Title: Patient-therapist need compatibility and expectation of psychotherapeutic outcome
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Title: Patient-therapist need compatibility and expectation of psychotherapeutic outcome
Physical Description: viii, 101 leaves. : illus. ; 28 cm.
Language: English
Creator: Plummer, Noel Arthur, 1936-
Publication Date: 1966
Copyright Date: 1966
 Subjects
Subject: Psychotherapy   ( lcsh )
Interpersonal relations   ( lcsh )
Psychology thesis Ph. D   ( lcsh )
Dissertations, Academic -- Psychology -- UF   ( lcsh )
Genre: bibliography   ( marcgt )
non-fiction   ( marcgt )
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Thesis: Thesis -- University of Florida.
Bibliography: Bibliography: leaves 99-100.
Additional Physical Form: Also available on World Wide Web
General Note: Manuscript copy.
General Note: Vita.
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Bibliographic ID: UF00097872
Volume ID: VID00001
Source Institution: University of Florida
Holding Location: University of Florida
Rights Management: All rights reserved by the source institution and holding location.
Resource Identifier: alephbibnum - 000574360
oclc - 13854140
notis - ADA1726

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PATIENT-THERAPIST NEED COMPATIBILITY

AND EXPECTATION OF

PSYCHOTHERAPEUTIC OUTCOME



















By
NOEL ARTHUR PLUMMER










A DISSERTATION PRESENTED TO THE GRADUATE COUNCIL OF
THE UNIVERSITY OF FLORIDA
IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE
DEGREE OF DOCTOR OF PHILOSOPHY









UNIVERSITY OF FLORIDA


APRIL, 1966













ACKNOWLEDGMENTS


I wish to express appreciation and acknowledgment of the

help and guidance of those who aided in the completion of this

dissertation. Without their help, a study of this nature could

not have been attempted.

Deepest appreciation is due my chairman, Dr. Audrey S.

Schumacher. Her contributions covered a wide range of involve-

ment from encouragement through sympathy, instruction, construction,

guidance and challenge.

I wish to thank Dr. Benjamin Barger for his dual contribution

as a committee member and as Director of the Mental Health Clinic

where some of the subjects were secured. I also wish to thank the

other members of the committee; Dr. Richard Anderson, Dr. James

Dixon and Dr. Milan Kolarik for their concern and thoughtful sugges-

tions regarding hypotheses formulation and statistics, and Dr. George

Bartlett for his interest.

I wish to thank Dr. Thomas Martin, Director of the University

Counseling Center and the office staffs at both the Counseling Center

and Mental Health Clinic for their help in obtaining subjects, and

Dr. David Lane for his interest and permission to use the reproduced

portions of the counseling films for the study.

Especially I wish to express appreciation to the students who

gave so willingly of their precious time. Without them, there would









have been no study.


And finally, to my wife and children, I must express my

sincere gratitude, to Nancy, for her work in the numerous early

typings, and acceptance of considerable neglect and stress in

some very trying times, and to all concerned for helping to make

the effort of research more meaningful.












TABLE OF CONTENTS


Page
ACKNOWLEDGMENTS . . . . . . . ... i

LIST OF TABLES . . . . . . . . . vi

LIST OF FIGURES. . . . . . . . . .. viii


CHAPTER

I INTRODUCTION . . . . . . . I

Development of Hypotheses. . . . 7

Hypotheses'to be Tested. . . . .. 10

II METHOD. . . . . . . . . .. .12

Subjects . . . . . . . . 12

Measures of Patient's Needs. . . ... 13

Measures of Therapist's Needs as
Perceived by Patients ..... .19

Measures of Patient's Expectations
for Outcome . . . . ... 24

Testing of Hypotheses. . . . ... .26

III RESULTS . . . . . . . . ... .31

Effect of Presentation Order of
Therapist Films . . . ... .48

Perceived Characteristics of Therapists. 54

IV DISCUSSION. . . . . . . . ... .58

V SUMMARY .. . . . . . . . .. 67










Table of Contents, Continued


Page

APPENDICES . . . . ... .... .. . .72

REFERENCES .... ....... ..... ..... .99

BIOGRAPHICAL SKETCH ...... ..... ... ... 101













LIST OF TABLES


Table Page

1 PIT to FIRO-B Conversion Table . . . ... 19

2 Reliability of Patients' Perceptions of
Therapists (on PIT) Needs Using Alternate
Rating Forms . . . . . . . .. . .22

3 Reliability of Patients' Perceptions of
Therapists on PIT Needs. . . . . ... 23

4 Differences between Mean Scores on
Semantic Differential Factors for the Most,
Second and Least Preferred Therapists. ... . 25

5 Differences between Mean Scores for
Discrepancies between Patients' Value Rankings
of Own Needs and of Therapist Needs. . . . 32

6 Differences between Mean Scores for Discrepancies
between Patients' Level of Conflict Scores for
Valued Needs and Scores of Therapists' Needs . 36

7 Differences between Mean Scores for Discrepancies
between Patients' Level of Conflict Scores for
Valued Needs and Scores of Therapists' Needs . 37

8 Differences between Mean Scores for Discrepancies
between Patients' Level of Conflict Scores for
Devalued Needs and Scores of Therapists' Needs 38

9 Differences between Mean Scores for Discrepancies
between Patients' Level of Conflict Scores for
Devalued Needs and Scores of Therapists' Needs 39

10 Differences between Mean Scores for Discrepancies
between Patients' FIRO-B Wanted Score Converted
to PIT Needs and Scores of Therapists' Needs . 40

11 Differences between Mean Discrepancy Scores
for the Three Therapists for FIRO-B Affectional
Needs with Individual Patient Scores Combined. 41

12 Differences between Mean Discrepancy Scores
for the Three Therapists for FIRO-B Inclusion
Needs with Individual Patient Scores Combined. 41










List of Tables, Continued


Table Page

13 Differences between Mean Discrepancy Scores
for the Three Therapists for FIRO-B Control
Needs with Individual Patient Scores
Combined . . . . . . . . .. .... 42

14 Mean Discrepancy Score Distribution for
the Three Therapists for FIRO-B Control
Needs with Individual Patient Scores Combined. 44

15 Mean Discrepancy Score Distribution for the
Three Therapists for FIRO-B Control Needs
with Wanted Score Greater than the Expressed
Score and Individual Patient Scores Combined . 45

16 Mean Discrepancy Score Distribution for the
Three Therapists for FIRO-B Control Needs
with Expressed Score Greater than the
Wanted Score and Individual Patient Scores
Combined . . . . . . . . ... .. 46

17 Analysis of Variance of Adjusted Scores for
Discrepancies between the Patients' FIRO-B
Control Needs Converted to PIT Needs and Scores
of Therapists' Needs when Patients' Wanted Score
is Greater than the Expressed Score and all Control
Need Scores Combined . . . . . .. .48

18 Differences between Mean Discrepancy Scores for the
Three Therapists for FIRO-B Control Needs Con-
verted to PIT Needs and Scores for Therapists'
Needs when Patients' Wanted Score is Greater than
the Expressed Score with Individual Needs
Combined . . . . . . . . ... .. 50

19 A Comparison of Presentation Order with
Preference Order of Therapists . . . ... .51

20 A Comparison of the Preference Order and
the Frequencies of Therapist Choice. . . .. 52

21 Chi-Square Analyses of Individual Therapist
Preference for Each Presentation . . . ... .53

22 T-tests between Therapists' Mean Scores on 21
PIT Needs as Characterized by Patients . . .. 56













LIST OF FIGURES


Figure


I Mean Scores of Perceived (PIT) Needs
of Therapists . . . . . . . . .


viii


Page












CHAPTER I

INTRODUCTION


Psychotherapy as a scientific discipline is barely 75 years

old. Broadly speaking, however, it is as old as mankind. The heal-

ing effects of a human relationship have always been recognized, at

least implicitly (Szasz, Knoff and Hollender, 1958). The human

relationship between patient and therapist is central to many con-

temporary conceptions of psychotherapy. Psychotherapy as a process

and the patient-therapist relationship have often been the objects

of study. Originally, observations by the therapist and written case

accounts were the only methods of study. These were, of course, in-

fluenced considerably by the personal feelings and theoretical positions

of the therapist. Later, observation rooms and recording devices per-

mitted others to see and hear the events which happened in the therapy

hour. These observations were also subject to considerable distortion

and lacked the precision which was beginning to characterize a large

part of the psychological literature in other areas.

Many professional people began to urge that psychotherapy should

also be subjected to experimental investigation. Others rejected this

idea stating that psychotherapy was so complex and dependent upon the

art of the therapist that scientific investigations of it were con-

sidered almost impossible. Strupp (1962) however, has stated, "To the

extent that psychotherapy attempts a systematic and self-conscious

manipulation of variables in a human relationship and notes its effects,










it has the makings of a scientific discipline" (p. 577). Research

in psychotherapy has been extremely difficult due in part to the

number of pertinent variables and their interactive effects.

One of the most promising lines of research upon the process

of psychotherapy which retains some of the necessary complexity

focuses upon the relationship between the patient and therapist.

These studies have emphasized the patient and therapist personality

variables which interact to increase the probability of favorable

outcome in therapy. Hiler (1958) studied the characteristics of the/

therapist which might influence the patient to remain in or to dis-

continue therapy. Using the total number of Rorschach responses as

an indirect measure of the patient's motivation for therapy, he showed

that therapists who were rated by colleagues as most warm and friendly

tended to keep in therapy a large percentage of unproductive patients.

Furthermore, therapists who were rated as more competent tended to

lose fewer productive patients. As Hiler points out, staying in

therapy, while not synonymous with favorable outcome, is an indis-

pensable prerequisite. In a study of client dependency and therapist

expectancy as relationship maintaining variables in psychotherapy,

Heller and Goldstein (1961) have shown that favorable therapy expec-

tation may help in maintaining the therapeutic relationship. Drop-out

rates were significantly influenced by pre-therapy attraction.

The effect of the initial impressions or expectations held by

the participants in psychotherapy is one of the important aspects of

the patient-therapist interaction and the psychotherapeutic process.

The patient's initial impressions of the therapist, and the patient's









expectations for favorable or unfavorable outcome are seen to be

important factors which may well influence the nature of the inter-

action and the eventual outcome of therapy. Parloff (1956) investi-

gated the influences of the therapist's personality and his perception

of the patient upon the quality of the therapeutic relationship. He

studied the relationships that each of two expert therapists estab-

lished with the same patients in group therapy. He was able to

conclude that the therapist who perceives the patient as more closely

approximating his "ideal patient" concept, created the better thera-

peutic relationship. He also stated, "Clinical experience, as well

as experimental studies suggest that the quality of the relationship

created between patient and therapist may also be a function of the

particular aspects of their personalities and perceptions of each

other" (p. 8).

Apfelbaum (1958) reports a series of studies which are particu-

larly important as background for the present study. Specifically, h-sI

investigations were concerned with patients' strongly held expectations

regarding the personalities of their prospective psychotherapists. The

results which are of interest for the present study suggested a per-

severance through therapy of the patients' expectations of their thera-

pists (Q-sorts at the end of therapy were quite similar to those at

the beginning. The Q-sorts also represented to some degree realistic

descriptions of the therapists). Further, expectation clusters were

associated with interpersonal expectations which were related not only

to general personality functioning of the patients, but also to the

subsequent character of the patient-therapist relationship.










Except for Parloff's, the previously mentioned studies have

been concerned with the characteristics which might affect the indi-

vidual's therapeutic relationships in general. It was suggested\,

that the listed factors would enhance the probability of a good

relationship between the patient and therapist and lead to a gen-

erally favorable outcome. However, it has been suggested further

that many of the important variables in psychotherapy are to be

found in the study of the individual interactions. Fiedler's (1951)

findings encouraged speculation that some characteristics of the

individual interaction and relationship might be more important in

determining outcomes than theoretical orientation or even extent of

training of the therapist. Others have suggested that a therapist

might work well with one patient, or with patients of similar per-

sonality structures, cultural backgrounds, etc., but not with others.

Strupp (1962) states, "an important contribution of research along

these lines would be improved ability to predict the course and out-

come of psychotherapy for a particular patient with a particular

therapist."

The ensuing studies have been referred to as "goodness of fit"

studies because they emphasize the importance of a "fit" between the

personality of the therapist and the personality of the patient.

Studies of the goodness of fit of therapist and patient are repre-

sented by Heine and Carson (1962). Their work showed that the

respective personality patterns of the patient and therapist as

measured by the MMPI should not be too similar or too dissimilar for

the most effective outcome. In his study on authoritarianism in the









therapeutic relationship, Vogel (1959) has suggested that similarity

with respect to attitudes of patient-therapist pairs would enhance

their degree of satisfaction with the relationship. Rosenthal (1955)

has shown that patients who improved in therapy tended to revise

certain of their moral values in the direction of the therapist's

values. Each of these studies seems to suggest that the interaction

of the patient's and therapist's personalities, and their relative

appropriateness to each other would have a significant effect upon

the process of psychotherapy.

Leary (1957) and Snyder (1961) have made extensive attempts

to provide a more scientific basis for patient therapist pairings.

Leary's work began with a basic aim of study of "process in

psychotherapy." However, it was considered a necessary step prior

to process study to construct a systematic way of viewing personality

structure before therapy. An objective detailed analysis of person-

ality on a number of levels was made. Leary presents a system with

many diagnostic and prognostic features. However, the major situation

about which predictions were to be made was the interaction of a

patient with a therapist. One of his primary goals was the assign-

ment of patient and therapist in a fashion that would bring about

the most effective and efficient therapeutic result. It was thought

that this might be achieved through a matching based upon need oriented

diagnostic testing of patient and therapist with the measures selected.

Snyder (1961) reported the results of a four year research pro-

ject in his book, The Psychotherapeutic Relationship. Twenty patients

were seen by one therapist during the course of psychotherapy. The










subjects, with one exception, were graduate students in psychology.

Both therapist and patient were extensively tested and rated before,

at selected intervals during, and after therapy on personality

patterns, preferences and affect toward each other. These data were

then analyzed in terms of the relation of patient to therapist pro-

files and to the outcome of therapy. Snyder concludes,

To us it seems that relationship is a basic component
of therapy. Without it, techniques are of little
value. When client and therapist are properly matched,*
they can develop an effective interpersonal and thera-
peutic relationship which is quite reciprocal in
character, and which grows increasingly positive, making
an effective therapeutic outcome probable. With more
knowledge, it should be possible to determine at the
beginning of therapy which clients and therapists are
best suited to each other, and most likely to be able
to establish a therapeutic relationship. At that point,
therapy will have taken a large step in the direction
of science, and will be less dependent upon the art of
the therapist. (p. 367)

There is support then for the notion that their relationship

may be significantly affected by the relative compatibility of needs

of the patient and therapist. Earlier the importance of the patient's

expectations of the therapist for their relationship was brought out.

These concepts could be combined in the following way: the compati-

bility of the individual patient's needs with the needs of the indi-

vidual therapist as perceived by the patient would be related to the

patient's expectations about the relationship at the beginning of

therapy. These expectations, in turn, would be related to the relation-

ship that was established and to the eventual outcome. The present

study is an investigation of the relations between the compatibility

of the patient's needs with the therapist's needs as perceived by the


"italics inserted










patient and the patient's expectations for therapeutic outcome.


Development of Hypotheses

Hypothesis I

Research with the PIT (Chambers & Broussard, 1960a, 1960b)

(Currier, 1963) and everyday experience suggests that if a person

values a particular need he will feel positively toward people whom

he perceives as having that need. And if he attaches a negative

value to a need, he will generally feel negatively toward those he

perceives to have the need. Thus it seems likely that a patient

will generally seek a relationship with a therapist whom he per-

ceives as having the same values as himself, and that he will have

favorable expectations of this relationship.

It is hypothesized that the patient will have a more

favorable expectation of outcome with a therapist as

his needs are perceived to be more similar to the most

highly valued needs of the patient.

Hypothesis II

Another variable which is seen to be important for the patient's

perceptions of and interactions with the therapist is his relative

level of conflictedness about his own needs. Apfelbaum (1958) has

noted that the patient's level of maladjustment significantly affects

the relationship and eventual outcome of therapy. In many respects

the level of maladjustment might be equated with the patient's degree

of conflictedness in achieving satisfaction of his needs. For the pur-

pose of this study, the patient who cannot combine his needs so as to










achieve satisfaction of a number of needs at the same time is

considered to be conflicted about his needs and to experience a

high level of maladjustment. Whereas the patient who can combine

needs so as to achieve satisfaction of a number of needs at the

same time is seen to be less conflicted and to have a lower level

of maladjustment. It seems plausible that the patient's degree of

conflictedness about his needs will affect his expectations for

therapeutic outcome with a particular therapist. A patient may

positively value certain needs, but be conflicted about them so that

he will avoid a relationship with another person whom he perceives as

also having strong needs the same as his own conflicted ones. For

example, a patient with strong needs for autonomy, dominance, and

aggression, who is conflicted about these needs seems unlikely to

seek a relationship with another person whom he perceives as having

strong needs for autonomy, dominance and aggression. He is likely to

seek a therapist whose perceived need structure is different from his

own. This may be because he seeks easy expression of his own needs

and avoids the competition for need satisfaction, or he may want to

avoid the arousal of anxiety and discomfort in perceiving those needs

in the therapist and thus have to deal with them at some level in

their interaction.

It is hypothesized that the patient's level of conflict about

his highly valued needs will differentially affect his expectation of

outcome with a particular therapist:

The patient with high conflict about his highly valued

needs will have a more favorable expectation of outcome











with a therapist as he perceives the therapist's

needs to be different from his own; the patient with

low conflict about his highly valued needs will have

a more favorable expectation of outcome with a thera-

pist as he perceives the therapist's needs to be

similar to his own.

Hypothesis III

In addition to those findings which suggest that patient-

therapist need structures should be similar, and those which suggest

that difference is desirable, some investigators have suggested that

the respective need-structures should be complementary or reciprocal

in nature for the most effective relationship. Leary (1957), Snyder

(1961), and Apfelbaum (1958) have made suggestions to this effect.

Snyder noted in his extensive study that there was a tendency for

poorer clients to be more like the therapist at the beginning of therapy,

particularly in their high needs for independence. The four clients

least like the therapist at the beginning of therapy were the four cases

ranked as most successful during treatment. He concludes,

We see in these facts some evidence for the concept
of a desirable reciprocity of personality between
client and therapist, or as Leary has suggested that
individuals tend to "pull" from others responses
opposite from their own. At least, it appeared in
our study, that the therapist and client had a better
relationship when their need structures tended to
complement each other, rather than be similar. A
symbiotic type of relationship is suggested here.
(p. 356)

Schutz (1958) in his book FIRO has made an important contri-

bution to this area with his three dimensional theory of interpersonal











behavior. He has attempted a clarification of interpersonal

behavior theory which includes considerable explanation of reciprocal

or complementary needs. The central concept used in this theoretical

explanation of the interaction of the individuals is "compatibility."

"Compatibility is a property of a relation between two or more persons

..., that leads to mutual satisfaction of interpersonal needs and

harmonious coexistence" (p. 105). Reciprocal compatibility exists

when the expressed behavior of one member of a dyad equals the wanted

behavior of the other member, and vice versa. Each individual is

seen as desiring a certain optimal relation between himself and others

in each need area.

Applying this thinking to the present study's focus on the

patient's needs and his perceptions of the therapist,

it is hypothesized that a patient will have a more

favorable expectation of outcome of therapy for a

therapist as he is seen as needing to express what

the patient needs to receive.


Hypotheses to be Tested

General statement

A patient's expectation of outcome of therapy with a particular

therapist can be related in some systematic and predictable ways to

relations between the patient's own need structure and his perception

of the therapist's needs.

Some specific hypotheses about the relationships between patient's

need patterns, his perceptions of the therapist's needs and the patient's

expectation of therapeutic outcome are:










Hypothesis I.--Patients will have a more favorable expectation

of therapeutic outcome with a therapist as his needs are perceived

to be more similar to the most highly valued needs of the patient.

Hypothesis II.--The patient's level of conflict about his most

highly valued needs will differentially affect his outcome expectation

with a therapist, depending upon his perception of the therapist as

having needs similar or dissimilar to his own.

1. The patient who has high conflict about his most highly

valued needs will have a more favorable expectation of outcome in

psychotherapy with a therapist as he perceives the therapist's needs

to be different from his own.

2. The patient with low conflict about his most highly valued

needs will have a more favorable expectation of outcome in psycho-

therapy with a therapist as he perceives the therapist's needs to

be similar to his own.

Hypothesis Ill.--A patient will expect a more favorable out-

come in psychotherapy for a therapist as he perceives him as having

needs reciprocal to his own. A more favorable expectation for outcome

will be held as the therapist is perceived as needing to express what

the patient needs to receive.













CHAPTER II

METHOD


Subjects

Subjects were 42 male university students secured from

both the Mental Health Unit at the University of Florida Infirmary

and from the Counseling Center of the University of Florida. They

ranged from 18 to 31 years of age with a mean of 21.66 years. Only

five were over 25 years of age. The subjects were students who had

applied for help with personal problems but had not begun treatment

at the time of the study. Two measures of the patients' needs were

taken first. They then viewed films of three therapists in action

with the same patient. After each film each patient completed a

form indicating his perception of each therapist's needs, and a form

indicating his expected feelings about the relationship after therapy

with each therapist. Finally, after the films had been seen, the

patients were asked to rank the therapists in terms of the most favor-

able, second favorable, and least favorable expectations for psycho-

therapeutic outcome. The instructions to the patients and a detailed

sequence of procedure administration appear in Appendix A. Only male

patients were used since some studies have reported differences in

therapeutic relationships depending upon whether the therapist and

patient were of same or opposite sexes, Currier (1963) and Apfelbaum

(1958). It also seemed important to exclude from the study those

people who had previous experience with psychotherapy, those who had










previous acquaintance with any of the therapists in the films, and

foreign born students who presented some problems in language

communication.


Measures of Patient's Needs

Picture Identification Test (PIT)

A measure of the patient's dominant needs and need structure

was derived from the scores on the PIT (Chambers, 1958). This instru-

ment is not commonly used in clinical practice, but seems to be a

promising objectively scored projective personality inventory for

use in many areas of clinical practice and research. There are two

forms, Male and Female. The test material consists of six plates of

photographs of same sex persons, ages 18-20, taken from college

annuals. Six pictures are included on each plate. In Part One of

the test, the S is asked to select the two people from each plate he

would like best as friends or people, just by what he can see in the

picture. Then, he is asked to select two from each plate he feels he

would like least.

Part Two consists of six pages, one for each plate of pictures.

Each page has 21 statements, and each statement refers to a need in

the Murray Need System. The subject is asked to indicate which picture

he feels best fits the "personality description" represented by the

statement. Within the 126 statements, there is a repetition of 63

basic statements.

Scoring is done with the IBM 101, 650, or 709. Three dimen-

sions of needs can be derived as a result of three separate scoring










operations. These dimensions are (1) stanine Attitude (A) scores,

(2) stanine Judgment (J) scores and (3) stanine Association Index

(Al) scores, for each of the 21 needs. The (A) Attitude scores and

the (Al) Association Index scores were used in this study. As in

the Currier study (1963), PIT Attitude Scores (A) were treated con-

ceptually as "values." These scores were derived from a summing of

the number of times a particular set of need statements were asso-

ciated with "like best" pictures. A need frequently associated with

"like least" pictures was assumed to be devalued. A high stanine

score represented a need which was positively valued to a greater

degree than the norm group and a low stanine score represented a

need which was devalued to a greater degree than the norm group.

For this study, the highly valued needs of the patient were those

needs which received an attitude or value rating which fell in the

5th, 6th, 7th or 8th stanine category. A copy of the patients'

Attitude Scores for this study appears in Appendix B.

A PIT Association Index (Al) score for a need was considered

an indicator of conflict regarding that need, as was done in the

Currier study. This score was derived from the degree to which the

subject's need combinations.coincided with the norm group. A low

score indicated that he combines needs differently from the norm

group. If a person evidenced an idiosyncratic pattern of need com-

binations, as shown by his low (Al) score, this was considered conflict

about the need. It was inferred that he is unable to combine the need

effectively or to integrate it adequately into his personality. A

high (Al) score was interpreted as indicating relatively little conflict










about a need. A copy of the patient's Association Index scores

for this study appears in Appendix C.

Norms, Reliability and Validity.--Size of the norm groups

has varied for the different types of 'scores, but there were never

fewer than 200 cases for the college student norm groups. An

analysis of the Judgment choices of 600 adult females showed an

average correlation of +.89 with those of college women. Test-retest

reliability with an interval of two months showed a correlation of

+.70 for Judgment choices and +.73 for the Association Index. These

results were similar to those obtained by Chambers (private communi-

cation quoted by Currier), who found reliability coefficients for each

of the 21 needs, to be "around +.50, while coefficients for patterns

were around +.80." (1963).

This test had been administered as part of the Orientation

Testing Program at the University of Florida in February, June and

September, 1962. Norms are being evolved, based on a sample of 2400

students. The male Judgment tables on this sample correlated +.93

with those reported by Chambers. The present study will use Chambers'

norms.

In an early study of validity, Chambers (1957) used the PIT

and the GAMIN, and found that college students' results indicated sig-

nificant correlations among several measures of attitudes. The high

agreement between the self ratings and the objective tests was inter-

preted as support for the concept of identification with the pictures

used to measure attitudes on the PIT.

Two other validity studies by Chambers and Broussard (1960a)










(1960b) investigated the need patterns of normal adult males and

hospitalized veterans. Intercorrelations between groups of needs

and cluster analyses were done. Significant differences were found

between the normals and the patients, thus verifying the importance

of the associations or clusters. This relates to the Association

Index measure.

Fundamental Interpersonal Relations Orientation-Behavior (FIRO-B)

This test was used to measure further aspects of the patient's

need structure. The FIRO-B is a test devised by Schutz (1958) and

was designed to measure an individual's orientation to the inter-

personal needs of inclusion, control and affection. The primary

purposes for its construction were (1) to have a measure of how an

individual acts in interpersonal situations and (2) to have a measure

that will lead to the prediction of interaction between people, based

on data from the measuring instrument alone. It was designed to

measure the individual's desires to express behavior toward others

(e) and his desires for behavior from others (w) in the three areas

of interpersonal interaction; inclusion, affection and control. Each

of the six scores was derived from a separate scale which was composed

following the Guttman (1950) technique for cumulative scale analysis.

Subjects are assigned scale scores (I to 9) equal to the number of

items accepted. Thus, there are six scale scores, one for each area,

expressed inclusion behavior (el), wanted inclusion behavior (wl),

expressed control behavior (eC), wanted control behavior (wC), expressed

affection behavior (eA), and wanted affection behavior (wA). The

wanted dimension of interpersonal needs for the subjects was of major










interest in formulating the hypotheses for the present study. A copy

of the patients' FIRO-B Scaled Scores appears in Appendix D.

Norms, Reliability and Validity.--The original scales were

developed on 150 Ss gathered from the Boston area colleges and mili-

tary units. A cross-validation study was done on 1500 Ss, primarily

from Harvard, Radcliffe, Harvard Business School and other colleges

in the Boston area. Since the split-half method is not appropriate

to the Guttman type scales, reproduclblllty was the appropriate measure

of internal consistency. The coefficient of internal consistency cal-

culated in this way over the six sub-scales yielded a mean of +.94,

with a low of +.93 and a high of .+94. A coefficient of stability,

test-retest reliability, with a one-month interval showed a mean

correlation of +.76, with a low of +.71 and a high of +.82 over the

six sub-s'.iles.

Each of the many studies presented in Schutz's book may be

considered relevant to predictive validity. Some studies show sig-

nificant differences in the interpersonal character of various jobs

and choice of occupation. For example, Business School students were

found significantly higher than Harvard and Radcliffe freshmen on

controlling and influencing others. In the desire to have extensive

relations with people, they scored significantly higher than the

freshmen.

Another area in which data supported the concurrent validity

of FIRO-B was that of political attitudes. Using the FIRO-B and

constructed political questionnaires, McElheny (1957) compared the

interpersonal orientations of the subjects with differing political










attitudes and found significant relationships (.05 level or better

for the individual predictions, and less than .01 for the combined

predictions), which would discriminate individuals with divergent

political attitudes. Other studies by Bunker (1957) and Cohen (1957)

have shown significant relations between interpersonal orientations

on the FIRO-B and conformity behavior situations.

Conversion of PIT Scores to FIRO-B Scores

Since it was planned to compare the behaviors the patients

"wanted" with their perceptions of the behaviors the therapists needed

to express, it was necessary to devise a method for converting the 21

PIT Needs to wanted behaviors in the three FIRO-B categories. This

conversion was done in the following way: the definitions of the 21

PIT Needs as contained in the PIT Manual for Subjects (Chambers, 1958)

were compared with the definitions for each of the three need areas

of the FIRO-B (Schutz, 1958). Each of the PIT Needs was then placed

into one of the three FIRO-B categories on the basis of what appeared

to be the most crucial behavioral dynamic of the definition. For

example, the need to dominate was seen to involve primarily the be-

havior of attempting to control others and was classified under the

FIRO-B Control Needs. In a similar manner, the need for affiliation

appeared primarily to involve a general need for Inclusion. Similarly,

the need of nurturance seemed to involved primarily Affection Needs.

Some needs, as the ones mentioned above, were quite easy to place into

FIRO-B categories. A few needs such as PIT Need #12 Harm Avoidance,

#19 Sex, and #11 Exhibition were not as simple to categorize. A chart

showing the conversions appears in Table 1.




19

Table 1

PIT to FIRO-B Conversion Table


FIRO-B Needs

INCLUSION AFFECTION CONTROL


PIT Needs

# 3 Affiliation # 1 Abasement # 2 Achievement

# 6 Blame # 8 Deference # 4 Aggression
Avoidance

#12 Harm #14 Nurturance # 5 Autonomy
Avoidance

#13 Inferiority #18 Sentience # 7 Counteraction
Avoidance

#16 Play #19 Sex # 9 Defendance

#17 Rejection #20 Succorance #10 Dominance

#11 Exhibition

#15 Order

#21 Understanding



Measures of Therapist's Needs as Perceived by Patients

Separate films of the three individual therapists in action with

the same client were taken from a series of counseling films already

available at the University of Florida. Gollin (1960) used a movie

presentation to study the forming of impressions of personality. He

states regarding moving picture presentations, "Information about social

perception may be obtained by a variety of methods, but it is likely

that the most productive methods will be those which attempt to retain

the rich and varied stimulus properties of persons while exercising









optimal experimental control over the judgment producing situation...

the use of motion pictures provides an excellent vehicle for achieving

these methodological goals." (1960, p. 161.)

The therapists and the patient in the films are all males with

PhD's in Clinical Psychology with at least five years experience as

counselors or psychotherapists. They ranged in age from 38 to 52.

The films are from 20-28 minutes long. From five films that were

available, three were used in this study. They were selected on the

basis of the therapist characteristics which most closely approximated

the three therapist types which were pre-conceived by Apfelbaum's (1958)

patients. They were also selected for diversity of therapist charac-

teristics on the basis of ratings done by five graduate students in

psychology. A ten-minute segment from each film was selected for pre-

sentation. Presentation of therapist films to the subjects was

systematically varied as follows: ABC, BCA, CAB, ACB, BAC, CBA to

control for possible sequential effects.

PIT Behavior Rating Scale (BRS)

This test was devised by the author to measure the patient's

perceptions and impressions of the therapists' need structures. This

was achieved by securing ratings on the behavior description statements

from Part II of the PIT. A copy of this form and the instructions

given to the patients appears in Appendix E. Each of the 21 state-

ments refers to a need in the Murray System, and was selected from

three possible statements as best representing that particular need.

The patient was asked to rate each therapist on each statement on an

eight point rating scale indicating the degree to which a particular










need behavior was perceived as characteristic of a given therapist.

The scales for each therapist were completed immediately after the

film in which he was portrayed, to prevent overlap or confusion of

impression. A copy of the BRS Scores attributed to the therapists

in this study appears in Appendix F.

Reliability.--An important question affecting the outcome of

this study was related to the problem of the consistency or reliability

with which the needs were attributed to a given therapist, and also

that some needs may be rated high or low more consistently than others.

If the needs were not rated consistently high or low to a given thera-

pist, though they may vary between therapists, it would be difficult

to draw meaningful conclusions regarding the impressions formed. It

was important that they be related to stable impressions of personality

characteristics of the therapist, rather than momentary feelings or

impressions.

A study was made of the reliability of patient perceptions of

the therapists. This was done through the construction of an alternate

form to the original measure. The alternate form was constructed by

using 21 additional behavior description statements from Part II of the

PIT, one for each of the 21 needs. These statements were presented at

the same time as the original and scored in the same way. A copy of

this form appears in Appendix E. The original form occupies the first

page of the Behavior Rating Scale, and the alternate form is on the second

page. The original and alternate forms were used to rate each therapist.

Two measures of consistency were computed. Firstly, it was possible

to determine the degree of consistency with which the needs were assigned










to the individual therapists. The correlation between the original

and alternate form ratings for each therapist indicated the strength

of the tendency for the needs to be consistently rated for a particular

therapist. The correlations for the three therapists appear in Table

2. The correlation of the ratings of Therapist B's needs between the

original and alternate forms for all needs by all subjects was .642,

for Therap'st C .618 and for Therapist A .59. And secondly, corre-

lations were computed to determine the consistency with which each of

the 21 needs was rated high or low for any therapist. Table 3 shows

the correlations between the original and alternate forms for each of

the 21 needs, therapists combined. They range from a correlation of

.757 for .eed #2 (Achievement) to an R of .307 for need #3 (Affilia-

tion).


Table 2

Reliability of Patients' Perceptions of Therapists
(on PIT) Needs Using Alternate Rating Forms

Needs by all Ss



Therapists Pearson r


Therapist A .590

Therapist B .642

Therapist C .618













Table 3

Reliability of Patients' Perceptions of
Therapists on PIT Needs


Need Pearson r Need Pearson r


Abasement

Achievement

Affiliation


Aggression

Autonomy

Blame Avoidance

Counteraction

Deference

Defendance

Dominance


.415

.757

.307


.522

.466

.419

.741

.605

.549

.530

#21


#11 Exhibition

#12 Harm Avoidance

#13 Inferiority
Avoidance

#14 Nurturance

#15 Order

#16 Play

#17 Rejection

#18 Sentience

#19 Sex

#20 Succorance

Understanding .647


# 1

#2

#3


#4

#5

#6

#7

#8

#9

#10


.558

.488


.629

.395

.675

.707

.565

.518

.737

.493










Measures of Patient's Expectations for Outcome

Semantic Differential

A Semantic Differential Scale was presented after each film.

A copy appears in Appendix G. This scale, based on Osgood's findings

(1957), was used to obtain a measure of the patient's anticipated

feelings about the therapeutic relationship after psychotherapy with

each therapist. It also provided a comparison to the actual rank-

ings of the therapists. The word pairs were selected from the list-

ings of Osgood to include the highest pure factor loadings. Only

scores on the Evaluative and Potency Factors were used in the present

study.

Rankings

After viewing the three films the patients were asked to indi-

cate their expectations for therapy outcome by ranking and comparing

the three therapists in two ways. A copy of this form and instruc-

tions appears in Appendix H. Patients ranked therapists, listing

first the therapist for whom the most favorable expectation was held;

second, the therapist for whom the next most favorable expectation

was held; and third, the therapist for whom the least favorable out-

come was expected. Next, they were asked to compare the therapists

and rate them on a four point scale on the degrees of difference they

perceived between the therapists. A copy of the Actual Rankings and

the rankings as determined by the Semantic Differential Factors E and P

appears in Appendix I.

Comparisons Between Semantic Differential and Actual Ranking

The mean factor scores for each therapist on each of the Semantic





25


Differential factors were placed in one of three columns, for the

most preferred, second preferred, or least preferred therapist as

based upon the actual rankings. T-tests were then determined on the

differences between the means of the distributions. These analyses

for both the Evaluative and Potency Factors appear in Table 4. All

six of the tests are significant beyond the .01 level. There were

significantly higher mean factor scores on both factors for the most

preferred therapist than for the second and least preferred therapists.

There were also significantly higher mean factor scores on both factors

for the second as compared with the least preferred therapists.


Table 4

Differences between Mean Scores on Semantic
Differential Factors for the Most,
Second and Least Preferred Therapists

-?, 0 I 2


SEMANTIC DIFFERENTIAL EVALUATIVE FACTOR E
X Analysis


Most Preferred

Second Preferred

Least Preferred


1.56

.76

- .11


SEMANTIC DIFFERENTIAL

X


Therapist


Most Preferred

Second Preferred

Least Preferred


1.45

.62

- .27


x with y 4.922

x with z 9.68"'

y with z 4.54'"


POTENCY FACTOR P

Analysis t


with

with

with


4.59"

9.38

4.15'


**P < .01 level


Therapist










Testing of Hypotheses

Hypothesis I

Patients will have a more favorable expectation of thera-

peutic outcome with a therapist as his'needs are perceived to be

more similar to the most highly valued needs of the patient. Com-

parisons were made between the scores of the highly valued needs of

the patient (5th, 6th, 7th, and 8th stanine Attitude scores on the

PIT), and each therapist's scores for the same needs on the PIT

Behavior Rating Scales. Discrepancy scores were computed between

the high ratings of the patient's needs and his high or low ratings

of the therapists for each of those needs. The Behavior Rating

Scales were designed with an eight point rating range to make possible

an easier comparison with the stanine scores of the PIT. A high

discrepancy between a patient's score and the therapist's score would

indicate a difference in need structure; whereas a low discrepancy

score between patient and therapist need scores would indicate a

similarity between the highly valued needs of the patient and those

needs seen as characteristic of the therapist. Thus, high discrepancy

means difference, and low discrepancy means similarity.

The discrepancy scores for each of the patient's highly valued

needs were summed and divided by the number of highly valued needs.

This resulted in a mean discrepancy score for each patient-therapist

pair. This score was assumed to be an indication of the degree of

similarity or difference, the "fit" between the most highly valued needs

of the patient and his ratings of the therapists on those needs. The

mean discrepancy scores were placed in one of three columns, for the









most preferred, second preferred, or least preferred therapist as

determined by the actual rankings. A second ranking of the thera-

pists was achieved by using the semantic differential mean factor

scores. The highest factor score was assumed to indicate the most

preferred therapist, the second highest score, the second preferred

therapist, and the lowest factor score for the least preferred thera-

pist. Analyses were done for both the Evaluative and Potency Factors.

Operationally, Hypothesis I predicted that the mean discrepancy

scores would be lowest for the most preferred therapist, next lowest

for the second preferred therapist, and highest for the -st preferred

therapist.

Hypothesis II

The patient's level of conflict about his most highly valued

needs will differentially affect his expectation of outcome with

therapists.

1. The patient with high conflict about his most highly

valued needs will have a more favorable expectation of

outcome in psychotherapy with a therapist as he perceives

the therapist's needs to be different from his own.

2. The patient with low conflict about his most highly

valued needs will have a more favorable expectation of

outcome in psychotherapy as he perceives the therapist's

needs to be similar to his own.

As stated earlier, each need for each patient received both an

Attitude Score (treated conceptually as valued), and an Association

Index Score (treated conceptually as conflict indicator). A high










Association Index Score for a particular need meant relatively low

conflict about the need, and a low Association Index Score means

relatively high conflict about a particular need. Only the Associa-

tion Index Scores for the most highly valued needs were used in the

analysis. These scores were then compared with the scores attributed

to each therapist for those needs. Discrepancy scores were then com-

puted for each need and averaged for each patient-therapist pair,

yielding a mean discrepancy score as in Hypothesis I.

The patients were then divided into high and low conflict

groups and these were analyzed separately. The division was done

in the following way: the sum of a patient's individual Association

Index scores for highly valued needs was divided by the number of

needs involved to obtain a mean Association Index Score. This score

was assumed to indicate a general level of conflictedness about the

patient's most highly valued needs. The mean Association Index scores

were ranked from highest to lowest and then divided at the midpoint

of the distribution into High and Low Conflict Groups. It was assumed

that t,.e group having high mean Al scores were relatively less con-

flicted about their most highly valued needs than the group having

lower Al scores.

A low mean discrepancy score for the most preferred therapist

of a low conflict patient (High Al score) was assumed to mean that the

patient who was relatively less conflicted about his highly valued

needs had sought a relationship with a therapist who was characterized

by those needs and thus similar in need structure to the patient. Where-

as, a low mean discrepancy score for the most preferred therapist of










a high conflict patient (Low Al score) was assumed to mean that

the patient had sought a relationship with a therapist who was not

characterized by those needs and thus different in need structure

from the patient.

Operationally, the discrepancies between the Al scores of

the patient for his highly valued needs, in both the High and Low

Conflict Groups, and his ratings of the therapist on those needs

would be lowest for the most preferred therapist and highest for

the least preferred therapist.

Hypothesis III

A patient will expect a more favorable outcome with a thera-

pist as he perceives him as having needs reciprocal to his own. A

more favorable expectation for outcome will be held as a therapist

is perceived as needing to express what the patient needs to receive.

Comparisons were made between each patient's FIRO-B scaled

scores for wanted behavior from others translated into his most highly

valued PIT needs and the patient's ratings of each therapist on those

needs from the BRS. The translation was done in this manner since the

crucial factor in the analysis of this hypothesis was the degree that

a particular valued PIT need behavior was wanted by the patient. This

permitted comparison between the degree of the patient's desire for

satisfaction of a given need and his perception of a particular thera-

pist's likelihood of fulfilling that need. The conversion from the

FIRO-B wanted score to the PIT needs was done in the following way. If

the wanted dimension of the Inclusion Needs of the FIRO-B received a

score of 6, then each of the PIT Needs which was regarded as Inclusion










Needs (conversion formula in Table 1) also received a score of 6.

The Affection and Control Needs were also handled in the same way.

The discrepancies between the patient's score and those of

the therapists were computed in the following way. Since the

patient's wanted score for a given need ranged from 1 through 8,

it was assumed in this study that a patient score of 4 or lower on

a need indicated a low desire for that behavior from others. A

patient score of 5 or above was considered as indicating a high

desire for a given behavior from others. Thus, it was assumed that

a patient with a low desire for a particular behavior would have a

more favorable expectation of therapeutic outcome in a relationship

with the therapist who was perceived as at least having that need.

Likewise, a patient with a high desire for a particular behavior would

have a more favorable expectation with the therapist who was perceived

as most possessing that need.

For example, if patient X's wanted score for Need #4 was 3,

and the scores for the therapists were Therapist A, 4; Therapist B, 2;

and Therapist C, 5, patient X would have the most favorable expectation

for Therapist B. Therapist B would receive a discrepancy score of 0,

Therapist A, 2, and Therapist C, a score of 3. If patient Y's wanted

score was 7 for Need #4, and the therapists' scores were Therapist A, 8,

Therapist B, 3, and Therapist C, 7; patient Y would have the most favor-

able expectation for Therapist A. Therapist B would receive a dis-

crepancy score of 5, and Therapist C a score of 1. The therapist for

whom the most favorable expectation was held received a discrepancy

score of 0, and the other therapists' scores were based upon their

numerical distance from the score of the most preferred therapist.













CHAPTER III

RESULTS


The results of the study will be reported in relation to

the hypotheses that were tes.ted.

Hypothesis I stated that a patient would have a more favor-

able expectation of outcome with the therapist whose perceived needs

were similar to his own most highly valued needs. Operationally,

it suggested that the discrepancy scores would be lowest for the

most preferred therapist, somewhat higher for the second preferred

therapist, and highest for the least preferred therapist. The

attitude scores for each patient's most highly valued needs were

compared with his ratings for each of the therapists on the same

needs as described in Chapter II. Discrepancy scores, after being

computed and averaged, yielded a mean discrepancy score for each

patient-therapist pair. These mean discrepancy scores for each pair

were then placed in columns for most, second, and least preferred

therapist as determined by the actual rankings by the two Semantic

Differential Factors, Evaluative (E) and Potency (P). For the Seman-

tic Differential criteria, the therapist with the highest mean factor

loading was assumed to be the most preferred, the therapist with the

second highest factor loading was considered the second preferred,

and the therapist receiving the lowest factor loading was considered

the least preferred.

Table 5 shows the means for each distribution and the t-tests













Table 5

Differences between Mean Scores for Discrepancies
between Patients Value Ranking of Own
Needs and of Therapist Needs

N = 42


Therapist

X Most Preferred

Y Second Preferred

Z Least Preferred


ACTUAL RANKING

X Analysis


1.79

1.80

1.90


x with

x with

y with


SEMANTIC DIFFERENTIAL

X


Therapist


Most Preferred

Second Preferred

Least Preferred


1.76

1.86

1.94


SEMANTIC DIFFERENTIAL

X


Therapist


Most Preferred

Second Preferred

Least Preferred


1.78

1.82

1.98


FACTOR E

Analysis


x with y

x with z

y with z

FACTOR P

Analysis


x with

x with

y with


*P < .05


.13

2.08*

1.79


.96

1.80

.72


.40

2.07*

1.55










for the differences between the means. The two significant relation-

ships (P <.05) indicate significantly lower discrepancy scores for

the most preferred than for the least preferred therapist on the

actual rankings and for the Semantic Differential Factor P. The t-

test for the Semantic Differential Factor E between the mean of the

most preferred and the least preferred therapist is suggestive of a

similar trend, but is not significant. In each of the analyses, the

means are in the predicted direction for all therapists with the lower

mean scores associated with the most preferred, the next highest means

for the second preferred, and the highest mean for the least preferred

therapist. No significant relationships were found between the means

of the first and second preferred therapists, nor between the means of

the second and least preferred therapists.

Hypothesis II stated that the patient's degree of conflict about

his most highly valued needs would differentially affect his outcome

expectation for different psychotherapists in the following ways: (1)

the patient with high conflict about his most highly valued needs would

have a more favorable expectation for outcome with a therapist of

different need structure, and (2) the patient with low conflict about

his most highly valued needs would have a more favorable expectation

for outcome with a therapist of similar need structure. The Ss were

divided into High Conflict and Low Conflict Groups as described in

Chapter II. It was predicted that the discrepancy scores for both

groups would be lowest for the most preferred, next highest for the

second preferred, and highest for the least preferred therapist. Analyses

were done using both the actual rankings and the Semantic Differential










factors as criteria.

T-tests on the differences between the mean discrepancy scores

for each of the therapists for the Low Conflict Group appear in Table 6,

and for the High Conflict Group in Table 7. These differences were

not statistically significant. However, the lowest discrepancies were

associated with the least preferred therapist in every analysis for

both the Low and High Conflict Groups, and the highest discrepancies

were associated with the most preferred therapist in one of three

cases with the Low Conflict Group with all three cases in the High

Conflict Group. Further analyses were also done on the devalued needs

for both the Low and High Conflict Groups. These analyses are pre-

sented in Tables 8 and 9. These results were also insignificant.

However the lowest discrepancies were associated with the least pre-

ferred therapist in two out of three cases for the Low Conflict Group

and for all three cases in the High Conflict Group. The highest dis-

crepancies were associated with the most preferred therapist in all

six instances. Combined, these data show the lowest discrepancies

associated with the least preferred therapist in 11 of 12 possible

instances, and the highest discrepancies associated with the most pre-

ferred therapist in 10 out of 12 instances.

Hypothesis III stated that a reciprocity of need patterns of

patient and therapist would be associated with patients' expectations

of favorable outcome. Comparisons were made between the patient's

wanted score as indicated on the FIRO-B and converted to PIT for a

particular need and the scores attributed to each of the therapists

for the same PIT need. T-tests on the differences between the mean










discrepancy scores for the first, second and least preferred thera-

pists using the actual rankings and the Semantic Differential Factor

Rankings appear in Table 10. These results suggest there are no non-

chance variations in this sample as presented.

A further breakdown of these data was made using the method

shown in Table 1. In order to permit a more specific analysis, the

21 needs of the PIT were separated into one of the three major need

classifications as described by Schutz (1958); Affection, Inclusion,

and Control.

Discrepancies were computed between the patient's wanted score

and the score attributed to each therapist as in previous analyses.

However, these raw discrepancies were then summed for the most, second

and least preferred therapist according to the PIT Needs and these

sums were placed into distributions based on the FIRO-B Need cate-

gories using the conversion chart presented in Table I. All patients

did not, of course, highly value the same needs or types of needs, thus

there were unequal numbers of patients who contributed to each of the

Need scores. The total discrepancy score for the most, second and

least preferred therapist for a particular need was therefore divided

by the number of patients who had contributed to that discrepancy and

yielded a mean discrepancy score for each therapist for each need,

patients combined. T-tests between the mean discrepancy scores of

the Affective needs are presented in Table 11. These show no signifi-

cant relationships and no consistent trends. T-tests for the Inclusion

Needs are presented in Table 12. No significant relationships or

trends are noted here.













Table 6

Differences between Mean Scores for Discrepancies
between Patients' Level of Conflict Scores for
Valued Needs and Scores of Therapists' Needs

Low Conflict Patients

N = 21


Therapists


X Most Preferred

Y Second Preferred

Z Least Preferred


ACTUAL RANKING

X Analysis


2.06

2.10

1.91


x with y .21

x with z .81

v with z .93


SEMANTIC DIFFERENTIAL

X


Therapists


Most Preferred

Second Preferred

Least Preferred


2.03

2.09

1.95


FACTOR E

Analysis


SEMANTIC DIFFERENTIAL

X


Therapists


X Most Preferred

Y Second Preferred

Z Least Preferred


2.12

1.97

1.88


FACTOR P

Analysis t


with

with

with


.78

1.319

.429


with

with

with


.30

.43

.68


_ _












Table 7

Differences between Mean Scores for Discrepancies
between Patients' Level of Conflict Scores for
Valued Needs and Scores of Therapists' Needs

High Conflict Patients

N = 21


ACTUAL RANKING

X Analysis


Therapists


X Most Preferred

Y Second Preferred

Z Least Preferred


SEMANTI


1.84

1.80

1.74

C DIFFERENTIAL

7


Therapists


x with y .29

x with z .69

y with z .50

FACTOR E

Analysis t


X Most Preferred

Y Second Preferred

Z Least Preferred


1.87

1.75

1.76


SEMANTIC DIFFERENTIAL


Therapists


X Most Preferred

Y Second Preferred

Z Least Preferred


1.85

1.77

1.76


x with y

x with z

y with z

FACTOR P

Analysis


x with

x with

y with






38





Table 8

Differences between Mean Scores for Discrepancies
between Patients' Level of Conflict Scores for
Devalued Needs and Scores of Therapists' Needs

Low Conflict Patients

N = 21


ACTUAL RANKING
X Analysis


Therapists


Most Preferred

Second Preferred

Least Preferred


2.09

2.03

-1.99


x with y .71

x with z .86

v with z .58


Therapists


SEMANTIC DIFFERENTIAL

X


FACTOR E

Analysis t


X Most Preferred

Y Second Preferred

Z Least Preferred

S

Therapists


X Most Preferred

Y Second Preferred

Z Least Preferred


2.02

1.92

1.94

EMANTIC DIFFERENTIAL
X


2.06

1.97

1.95


1.21

.98

.42


x with y

x with z

y with z

FACTOR P

Analysis


x with y

x with z

y with z


.83

1.18

.37













Table 9

Differences between Mean Scores for Discrepancies
between Patients' Level of Conflict Scores for
Devalued Needs and Scores of Therapists' Needs

High Conflict Patients

N = 21


ACTUAL RANKING
X


Therapists


Analysis


X Most Preferred

Y Second Preferred

Z Least Preferred

S

Therapists


X Most Preferred

Y Second Preferred

Z Least Preferred


2.02

1.92

1.88


EMANTIC DIFFERENTIAL

X


2.08

1.85

1.88


x with y .55

x with z .79

y with z .23


FACTOR E

Analysis t


x with

x with

y with


1.30

1.19

.18


Therapists


SEMANTIC DIFFERENTIAL

79


X Most Preferred

Y Second Preferred

Z Least Preferred


1.98

1.92

1.91


t.


FACTOR P

Analysis


x with y

x with z

y with z












Table 10

Differences between Mean Scores for Discrepancies
between Patients' FIRO-B Wanted Score Converted
to PIT Needs and Scores of Therapists' Needs

N = 42


ACTUAL RANKING
X Analysis


Therapists


X Most Preferred

Y Second Preferred

Z Least Preferred


.99

1.03

.97


x with y

x with z

y with z


Therapists


X Most Preferred

Y Second Preferred

Z Least Preferred


SI

Therapists


X Most Preferred

Y Second Preferred

Z Least Preferred


SEMANTIC DIFFERENTIAL FACTOR E

7 Analysis


1.04

1.01

.93


SEMANTIC DIFFERENTIAL

X


1.002

1.000

.985


x with y

x with z

y with z


FACTOR P

Analysis


x with y

x with z

y with z


.364

.018

.541


.28

1.00

.71






41



Table 11

Differences between Mean Discrepancy Scores
for the Three Therapists for FIRO-B Affectional
Needs with Individual Patient Scores Combined

N = 6


ACTUAL RANKING
Therapists X
------------------- -- -- - - --- --- ----- -1 .


X Most Preferred

Y Second Preferred

Z Least Preferred


1.02


.84


Analysis t


x with y

x with z

y with z


.24

1.04

.88


Table 12


Differences between Mean Discrepancy Scores for the
Three Therapists for FIRO-B Inclusion Needs
with Individual Patient Scores Combined

N = 6



ACTUAL RANKING


Therapists X


X Most Preferred

Y Second Preferred

Z Least Preferred


1.10

1.06


Analysis t


x with y

x with z

y with z


.27

1.52

.86










T-tests between the means of the discrepancy scores for the

control needs are presented in Table 13. There are no significant

differences among the scores. The mean discrepancy score distri-

bution for the control needs is presented in Table 14. The column

totals and the entries for needs #4, #5, and #10, are in the predicted

direction with the lowest mean discrepancy scores associated with

the most preferred, the next highest scores with the second preferred,

and the highest scores with the least preferred therapist. In five

of nine instances the lowest discrepancies are associated with the

most preferred therapist.

A further breakdown of the control needs was done by dividing

the patients into two groups. As previously indicated (Schutz, 1958)

each need received two scores; a score indicating the degree that the

patient wanted to be acted toward in a given way, and a score indi-

cating the degree that the patient wanted to express a behavior

toward others.


Table 13

Differences between Mean Discrepancy Scores for the Three
Therapists for FIRO-B Control Needs with Individual
Patient Scores Combined

N = 9



ACTUAL RANKING
Therapists 9 Analysis t

X Most Preferred .87 x with y .99

Y Second Preferred 1.04 x with z 1.53

Z Least Preferred 1.14 y with z .41










In Group X were placed those patients whose wanted score

for control was greater than their score for the need to express

control over others. In Group Y were placed those patients whose

wanted score was equal to or less than the score for the need to

express control over others. Comparisons were then made among the

discrepancy scores for the most, second and least preferred thera-

pists for both groups. These data appear in Tables 15 and 16. The

column totals for Group X Table 15 do not fall in the predicted

direction. But they continue to show a tendency for the lowest

discrepancy scores to be associated with the most preferred thera-

pist (five of nine). In addition, it must be noted that the differences

in the scores became more pronounced and more consistently in the

direction of the lowest discrepancy scores being associated with the

most preferred and the higher ones with the second and least preferred

therapists. For example, when comparing scores in Table 14 with those

in Table 15, the discrepancy scores for Group S, for the most pre-

ferred therapist became lower in six of nine instances, where as the

discrepancy scores became higher for the second preferred therapist in

eight of nine instances, and higher in six of nine instances for the

least preferred therapist.

In Group Y, Table 16, the highest discrepancies are associated

with the most preferred therapist in the column totals and for five

of the nine individual needs. In addition, the comparison between

Table 14 and Table 16 show that the discrepancy scores for the most

preferred therapist became higher in five cases, remained the same in

three cases, and became lower in one. Whereas the discrepancy scores











Table 14

Mean Discrepancy Score Distribution for the Three Therapists
for FIRO-B Control Needs
with Individual Patient Scores Combined

N=9



Control Most Preferred Second Preferred Least Preferred
Needs Therapist Therapist Therapist


# 2 1.15 .95 .45

# 4 .91 1.55 1.64

# 5 1.00 1.22 1.74

# 7 1.26 .42 .74

# 9 .63 1.69 1.56

#10 .57 .86 1.33

#11 .47 1.58 1.00

#15 1.00 .58 1.05

#21 .83 .63 .71



-X 7.82 9.48 10.22 27.52

X .87 1.05 1.14 1.02











Table 15

Mean Discrepancy Score Distribution for the Three Therapists
for FIRO-B Control Needs
with Wanted Score Greater than the Expressed Score
and Individual Patient Scores Combined

Group X

N =9



Control Most Preferred Second Preferred Least Preferred
Needs Therapist Therapist -- Therapist


# 2 1.00 .88 .38

# 4 .83 2.25 1.83

# 5 1.00 1.27 2.09

# 7 .88 .75 1.13

# 9 .22 2.00 2.00

#10 .43 1.43 1.00

#11 .29 2.00 1.14

#15 .90 .60 1.10

#21 .85 .69 .69



2 X 6.40 10.43 9.54 26.37

X .71 1.15 1.06 .98











Table 16

Mean Discrepancy Score Distribution for the Three Therapists
for FIRO-B Control Needs with Expressed Score
Equal to or Greater than the Wanted Score
and Individual Patient Scores Combined

Group Y

N=9



Control Most Preferred Second Preferred Least Preferred
Needs Therapist Therapist- Therapist


# 2 1.15 .92 .46

# 4 1.00 1.10 1.40

# 5 1.00 1.16 1.41

# 7 1.54 .18 .45

# 9 1.14 1.28 1.00

#10 .57 .50 1.50

#11 .58 1.33 .91

#15 1.11 .55 1.00

#21 .81 .54 .72



1X 8.90 7.56 8.85

" .98 .84 .98










became lower in all nine instances for the second preferred therapist,

and lower in six of nine instances for the least preferred therapist.

An analysis of variance of the data in Table 15 appears in

Table 17. A further statistical adjustment was required to permit

this analysis. Each need score was contributed to by individual

subject scores for that need. The individual subject scores on a

particular need were recorded in the following manner. A zero score

was given for the therapist who most fit (page30, Chapter 11) the

patient's needs, and other scores were recorded according to their

numerical distance from the score for the therapist most fitting the

needs of the patient. For the present statistical analysis, an

addition of one point was made to each score.

The F ratio of 4.74 with two and 249 df is significant beyond

the .01 level. Table 18 shows the t-tests for all three criteria,

the actual rankings, and Semantic Differential Factors E and P. Five

of the nine tests are statistically significant, three beyond the

.01 level and two beyond the .05 level. There were significantly

lower discrepancy scores for the most preferred than for the second

preferred therapist for the actual rankings (P < .01), and for the

Semantic Differential Evaluative Factor (P < .05). There were sig-

nificantly lower discrepancy scores for the most preferred than for

the least preferred therapist for the actual rankings (P < .01), for

the Semantic Differential Evaluative Factor (P < .05), and for the

Semantic Differential Potency Factor (P < .01) when the wanted scores

are greater than the expressed scores.










Table 17

Analysis of Variance of Adjusted Scores for Discrepancies
between the Patients' FIRO-B Control Needs Converted to PIT Needs
and Scores of Therapists' Needs When Patients' Wanted Score is
Greater than the Expressed Score and Individual Patient and
all Control Need Scores Combined

Group X

N = 84




Source df MS F


Between 2 9.155 4.74"

Within 249 1.93



P < .01


Effect of Presentation Order of Therapist Films

The order of therapist film presentation was systematically

varied in this study (as described in Chapter II) to control for the

possible effect on the patient's ranking of therapists for favorable

outcome by the preference order. Pairing of the order of presentation

distribution with the order of preference distribution for each sub-

ject suggested that a possible relationship may be present. Since

these data were in the form of frequencies a chi-square analysis was

done. This analysis is presented in Table 19. A significant relation-

ship (P < .01) was found between the order of therapist presentation

and expectation of favorable outcome.

A comparison was then made of the frequencies with which each










of the three therapists A, B, and C were placed in the first, second,

and third order of preference regardless of the presentation order.

For example, Therapist A was most preferred only 3 times, second

preferred 15 times and least preferred on 24 occasions; Therapist B

was preferred most 11 times, second 20 times, and least preferred on

11 occasions; and Therapist C was most preferred 28 times, second

preferred 7 times, and least preferred 7 times. A chi-square analysis

of these data appears in Table 20. The chi-square of 40.70 is highly

significant beyond the .01 level. The observed cell frequencies are

significantly different from what would be expected purely on a chance

basis.

The diagonal column starting from bottom left to top right

suggests a definite ordering of the therapists in terms of their

attractiveness or preferability to the patients; Therapist C, most

preferred, Therapist B, second preferred and Therapist A, least pre-

ferred. These data were then divided into three chi-square tables

showing the frequencies of preference of each therapist for each of

the three possible presentation placements. This was done to deter-

mine if the significant trends noted might be related to a specific

placement in the order of presentation, or whether the apparent pre-

ference for Therapist C was consistent regardless of the placement in

the presentation order. The chi-square tables and analyses are pre-

sented in Table 21. The results show significance in all three pre-

sentations (P < .05 in the first presentation, P <.01 in the second

and third presentations). The column totals for preference order

suggest a trend toward avoiding the first presented therapist, whereas









Table 18

Differences between Mean Discrepancy Scores
for the Three Therapists for FIRO-B Control Needs
Converted to PIT Needs and Scores for Therapists' Needs
when Patients' Wanted Score is Greater than
the Expressed Score with Individual Needs Combined

N = 83



ACTUAL RANKING
Therapists X Analysis t

X Most Preferred 1.78 x with y 2.80'

Y Second Preferred 2.30 x with z 2.64""

Z Least Preferred 2.32 y with z .11

SEMANTIC DIFFERENTIAL FACTOR E

Therapists X Analysis t


X Most Preferred 1.85 x with y 2.05*

Y Second Preferred 2.26 x with z 2.11"

Z Least Preferred 2.30 y with z .17

SEMANTIC DIFFERENTIAL FACTOR P

Therapists X Analysis t


X Most Preferred 1.83 x with y 1.54

Y Second Preferred 2.14 x with z 2.89*

Z Least Preferred 2.44 y with z 1.32



P < .05
""P < .01












Table 19

A Comparison of Presentation Order with
Preference Order of Therapists


Preference
Order


Order
of
Presentation


Expected Cell Frequency = 14


X2 (fo fe) 2

X2 = 18.27

df = 4


6 12 24


19 14 9


17 16 9


P < .01 A chi-square value of 13.277 significant at the .01
level.











Table 20

A Comparison of the Preference Order and the
Frequencies of Therapist Choice


Preference Order


Therapists


3 15 24


11 20 11


28 7 7

42 42 42


Expected Cell Frequency = 14


X2 =


X2 = 40.70"

X2 = 4


P < .01










Table 21

Chi-Square Analyses of Individual Therapist
Preference for Each Presentation


FIRST PRESENTATION


Preference Order


A 0 3 11

B 0 6 8

C 6 3 5
6 12 24


X2 = -(fo fe)2


X2 = 10.61*

df = 4


SECOND PRESENTATION


Preference
i 1 2


Order

I 3 .1


A 0 7 7

B 8 4 2

C 11 3 0


X2
X2 =


(fo fe)2

15.58**"'


df = 4


THIRD PRESENTATION


Preference Order


A 3 5 6

B 3 10 1

C 11 1 2


X2 (fo fe)2

X2 = 14.35*

df- 4


*P < .05
1CP< .01










this trend is reversed for the second and third presentations.

In addition to the above cited results, the data and analyses

in Tables 20 and 21 suggest.that a large part of the variances are

accounted for in the scores associated with Therapist C. These

scores indicate a definite preference for Therapist C when compared

with those of Therapists A and B.


Perceived Characteristics of the Three Therapists

It was assumed that this definite indication of preference

should also be reflected in observed and significant differences in

the patients' impressions of the therapists. It was expected that

the most significant differences would appear in comparisons of

patient impressions of Therapist C with the impressions of Therapists

A and B.

A means of comparison was afforded by the ratings of the

therapists used for measuring the patients' perceptions of the

therapists. This test provided 6 scores for each therapist for each

need, indicating the patients' estimates of how characteristic a need

was of a particular therapist. The scores ranged from I to 8. A

score of 8 indicated the need was perceived to be highly characteristic

of a therapist, and a score of one indicated the need was considerably

less characteristic of a given therapist. (The reliability data for

this scale were presented in Chapter II.) The mean score for each

need for each therapist then, indicated the degree to which a particu-

lar need was seen as characteristic of a given therapist by all 42

patients. A graph showing these mean scores is presented in Figure 1.

Visual analysis of this graph shows Therapists A and B to be quite










similar with few real differences. Whereas, the means for Therapist

C are quite different from Therapists A and B, particularly on

needs #4, #5, #9, #10, #11, #14 and #17. T-tests were computed on

the difference between the means for the three therapists over the

21 needs. These t-tests are presented in Table 22. Of the 63 t-tests,

13 were statistically significant, six at the .01 level, and seven at

the .05 level. Only one of the differences between Therapist A and

Therapist B was significant (P <.05). There were eight significant

t-tests between the means of Therapist C and Therapist A, five at

the .01 level and three at the .05 level; and there were four sig-

nificant differences between the means of Therapist C and Therapist

B, one at the .01 level and three at the .05 level. The greatest

differences in the patient's impressions of the therapists are in

the differences between Therapist C and Therapists A and B. Thera-

pist C was significantly higher than both Therapist A and B on needs

#5, Autonomy; #11, Exhibition; #17, Rejection; and significantly

lower than both on need #14, Nurturance. Therapist C was also sig-

nificantly lower than Therapist A on need #6, Blame Avoidance; #12,

Harm Avoidance; and #16, Play. Therapist C was significantly higher

than Therapist A on need #10, Dominance; and #16, Play.









Table 22

T-tests between Therapists' Mean Scores on 21
PIT Needs as Characterized by Patients


Needs A with B A with C B with C


# 1 Abasement .1787 1.0036 .8573

# 2 Achievement .0000 1.1493 1.2661

# 3 Affiliation .6864 .0871 .5414

# 4 Aggression .1463 1.8055 1.7441

# 5 Autonomy .2704 2.3414* 2.5605*

# 6 Blame Avoidance 2.1458* 2.7681** .6507

# 7 Counteraction .5880 1.7679 1.2425

# 8 Defendance 1.7111 1.8236 .1967

# 9 Deference .8068 1.7549 1.0478

#10 Dominance .6209 2.3028* 1.5065

#11 Exhibition .1613 2.8285** 2.5173*

#12 Harm Avoidance 1.9363. 2.7360*"' .7647

#13 Inferiority
Avoidance 1.5116 1.7704 .4791

#14 Nurturance .4580 3.3058** 2.9528*"

#15 Order .0000 .1714 .1494

#16 Play 1.9145 2.4694* .7295

#17 Rejection .3821 3.1566** 2.6235*

#18 Sentience .7951 1.1410 .3642










Table 22, Continued


Needs A with B A with C B with C


# 19 Sex .2741 1.5251 1.6850

# 20 Succorance .5799 1.5198 .693

# 21 Understanding .6209 .9291 1.4444


*P < .05
*'P < .01













CHAPTER IV

DISCUSSION


Fit of Patient and Therapist (as he is perceived by the patient)

The results of this study suggest that Hypothesis I is tenable.

The data suggest that the patients had the most favorable expectation

for therapy with the therapist whose perceived needs were most similar

to their own highly valued needs. This is demonstrated empirically

by the statistically significant lower discrepancy scores which were

found for the most preferred therapist when compared with the scores

of the least preferred therapist for both the actual rankings and the

Semantic Differential Factor P (Power).

These findings might lend some support to the work of Heine

and Carson (1962) whose, results in comparing personality patterns

of the patient and therapist on the MMPI suggested that the most

effective patterns were not too similar, but not dissimilar. Vogel's

(1959) results also suggested that similarity with respect to atti-

tudes of patient-therapist pairs would'enhance their degree of satis-

faction with the relationship. Currier's results (1963) on the other

hand suggested that patients with same sex therapists tended to rate

the relationship good when their values were different from those of

the therapist. However, she combined the data of same sex pairs,

male with male, and female with female in the same analysis. There

may be a different principle involved with female patient and female

therapist, than with male patient and male therapist, just as there










appears to be different principles involved with opposite sex pairs.

Hypothesis II predicted that the patient's level of conflict

about his most highly valued needs would have a significant bear-

ing upon the characteristics of the therapist for whom he would

have the most favorable expectation of outcome. The results of

this study, however, did not support this formulation. Further

analyses with the devalued needs were also insignificant. That is,

therapists were not ranked significantly lower because they had needs

which the patient devalued and had conflict about. On the basis of

these results it would seem that there are no clear relationships

of the degree of conflict in regard to different needs with therapist

preference as measured in this study. There was a tendency regardless

of group placement for the lowest discrepancies to be associated with

the least preferred therapists and the highest discrepancies to be

associated with the most-preferred therapist. For the High Conflict

Group, this means that the most preferred therapist expressed the

needs that they were most conflicted about. For the Low Conflict

Group it can only be stated that the most preferred therapist did

not express the needs that they had little conflict about. Perhaps

a number of principles operate, dependent upon factors not delineated

at this time. Various individual needs or types of needs may be

governed by different principles which operate in opposing ways. When

combined in an analysis such as this, their specific directions could

be cancelled out. For example, needs for Affection and Inclusion,

as measured by Schutz (1958), may operate in such a way that a patient

who highly values these, and is unsuccessful in satisfying them, might











seek a therapist who expressed affection and inclusion. The thera-

pist in this case might serve as a teacher or an example for the

patient to follow. Whereas, a patient who highly values needs for

control, but is unsuccessful in achieving satisfaction of them,

may seek a person who is not seen as valuing control needs highly.

This would be consistent with the general hypothesis proposed in

this study.

The suggestion that several different principles may operate

in the relationship between need structures in psychotherapy appears

to present itself in the results of Hypothesis II. The consistently

suggestive relationship which approaches or reaches significance

through many of the analyses of the Control Needs as compared with

the Inclusion and Affection Needs seems to support this.

The failure of the Affection or Inclusion needs to show any

consistent trend suggests at least two explanations. It suggests, of

course, that there may not be any relationships between a patient's

wanted dimensions of Affection and Inclusion and this perception of

the therapist's expression of these dimensions as measured in this

study. It also again permits speculation that perhaps these needs

are governed by other principles than Control type needs. For example,

it seems possible that Affection and Inclusion needs do not demand

the same type of interaction and compatibility as Control'needs. A

Control need interaction seems to imply a more specific situation where

a patient either wants to control others, or wants to be controlled by

others. Whereas, it seems possible that patient, and/or therapist

may have both a high dimension for expressing love and inclusion toward


I I --











others, and a high desire to be loved and included by others without

producing major conflict in a relationship, or within a particular

patient.

The significant relationship for control needs when the need

to be controlled is stronger than the need to exert control over

others, instead of the reverse, suggests a more complex type of

interaction than originally anticipated. It may be that a strong

need to control others and a strong need to receive control from

others within the same patient produces considerable anxiety and

conflict. Specifically, a need to express control of one's thera-

pist may give rise to conflict. This type of patient may be unable

to seek a relationship with a therapist whom he felt might control

him, because he also seeks to control others. However, when the

patient clearly desires control from others, he will most likely

seek a relationship with a therapist whom he anticipates will exert

the most control over him and thus satisfy his needs. These results

support the suggestions and findings of Leary (1957), Snyder (1961)

and Schutz (1958) regarding the possibility of a patient-therapist

"fit" based upon a reciprocity or compatibility of need structures.

The significant differences between the mean scores on the

Semantic Differential Factors show this instrument's ability to re-

flect accurately the actual rankings of the patients on their expec-

tations for favorable outcome in psychotherapy. These results suggest

further that it can be effective in assessing the patients' feelings

and expectations about a psychotherapeutic relationship. The present

research confirms that of Currier (1963), and a number of other










studies on the applicability and value of this instrument.

Order of Presentation and Preference Relationship

Analyses of the order of presentation definitely indicate

a relationship between the order of presentation and the order of

preference for therapists. The patients were inclined to have a

more favorable expectation for outcome with the therapist presented

second or third than for the therapist presented first. This may

be interpreted as support for a widely used practice of "intake"

interviewing or team evaluation where the patient has several con-

tacts with the professional staff prior to starting therapy. It

might also be that the patient simply becomes more comfortable with

the situation and knows better what is expected of him.


Relationships between Perceived Characteristics of Therapists and
Therapist Preference

One of the most interesting aspects of this study is found

in the comparison of the perceived characteristics of the therapists

as indicated by the Behavior Rating Scale and the preferences ex-

pressed for the therapists in the actual rankings. Therapist C was

rated significantly higher than Therapist A and/or Therapist B on

the needs for Autonomy, Dominance, Exhibition, Play and Rejection,

and significantly lower than Therapist A and/or Therapist B on needs

for Blame Avoidance, Harm Avoidance and Nurturance. Other needs

which showed Therapist C rated higher, but not significantly different,

were needs for Aggression, Counteraction, Defendance, Sentience, Sex

and Understanding. Needs which showed Therapist C lower, but not

significantly different, were Abasement, Achievement, Deference,











Inferiority Avoidance and Succorance. By referring to Table 1

in Chapter II, which shows the conversion of the PIT needs to the

FIRO-B need categories, it is readily evident that with exception

of #17, Rejection, the needs on which Therapist C was rated highest

are the FIRO-B Control. The needs on which Therapist C was rated

lowest were the Affection and Inclusion needs.

The highly significant preference for Therapist C (Table 20,

page 52) seems to reflect the influence of this therapist's per-

ceived personality. The patients in this study had the most favorable

expectation for psychotherapeutic outcome with a therapist who was

seen as independent and controlling; controlling in that he expressed

achievement, aggressiveness, autonomy and dominance, but would not

nurture the patient, attempt to solve his problems, or seek to avoid

blame or difficulty.

In many ways these needs are those which characterize and

reflect the problems and issues which are most important and pertinent

to the stage of socialization experienced by most of the patients of

this study. They are male adolescents, or young adults who are still

dependent upon parental aid, but who are struggling to find their

own independence and acceptance as individuals. They still need some

control, but in a way which emphasizes and supports their ability to

deal with their own problems, without the nurturing characteristic of

many parent-child relationships. Therapist C's perceived personality

appears to have "fit" more closely the needs and wants of a majority

of the patients in this study. It might be said that Therapist C

approximated more closely the concept of the "ideal" psychotherapist











for the major portion of the patient population used in this study.

This could be compared with the findings of Parloff (1956) which

suggested that the therapeutic relationship would have a more

favorable prognosis when the therapist perceived the patient as

more closely approximating his "ideal patient" concept.

It is possible that these results indicate a relationship

specific to this population and the stage of development repre-

sented by most of the patients. It is also possible that the

found relationship is accentuated by the fact that the patients

were still in college, and that it would be less if they were more

independent. These results do, however, appear to support the con-

cept of a patient-therapist fit which would increase the expectation

for successful outcome in therapy.

Future Research

As for future research, the ultimate question that might be

asked still remains to be answered. That is, even if the patterns

suggested by the results of this study and others are true, does the

patient in fact have a more favorable and successful outcome with

the therapist of his choice? The extensive studies of J. McV. Hunt

(1959) have suggested that getting the requested therapist was

very important to some prospective patients, and that it might be

associated with favorable outcome in therapy. However, it may be

that an inverse relationship, the patient with the therapist of least

favorable expectation, would be the most successful in actual thera-

peutic contact. Though the results of the present study might be

suggestive, it is felt that further research with refinement of theory










and method is needed before predictions of outcome based upon

patient choice of therapist can be made.

Generally, it does appear that different principles may

govern a given need or need cluster. For example, the Control

needs in Hypothesis IIl appeared to follow the original predic-

tions and the Inclusion and Affection needs did not. Other prin-

ciples were suggested that may influence these needs. Further

research on these relationships would permit more accurate assess-

ment of the need-impression interaction. A more specific delineation

of the relationship regarding the similarity of values between the

patient's most highly valued needs, and his impression of therapists'

needs is needed.. Is the relationship similar to that posed by Heine

and Carson (1962)? Though no relationship was found between the

degree of conflict and outcome expectation, the results suggested

that some differences may be present. Are these differences pre-

dictable and meaningful? It seems reasonable to assume that the

degree of conflict about one's most highly-valued needs would affect

such things as impressions of a helping person's personality and of

eventual outcome. The present research techniques or instruments

may not be sensitive enough to discover this relationship.

Perhaps the most interesting investigations would further ex-

plore the general area of this study in relation to the need compati-

bility dimensions as proposed by Schutz (1958). He suggested that

the expressed dimension of one member of the dyad must equal the

wanted dimension of the other member of the dyad for the most favor-

able compatibility. The results of this study have supported his






66



general hypothesis for control needs, but indicate that a slightly

different manipulation of the interaction could be potentially more

satisfying and successful, particularly when the patient desires

control from others more than he desires to control others. If

this type of planned matching could be combined with some of the

suggestions of Apfelbaum (1958), which indicate an enduring set of

first patient impressions in therapy, a potentially even more satis-

fying and successful relationship might be established.














CHAPTER V

SUMMARY


Research in psychotherapy has been difficult partially

because of the number of pertinent variables and their interactive

effects. One of the most promising lines of research has focused

upon the relationship between the patient and therapist. A prevalent

concept has stressed that the psychotherapeutic relationship may

be significantly affected by the relative compatibility of the

needs of the patient and therapist. The present study was an in-

vestigation of the relation between.a "fit" or match of patient and

therapist and the patient's characterizations of the expected relation-

ship and outcome.

Forty-two subjects were secured at the Counseling Center and

the Mental Health Clinic of the.University of Florida. They had

applied for help with personal problems, but had not begun treatment

at the time of the study. After measures of the patients' need

structures were secured, they each viewed three motion pictures each

showing a different therapist in action with the same patient.

Immediately after each film, they were asked to complete two forms,

one of which indicated their impressions of the therapist's need

structure and the other characterized the expected relationship with

each therapist. After all three films were presented, the patients

were asked to rank the therapists according to their most favorable,

second favorable and least favorable expectations of outcome.











Patient and therapist needs as perceived by the patient were

compared on three bases; similarity of values, the effect of the

patient's degree of conflictedness about his highly valued needs, and

the degree of reciprocity between patient and therapist needs. Each

comparison was then related to the patient's indication of favorable

expectation for outcome on two separate criteria. Three hypotheses

were formulated.

Hypothesis I predicted that the patient would have a more

favorable expectation of outcome with a therapist as his needs were

perceived to be more similar to the highly valued needs of the patient.

The results suggest that such a hypothesis is tenable. Statistically

significant differences were found in the degree of differences between

the values of the patient and the most preferred therapist when com-

pared with the differences between the values of the patient and those

attributed to the least preferred therapist. The patients had the

most favorable expectation for the therapist whose perceived needs

were most similar to their own highly valued needs.

Hypothesis II predicted that the patient's level of conflict

about his most highly valued needs would differentially affect his

expectation of outcome with a therapist.

I. The patient with high conflict about his highly valued

needs would have a more favorable expectation of outcome

with a therapist as he perceived the therapist's needs 'o

be different from his own.

2. The patient with low conflict about his highly valued

needs would have a more favorable expectation of outcome











with a therapist as he perceived the therapist's

needs to be similar to his own.

There were no significant differences for either the High

Conflict or Low Conflict Groups. The tables did suggest a trend

for the highest differences to be associated with the most preferred

therapist and the lowest differences to be associated with the least

preferred therapist, regardless of group.

Hypothesis III predicted that a patient would have a more

favorable expectation for outcome with a therapist as he perceives

him as having needs reciprocal to his own. Specifically, it was pre-

dicted that a patient would have a more favorable expectation for

outcome of therapy for a therapist as he was seen as needing to

express what the patient needed to receive. A highly significant

relationship was found when the patient's need to receive Control

from others was greater than the need to express Control toward others.

He had the most favorable expectation for outcome with a therapist

who would most express control toward him and thus fulfill his needs.

A highly significant relationship was found between the order

of presentation and the preference order or order of ranking. These

results show that the patient is inclined to have a more favorable

expectation for outcome with the therapist presented second or third

than for the therapist presented first. This was interpreted as

support for the widely used practice of "intake interviewing" or team

evaluation where the patient had a number of contacts with professional

helping people prior to starting therapy.











A distinct preference for one therapist (C) was interpreted

to reflect the influence of that therapist's perceived personality,

and that he may have "fit" the needs of the patients in this study.

Further support for this was found in the significant differences

between the patients' impressions of the therapists. Therapist C

was found to be significantly different from Therapists A and B on

Control needs. In general, patients in this study had the most

favorable expectation for outcome with a therapist who was seen as

independent and controlling, controlling in that he expressed achieve-

ment, aggressiveness, autonomy and dominance, but who would not nurture

the patient or solve his problems for him. It was felt that this

might be a characterization of the "ideal" therapist, and that they

reflected the problems and issues which were most important and

pertinent to the stage of socialization that most of the patients in

the study were experiencing.

It appeared consistent with the results of this study to

suggest that predictable relationships do exist between a patient's

need structure, his impressions of therapist's needs, and his expec-

tations for outcome in psychotherapy. Support was given for the

concept of patient-therapist fit based on the compatibility of their

need structures. However, further refinement of theory and method

and study of the patterns of interaction in shared valued and in

reciprocity of needs is needed. Only when therapist and patient are

paired on a planned basis and the course and outcome of therapy

determined will the eventual value of the present results be realized.




































APPENDICES













APPENDIX A


Sequence of Procedures and Instructions to Subjects


Applicants for psychotherapy at the two centers who met
the criteria set up were asked to participate in the study.

Instructions

The reason I wanted to talk with you is to ask if you
would be willing to participate in a research project that I am
doing as part of my graduate work. It is completely separate from
the Counseling Center (or Infirmary) and is not part of any work
being done there. Your participation is strictly voluntary and
nonparticipation will not influence your experience here in any way.

I am attempting to study some aspects of the psychotherapy
or counseling situation, specifically related to people who have
asked for help, but as yet have not been seen by a counselor.
Fortunately, you meet the requirements for my study.

Scheduling of your participation can be made at your con-
venience. The total time involvement would be less than two hours.
All records will be confidential and individual results will not be
made available to anyone. The final data will appear in group form
without names.

Are there any questions you would like to ask?

Do you think you would be willing to participate?

If they agree to participate:

Have you ever been seen by a counselor or therapist before?

Do you personally know or have you had continued contact with
any of the following people whose names I will read to you?

(The three therapists' names were read at this point.)

If subject was not rejected on basis of above:.

Picture Identification Test and FIRO-B were administered.

1. PIT (Complete)
2. FIRO-B










Then the following instructions were given:

You have come to the University Counseling Center (or
Mental Health Clinic) for help in dealing with some personal
problems which you feel to some degree unable to handle yourself.
The specific nature of your problem may be quite varied. It may
be with parents, or other family members, a girlfriend, sweetheart,
wife, your course work or educational goals, or just something
about yourself that worries you. Since these problems are very
important and personal to you, and at times perhaps uncomfortable
to you, the personality of the therapist, or the "kind of guy"
you talk to, will be important.

In this study, I am attempting to see how patients perceive
and feel about therapy with different therapists.

You will now be shown moving pictures of three therapists
in a simulated counseling situation with the same patient. The
patient is playing the same personality with the same problem with
each therapist. The therapist knew only that the patient was playing
a role of a man of the same age who had a problem. The therapist
was to be himself as he is in a regular counseling situation. I
would like for you to try to put yourself in the place of the patient
as if you were being seen by this person. How would you feel and
how would his personality seem to you?

After each film you will be asked to complete some forms on
your impressions of the therapist you have just seen.

Film I was shown

1. Behavior Rating Scale (BRS)
2. Semantic Differential

Film 2 was shown

1. Behavior Rating Scale (BRS)
2. Semantic Differential

Film 3 was shown

1. Behavior Rating Scale (BRS)
2. Semantic Differential

Their Therapist Rapkings and Comparisons were taken and subjects
were dismissed.












APPENDIX B

PIT Need Scores

Attitude Stanines

Needs
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21


325635584

834617133

345432866

714674763

464418555

175676358

5537 8435

25 5365466

348356161

364256752

245555365

442147484

543871617

551863455

541447332

664446642

4 6 5 5'5 4 6 4 3

2 1186 1358

652417382

322613832


1 4 5 6 8 2 5 3 5 1 8 6


2 6

4 3

5 5

3 2

5 8

3 4

4 5

4 5

5 1

4 4

4 1

5 2

7 7

8 6

1 3

5 3

8 4

5 4

5 5


5 8 4

4 5 5

1 4 4

7 8 5

5 2 2

8 8 4

3 1 2

5 4 4

5 4 4

4 1 8

6 6 5

4 5 1

4 5 4

6 2 5

4 6 6

3 3 6

8 5 3

7 5 3

5 6 6
566


4 5 4 5 3 8


3 3 8

2 5 5

2 3 3

1 5 4

1 8 3

5 8 7

1 7 4
7 4 2

6 5 1

8 3 4

7 1 7

3 6 3

6 1 3

5 4 4

4 5 5

1 4 8

8 1 3

2 5 6
256


1 5

4 4

8 1

6 4

4 1

4 7

6 7

7 3

3 5

7 1

6 5

1 7

8 5

6 3

7 3

3 6

6 2

7 4


Patients








Appendix B, Continued

Needs
Patients 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

21 4 6 7 4 3 5 5 4 5 6 5 1 4 6 4 8 6 1 3 4 4

22 2 6 3 7 6 4 8 5 4 3 2 3 1 6 5 4 4 6 7 5 2

23 3 3 5 3 5 3 4 6 3 6 3 6 7 4 6 5 2 1 8 4 8

24 7 5 1 6 5 5 5 2 6 1 2 5 7 5 4 1 8 7 3 4 6

25 4 2 7 7 5 5 1 1 6 2 6 8 2 5 6 8 4 6 2 4 3

26 4 5 1 3 2 5 4 8 4 4 3 1 4 4 7 6 5 7 4 7 4

27 3 4 6 2 4 3 5 6 2 5 7 4 3 6 8 4 2 4 4 6 4

28 4 3 5 4 1 7 7 5 4 4 3 2 6 6 3 5 8 5 2 6 6

29 4 6 3 3 6 6 2 4 5 2 6 5 2 7 4 5 7 4 3 8

30 2 6 3 4 8 4 3 5 6 7 4 4 2 1 5 1 6 7 5 5 8

31 3 1 5 4 5 1 6 6 4 3 5 5 8 3 4 5 5 3 8 6 3

32 3 5 8 2 5 4 1 5 4 1 5 5 7 6 3 7 4 4 6 8 3

33 5 4 5 5 5 5 8 5 4 5 3 2 3 2 7 5 5 6 4 1 6

34 4 3 1 8 2 7 2 3 6 4 5 7 <8 5 2 6 2 8 6 2 4

35 5 7 6 8 4 5 4 4 6 2 3 5 4 5 5 8 6 2 3 4 1

36 4 8 6 7 8 4 4 5 3 4 3 1 4 4 6 7 3 2 4 6 3

37 4 4 3 5 8 1 5 1 6 5 5 3 4 3 7 1 6 7 3 3 8

38 4 6 1 6 3 6 3 5 51 1 8 7 6 3 3 3 8, 2 6 6

39 6 4 4 2 1 3 2 5 4 7 7 5 5 8 3 4 6 4 6 2 5

40 4 4 5 6 7 4 2 2 4 7 6 5 2 3 4 6 1 3 7 8 3

41 5 4 3 7,6 6 1 4 4 .7 6 6 3 7 8 2 3 3 8 6

42 3 5 1 4 8 3 2 7 4 5 7 4 7 3 3 5 7 6 4 1 4












APPENDIX C

PIT Need Scores

Association Index Stanines

Needs
Patients 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21
1 4634348 15 5 2 2 4 8 8 6 3 6 3 6 8

2 63 1 3 2 4 1 3 4 3 3 4 4 4 2 4 5 3 4 3

3 4 6 3 5 6 5 6 5 7 7 7 6 6 4 3 2 7 1 4 1 1

4 1 1 3 5 3 4 4 3 5 6 4 2 2 4 3 2 7 3 2 5 2

5 4 7 4 6 73523 6 5 5 6 5 4 4 3 7 4 5 4

6 4 1 4 6 6 6 3 55 6 4 4 2 7 5 3 4 6 4 1 4

7 7 3 6 6 8 8 4 6 7 8 7 8 7 7 4 1 4 4 7 7 4

8 3 6 3 2 5 7445 6 4 2 4 7 2 6 3 5 4 1 6

9 4 4 2 7 6 5 4 2 4 7 6 4 3 4 4 1 6 3 4 2 6

10 6565 13524 3 2 5 2 1 8 5 5 5 5 5 5

11 2 1 6 7 4 3 2 2 7 5 5 5 4 2 4 4 6 6 5 1 3

12 5 3 3 3 4 7 4 4 3 4 5 4 1 8 4 4 4 8 6 4 3

13 7 2 6 5 4 5 2 6 4 4 6 5 7 3 4 5 6 2 4 8 1

14 4 1 4 5 2 8 1 4 5 2 8 8 7 5 5 8 6 6 8 4 4

15 3 3 5 4 1 5 4 4 3 3 2 3 1 6 4 5 6 4 1 6 1

16 564545545 5 7 5 5 5 5 7 6 4 6 6 5

17 5 5 3 5'8 6 7 2 7 7 6 7 5 7 6 1 3 6 7 6 8

18 5 8 4 8 7 5 15 8 1 1 6 5 5 5 8 8 7 6 5

19 6 4 4 8 6 4 1 5 7 6 3 4 3 4 6 1 8 3 4 5 4

20 7 3 3 4 5 6 6 7 5 3 5 1 6 5 6 3 4 6 2 6 7








Appendix C, Continued

Needs
Patients 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

21 5 4 4 5 5 3 2 4 6 2 3 4 4 2 4 4 5 2 4 6 5

22 5 4 6 6 4 4 2 4 6 5 5 5 2' 5 4 5 6 6 2 1 3

23 1 1 54 1 4 5 4 5 3 5 3 1 4 5 4 7 3 3 5 2

24 5 3 6 7 7 4 4 6 3 7 8 4 4 8 5 5 6 7 8 4 6

25 4 3 4 1 2 2 3 4 2 1 5 3 3 5 4 5 4 5 2 4 3

26 7 7 8 7 7 7 8 6 7 6 8 3 4 8 5 4 4 7 8 3 6

27 6 44 5 44 6 4 5 4 8 4 5 8 7 7 4 6 5 5 6

28 4 5 4 7 8 7 4 8 7 7 4 1 7 8 5 5 3 7 4 7 5

29 4 5 2 5 7 6 5 7 7 6 5 5 7 5 7 4 6 8 6 6 5

30 6 3 4 2 4 6 1 1 4 4 3 4 3 5 5 6 7 5 4 5 2

31 2 1 4 1 2 5 1 5 1 2 3 3 5 5 3 4 4 2 2 5 1

32 6 4 5 7 4 6 4 6 7 5 4 6 4 4 .2 5 5 7 2 5 5

.33 4 3 3 7 6 6 2 8 4 6 2 8 8 5 4 2 6 6 4 7 5

34 5 2 4 4 3 3 5 4 4 3 2 4 5 5 3 4 4 5 2 5 4

35 5 7 4 5 3 6 5 7 7 6 3 7 7 4 8 4 6 6 6 7 4

36 6 5 5 5 4 8 6 7 3 4 5 5 2 5 5 4 2 4 3 5 4

37 4 2 4 6 6 6 4 6 5 6 4 5 4 5 4 1 6 3 4 1 1

38 5 8 8 5 6 3 5 3 6 6 8 3 5 6 3 6 8 6'2 2 6

39 4 8 4 7 7 7 5 4 5 6 6 8 6 4 4 5 2 6 8 6 6

40 4 3 8 2 2 2 4 2 2 3 8 3 4 3 6 8 3 2 5 5 3

41 6 4 3 1 3 5 3 3 4 4 2 4 5 3 5 4 6 3 1 4 3

42 5 5 5 3 1 3 4 1 2 3 4 4 2 5 6 5 4 4 3 1 5













APPENDIX D

FIRO-B Scaled Scores


Expressed Wanted
Inclusion Inclusion
Patients Behavior Behavior


Expressed
Affection
Behavior


Wanted
Affection
Behavior


Patients'


Expressed
Control
Behavior


Wanted
Control
Behavior








Appendix D, Continued


Patients
21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40

41

42


Expressed
Inclusion
Behavior
4

3

4

0

9

6

5

0

5

1

4

3

2

1

6

2

5

2

0

2

6

4


Wanted
Inclusion
Behavior
0

1

1

0

8

9

3

5

0

0,

8

1




1


0

8

4

7

0

8

8


Expressed
Affection
Behavior
2

1

2

0

2

4

6

0

9

1

5

2

5

4

2

0

4

5

0

3

3

2


Wanted
Affection
Behavior
2

3

1

0

2

5

5

2

7

I1

4

5

5

2

5

3

6

8

2

0

5

6


Expressed
Control
Behavior
5

9

2

1

4

6

9

0

5

7

4

2

1

5

3

2

7

6

6

8

3

7


Wanted
Control
Behavior
5

4

3

4

,8

4












APPENDIX E


PIT Behavior Rating Scale


Name

Student #

Instructions

On the next page you will find brief personality descriptions.
Read each of the descriptions listed and then rate, using the rating
scale below, how strongly you feel the given statement is character-
istic of the therapist in the motion picture you have just seen.


Rating Scale

8. Highly characteristic 4. Somewhat uncharacteristic
7. Quite characteristic 3. Fairly uncharacteristic
6. Fairly characteristic 2. Quite uncharacteristic
5. Somewhat characteristic 1. Highly uncharacteristic

Place the number of the rating in the space provided before the descrip-
tion. For example, if you feel a personality statement is highly
characteristic of the therapist just seen, you would place the number
8 in the space provided.

8 1. Others think more highly of this man than he thinks of himself.

OR, if you felt that the statement was quite characteristic of him,
you would place the number 7 in the space provided, and so on.

7 1. Others think more highly of this man than he thinks of himself.

It is best not to spend too long in making your judgments. It is
your first impression that is important.










Therapist_

8. Highly characteristic 4. Somewhat uncharacteristic
7. Quite characteristic 3. Fairly uncharacteristic
6. Fairly characteristic 2. Quite uncharacteristic
5. Somewhat characteristic 1. Highly uncharacteristic

1. A man who readily admits his faults.

2. A man who tries with all his might when he had a hard job
to do.

3. A man who feels having friends is more important than any-
thing else.

4. A man who shows it when he gets mad or angry.

5. A man who does what he feels like doing without worrying
about what others think.

6. This man wouldn't do anything that others might think wrong.

7. If this man fails at something, he tries harder than ever to
succeed.

8. A man who likes to have someone he looks up to for guidance
and inspiration.

9. When he is criticized, this man is quick to argue back and
defend himself.

10. A man who likes to have others follow his orders.

11. A man who likes to make people sit up and take notice.

12. A man who is especially careful to avoid danger.

13. A man who often stays out of things because he feels he
doesn't have the ability.

14. Friends think this man is too sympathetic toward those who
need help.

15. A man who likes to keep things neat and orderly.

16. A man who is always ready to relax and have a good time.

17. A man who can turn people down when they don't do what he
thinks they should.






82


18. A man who enjoys the beauties of nature.

19. A man who spends a great deal of time thinking about
women.

20. A man who likes to be around someone who is sympathetic
and helpful.

21. A man who likes to study and learn about things.










Therapist


8. Highly characteristic 4. Somewhat uncharacteristic
7. Quite characteristic 3. Fairly uncharacteristic
6. Fairly characteristic 2. Quite uncharacteristic
5. Somewhat characteristic 1. Highly uncharacteristic

1. A man who is very modest about his abilities.

2. A hard working man.

3. A man who likes to be around his friends as much as
possible.

4. A man who has a quick temper.

5. A man who doesn't like to be bound by a lot of rules
and regulations.

6. Before he does anything this man tries to figure out
whether people will think it is all right or not.

7. A man who won't give up, even when things look hopeless.

8. A man who tries to be like those he looks up to.

9.'This man snaps back if anyone criticizes him.

10. A man who likes to have authority and give orders.

11. A man who enjoys performing before a crowd.

12. A man who likes to be sure it's not dangerous when he
does something.

13. A man who sometimes feels he isn't as good as others.

14. A man who is apt to spoil children and pets by being
very tenderhearted.

15. A man who likes to have a place for everything and to
keep everything in its place.

16. A man who likes to have fun.

17. This man won't waste his time and energy on people who
don't deserve it.

18. A man who likes art and music and poetry.










19. A man who notices every good looking woman who goes by.

20. A man who likes to have someone help him out when he is
in a strange place.

21. A man who likes to ask questions and gain knowledge.












APPENDIX F-1

Behavior Rating Scale (BRS) Scores
PIT Need Scores Attributed to Therapist A

PIT Needs
Patients 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

1 76422 78 5 1 4 4 6 3 7 5 2 3 5 5 4 7

2 4 5444 55 5 4 6 5 6 4 4 4 4 5 5 4 5 6

3 7 7 6 26 26 5 2 4 6 4 3 6 6, 4 4 6 3 6 6

4 5 46 74 63 2 8 4 4 6 2 8 5 5 7 4 3 8 8

5 5 55 36 55 65 5 4 6 3 4 5 5 6 4 4 5 6

6 444 35 44 4 4 5 4 5 5 5 5 5 4 4 4 5

7 6624155 4 3 5 4 5 7 3 7 5 3 5 45 7

8 6 65 44 65 6 5 4 4 6 6 5 6 5 6 6 4 4 7

9 7 65 22 65 5 2 3 3 5 4 6 5 4 3 5 3 5 6

10 7 75 26 67 6 3 6 2 5 3 5 6 5 5 5 5 4 7

11 6 75 43 36 45 4 3 3 3 7 4 3 3 7 6 4 7

12 654 26 43 46 4 5 6 6 3 3 5 6 4 4 4 5

13 6 45 22 7 5 7 4 5 5 6 7 6 6 4 4 4 3 6 6

14 5 54 33 6 5 5 4 4 3 5 4 5 5 5 4 4 4 5 5

15 4 65 54 6 5 6 5 5 4 5 6 4 5 5 6 4 5 6 4

16 534 35 75 75 4 4 6 4 2 6 4 4 3 2 3 7

17 5 76 45 7 7 4 2 2 2 3 4 5 6 6 4 6 4 5 8

18 6 44 43 7 3 4 2 3 3 6 4 5 6 4 3 4 3 4 5

19 7 84 38 5 8 6 4 5 2 2 7 3 6 2 4 4 4 6 8

20 6 74 34 5 7 3 3 4 4 4 3 5 5 4 4 6 2 5 6





86



Appendix F-l, Continued

PIT Needs


1 2 3 45 6 7 8 9 10 11


12 13 14 15 16 17 18 19 20 21


763443533

551146632

675445654

753847637

323247222

584863871

665445554

444655546

563335534

464472664

654433434

773256524

886218754

663254643

555223553

664446756

767325574

554345553

544345454

576446786

365215562

774444664


4 4 5 4 4 5 4 3 6


3 3 5 5 5 6 4 4 5 4 6 6


Patients















APPENDIX F-2

Behavior Rating Scale (BRS) Scores
PIT Need Scores Attributed to Therapist B


PIT Needs


1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21


3 2 5 6 4 3 5 3 45


Patients


- I









Appendix F-2, Continued

PIT Needs
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21


6 5 5 45 4 5 44 5

3 5 3 2 4 5 5 5 3 4

5 6 5 4 3 3 664 4

734 1 8 1 3 1 8 7

5 6 6 3 7 3 6 3 4 4

7 6 1 1 27771 3

454444544 5

5 6 4 3 2 5 6 4 3 5

3 7 4 3 4 5 6 4 3 2

5 5 3 3 5 44 3 3 6

7 6 6 5 5 6 7 5 5 4

7 4 4 1 4 7 5 3 2 5

7 7 6 5 3 6 8 3 5 5

5 5 5 44 5 5 5 4 4

2 5 4 3 4 6 5 1 5 4

7 5 5 3 2 7 5 4 5 5

674444 7 3 5 5

5 6 4 2 5 5 5 4 5 5

5 6 6 7 5 4 6 2 5 4

6644445 7 5 4

7 6 2 3 1 5 4 3 2 2


5 4 4 4 4 4 4 5


4 3

5 3

2 2

5 4

6 2

5 4

4 3

2 2

.3 4

4 3

8 4

4 3

4 4

5 2

7 6

3 3

4 3

3 3

6 7

6 5


5 5 4 4 5

4 6 5 4 5

1 2 2 7 3

4 5 5 4 5

2 6 5 4 5

4 5 5 5 5

4 5 5 4 5

6 6 6 5 6

4 3 2 2 6

4 6 5 4 5

5 4 3 1 5

6 6 6 4 5

4 5 4 6 4

5 2 2 2 5

5 5 5 4 3

5 6 6 3 4
554 4 44

5 5 6 6 5

5 4 4 4 4

6 5 2 1 1
6521


644 5 5 4446 5 5 3 3 '4 3 4 6 4


4 5 5

3 5 5

4 5 6

2 1 1

4 4 5

1 5 6

5 4 5

2 3 6

4 4 6

4 3 5

6 5 7

3 5 4

5 5 7

5 5 5

2 1 7

3 5 4

5 5 8

2 4 7

5 3 5
4 7 6

2 6 6

4 4 5
445


Patients













APPENDIX F-3

Behavior Rating Scale (BRS) Scores
PIT Need Scores Attributed to Therapist C

PIT Needs
Patients 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21

1 4 6 5 3 6 4 6 3 3 2 5 3.3 6 4 6 4 6 7 3 7

2 7 7 7 3 3 4 5 3 4 6 7 2 3 6 7 6 5 6 5 5 6

3 7 6 4 2 6 3 7 5 4 6 6 4 2 3 7 5 7 6 3 5 6

4 7 7 3 3 6 4 8 5 4 3 3 2 1 5 4 6 4 6 3 6 8

5 5 45 4 3 6 6 4 7 5 6 5 3 4 6 5 6 6 4 5 7

6 7 7 4 4 44 6 3 3 5 3 4 2 2 5 6 5 5 4 3 6

7 7 7 3 5 2 4 5 3 3 6 2 3 4 3 6 6 3 5 3 5 7

8 7 7 6 4 4 6 6 6 4 5 7 6 6 6 7 7 6 5 4 5 7

9 7 5 5 3 4 5 6 3 2 5 4 6 4 5 4 6 4 4 4 7 5

10 3 6 6 3 4 5 6 6 5 7 6 4 3 5 6 7 5 5 5 4 7

11 7 7 5 5 4 3 8 2 2 3 2 3 2 4 6 3 5 6 5 5 7

12 7 6 5 4 4 5 6 6 4 5 4 2 2 3 7 4 4 5 3 5 7

13 7 8 5 8 8 2 8 3 7 8 8 4 3 2 5 7 7 6 6 3 6

14 4 5 4 3 4 55 5 56 5 6 5 3 4 2 5 5 5 55 5

15 3 6 6 5 3 6 4 2 5 4 4 7 7 4 5 4 5 3 5 7 3

16 4 6 5 3 6 5 7 7 5 6 6 5 2 3 6 5 5 3 3 4 6

17 1 7 5 8 8 2 7 8 6 7 8 2 1 1 8 5 8 5 2 1 8

18 6 6 6 7 6 4 5 4 7 6 '8 2 2 4 5 6 5 6 6 6 8

19 4 6 4 2 2 7 4 4 2 5 4 7 8 5 7 4 4 4 2 3 6

20 6 7 4 4 5 4 6 4 3 3 6 3 3 3 3 4 6 6 3 4 6








Appendix F-3, Continued

PIT Needs
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21


1*


4 5 4 2 3 5 4 5 6 5 3

2 7 2 6 7 2 7 2 7 6 6

2 4 3 2 5 5 3 3 6 6 6

7 5 5 7 8 1 6 5 3 1 4

6 7 6 3 6 6 6 3 5 5 5

88188285 1 4 1

5 4 4 3 5 5 5 6 4 5 5
66444 5 6 4 2 5 4

8 6 5 4 4 3 7 4 3 2 2

5 5 4 2 6 3 5 2 5 4 5

5 6 5 5 4 5 5 5 5 2 2

5 6 4 3 4 5 7 2 4 4 2

3 7 2 1 6 4 8 1 8 6 3

3 5 4 5 5 4 5 3 5 5 5
1 6 2 2 6 4 5 2 5 4 2

8 8 7 5 44 7 6 6 5 5

.4 5 3 6 7 2 5 3 7 6 6

3 5 5 6 5 4 5 4 5 6 4

7 5 5 2 1 5 6 2 3 3 5

7 5 4 4 4 7 5 8 3 6 4

5 4 3 6 2 8 5 5 3 5 6

7 7 3 4 7 2 7 7 5 4 4


6 4 4 4 4 5

2 2 3 6 2 6

5 5 4 5 5 6

1 4 1 7 8 8

5 3 4 5 5 5

3 1 1 7 2 7

5 4 4 4 5 5

4 2 2 5 5 5

3 2 5 5 7 5

4 3 3 5 4 4

4 3 3 6 6 5

5 5 2 5 6 1

6 1 1 5 2 7

4 3 4 3 4 6

5 5 4 4 3 3
4 2 4 5 6 6

3 2 4 5 5 5

5 6 2 3 5 3
4 5 6 4 4 4

5 7 7 2 2 4

5 7 2 3 4 4

5 4 4 6 5 7
544657


5 3 5 7
4 5 4 6

5 5 5 5

5 5 1 4

5 4 4 5

8 1 5 8

5 5 5 5

5 4 3 5

5 4 3 7

6 4 3 7

5 6 5 5
6 3 6 8

3 2 2 8

4 5 3 5

6 2 1 6

5 3 3 7

3 4 3 5
6 4 2 5

7 5 3 7
4 4 7 5

2 2 6 5

7 5 7 8
7578


Patients














APPENDIX G

Semantic Differential


Instructions:

One of the purposes of this study is to measure the
patient's expectations of his relationships with several thera-
pists. This form is intended to enable you to express the
feelings you would expect to have after a series of interviews
with a given therapist. Rate each relationship on each of the
scales presented on the following page.

How to use these scales:
If you feel that your relationship with the therapist just
seen would be very closely related to one end of the scale, you
should place your checkmark as follows:

Large X : : : : : : : Small

If you feel that this relationship would be very closely related
to the "large" end of the scale you should place your check mark
as shown above.

If you feel that the expected relationship is quite closely related
to one or the other end of the scale (but not very closely so), you
should place the check mark as follows:

Large : X : : : : : : Small

OR

Large : : : : : X : : Small

If you feel that the expected relationship being rated seems only
slightly related to one side as compared with the other (but that
it's not really neutral) then you should check as follows:

Large : : X : : : : Small

OR

Large : : : X : : : Small

If you think whatever is being judged (in this example the therapist)
is neutral on the scale, both sides of the scale equally associated
with him, or if the scale is completely irrelevant or unrelated to
the word, then place your mark directly in the middle:




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Last updated October 10, 2010 - - mvs