3198:: km We Deg?” 01: pk. D. WCMGAN STATE UREVERSKTY Karen S. Kamerschen 396%? IIBRARYL‘ lfllllflllflilfllfllfllwllljlllfljflmfllflwlflfllfl \ _ , - metylj THESIS This is to certify that the thesis entitled MULTIPLE THERAPY: VARIABLES RELATING TO CO—THERAPIST SATISFACTION presented by Karen S. Kamerschen has been accepted towards fulfillment of the requirements for 21M KW Major professor Um 72mm m Nag/9 47 , 0-169 n...” --,. . - . d'N—.'Mv n-v-wocy- -F7.- 4 , ’g-ofiwfl “u—FOI’L—C 300 A012 ABSTRACT MULTIPLE THERAPY: VARIABLES RELATING To CO-THERAPIST SATISFACTION By Karen S. Kamerschen The purpose of the research was to explore and elucidate the relationship between male-female therapist pairs who were simultaneously doing psychotherapy with an individual or couple. Satisfaction was defined as the central variable in the multiple therapy relationship and was related to the variables of Selection of Co-therapist, Self-Disclosure, Flexibility, and Attitudes toward the Opposite Sex. The subjects were nine females and eighteen males who composed twenty-three non-independent current multiple therapist pairs. All therapists were on the staff of the Michigan State Uni- versity Counseling Center and the therapist pairs were comparable with respect to age and experience level. The variance in multiple- therapy experience did not appear extensive enough to warrant concern. Karen S. Kamerschen Two instruments were devised to measure satisfaction. In one measure, a D-score was derived by comparing each therapist' s Interpersonal Check List (ICL) scores for his/her ideal co-therapist with those he ascribed to his/her actual co -therapist(s). The second satisfaction measure, the Co-therapist Inventory (CI), was the researcher' s modification of van der Veen' s Family Concept Q-Sort. The Selection of Co-therapist (SC) variable was investigated with a series of four open-ended questions constructed by the researcher and inquiring about the selection process. Scoring was based on the Personal/Impersonal quality of the responses. The Self-Disclosure variable was measured by Jourard' s Self-Disclosure Questionnaire (JSDQ). The measure for Flexibility was derived from ICL data and in the context of this study. The variable of Attitudes toward the Opposite Sex (AOS) was explored with an open— ended questionnaire conceived of by the researcher. Each therapist completed an ICL for self, ideal co -therapist, and actual co-therapist(s). He also answered the CI, SC, and JSDQ with reference to each of his co -therapists. In addition, he responded to the A08 questionnaire. The findings of the research can be summarized as follows: 1. The ICL and CI satisfaction measures were positively and significantly correlated with each other for both the II. III. IV. Karen S. Kamerschen individual co—therapist' 3 evaluation of his multiple therapy satisfaction and for the multiple therapist pair' 3 combined evaluation (individual: rS = .42, p? .01; pairs: rS = .46, p/< .05). Co—therapist pairs where the selection and acknowledgment of selection were Personally felt regardless of the verbal communication dimension were more satisfied with their relationship than those pairs where selection and/ or acknowledgment were not Personally felt. This finding did not reach significance for the ICL (p > .05) but did reach significance for the CI (p/< .025). Co-therapist pairs in which selection and acknowledgment were felt and communicated/received on a Personal basis were more satisfied than pairs where the selectee had felt and heard an Impersonal message regardless of the selector' 5 reported feelings or behavior. The relationship did not reach significance (p > . 05) for the ICL but was significant for the CI (p/< .01). The amount of a therapist' s Self-Disclosure was positively correlated with the degree of satisfaction he felt with his co—therapist. This finding failed to reach significance for the ICL (rS = . 15, p > .05) but did reach significance for the CI (rs = .46, p’< .005). Karen S. Kamerschen V. Pair Flexibility, as measured in this study, was not found to be significantly related either to the ICL (p > .05) or CI (p > .05) measures of multiple therapist pair satisfaction. VI. Congruency of self-co-therapist Flexibility perceptions, as measured in this study, was not found to be significantly related to either the ICL (p > .05) or CI (p > .05) measures of multiple therapist pair satisfaction. VII. As measured in this study, a co-therapist' s Attitudes toward the Opposite Sex were not found to be significantly related to either the ICL (p > .05) or CI (p > .05) measures of pair satisfaction. It was concluded that the Co-therapist Inventory is a more direct and sensitive measure of the relationship existing between the multiple therapists than is the ICL. It was also concluded that Self- Disclosure and the Personal/Impersonal dimension of co-therapist selection are variables relevant to a therapist' s satisfaction with the co—therapy relationship. Continued exploration of the relation- ship between the multiple therapists presents a fruitful avenue for future research. MULTIPLE THERAPY: VARIABLES RELATING TO CO-THERAPIST SATISFACTION By ( Karen S? Kame rs chen A THESIS Submitted to Michigan State University in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY Department of Psychology 1969 642//657 3~/2/~7o To Bill, for being, with me and with others ii PREFACE The investigation reported in the following dissertation was planned as part of a joint research project with Christie Randolph. Measures not elaborated upon in the dissertation will be discussed in the second portion of the project. iii ACKNOWLEDGMENTS To Bill Kell, Chairman of my dissertation committee, for his immeasurable contributions to my growth as a person and a therapist, I offer my most sincere caring and respect. To C. L. Winder, Chairman of my guidance committee and National Institute of Mental Health Fellowship sponsor, for his encouragement and guidance of my professional growth, I extend my warmest appreciation. To William Mueller, for his caring support as a person, supervisor, and researcher, I offer my fond admiration and grati- tude. To John Powell, for his warmth and concern, I express my sincerest thanks. To the therapists, for their considerable contribution, I present my warmest regards. To Patricia Hays and Thelma Ellis, for their assistance in typing the dissertation, and to Jill Brunett, for her skills as a keypunch operator, I extend my sincere appreciation. iv To Christie Randolph, my closest friend and co-researcher, for her unlimited emotional and academic support and encourage- ment, I offer my deepest caring. The research for this study was in part supported by a Predoctoral Fellowship from the National Institute of Mental Health, United States Public Health Services. Sincere thanks are due them for the freedom that permitted the investigator to more fully invest herself in this research. TABLE OF CONTENTS Page INTRODUCTION . . . . . . . . . . . . . . . . . . . . . 1 History of Multiple Therapy. . . . . . . . . . . . . . 2 The Multiple Therapy Relationship . . . . . . . . . . . 6 Variables . . . . . . . . . . . . . . . . . . 13 Satisfa ction . . . . . . . . . . . . . . . . 1 3 Selection of Co- -therapist . . . . . . . . . . . . . 16 Self- Disclosure . . . . . . . . . . . . . . . . . 17 Flexibility . . . . . . . . . . . . 18 Attitudes toward the Opposite Sex . . . . . . . . . 19 HYPOTHESES . . . . . . . . . . . . . . . . . . . . . . 22 METHOD . . . . . . . . . . . . . . . . . . . . . . . . 25 Subjects . . . . . . . . . . . . . . . . . 25 Description of the Instruments . . . . . . . . . . . . . 27 Interpersonal Check List . . . . . . . . . .. . . . 27 Co- -therapist Inventory . . . . . . . . . . 28 Selection of Co- -therapist Questionnaire . . . . . . . 29 J ourard Self-Disclosure Questionnaire . . . . . . . 29 Attitudes toward the Opposite Sex . . . . . . . . . 32 Procedure . . . . . . . . . . . . . . . . . . . 32 Scoring of the Variables . . . . . . . . . . . . . . . 34 Satisfaction . . . . . . . . . . . . . . 34 Selection of the Co- -therapist . . . . . . . . . . . 34 Self- Disclosure . . . . . . . . . . . . . . . . . 36 Flexibility . . . . . . . . . . . . 36 Attitudes toward the Opposite Sex . . . . . . . . . 37 Procedures for Statistical Analysis of the Data . . . . . 38 Hypothesis 1 . . . . . . . . . . . . . . . . . . 39 Hypothesis 2 . . . . . . . . . . . . . . . . . . 40 Hypothesis 3 . . . . . . . . . . . . . . . . . . 40 Hypothesis 4 . . . . . . . . . . . . . . . . . . 43 vi RESULTS Relationship between Criteria of Satisfaction Hypothesis 1: Personal Selection of Co-therapist and Satisfaction . Hypothesis 2: Self— Disclosure and Satisfaction Hypothesis 3: Flexibility and Satisfaction . Hypothesis 4. Attitudes toward the Opposite Sex and Satisfaction . . . . . . . . DISCUSSION . Implications for Future Research SUMMARY . REFERENCES . APPENDICES Appendix A: Summary of Raw Data Scores Relevant to the Relationship between the Two Satisfaction Measures and to the Hypotheses . Appendix B: Measuring Instruments Interpersonal Check List . Selection of Co- -therapist Questionnaire Jourard Self—Disclosure Questionnaire Affection Scale . . Co- -therapist Inventory . Attitudes toward the Opposite Sex: Male and Female Forms Appendix C: Interpersonal Check List Circumplex . vii Page 44 44 45 46 47 49 51 61 64 68 73 73 77 78 80 82 84 87 88 90 LIST OF TABLE S Table . Page 1. Spearman Rank Correlation Coefficient between Interpersonal Check List and Co-therapist Inventory Therapist Satisfaction Measures . . . . . . . . . . . . 44 2. Mann~Whitney U Test Relating Personal Selection of Co-therapist and Pair Satisfaction as Measured by the Interpersonal Check List and the Co-therapist Inventory . . . . . . . . . . . . 45 3. Spearman Rank Correlation Coefficient between Self-Disclosure and Individual Therapist Satisfaction as Measured by the Interpersonal Check List and the Co-therapist Inventory . . . . . . . . . . . . 46 4. Mann-Whitney U Test Relating Therapist Flexibility and Pair Satisfaction as Measured by the Interpersonal Check List and the Co-therapist Inventory . . . . . . . . . 48 5. Mann-Whitney U Test Relating Attitudes toward the Opposite Sex and Satisfaction as Measured by the Interpersonal Check List and the Co-therapist Inventory . . . . . . . . . 50 6. Mann-Whitney U Test Relating Personal- Impersonal Communication and Pair Satisfaction as Measured by the Interpersonal Check List and the Co-therapist Inventory . . . . . . . . . . . . 55 viii Table Raw Data Scores Relevant to the Relationship between the Interpersonal Check List and Co-therapist Inventory Measures of Satisfaction and Relevant to Hypothesis 2: Self-Disclosure Raw Data Summary Scores Relevant to Hypothesis 1: Selection of Co-therapist Raw Data Summary Scores Relevant to Hypothesis 3: Flexibility Raw Data Summary Scores Relevant to Hypothesis 4: Attitudes toward the Opposite Sex . . . . . . ix Page 73 74 75 76 INTRODUCTION Therapists have developed a variety of approaches in their continual efforts to alleviate psychological distress. One approach that has recently aroused considerable interest is multiple therapy. While this particular use of two therapists may prove very beneficial to the client, it may also prove to be very problematic for the therapists involved. Most psychotherapists learn to function inde- pendently within the therapy session but multiple therapy requires that the therapists collaborate and work interdependently. How do therapists attain this collaborative relationship? How do they select their co-therapists? What variables are relevant to a satisfying relationship? How are differences handled? How much of them- selves do they share with their partners? The author believes that the issues touched upon by the foregoing questions are important ones and has designed the present study as an initial approach to some of those areas. This research does not propose to investigate the effectiveness of multiple therapy nor does it attempt to explore the complex interactions between client and therapists. Rather it aims at exploring and elucidating the relationship between male-female therapist pairs who are simultaneously doing psychotherapy with an individual or couple. History of Multiple Therapy Dreikurs (1950) reported that the simultaneous use of two counselors as a method of therapeutic intervention dates back to the early 1920' s when Adler and his colleagues at the Vienna Child Guidance Clinic employed the technique to overcome their clients' blocking and resistance. Their form of multiple therapy consisted of a frank discussion of the clients' problems in the presence of the client and was not designed as an active encounter directly with the client. In 1939, Reeve discussed the favorable results he obtained by altering the technique to include direct interaction between the client and therapists. He felt this "joint interview" method provided an increased understanding of the client, allowed the client greater opportunity to express his ambivalent feelings, and held training benefits for the less-experienced therapist. Without ignoring the therapeutic advantages for the group itself, Hadden (1947) empha- sized the training benefits resulting from having more than one therapist in group therapy sessions. Since his primary concern lay in the training aspect, his conception of multiple therapy involved a considerable difference in the experience level of the therapists. When Whitaker, Warkentin, and Johnson (1949) published their first article mentioning their three-year experimentation with multiple therapy, they cited their long-range objective as the development of concepts that would facilitate the teaching of psycho- therapy. They had, however, initiated their work with multiples in an attempt to provide therapists with a means of sharing the emotionally—laden treatment interviews. They began by having the second therapist function as a relatively inactive critical observer but soon realized that allowing him to participate more fully both increased his satisfaction and facilitated therapeutic progress. Nevertheless, their immediate objective was to develop the capacity of the therapist. This primarily referred to the personal and pro- fessional growth of equally experienced colleagues rather-than to the training of less-experienced therapists. This emphasis on professional enhancement appears to have been one of the important factors in bringing multiple therapy to the attention of the therapeutic community. Continuing their innovative use of multiple therapy, the Atlanta group published an article the following year (Whitaker, Warkentin, and Johnson, 1950) suggesting the addition of a second therapist successfully surmounted therapeutic impasses occurring in individual therapy. The co-therapist tried to enable both client and therapist to express their dammed feelings of frustration and inadequacy in the blocked relationship thereby helping them to proceed in therapy. Responding to somewhat different motivating factors, Dreikurs (1950) introduced multiple therapy into his practice to meet an emergency situation. He initially envisioned this joint interview as a means of facilitating the patient' 3 smooth transfer from therapist to therapist; but when the interview also proved to be an effective treatment technique, he decided to continue the procedure on a co-led consultative basis approximately every third session. As had others before him, Dreikurs also recognized the usefulness multiple therapy held for training purposes. In 1950, Haigh and Kell commended multiple therapy for its training potential, its therapy research possibilities and its psychotherapeutic effective- ness. Two years later, Dreikurs, Shulman, and Mosak published a two-part article enumerating the many advantages multiple therapy held for both the therapist (1952a) and the patient (1952b). Their articles also cautioned about the potential pitfalls the therapy team could encounter within the therapy/ consultative relationship. The following year, Dyrud and Rioch (1953), operating from Dreikurs' consultative mode of multiple therapy, re-emphasized the usefulness of multiples in overcoming a therapy impasse. They, too, focused upon the pitfalls and pleasures contained in the relationship between the therapists and specifically attended to the competitive-collaborative aspects as they affected therapeutic effectiveness. In their 1956 article, Whitaker, Malone, and Warkentin broadened their exploration of multiple therapy to include an extensive examination of the relationship between the multiple therapists them- selves. Prior to this time, those interested in multiple therapy had viewed it primarily from an outcome vantage point and had focused on the technique' 3 usefulness in training new therapists, advancing research horizons, promoting therapeutic gains for the client and providing professional growth for the therapist. The Atlanta group moved beyond this focus and began giving attention to the process aspects of multiple therapy, 1. e. , the interpersonal variables relevant to collaboration. They carefully defined their concept of multiple therapy, differentiated it from other types, and delineated some of the characteristics essential to a satisfying relationship between the multiple therapists. In summary, they provided a major impetus for a personal and totally involving form of multiple therapy. The Multiple Therapy Relationship Although the terms multiple therapy, co-therapy, role- divided therapy, three-cornered interview, joint-interview, cooperative psychotherapy, and dual leadership all refer to the use of more than one therapist in the individual, conjoint, or group treatment session, they are by no means synonymous. Each is a variation on a basic theme and each has its own distinguishing features. Whitaker et a1. define multiple therapy as . . the treatment of a single patient by two (or more) psycho- therapists who make up a therapeutic unit. . . . The patient is seen jointly by both therapists from the first contact through the termination of treatment. . . . During the treatment session, each therapist is free to function in his own way with- in the limits of the group relationship. This works only if the two therapists have equal capacity as therapists, and are comparatively mature. Where this is not the case, the function of the adequate therapist is altered critically by the patient and the student vectors in the other therapist. We prefer not to include such an unbalanced team within the definition of multiple therapy (Whitaker et a1. , 1956, pp. 210-211). They further advocate that the therapists resolve their personal or professional differences during the treatment interview with the patient. As an additional index of the totality of the relationship, they state that: "Intellectual participation on the part of either is not enough. It is the emotional substrate of the experience which appears to be crucial" (Whitaker et a1. , 1956, p. 212). Mullan and Sanguiliano support and amplify Whitaker' 3 definition by stating that "Multiple therapy is the simultaneous therapeutic approach by two or more separate and yet related therapists to a single patient, married couple, family or patient group" (Mullan and Sanguiliano, 1964, p. 164). More definitively they add The mere presence of two therapists with the patient, the couple or the group, however, does not of itself necessarily heighten the transactional level of the therapy. Similar to any therapeutic procedure if applied by rule with the therapists acting parts, it can become just another technique. A crucial distinction must be made. For our purposes multiple-therapy is the genuine meeting of the patient and therapists in which whatever is present in their thoughts and feelings relevant to the trilateral engagement becomes the common knowledge and experience of all. This is distinct from co-therapy, a more highly structured and formalized meeting. In a co-therapy team the therapists many times restrict their feelings and thoughts, assume prescribed roles and, thereby, behave in ways which are alien to themselves at the moment (Dreikurs et al., 1952a) (Mullan and Sanguiliano, 1964, p. 165). Mullan and Sanguiliano repeatedly emphasize the importance of the authentic, experiential, spontaneous, self-disclosing nature of the multiple relationship and cite affective honesty as an essential though initially difficult to achieve quality among patient and therapists alike. They believe that . . the patient benefits from the necessity of facing and responding not only to two distinct and unique persons but also to their mutuality as well (Mullan and Sanguiliano, 1964, p. 173). Mutuality thus does not refer to similarity of training or background. Rather the relationship becomes mutual as both therapists express their need to be together not only as a team but also as unique individuals with definite growth striv- ings. Within the therapeutic framework, therefore, each is free to respond in his own fashion. The individual experience of each is equally relevant and vital. In this way, whatever the differences, real or otherwise, which exist between the thera- pists, can be responded to and maintained without disruption to the therapeutic effectiveness (Mullan and Sanguiliano, 1964, pp. 174-175). As a further emphasis upon the importance of the relation- ship between the two therapists, Warkentin, Johnson, and Whitaker reported that ”. . . it became apparent that the intensity of the relationship between the patient and the therapy group could not exceed that existing between the therapists themselves" (Warkentin, Johnson, and Whitaker, 1951, p. 418). Since the patient' 3 defensive repertoire usually embodies an attempt to divide and conquer the therapists, a deeper bond between the two therapists becomes especially important in disrupting this aspect of the patient' 3 self- defeating behavior. Since this mutuality is not present in co—therapy, the patient could conceivably successfully seduce the therapists into splitting up through his offerings of praise, admiration, and undying gratitude. At that point, there would be a closer bond between therapist and patient than between the two therapists and many of the benefits of multiple therapy would disappear. Mullan and Sanguiliano define co-therapy as "the presence of two therapists in the treatment situation where interpersonally it is found that they play roles, and intrapsychically there is the absence of outspoken self-inquiry and self—evaluation. In short the co-therapists find it practical and rewarding to come together with the patient in a pre- conceived manner while one assists or learns from the other" (Mullan and Sanguiliano, 1964, p. 182). They distinguish this from multiple therapy where ". . . the orientation is toward the phenomenological process, and there are no external indications as to who each therapist is, or how he is to function. Rather, each participant becomes identified through the multilateral interaction which takes place and then only retrospectively" (Mullan and Sanguiliano, 1964, p. 183). The practitioners of co-therapy cling to status and role playing, use a fixed technique of intervention, and fail to fully encounter their own self-deceptions. They thus allow themselves a degree of isolation and detachment not found in the mutuality of the multiple therapy team. In co-therapy, the complex interrelationship of the two therapists is apt to be partly or entirely ignored whereas in multiple therapy, the intrapsychic dynamics of the therapists are continuously called upon to forcefully alter the quality of the interpersonal communication (Mullan and Sanguiliano, 1964). In there slightly different approach to a definition of multiple therapy, Kell and Burow state that 10 . it refers to the multiplicity of relationships which are possible. There are at least four dynamically distinct possible relationships when two therapists work with one client, and when a second client is involved,‘the number of relationships increases considerably. These relationships are, namely, (1) and (2) that between the client and each of the therapists separately, (3) that between the two therapists and (4) the client' 3 interaction with the relationship between the two therapists. . . . but we can add to it two more, which are each therapist' 5 interaction with the relationship between the client and the other therapist. . . . While the multiplicity of the relationships may lead to confusion and maladaptive ways of coping most of the problems of this kind can be resolved if the therapists are able to keep their relationship genuinely collaborative (Kell and Burow, in press, pp. 372-373). Many qualities must be present for a multiple relationship to be truly collaborative. The therapists need to be separate and autonomous individuals rather than being submerged in the person- ality of the partner. However, it is also essential that these two individuals are able to freely depend on and understand each other as well as at times be puzzled by or disagree with the other (Kell and Burow, in press). Learning to depend on a colleague is not typically part of the psychotherapy training program so allowing oneself and one's colleague to be dependent in the multiple therapy relationship is something new and perhaps anxiety provoking. The experience of responding dependently and appropriately in a spon- taneous therapeutic interaction is far different from cognitively recognizing the importance of dependence in the co-therapist' 3 relationship. The on-going trust and dependency that allows each 11 therapist the freedom to be spontaneous and open in his interaction is a vital part of the bond between the multiple therapists. As in every two person interaction, there are inevitably times when the two therapists will not agree. If the therapists are not threatened by the lack of agreement, it can be a valuable asset, e. g. , the per- ceptual differences of males and females. If, however, their security is such that they need total agreement, every difference in perception could become a point of conflict and potential disruptor of therapeutic progress. On the other hand, there are situations where differing perceptions are intense enough to arouse true con- flict. Should this occur, it should be immediately recognized and dealt with openly and honestly as soon as possible. Many conflicts can be readily resolved within the treatment hour with considerable benefit for the client, since he will learn that although conflicts and anger do arise, they can be expressed and fruitfully resolved. Thus far the comments and articles cited have made little reference to sex of the multiple therapists. While some authors apparently do not view this as an important variable (Dreikurs, 1950; Hadden, 1947; Reeve, 1939), others feel that it does make an appreciable difference in the conduct of therapy (Demarest and Teicher, 1954; Mintz, 1963, 1965; Mullan and Sanguiliano, 1964; Sonne and Lincoln, 1966; Rabin, 1967; Nunnelly, 1968; Kell and 12 Burow, in press). The present writer agrees with Kell and Burow in their feeling that the multiple therapists should usually be a man and a woman. It is this re-creation of the parental situation that contains the most potential for resolving problems in identification and heterosexual relationships and for allowing a fuller appreciation of both sexes, separately and in their relatedness. While special instances may suggest that two males or two females work together in a multiple, the predominant mode would be a heterosexual therapy team. The authors of the above three major definitions of multiple therapy substantially concur in citing authenticity, mutuality, relatedness, equality, spontaneity, affective involvement, autonomy and interdependency as essential to the multiple therapists' rela- tionship but they differ slightly in the particular qualities they emphasize. As multiple therapy progresses from the writings of Whitaker $221.: to those of Mullan and Sanguiliano and finally to those of Kell and Burow, the subtle nuances of the interpersonal relationship receive an increasing amount of exploration and atten- tion. The present author agrees with the emphasis Kell and Burow place on the multiplicity of relationships, the importance of each therapist' S separateness and autonomy, their willingness to be interdependent, their ability to collaborate either through similar 13 or dissimilar perceptions and understandings and the unique contributions each sex has to offer in the male-female therapy team. It is this interpretation of multiple therapy that stimulated many of the hypotheses proposed in the present study. Variables The preceding definitions highlight many qualities essential to the multiple therapy relationship. Since the writer believes that the collaboration between the two therapists is at the essence of multiple therapy, this research paper investigates several dimen- sions of the collaborative relationship. The specific variables investigated follow. Satisfaction Satisfaction is one of the basic needs motivating individuals, client and therapist alike, to initiate and develop relationships with others. Although a therapist typically receives much satisfaction from his relationship-oriented career choice, there are, neverthe- less, many burdens a therapist must bear in helping his client to improve interpersonal relationships. One means of both lightening that burden and augmenting the therapist' s satisfaction in the treat- ment hour is by sharing the experiences with a colleague. If this sharing is an expression of the therapists' mutuality and their 14 personal commitment to each other rather than one based on external factors, e. g. , convenience of time or location, greater satisfaction should emerge. Since the search for satisfaction appears to be a focal point for life itself, it seems appropriate that it be the central variable in this research as well. Leary (1956) suggests that the Interpersonal Check List (ICL) provides a measure of self-satisfaction by comparing the respondent' s self-perception with his perception of the ideal self. It seems logical that to extend this measure to a comparison of a therapist' s perception of h_is_ co-therapist with his perception of 1_ii_s ideal co-therapist would yield a measure of co-therapist satisfaction. This transformation seems to preserve the integrity of the instru- ment while permitting a reasonably direct measure of an individual' 8 satisfaction in a given relationship. Many authors (Linden, 1954; Solomon, Loeffler, and Frank, 1954; Sonne and Lincoln, 1966; Rabin, 1967) compare the multiple therapy relationship to a marital relationship and consider a suc- cessful marriage to be one that is satisfying to both partners. Although some researchers (Terman, 1938; Locke and Wallace, 1959) have developed marital adjustment questionnaires, their questions are too specific to the marital relationship for application to the multiple therapy interaction. However, there is one instrument, 15 the Family Concept Inventory (FCI) (Palonen, 1966), that approaches family relatedness in a way that lends itself to modification for a measure of multiple therapist satisfaction. The FCI is a variation of van der Veen' s Family Con- cept Q-Sort (1964). Van der Veen developed his Q-Sort to investigate family adjustment and compared the real and ideal family Q—Sorts to obtain a measure of an individual' 5 satisfaction with his family. In 1966, Hofman converted van der Veen' s instrument from a Q-Sort to a True—False questionnaire (FCT—F). Palonen (1966) again revised the response format by administering Hofman' s FCI-F with instructions to answer each statement by checking one of five cate- gories ranging from strongly agree to strongly disagree rather than using true-false responses. In an effort to obtain a measure of satis- faction in the multiple therapy relationship, the present research then modified Palonen' s FCI by omitting some items and revising the wording of others. This revision, referred to as the Co—therapist Inventory (CI), does retain the majority of the FCI statements ver- batim and also preserves the 5-category response set. If the CI correlates positively with the satisfaction measures obtained from the ICL real-ideal comparisons, the CI may provide a briefer, more direct measure of co-therapist satisfaction. 16 Selection of Co-therapist The process of deciding to initiate and/or enter a multiple therapy relationship partially establishes the tone of the subsequent interaction between the therapists. The desire to surmount an impasse frequently serves as a motivating factor for the joint endeavor; but if this is the entire reason, the multiple relationship lacks an important personal quality. The therapy might then more aptly be termed "co—therapy" where the emphasis is on product, e. g. , benefits for the client, rather than on process, e. g. , the dynamically evolving relationship for client and therapists alike. However, if the therapists' mutual desire to share the growth experiences in therapy is an important part of the decision for multiple therapy, the therapists' relationship becomes a more personal and satisfying one where both partners know that they are valued for themselves. Therapy relationships that specify the incoming therapist' s role, be it rescuer or nurturant parent, represent neither a true sharing nor a mutuality, for they poten— tially limit the new therapist' 3 freedom to respond spontaneously and reveal a distrust in his ability to respond appropriately. Communication is extremely important to effective and satisfying interpersonal relationships and this seems especially true of multiple therapy. Questions about how accurately therapist A 17 represents his reasons for asking therapist B to join the therapy and how clearly therapist B hears these reasons seem an important place to begin exploring the relatedness of the multiple therapists. Although many researchers have investigated the processes and components of mate selection (Winch, 1958, 1967; Kerchoff and Davis, 1962; Tharp, 1963; Udry, 1963; Goodman, 1964; Murstein, 1967; Trost, 1967a, 1967b), only one researcher (Treppa, 1969) has touched upon the co-therapist selection process for multiple therapy. His study explored the interaction of the co-therapists' underlying psychological need patterns but did not focus upon the therapists' conscious and/or communicated aspects of their partner selection. It seems important to know more about an area that, in part, initiates the multiple therapy relationship and this research attempts to answer some of those questions. Self-Disclosure One of the major qualities repeatedly associated with a satisfying relationship is openness. It serves as an index of trust and non-defensiveness and many authors include this quality in their definition of multiple therapy itself (Whitaker fl- , 195 6; Mullan and Sanguiliano, 1964; Kell and Burow, in press). Fitzgerald (1963) views the amount of information shared as an indication of the close- ness of the relationship and Jourard proposes that "a truly personal 18 relationship between two people involves disclosure of self one to the other in full and spontaneous honesty" (J ourard, 1964, p. 28). The questionnaire he devised to obtain information about the amount and content of self-disclosure to selected persons (mother, father, same-sex friend, opposite-sex friend or spouse) appears to be the only instrument cited in the literature that meets the needs of the present research. With modification of the specified recipient (target person), J ourard' 3 measure can conveniently explore the stated openness between the multiple therapy pairs in a way that directly involves the therapists themselves. Flexibility Psychotherapy is an interaction designed to enable change and as such it is or should be a continuously evolving process. The individual client and his needs vary from moment to moment and clients differ one from another. If a therapist is to be effective, it seems essential that he be able to move with his client as the client progresses toward psychological health. In multiple therapy, the collaborating therapists must be flexible in responding to each other as well as to the client. This flexibility necessarily includes an openness to change in themselves, for if they are not open to change, neither is their client likely to be (Kell and Mueller, 1966). Moreover, the distressed client is 19 often unable to respond appropriately to life' s complexities because he lacks the emotional and/ or behavioral repertoire to do so. The therapists, therefore, need access to a full range of human emotions and behaviors in order to fully understand and aid the troubled client. The Leary ICL represents a wide range of personality variables and LaForge and Suczek (1955) and Leary (1956) suggested that it could be used to provide a measure of flexibility. Although they did not specify the procedure for obtaining such a measure, they implied that it was the comprehensive range and intensity of the 16 ICL categories obtained from the ICL adjectives checked by the respondent that made the measure a possibility. Since the literature does not mention another interpersonal flexibility measure, the present researcher used the ICL to investigate flexibility. Attitudes toward the Opposite Sex Although males and females encounter many similar situa- tions in the process of growing up, they also undergo many dissimilar cultural and biological experiences. Whether these differences result in a competitive or a collaborative effort between co-therapists partially depends on the male and female therapist' s attitudes toward the opposite sex. If the competitive academic spirit of the graduate schools or stereotyped male-female images prevail, collaborative 20 efforts are hindered. If, however, males and females are both recognized as potentially competent and sexual persons capable of a full range of human emotions and reactions, then each has the freedom to be spontaneous and thereby make the unique contribu— tions each sex and each individual has to offer. If either competence or sexuality is emphasized to the relative exclusion of the other, a distorted image of the individual, male or female, emerges. Although competence is the more obvious area of competition, an overemphasis on sexuality or seductiveness may also arise from competitive motives. The basic antagonism and conflict of the multiple therapists' relationship may disguise themselves in a one-sided facade of sexuality. On the other hand, the avoidance of sexuality may suggest a fear of the area that also serves to distort the individual' 3 integrity. It seems important that the therapists be able to attend to their sexual feelings either toward their co-therapists or their clients without the fear of acting on them. If the therapists cannot separate their feelings and actions in such an important area, it seems unlikely that they can help their clients to do so. In summary, attitudes toward the opposite sex play an important role in the collaborative efforts of the multiple therapy team. Despite the importance of this area, no one has yet devised an instrument to measure male and female attitudes toward the 21 opposite sex. One researcher (Centers, 1963) reviewed the literature and, finding no existing measure of attitudes toward women, devised such a scale. He did not compose a corresponding scale toward men. The Edwards Personal Preference Schedule (EPPS) measures desire to be with the opposite sex and the masculinity-femininity scale of the Minnesota Multiphasic Personality Inventory (MMPI) reflects same-sex identification, but neither instrument taps cross-sex attitudes. This absence necessitated the construction of an instrument to explore those attitudes and the present research initiated an open-ended questionnaire in an attempt to meet these needs. HYPOTHE SES 1. It is hypothesized that multiple therapy teams where the selection and acknowledgment of selection are personally felt regardless of whether the message is verbally communicated or received are more satisfied than those therapy teams where either the selection and/ or the acknowledgment is not personally felt. a. It is hypothesized that multiple therapy pairs in which the selection and acknowledgment of selection are personally felt and verbally communicated and received are more satisfied than those pairs where the selection and acknowl— edgment are neither felt nor verbally communicated and received on a personal basis. 2. It is hypothesized that the amount of self-disclosure to one' s co-therapist is positively correlated with the degree of satis- faction felt with the co-therapist. 22 23 It is hypothesized that multiple therapists who are both high on flexibility are more satisfied with their relationship than multiple therapists who are both low on flexibility. a. It is hypothesized that multiple therapist pairs whose flexibility levels are alike are more satisfied with their relationship than multiple therapist pairs whose flexibility levels are discrepant. b. It is hypothesized that co—therapist pairs whose perceptions of their partner' 5 flexibility are congruent with the partner' 3 self-perception on flexibility are more satisfied than those pairs where the self-co-therapist flexibility perceptions are not congruent. c. It is hypothesized that in co-therapist pairs where the self-co-therapist perceptions of flexibility are not congruent, pairs in which only one therapist is "inaccurately" perceived are more satisfied than pairs in which both therapists are "inaccurately" perceived. It is hypothesized that co-therapist pairs in which both therapists have well-balanced attitudes toward the opposite—sex co-therapist are more satisfied with their relationship than co-therapis‘t pairs in which either or both therapists hold one-sided attitudes toward the opposite-sex co-therapist. 24 It is hypothesized that co-therapist pairs who hold similar one-sided attitudes toward their opposite-sex co-therapists are more satisfied with their relationship than co-therapist pairs who hold dissimilar one-sided attitudes toward their opposite-sex co-therapists. ME THOD Subjects The subjects were drawn from the staff of the Michigan State University Counseling Center. The 46 staff members doing therapy were first asked to respond to a questionnaire listing whether or not they were currently doing multiple therapy and if so, with whom. From this initial questionnaire, all male-female multiple therapy pairs working with individuals or couples were noted and a sample was composed that maximized the number of participating therapists. This was accomplished by first including all the staff members who were working with only one co-therapist. To keep-the request for staff time at a minimum, no therapist was paired with more than three co-therapists despite the fact that some females had seven different partners. Since there were more males than females available, the remaining therapist pairs were selected to include as many males as possible and to use each female in the sample as many times as possible (i. e. , maximum number of co- therapy relationships up to and including three pairs). 25 26 The resulting sample was examined for degree of familiarity in the co—therapy relationship. Since the pairings displayed a natural variation ranging from first multiple together to three years experience together, no pair manipulations were necessary. The resultant sample was composed of 27 therapists: 14 senior staff members, 12 first and second year interns, and one advanced practicum student who was to be an intern the following year. There were 18 males and 9 females and the total number of pairs in the sample was 23. Of those individuals asked to participate in the research, one female refused. The therapists' experience doing multiple therapy ranged from approximately 2 to 22+ individual multiple therapy cases, with a median of 9. Some had worked both with same and opposite-sex - co-therapists and some only with opposite-sex co-therapists. All therapists had done multiple therapy with individual clients while some had also worked with couples and/or groups. Senior staff members are full-time counselors, the majority of whom hold a PhD in Counseling or Clinical Psychology and had several years experience beyond the degree. Two staff members hold an MSW degree plus several years experience. The interns were advanced clinical or counseling psychology PhD graduate students who were 27 in the final stages of their graduate training and had between 1000-4000 hours of supervised psychotherapy experience. Description of the Instruments Intergrsonal Che ck List The Interpersonal Check List IV (ICL) is composed of 134 adjectives and adjective phrases, 128 of which are scored. The respondent is asked to indicate the items as true or false in accordance with his perception of himself or selected others (ideal co-therapist and actual co-therapist partners in this study). The 128 items are classified in groups of 8 under the 16 basic personality variables labeled A through P (see Appendix C). These variables are: A--Managerial, B--Narcissistic, C--Competitive, D--Sadistic, E--Aggressive, F--Rebe11ious, G--Distrustful, H--Self—effacing, I-—Masochistic, J--Docile, K--Dependent, L--Cooperative, M-- Over-conventional, N--Hypernormal, O--Responsible, and P-- Autocratic. The 16 clusters of 8 adjectives have been arranged in a circular profile according to their interpersonal score or meaning. Contiguous variables are similar in meaning while variables on opposing sides of the circleare logically opposite. The ICL is scorable in a number of ways ranging from global factor scores to scores for the 16 variables. Each of the adjectives is assigned an 28 intensity. value based on the amount of the trait represented and the variable scores are obtained by summing the adjective scores for each of the categories. Co-therapist Inventory The Co—therapist Inventory (CI) consists of 44 statements which can be applied to some aspect of the co—therapists' relation- ship. Of these 44 statements, 28 have been taken directly from van der Veen' s Family Concept Q-Sort*, 14 have been taken from the Q-Sort and modified to fit the co-therapy relationship, and 2 were written specifically for this inventory. Six of van der Veen' s scorable items were discarded because they did not seem to apply to the co—therapy relationship. The statements in the C1 are responded to by one of five possible categories of agreement: strongly agree, tend to agree, neither agree nor disagree, tend to disagree, and strongly disagree. A maximum score of 176 is earned by strongly agreeing with those statements which are indicative of an ideal co—therapy relationship and strongly disagreeing with those that are indicative of a poor co-therapy relationship. The author assumed that the ideal co- therapy relationshipwould parallel the ideal family relationship, *Permission for modification and use of FC Q-Sort granted by F. van der Veen, 7/16/69. 29 and in the cases where van der Veen' s statements were altered or new statements were added, the author assigned their scoring direction according to whether or not the statement seemed indica- tive of the ideal relationship. Selection of Co-therapist Questionnaire The Selection of Co-therapist Questionnaire (SC) is a series of 5 questions. designed to elicit the following information: what factors influenced the decision to employ multiple therapy, why a particular person was chosen as a co-therapist, what was com- municated to this person about why he was selected, why a given therapist felt he was selected as the co-therapist, and what his co- therapist told him about why he was chosen. If the subject initiated the multiple, he answered the first three questions; and if he was selected, he answered only the last two. Jourard Self-Disclosure Questionnaire There are 60 items on the Jourard Self-Disclosure Ques- tionnaire (JSDQ)*, and each item is classified into one of 6 ten-item groups, each group referring to a different kind of information about *Permission to employ the JSDQ granted by S. M. Jourard (7/15/69) and the American Psychological Association (Helen Orr, Managing Editor, 7/22/69). 30 the self. The six aspects of the self are: attitudes and opinions, tastes and interests, work, money, personality, and body. The standard instructions ask the respondent to indicate the extent to which he has made himself known to each of four target persons: mother, father, same-sex friend, opposite-sex friend or spouse. The extent of self-disclosure is measured on the rating scale which follows: 0: Have told the other person nothing about this aspect of me. 1: Have talked in general terms about this item. The other person has only a general idea about this aspect of me. 2: Have talked in full and complete detail about this item to the other person. He knows me fully in this respect, and could describe me accurately. X: Have lied or misrepresented myself to the other person so that he has a false picture of me. The self-disclosure score is determined by totaling the points for each item (X' s are counted as zeros). Jourard (1964) found that the amount of information disclosed to another person varied with the information category. On this basis, he designated "attitudes and opinions," "tastes and interests, " and "work" as the "high disclosure" cluster (i. e. , information in these categories was " "personality, " and "body" as more readily revealed) and "money, the "low disclosure" cluster (i. e. , information in these categories was less readily revealed). 31 Jourard (1964) reported, "We have been able to demonstrate that our questionnaires (of lengths that include 15, 25, 35, 45, and 60 items) have satisfactory reliability (odd-even coefficients for larger subtotals run in the 80' s and 90' s), and results until now show this method has some validity" (p. 17 6). Research findings reported since 1964 reveal conflicting evidence for the concurrent validity of the J SDQ. In their attempt to use the JSDQ as a measure of general "disclosingness" in an interaction-oriented w counseling course with 50 students, Hurley and Hurley (unpublished manuscript) found non-significant negative correlations between the JSDQ and three independent measures of self-disclosure derived from ratings by fellow small-group members and a non-significant positive correlation between the J SDQ and a measure of self— concealment similarly derived from the group mem- bers. Swensen, Shapiro, and Gilner (unpublished manuscript) administered the JSDQ to spouses in a form measuring both output and input and found the correlation between stated self-disclosure and accurate knowledge to be . 68 for the 30 wives and .72 for the 30 husbands. In a study using male college students, Vargas (unpub- lished manuscript) found a significant and positive correlation (r = . 44, p/< .001) between the students' JSDQ scores and their scores on self-disclosure as rated independently by seven raters. 32 Despite the conflicting research evidence, the J SDQ does seem to present the most meaningful way available of approaching self-disclosure in a dyadic relationship. In order to modify the J SDQ to apply to the multiple therapy relationship, the author specified only one target person, the respondent' s co-therapist. Attitudes toward the Opposite Sex The Attitudes toward the Opposite Sex Questionnaire (AOS) consists of three separate questions regarding the attributes one finds desirable in (1) a man/woman, (2) a co—therapist, and (3) a husband/wife. There are appropriate forms for men and women. Procedure Each of the 27 subjects in the sample was given a packet of coded materials containing the six instruments used to measure the variables under consideration and instructions on how to proceed. First the subjects were instructed to answer the ICL as it applied to their ideal opposite-sexed co—therapist and then as it applied to themselves. Next, they were asked to respond to the ICL with a designated co-therapist in mind. With reference to this same co— therapist, they were asked to complete the SC, JSDQ, Affection 33 Scale*, and the CI. If the therapists were paired with more than one co-therapist, they were given another set of measures for each additional partner. Finally, the subjects were asked to answer the A08. In ordering the measures, the author made the assumption that it would be easier for the subjects with more than one co-therapist to answer all of the instruments with a particular co-therapist in mind than it would be for them to respond to a given measure for each co-therapist and then turn to another instrument. This pro- cedure was also intended to maximize the perceived distinctions between the co-therapist partners. The second part of the study required each of the multiple therapist pairs to spend 15 minutes talking to one another about their multiple in any way that they-would find helpful. If they had more than one multiple, they were asked to discuss the one they referred to in the SC questionnaire. The conversations were electronically recorded in a room set aside for that purpose. Each pair was pro- vided with a separate tape marked with their code names. *,* The tape boxes also included an additional question regarding the initiation of the multiple. * *The Affection Scale and the additional question regarding the initiation of the multiple form a portion of the dissertation being completed by co-researcher Christie Randolph (1969). **The tape-recorded discussions will be analyzed at a future date as part of another proposed research project. 34 SCOPE of the Variables Satisfaction A satisfaction score for each co-therapist within a pair was computed by comparing the ICL profile for his ideal co-therapist with the profile for his actual co-therapist. For each therapist within a pair, a D-score was obtained across the 16 variables (Cronbach and Gleser, 1953). A low D-score was indicative of high satisfaction with one' s co-therapist and a high D—score indicated low satisfaction with one' s co-therapist. A measure of team satis- faction was obtained by summing the two therapists' D-scores. A CI satisfaction measure was obtained by summing the number of points (0-4) scored on each of the 44 CI items. The pos— sible total point range is 0—176, with the lowest satisfaction at 0 and the highest at 176. Selection of the Co-therapist Each of the four open-ended SC questions referring to co—therapist selection and acknowledgment received a global rating of Personal (P) or Impersonal (1) determined by whether the raters judged the answer to be specific or non-specific to the co-therapist being chosen. Each of the four SC answers was divided into indi- vidual response units, with each unit expressing a separate reason 35 for choosing or being chosen as a co-therapist. A P or I rating was given to each separate response unit. A global rating of P was then assigned if the ratio of P to I responses within a given question was equal to or greater than one and the global rating of I if the ratio was less than one. Responses judged P included: (a) wanted to work together, (b) enjoy working together, (c) competence of the co-therapist, (d) mention of the specific qualities of the selected co-therapist, and (e) references to the client's or therapist' 3 needs if it is clear that this particular co-therapist was chosen to meet them. Responses judged I suggested any co—therapist would be acceptable as a partner and included (a) information about the client, (b) client needed a male/female (strong male, etc. ), (c) wanted a co-therapist, (d) have not worked together before, (e) co-therapist' 3 previous involvement with the client (wanted experience doing multiple therapy), (f) con- venience (same time free, etc. ), (g) bargains, (h) participation in projects, and (i) to overcome an impasse. The investigator' s co-researcher devised the above scor- ing system following inspection of the SC answers. The co-researchers then independently scored the data accordingly and computed the measure' S scoring reliability. There were 89/92 identical scorings and the percent agreement between the raters was found to be 97% 36 across categories. Discrepant scorings were assigned a pooled rating subsequent to the judges' discussion of those items. Relevant hypotheses were analyzed using the pooled judgments for the dis— crepancies. Self-Disclosure The self-disclosure score of each therapist toward his co-therapist(s) was obtained by totaling the number of points scored on each of the 60 items of the J SDQ. Since each item may receive a score of 0-2, the total range possible is 0-120, with 0 designating no self—disclosure and 120 designating complete self-disclosure. Flexibility The flexibility rating was based on the score obtained for each of the 16 variables on the ICL and the author assumed that-a flexible individual should have one-sixteenth of his total number of true responses in each of the 16 categories. Since it was reasoned that comparison of the actual scores with this flexibility ideal would yield a measure of flexibility, a D-score was obtained across the 16 variables (Cronbach and Gleser, 1953). The D-scores of the 27 therapists were ranked and the lowest rank was assigned to the greatest D—score. They were divided into High and Low Flexibility at the median with the score ranked fourteenth designated as Low 37 Flexibility since the D-score was closer to the one ranked thirteenth than the one ranked fifteenth. Attitudes toward the Opposite Sex Only the A08 question referring to co-therapist was examined to determine the appropriate categorization for the A08 variable of particular interest in this study (AOS-CT). Individual responses were scored as Sexual (S), Competent (C), and Other (0). "Sexual" responses included feminine, comfortable with being a woman, accepting of sexuality, attractive, and likes members of the opposite sex. "Competent" responses included intelligence, sensitivity, warmth (if modified to apply specifically to the therapy relationship), empathy, ability to have an impact on the client, and willingness to communicate about the therapy relationships and interactions. "Other" responses included general personality characteristics, such as sense of humor or warmth, that could not clearly be classified as either Sexual or Competent. In scoring the AOS-CT answer, these three classifications were assigned either separately or in various combinations, thus yielding seven possible scoring categories: S, C, 0, SO, CO, SC, and SCO. Each therapist' s AOS-CT answer was assigned one of the seven possible summary score categories. 38 As was true of the SC, the investigator' s co-researcher developed the AOS-CT scoring system following inspection of the relevant data. The co—researchers independently scored the AOS—CT accordingly and computation of the measure' 3 scoring reliability showed 24/27 identically scored units, yielding a percent agreement of 89% across categories. Discrepant scorings were assigned a pooled rating subsequent to the raters' discussion of those items. Relevant hypotheses were analyzed using the pooled discrepancy ratings. Procedures for Statistical Analysis of the Data The, co-researchers modified, developed, and used two separate measures of satisfaction in an attempt to more fully under- stand the satisfaction experienced by multiple therapists. This raised a question regarding the relationship between the ICL and CI both for each therapist' 5 evaluation of his/her satisfaction within a pair and for the co-therapists' combined evaluation of team satis- faction. There were 23 co-therapy pairs, thereby yielding 46 separate therapist scores for each measure. To investigate the ICL-CI relationship for individual therapists, the 46 scores obtained when each therapist indicated his/her satisfaction within a given pair were ranked from 1-46 (1 = low, 46 = high) on each measure. A 39 Spearman Rank Correlation Coefficient (rs) incorporating the correction factor for tied ranks (Siegel, 1956) was then computed between the ICL and CI. To investigate the ICL-CI relationship for therapist pairs, the 23 scores obtained from the co-therapists' combined evaluation of pair satisfaction were ranked from 1—23 (1 = low, 23 = high) on each measure. The two rankings were then compared using the Spearman Rank Correlation Coefficient (rs). Hypothesis 1 To test the hypothesis that there is greater satisfaction in multiple therapy pairs where the selection and acknowledgment of selection are personally felt regardless of the verbalization dimen- sion than in therapy pairs where either the selection or acknowledg- ment is not personally felt, the 23 pairs were first divided into two mutually exclusive groups. The Personal group included only. those pairs where both co-therapists felt selection had a personal basis, whereas the Impersonal group included those pairs where either or both co—therapists felt selection had not had a personal basis. The hypothesis was analyzed twice, once using the ICL pair satisfaction rankings and again using the CI pair satisfaction rankings. A Mann- Whitney U test was computed for each analysis. 40 Hypothesis 1a that there is more satisfaction in multiple therapy pairs where the selection and acknowledgment are both personally felt and accurately communicated than in those pairs where selection and acknowledgment are neither felt nor accurately communicated on a personal basis proved to be non—testable. The latter group (Impersonally felt and communicated) had an n = 1, rendering the proposed Mann-Whitney U test unemployable. Hypothesis 2 The hypothesis that the amount of one' s self-disclosure is positively correlated with the degree of satisfaction felt with one' s co—therapist was analyzed for both the ICL and CI satisfaction measures. The 46 JSDQ scores reflecting the stated amount of self- disclosure to one' s co—therapist(s) were ranked with 1 2 low (little disclosed) and 46 = high (much disclosed). Each satisfaction measure was similarly ranked from 1-46, with 1 = low satisfaction and 46 = high satisfaction. A Spearman Rank Correlation Coefficient incorporating the correction factor for tied ranks was computed for both the ICL and the CI. Hypothesis 3 To test the hypothesis that multiple therapist pairs who are both high on flexibility are more satisfied with their relationship than 41 those pairs who are both low on flexibility, the flexibility scores of the 27 therapists were ranked from. 1 (low) to 27 (high) and then divided into two groups at the median rank of 14. The 14th rank was designated as low since it lay closer to the 13th rank than to the 15th. Each of the 23 pairs then received a two—letter code (LL, LH, HL, HH) reflecting the combined flexibility designation assigned to each partner. The relationship of the HH and LL groups to satisfaction was then tested for both the ICL and CI using the Mann- Whitney U test. Hypothesis 3a, that there is greater satisfaction in multiple therapist pairs in which the therapists have identical flexibility levels than in those pairs with discrepant levels, was also tested for both the ICL and CI. The 23 pairs were assigned to one of the two mutually exclusive groups (HH + LL vs HL + LH) based on their pair flexibility designation. The Mann-Whitney U test was computed for both satisfaction measures. Hypothesis 3b stated that there is more satisfaction in co- therapy pairs where both therapists' perceptions of their partner' 3 flexibility are congruent with the partner' s self-perception on flexibility than in pairs that lack this congruency of perceptions. The 46 perception of co-therapist flexibility scores were ranked from 1 (low) to 46 (high) and divided into Low and High Flexibility 42 between ranks 23 and 24. Each of the 27 therapist' s self-percepts of flexibility was then paired with his/her co-therapist' s percept, thus yielding a four-letter code reflecting the combined self— co- therapist flexibility congruence for each of the 23 co-therapy pairs. To test Hypothesis 3b, the pairs categorized HH-HH, HH-LL, LL-HH, LL-LL were combined and compared with all those pairs in which congruence was lacking in the self- co-therapist perceptions of one or both partners. Mann-Whitney U tests served to compare the two groupings for both the ICL and CI. In examining the pairs characterized by non-congruent self-co-therapist perception, Hypothesis 3c states that there is more satisfaction in pairs lacking congruence in the perception of one co-therapist than in pairs lacking perceptual congruence for both co-therapists. The four-letter code (reflecting perceptual congruence of self-co-therapist flexibility) referred to in Hypothesis 3b facilitated further dividing the non- congruent pairs into two smaller groups, lack of congruent percept for one co-therapist vs lack of congruent percept for both co-therapists. Comparison of the two sub-groups for both satisfaction measures obtained through the Mann-Whitney U test. 43 Hypothesis 4 To test the hypothesis that there is more satisfaction in co-therapist pairs where both therapists hold well-balanced attitudes toward the opposite sex than in those pairs where either or both therapists hold one-sided opposite-sex attitudes, the "Other" cate- gory was ignored and only the designations of Sexual and Competent were attended to. Pairs that designated therapists SC were compared to all the remaining pairs through a Mann—Whitney U test for each satisfaction measure. Hypothesis 4a regarding the greater satisfaction in pairs with similar one-sided attitudes as opposed to those with dissimilar one—sided attitudes was not testable due to an n = 1 for the dissimilar and similar attitude categories. A Mann-Whitney U test had been proposed. RE SULTS Relationship between Criteria of Satisfaction The Spearman Rank Correlation Coefficient (rs) between the Interpersonal Check List (ICL) and Co-therapist Inventory (CI) measures of each therapist' s satisfaction within a team was r8 = .42 (N = 46). A Student' 8 t test for the significance of rS indicated it to be significant at the p/< .01 (df = 44) for a two-tail test. The rS between the ICL and CI measures of pair satisfaction was .46 (N = 23). A Student's t test indicated this rS to be signifi- cant at p/< .05 for a two-tail test. Table 1 Spearman Rank Correlation Coefficient between Interpersonal Check List and Co-therapist Inventory Therapist Satisfaction Measures Multiple Therapists N rs df t Individual 46 . 42 44 3. 0702** Pairs 23 . 46 21 2. 3736* *p/< .05 (two-tailed) **p/< .01 (two-tailed) 44 45 Hypothesis 1: Personal Selection of Co-therapist and Satisfaction Hypothesis 1 stated that co-therapist pairs where the selection and acknowledgment of selection are personally felt regard- less of whether the message is verbally communicated/ received are more satisfied with their relationship than those pairs where selec- tion and/ or acknowledgment are not personally felt. A Mann-Whitney U test relating selection and the ICL measure of satisfaction failed to reach significance, p > .05 (one-tail test). However, the Mann- Whitney U test relating selection to the CI satisfaction measure did reach significance, p/< .025 (one-tail test). Table 2 Mann-Whitney U Test Relating Personal Selection of Co-therapist and Pair Satisfaction as Measured by the Interpersonal Check List and the Co-therapist Inventory Satisfa ction. n n U Measure 1 2 ICL 6 17 43“ S CI 6 17 22* S'non-significant, p > .05 (one-tailed); p’< .05, critical value U = 26 *p’< .025 (one-tailed); p/< .025, critical value U = 22 46 Hypothesis 1a relating the messages felt and verbalized to satisfaction was not testable due to an 111 = 1 for the Impersonally felt and communicated/received group. Hypothesis 2: Self-Disclosure and Satisfaction Hypothesis 2 predicted a positive correlation between the degree to which a therapist was self—disclosingto his/her partner and the therapist' s satisfaction with that partner. The Spearman Rank Correlation Coefficient (rs) computed to relate the 46 J SDQ ranked scores to their corresponding ICL satisfaction ranks was . 15. A Student' 3 t test revealed rS to be non-significant (one-tail test). Table 3 Spearman Rank Correlation Coefficient between Self-Disclosure and Individual Therapist Satisfaction as Measured by the Interpersonal Check List and the Co-therapist Inventory Satisfaction N r d f t ‘ Measure 3 ICL 46 .15 44 0. 970“ 8' CI 46 . 46 44 3. 299* s. non-significant, p > .05 (one-tailed) *P 2 . 005 (one-tailed) 47 The rS relating the 46 J SDQ ranks to their corresponding CI satisfaction ranks was computed to be .46. A Student' 5 t test for the significance of rS indicated rho to be significant, p/< .005 (one-tail test). Hypothesis 3: Flexibility and Satisfaction Hypothesis 3 predicted that multiple therapists who are both high on flexibility are more satisfied with their relationship than pairs who are both low. The Mann-Whitney U test comparing the high vs low groups on the ICL satisfaction measure failed to reach significance, p > .05 (one-tail test). A similar comparison on the CI measure also failed to reach significance, p > . 05 (one- tail test). (See Table 4.) Hypothesis 3a predicting more satisfaction in multiple therapy pairs having identical flexibility levels than in pairs with discrepant levels was not supported by either satisfaction measure. (See Table 4.) Neither the ICL nor the CI supported Hypothesis 3b, which predicted more satisfaction in multiple therapy pairs where both self-co-therapist flexibility perceptions were congruent than in pairs lacking congruency for one or both partners. (See Table 4.) 48 Table 4 Mann-Whitney U Test Relating Therapist Flexibility and Pair Satisfaction as Measured by the Interpersonal Check List and the Co-therapist Inventory Satisfaction n ' n ‘ U Critical Measure 1 2 U Value Hypothesis 3 CI 5 5 7.5 *4 Hypothesis 3a ICL 10 13 59 37 CI 10 13 47 37 Hypothesis 3b Hypothesis 3c ICL 2 15 11 3 C1 2 15 14.5 3 *p/< .345 (one-tailed) **p/< .155 (one-tailed) 49 In its examination of multiple therapy pairs having non- congruent self-co-therapist perceptions, Hypothesis 3c predicted greater satisfaction in pairs where non—congruency existed in the perception of only one partner than in pairs where perceptual con- gruency held for neither partner. The hypothesis was not upheld either for the ICL or the CI satisfaction measure. In summary, none of the hypotheses relating flexibility and satisfaction received support from the data gathered in the present study. @pothesis 4: Attitudes toward the Opposite Sex and Satisfaction Hypothesis 4 predicted greater satisfaction in multiple therapy pairs where both therapists hold well-balanced attitudes toward the opposite sex than in pairs in which either or both thera— pists hold one-sided attitudes. The Mann-Whitney U test rejected the Null Hypothesis (HO) for both the ICL and the CI satisfaction measures but could not accept the predicted alternative (H1) because of the inverse relationship between satisfaction and well-balanced attitudes evidenced in the data. Hypothesis 4a relating similar and dissimilar one—sided attitudes to satisfaction was not testable due to an n = 1 for both similar and dissimilar one-sided attitudes. 50 Table 5 Mann-Whitney U Test Relating‘Attitudes toward the Opposite Sex and Satisfaction as Measured by the Interpersonal Check List and the Co—therapist Inventory Satisfaction n n Obtained Measure 1 2 U ICL 5 1 8 12 CI 5 1 8 6. 5 Note--—Ho rejected, but H1 not accepted sipce H1 prediction was in the opposite direction. p < .01 (one -tailed); critical value U = 14. DISCUSSION The primary intention of the present research was exploration of the multiple therapists' relationship. Satisfaction was defined as the central variable in the co-therapy relationship and was related to the variables of selection of co-therapist, self- disclosure, flexibility, and attitudes toward the opposite sex. Since satisfaction was central to the research, the investigator attempted to gain a more comprehensive understanding of this variable by measuring it from two perspectives. The ICL obtains information about a person' s generalized attributes, characteristics or behaviors and seems to measure the perceived range of a person' s behavior rather than the manifestation of any particular behavior under specified circumstances. When a therapist completed the ICL on his ideal co-therapist, he gave infor- mation on the behaviors he did or did not value for that ideal. When he completed the ICL on an actual co-therapist, he merely specified the behaviors he perceived the co-therapist as capable of or as having displayed, but this did not assure that the specified behaviors had been directed toward him. For example, therapist A may not value 51 52 critical or angry behavior but may see therapist B as "critical of ' However, he may never have been others" and "frequently angry.‘ the recipient of those behaviors from B, and thus their relationship may be quite amiable despite the discrepancy between ideal and actual. In summary, the ICL measure of satisfaction seems to provide a broad index extending beyond the specific interaction between two co-therapists and incorporating their behavior with other persons as well. It seems to be a more generalized measure of potential conflict areas and perhaps suggests the number of compromises or adjustments that may need to be made for the rela- tionship to become personally satisfying. The CI apparently measures satisfaction in a more direct, personal manner. Its questions are specific to the interpersonal interaction between the co-therapists and it seemingly highlights aspects within m relationship that are in various stages of harmony or disharmony. The total CI score obtained seems to be a direct measure of adjustment in the multiple therapists' relationship since it yields information on the specifics of the interpersonal interplay of two unique personalities. Nevertheless, since both the ICL and CI do generate data on satisfaction, albeit from different perspectives, they should demonstrate some positive correlation to each other. Results of 53 the Spearman Rank Correlation Coefficient computed between the ICL and CI do support the reasoned expectation of a low but positive and significant relationship. Although the CI would be expected to provide a more direct and sensitive index of the variables relevant to a satisfying co—therapy relationship, all variables were analyzed using both measures of satisfaction. The positive relationship between the personal selection of one' s co-therapist and satisfaction predicted by Hypothesis 1 was not supported by the ICL but was supported by the CI. Although the relationship was in the predicted direction for the ICL, it appears that the instrument was not sensitive enough to the particular inter- personal interactions between the co-therapists to relate to the rather personal aspect embodied in selection of a partner. In con— trast, being a more direct and sensitive measure of the actual co— therapists' relationship, the CI did significantly relate to the personal dimension of selection. The discrepancies in the personal qualities of the messages reported by the selector—selectee pairs suggested the presence of a non-verbal dimension of behavior. Three selectees felt and heard a Personal message from their selector despite the selector' 3 self- reported Impersonal verbalization of his Personal feelings. In addition, five co-therapists reportedly felt that they were chosen 54 Impersonally and four of the five "heard" an Impersonal message despite their selector' 3 report of a Personally felt and verbalized message. It seems possible that the selectors may have sent non- verbal messages that conflicted with their verbal messages and that in the case of conflict, the non-verbal communication prevailed. Although Hypothesis 1a comparing co-therapy pairs where selection and acknowledgment were felt and communicated/received on a Personal basis with pairs where all four aspects were Impersonal proved to be untestable, the only IIII pair had received a lower CI satisfaction rank than any of the nine PPPP pairs. Post-hoe analysis of the data suggested the additional hypothesis that pairs in which selection and acknowledgment were felt and communicated/received on a Personal basis (1. e. , PPPP) are more satisfied than pairs where the selectee had felt and heard an Impersonal message regardless of the selector' s behavior (i. e. , PPII + IIII). A Mann—Whitney U test supported this hypothesis for the CI (p/< .01, n = 9, n = 5, U = 3, one-tail test) but failed to l 2 support it for the ICL (p > .05, n = 9, n = 5, U = 13, one-tail 1 2 test). Again the relationship on the ICL was in the predicted direc- tion but not of sufficient magnitude to reach the p/< . 05 level of significance (critical value of U = 9). 55 Table 6 Mann-Whitney U Test Relating Personal- Impersonal Communication and Pair Satisfaction as Measured by the Interpersonal Check List and the Co-therapist Inventory Satisfaction ' n n U Measure 1 2 CI 5 9 3* ICL 5 9 13n' S n. s 'non—significant, p > .05 (one—tailed); P/< -05, critical value U = 9 *p/< .01 (one-tailed); p/< .01, critical value U = 5 The differing perspectives of the two satisfaction measures were again evidenced in the analysis of Hypothesis 2. The predicted positive correlation between self—disclosure and satisfaction did not reach the p/< .05 significance level with the more global ICL but attained the p/< . 005 significance level using the CI measure. While to some degree self-disclosure or openness is a general behavioral characteristic, it becomes a more precise and meaningful dimension for the multiple therapy relationship when some of the potentially modifying parameters are specified, e. g. , the intended recipient of one' s self-disclosure. Jourard' s 56 questionnaire assumes variability in the degree of self-disclosure depending upon the intended recipient. The CI specifies the partner and thus enables the responder to give more specific information about their relationship. The present researcher' s finding demonstrating a positive correlation of self-disclosure or openness to satisfaction does concur with the assertions by Whitaker e_t__a_l. (1956), Mullan and Sanguiliano (1964), and Kell and Burow (in press) holding openness to be an essential part of the multiple therapy relationship. Review of the analyses performed on the four hypotheses regarding flexibility revealed none of the hypotheses received sup- port from the present data. This led the researcher to re-examine her concept of flexibility and the appropriateness of the instrument chosen to measure the concept. The researcher' s concept of flexibility assumes not only that the therapist has access to a wide range of human responses or behaviors but that an appropriate responsiveness is combined with an acceptance of and respect for another individual' s different beliefs, approaches or behaviors. This concept seems to extend beyond the strict definition of flexibility as a wide repertoire of responses with a moderate balance of behavior along a dominance-submission and/ or love- hate axis. 57 LaForge and Suczek (1955) and Leary (1956) suggested the ICL as a measure of flexibility. In retrospect, however, the researcher tends to view the ICL as capable of providing a global discrimination of flexibility in a pathological or disturbed population but as not capable of discriminations between degrees of flexibility in a healthy and fairly well-balanced population. The criteria with which the researcher initially proposed to discriminate flexibility in the present sample combined the proportion of the 16 ICL categories each therapist checked as true and the locus of the two-dimensional grid point summarizing each individual' 3 self, ideal, or co-therapist' (s) profile. These criteria yielded almost no variance in the flexibility dimension within the therapist population. All 27 therapists used all 16 categories in their self-perceptions and the grid points for all therapists fell within 20—2 of the intersection of the two major axes. The majority of the grid points were tightly clustered between 1 and 20—25 in the AP, BC, or DE octants. Although the conclusion evident was that the therapists were all rather flexibile persons, there were some variations amongst the sample and a method was sought to expand and clarify this variance. An approach that logically extended from LaForge' 3 ideas on flexibility defined the flexibility ideal as having 1/ 16th of his total true responses in each of the 16 categories and computed a D-score from this ideal (Mueller, 1969). While this 58 approach did provide therapist variance from the generalized therapist ideal within the sample, it also assumed discrepancies in all 16 sectors to be equally important and that the therapists should display all behaviors equally. These latter assumptions do not appear tenable since it seems reasonable that to be helpful, a therapist should be more dominant than submissive or more confident than self-effacing. Thus, although a therapist should be sufficiently "in touch" with each area of human behavior, the areas should not be equally emphasized. The dimension of response appropriateness as an aspect of flexibility received no discernable elucidation from the ICL flexibility measure used. It seems important that a therapist should not only be able to be nurturant or critical but that he should also be able to be nurturant or critical at the appropriate times with his client or co-therapist. A final aspect of the researcher' s concept of flexibility is that of an individual' 8 acceptance of another person' 8 way of behaving, i. e. , respect for another' s differences. This seems particularly relevant to a collaborative relationship and may be evidenced by a therapist' s willingness to accept and adapt to his co-therpist' s perceptions, beliefs, and behaviors without the need to obliterate ,differences either by denial or by force. Thus 59 flexibility as the investigator conceives of it is permissive of differences and variability in others. It also implies that the therapist is open to change within himself as a result of his inter- actions with differing others. Having expanded the originally imprecise and compacted concept of flexibility, the researcher feels the need for a new approach to measurement of the concept. Perhaps flexibility will require a combination of several small but precise instruments rather than one encompassing measure. The concept retains its importance for the researcher and she proposes the area as a fruit- ful one for future research. Analysis of Hypothesis 4 presented rather unanticipated findings. The prediction that co-therapist pairs with well-balanced attitudes toward the Opposite sex are more satisfied than pairs where either or both co—therapists hold one-sided views was not supported. Examination of the data revealed that 11 of the 18 males were scored SC and 1 was scored S, whereas only 3 of the 9 females received scores of SC." Since Competence was mentioned with approximately equal frequency by both males and females, the dif- ference in the proportions of SC responses appears to have been based upon the scoring of the S category. Re-evaluation of the responses scored as Sexual revealed that the females' responses were borderline whereas the males' 60 responses generally were unambiguously scored Sexual. Upon closer inspection of the Sexuality criteria it became evident that some of the responses considered Sexual differed in tone from the majority of responses categorized as Sexual. For example, a female therapist' s desire for a co-therapist who "likes or enjoys women" reflects a different attitude than one who requests a male co-therapist who is physically attractive. Having thus re-defined Sexual, the researcher re-examined the SC-SC pairs and thereby subsequently eliminated four of the five pairs on this basis. The eliminated pairs had CI satisfaction ranks of 1, 2, 3, 5 while the only remaining pair had a rank of 10. 5 (highest satisfaction rank = 23). This rendered the hypothesis untestable with the revised sample. It seems both necessary and appropriate to briefly trace the development of the A08 scoring system. The original system devised before examination of the AOS-CT answers contained a more restrictive definition of Sexuality but this criterion failed to yield Sexuality variance within the sample. This restrictive definition of Sexuality was then broadened, yielding less well-defined criteria along with variance on the scoring of Sexuality. In retrospect, it appears that the puzzling finding for Hypothesis 4 resulted primarily from the imprecise criteria employed. An additionally confounding 61 factor was a considerable number of individual responses scorable neither as Sexual nor Competent. The "Other" category was devised to permit some designation for these responses, but it is the researcher' s feeling that valuable information was lost in the "Other" category and that further analysis of this "Other" category would likely prove very fruitful. Implications for Future Research The researcher has investigated the relationship between the multiple therapists by relating therapist satisfaction to the variables of Selection of Co-therapist, Self—Disclosure, Flexibility, and Attitudes toward the Opposite Sex. Since the instruments measuring Flexibility and AOS proved to be imprecise, the investi- gator proposes a renewed attempt to measure these variables. Another research area is the evolution and resolution of conflict between the co-therapists. Do clients precipitate the con- flicts? How? Are the conflicts related to the clients' experiences with their parents? What factors determine whether or not the re-enactment of earlier conflicts proves helpful? One manner of approaching these complex questions is through the interpersonal system of behavioral analysis developed by Freedman, Leary, Ossorio, and Coffey (1951), LaForge, Leary, Naboisek, Coffey, and Freedman (1954), LaForge and Suczek (1955), Leary (1957), 62 and LaForge (1963). Applying this system of behavioral analysis to the interaction of the therapy triad would yield an abundance of information clarifying many questions of overall therapist-client behaviors. The co «therapist or triad interaction patterns should also be related to therapist effectiveness and to co -therapist satis- faction as measured by the CI. Although the present research has chosen not to investigate the effectiveness of multiple therapy, the question remains an important one. Perhaps the effectiveness varies depending upon the relationship between the co-therapists, the type of client, the client' s problem, etc. Kell and Burow (in press) suggest some client behaviors and defenses that invite or contraindicate the initiation of multiple therapy. Comparing the effectiveness of individual and multiple therapy with these clients would seem fruitful both in clarifying the process of therapy and in suggesting an approach to clients that might more directly attend to their particular needs. The findings of the present research should not be generalized to apply to all therapists engaged in multiple therapy since the therapists in the study cannot be considered representa- tive of all multiple therapists. The Michigan State University Counseling Center staff is a closely knit staff with a predominantly interpersonal orientation. The staff members readily confront and 63 care about their clients. Their choice of a particular co -therapist primarily emerges from personal rather than impersonal reasons and they are relatively self-disclosing to their co-therapists. The original flexibility measure derived from the ICL suggests that they demonstrate fairly high interpersonal flexibility. One profitable extension of the present research would be to re -examine the study' 3 hypotheses in a therapist population maintaining a different orienta- tion to therapy. Such a re -examination may either support the given hypotheses or suggest new variables operative in multiple therapy. SUMMARY The purpose of the research was to explore and elucidate the relationship between male-female therapist pairs who were simultaneously doing psychotherapy with an individual or couple. Satisfaction was defined as the central variable in the multiple therapy relationship and was related to the variables of Selection of Co-therapist, Self-Disclosure, Flexibility, and Attitudes toward the Opposite Sex. The subjects were nine females and eighteen males who composed twenty-three non-independent current multiple therapist pairs. All therapists were on the staff of the Michigan State Uni- versity Counseling Center and the therapist pairs were comparable with respect to age and experience level. The variance in multiple- therapy experience did not appear extensive enough to warrant concern. Two instruments were devised to measure satisfaction. In one measure, a D-score was derived by comparing each therapist' s Interpersonal Check List (ICL) scores for his/her ideal co-therapist with those he ascribed to his/her actual co-therapist(s). The second 64 65 satisfaction measure, the Co-therapist Inventory (CI), was the researcher' s modification of van der Veen' s Family Concept Q-Sort. The Selection of Co-therapist (SC) variable was investi- gated with a series of four open-ended questions constructed by the researcher and inquiring about the selection process. Scoring was based on the Personal/Impersonal quality of the responses. The Self-Disclosure variable was measured by Jourard' s Self-Disclosure Questionnaire (JSDQ). The measure for Flexibility was derived from ICL data and in the context of this study. The variable of Attitudes toward the Opposite Sex (AOS) was explored with an open- ended questionnaire conceived of by the researcher. Each therapist completed an ICL for self, ideal co-therapist, and actual co-therapist(s). He also answered the CI, SC, and JSDQ with reference to each of his co-therapists. In addition, he responded to the AOS questionnaire. The findings of the research can be summarized as follows: I. The ICL and CI satisfaction measures were positively and significantly correlated with each other for both the individual co-therapist' 3 evaluation of his multiple therapy satisfaction and for the multiple therapist pair' 3 combined evaluation (individual: rs = .42, p/< .01; pairs: rs = .46, p/< . 05). II. III. IV. 66 Co-therapist pairs where the selection and acknowledgment of selection were Personally felt regardless of the verbal communication dimension were more satisfied with their relationship than those pairs where selection and/ or acknowledgment were not Personally felt. This finding did not reach significance for the ICL (p > .05) but did reach significance for the CI (p/< .025). Co-therapist pairs in which selection and acknowledgment were felt and communicated/received on a Personal basis were more satisfied than pairs where the selectee had felt and heard an Impersonal message regardless of the selector' 8 reported feelings or behavior. The relationship did not reach significance (p > . 05) for the ICL but was significant for the CI (p/< . 01). The amount of a therapist' s Self—Disclosure was positively correlated with the degree of satisfaction he felt with his co—therapist. This finding failed to reach significance for the ICL (rS = . 15, p > .05) but did reach significance for the CI (rs = .46, p’< .005). Pair Flexibility, as measured in this study, was not found to be significantly related either to the ICL (p > .05) or CI (p > .05) measures of multiple therapist pair satisfaction. 67 VI. Congruency of self-co-therapist Flexibility perceptions, as measured in this study, was not found to be significantly related to either the ICL (p > . 05) or CI (p > . 05) measures of multiple therapist pair satisfaction. VII. As measured in this study, a co-therapist' s Attitudes toward the Opposite Sex were not found to be significantly related to either the ICL (p > .05) or CI (p > .05) measures of pair satisfaction. It was concluded that the Co-therapist Inventory is a more direct and sensitive measure of the relationship existing between the multiple therapists than is the ICL. It was also concluded that Self- Disclosure and the Personal/Impersonal dimension of co-therapist selection are variables relevant to a therapist' s satisfaction with the co-therapy relationship. Continued exploration of the relationship between the multiple therapists presents a fruitful avenue for future research. REFERENCES REFERENCES American Psychological Association. Personal communication with Helen Orr, Managing Editor, July 22, 1969. Centers, R. Authoritarianism and misogyny. J. Soc. Psychol., 1963, _6_1(1) 81-85. Cronbach, L. J., and Gleser, G. Assessing similarity between profiles. Psychol. Bull., 1953, 52, 456-473. Demarest, E. , and Teicher, A. Transference in group therapy: Its use by co-therapists of opposite sexes. Psychiat. , 1954, 17, 187-202. Dreikurs, R. Techniques and dynamics of multiple psychotherapy. Psychiat. Quart., 1950, 2_4, 788-799. Dreikurs, R., Schulman, B. H. , and Mosak, H. Patient-therapist relationship in multiple psychotherapy. 1. Its advantages to the therapist. Psychiat. Quart., 1952, 26, 219-227. (a) Dreikurs, R., Schulman, B. H., and Mosak, H. Patient-therapist relationship in multiple psychotherapy. 11. Its advantages for the patient. Psychiat. Quart. , 1952, 2_6, 590-596. (b) Dyrud, J. E. , and Rioch, M. Multiple therapy in the treatment program of a mental hospital. Psychiat. , 1953, _1_6_, 21-26. Fitzgerald, M. P. Self-disclosure and expressed self-esteem, social distance and areas of the self revealed. J. Psychol. , 1963, 56, 405-412. Freedman, M. B., Leary, T. B., Ossorio, A. G., and Coffey, H. S. The interpersonal dimension of personality. J. Personality, 1951, 2_0, 143-161. 68 69 Goodman, M. Expressed self acceptance and interpersonal needs: A basis for mate selection. J. Counsel. Psychol. , 1964, l_1_, 129-135. Hadden, S. B. The utilization of a therapy group in teaching psycho- therapy. Amer. J. Psychiat., 1947, 103, 644-648. Haigh, G. , and Kell, B. L. Multiple therapy as a method for training and research in psychotherapy. J. Abnorm. Soc. Psychol., 1950, 4_5_, 659-666. Hofman, K. An investigation of the construct validity of marital adjustment and the similarity between marital adjustment of spouses. Unpublished master' 8 thesis, Michigan State University, 1966. Hurley, J. R., and Hurley, S. J. Toward authenticity in measuring self-disclosure, unpublished manuscript. Cited by G. R. Breed and S. M. Jourard, Research in self- disclosure. Unpublished manuscript, University of Florida, 1969. Jourard, S. M. Personal communication, July 15, 1969. Jourard, S. M. The transparent self: Self-disclosure andwell- being. Princeton, N.J.: D. Van Nostrand, 1964. Kell, B. L. , and Burow, J. M. Developmental counselipg and therapy. Boston: Houghton Mifflin, in press. Kell, B. L. , and Mueller, W. J. Impact and change: A study of counselirg relationship}. New York: Appleton-Century- Crofts, 1966. Kerchoff, A. C. , and Davis, K. E. Value consensus and need complementarity in mate selection. Amer. Sociol. Rev. , 1962, 21, 295-303. LaForge , R. Research use of the ICL. Oregon Research Institute: ORI Technical Report, :_3_, No. 4, 1963. LaForge, R., Leary, T. F., Naboisek, H., Coffey, H. S., and Freedman, M. B. The interpersonal dimension of personality: II. An objective study of repression. J. Personality, 1954, 22, 129-153. 7O LaForge , R. , and Suczek, R. The interpersonal dimension of personality: III. Aninterpersonal check list. J. Per- sonality, 1955, a, 94-112. Leary, T. Interpersonal diagnosis of personality. New York: Ronald Press, 1957. Leary, T. Multilevel measurement of interpersonal behavior: A manual for the use of the interpersonal system of per- sonality. Berkeley, California: Psychological Consulta- tion Service, 1956. Linden, M. E. The significance of dual leadership in gerontolic group psychotherapy: Studies on gerontolic human rational III, Int. J. Group Psychother., 1954, 4, 262- 273. Locke, H. J. , and Wallace, K. M. Short marital-adjustment and prediction tests: Their reliability and validity. J. Marr. Fam., 1959, _2_1_, 251-255. Mintz, E. A. Male-female. co-therapists: Some values and some problems. Amer. J. Psychother., 1965, 19, 293-301. Mintz, E. A. Special values of co-therapists in group psychotherapy. Int. J. Grog) Psychother., 1963, 13,127-132. Mueller, W. J. Personal communication, July, 1969. Mullan, H. , and Sanguiliano, I. The therapist's contribution to the treatment process. Springfield, 111.: Charles C. Thomas, 1964. Murstein, B. J. Empirical tests of role, complementary needs, and homogamy theories of marital choice. J. Marr. Fam. , 1967, 29(4), 689-696. Nunnelly, K. G. The use of multiple therapy in group counseling and psychotherapy. Unpublished doctoral dissertation, Michigan State University, 1968. Palonen, D. J. Interpersonal perceptions and marital adjustment. Unpublished master' 8 thesis, Michigan State University, 1966. 71 Rabin, H. M. How does co-therapy compare with regular group psychotherapy. Amer. J. Psychother., 1967, _2_1_(2), 244-255. Reeve, G. H. Trends in therapy; V. A method of coordinated treatment. Amer. J. Orthopsychiat., 1939, 9, 743-747. Siegel, S. Nonparametric statistics for the behavioral sciences. New York: McGraw-Hill, 1956. Solomon, A., Loeffler, F. J., and Frank, G. H. An analysis of co-therapist interaction in group psychotherapy. Int. J. Group Psychother., 1954, 3, 171-180. Sonne, J. C. , and Lincoln, G. The importance of a heterosexual co-therapy relationship in the construction of a family image. Psychiatric Res. Rep. , 1966, 22,196-205. Swenson, C. H., Jr., Shapiro, A., and Gilner, F. The validity of J ourard' s Self-Disclosure Scale, unpublished manu- script. Cited by G. R. Breed and S. M. Jourard, Research in self-disclosure. Unpublished manuscript, University of Florida, 1969. Terman, L. M. Psychological factors in marital happiness. New York: McGraw-Hill, 1938. Tharp, R. G. Psychological patterning in marriage. Psychol. Bull., 1963, 60(2), 97-117. Treppa, J. A. An investigation of some of the dynamics of the interpersonal relationship between pairs of multiple therapists. Unpublished doctoral dissertation, Michigan State University, 1969. Trost, J. Some data on mate selection: Complementarity. J. Marr. Fam., 1967, 2_9(4), 730-738. (a) Trost, J. Some data on mate selection: Homogamy and perceived homogamy. J. Marr. Fam., 1967, 2_9(4), 739-755. (b) Udry, J. R. Complementarity in mate selection: A perceptual approach. J. Marr. Fam., 1963, 2_5, 281-289. 72 van der Veen, F. Personal communication, July 16, 1969. van der Veen, F., Huebner, B., Jorgens, B., and Neja, P., Jr. Relationships between the parents' concept of the family and family adjustment. Amer. J. Orthopsychiat., 1964, 3_4 (1), 45-55. Vargas, R. A study of certain personality characteristics of male college students who report frequent positive experiencing and behaving. Paper presented at a meeting of the South Eastern Psychological Association, New Orleans, February, 1969. Cited by G. R. Breed and S. M. Jourard, Research in self-disclosure. Unpublished manuscript, University of Florida, 1969. Warkentin, J. , Johnson, N. L. , and Whitaker, C. A. A compari- son of individual and multiple psychotherapy. Psychiat. , 1951, _1_4, 415-418. ~ Whitaker, C. A., Warkentin, J., and Johnson, N. L. A philo- sophical basis for brief psychotherapy. Psychiat. Quart. , 1949, 53., 439-443. Whitaker, C. A. , Malone, T. P. , and Warkentin, J. Multiple therapy and psychotherapy. In F. Fromm-Reichmann and J. L. Moreno (Eds.). Progress in psychotherapy. Vol. 1, New York: Grune and Stratton, 1956, 210-216. Whitaker, C. A., Warkentin, J., and Johnson, N. L. The psycho- therapeutic impasse. Amer. J. Orthopsychiat., 1950, a, 641-647. Winch, R. F. Another look at the theory of complementary needs in mate-selection. J. Marr. Fam., 1967, 29(4), 756-762. Winch, R. F. Mate selection: A study of complementary needs. New York: Harper & Brothers, 1958. APPENDICES APPENDIX A Summary of Raw Data Scores Relevant to the Relationship between the Two Satisfaction Measures and to the Hypotheses 73 Table A Raw Data Scores Relevant to the Relationship between the Interpersonal Check List and Co-therapist Inventory Measures of Satisfaction and Relevant to Hypothesis 2: Self-Disclosure NA NA NA In 60 91 Multiple Q g p g a 8 8 Therapist .. 8 5 8 8 .2 8 .9 8 .9 Pairs N '3 '3 .3 3.; t: 0’ a g t: 3.; t: «as: g~o~9 66 ogago .u4 Jig 32 m 3 i ENS g; 3 i 1.5 7 7 E +0 O '5 I I 9. 9552 663:2 8563 East? 2693 .42 96752 96"., 5673 8"“... 012-041 5.00 10.5 133 17 - 6.5 42 25 19.5 - 9.0 81 - 2.5 6-25 071 5.00 10.5 140 23.5 -13 169 31.5 -21 0 441 - 8 64 022-071 4.47 18.5 125 13 5.5 30.25 10 8.5 72 25 3 9 081 7.28 4 102 4 0 o 27 -23 529 -23 529 251 6.00 6 99 2.5 3.5 12.25 7 - 1 1 - 4.5 20.25 032-141 3.46 33.5 163 41 - 7.5 56 25 13.5 20 400 27.5 756.25 181 2.45 42 139 21.5 20.5 420.25 22.5 19.5 380 25 - 1 1 241 3.16 38 166 43.5 - 5.5 30.25 31.5 6.5 42.25 12 144 041-012 3.16 38 159 37.5 .5 .25 26 12 144 11.5 132.25 202 3.61 31 156 36 - 5 25 24.5 6.5 42.25 11.5 132.25 051-172 4.47 18.5 152 31 -12.5 156.25 36 -17.5 306.25 - 5 25 061-262 4.47 18.5 137 18.5 o o 21 - 2.5 6.25 - 2.5 6.25 071-012 8.25 1 159 37.5 -36.5 1332.25 45 -44 1936 - 7.5 56.25 022 7.87 2 89 1 1 1 13.5 -11.5 132.25 -12.5 156 25 081-022 5.10 9 123 12 - 3 9 16.5 - 7.5 56.25 - 4.5 20.25 122 2.83 40 122 11 29 1841 24.5 15.5 240.25 -13 5 182.25 091-262 2.45 42 129 14.5 27.5 758.25 40.5 1.5 2.25 -26 676 101-162 4.69 13.5 146 27.5 -14 196 42 -28.5 812.25 -14 5 210 25 111-122 1.00 46 168 46 o o 37 9 61 9 81 122-081 4.24 22 117 6 16 256 22.5 - .5 25 -15.5 240.25 111 4.80 12 140 23.5 -11.5 132.25 29 -17 289 - 5.5 30.25 211 3.74 28 "138 20 8 84 16.5 11.5 132 25 3.5 12.25 131-162 3.32 35.5 161 39.5 - 4 16 12 23.5 552.25 27.5 756 25 141-032 4.00 24 131 16 8 64 29 - 5 25 -13 169 151-232 5.66 7 L16 5 2 4 7 o o - 2 4 162-101 4.47 18.5 137 18.5 o o 3 15.5 240.25 15.5 240 25 131 4.24 22 153 33 -11 121 18 4 16 15 225 191 4.58 15.5 119 9 6.5 42.25 2 13.5 182.25 7 49 172-051 3.87 25.5 161 39.5 -14 196 34.5 - 9 81 5 25 221 4.69 13.5 151 29 -15.5 240.25 33 -19.5 360.25 - 4 16 251 3.16 38 155 34.5 3.5 12.25 38 o o - 3.5 12.25 181-032 7.35 3 99 2.5 .5 .25 11 - 8 64 - 6.5 72.25 191-162 2.00 45 118 7 38 1444 1 44 1936 6 36 202-041 3.74 28 129 14.5 13.5 182.25 39 -11 121 -24.5 600.25 241 4.58 15.5 155 34.5 -19 361 44 -28.5 812.25 - 9.5 90.25 211-122 4.24 22 144 26 4 16 5 17 289 21 441 221-172 3.61 31 164 42 -11 121 34.5 - 3.5 12.25 7.5 56.25 232-151 3.32 35.5 142 25 10.5 110.25 19.5 16 256 5.5 30.25 241-032 2.45 42 166 43.5 - 1.5 2.25 40.5 1.5 2.25 3 9 202 2.24 44 167 45 - 1 1 46 - 2 4 - 1 1 251-022 3.74 28 119 9 19 361 15 13 169 - 6 36 172 5.29 8 152 31 -23 529 43 -35 1225 12 144 262-061 3.61 31 146 27.5 3.5 12.25 4 27 729 23.5 552.25 091 6.56 5 119 9 - 4 16 7 - 2 4 2 4 271 3.46 33.5 152 31 2.5 6.25 9 24.5 600.25 22 484 271-262 3.87 25.5 139 21.5 4 16 29 - 3.5 12.25 - 7.5 56.25 Zdz‘: 2‘12! Zdza i 1 i 9424.25 13840.50 8812.75 74 Table B Raw Data Summary Scores Relevant to Hypothesis 1: Selection of Co-therapist :: c: .9. .2 Multiple “a “a 8 8 61 a Therapist '5 '33 'E "a 6 0 Pairs* (9'25, (9% 8 44913 5 25'5“?) '5 4..., .,_, >48 :68..- '33 76561 >463 966669 55 £89 68 585556 012-071 1 16 P I P P PP 022-071 3 1 P P P I PP 251 5 2 P P P I PP 041-012 12 14 P P P P PP 202 17 12 P P P P PP 051-172 10 19 P P P I PP 061-262 13 10.5 P I P P PP 081-022 2 3 P P I I PI 122 19 6 P P P P PP 091-262 7 7 P P I I PI 111-122 22 18 P P P I PP 141-032 16 15 P P I P PI 162-101 6 10. 5 P P P P PP 131 15 20 P P P P PP 181-032 4 5 P P I I PI 191-162 21 4 I I I I II 211-122 14 9 P P I I PI 221-172 11 21 P P P P PP 232-151 8 8 P P P P PP 241-032 23 23 P P P P PP 241-202 20 22 P P P P PP 251-172 9 17 P P P I PP 271-262 18 13 P I P P PP *The selector is given first. 75 Table C Raw Data Summary Scores Relevant to Hypothesis 3: Flexibith >4 0*- 2) Lt 5: u u c: 2: 86's 61 : o v I 0 Multiple _g _g g E. g :3 8 g 3: 8 Therapist 2'3 2'3 :3 ~71 8 g 71 o m a 71 o {2 5;: Pairs '9 '53 c: :1: r: m :4, 0 c: :1: E °° 9 r: :1: a °° 9 U! m o o +0 n. o N- 0 o m- U =3 '3 '5 t: 4: 2* 0+: . '7 5 ‘6‘ 8 '7 3’ 8‘1): 8 8 3w o e- 0 v3: 3 0 0'2 E o OVA 0 - no 0 .—. no a .... a; 8 no 0 60 2'2) 4.28 ":3 96:8 9 91.3 3 “’51. 91.04- 9 £01"? 9;?) f3 ‘8 3’ CV 60 H 0 0 a! o-I 4) C6 29.6: on. 0+2?) 5 “097's 0 “but-.9 230.6 0 6.8 CHI-"5 (.2 280+- 041-012 12 14 31 76 L 24.00 H LH 17.04 H LH 25 76 H HH 041-202 17 12 31.76 L 24.00 H LH 19.44 H LH 38. 96 L HL 051-172 10 19 28.96 L 34.64 L LL 34.96 L LL 17.96 H LH 061-262 13 10. 29.56 L 31.44 L LL 23.44 H LH 19.44 H LH 071-012 1 16 31.76 L 28.44 L LL 53.36 L LL 35.04 L LL 071-022 3 1 21.76 H 28.44 L HL 59.74 L HL 37.44 L LL 081-022 2 3 21.76 H 29.44 L HL 34.44 L HL 31.76 L LL 081-122 19 6 14.64 H 29.44 L HL 12. 96 H HH 9.44 H LH 091-262 7 7 29.56 L 21.44 H LH 36.44 L LL 29.44 L HL 101-162 6 10. 19.76 H 18.64 H HH 19.76 H HH 30.64 L HL 111-122 22 18 14.64 H 30.96 L HL 28.96 L HL 39.76 L LL 131-162 15 20 19.76 H 37.16 L HL 20.96 H HH 30.96 L LL 141-032 16 15 16.64 H 23.96 H HH 23.04 H HH , 23.76 H HH 151-232 8 8 35. 44 L 19.04 H LH 27.04 L LL 40.96 L HL 181-032 4 5 16. 64 H 20.00 H H 22.44 H HH 19.76 H HH 191-162 21 4 19.76 H 31.44 L HL 22.96 H HH 25.76 H LH 211-122 14 9 14.64 H 15.96 H HH 29.76 L HL 20.96 H HH 221-172 11 21 28. 96 L 21.44 H - LH 22. 00 H LH 19.44 H HH 241-032 23 23 16.64 H 10.00 H HH 27.44 L HL 21.76 H HH 241-202 20 22 31.76 L 10.00 H LH 20. 96 H LH 25.76 H HH 251-022 5 2 21.76 H 33.04 L HL 17.76 H H 29.04 L LL 251-172 9 17 28.96 L 33.04 L LL 29.04 L LL 17.44 H LH 271-262 18 13 29.56 L 41.76 L LL 30.96 L LL 29. 36 L LL 76 Table D Raw Data Summary Scores Relevant to Hypothesis 4: Attitudes toward the Opposite Sex 5 5 .... .5 U) Multiple g 3 530+- Therapist u “a H u “a i U) m 1.. 1 Pairs 61:; '43 a, ... '3 6;: o"o 00+- '5'?) ... a. m a: o n. m 6‘? <4 <1: 8- 041-012 12 14 sco CO SCO-CO 041-202 17 12 sco CO SCO-CO 051-172 10 19 sco o sco-o 061-262 13 10. 5 sco sco SCO-SCO 071-012 1 16 sco co SCO-CO 07 1 - 022 3 1 sco sco SCO-SCO 0810-022 2 3 sec sco sco-sco 081-122 19 6 SCO co sco-co 091-262 7 7 CO sco CO-SCO 101-162 6 10.5 co 0 CO-O 111-122 22 18 S0 C0 SO-CO 131-162 15 20 sco o sco-o 141-032 16 15 co sco co-sco 151-232 8 8 sco CO SCO-CO 181-032 4 5 sco sco SCO-SCO 191-162 21 4 sco o sco-o 211-122 14 9 SCO co SCO-CO 221-172 11 21 sco o sco-o 241-032 23 23 co sco CO-SCO 241-202 20 22 co co C0-C0 251-022 5 2 SCO sco sco-sco 251-172 9 17 sco o sco-o 271-262 18 13 co sco co-sco APPENDIX B Measuring Instruments Therapists Therapist' 3 Name Code Name 77 78 Interpersonal Che ck Li st Please answer the following adjective check list as it applies to: 1. Your ideal opposite-sexed co—therapist. 2. Yourself. 79 Interpersonal Check List INSTRUCTIONS: Please indicate whether you view each of the attributes listed below as being either mostly true or mostly false as they apply to you. It is very important that you check either "true" or "false" for each item, even if you are somewhat uncertain of your choice. Also, try to work quickly; most people can complete this information in less than 15 minutes. dethr-n Able to give orders Appreciative Apologetic Able to take care of self Accepts advice readily Able to doubt others Affectionate and under— standing Acts important Able to criticize Admires and imitates others Agrees with everyone Always ashamed of self Very anxious to be approved of Always giving advice Bitter Bighearted and unselfish Boastful Businesslike Bossy Can be frank and honest Clinging vine Can be strict if necessary Considerate Cold and unfeeling Can complain if necessary Cooperative Complaining Can be indifferent to others Critical of others Can be obedient Cruel and unkind Dependent Dictatorial Distrusts everybody Dominating Easily embarrassed Eager to get along with others Easily fooled Egotistical and conceited Easily led Encouraging others Enjoys taking care of others Expects everyone to admire him Faithful follower Frequently disappointed Firm but just 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 Fond of everyone Forceful Friendly Forgives anything Frequently angry Friendly all the time Generous to a fault Gives freely of self Good leader Grateful Hard-boiled when necessary Helpful Hard-hearted Hard to convince Hot-tempered Hard to impress Impatient with others' mistakes . Independent Irritable Jealous Kind and reassuring Likes responsibility Lacks self-confidence Likes to compete with others Lets others make decisions Likes everybody Likes to be taken care of Loves everyone Makes a good impres- sion Manages others Meek Modest Hardly ever talks back Often admired Obeys too willingly Often gloomy Outspoken Overprotective of others Often unfriendly Oversympathetic Often helped by others Passive and unaggres- sive Proud and self- satisfied 90 Always pleasant and 91 92 93 94 95 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 agreeable Resentful Respected by others Rebels against everything Resents being bossed Self-reliant and assertive Sarcastic Self-punishing Self - confident Self-seeking Shrewd and calculating Self-respecting Shy Sincere and devoted to friends Selfish Skeptical Sociable and neighborly Slow to forgive a wrong Somewhat snobbish Spineless Stern but fair Spoils people with kind- ness Straightforward and direct Stubborn Suspicious Too easily influenced by friends Thinks only of self Tender and soft hearted Timid Too lenient with others Touchy and easily hurt Too willing to give to others Tries to be too successful Trusting and eager to please Tries to comfort everyone Usually gives in Very respectul to authority Wants everyone' 3 love Well thought of Wants to be led Will confide in anyone Warm Wants everyone to like him Wi-ll believe anyone Well-behaved 8O Selection of Co-therapist Please answer the following materials as they apply to your co—therapist and/ or to your relationship-with your co-therapist 81 Selection of Co-therapist If you initiated the multiple: 1. Why did you decide upon a multiple? 2. Why did you choose as your co-the rapist ? 3. What did you communicate to about why you chose him/her as your co-therapist? OR If your co-therapist initiated the multiple: 1. Why do you feel chose you as his/ her co-therapist? 2. What did communicate to you about why he/she choseyou as his/her co-therapist? 82 J ourard Self-Disclosure Questionnaire Please read each item on the questionnaire and then indicate on the answer sheet the extent that you have talked about that item to ; that is, the extent to which you have made yourself known to Use the following ratings scale to describe the extent that you have talked about each item: 1. Have told the other person nothing about me. 2. Have talked in general terms about this item. The other person has only a general idea about this aspect of me. 3. Have talked in full and complete detail about this item to other person. He/she knows me fully in this respect, and could describe me accurately. 4. Have lied or misrepresented myself to the other person so'that he/she has a false picture of me. N mummaw CD . 40. 41. 42. 433. 44. 83 Jon rard Self-Disclosure Questionnaire What I think and feel about religion; my personal religion; my personal religious views. My personal opinions and feelings about other religious groups than my own, e. g. , Protestant. Catholics, Jews, atheists. My views on communism. My views on the present government-~the president, government, policies, etc. My views on the question of racial integration in schools, transportation, etc. My personal views on drinking. My personal views on sexual morality--how I feel that I and others ought to behave in sexual matters. My personal standards of beauty and attractiveness in women--what I consider to be attractive in a woman. The things that I regard as desirable for a man to be--what I look for in a man. My feeling about how parents ought to deal with children. My favorite foods, the ways I like food prepared, and my food dislikes. My favorite beverages and the ones I don't like. My likes and dislikes in music. My favorite reading matter. The kinds of movies that I like to see best; the TV shows that are my favorites. My tastes in clothing. The style of house, and the kinds of furnishings that I like best. The kind of party, or social gathering that I like best, and the kind that would bore me. or that I wouldn't enjoy. My favorite ways of spending spare time, e.g. , hunting, reading, cards, sports events, parties, dancing, etc. What I would appreciate most for a present. What I find to be the worst pressures and strains in my work. What I find to be the most boring and unenjoyable aspects of my work. What I enjoy most. and get the most satisfaction from in my present work. What I feel are MY shortcomings and handicaps that prevent me from working as I'd like to, or that pre- vent me from getting further ahead in my work. What I feel are my special strong points and qualifications for my work. How I feel that my work is appreciated by others (e.g. , boss, fellow-workers, teacher, husband, etc. ). My ambitions and goals in my work. My feelings about the salary or rewards that I get for my work. How I feel about the choice of career that I have made--whether or not I'm satisfied with it. How I really feel about the people that I work for, or work with. How much money I make at my work, or get as an allowance. Whether or not I owe money; if so, how much. Whom I owe money to at present; or whom I have borrowed from in the past. Whether or not I have savings, and the amount. Whether or not others owe me money; the amount, and who owes it to me. Whether or not I gamble; if so, the way I gamble, and the extent of it. All of my present sources of income--wages, fees, allowance, dividends, etc. My total financial worth, including property, savings, bonds, insurance, etc. My most pressing need for money right now, e.g. , outstanding bills, some major purchase that is desired or needed. How 1 budget my money--the proportion that goes to necessities, luxuries, etc. The aspects of my personality that I dislike, worry about, that I regard as a handicap to me. What feelings, if any, that I have trouble expressing or controlling. The facts of my present sex life--including knowledge of how I get sexual gratification; any problems that I might have; with whom I have relations, if anybody. Whether or not I feel that I am attractive to the opposite sex; my problems, if any, about getting favorable attention from the opposite sex. Things in the past or present that I feel ashamed and guilty about. The kinds of things that make me just furious. What it takes to get me feeling real depressed or blue. What it takes to get me real worried, anxious, and afraid. What it takes to hurt my feelings deeply. The kinds of things that make me especially proud of myself, elated, full of self-esteem or self-respect. My feelings about the appearance of my face--things I don't like, and things that I might like about my face and head--nose, eyes, hair, teeth, etc. How I wish I looked: my ideals for overall appearance. My feelings about different parts of my body--legs, hips, waist, weight, chest or bust, etc. Any problems and worries that I had with my appearance in the past. Whether or not I now have any health problems--e. g. , trouble with sleep, digestion, female complaints, heart condition, allergies, headaches, piles, etc. Whether or not I have any long-range worries or concerns about my health, e. g. , cancer, ulcers, heart trouble. My past record of illness and treatment. Whether or not I now make special effort to keep fit, healthy, and attractive, e. g. , calisthenics, diet. My present physical measurements, e.g. , height, weight. waist, etc. My feelings about my adequacy in sexual behavior- -whether or not I feel able to perform adequately in sex-relationships. 84 Affection Scale Have you ever been spontaneously affectionate (held hands, given a hug, etc. ) with your co-therapist A. Within the therapy hour(s): Yes No If yes: Please rate the intensity: 1 2 3 4 5 Weak Moderate Very strong Please rate the frequency: 1 2 3 4 5 Once or Often In most twice sessions How does the intensity of your experiences compare with that towards other co-therapists? 1 2 3 4 5 Much less Approximately Much the same stronger B. Outside the therapy hour(s): Yes No If yes: Please rate the intensity: 1 2 3 4 ' 5 Weak Moderate Very strong 85 Please rate the frequency: 1 2 3 4 5 Once or Often In most twice sessions How does the intensity of your experiences compare with that towards other co-therapists? 1 2 3 4 5 Much less Approximately Much , the same stronger 11. Have you ever been verbally affectionate with your co-therapist ? Yes No 111. Have you ever felt like being affectionate with your co- therapist but n_ot acted on the feelings or impulse? A. Within the therapy hour(s): Yes No If yes: Please rate the intensity of the desire: 1 2 3 4 5 Weak V Moderate Very strong Please rate the frequency of the desire: I 2 3 4 5 Once or Often In most twice sessions 86 How does the intensity of the desire compare with that towards other co-therapists? 1 2 3 4 5 Much less Approximately Much the same stronger B. Outside the therapy hour(s): Yes No If yes: Please rate the intensity of the desire: I 2 3 4 5 Weak Moderate Very strong Please rate the frequency of the desire: 1 2 3 4 5 Once or Often In most twice sessions How does the intensity of the desire compare with that towards other co-therapists? l 2 3 4 5 Much less Approximately Much the same stronger IV. Have you ever felt like being verbally affectionate with your co-therapist but £191 acted upon the feelings? Yes No 87 Co-therapi st Inventor: INSTRUCTIONS: Indicate the degree of your agreement or disagreement with each of the following items as it applies to your relationship with your co-therapist and encircle the letter(s) representing the appropriate response. First impressions are satisfactory, and most people are able to complete this inventory in ten minutes. It is quite important that you give a response to each item, even though it may sometimes be difficult to make a decision. We usually can depend on each other. We are as close to each other as we want to be. We feel comfortable when we are with each other. We talk about many things together. Each of us wants to tell the other what to do. There are serious differences in our standards and values. We feel free to express any thoughts or feelings to each other. ' We allow each other to ask for help. We are affectionate with each other. It is not our fault that we are having difficulties. Little problems often become big ones for us. . We do not understand each other. We get along very well. . We often praise or compliment each other. . We do not talk about sex. . We usually get along much better with the client than with each other. . We are proud of our efforts as a multiple therapy team. There are many conflicts in our relationship. . We are usually calm and relaxed when we are together. . We respect each other' 5 privacy. Accomplishing what we want to do seems to be difficult for us. . We tend to worry about many things. We are continually getting to know each other better. . We encourage each other to develop in his or her own individual way. . We have warm, close relationships with each other. Together we can overcome almost any difficulty. . We really do trust and confide in each other. . Our relationship is very important to us. We are considerate of each other. . We can openly and strongly disagree with one another. . We have very good times together. Usually each of us works in his own separate way with the client. . We have respect for each other! 3 feelings and opinions even when we differ strongly. . We sometimes wish we were not working together. . We really enjoy being with each other. We are a disorganized team. , We are not really fond of one another. We are a strong, competent team. We just cannot tell each other our real feelings. . We are not satisfied with anything short of perfection. . We forgive each other easily. . We usually reach decisions by discussion and compromise. . We can adjust well to new situations. . Our decisions are not our own, but are forced on us by circumstances. % (:2 E2 5’; g E: I Strongly Agree Egggggggg UJCDUJ >>> E? E? g E EEEEEEEEEEE E Eggfigggg n: no a: w a: n: lTendtoAgree 33339393” wmwmmmmw mmmmwmmwmwm ID ID N 341 L0 ms