses judged understanding might be either specific (core) or nonspecific (peripheral) i.e. they would be peripheral if the counselor conveys only a vague idea that a problem exists or "flirts" with the idea rather than helping the client delineate some of the dimen- sions of his concerns. A. Specific responses--Specific responses focus on the core concerns being presented either explicitly or im- plicitly, verbally or nonverbally, by the client. Such responses: (a) Delineate more closely the client's basic concerns. Example: "This vague feeling you have when you get in tense situations--is it anger or fear?" (b) Encourage the client to discriminate among stimuli affecting him. 133 Example: "Do you feel in all your classes or only in some classrooms? (c) Reward the client for being specific. Example: CL: "I guess I feel this way most often with someone who reminds me of my father." CO: "So as you put what others say in per- spective, the whole world doesn't seem so bad, it's only when someone you value, like Father, doesn't pay any attention that you feel hurt." B. Nonspecific responses--Nonspecific responses indi- cate that the counselor is not focusing on the basic con- cerns of the client or is not yet able to help the client differentiate among various stimuli. Such responses either miss the problem area completely (such responses are also nonunderstanding) or occur when the counselor is seeking to understand the client's communication and has been pre- sented with only vague bits of information about the client's concerns. Thus such responses: (a) Fail to delineate the client's concern and cannot bring them into sharper focus. Example: "It seems your problem isn't very clear--can you tell me more about it?" (b) Completely miss the basic concerns being presented by the client even though the counselor may ask for Specific details. Example: CL: "I've gotten all A's this year and I still feel lousy." CO: "What were your grades before then?" (c) Discourage the client from bringing his concerns into sharper focus. Example: "You and your sister argue all the time. What do other people think of your sister?" IV. Exploratory--Nonexploratory dimension The exploratory-nonexploratory dimension indicates whether a counselor's response permits or encourages the 134 client to explore his cognitive or affective concerns, or whether the response limits a client's eXploration of these concerns. A. Exploratory responses--Exploratory responses encourage and permit the client latitude and involvement in his response. They may focus on relevant aspects of the client's affective or cognitive concerns but clearly attempt to encourage further eXploration by the client. Such responses are often open-ended and/or are delivered in a manner permitting the client freedom and flexibility in response. These responses: (a) Encourage the client to explore his own concerns. Example: Cognitive--"You're not sure what you want to major in, is that it?" Affective--"Maybe some of these times you're getting mad at yourself, what do you think?" (b) Assist the client to explore by providing him with possible alternatives designed to increase his range of responses. Example: Cognitive--"What are some of the other alternatives that you have to history as a major?" Affective--"In these situations do you feel angry, mad, helpless, or what?" (0) Reward the client for exploratory behavior. Example: Cognitive--"It seems that you've considered a number of alternatives for a major, that's good." Affective--"So you're beginning to wonder if you always want to be treated like a man." B. Nonexploratory responses--Nonexploratory responses either indicate no understanding of the client's basic com— munication, or so structure and limit the client's responses that they inhibit the exploratory process. These responses 135 give the client little Opportunity to eXplore, eXpand, or express himself freely. Such responses: Discourage further exploration on the part of the client. Example: Cognitive--"You want to change your major to history." Affective--"You really resent your parents treating you like a child." V. Effective--noneffective dimension Ratings on the effective--noneffective dimension may be made independently of ratings on the other four dimen- sions of the scale. This rating is based solely upon the judge's professional impression of the appropriateness of the counselor's reSponses, that is how adequately does the counselor's response deal with the client's verbal and non- verbal communication. This rating is n95 dependent on whether the response has been judged affective--cognitive, etc. A rating of 4 indicates that the judge considers this response among the most appropriate possible in the given situation while a 3 indicates that the response is appro- priate but not among the best. A rating of 2 indicates a neutral response which neither measurably affects client progress nor inhibits it, while a rating of 1 indicates a response which not only lacks basic understanding of the client's concerns but which in effect may be detrimental to the specified goals of client growth. 136 SESSION 2 Audio Tapes A. Identification of client feelings B. Responding to client feelings Handout: Empathic Understanding in Interpersonal Processes (revised) The students will meet in triads for the following 2 hour period. A staff member will be present to conduct the training. The session will be divided into two parts. Part I will focus on identification of client feelings. Part II will center on responding to the client. Part I--45 minutes Instructions to the Staff: Use the audio tape that contains a series of client statements. Play an individual segment and then st0p the recorder for discussion. Encourage the students to hear: 1. the client's concern or the cognitive (story-line) aspect of his statement. 2. the client's feeling about his concern or the affective part of his statement. 3. the specific feelings the client is experiencing during the interview--labeling. 4. whether the client is "in touch" with his feelings or whether he is unaware of his emotional response. In summary, the students should end the discussion of each segment with a fairly clear picture of the client's concern as well as the specific feelings he's having about it. 137 Part II--One hour, 15 minutes Instructions to the Staff: Provide the students with the following introduction: Throughout our lives, most of us have been repeatedly taught to respond to the content or the story-line of what someone has said--this comes naturally for most of us. One of the things we would like to have you learn is to be able to respond directly to the emotional part of the message, also. For a moment, then, let's turn our efforts away from the cognitive aspect of communi- cation. You have just spent some time learning to recognize and label client feelings in a number of situations. The next step is to communicate to the client that you did hear what he was feeling. Explain the three levels (adding, interchangeable and detracting) of empathic understanding. The next section of the audio tape will contain two excerpts (nos. 1 and 2 used in Part I), each followed by three counselor responses. Have the students talk about each response in terms of whether it added to, was interchangeable with, or detracted from the client's affect. Listen to the next three statements and have the students come up with their own response to the client. Have them share their responses aloud with each other. It might be helpful to have them think about the perceptions they had of the client in Part I (nos. 3, 4, and 5) before they attempt to respond. As time permits, listen to the remaining (new) client statements. Let the students think about what the per- son is feeling, label it, and then write down their best reSponse. 138 EMPATHIC UNDERSTANDING IN INTERPERSONAL PROCESSES (Revised) Robert R. Carkhuff Level 1. (Detracting Level) The verbal and behavioral expressions of the listener either do not attend to or communicate less of the speaker's feel- ings than the Speaker has communicated himself. The listener tends to subtract from or respond to other than what the speaker is expressing or indicating. Level 2. (Egual Level) The expressions of the listener in response to the expressed feelings of the speaker are essentially interchangeable with those of the speaker in that they express essentially the same affect and meaning. The listener is responding so as to neither subtract from nor add to the expressions of the Speaker; but he does not respond accurately to how the speaker really feels beneath the surface feelings. The equal level constitutes the minimal level of facilitative interpersonal functioning. Level 3. (Adding Level) The responses of the listener add to the expressions of the speaker in such a way as to express feelings deeper than the speaker was able to express himself. In the event of ongoing deep eXploration of feelings on the Speaker's part, the listener communicates a full awareness of what the speaker is experiencing. Examples Speaker Statement I don't know - I guess I've had it - I'm through. It seems like every time I try to get close to someone I get burned and I'm tired of the whole damned thing. Listener Response Level 1 (detracting): I guess we all tend to feel like that some times, but we recover. You just have to learn to expect that there are times when you'll get hurt. Level 2 (equal): There just doesn't seem to be any way for you to find a deep relationship Level 3 (adding): 139 with anyone and you've run out of gas. You just can't face that hurt again. You're hurt and you're angry to think that the only thing that ever happens with your love is that it gets thrown back in your face. You can't bear that again but the only thing left for you is loneliness - there's no way out of the pain. 140 SESSION 3 Counselor Reca11--recall conducted by staff member Handout: Explanation of Recall The purpose of this counselor recall session is to introduce the Interpersonal Process Recall technique. ,The students will meet in their triads, along with a staff mem- ber, in one of the video facilities. This 2 hour session will begin with a 5-10 minute interview with one student taking the role of client and a second student taking the role of helper. This interaction will be videotaped. The staff member will be the inquirer for a 30 minute counselor recall session. The other two students will not be present during the inquiry. This procedure will be rotated three times so each student will experience counselor recall. Instructions to the Client: For the next 5-10 minutes we would like you to take the part of the client. If possible, please talk about some concern which you are now struggling with or have had to deal with in the recent past. It need not be a "big problem." Rather, we would like to have you talk about something that is real enough for you to be able to recall some of the feelings or thoughts you had in that situation. Instructions to the Counselor: For the next 5-10 minutes, another student will be talking with you about a concern of his. As the counselor, try to be as understanding and help- ful as you can. Avoid giving solutions or advice to the c1ient--try to respond in ways that are consistent with the elements of effective communication (affective, understand- ing, Specific, and exploratory) and which are adding or in- terchangeable rather than detracting of the client's feeling. 141 Instructions to the Staff: Before beginning the inquiry, explain the rationale and procedure involved in conducting a recall session (see accompanying sheet). 142 EXPLANATION OF RECALL These instructions are to be given prior to the student's first recall session. 1. 2. We know that the mind works faster than the voice. As we talk with peOple, we think of things which are quite different from the things we are talking about. Everyone does this and there is no reason to feel em- barrassed or to hesitate to "own up to it" when it does occur. We know that as we talk to peOple, there are times when we like what they say and there are times when we are annoyed with what they say. There are times when we think they really understand us and there are times when we feel they have missed the point of what we are saying or really don't understand what we were feeling or how strongly we were feeling something. There are also times when we are concerned about what the other person is thinking about us. Sometimes we want the other person to think about us in ways which he may not be. If we ask you at this moment just when you felt the counselor understood or didn't understand your feelings, or when you felt you were making a certain kind of im- pression on him, or when you were trying to say some- thing and it came out quite differently from the way you wanted it to, it would probably be very difficult for you to remember. With this T.V. playback immedi- ately after your interview, you will find it possible to recall these thoughts and feelings in detail. You may stOp and start the playback as often as you remem- ber your thoughts and feelings (Kagan, 22- gl., 1967, p. 13. 143 SESSION 4 Client Recall--recall conducted by staff member This client recall session will take 2 hours. The triads will meet with a staff member in one of the video facilities. The session will begin with a 5-10 minute client-~counselor interview which will be video taped. The staff member will conduct a 30 minute inquiry with the client, the other two students observing. Rotation will be such that each student will experience each of the three positions. Instructions to the Client: For the next few minutes, please talk about a personal concern which you have either resolved or are in the process of resolving. Instructions to the Counselor: For the next 5-10 minutes a student will be talking with you about something of im- portance to him. Try to understand and respond to what he is feeling. Instructions to the Staff: You will be conducting three, 30 minute client recall sessions. Please watch the time so each student has an opportunity to experience client recall within the 2 hour period. 144 SESSION 5 Inquirer Training A. Kagan's video tape (1 hour) Handout: Role and Function of the Inquirer This 3 hour session will provide an explanation of and practice in the role of inquirer. First, the students will listen to the Kagan Inquirer Training video tape (runs about 1 hour). Then, two of the students will engage in a 5-10 minute client-counselor video-taped interaction. The third student will conduct the client recall, with the sup- port and critique of the staff person. Instructions to the Staff: After seeing the video tape, give the students a summary overview of the inquirer role and contrast it to the role of counselor (see attached sheet). As they try out the role, provide as much feedback as possible. You may want to remind them to keep their questions brief, avoid interpretations, and avoid the temptation to put words into the client's mouth. 145 ROLE AND FUNCTION OF THE INQUIRER Ideally, the inquirer should remain as neutral as possible and avoid forming a new relationship with the person experiencing the recall. The inquirer's function is to help the person discover for himself some of his feelings and thoughts which interfered with effective communication. Often he will gain insight before the person being ques- tioned, but the inquirer should lead the person to discover for himself what was happening. He should avoid making judgments and interpretations for the other person. Rather, (he should gently probe and push for more material with a direct line of questioning and only occasional use of re- flective statements. It takes time for the person to gain insight, so the inquirer should be wary of a need to get the job done quickly. The inquirer should focus on the feelings of the person experiencing recall--i.e., the feelings the person was having about himself and the other person during the video-taped interaction. A suggested line of questioning might be the following: 1. What do you think he was trying to say? 2. What do you think he was feeling at this point? 3. Can you pick up any clues from his non-verbal behavior? 4. What was running through your mind when he said that? 5. Can you recall some of the feelings you were having then? 6. Was there anything that prevented you from sharing some of your feelings and concerns about the person? 7. What kind of risk would there have been if you had said what you really wanted to say? 8. How did you want this person to see you? 9. What do you think his perceptions are of you? The inquirer should encourage the person to stop the machine as often as he wants. 146 SESSION 6 Mutual Recall--recall conducted by student For the next 2 hours, the students will be intro- duced to mutual recall. The triads will work with a staff member in the video facility. First, two students will interact for 5-10 minutes in a helper--he1pee situation. Following an explanation by the staff of the goals of mutual recall, the third student will conduct the 20-30 minute inquiry. Instructions to the Staff: Give the students the following introduction to mutual recall: The goal of mutual recall is to have the client and counselor talking with each other about the inter- view. The inquirer's task is to gently push both peOple to think about and share what they were eXper- iencing. He acts as a catalyst, shifting to the role of listener as the two learn to interact. Encourage the student inquirer to consult with you during the recall session. For example, he may see some- think which would be interesting to pursue, but not know how to use the information he has. Help him learn to identify and label what he is reSponding to as well as how to use his perceptions within the inquirer role. Instructions to the Inquirer: After one has stopped the tape and related what he was experiencing, have the other person talk about what he was feeling at that same point in the interview. Help them see where they understood and where they didn't understand the other person (did they know then that the other person felt as he did?). At any time, have them talk with each other about how they were feeling, what thoughts they had, etc. 147 SESSION 7 Stimulus Films Handout: Establishing Ownership of Feelings--Part I The triads will meet with a staff member for this 2 hour session. During this time, the Stock and Vicki stimulus films will be shown, followed by discussion. The purpose is to have the students focus directly on their own feelings as they are elicited in the simulated interpersonal situation. Instructions to the Students: You will be watching a number of 1-2 minute filmed sequences. Assume that the actor or actress is talking directly to you. This is not a client-- counselor interaction. Instructions to the Staff: Play the Stock and Vicki vignettes one at a time. Be as facilitative as you can, encouraging them to talk about and explore the feelings they were having. Have them recognize that their reactions to the film are unique to them and different from other members in the class. Remind them that there is no "right" or "wrong" way to respond. In addition to a general discussion, ask the students to consider the following: 1. What would you like to say to this person? 2. What might you have done to elicit this kind of response? 3. Did any pictures or images come to mind? 4. Did instances in your life come to mind as the actor spoke? 148 ESTABLISHING OWNERSHIP OF FEELINGS-~PART I Karen K. Rowe Sometimes our feelings seem to get in the way as we try to relate to others. During your first IPR recall session, for example, you may have found yourself thinking "if I only didn't get so nervous." Being nervous is a very typical reaction. For some reason, however, it seems easier to bulldoze over that feeling, pretending it isn't there, than to talk about it. Assume, for a moment, that you are a client coming in to talk to a counselor for the first time--a counselor who is anxious about being video-taped. As a client, what does the counselor's anxiety mean to you? Well, it may mean that you are somehow responsible for his anxiety, or that it's your fault that the interview is strained. You may leave feeling that you weren't understood and that some- how it's your fault ("if I could have only said it better," "I knew he wouldn't like me," etc.). This is an example of how the counselor's unlabeled or unacknowledged feelings may temporarily impede the help- ing relationship. Counselors are human and therefore are going to feel anxious at times. The important thing is how you, as counselor, choose to deal with the anxiety. If you are aware and assume responsibility for it as you own feel- ing, then the client doesn't have to take it on as his own. 149 In fact, if you choose to share it, much of the anxiety will probably dissipate. The theoretical assumption here is that by denying your feelings, you allow yourself to be controlled by them. In the case of the counselor's attempt to cover up his anxiety in the example above, additional discomfort is created. The resulting anxiety, then, comes from two sources--feelings about being videotaped and feelings about not wanting to share that fact. By choosing to own your feelings, you are choosing to have better control of them. 150 SESSION 8 Interview--Client Recall--Interview The following 3 hour task will include a 10 minute interview, a 40 minute client recall (counselor present), and a second 10 minute interview. The third student will serve as inquirer, while the staff will be available for feedback. Positions will be rotated so each student will have additional practice in each of the three roles: client, counselor and inquirer. The purpose of the inter- view-recall-interview format is to allow the client and counselor to immediately use the information they gained during the recall session. Instructions to the Client: For the next 10 minutes, talk about your reaction to what you've experienced so far in this training program. Instructions to the Counselor: Try to understand what kind of experience this training has been for the client. You might explore why some parts seemed more helpful than others, what things had the greatest impact, which were more difficult to grasp, etc. Instructions to the Inquirer: Focus on the thoughts and feelings the client was having during the interview. Help him focus his attention on his reactions to the counselor. Instructions to the Staff: Encourage the inquirer to "push" the client to be Specific about when he thought the counselor was hearing his feelings, as well as those times when he felt misunderstood. 151 SESSION 9 Interview--Mutual Recall--Interview Handout: Establishing Ownership of Feelings--Part II For the next three hours, the triads will meet in the video facility for mutual recall. Two students will begin with a 10 minute client-counselor interaction. Then, the third student will conduct a 30-40 minute mutual re- call, with a staff member as consultant. Following the inquiry the two students will meet again (not video taped) for about 10 minutes to continue the relationship, hopefully with added understanding. Instructions to the Client: For the next 10 minutes, eXplore your reasons for wanting to be a counselor to other peOple. Instructions to the Counselor: Feel free to pursue any areas that seem meaningful to the counselee. If possible, let him provide the direction, and you follow in an attempt to understand what's important to him. If he has trouble getting started, you might eXplore his motivating factors (significant people, situations, etc.), his need system, things about counseling which might cause difficulty, or perhaps his fears about entering this kind of job. Another alternative would be to talk with him about his difficulty coming up with something to talk about --is he anxious in the interview situation, has he not thought about this question before, does he mistrust you in some important way? Instructions to the Ingpirer: As you do the mutual recall, strongly encourage them to explore the feelings they had about each other during the interview. 152 Instructions to the Staff: Make sure the inquirer doesn't let the interviewees off the hook too soon. Encourage him to follow-through with his line of questioning. 153 ESTABLISHING OWNERSHIP OF FEELINGS--PART II Karen K. Rowe Part I dealt with feelings that had originated outside and were independent of the interview. Part II will deal with emotions aroused during the interview itself. There are times when our feelings can be powerful indicators of what is happening in the ongoing relationship with a client. For example: if you haven't already ex- perienced it, sometime in your growth as a counselor you will probably learn to be sensitive to changes in the in- tensity of the relationship. There will be times when you feel very close to a client, when you really understand what he's saying. There will be other times, perhaps within the same session, when you'll be aware of an emotional dis- tance between the two of you--as though you're missing each other. What does it mean if you are feeling "tuned in" emotionally to a client and then you feel a sudden pulling away? What you know for sure is that the intensity of involvement has dropped--trust that feeling! What you don't know is who (client or counselor) backed away. There are a number of different ways to deal with this situation. One obvious alternative would be to talk with the client and check out your perceptions with him. If he was aware of the shift, the two of you may choose to explore the reasons for its occurrence and the meaning it 154 has in the present relationship. If he did not perceive a change in the intensity of involvement, you may want to make a mental note, and try to understand what happened at a later time (after the session). Another possibility is to be as knowledgeable about how you respond in different situations as possible (do you generally back away from this kind of intensity? or when someone talks about what the client was talking about?). By knowing what situations usually elicit a particular feel- ing (an anxious pulling away, for example), you can use this information as a starting point to understand the dynamics operating between you and the client. Your thought process might be Similar to the following: We've pulled away from each other . . . the change occurred when we were talking about the client's marriage . . . in fact, he became sarcastic when I asked him to clarify his feelings of hurt . . . I don't usually pull back when talking about hurt . . . I do pull back when someone is angry with me . . . perhaps his sarcasm is his way of showing anger . . . he is angry at me. At this point, the counselor has some handles on what is happening and may decide to respond directly to the client's anger. While we have used "change in intensity of involve- Inent" as an example, this model of conceptualization is applicable to any feelings stirred up in the relationship. In order for the model to be operational, however, you need tn) be aware of your own reactions as they occur. This in- volves a lot of sorting and sifting as you begin to discover 155 the intricacies of your own feelings. You will find that when you back away it feels different from when a client backs away--now you have to learn to "hear" that difference in your gut. 156 SESSION 10 Stimulus Films The students will work in triads for this exercize involving use of the stimulus films. The total task time will be 2 hours. A staff member will be present to facili- tate the interaction. Instructions to the Students: 1. First Student--enter the video room and watch one vignette from the stimulus film. Listen to the segment, let yourself continue reacting for a couple minutes, then view the same segment again. 2. Second Student--talk with the first person about his reaction to the film (what feelings were aroused, what images came to mind, etc.). As he begins to label his feelings, "push him" to become specific and to identify their source. Your task is to understand his reaction to the film as deeply as you can. 3. Third Student--monitor the interaction. Check with the person who viewed the film to see if the second person really does understand how he felt. Instructions to the Staff: Each person should have at least one opportunity in each of the three positions. Continue rotating for the remainder of the available time, using different stimulus vignettes. It is appropriate for you to talk with the third student about the ongoing interaction. He may have 157 questions or you may have suggestions about how he could intervene in a helpful way. 1‘. Q“. Ln ‘\. .9. v A. 5“ o )r\ ~\\ 1% .4» I 1 4..\. 158 SESSION 11 Mutual Recall--Assertiveness Handout: Feelings Touched, Now What? This 3 hour session will focus on counselor assert— iveness. The students will work in triads with the help of a staff member. The format will include a 15 minute inter- view followed by a 40-45 minute mutual recall session. Each student will function in each of the 3 roles: client, counselor and inquirer. Instructions to the Client: Take a moment to think about which of your feelings you understand the least--it could be the one you have the most difficulty sharing with others, the most difficulty controlling, the most threaten- ing, the one you feel the most uncomfortable with, most concerned about, most puzzled by. Pick gne feeling which is difficult for you to eXplore. Instructions to the Counselor: One of the things you may have noticed is that the inquirer is often much more asser- tive in questioning and probing the counselor during the recall session, than the counselor is in trying to under- stand the client during the counseling interview. For the next 15 minutes a client will be talking with you about a feeling that is important to him. Your task as counselor is to try to be helpful in a more asser- tive, more active way than you have before. Instead of being passive, respond to your "hunches," test them out-- make the client help you understand where he is. 159 Instructions to the Inquirer: Although many things un- doubtedly occurred during the interview which would be fruitful to explore, the focus of this particular session is to be the impact of the counselor's assertive behavior. Concentrate on some of the following issues during the recall: 1. To the counselor-- A. How did it feel to be assertive? B. Were you able to try out some new kinds of aggres- sive behavior that you have shied away from in the past? C. Were there times when the assertiveness felt appro- priate and other times when it felt inappropriate? D. Did being more active during the interview seem awkward to you? E. Were you aware of feeling anxious at times? If so, can you identify what it was you were responding to? 2. To the client-- A. Speaking generally, was your counselor's assertive- ness helpful to you, or did it in some way interfere with your growth? B. Was his directness on target or did it seem to miss the boat? C. What kind of impact did the assertiveness have on you--can you Specifically label the feelings that were stirred up as he became more confronting? D. Even though the confrontations may have made you anxious or uncomfortable in some way, do you have a feel for whether they were helpful or not? 3. Mutual recall-- Have the client and counselor talk with each other about what the directness meant to each of them. If possible, have the client be specific about the times when the directness was helpful as opposed to those times when it seemed to impede his progress. Did the counselor feel differently about his assertiveness when the client felt it was constructive as opposed to when it seemed to get in the way? Instructions to the Staff: Rather than starting at the be- ginning, go directly to the point on the tape where the counselor was trying to be assertive. 160 Encourage them to be as genuine in giving feedback to each other as they can. The goal is that the counselor learn when it is appropriate and helpful to be assertive so he needs accurate data about his impact. 161 FEELINGS TOUCHED, NOW WHAT? Karen K. Rowe One question that counselors frequently ask after they've learned to respond directly to client feelings is: now that I can hear what a client is feeling, how do I help him come to some kind of resolution, what has to happen in order for him to continue to grow? Tapping into the feeling is a necessary, but often not a sufficient condition for change to take place. The next step is to help the client make sense out of them. He needs to struggle to understand what his feelings mean for him--to understand gny_he responds in a particular way. At this point, the counselor can draw on his theoretical back- ground to facilitate client growth. The following questions are offered as a context for you, as counselor, to begin thinking about what differ- ent feelings might mean to a client. How you use them is highly dependent on where the client is--they will not always be apprOpriate. Anxiety: What is your client anxious about . . . what situ- ations bother him the most . . . is this a new reaction or one he's had for quite a while . . . did some particular incident set this feeling off . . . can he remember having felt this way before . . . do any other feelings accompany 162 the anxiety . . . does he have any ideas about why he feels anxious . . . how does the anxiety get in his way now . . . what purpose does the anxiety serve . . . in what ways does it protect him . . . is the anxiety related to the counselor and the counseling situation, or is it related to the sub- ject matter, or both . . . is he scared of being scared (is he frightened by his anxiety) . . . if he let the feel- ing go, what does he imagine would happen . . . if he gave the anxiety a voice, what would it say . . . E429: In what situations does your client end up being hurt . . . does this happen with specific people . . . is it an angry or a sad hurt . . . when he's been hurt, how does he typically respond . . . how do others get the power to hurt him . . . how does he want others to respond when he's hurt . . . what does it mean to him when they don't respond in ways he would like them to . . . did he antici- pate being hurt before he entered the relationship . . . are there ways he contributed to "set up" being hurt . . . how does he let others know that he's been hurt . . . has he been hurt badly in the past . . . does one incident stick out in his mind as being particularly painful . . . if so, what were the consequences for him then . . . what needs does he have now that aren't being met . . . 163 What does the client feel guilty about . . . is it one particular thing that happened or a lot of things . . is he afraid somebody will find out . . . what does he think would happen if they did . . . how would he react . . . when he's felt guilty before, how has he handled it . . . who taught him to feel guilty in this kind of situation . . . does it seem that he gives others the power to make him feel guilty . . . what does it mean, in terms of how he sees him- self, when he feels guilty . . . when he responds with guilt, what would he really like to say or do . . . what conse- quences does he anticipate . . . is his guilt relevant today or is it carried over from an earlier period in his life . . Affection: What fears does the client have about being close to others . . . is the difficulty in giving affection, re- ceiving it, or both . . . how has he handled his need for affection in the past . . . and loneliness . . . how would he like people to Show their affection to him . . . have there been times in his life when he has really needed affection and understanding and didn't get it . . . in retrospect, can he see any reason why he didn't get it (was part of it Eneip inability to respond) . . . are there ways that he makes it difficult for others to respond warmly and affectionately to him . . . does the client see parts of him as being unlovable . . . if so, how did he learn that . . . 164 how does he let others know that he needs them to care . . . does he experience the ambivalence of being afraid of affec- tion and wanting it at the same time . . . 8999;: Does the client feel angry all the time, or just in specific situations . . . what do pe0ple do that makes him angry . . . how does he express his anger--physically, ver- bally or by holding it inside . . . what value judgment does he put on being angry . . . does the anger get displaced to relatively unimportant situations . . . who is he angry with . . . why . . . how does he deal with other people's anger . . . what have been the consequences of his anger in the past . . . how did his mother and father fight . . . what was his role in their conflicts . . . if he really got angry what does he imagine would happen . . . is he afraid his anger will have no impact at all . . . 165 SESSION 12 Lecture: How Clients Run from Counselors: Interpersonal Defenses The following is an outline of the lecture on inter- personal defenses. I. II. III. IV. Assumption: Through the socialization process, peOple learn to anticipate the way others will respond to them. Beginning at an early age, patterns of response are developed in an effort to c0pe with the inter- personal environment. A. In order to function with a relative degree of comfort, a certain psychological distance is main- tained. The distance serves as a protection against fears learned at an earlier time. B. According to Horney, the feelings that persist are those associated with being very small in a very big world. C. The paradox is that people need each other to live (for stimulation), yet are emotionally afraid of each other. D. As a result, people establish a psychological distance that is close enough for nurturance, yet distant enough to be safe. Premise: People maintain more distance than is neces- sary. The result is that they don't have the option to get close to others, even when they want to. Horney's basic interpersonal posture: The healthy person has various strategies available, depending on the situation. The neurotic is locked into one style. Ways to avoid intimate interpersonal contact: A. Withdrawal can be used, 1. to achieve distance by pulling away 2. as a passive way of striking back 3. to achieve conformity to a set of standards which remain unquestioned. 166 B. Attack can be used, 1. to achieve distance by pushing others away 2. as a way of withdrawal 3. as a way of maintaining unchallenged allegiance to a system. C. Conformity can be used, 1. to achieve distance by not getting involved 2. as a way of withdrawing 3. as a way of attacking (sociopath). The issue for counseling: What is the payoff of the behavioral pattern? As these styles or patterns emerge in the therapy relationship, the counselor needs to understand what these interpersonal defenses achieve for the client. 167 SESSION 13 Client Recall--Role-played Client Handout: Identification of Client Needs Each student will talk for 15 minutes with a "role- played" client. A second student will conduct a 30 minute client recall with the counselor present. A staff member will be available for consultation. The purpose of this 3 hour session is to have the counselor begin to integrate those things he's learned this far in the training program. Instructions to the Staff: The students should not know the "role" before their interview. ExPlain the following role to the "client" and answer any questions he may have: Client role--First, decide on a problem (expelled from school, your parents are getting a divorce, you can't get dates, etc.). The situation is this--you have some- think you want to talk about, but you are frightened about seeing a counselor. You are noticeably upset, but at the same time, are withdrawn and silent. The coun- selor will have to be supportive, yet gently assertive in order for you to "Open up." Instructions to the Counselor: For the next 15 minutes, a student will be talking with you about a concern. Be as helpful to him as you can. Instructions to the Inquirer: Help the client to discover the thoughts and feelings he was having during the inter- view. Also, try to get him to identify what he needed from the counselor and how he wanted the counselor to respond at various times during the session. Note to the student in- quirer: Remember, this is the client's first experience 168 with IPR recall. Therefore, it would be appropriate to ask very basic questions, letting the client "discover for himself." 169 IDENTIFICATION OF CLIENT NEEDS Karen K. Rowe I'm two different people looking for unity. Part of me is emotional and reactive and sensitive. Another part is a cognitive theoritician. Part of me seeks to experience those things which seem to lead me to the core of what I'm all about, and part seeks to understand my dynamics in a deeper, more introspective, wholistic way. My experience tells me that the more of these isolated parts that I can integrate, the freer I am to experience at a new, unknown level. I am both a cognitive and affective being. I get my sense of direction from theorizing about the ideal and my sense of meaning from ex- periencing the real. Consider the following conceptual framework as a basis for understanding client needs: There is a difference, often, between what a client says he needs and what he actually needs in order to grow. Sometimes the very things he asks of others are things which, ironically, perpetuate his misery. When a person is locked into an inflexible life style, he needs to ex- perience new, more adaptive ways of relating to his environ- ment. The counselor must learn to see his client's needs from a number of perspectives. Imagine looking through a tightly focused telescope at a client's particular need. As you watch, slowly turn the lense to include more of the picture. Although each part will become less distinct, you will begin to see how the many parts intertwine. Finally, a gestalt of the client's need system will appear and you 170 will see how each aspect fits into the client's way of relating to his world. It probably won't be helpful for the counselor to respond in ways that are consistent with and feed into the client's inadequately functioning system. What would be helpful, however, would be for the counselor to respond in facilitative ways that are incompatible to his client's self-defeating cycle. For example, it is not uncommon for a highly cogni- tive person to ask for help in understanding why he doesn't feel close to others. What he's asking for is cognitive input; what he needs is to be "touched" emotionally. Shifting to a theoretical base, the more out-of- balance the client is in terms of the relative strength of his affective and cognitive processes, the more immobilized he is going to be. Within this context, the imperative is on the counselor to interact in a way that contributes to a balance, rather than add weight and power to the already dominant Side. The decision the counselor must make, then, is to determine whether the client needs the cognitive tools which will enable him to understand his mixed-up feelings, or whether he needs to experience his feelings to give meaning to all his intellectual mechanisms. In either case, the counselor needs to hear both the cognitive and the affective--then he is free to choose which one is the most appropriate for him to respond to. 171 The idea of helping the client maintain a balance which gives him maximum flexibility and adaptability can be expanded to include many facets of the client's life style. For instance, if the client jumps quickly from sub- ject to subject during the interview, the counselor might have him try to keep himself focused on one area. In this case, he may set some limits to offer the client some structure in his otherwise inconsistent world. However, if the client is rigid and constricted, additional structure will only serve to box him in further. In this instance, the counselor may decide to relate in a flexible, creative manner, which will allow for more spontaneity. From a slightly different angle, if a male counselor knows that the client's father was punitive and demanding, it would be helpful for the client to experience a warm nurturant man. If his mother was manipulative and over- bearing, a female counselor might respond with warmth, yet be clear about her messages. The possibilities for using this general notion are limited only by the counselor's creativity. First, he needs to understand how the client "sets up" and maintains his behavior. This generally involves looking at the client's whole life style rather than at small segments or specific situations. Then the counselor can choose to respond in ways which are incompatible with his present system of adaptation. This provides the client with the opportunity 172 to either learn or relearn different ways of interacting with those around him. 173 SESSION 14 Conceptualization of Client Dynamics A. Video tape of counseling session Handout: Use of Fantasy This will be a 2 hour meeting. The triad will watch a video tape of a counseling session. The staff will conduct a group discussion, focusing on the client's dynamics. Instructions to the Staff: Stop the tape at any time to have the students share their hypotheses about the client's concern or the way the client relates to the counselor. The emphasis of this session is to be the conceptualization of client dynamics. Focus on: identification of client feelings the client's proximity to his feelings what are his interpersonal defenses --how do they work --what does he gain by using them --how do they keep him from growing in what ways do you suppose he would have the most difficulty relating to others in a dynamic way (not story-line), what is his problem how does he maintain his self-defeating behavior what does he want from the counselor what do you think is his greatest strength what has to happen for him to feel better 174 USE OF FANTASY Karen K. Rowe Use of fantasy in counseling can make the thera- peutic encounter a tremendously creative experience. By letting your imagination go with a client, you can often get a feel for what life is like for him. You can also begin to understand the needs he brings to the counseling relationship, as well as how he wants you to respond to those needs. Getting in touch with your fantasy life will be relatively easy for some, while others of you will exper- ience difficulty letting your imagination go. Learning how to tap into your own creativity, just like learning to respond to feelings, takes practice. After you see a client, take some time to be by yourself. Get a mental image of the client in your mind. In your fantasy, let him take your hand, while you follow. What does he want to Show you . . . where does he take you . . . what does he say . . . what people did he bring along . . . how does he relate to those who surround him (in an angry manner, passive, uninvolved, dependent, etc.)? The possibilities are unlimited--let him Show you the things that are important to him, whether they be painful or joyous. While you continue to do this outside the counseling interview, also try to be aware of mental images as they 175 occur when you're with the client. As you begin to trust your fantasies, you will sometimes find it appropriate to share them as they occur. One way of doing this is to tell. the client what you experienced and ask him if it has any meaning for him. Sometimes it will make sense to him and he will help you understand. At other times, he may not react immediately, but take your fantasy home with him to think about. In still other instances, he will not be able to relate to it at all, in which case, consider your fantasy a momentary diversion, and continue where you left off. Generally, the stronger the relationship, the more freedom the client will allow you to have and share your fantasies. The next step is to learn what your imaginative cues mean and how to use them to add another dimension to the intricate process of counseling. First, you may discover incongruencies between your fantasies about the client and the way he actually talks about himself. For example, a client may relate in ways that suggest he's tough and can handle anything. As you think about him, however, you might have a picture of a young boy, very much afraid of the world around him. Assuming that this picture fits for him, you now have some information about the parts of him that are hidden because of the tough exterior. You can then choose to respond in ways which communicate that you understand that side of him, too 0 176 You may also be able to use your imagination as an avenue for discovering what life was like when the client was young. As young and small and not having much control over his Situation, how did he learn to cope when times were rough. You may begin to see connections between young patterns of response to stress and the ways he c0pes today. Important, however, is whether they are still appropriate, or whether there are other more effective, more satisfying ways to deal with similar circumstances. Still another way to use fantasy in counseling is to teach the client to be aware of his own fantasies. For example, if your client is unhappy about the ways others respond to him, you might have him fantasize about how he would like his world to be. This might provide both of you with some clues about the needs he has that remain unfull- filled. In addition, this provides you with an opportunity to help him sort out, if necessary, those parts of his dream that involve unrealistic expectations of others. On the other hand, you may have your client imagine what "disasterous" consequences would occur if he took some of the risks he has been afraid to take. Have him "live out" his fantasy by following it to its logical conclusion. Even though this may be painful, he will find out that he can and will protect himself--that neither the fantasy nor his thoughts will destroy him. The counselor can then help him understand the parts of the fantasy that were difficult 177 for him--to help him discover where his fears are and why they are so frightening. 178 SESSION 15 Mutual Recall--Existential Relationship This session will take a total of 3 hours. The students will work in groups of 3 with the help of a staff member. The format will include a 15 minute interview followed by a 30 minute mutual recall session. After the recall, the two students will continue the first interview for another 10 minutes. This second session, which will not be video taped, will provide an immediate opportunity to use the feedback given during the inquiry. Each student will have the chance to function in the role of inquirer. The staff member's task will be to help the inquirer open up new areas of exploration. The purpose of this session is twofold. First, the students will have a chance to act on their feelings as they occur in the ongoing relationship. Secondly, they will be able to test out new ways to maximize their impact in the inquirer role. Instructions to the Students: Two students go into the video room to "talk about how you feel about each other." Try to focus on sharing your own feelings about the other person--both past perceptions and immediate feelings. The purpose of this task is to focus as closely as possible on the ongoing feelings you have as you Sit and talk with the other person. Try to be as fully aware of the reciprocal impact of the relationship as possible. The third student will conduct the mutual recall session with the help of a staff member. Instructions to the staff: It is appropriate for the staff member to hold a “conference" with the student inquirer to help him define what he is responding to and get a feel for how he can use that information in a productive way during 179 the recall session. He Should, however, let the inquirer do the work. Instructions to the Inquirer: It might be helpful to focus on some of the following dynamics in order to help both individuals understand the interaction they have just ex- perienced. 1. 2. What things do you respond positively to in the other person? What kinds of fears do you have about a more intense involvement with this person? Do you have reservations about getting closer? Are you aware of any sexual feelings? Are you aware of anything that seemed to get in the way of your relationship? Are you aware of any defenses that you used to keep this person at a safe distance? Vflua seemed to control the course of the interview? How do you feel about the role (passive or aggressive) that you assumed? Are you aware of the impact that this role had on the other person? Does this person remind you of anyone you've known before? If possible, can you be Specific about the kinds of similiarities you are responding to? Which of your parents is this person most like? Are the likenesses things you respond positively or nega- tively to? 180 SESSION 16 Stimulus Films For the next 3 hours, the students will be working with the "Kids" stimulus film. The purpose is twofold. The first is to concentrate on getting a picture of the speaker's interpersonal style. The second is to arrive at some plan for working with this person if he were your client. Instructions to the Staff: Push the students to integrate their knowledge--they have the information they need, if they can get to it. Encourage them to trust their own per- ceptions, their "gut" reactions, and their own understanding of how people grow. 181 SESSION 17 Lecture: IPR Counseling and Summary Overview This meeting was devoted to clarifying the mechanics of scheduling, use of video equipment, room assignments, etc., in preparation for the IPR counseling experience. 182 SESSION 18 IPR Counseling--Actua1 Client Each student will have 3 IPR Counseling sessions with an actual client. In addition, each student will be conducting 3 recall sessions for the other members of his triad. This will involve a total of 10 hours: 5 hours as a counselor and 5 hours as an inquirer. Although a staff member will be "on call" for consultation, he will not be in the room. lst day 30 minute interview 15 minute client recall (counselor absent) 45 minute counselor recall (client absent) 2nd day 30 minute interview 60 minute client recall (counselor present) 30 minute interview 3rd day 30 minute interview 30 minute mutual recall 30 minute interview Instructions for the First Dsy: First, the counselor will meet with his client for a 30 minute interview, which will be video taped. Then, another member of the counselor's triad will conduct a 15 minute client recall, with the counselor absent from the room. The purpose of this is to give the client a brief exposure to the IPR process under conditions of minimal threat. Before beginning the inquiry, the inquirer Should explain to the client what will happen during the recall session. After this, the client may leave for the day. 183 The counselor will then return to the room for a 45 minute counselor recall with the same inquirer. The purpose of this phase is to allow the counselor to gain as much insight as possible about how he related to his client. Note: it is not appropriate for the inquirer to share what happened during the 15 minute client recall. If the in- quirer is concerned about something that took place, he should consult with a staff member. Instructions for the Second Day: The session will begin with the counselor having a 30 minute video taped interview with the same client. Then an inquirer from the counselor's triad will conduct a one hour client recall. The counselor will be present, but should refrain from actively participating. He will be in the room with the client and inquirer to ob- tain as much understanding as he can about the way the client was thinking and feeling. The inquirer's job is to help the client discover for himself the many things he reacted to during the interview. Following the recall session, the client and coun- selor will have another 30 minute interview--taking up where they left off, but hopefully having a clearer picture of how they relate to each other. This second interview will not be video taped. 184 Instructions for the Third Dsy: This session will begin with a 30 minute video taped client-counselor interview. Then, another member of the counselor's triad will conduct a 30 minute mutual recall. The goal of this step is to have the client and counselor talking with one another about the interaction they just experienced. The inquirer should be ready to assume a less active role as this begins to happen. Following the recall, the client and counselor will have another 30 minute interview. Since this will probably be the last time the counselor will see this student, it would be appropriate to spend part of the time working toward some kind of closure. APPENDIX B LETTER OF EXPLANATION TO INTERVIEWEES Dear You indicated an interest in participating in a project involving the training of counselors. Within the past couple of days, you were contacted about your schedule of free time. Here are your appointment times, as well as a brief description of what to expect. You will be working with graduate students who have recently received intensive training in interview Skills and use of a video feedback technique called IPR (Inter- personal Process Recall). You may be wondering what is apprOpriate for you to talk about. Well, anything that is important to you is fair game. You may have something in particular you are concerned about, or you may want to talk about what it means for you to shift from a high school environment to a large university campus. Whatever you choose to talk about, you will have an Opportunity to sit down and talk with someone on a one-to-one basis--a rare experience on a campus this size! You will be talking with the same person for all 3 interviews. You will be meeting on the second floor of the Student Services Building in either room 203 or 252A. Since many of you will be going through this same experi- ence, and since we are on a tight schedule, please make every effort to be there on time. Your meeting times are scheduled for the end Of this week and the early part of next week. These following times have been assigned to you: 22y 2323 Interviewer 529m 1. 2. 3. Hundreds of pe0ple have already had an experience similar to the one you are about to have-~and they have found it to be a tremendously exciting one. I sincerely expect that the same will be true for you. If you have any questions, please contact me at my office in the Counseling Center (355-8270). If I'm not in, leave a message and I will return your call. Karen K. Rowe 185 APPENDIX C FORM FOR SUMMARY INTERVIEW NOTES SUMMARY INTERVIEW NOTES Student Counselor Date Write a brief summary of your three interviews. Include: l. The client's concern 2. Contents of the interview 3. Description of the counselor-client relationship 4. Counselor's impressions and recommendations 186 APPENDIX D THE AFFECTIVE SENSITIVITY SCALE AFFECTIVE SENSITIVITY SCALE Instructions You will be viewing short scenes of actual counseling sessions. You are to identify what feelings the clients have toward themselves and toward the counselors they are working with. Although in any one scene a client may exhibit a variety of feelings, for the purpose of this instrument you are to concentrate on identifying his last feelings in the scene. On the following pages are multiple choice items consist- ing of three responses each. Most scenes have two items, but a few have one or three items. After you view each scene, you are to read the items and ask yourself the following question: If the client were to view this same scene, and if he were completely Open and honest with him- self, (i.e., if he could identify his real feelings) which of these three responses would he use to describe his feelings? After you decide which response accurately describes what the client is actually feeling whether about himself or the counselor he is with, indicate your choice on the answer sheet. Here is a sample item: CLIENT I Scene 1 Item 1 I. This exploring of my feelings is good. It makes me feel good. 2. I feel very sad and unhappy. 3. I'm groping and confused; I can't bring it all together. 187 188 After you had viewed Scene 1 for CLIENT I, you would read these three statements (Item 1) and would then decide which one best states what the client would say about his own feelings after viewing the same scene. For example, if you decide number two best states what the client is feel- ing, you would then find the number 1 on your answer sheet and darken in the space for number two. We will only make use of the first three answer spaces following each item on your answer sheet. Remember you are to concentrate on the latter art of each scene in determining the most accurate description of the client's feelings. After you view the apprOpriate scenes, you will have thirty seconds to answer each of the first twelve items. For each of the remaining items, you will be allowed twenty seconds. CAUTION: The item numbers on your answer sheet go across the page, not down the page as you would usually expect! AFFECTIVE SENSITIVITY SCALE REVISED FORM B CLIENT I Scene 1 Item 1 I. I feel sorry for my husband and the relation- ship we have. 2. I don't really understand what I feel. Yet, I do feel guilty about creating pain in others which returns to me. ' 3. I feel pleased at seeing a possible relation- ship between my feelings of anger and pain. Item 2 1. He (counselor) doesn't have to like me. I just want him to agree with me and tell me I'm right. 2. I'm trying to please you. Do you like me? 3. He's really understanding me now. 189 CLIENT I Scene 2 Item 3 I. I feel calm and collected. I just want to think for a while. 2. Yes, that is when I get angry. I see it all clearly now. 3. I feel anxious and stimulated. Item 4 I. I'll pretend I'm agreeing with him (counselor), but I don't see the connection at all. 2. I like what he's doing. I don't feel as uncomfortable now. 3. I wish he would stOp pushing me in this direction. CLIENT II Scene 1 Item 5 1. I'm pleased, happy; I feel good all over! 2. It was brought right back, that amazes me, but it hits quite bad too. It hurts! 3. I'm not bothered by this. I can handle it. I'm confident. Item 6 I. He's (counselor) caught me: careful, I'm not sure I want that. 2. I like him. He's trying to make the situation a little lighter and made me feel better about it. 3. I don't feel he understands. He's sarcastic. I don't like that. 190 CLIENT I I Scene 2 Item 7 I. I feel a little uneasy and self-conscious, but not much. 2. This scares me. I feel frightened! 3. I feel flirtatious. I like this! Item 8 l. I feel a little bit embarrassed, but that's all right as long as I can keep my composure. 2. I have a feeling of sadness. 3. I feel flustered and embarrassed. Item 9 I. He's asking for some touchy material, but that's all right. It's about time he knew. 2. He's being very frank and open! I'm not sure I want that. 3. I want him to leave me alone--I want out of here. I don't like this. CLIENT II Scene 3 Item 10 I. I'm getting so much attention. I really enjoy this. It makes me feel good. 2. I'm scared by what I'm feeling. I feel embarrassed and threatened. 3. I have the feeling that what I wanted was wrong, and I'm a little ashamed of myself. Item 11 I. This is good. We're really moving into my feelings. 2. He's too perceptive; he's looking right through me. 3. He's getting a little sticky; I'm not sure I like that. 191 CLIENT III Scene 1 Item 12 l. I feel protective and defensive of what peOple may think about my family. 2. All this seems so pointless! I'm puzzled and bored. 3. We're having a nice conversation. Some of these things really make me think. Item 13 1. This guy (counselor) embarrasses me with the questions he asks. 2. The questions he asks really make me think, I'm not sure I like that. 3. I can't follow this guy's line of thought. What's he trying to do? CLIENT IV Scene 1 Item 14 I. I'm concerned about my physical condition. I'm worried about it. 2. I want pity. I want her to think "Oh, you poor boy." 3. I feel good--nothing's bothering me, but I enjoy talking. Item 15 1. She's too young to be counseling, and she's a girl. I'm not sure I like this. 2. She likes me; I know she does. 3. I'd like her to think I'm great. 192 CLIENT IV Scene 2 Item 16 I. I'm a little annoyed with my family's ambitions for me. 2. That's a hell of a lot to ask! It makes me mad! 3. I feel sorry for myself, and I want others to feel the same. Item 17 I. She (counselor) really understands me! She's with me now. 2. I don't feel much either way towards the counselor; she's not important to me. 3. I wonder if She appreciates the pressure that's put on me? CLIENT IV Scene 3 Item 18 I. Tfiis whole thing just makes me feel sad and unhappy. 2. It kind of angers me that they don't appreci- ate me when I feel I did my best. I wish I could tell them off. 3. No matter how well I do, I'm always criti- cized. It doesn't bother me too much though, because I know that I did my best. Item 19 l. I can tell that she understands what I'm saying. She's really with me. 2. I wish I could get out of here; I don't like her. 3. Understand what I'm saying; I want her to know how I feel. 193 CLIENT IV Scene 4 Item 20 l. I really want to be successful, and somehow I know that I can be. 2. That makes me feel kind of sad, unhappy. I don't want to believe that it's true--I want to be good. 3. I don't know what I feel here. It's all very confusing. Item 21 , l. I feel neutral towards her here. I'm not paying any attention to her. 2. Please feel sorry for me and try to help me. I wish she would praise me. 3. I like talking to her. She can be trusted even to the point of telling her how I really feel about myself. CLIENT V Scene 1 Item 22 I. I feel rejected and empty inside. Am I unloveable? 2. I feel a little lonely. I want my boy friend to pay a little more attention to me. 3. I really don't feel much here; I'm just kind of talking to fill up space. Item 23 1. Please say it isn't fair, Mr. Counselor. 2. He really understands me. I can tell him anything. 3. I'm not sure I care what he says. It's kind of unimportant to me what he feels about me at this time. 194 CLIENT V Scene 2 Item 24 . I'm afraid of marriage--insecure; it might not work out, and I'd be lost. 2. I really can give him all the affection he needs, I feel I'm a worthwhile person to be desired. He wouldn't dare step out on me. 3. I'm really not too worried; it'd all work out in the end even if we have to go to a marriage counselor. Item 25 I. I don't care if he (counselor) can help me or not. I'm not sure I want his help. 2. He's so sympathetic. That makes me feel good. 3. Can you help me? CLIENT V Scene 3 Item 26 I. I feel I have some need to be liked, but it's not real strong. 2. I'm not loveable; I don't really like myself. 3. I'm a good person; I'm loveable. Down deep I know I am. Item 27 l. I feel dejected, kind of insecure. I want to be likeable! 2. My main concern is that it's hard for me to take criticism. I usually think of myself as perfect. 3. I feel a little sad about all this; I do kind of want people to like me. Item 28 I. He thinks well of me; I know he does, I can tell. 2. I want the counselor to really like me, but I'm not sure he does. 3. I like it when he asks questions like that. They make me really think about deeper things. 195 CLIENT V Scene 4 Item 29 I. I wouldn't want to be treated like he treats Mother, but I don't mind him (stepfather) too much. 2. I feel very little emotion about anything at this point. 3. I hate him (stepfather)! Item 30 I. Boy, I'm happy that he (counselor) agrees with me. He sympathizes with me. I feel completely accepted. 2. I'm embarrassed to tell the counselor how strong my feelings really are. 3. I'm not sure he'll be able to help me much after all. I'll just have to work this out by myself. CLIENT V Scene 5 Item 31 I. I'm kind of feeling sorry for myself, but I'm not really too worried. 2. I want to move out of the house as soon as possible. I feel I would be better off on my own. 3. My own parents don't want me; I feel cut off and hurt. Item 32 I. I don't feel he's (counselor) helpful at all, and if he can't help me and see my side, I'm not going to like him either. 2. He's got me in a spot, but I feel I can still get him to see me as a good girl who is persecuted. 3. I wish the counselor were my father. He's listening; he understands how I feel. 196 CLIENT VI Scene 1 Item 33 I. Disapprove! She'd kill me! 2. I feel jovial; this is real interesting. 3. I'm not sure how she would feel but the whole idea of her finding out excites me. Item 34 I. He (counselor) understands me completely. He certainly is relaxed and comfortable. 2. I really don't care what he feels about me. I just want someone to talk to--anyone will do. 3. I was wondering how he would feel about me and what I'm saying. CLIENT VI Scene 2 Item 35 l. I think my brother is O.K. We have fun together. 2. I don't know what I'm saying here. I'm a little mixed up and confused. 3. I'm saying something that's important to me. I like Doug. CLIENT VI Scene 3 Item 36 I. This is very confusing for me. I'm not sure I understand what is going on. 2. This is how I really feel, I'm kind of start- ing to be myself. 3. I'm just talking to be talking here; this really doesn't mean much to me. Item 37 I. I guess he's (counselor) all right, but I'm still not sure he understands me. 2. Let's get going. I'm impatient! I want to move to more important matters. 3. I feel comfortable with him. He understands me. 197 CLIENT VI Scene 4 Item 38 I. I Iove my brother, but not romantically. We just have a good brother-sister relationship. 2. I don't know about feeling this way about Doug; it feels so good, but it concerns me too. 3. I feel better about my relationship with Doug now. It helps to get it out in the Open. Now I feel it's all right. CLIENT VI Scene 5 Item 39 I. I'm not feeling much of anything here. I'm just kind of talking to be talking. 2. I'm mad at everyone at this point and don't know which way to turn; I guess I'm mad at myself too. 3. Now I'm talking about things that are real. I'm not on stage anymore. She is a louse! Item 40 I. He (counselor) feels She's a bad person too. I can tell; he agrees with me. 2. Don't you agree with me? I want to know what you think. 3. He thinks this all sounds petty. He doesn't understand. 198 CLIENT VII Scene 1 Item 41 I. I felt angry with my mother, but this made me feel guilty. I needed to make an excuse for her. 2. I'm really not angry with mother. It's not her fault. 3. I'm in a very passive mood. I'm just relaxing and talking about things that interest me. Item 42 _ I. This counselor is all right. I feel I can confide in him. 2. I feel uncomfortable. I'm not sure what this counselor wants me to do. 3. I feel he wants me to talk about myself, but I don't care. I'm going to talk about what I want to talk about. CLIENT VII Scene 2 Item 43 I. I'm very sensitive; I'm very easily hurt. 2. I'm somewhat sensitive and easily hurt, but not deeply so. 3. I'm not sensitive or easily hurt at all. I just like to make peOple think I am. Item 44 I. That makes me mad, I can do it--I know I can, but things just keep getting in my way. 2. It's really all his fault, if he just wouldn't have been such a joker. 3. This makes me feel guilty; I need to blame someone else instead of blaming myself. Item 45 I. I'm neutral towards the counselor. I don't care what he feels about me. 2. I'm afraid he doesn't like me and what I'm saying about myself. I don't want to be harsh with me. 3. He's easy to talk to. He understands what I'm like, and he still likes me. I can confide in him. 199 CLIENT VIII Scene 1 Item 46 I. Say, this is all right. I like this. 2. I'm not feeling anything deeply. I know what I need! 3. It's embarrassing and difficult. I feel a little annoyed. Item 47 I. I feel I can rely on this guy, so I'll let him talk and I'll just answer his questions. 2. I wonder what you think about this--please respond. Give me some help! 3. The counselor is a good guy. I like his questions; they make it easier for me. CLIENT VIII Scene 2 Item 48 I. I feel very unhappy about what I may eventually have to do. 2. I don't know what I feel; I'm confused about what I feel. 3. I'm damned uncomfortable; it's so confusing. I feel kind of 'blah' about it all. Item 49 . He's (counselor) missing the point. He bugs me. 2. I can't really tell about this guy. I don't know how I feel about him. 3. He seems like a good buy. He asks nice questions. I like him. CLIENT IX Scene 1 Item 50 I. I'm not sure how I feel about this counselor. I don't feel one way or the other about him. 2. I like the counselor very much--he makes me feel good. 3. He understands me pretty well and is trying to help. I guess I kind of like him. 200 CLIENT IX Scene 2 Item 51 I. Goody, goody peOple don't really know any better, so I can't be too disgusted with them, but it does make me angry. 2. I don't really mind people feeling superior to me. It just makes me a little angry. 3. It tears me up inside when peOple think they're better than I am. I want people to be the same as me. Item 52 I. I'm every bit as good as they are. I really feel I am. I know I am. 2. I kind of wished they liked me, but I can live without being a member of their group. 3. Those smart kids make me feel stupid. Item 53 l. I feel sorry for them; they just don't realize what they're doing to peOple like me. 2. I feel I'm not as good as they are, and it really hurts when people act that way. 3. It makes me a little angry. I'm every bit as good as they are. CLIENT IX Scene 3 Item 54 l. I feel a little insignificant, and this makes me a little unhappy. 2. I'm a nobody. I'm always left out. 3. I'm unhappy with school. That's what is really bothering me. Item 55 I. He (counselor) doesn't quite understand, but I don't care. It doesn't matter. 2. I don't feel one way or the other towards this counselor, we're just having a nice talk. 3. He (counselor) is really listening to me, and I feel he understands what I'm feeling. 201 CLIENT X Scene 1 Item 56 I. I'm feeling scared, concerned. Is this for me? 2. I just feel uncertain about what to talk about. If I once get started, I'll be all right. 3. I feel very deeply depressed. Item 57 1. He (counselor) seems to be listening--can he understand how I feel? 2. He's really with me. I can tell he understands me. 3. He doesn't keep things moving enough. I don't like that. CLIENT X Scene 2 Item 58 1. I'd like to think I could make it, but I'm not sure. I feel inadequate. 2. I just have an I-don't-care feeling; that's my real attitude towards all of this. 3. I'm confused here. I really don't have any definite feelings. Item 59 1. I want to impress the counselor. I want him to believe I can do it. 2. He believes me; he thinks I can do it; I can tell. 3. I really don't care what the counselor thinks. It's not important to me. 202 CLIENT X Scene 3 Item 60 I. What's the use of looking ahead? I'm scared to think about it. 2. I can accept my situation. Really, things aren't so bad. Things may bother me a little, but really not much. 3. I enjoy just living for today. Item 61 . I. He's (counselor) all right. He really under- stands me. 2. Nobody can really understand this. I don't think he will be any different. 3. I don't care what he thinks or feels; he's not important to me anyway. CLIENT X Scene 4 Item 62 I. I feel somewhat unhappy. I don't like to feel this way. 2. There's something about me; I just don't fit in, and that makes me feel real inadequate. 3. In some instances, I'm unsure of myself. I'm afraid I'll do the wrong thing, but I can handle this just by avoiding these situations. 203 CLIENT XI Scene 1 Item 63 . I m unhappy about all this, but I'm afraid to make a change. 2. It's not that I don't like school, it's just that I want to do the things I like most. 3. I'm not the student type. School bores me, but it embarrasses me when I say it. Item 64 I. The counselor is a nice buy. I like him, and I think he likes me. 2. I wonder what the counselor thinks of me. He'll probably think less of me for saying this. 3. I don't care what he thinks Of me. It doesn't really matter to me. CLIENT XI Scene 2 Item 65 l. I ve found some new dimensions. I like to feel that I can have some excitement, but this kind Of scares me too. 2. This doesn't really mean much. I'm not feeling much of anything. 3. This makes me feel very guilty; I'm very ashamed. Item 66 . I suppose he'll (counselor) tell me that's wrong, too. I'm not sure he understands me very well. 2. He's O.K.; he's listening to what I have to say. He really understands me and my feelings. 3. I don't care what he thinks or feels; it's not important. I don't have any feelings towards the counselor. APPENDIX E THE EMPATHIC UNDERSTANDING IN INTERPERSONAL PROCESSES SCALE Scale 1 Empathic Understanding in Interpersonal Processes, II A Scale for Measurement1 Robert R. Carkhuff Level 1 The verbal and behavioral expressions of the first person either do not attend to or detract significantly from the verbal and behavioraI expressions of the second person(s) in that they communicate significantly less of the second person's feelings than the second person has communicated himself. Examples: The first person communicates no awareness of even the most obvious, expressed surface feel- ings of the second person. The first person may be bored or disinterested or Simply Oper- ating from a preconceived frame of reference which totally excludes that of the other person(s). In summary, the first person does everything but express that he is listening, understanding or being sensitive to even the feelings of the other person in such a way as to detract significantly from the communications of the second person. 1The present scale "Empathic understanding in interpersonal processes" has been derived in part from "A Scale for the measurement of accurate empathy" by C. B. Truax which has been validated in extensive process and outcome research on counseling and psychotherapy (sum- marized in Truax and Carkhuff, 1967) and in part from an earlier version which has been validated in extensive pro- cess and outcome research on counseling and psychotherapy (summarized in Carkhuff & Berenson, 1967). In addition, Similar measures of similar constructs have received ex- tensive support in the literature of counseling and therapy and education. The present scale was written to reduce 204 205 Level 2 WEiIe the first person responds to the expressed feelings of the second person(s), he does so in such a way that he subtracts noticeable affect from the communications of the second person. Examples: The first person may communicate some awareness of obvious surface feelings of the second person but his communications drain Off a level of the affect and distort the level of meaning. The first person may communicate his own ideas of what may be going on but these are not congruent with the eXpressions of the second person. In summary, the first person tends to respond to other than what the second person is expressing or indicating. Level 3 The expressions of the first person in response to the expressed feelings of the second person(s) are essentially interchangeable with those of the second person in that they express essentially the same affect and meaning. Example: The first person responds with accurate under- standing of the surface feelings of the second person but may not respond to or may misinter- pret the deeper feelings. In summary, the first person is responding so as to neither subtract from nor add to the expressions of the second per- son; but he does not respond accurately to how that person, really feels beneath the surface feelings. Level 3 consti- tutes the minimal level Of facilitative interpersonal functioning. Level 4 The responses of the first person add noticeably to the expressions of the second person(s) in such a way as to express feelings a level deeper than the second person was able to express himself. the ambiguity and increase the reliability of the scale. In the process many important delineations and additions have been made, including in particular the change to a systematic focus upon the additive, subtractive or inter- changeable aspects of the levels of communication of understanding. For comparative purposes, Level 1 of the present scale is approximately equal to Stage 1 of the Truax scale. The remaining levels are approximately correspondent: Level 2 and Stages 2 and 3 of the earlier version; Level 3 and Stages 4 and 5; Level 4 and Stages 6 and 7; Level 5 and Stages 8 and 9. The levels of the present scale are approximately equal to the levels of the earlier version of this scale. 206 Example: The facilitator communicates his understanding of the expressions of the second person at a level deeper than they were expressed, and thus enables the second person to experience and/or express feelings which he was unable to express previously. In summary, the facilitator's responses add deeper feeling and meaning to the expressions of the second person. Level 5 THe first person's responses add Significantly to the feeling and meaning of the expressions of the second person(s) in such a way as to (l) accurately express feel- ing levels below what the person himself was able to ex- press or (2) in the event of ongoing deep self-exploration on the second person's part to be fully with him in his deepest moments. Examples: The facilitator responds with accuracy to all of the person's deeper as well as surface feel- ings. He is "together" with the second person or "tuned in" on his wavelength. The facili- tator and the other person might proceed to- gether to explore previously unexplored areas of human existence. In summary, the facilitator is responding with a full awareness of who the other person is and a comprehensive and accurate empathic understanding of his most deep feel- ings. APPENDIX F EVALUATION FORM EVALUATION FORM 1. Rank these sessions in the order that they were help- ful to you. A. Lecture: Elements of Effective Communication and Introduction to Interpersonal Process Recall (IPR). Audio Tapes --Identification of client feelings --Responding to client feelings Counselor Recall--recall conducted by a staff member Client Recall--recall conducted by a staff member Inquirer Training --Kagan video tape Mutual Recall--recall conducted by student Stimulus Films (Stock & Vicki) Interview--Client Recall--Interview Interview--Mutual Recall--Interview Stimulus Films (Stock & Vicki) Mutual Recall--Assertiveness Lecture: How Clients Run from Counselors: Interpersonal Defenses Client Recall--Role-played client Conceptualization of Client Dynamics --video tape of counseling session 207 2. 208 Mutual Recall--Existential Relationship Stimulus Films (Kids) Lecture: IPR Counseling and Summary Overview IPR Counseling--Actual Client Please Share your reactions to each of the above sessions (refer to them by letter). What is your reaction to the following handouts: A. B. Establishing Ownership of Feelings--Part I Establishing Ownership Of Feelings--Part II Feelings Touched, Now What? Identification Of Client Needs Use of Fantasy 209 Did you see each step as important to later steps, or did some seem irrelevant to you (please be specific)? What was the one most important thing you learned throughout this training program? What one change would you make? General feedback: nICHIGnN STATE UNIV. LIBRARIES 1|HIWIW\IIHIIWMWININllll‘llli"UlllllHlllHl 31293100295686