Group Title: effects of variations in client topic area, affective presentation, and sex on counselor trainee
Title: The effects of variations in client topic area, affective presentation, and sex on counselor trainee
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Title: The effects of variations in client topic area, affective presentation, and sex on counselor trainee demonstration of accurate empathy
Physical Description: xii, 113 leaves : ; 28 cm.
Language: English
Creator: Cawley, Roger Conant, 1947-
Publication Date: 1976
Copyright Date: 1976
 Subjects
Subject: Student counselors -- Training of   ( lcsh )
Psychotherapist and patient   ( lcsh )
Counselor Education thesis Ph. D
Dissertations, Academic -- Counselor Education -- UF
Genre: bibliography   ( marcgt )
non-fiction   ( marcgt )
 Notes
Thesis: Thesis--University of Florida.
Bibliography: Bibliography: leaves 73-82.
Statement of Responsibility: by Roger Conant Cawley.
General Note: Typescript.
General Note: Vita.
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Bibliographic ID: UF00098112
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 - 000176312
oclc - 03067439
notis - AAU2792

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THE EFFECTS OF VARIATIONS IN CLIENT TOPIC AREA,
AFFECTIVE PRESENTATION, AND SEX ON COUNSELOR
TRAINEE DEMONSTRATION OF ACCURATE EMPATHY













By

ROGER CONANT CAWLEY


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


1976


_I
































To my wife, Doreen, and my parents, Arnold and Sarah Cawley


It makes all the difference
whether one sees darkness through
the light or brightness through
the shadows.
David Lindsay














ACKNOWLEDGEMENTS

I wish to express my deep appreciation to a number

of people.

First, I want to thank my chairman, Dr. Harold

Riker. Dr. Riker has taken a great deal of interest in

this study. His comments and suggestions have had a high

degree of quality, and he has given of his time most freely.

The assistance which my former chairman, Dr. E. L. Tolbert

offered to me was also substantial. Dr. Tolbert was patient,

supportive, and willing to dedicate considerable effort to

this study.

I wish to also express my appreciation to my other

committee members, Dr. James Joiner, and Dr. Larry Loesch.

Their encouragement and advice have been invaluable.

Additionally, the entire Rehabilitation Counseling

Department committed a great deal of its time and helped

tremendously with my study.

My typist, Mrs. Virginia Walker, has always been

conscientious and thorough. Her assistance has been greatly

appreciated.

Drs. Warren Rice, Robert Hornberger, and Gerald

Bozarth were interested and encouraging in their role as

therapists.

The dramatists, George Gercken, Leon Plimpton, Nell

Page, and Becky McKee, were both brilliant actors and









actresses, and a joy to work with throughout the study.

Barbara Lewis, Skip Higley, and Carol Klopfer were

patient and persevering raters. The thoroughness and effort

that they dedicated to this study was of a high caliber.

I would also like to thank the following interested

individuals for their time and extremely valuable assis-

tance: Dr. Rod McDavis, Dr. Harry Grater, Dr. Hugh Davis,

Mr. Joseph Fritsch, Ms. Andrea Cohen, Ms. Barbara Lewis,

Ms. Mary Ganikos, Mr. Carl Zahner, Ms. Diane Zimmerman, Ms.

Barbara Rucker, Ms. Judy McBride, Mr. Mousa Karayanni, and

Ms. Patty Beal.

Finally, my wife, Doreen, whose support and en-

couragement have been inestimable, has contributed immeasur-

ably to the strength of the entire undertaking.















TABLE OF CONTENTS
Page

ACKNOWLEDGEMENTS . . . . . . ....... iii

LIST OF TABLES . . . . . . . . . . viii

LIST OF FIGURES . . . . . . . . .. ix

ABSTRACT . . . . . . . . .. . . x

CHAPTER I INTRODUCTION . . . . . . . 1

Rationale for the Study . . . . . . 4

Purpose of the Study . . . . . . . 6

Definitions of the Terms . . . . . . 7

Organization of the Remainder of the Study. . . 8

CHAPTER II REVIEW OF RELATED LITERATURE. . . . 9

The Reciprocity of the Counseling Relationship . 9

Client Variables . . . . . . .. 16

The effects of Client Topic Area and
Affective presentation . . . .. 16

Effects of Client Dependency, Hostility,
and Friendliness . . . . . . 18

Therapists' Preference for Clients . . .. 23

Effects of Sex of the Counselor . . . ... 25

Therapist Experience and Training . . . .. 27

A Scale for the Measurement of Accurate Empathy 31

Reliability and Validity of the Accurate
Empathy Scale . . . . . . . .. 32

Additional Research using the Accurate Empathy
Scale . . . . . . . . . . 34

Summary . . . . . . . .. . . 35















TABLE OF CONTENTS (continued)

Page

CHAPTER III RESEARCH METHODOLOGY . .. . ... . 36

The Sample ,. .. . . , . .. 37

Clients . . . . . . . . ... .. . 38

The Experimental Hypotheses . . . . .. 41

Raters . . . . . . . . ... .. . 41

The Experimental Treatment . . . . .. .. 47

Collection of Data . . . . . . ... 50

The Statistical Design . . . . . ... 51

CHAPTER IV ANALYSIS OF THE DATA . . . . .. 53

Results . . . . . . . . ... .. . 53

Therapists' Ratings for Authenticity . . . .53

Rater Reliability . . . . . . . .. 54

Evaluation of the Experimental Treatments . 54

The Null Hypotheses . . . . . ... 59

Discussion . . . . . . . . .. 65

Summary . . . . . . . . . . 68

CHAPTER V SUMMARY, LIMITATIONS, IMPLICATIONS, AND
CONCLUSIONS . . . . . . .. 69

Summary . . . . . . . . ... . 69

Limitations . . . . . . . . .. 70

Implications and Conclusions . . . ... 71

REFERENCES . . . . . . . . ... . . 73









TABLE OF CONTENTS (continued)


Page

APPENDIX

A Role Descriptions for Clients . . . .. 83

B A Scale for the Measurement of Accurate
Empathy . . . . . .. ..... . . 91

C The Therapists . . . . . . . .. 95

D Informed Student Consent . . . . .. 98

E A Schematic Presentation of a Scale for the
Measurement of Accurate Empathy . . .. 99

F Instructions to Raters of Accurate Empathy. . 101

G Therapists' Mean Ratings of the Drama Students'
Performance . . . . . . . ... 102

BIOGRAPHICAL SKETCH . . . . . . . ... 112














LIST OF TABLES


Table Page

1 Pre-experimental Rater Reliability . . .. 55

2 Rater Reliability during the Present Study . 56

3 Reliability between the Ratings of Professional
Therapists and the Trained Raters . . . 58

4 Means and Standard Deviationsof Accurate Empathy
by Topic, Affect and Sex. .. . . . . 60

5 Analysis of Variance on Ratings of Accurate Em-
pathy . . . . . . . . . . 61

6 Description of the Subpopulations . . .. 62


viii














LIST OF FIGURES


Figure Page

1 Therapists' Ratings of the Degree of Threat
in the Presenting Problems . . . . .. 39

2 Therapists' Ratings of the Degree of Threat
in Drama Students' Presentations . . . .. 45

3 Design of the Study . . . . . ... 49

4 Graph of Counselor Trainees' Accurate Empathy
Levels . . . . . . . . ... .. . 63

5 Graph of Counselor Trainees' Accurate Empathy
Levels when Topic and Affect are Combined .. 64














Abstract of Dissertation Presented to the Graduate Council
of the University of Florida in Partial Fulfillment of the
Requirements for the Degree of Doctor of Philosophy

THE EFFECTS OF VARIATIONS IN CLIENT TOPIC AREA,
AFFECTIVE PRESENTATION, AND SEX ON COUNSELOR
TRAINEE-DEMONSTRATION OF ACCURATE EMPATHY

By

Roger Conant Cawley

August, 1976

Chairman: Harold C. Riker
Major Department: Counselor Education

The purpose of this investigation was to study the

effects of variations in client topic area, affective

presentation, and sex on counselor trainee demonstration

of accurate empathy.

Research related to the area of this study indicates

that high levels of client hostility directed at the thera-

pist were associated with low levels of therapist verbal

behavior (Gamsky and Farwell, 1966).

The major aspects of the present study were as follows:

1. Topic area was varied on the basis of a nonthreaten-

ing topic (Academic Information Seeking) and a threatening

topic (Intent of Suicide).

2. Affective presentation was varied on the basis of

nonthreatening affect (as defined by a panel of three

therapists) and threatening affect (as defined by the same

panel).








3. Sex was varied through presentations by two male

role playing drama students and two female role playing

drama students.

There were eight (8) client presentations. That is,

of the four role playing drama students, one male (Client 1)

and one female (Client 2) roleplayed clients who presented a

nonthreatening topic in a nonthreatening manner. A second

set of male (Client 3) and female (Client 4) presented a

nonthreatening topic in a threatening manner. Clients 1

and 2 also presented a threatening topic in a nonthreatening

manner. Clients 3 and 4 also presented a threatening topic

in a threatening manner.

The sample in this study consisted of forty-two full

time students from the Rehabilitation Counseling Department.

These students, or counselor trainees, represent the total

number of students who have completed at least one practicum

in the department.

Each counselor trainee was placed in a counseling

situation with one of the role playing drama students. The

drama student then presented the trainee with a problem that,

as previously mentioned, varied by the degree of threat or

nonthreat that was contained within topic area and affective

presentation.

The data in this study was collected in the following

sequence:









1. After the live interaction between the counselor

trainees and the drama students was completed, videotapes

of the sessions were sent to three previously selected

therapists. The therapists rated the drama students' pre-

sentations for authenticity.

2. Audiotapes of the interaction between the counselor

trainees and the drama students were given to raters who had

been trained on the Truax Accurate Empathy Scale to estab-

lish pre-experimental reliability. These trained raters

scored the audiotapes for their level of accurate empathy.

The results of the authenticity ratings found the drama

students to all be presenting their roles properly.

The results of the interaction between the counselor

trainees and the role playing drama students follow:

Using a 2 x 2 x 2 factorial analysis of variance and

the .05 level of significance, the researcher found no sig-

nificant effect on counselor trainee demonstration of accurate

empathy due to variations in affective presentation, sex, or

combinations of topic area, affective presentation, and sex.

There were, however, significant differences due to

topic area. Specifically, the threatening topic "Intent of

Suicide" elicited a higher level of counselor trainee accurate

empathy than the nonthreatening topic.

The implications of these results were discussed in

Chapter V. Limitations of the study were stated, and directions

for further research were indicated.













CHAPTER I

INTRODUCTION

Within the counseling field there have been innumerable

studies which have attempted to explore the counselor-

client relationship. Additionally, there have been a great

number of studies which have researched the impact that the

client and the counselor have on each other in the therapy

setting. It is this area of counselor-client impact that

the present study addresses, specifically researching the

effect that the client may have on the counselor.

It is important to note that early studies had a

marked emphasis on the effect that the counselor has on the

client. Although Leary (1957) emphasized the reciprocal

influences that occur in dyadic relations, and Harry Stack

Sullivan's (1953) interpersonal theory of psychiatry clear-

ly advocates the viewpoint of psychotherapy as a manifesta-

tion of an interpersonal relationship, the immunity of the

counselor largely persisted into the early 1960s.

However, through the work of a number of researchers,

it gradually became accepted that clients do, in fact, af-

fect counselors. For example, in a study which analyzed

the effects of the patient and the therapist on each other's

behavior in the therapy setting, Van der Veen (1965)

studied three patients, each of whom was seen by the same









five therapists twice. The therapist variables he rated

were congruence and accurate empathy; these were found to

result from the interactions of patients and therapists.

The patient variables rated were problem expression and

levels of experiencing. These were also found to be a

function of the patient-therapist interaction. According-

ly, Van der Veen concluded that both the therapists and

patients significantly influenced each other's therapeutic

behavior.

Also, in an interaction study which researched the ef-

fect of patient-therapist similarity on therapy outcome,

Carson and Heine (1962) matched their patient-therapist

dyads on the basis of MMPI scores, and found a curvilinear

relationship between MMPI score similarity and success in

therapy. That is, patients whose profiles were moderately

similar to their therapists were judged most improved, (in

this study the criterion of success was a composite of out-

come ratings made by the supervising psychiatrist, the rat-

er's own judgment of outcome, occupational adjustment, and

adequacy of interpersonal relations and symptomatic status).

The authors reasoned that if similarity is too great, the

therapist loses his objectivity, and when there is a great

dissimilarity, the therapist is unable to empathize or un-

derstand the patient's problem. The results of this study

have been supported by Holt and Luborsky (1952) and Lichten-

stein (1966).









Bandura (1956), in an early study on client-therapist

interaction, found that therapeutic competence is inversely

related to therapist anxiety. When the patient expressed

hostile tendencies that were threatening to the therapist,

the anxieties elicited often motivated the therapist to

avoid the anxiety producing interaction.

Furthermore, in another study which focused specifi-

cally on the effects of the client on the counselor (Rus-

sell and Snyder, 1963), actors role-played a hostile and

friendly client, and interacted with twenty counselors of

varying levels of clinical experience. The dependent vari-

able was counselor anxiety. The results indicated that

hostile client behavior led to significantly greater anxi-

ety than did friendly client behavior, for both experienced

and inexperienced counselors.

In another study of counselor behavior as a function

of client stimulus input, Heller, Myers, and Kline (1963)

hypothesized that interviewers presented with client

friendliness would respond with likeable, agreeable behav-

ior, and client dependence would evoke interviewer activity

and an increased sense of responsibility within the coun-

seling relationship. To control client input, four actors

were trained as clients and were presented in counterbal-

anced order to thirty-four therapist trainees for one half

hour interviews. On the basis of observer ratings, all hy-

potheses, with the exception of interviewer anxiety, were

confirmed.








Later, Houts et al. (1969) stated:

Our behavior ratings, in common with Moos and
Clemes (1967), indicate that therapists are more
influenced by patients than patients are by thera-
pists. This is indicated by the strong patient
main effects on ratings of both patient and thera-
pist behaviors. (p. 40)

Rationale for the Study

From the aforementioned research, it can be seen that

a number of studies have focused on the effects that dif-

ferent types of clients have on the therapists' behaviors

and attitudes. These studies have pointed out that clients

do have an impact on their counselors. Specifically, such

studies as Bandura (1956), Russell and Snyder (1963), and

Heller, Myers, and Kline (1963), emphasize that the client

can cause the counselor to become anxious, and/or exhibit

avoidance behavior.

At this point, it is most important to note that

Rogers (1957) stated that there were three components which

he felt were most important to successful and facilitative

therapy. These were the therapist's ability to communicate

empathic understanding and unconditional positive regard

for the client to the client, and also his or her ability

to be a congruent and genuine person in the relationship.

In a study related to the conditions necessary for op-

timal performance, Yerkes and Dodson (1908) in Egan (1970),

researched the curvilinear relationship between anxiety

and successful performance. These researchers state that

the level of anxiety which stimulates the most effective

performance lies in a moderate range. That is, the anxiety









level must be neither too high nor too low, if effective

performance is to be maintained. Studies by Matarazzo,

Ulett, and Saslow (1955), and later Stennett (1957), have

supported this proposition.

This curvilinear relationship is pertinent to the pre-

sent study, because of the issue as to whether certain topic

areas, and/or affective presentations may cause the

counselor a high amount of anxiety, and thus decrease the

effectiveness of his or her performance.

Little research has been done identifying those client

behaviors which may affect counselor facilitativeness. In

fact, to date, in no studies have the effects of threaten-

ing and nonthreatening topic areas been crossed with

threatening and nonthreatening affective presentation in

order to view their impact on counselor facilitativeness.

However, it is assumed by this researcher that if a client's

presentation raises the level of therapist anxiety too high,

the counselor may not give his or her most "effective per-

formance." That is, it is possible that the level of

counselor facilitativeness may be lowered as a result of

the experienced anxiety. This possibility has important

implications for counseling in terms of present and future

training programs.

Specifically, the rationale for the present investi-

gation is that if variations in client topic areas and af-

fective presentation are shown to have no major impact on









the level of counselor accurate empathy, it may be consid-

ered that rehabilitation counselor trainees are receiving

adequate preparation for dealing with these types of cir-

cumstances. However, if there is shown to be such an im-

pact, this would indicate that certain changes should take

place, such as sensitivity training or in-service training,

in order to help counselor trainees adapt to threatening

topic areas and affective presentation. Such changes would

contribute to producing more competent counselors. These

changes would result in improved services for future cli-

ents of these counselors.

Purpose of the Study

In order to, 1) enlarge upon the findings of the pre-

viously mentioned studies which researched counselor-client

impact, and 2) identify additional influences that the

client may have on the counselor, the purpose of the pres-

ent study is to determine if variations in client topic

areas, affective presentations, and sex will produce dif-

ferences on the level of accurate empathy of counselor

trainees.

The following questions will be investigated:

1. Will variations in client topic area affect the

level of counselor trainee accurate empathy?

2. Will variations in the client's affective presen-

tation affect the level of counselor trainee

accurate empathy?

3. Will the sex of the client affect the level of









counselor trainee accurate empathy?

4. Will the interaction of variations in client sex,

topic area and affective presentation affect the

level of counselor trainee accurate empathy?

Definitions of Terms

Coleman (1972) described how the degree of threat in-

volved in a given situation influences the severity of

stress. Specifically, he discussed threat in the following

manner:

Degree of threat Threat is the anticipation of
harm. Stress situations that are perceived as po-
tentially damaging or threatening to survival car-
ry a high degree of threat. Similarly, stress
situations that threaten the adequacy and worth of
the self, such as loss of social status, failure
in one's chosen occupation, or desires that the
individual considers highly immoral or incompat-
ible with his self concept and self ideal, involve
a strong element of threat. The individual is al-
so likely to feel threatened in situations which
place demands on him that he perceives as impor-
tant but beyond his power to meet. (p. 178)

Using Coleman's statement on threat as a basis, the

following definitions are used in this study:

1. A threatening topic will be one judged by a panel

of three therapists to have high potential to

raise the level of counselor trainee anxiety.

2. A nonthreatening topic will be one judged by a

panel of three therapists to have low potential

to raise the level of counselor trainee anxiety.

3. A threatening affective presentation will be one

judged by a panel of three therapists to have

high potential to raise the level of counselor

trainee anxiety.









4. A nonthreatening affective presentation will be

one judged by a panel of three therapists to have

low potential to raise the level of counselor

trainee anxiety.

5. A vignette will be the brief twenty-minute presen-

tation which a role playing drama student makes to

a counselor trainee. Each vignette will be based

on a presenting problem.

6. A presenting problem will be the topic assigned by

the researcher to the role playing drama student

(See Appendix A).

7. Accurate Empathy will be defined as the ability of

the counselor trainee to:

a. Be aware of and appreciate the feelings of a

"client," and

b. effectively communicate that understanding

to the "client."

Organization of the Remainder of the Study

The remainder of the study will be organized as fol-

lows: Chapter II contains a review of the literature.

Chapter III contains a discussion of the procedures in-

volved in conducting the present study. Additionally, a

discussion of the instrument to be used will be presented

in this paper. The findings of the study will be presented

in Chapter IV. Chapter V will include the summary, conclu-

sions and limitations.














CHAPTER II

REVIEW OF RELATED LITERATURE

The review of the literature is divided into the fol-

lowing sections:.

1. The reciprocity of the counseling relationship

2. Client variables

a. The effectsof client topic area and affective

presentation

b. The effects of client friendliness, hostility,

and dependency

3. Therapist preferences for clients

4. Effect of sex of the counselor

5. Therapist experience and training

6. The Truax Accurate Empathy Scale

7. A summary of the therapeutic relationship.

The Reciprocity of the Counseling Relationship

The reciprocal influences that occur in the counseling

relationship are important to emphasize in a study such as

this. Sullivan (1953) was one of the early advocates of

the need to be aware of the interpersonal nature of the

counseling interview. He viewed the interview as,

S. a special instance of interpersonal rela-
tions, characterized by the coming together of
two people, one recognized as an expert in inter-




9








personal relations, the other known as patient,
who expects to derive some benefit from a serious
discussion of his needs with this expert. (p. 357)

Another researcher, Leary (1957), deals with the re-

ciprocal influences that occur between people. He contends

that,

The actions of any person in a given social sit-
uation is a function of at least two factors: a)
his multi-level personality structure, and b) the
activities of the other person. (p. 91)

Additionally, Leary regards the most important aspect

of personality as being the "reflex manner in which human

beings react to others and are responded to by others."

With regard to psychotherapy, he emphasized that "the re-

ciprocity of interpersonal forces in dyads is often over-

looked in discussions of psychotherapy."

It is remarkable that the counselor should have been

regarded as being so invulnerable for such an extended period

of time. For example, although Sullivan's interpersonal

theory of psychiatry viewed psychotherapy as a specific ex-

ample of an interpersonal relationship, even he did not

deal with the influence of the client on the counselor, but

rather with the remedial effects that the counselor should

have on the clients. Other researchers similarly concen-

trated on the effect that the counselor should have on the

client. In fact, the counseling profession has consistent-

ly attempted to prove that counselors influence clients,

but that the reverse does not take place to a significant

degree.

Rogers (1957) for example, postulated that there are









necessary and sufficient conditions of change (these are

the previously mentioned empathic understanding, positive

regard, and ability to be a congruent and genuine person).

His contention was that these conditions are principally

offered by the counselor. This concept is, of course, most

important to the present study, because it deals with the

issue of who influences whom in the therapy setting.

In a well known study which attempts to support the

Rogerian theory that counselors determine the conditions

necessary for change, Truax and Carkhuff (1965) studied the

effect of manipulating the levels of therapeutic conditions

within one therapeutic hour upon the interpersonal explora-

tion of three hospitalized female schizophrenics. During

the first twenty minutes, a base-line level of the pa-

tient's interpersonal exploration was established. For the

next twenty minutes, the therapist deliberately lowered his

empathic understanding and positive regard for the patient.

He lowered conditions by "withholding the best response."

During the last twenty minutes, he restored his empathic

understanding and his unconditional positive regard for

the patient.

Analysis of the data showed that empathy, positive re-

gard, and genuineness were lowered during the experimental

middle third of the interview, as intended. These changes

in therapist-offered conditions served to lower the pa-

tients' depth of self-exploration. Thus, it would appear

that the Truax and Carkhuff contention is supported.









One factor which makes this study difficult to accept

is that when one considers that there was (1) a marked

restriction of the therapist's behavior at a given time and

(2) a simultaneous indication of his disinterest, it is not

surprising that this would lead to a parallel reduction in

patient response. It is the opinion of the present re-

searcher that a more acceptable demonstration of Truax and

Carkhuff's point would have been the reduction of the "con-

ditions" without reduction of the level of participation.

In a study which also relates to this area, Alexik and

Carkhuff (1967) attempted to vary the relevant behavior of

a client to demonstrate that a low-functioning counselor

would be manipulated by the degree of the client's self ex-

ploration but that a high-functioning counselor would not;

rather, he would continue to offer high levels of the fa-

cilitative variables. Two counselors, both with doctoral

training, similar orientations, and eight years of exper-

ience, interviewed the same graduate student separately.

The counselors believed that they were seeing a real client

for the first interview. (The counselors had been scored

in previous studies on the facilitative variables; Counse-

lor A had scored low on all, while Counselor B had scored

at minimally facilitative levels on all but one.) For both

counselors, the "client" explored herself significantly

more during the first and last periods than during the mid-

dle phase. Counselor A, as expected, functioned on a lower

level than his colleague during all periods. During the








experimental middle period, he dropped significantly below

the level he demonstrated in periods one and three. For

Counselor B, there was no such change.

The results of this study appear to support the ini-

tial hypothesis (that a low-functioning counselor would be

manipulated by the degree of the client's self-exploration,

but a high-functioning counselor would not). Nevertheless,

the following shortcomings of this study are noted by

Meltzoff and Kornreich (1970):

1. Even the researchers themselves were aware of the

need for replication with larger numbers of clients and

counselors. (For example, the limited sizes of the samples

may fail to take individual differences into account. This

detracts from the generalizability of the study.)

2. This was an initial interview which was conducted

under very atypical "therapeutic" conditions.

Because of these important aspects of the study, it is

reasonable to conclude that the hypothesis remains uncon-

firmed.

Another study researching this area of concern was

conducted by Holder, Carkhuff, and Berenson (1967). In

this study, the sample consisted of eleven female college

students who had enacted the role of counselor. The three

highest and three lowest functioning students were selected

to be clients. The counseling hour was divided into

thirds. During the hour, an experienced counselor lowered

the therapist-offered conditions in the middle third of the








interview. With each client, the difference in the offered

conditions (here--empathy, respect, genuineness, and con-

creteness) between the first and third periods, on the one

hand, and the second period, on the other, was significant.

Throughout all periods, the high-functioning group func-

tioned at higher levels than did the low-functioning group.

For the high-functioning group, there were no differences

in the level of self-exploration between the middle third

of the interview and other portions. For the low-function-

ing group, however, this difference was significant.

Meltzoff and Kornreich (1970) take issue with the re-

sults of this study in the following quote:

High-level clients may make good use of counsel-
ing despite the low levels offered by a counse-
lor. Only 'low-level' clients seem to require
high levels of these therapeutic conditions from
the counselor. The clients in this study were
obviously pseudoclients, and the therapeutic pro-
cess scarcely therapy. Moreover, do the charac-
teristics that make for a good counselor also
make for a good client? (p. 396)

Truax, Wargo, Frank, Imber, Battle, Hoehn-Saric, Nash

and Stone (1966) tried to demonstrate that the therapist

alone determines the level of accurate empathy, nonposses-

sive warmth, and genuineness that he or she offers to the

patient. Forty psychoneurotic outpatients were randomly

assigned to four senior psychiatric residents. Half of the

patients of each therapist were screened by the two screen-

ing interviewers. Additionally, half of the patients

screened by each interviewer were given a Role Induction

Interview (orientation to psychotherapy) and half were not.








Each patient was seen once a week for a four month period

by the assigned psychotherapist. Two three-minute segments

were recorded from the first, fifth, and tenth therapeutic

interviews. The segments were randomly selected from the

middle and final third of the interview with the provision

that both a patient and therapist verbalization would be

present in each sample. The reason for this was that the

investigators decided that one would expect differences at-

tributable to therapists in these variables for all pa-

tients if the therapists did in fact offer different levels.

If the patients elicited different levels from their

therapists, one would expect significant patient variation

and insignificant therapist variation.

When the data from the first, fifth, and tenth inter-

view were averaged, the therapists were found to differ

significantly on all three variables (genuineness, accurate

empathy, and nonpossessive warmth). The conclusion drawn

by the researchers was that the therapist alone determines

these therapy variables.

It appears that the major defect of this study was

that its design did not deal with any patient characteris-

tics (such as diagnosis, degree of pathology, attractive-

ness, sex, personality) that may have contributed in some

way to the therapists' responses. Thus, one must wonder

how important or conclusive the results of this study are,

when such important characteristics are not included.

To summarize this section, it is reasonable to state








that such studies as the aforementioned, which have advo-

cated the position that it is the counselor who solely de-

termines the levels of conditions he offers, have been in-

conclusive. In several studies, movement has been shown in

the direction of supporting the hypothesis that the counse-

lor does determine the levels of conditions offered in

therapy. However, in each of these studies, important cli-

ent variables have not been taken into account. Thus, it

is not possible, on the basis of the studies to date, to

validate this hypothesis.

It is possible that various aspects of the client's

repertoire are important variables in therapy. In fact, it

has begun to become accepted, as was suggested by the pre-

viously mentioned research of Bandura (1956), Carson and

Heine (1962), Van der Veen (1965), Houts et al. (1969), etc.

that the therapists are a variable in the therapeutic

setting, and that clients do have an impact on their thera-

pists. Further research to elucidate that position will

now be presented.

Client Variables

The Effects of Client Topic Area and Affective Presentation

As mentioned in Chapter I, within the fields of coun-

seling and psychology, it can be noted that only a small

amount of research has been conducted on the impact that

the specific variables of client topic area and affective

presentation have on counselors and their responses to cli-

ents. One aspect of this point is underlined by Melnick

(1975):








Little has been done to study directly the effect
of the problem on counseling response. If the
problem does affect the responses elicited, the
problem may warrant consideration in the evalua-
tion of counseling. (p. 108)

One of the few studies which has explored the influ-

ence of the client on the counselor was conducted by

Dipboye (1954). He found that counselors' responses dif-

fered, depending on the type of topic which was presented.

For example, within the general fields of (a) a cognitively

oriented topic, and (b) an effectively oriented topic, he

found that counselors would respond in a cognitive manner

to topic (a) and an affective manner to topic (b).

Little further research was done on this area until a

broad study by Carkhuff (1969a) was undertaken. This study

focused on the level of communication of helpers as a func-

tion of helper experience and training, and helpee affect

(depression, distress; anger, hostility; elation, excite-

ment) and content (social, interpersonal; educational, vo-

cational; child rearing; sexual, marital, confrontation of

counselors). The helpers responded to audiotaped stimuli

(helpee statements) which reflected all combinations of af-

fect and content. Each affect area was matched with each

content area. The results indicated that there was an in-

crease in the level of communication as level of experience

and training increased. Additionally, helpers in all the

groups consistently had the most difficulty in communica-

ting accurate empathy when presented with elation-affect

and confrontation-content.








In a recent study by Melnick (1975), the effects of

(1) client problems and (2) different methods of problem

presentation on the counseling responses of forty-two(42)

counselor trainees were investigated. The subjects re-

sponded to client statements which involved both social-per-

sonal and vocational-educational concerns. These were pre-

sented by typescript, videotape, and roleplaying actors.

The students' responses were rated for levels of empathy,

respect, and genuineness, and for the proportion of affec-

tive responses as opposed to exploratory responses. Analy-

ses of variance and correlational procedures indicated that

the method of problem presentation and types of problems

presented have significant effects on counseling response.

For example, when the counselor trainee was presented with a

typescript and videotape of the client's presentation, he

responded significantly more facilitatively (as measured by

the Carkhuff Empathic Understanding Scale) than if presented

with a roleplayed performance of the client's presentation.

Effects of Client Dependency, Hostility, and Friendliness

Despite the limited number of studies pertaining to

how client topic area and affective presentation affect the

counselor, there have been numerous studies on how certain

other aspects of the client's presentation do so.

Snyder and Snyder (1961), for example, found that cli-

ents' behavior in therapy caused the therapist to use spe-

cific techniques. For example, when the client made ex-









pressions of dependency directed towards the therapist, the

therapist's supportive behavior increased. Interestingly

enough, therapists decreased their supportive behavior when

the client's dependency was directed at persons other than

the therapists. Also, with dependent clients, the thera-

pists increased their reflective and re-educative tech-

niques as therapy progressed. The tendency of therapists

to lead and direct the client decreased over time. The

more dependent client elicited more supportive and less in-

tellectual responses than the less dependent client. Snyder

concluded that the relationship between client and thera-

pist is a basic component of therapy, and that there are

personality characteristics which make it possible for some

clients to establish a better relationship with some thera-

pists than others. Also, Snyder indicated that the clients

toward whom he felt most friendly were "relatively more

energetic and uninhibited."

In a follow up to Bandura's 1956 research, Bandura et

al. (1960) designed a study to assess the therapist's ap-

proach-avoidance to the patient's expression of hostility.

The following results were found:

1. Therapists who express their own hostility in di-

rect forms, and who have low need for approval,

approached patients' expression of hostility.

2. In general, therapists were less likely to ap-

proach the patient's hostility when the therapist

was the object of hostility than when the patient










directed his hostility toward others.

A similar study was conducted by Malletta (1972). This

researcher explored therapist anxiety in relation to client

affect in a simulated therapy setting. Therapist approach-

avoidance responses to client affect were examined as a

function of therapist level of anxiety. The results con-

firm the hypothesis that there is a significant difference

between the number of approach responses to client friendli-

ness and the number of approach responses to client hostility.

In a study which researched both client variables and

therapist variables, Yulis and Keisler (1968) had twelve

high anxiety and twelve low anxiety therapists listen to

three client tape recordings characterized by sexual, ag-

gressive, and neutral content, respectively. Ten times in

each tape the therapists were asked to select one of a pair

of interpretive statements (differing in degree of "person-

al involvement") they would have responded with had they

been the therapist of the clients. The results of this

study supported the prediction that low-anxiety therapists

would be more personally involved (show less counter-trans-

ference) with their clients than high-anxiety therapists.

A study designed to determine if client type is a de-

terminant of counselor behavior was conducted by Bohn

(1965). This research investigated counselor directive-

ness. The independent variables were as follows:

1. Experienced counselors









2. Inexperienced counselors

3. Typical, inexperienced and hostile clients.

The subjects were told to assume the role of counse-

lor. At predetermined points in the tapes, they were asked

to respond to the clients by selecting one of the four pos-

sible statements that had been previously rated, and repre-

sented four levels of directiveness.

The results were that there was no difference in the

directiveness scores of high and low dominance counselors.

Experienced counselors were less directive and used fewer

categories of responses than inexperienced counselors. The

dependent client elicited the most directiveness.

Bohn concluded that client type was a very potent de-

terminant of counselor behavior, since the three client

types (typical, inexperienced, and hostile) elicited dif-

ferent responses from the same counselors.

One of the first studies to examine the specific area

of the effect of client hostility upon counselor verbal be-

havior was conducted by Gamsky and Farwell (1966). Four

actors were trained to perform the roles of a friendly

male, friendly female, hostile male, and hostile female.

Under the hostile conditions they initially directed their

hostility at others, and later at the counselor. Three

groups of ten counselors each were used, half of who were

males, and half females.

Each "client" was interviewed by the thirty counselors.

These counselors thought they were seeing real clients.


_ _








Each interview was recorded and scored by a modification of

the Bales System of Interaction Process Analysis (1950).

Three raters were trained to rate segments of each recorded

interview. By analysis of variance, the experimenters ex-

amined the main and interaction effects of counselor exper-

ience, sex, focus of hostility, and client sex. No effects

of counselor sex were obtained, but there were several ef-

fects of client sex that Gamsky and Farwell feel may have

been due to uncontrolled variables. The main issue, that

of client focus on hostility, significantly affected eleven

of the fourteen categories. When client hostility was fo-

cused on them, the counselors used more reassurance, sug-

gestion, and information, but also showed more avoidance,

disapproval, and antagonism. When confronted with hostility,

counselors also used less agreement, interpretation, reflec-

tion, elaboration, and requests for information. The

general conclusion was that counselors responded in a nega-

tive manner when hostility was directed at them. Also, the

authors felt that, ironically, the counselors may have used

more reassurance in such situations in an effort to reassure

themselves.

The importance of the Gamsky and Farwell study is that

the authors began to go beyond trying to ascertain whether

counselors are made anxious by client hostility to the more

important issue of how the hostility is handled and how it

affects the therapeutic process.

In conclusion, this section on how client friendliness,

hostility, and dependency affect the therapist is most im-








portant because:

1. It further demonstrates the importance of the cli-

ent as a variable in the therapy setting.

2. It reviews aspects of the client's repertoire

which are introductory to the following section, Therapist

Preferences for Clients. Specifically, the following sec-

tion asks the question: Will the personality and/or back-

ground of the client have any impact on the counselor, and

if so, will this affect the course of therapy?

Therapists' Preference for Clients

Following from the preceding section, it may first be

said that a certain amount of research has shown that spe-

cific types of clients are, indeed, more preferable to

therapists than others. This contention is supported by

the following literature:

In two similar studies, Strupp (1958) and Wallach and

Strupp (1964), found that therapists had a greater liking

for patients who evidenced a desire to change and improve.

This is not surprising since motivation for therapy has of-

ten been a most important consideration in making a progno-

sis. Wallach and Strupp inferred from their data that the

patient's motivation probably does influence the thera-

pist's attitude, but only when the degree of maladjustment

in not too great.

Stoler (1961) found that raters who were familiar with

patients' cases judged the patients as more likeable than








did raters reviewing the same cases for the first time.

As previously stated, Heller et al. (1963) pointed

out that client friendliness evoked more interviewer

friendliness than did client hostility.

Even variables such as social class can affect the

counselor-client relationship. Hollingshead and Redlich

(1958) observed that therapists' attitudes toward their pa-

tients were positively related to the patient's social

class. The authors felt that middle-class therapists gen-

erally were unable to understand lower-class values, and

therefore were less likely to have positive feelings for

individuals holding such values.

Additionally, a number of studies have shown that the

therapists' feelings for the client can have important re-

sults on therapy outcome. For example, Strupp et al. (1969)

found positive correlations between ratings of successful

outcome and feelings of warmth (0.61) and liking for the

client (0.53).

Caracena (1965) obtained liking ratings by thirty

counselors for sixty undergraduate students, and found that

those who were liked were more apt to remain in therapy

than those who were disliked.

Stoler (1961) viewed liking for the client more in

terms of a patient's trait of likeability. He attempted to

determine if a global personal reaction to some clients led

therapists to feel immediately more compassionate and opti-

mistic toward them. He studied the relation between this








factor of likeability and success in therapy, and determined

that more successful clients received significantly higher

mean likeability ratings from certain designated judges.

These judges had listened to short taped interview segments.

Thus, the literature in this area is replete with evi-

dence which indicates that clients, both through their per-

sonal characteristics and their behavior, have an influence

on the counselor. Furthermore, the client may also affect

the course of therapy, simply by causing the counselor to

feel a certain way about him or her.

Effects of Sex of the Counselor

Having stated many ways in which the client can affect

the counselor, the researcher must diverge briefly, and men-

tion a counselor variable which may possibly affect the

client. This variable is the sex of the counselor. Be-

cause this variable cannot be controlled for in this study,

due to sampling limitations, it should be reviewed in the

literature in order to discern if the sex of the therapist

will have any impact on the counseling relationship.

In a study which researched whether or not sex had any

impact on the effectiveness of therapy, twenty male and

forty female psychiatric aides worked with 117 chronic fe-

male hospitalized patients (Sines, Silver, and Lucero, 1961).

The aides worked closely with assigned patients twice weekly

for a year in verbal, recreational, and offward activities.

Their treatment plans were supervised and guided, and the








goal was to improve adjustment. No differences between

male and female aides were found on outcome measured by

behavior rating scales, MMPI data, or pre- and posttherapy

clinical ratings.

Mendelsohn and Geller (1963) examined client-counselor

combinations of sexes (male counselor-male clients, male

counselor-female clients, female counselor-male clients,

female counselor-female clients) in a relation to length of

counseling. In this study forty-one female and thirty-one

male clients were seen by six female and four male counse-

lors. Analysis of variance yielded a nonsignificant F-

value among the four sex combinations. When grouped into

two categories--same sex and opposite sex pairs--there was

no difference at all. This led the authors to conclude

that sex matching has little or no effect on length of

counseling.

In a subsequent investigation with 201 subjects (111

male and 90 female) seen in counseling by six female and

five male professional staff psychologists, it was again

found that neither the sex of the counselor nor any of the

four possible sex pairings had any differential effect on

the duration of counseling (Mendelsohn, 1966).

In summation, one finds that the few studies available

on the effects of therapist sex on patients' improvement

have shown no significant differences between male and fe-

male therapists. Thus, at present, there is no clear basis

for preferential assignment of a patient of either sex to a

therapist of either sex.









Therapist Experience and Training

Before moving to (1) an overview of the instrument to

be used, and (2) a summary statement about the therapeutic

relationship, it will be useful to review two important as-

pects of the therapist's repertoire which may also influ-

ence therapeutic behavior and the level of therapeutic

facilitativeness. These variables are experience and

training.

Therapist experience and training have often been

studied as determinants of therapy outcome, therapeutic

role and technique, the quality of the therapeutic rela-

tionship established, and various therapist attitudes rele-

vant to psychotherapy. Also, often the following question

has been asked: Does an increase in experience and train-

ing necessarily imply an increase in counselor facilita-

tiveness?

In attempting to answer this question, Beery (1970)

evaluated Rogers' assertion that experienced therapists

manifest more unconditional positive regard than do inex-

perienced therapists. Sixteen experienced and sixteen in-

experienced therapists served as subjects. One half of

each group responded to a taped analog of a patient present-

ing a friendly attitude, and the other half to a hostile

analog patient. On the dependent measure, experienced sub-

jects responded with a higher level of positive regard to

both patient types than did inexperienced subjects. How-

ever, experienced and inexperienced subjects did not differ









in exhibiting relatively greater positive regard to the

friendly patient than to the hostile patient. Hence, on

that measure, contrary to Rogers (1957), experienced sub-

jects were not found to respond more unconditionally.

Another study in this area researched differences in

facilitative conditions offered by trained and untrained

counselors. Specifically, Martin, Carkhuff, and Berenson

(1966) evaluated the differences between counselors and

"best friends" of clients. The clients were sixteen volun-

teer college students, and the counselors were two trained

counselors with over five years of experience.

Each client was interviewed by a counselor and by his

"best friend." Following the interview, the clients com-

pleted questionnaires on the empathy, genuineness, and con-

creteness of the counselor (or friend), and on their own

self-exploration during the interview. In addition, three

trained graduate students rated these five variables on

Truax and Carkhuff's five point scales.

The counselors differed significantly from the friends

on all rated variables. The counselors obtained a mean of

3.0 (the minimum level of facilitative counseling on the

Carkhuff Scale) while the friends obtained a score of 2.0.

The importance of the study is that, as demonstrated,

counselors were found to have higher facilitative levels

than "best friends." This study lends support to the con-

tention that experience and training are important varia-

bles in therapy.








In an elaborate study by Bohn (1967) therapist respon-

ses to a typical client, a hostile client, and a dependent

client were studied as a function of the subject's train-

ing. The subjects were eighteen (18) advanced graduate

students in a course in "Theories and Techniques of Psy-

chological Counseling." The course offered didactic mater-

ial plus supervised experience in the form of role playing,

structured interviews and practice counseling. Responses

to tape recordings of these subjects were obtained before

and after the course, and were scored for directiveness.

Results on the first administration showed subjects to

be least directive towards the typical client, more direc-

tive towards the hostile one, and most directive towards

the dependent client. On the second administration, while

maintaining the same order of directiveness, subjects were

significantly less directive toward the neutral and hostile

clients, but not towards the dependent client. The impli-

cations suggested by the researchers were that different

clients elicit different responses from the same therapist,

and that training may significantly enhance facilitative

responses to hostility. However, training may not have

this effect on dependency.

Sommers et al. (1955) researched the issue of the im-

portance of experience on therapeutic listening. A tape

recording of a therapeutic interview, with the original

therapist responses deleted, was played to a group of nine

graduate students in clinical psychology, and to ten experi-








enced clinical psychologists and psychiatrists. After the

interviews were completed, the researchers asked the sub-

jects to respond to the following question:

"What has the patient told you?"

The responses to this question were then classified

into seven content areas and as either descriptive or in-

terpretive. Analysis of the data revealed that the experi-

enced therapists did significantly more interpreting than

trainees. However, none of the content categories differed.

The experienced therapists simply tended to describe what

the patient said. As stated by the researchers of this

study:

Although this study does not necessarily prove
that the experienced therapists would be more in-
terpretive of the patient in an actual therapy
situation, or that if they did it would lead to a
more successful outcome, it does indicate that
experience encourages one to 'listen with the
third ear,' and get at the latent meanings of
manifest verbalizations. (Sommer, Mazo and
Lehner, 1955, p. 132)

In general, although researchers have come to no unani-

mous decision as to the usefulness of experience and train-

ing, there appear to be a majority of studies which show

these variables to be important factors in facilitative

counseling.

Insofar as the present study is concerned, the sub-

jects to be used have all had less than three practice, and

thus may be considered to be inexperienced. Thus, this

study may have interesting results on such an inexperienced

population, because what literature there is suggests that








such counselors may have more difficulty in responding fa-

cilitatively to threatening topic areas and affective pre-

sentations than more experienced counselors would.

A Scale for the Measurement of Accurate Empathy

The instrument to be used in the present investigation

is the Scale for the Measurement of Accurate Empathy

(Truax, 1961a). This scale is a measuring device on which

trained judges can reliably rate the extent of the empathic

understanding offered by the psychotherapist in psychother-

apy. The scale was designed to measure a conception of em-

pathy which involves the counselor's sensitivity to the

client's current feelings, and also the counselor's ability

to communicate this understanding in a language which re-

lates effectively to the feelings that the patient is ex-

periencing at that time. (See Appendix E.)

This instrument concentrates on the actual responses

that a given therapist makes to a client. That is, not

only must the counselor experience with sensitivity the

client's particular experience, but also respond to this

experience in meaningful terms. Truax and Carkhuff (1967)

state that:

Accurate empathy involves more than just the
ability of the therapist to sense the client or
patient's 'private world' as if it were his own.
It also involves more than just his ability to
know what the patient means. Accurate empathy
involves both the therapist's sensitivity to cur-
rent feelings and his verbal facility to communi-
cate this understanding in a language attuned to
the client's current feelings. (p. 46)

In order to specify the amount of empathic under-









standing that a counselor is offering a client at a given

time, Truax defined nine degrees of accurate empathy.

These begin at a very low level (at which the counselor

demonstrates almost a complete lack of empathy), and pro-

ceed to a very high level, at which the counselor is ex-

tremely responsive to the clients' full range of feelings

(See Appendix B).

Reliability and Validity of the
Accurate Empathy Scale

The Accurate Empathy Scale has been used in numerous

studies, and is substantiated with high degrees of relia-

bility and validity. These will now be elaborated upon.

One of the first studies to test the validity of the

Accurate Empathy Scale was conducted by Truax (1961a).

Truax compared the levels of accurate empathy presented to

eight hospitalized patients. Four of these clients showed

clear improvement and four showed clear regression on a

number of personality measures after six months of inten-

sive therapy. The findings of this study indicated that

the psychotherapists whose patients improved (as rated by

the personality measures) were rated consistently higher

(p < 0.01) on accurate empathy than were those whose patients

regressed.

A second study (Truax, 1962a) involved fourteen hospital-

ized schizophrenic cases and fourteen counseling cases.

This study used 112 samples of recorded psychotherapy from

early and late interviews. Analysis of the data indicated








that accurate empathy ratings were significantly higher for

the more successful cases than for the less successful (p<

0.01). Also, the positive relationship between accurate

empathy and outcome of therapy held true both for hospital-

ized schizophrenics and for counseling cases. That is, the

same conditions seemed relevant for both populations. The

more successful cases were shown to have received signifi-

cantly higher empathy ratings, while the less successful

cases had many more average and low accurate empathy ratings

(p < 0.05).

Subsequent studies (Truax, 1963; Bergin and Solomon, 1963;

Truax, Wargo, and Silbur, 1966) also confirmed the

validity of the instrument. The external criteria used in

these studies included time actually spent in the hospital

since beginning therapy, changes in psychological test

data, and outcome results.

The last of these studies (Truax, Wargo, and Silbur,

1966) was a social survey involving delinquent girls. The

researchers found that girls who took part in groups charac-

terized as being high in therapist-offered conditions of

accurate empathy and nonpossessive warmth, showed signifi-

cantly more progress than controls, as measured by release

from the institution, and amount of time spent in the com-

munity.

Insofar as reliability measures are concerned, the

following studies have found generally moderate to high de-

grees of reliability using the Truax Accurate Empathy Scale









in both individual and group counseling: Truax (1961a),

with a sample of 384, found 0.87 reliability; Truax and

Carkhuff (1965), with a sample of 297 found 0.89 reliabili-

ty; Bergin and Solomon (1963), with a sample of 28, found

0.79 reliability; Melloh (1964), with a sample of 56, found

0.62 reliability; Truax and Wargo (1966b), with a sample of

366, found a 0.95 reliability; Truax and Wargo (1966c), with

a sample of 698, found a 0.81 reliability; Dickenson and

Truax (1966), using a sample of 72, found a 0.83 reliability;

and Truax (1966a), using a sample of 283, found a 0.84

reliability.

Additional Research using the Accurate Empathy Scale

The Accurate Empathy Scale has been used for other

purposes than simply the evaluation of therapists and thera-

peutic outcomes. Studies on untrained social workers and

counselor aides (Stoffer, 1968; Carkhuff, 1968; Carkhuff

and Truax, 1965b), family relations (Shapiro, Kraus, and

Truax, 1969), and teachers' relations with students (Aspy,

1965; Aspy and Hadlock, 1966) have shown that where empathy

is high, the subjects rated have produced outcomes signifi-

cantly higher than those whose conditions of empathy have

been lower. Specifically, Carkhuff (969c) states that,

There is extensive evidence to relate the offer-
ing of high levels of facilitative and action or-
iented conditions by parents, teachers, counse-
lors, and therapists to constructive change or
gain on the part of their children, students, and
clients on both emotional and intellective indexes.
Similarly, the initiation of low levels of facili-
tative and action-oriented dimensions has been
related to the deterioration of children, students,








and clients on emotional and intellective indexes
(the literature is summarized in Aspy, Carkhuff, and
Douds, 1968; Berenson and Carkhuff, 1967; Berenson
and Mitchell, 1968; Carkhuff and Berenson, 1967;
Carkhuff and Truax, 1966; Rogers, 1967; Truax and
Carkhuff, 1967). (p. 22)

Summary

In summary, it has been shown that a number of thera-

pist qualities, such as experience, training, and personal

traits, may be important variables in the outcome of ther-

apy. Nonetheless, it should not be overlooked that therapy

outcome may not depend exclusively on therapist traits, but

also on client traits, and also upon the relationship be-

tween the therapist and the client (Fiedler, 1950; Carson

and Heine, 1962; Van der Veen, 1965; Moos and Macintosh,

1970).

The literature on psychotherapy research presented in

this section has clearly demonstrated that the client and

therapist influence each other's behavior, and significantly

effect the process and outcome of therapy. These factors

are both appropriate and important to the present study,

which focuses upon how variations in client topic area,

affective presentation, sex, and the interaction of these

three variables affect the level of counselor trainee

accurate empathy.













CHAPTER III

RESEARCH METHODOLOGY

The problem studied in the present investigation was

to rate the level of accurate empathy of forty-two

counselor trainees, when they were presented with the fol-

lowing different types of situations:

1. A nonthreatening topic presented in a nonthreaten-

ing manner (in which a nonthreatening topic, as

defined by a panel of three therapists, was pre-

sented in a nonthreatening manner, as defined

by the same panel of therapists).

2. A nonthreatening topic presented in a threatening

manner (again, both components were determined by

the same panel of therapists).

3. A threatening topic presented in a nonthreatening

manner (again, both components were determined

by the same panel of therapists).

4. A threatening topic presented in a threatening

manner (again, both components were defined by

the same panel of therapists).

The remainder of this chapter is comprised of a more

detailed explanation of the research procedures described

above, including the following: (1) the sample, (2) the








clients, (3) the experimental hypotheses, (4) the raters,

(5) the experimental treatment, (6) the collection of the

data, (7) the statistical design, and (8) the limitations

of the study.

The Sample

The sample for this study consisted of forty-two full

time students from the Masters Program in Rehabilitation

Counseling at the University of Florida. These forty-two

students, or counselor trainees, represent the total number

of students who have completed at least one, but not more

than three practice in counseling in this department, and

thus are eligible for the study.

Demographic data on these counselor trainees is as

follows:

1. 70% of this sample are females, and 30% are

males.

2. 90% of the sample are caucasian and 10% are black.

3. The sample ranges in age from twenty-one (21) to

fifty-three (53) with a mean age of twenty-seven

(27).

Counselor trainee experience in this study does vary

somewhat, in that some students have had several practice

and numerous therapy cases, while others have had only one

practicum and considerably fewer therapy cases. However,

these counselor trainees are not considered to be experienced

therapists, because they are still in the early stages of

practical counseling training.








Clients

Four volunteer drama students role played clients.

These individuals all have had a minimum of one year in

drama school, and performed in at least one play. This

group consists of two males and two females, most of whom

are presently performing in local repertory'companies. They

range in age from twenty-one (21) to twenty-nine (29).

Prior to training these individuals, Coleman's (1972)

definition of threat and scripts of the presenting problems

were given to the therapists. The therapists rated each

script as to whether a given presenting problem is in fact,

threatening or nonthreatening. A seven (7) point bipolar

scale was used to make this determination (See Figure 1).

A consensus was said to have been reached if all three

therapists scored the degree of threat or nonthreat in a

given script on the same and appropriate side of the mid-

point of the seven (7) point scale. This procedure of

rating the scripts took place in order to insure that the

presenting problems were rated as being appropriately

threatening or nonthreatening.

After this determination of appropriateness of topic

was made, the researcher trained the drama students in

role portrayal. This training took place in the following

manner:

The researcher distributed to each role playing drama

student a copy of the vignette that he or she was to por-

tray. The researcher then discussed the content of the













PRESENTING PROBLEM 1 CAREER INFORMATION SEEKING

(This topic is the presenting problem in cells
A, A B and B1 of the research design.)



Nonthreatening ; ; ; ; ; ; __threatening









PRESENTING PROBLEM 2 INTENT OF SUICIDE

(This topic is the presenting problem in cells
C, C D, and D1 of the research design.)



Nonthreatening ; ; _; ; ; threatening


Figure 1. Therapists' Ratings of the Degree of Threat in
the Presenting Problems.








vignette with the drama student, in order to determine if

the drama student fully understood what he or she was to por-

tray. When the researcher determined that the drama student

understood the content of the area to be portrayed, he dis-

cussed the affect which was to be portrayed in each section

of the vignette. At the conclusion of the discussion, the

researcher asked the drama student to portray the role. As

the drama student did so, the researcher coached him or her

throughout the portrayal, in order to inform the drama

student as to the effectiveness of his or her performance.

When the need arose, the researcher himself portrayed the

role, in order to help the drama student more effectively

portray it. This procedure took place until the role was

portrayed to the researcher's satisfaction.

It is important to note that a final check of the ef-

fectiveness of client presentation was made when the thera-

pists viewed a preliminary vignette in which each drama

student acted out the role that he or she was to portray.

The specific role that a drama student was to portray

was decided upon by the following factors:

1. A statement of preference by each drama student as

to the role he or she wished to portray.

2. Interviews conducted by the researcher, through

which he determined what he felt was the most

appropriate role for a given drama student to

portray. (In the case of a discrepancy between

the role a drama student preferred to portray, and








one that the researcher felt was most appro-

priate for that client, the researcher's

opinion determined the final placement.)

The Experimental Hypotheses

As previously stated, comparisons were made between

higher and lower degrees of threatening client topic areas

and affective presentation, and their effects on counselor

trainee level of accurate empathy. The following null hy-

potheses were tested:

HO1 There are no differences in the accurate empathy

levels of counselor trainees exposed to a

threatening topic, and those exposed to a non-

threatening topic.

H 2 There are no differences in the accurate empathy

levels of counselor trainees exposed to threatening

affect and those exposed to nonthreatening af-

fect.

HO3 There are no differences in the accurate empathy

levels of counselor trainees exposed to female

clients and those exposed to male clients.

H 4 There are no differences in the accurate empathy

levels of counselor trainees as a result of com-

binations of sex, topic area, and affective pre-

sentation.

Raters

Trained Raters

The trained raters in this study scored counselor








trainees for level of accurate empathy, as measured by

the Truax Accurate Empathy Scale. This group of raters

consisted of three advanced graduate students in the Coun-

selor Education Department of the University of Florida, who

range in age from twenty-three (23) to twenty-nine (29). The

raters did not know the identity of the counselor trainees

they were to rate.

The specific method of training for these raters was

as follows:

The researcher provided each rater with a copy of

Bozarth's (1975) "Levels of Interpersonal Skills in Psycho-

therapy: A Guide to Increased Discrimination." Section

Three (3) of the manual was concentrated upon. This sec-

tion, entitled, Accurate Empathy was first read by the

raters, and then discussed. Subsequently, Truax's Accurate

Empathy Scale was distributed, and then discussed. When a

consensus as to the meaning of the nine levels in the Truax

Accurate Empathy Scale was reached, the raters were con-

sidered prepared to rate tapes.

Training segments from prepared tapes of therapy in-

terviews were presented to the raters. Each segment contained

both therapist and client verbalizations. Each segment was

approximately two minutes in length. After each presen-

tation of a segment, the raters' ratings and their reasons

for giving those ratings were discussed. Similarities and

differences among raters were given attention. However,

special attention was given to a process of group dis-







cussion. This discussion attempted to resolve any differ-

ences which exceeded two full stages.

This initial training session was approximately two

hours long. Later during the same week, one more session

of similar length was scheduled. At this session, addition-

al training segments were presented, rated,'and discussed,

as during the first session. At the end of this session,

the raters were scored to establish pre-experimental

reliabilities. An acceptable level of interrater relia-

bility was r> 0.70 as measured by Ebel's Intraclass

Correlation Formula (Ebel, 1951), over a minimum of three

tapes.

Therapists as Raters

A second group of raters consisted of three therapists.

These individuals have a Ph.D. or an Ed.D. in the Psychology

or Counselor Education Fields, plus extensive professional

experience (See Appendix C).

As mentioned, these individuals initially rated

scripts of the presenting problems to determine whether or

not a given presenting problem had been appropriately

threatening or nonthreatening. Subsequently, they rated

the following two video taped drama student presentations:

1. In order to insure that the drama students were, in

fact, portraying the role which had been assigned to them,

the therapists, prior to the study, rated videotapes of

preliminary vignettes. These preliminary vignettes consisted








of the drama students portraying the same role that they

did during the live interaction. This measure was taken

in order to insure that the client was able to portray the

role that had been assigned to him or her. In each pre-

liminary vignette, one drama student (Client A, for example)

role played his or her vignette to another drama student

(Client B, for example), who was seated, and playing the

role of a counselor. The drama student who was to portray

the client in a given session was randomly selected by

picking the names of available drama students from a hat.

Subsequently, Client A's preliminary vignette was rated

by the therapists for effectiveness of presentation. All

vignettes presented were similarly rated. The specifics

of this rating are as follows: The therapists viewed three

two-minute excerpts of the video taped client presentations.

After viewing the tapes they were given a seven point bi-

polar scale, and asked to rate the presentation in terms

of its amount of threat or nonthreat on both the dimensions

of topic area and affective presentation (See Figure 2). A

consensus of the therapists was considered to have been

reached if all three therapists scored the client's presen-

tation on the same and appropriate side of the midpoint of

the seven (7) point scale.

If agreement was not reached by the therapists as to

the effectiveness of a given client's presentation, a period

of retraining and reevaluation was to be scheduled. The train-

ing period was to take place on the day following the rating









VIGNETTE A

TOPIC AREA:

NONTHREATENING

AFFECT:

NONTHREATENING


VIGNETTE A1

TOPIC AREA:

NONTHREATENING

AFFECT:

NONTHREATENING


VIGNETTE B

TOPIC AREA:

NONTHREATENING

AFFECT:

NONTHREATENING


VIGNETTE B1

TOPIC AREA:

NONTHREATENING

AFFECT:

NONTHREATENING


: : : : : : THREATENING



: : : : : : THREATENING







: : : : : : THREATENING



: : : : : : THREATENING







: : : : : : THREATENING



: : : : : : THREATENING







: : : : : : THREATENING



: : : : : : THREATENING


Figure 2. Therapists' Ratings of the Degree of Threat in
Drama Students' Presentations.








Figure 2 (continued)


VIGNETTE C

TOPIC AREA:

NONTHREATENING

AFFECT:

NONTHREATENING


VIGNETTE C1

TOPIC AREA:

NONTHREATENING

AFFECT:

NONTHREATENING


VIGNETTE D

TOPIC AREA:

NONTHREATENING

AFFECT:

NONTHREATENING


VIGNETTE D

TOPIC AREA:

NONTHREATENING

AFFECT:

NONTHREATENING


: : : : :THREATENING



: : : : :THREATENING






: : : : : THREATENING



: : : : : __THREATENING






: : : : : : THREATENING



: : : : : : THREATENING






: : : : : : THREATENING



: : : : : THREATENING


L








of the preliminary vignette. This training period was to

last until the presentation was portrayed to both the satis-

faction of the researcher and the drama student. A re-

evaluation was then to be scheduled for the earliest possible

date.

2. The therapists also rated a video taped presenta-

tion of the live interaction between the role playing drama

students and the counselor trainees for effectiveness of

the role playing drama students' presentations. Three, two-

minute segments from the beginning, middle, and end of each

of the forty video tapes were randomly selected for rating.

The manner in which this was done follows the format of

Lawlis (1968):

a. Randomly divide the twenty-minute tapes into three

six to seven minute segments.

b. Randomly choose any two-minute excerpts from each

segment.

Again, a consensus of the three therapists on each of the

vignettes was considered to have been reached if all

three therapists scored the client's presentation on the

same and appropriate side of the midpoint of a seven (7)

point bipolar scale (See Figure 2).

The Experimental Treatment

There were eight (8) client presentations in this

study. That is, of the four role playing drama students

previously mentioned, one male (Client 1) and one female

Client 2) role played a client who presented a nonthreaten-








ing topic in a nonthreatening manner (Cells A and Al in

Figure 3). A second set of male (Client 3) and female

(Client 4) presented a nonthreatening topic in a threaten-

ing manner (Cells B and B1 in Figure 3). Client 1 and

Client 2 also presented a threatening topic in a nonthreat-

ening manner (Cells C and Cl in Figure 3). Client 3 and

Client 4 also presented a threatening topic in a threatening

manner (Cells D and D1 in Figure 3).

The actual treatment was conducted as follows:

Each role playing drama student presented one vignette

within the categories noted in the paragraph above, to five

of the counselor trainees. The counselor trainees responded

as well as possible to the client that he or she saw.

This interaction took place in a counseling room in

the Rehabilitation Counseling Department, and was video-

taped from an adjoining room through a one-way mirror. As

previously mentioned, each counselor trainee was subsequent-

ly scored by the trained raters for level of accurate em-

pathy. Two three-minute excerpts from the beginning,

middle, and end of the video tape were randomly chosen to

present to these raters for scoring.

The specific topic presented by the drama students in

Cells A and Al and B and B1 (See Figure 3), was "Academic

Information Seeking." The topic presented by the dramatists

in Cells C and C1 and D and D was "Intent of Suicide."

Counselor trainees were informed that they were to














Nonthreatening Topic
(Academic Information
Seeking)


Threatening Topic
(Intent of Suicide)


Client 1: 5 counselor Client 1: 5 counselor
(male) trainees trainees


Client 2:
(female)


5 counselor
trainees


Client 2: 5 counselor
trainees


Client 3: 5 counselor Client 3: 5 counselor
(male) trainees trainees





Client 4: 5 counselor Client 4: 5 counselor
(female trainees trainees


Figure 3. Design of the Study








take part in a live situation in which an individual would

be presenting a specific problem. The counselor trainees

were told that the sessions would be video taped. They

were also told that the results were confidential, and

would not be reflected in their grades. They were to respond

as well as possible as helpers to the clients they saw.

When the sessions were terminated, the counselor trainees

were informed that the situations had been role playing

ones, and that their level of accurate empathy had been

evaluated. Additionally, at that time, both the researcher

and drama student discussed with the counselor trainee

any feelings that he or she may have had about participating

in the counseling session. Questions that the counselor

trainee may have had about the study were also discussed

during this period.


Collection of Data

The data in this study were collected in the follow-

ing sequence:

1. After the live interaction between counselor train-

ees and the drama students had been completed, three video

taped two-minute segments of their interaction were sent to

the therapists. The therapists rated the drama students'

presentations for authenticity of presentation (See Figure

3). That is, the vignettes were rated to answer the

following questions: (a) Were the drama students in Cells

A and A1 presenting a nonthreatening topic with nonthreaten-









ing affect? (b) Were the drama students in Cells B and

B1 presenting a nonthreatening topic with threatening

affect? (c) Were the drama students in Cells C and C1 pre-

senting a threatening topic with nonthreatening affect?

(d) Were the drama students in Cells D and.D presenting a

threatening topic with threatening affect?

2. Audiotapes of the interaction between the counse-

lor trainees and the drama students were also given to

the trained raters. These raters then scored the audio-

tapes for their level of accurate empathy.

3. The results of the authenticity of presentation

scores (from the therapists) and empathic facilitativeness

scores (from the trained raters) were returned to the

researcher for computation.

The Statistical Design

This investigation used a 2 x 2 x 2 (topic x effect x

sex) factorial design.

Issac and Michael (1971) point out an attribute of

factorial designs which pertains to the present study:

An important characteristic of factorial designs
is that several hypotheses can be tested simul-
taneously, releasing researchers from the rigid-
ity of classical designs. Whereas classical de-
signs allow only the study of a single variable
at a time, factorial designs permit several vari-
ables to be investigated in one experiment. (p. 52)

Counselor trainees were randomly assigned to one of

the eight statistical cells as follows: The names of each

of the counselor trainees were listed in alphabetical

order, and assigned to cells in the format specified in the





52



Table of Random Numbers (Glass and Stanley, 1970).

A 2 x 2 x 2 factorial analysis of variance was used

to detect any significant differences in the cells (p <0.05).














CHAPTER IV

ANALYSIS OF THE DATA

The data presented in the following section have been

analyzed in accordance with the statistical procedures

outlined in Chapter III.

Results

Forty-two counselor trainees who had completed at

least one practicum in the Rehabilitation Counseling

Department at the University of Florida volunteered to

take part in the present study. This study examined the

impact of variations in topic area, affective presentation

and client sex on these counselor trainees' empathy levels.

The counselor trainees' levels of accurate empathy

were judged by raters trained in the use of the Truax Ac-

curate Empathy Scale (1961a). Both the procedures used to

train the raters and the manner in which the data were to

be collected have been discussed in the previous chapter.

The results of the therapists' ratings for authenticity,

the rater reliability scores, and the actual ratings of

accurate empathy will now be presented.

Therapists' Ratings for Authenticity

The results of the group of three therapists, who were

to rate the drama students' presentations for authenticity

were as follows:








1. During the preliminary vignettes, two dramatiza-

tions were not marked by the therapists on the same and ap-

propriate side of the midpoint of the seven point bipolar

scale. These dramatizations were reenacted, and subsequent-

ly rated on the same and appropriate side of the midpoint

by all three therapists.

2. During.the actual study, all dramatizations were

rated on the same and appropriate side of the midpoint by

all three therapists.
Rater Reliability

Preexperimental interrater reliability and interrater

reliability in the actual study itself were both computed by

the use of Ebel's Intraclass Correlation Formula (Ebel,1951).

The preexperimental reliability of the trained raters

was r = .90 (see Table 1).

The reliability of the trained raters in the actual study

was r = .82 (see Table 2).

The Ebel Intraclass Correlation Formula was also used to

compute the reliability between the accurate empathy ratings

of the trained raters and those of the therapists. This r

was computed to be .84 (see Table 3).

Student's (1908) t test was used to examine the signifi-

cance of the correlation. The correlation proved significant

at the .05 level.

Evaluation of the Experimental Treatments

The influence of variations in client topic area, af-

fective presentation, and sex on counselor trainee accurate

empathy level was evaluated through a 2 x 2 x 2 analysis of














TABLE 1

Pre-experimental Rater Reliability


Rater Segment
1 2 3 4 5 6 7 8 9 10


1 6.5 1.5 1.0 5.0 1.5 2.0 4.0 6.5 6.0 1.0


2 6.5 1.0 2.0 3.5 3.0 1.0 1.5 5.0 8.0 2.0


3 6.5 1.0 1.0 2.5 2.0 1.0 1.5 7.0 7.0 1.0


Sum of squared

Product of sum


ratings 493.50

and mean 326.70


Sum of squares:

for raters 1.05

for counselor trainees 152.00

for total 166.80

for error 14.80


Mean square:

for


counselor trainees 16.90


for error 1.64

Reliability of ratings .755

Reliability of average ratings .90.























































































C0

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variance. For this analysis the measures used were the mean

of accurate empathy scores given by the trained raters to

each subject. Each rater's accurate empathy score for each

counselor trainee is presented in Table 2. The counselor

trainees are noted in Table 2 by segment numbers 1 42. The

results of the analyses are presented in Table 5. Accurate

empathy level results for topic, affect, and sex, are speci-

fied is Table 4. Additionally, a description of the subpopu-

lations in presented in Table 6. The subpopulation means

are graphically portrayed in Figures 4 and 5.

The Null Hypotheses

With 1 and 34 degrees of freedom, an F value of 4.08

would have been necessary for each null hypothesis to be

rejected at the .05 level of significance. The null hy-

potheses tested and the results of the analyses were as fol-

lows:

HO1 There are no differences in the accurate empathy

levels of counselor trainees exposed to a threatening topic,

and those exposed to a nonthreatening topic.

Inspection of Table 5 indicates an F value above 4.08.

Therefore, the null hypothesis is rejected. Thus client

topic area, in this study, is shown to have a significant

effect on counselor trainee accurate empathy level.

H02 There are no differences in the accurate empathy

levels of counselor trainees exposed to threatening affect

and those exposed to nonthreatening affect.

Inspection of Table 5 indicates an F value below 4.08.














TABLE 4

Means and Standard Deviations of
Topic, Affect and


Accurate Empathy by
Sex


Standard
Variable N Mean Deviation

Topic Threatening (T) 20 2.98 1.643

Nonthreatening (NT) 22 2.02 1.407

Affect T 21 2.20 1.584

NT 21 2.80 1.694

Sex Male 21 2.03 0.861

Female 21 2.97 1.796





















a)


O








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0 44 (1) 0 0 k4-4 0 x W) 0
E- N E-n E-i H : E-


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TABLE 6

Description of the Subpopulations


Standard
Variable Value Label N Mean Deviation


For Entire
Population

Topic

Affect

Sex

Sex

Affect

Sex

Sex

Topic

Affect

Sex

Sex

Affect

Sex

Sex


Threatening (T)

T

Male

Female

NT

Male

Female

Nonthreatening (NT)

T

Male

Female

NT

Male

Female


2.47

2.98

2.82

2.20

3.44

3.14

2.10

4.18

2.01

1.58

1.54

1.61

2.44

2.28

2.64


1.58

1.64

1.76

0.87

2.29

1.59

0.93

1.46

1.40

0.72

0.47

0.92

1.79

1.16

2.50









63











S0)






40






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0
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N (N H I


















64






9

8

7

Accurate 6
Empathy
Means 5

4


3.14
2 2.2.82
2.
1 1.58



NTT NTT TT TT
NTA TA NTA TA



Note: NTT signifies Non Threatening Topic
NTA signifies Non Threatening Affect
TA signifies Threatening Affect
TT signifies Threatening Topic


Figure 5. Graph of Counselor Trainees' Accurate Empathy
Levels when Topic and Affect are Combined.









Therefore, the null hypothesis is retained. Thus client af-

fect, in this study, is not shown to have a significant ef-

fect on counselor trainee accurate empathy level.

H03 There are no differences in the accurate empathy

levels of counselor trainees exposed to female clients and

those exposed to male clients.

Inspection of Table 5 indicates an F value below 4.08.

Therefore, the null hypothesis is retained. Thus client sex,

in this study, is not shown to have a significant effect on

counselor trainee accurate empathy level.

H04 There are no differences in the accurate empathy

levels of counselor trainees as a result of combinations of

sex, topic area, and affective presentation.

Inspection of Table 5 indicates an F value below 4.08.

Therefore, the null hypothesis is retained. Thus combina-

tions of topic, affect, and sex, in this study, are not

shown to have a significant effect on counselor trainees

accurate empathy level.

Discussion

Of the hypotheses orginially set forth in Chapter III,

only H01 (client topic area) achieved significant results.

Neither H02 (client affective presentation), HO3 (client

sex), nor H04 (interaction effects) had such results. In

order to understand these results most fully, it is impor-

tant to review research which bears on this area.

As previously mentioned in Chapter II, research re-

lated to the area of the present study is limited. However,









the results of the present study partially concur with the

existing literature. Carkhuff (1969), found that both topic

and affect significantly affected counselor facilitative-

ness (in terms of empathy, warmth, and genuineness). Mel-

nick (1975), in a similar study, also found that affect was

significant. Her study did not deal with sex.

Although the present study and related literature

agree that topic does influence counselor facilitativeness,

it appears that more research is necessary on the area of af-

fect. The types of affect in Carkhuff's (1969) study and the

present study were very dissimilar. Thus it is not possible

to state whether or not a trend exists with regard to affect.

Sex is not a variable considered in either Carkhuff's

or Melnick's studies. However, in the present study it was not

found to be significant. This finding supports the contention

that client sex does not influence counselor trainee accurate

empathy level to a significant degree.

It appears that the most important contribution of the

present study to the counseling field is discovering that a

threatening topic is responded to with higher levels of

accurate empathy than a nonthreatening topic. In attempting

to understand why this is so, the researcher noted the follow-

ing related research: Dipboye (1954) explored the relation-

ship between counselor response style and topic unit of dis-

cussion. He found that the "client problem did affect the

proportions of content and feeling responses in the counsel-

ing interactions."

On the basis of Dipboye's findings and the present










writer's observations, the following reasons for a threaten-

ing topic being responded to with high levels of accurate

empathy are suggested:

The topic of "Intent of Suicide" is more obviously a

topic of great emotional importance, and therefore counselor

trainees may feel that it requires a response with a high

degree of empathy. "Academic Information Seeking," on the

other hand, appears to be a topic which requires a content-

oriented response, rather than an empathic response.

Thus the counselor trainee who is dealing with the

topic of "Intent of Suicide" is more cued to be looking for

emotional content (content that he or she can respond to

empathically), whereas the counselor trainee who is dealing

with "Academic Information Seeking" is more cued into an

information giving set. He or she, therefore, may tend to

respond somewhat less empathically.

Related to the aforementioned possibilities is the fact

that the suicidal client may have more obviously been seri-

ously concerned than the academic information seeking client.

That is, when a client presented concerns of feeling deep

pain and loneliness, counselor trainees were able to re-

spond empathically, but when the client's feelings were less

extreme, they did not.

The findings of this study support the view that a deep-

seated area of concern, though it may be threatening, is re-

sponded to with a higher level of accurate empathy than a

less deep-seated area, though it may be nonthreatening.










Summary

The pre-experimental reliability of the trained raters

in rating accurate empathy was r = .90. The reliability of

the trained raters in rating accurate empathy during the

actual study was r = .82. The correlation between the em-

pathy ratings of the trained raters and those of the pro-

fessional judges was .84.

The sample in the study was composed of 42 counselor

trainees in the Rehabilitation Counseling department. Each

counselor trainee's demonstration of Accurate Empathy,

as determined by the Truax Accurate Empathy Scale, was

measured. A 2 x 2 x 2 factorial experiment was analyzed

using analysis of variance. This procedure tested for

differences among the means of the eight cells in the study

(See Tables 5 and 6).

As can be noted in Table 5, topic is the only vari-

able which leads to a significantly higher response. No

significant effects were noted due to client affect, sex,

or three way interaction. Thus all null hypotheses except

number one were retained.














CHAPTER V

SUMMARY, LIMITATIONS, IMPLICATIONS, AND CONCLUSIONS

Summary

The purpose of this study was to investigate the ef-

fects of variations in client topic area, affective pre-

sentation, and sex on counselor trainees' demonstration of

accurate empathy.

Three trained raters were used in this study to rate

the accurate empathy of forty-two counselor trainees in

the Rehabilitation Counseling Department. These raters

were trained in the use of Truax's Accurate Empathy Scale

(1961a). After training of these raters was completed, and

pre-experimental reliability was established, evaluation of

counselor trainee accurate empathy level was carried out.

During the actual study, counselor trainees were

placed in a counseling situation with roleplaying drama stu-

dents. (The counselor trainees were under the impression

that these individuals were real clients.) These drama

students, who had been equally divided by sex, presented

the trainees with problems that varied by the degree of

threat or nonthreat that was contained within topic area

and affective presentation. Subsequently, this 2 x 2 x 2

factorial experiment was analyzed using analysis of vari-

ance. In this manner, mean differences between the cells

were studied. Significant differences in the area of topic
69






70

were found, but not in affective presentation, sex, or inter-

action effects.
Limitations

There are three limitations in this study which should

be considered when discussing its implications:

1. The counselor trainees are all from the Rehabili-

tation Counseling Department, and may be in any one of four

states of progress. That is, they are either second,

third, fourth, or fifth quarter students. Because they are

at different levels of training, they may have responded to

clients with greater or lesser degrees of accurate empathy.

2. Although the quarter to which individual counselor

trainees had progressed in the Rehabilitation Counseling

program was not controlled, those with the highest accurate

empathy scores were fifth (final) quarter students. Fourth

quarter students also scored well; there appears to be a

consistent relationship between quarter in the program and

accurate empathy level.

3. An overall mean of 2.48 was achieved by the sub-

jects in this study, a low level of accurate empathy, as

defined by Truax's Accurate Empathy SCale. Specifically,

this mean is less than halfway between Truax's (1961a) Ac-

curate Empathy Step 2 "Accuracy negligible, poor under-

standing of obvious feelings, and ignores veiled feelings"

- and Step 3 "Often responds accurately to obvious feel-

ings, senses but understands veiled feelings poorly."

Nevertheless, although 2.48 is not defined by Truax as








a minimally facilitative accurate empathy level, it should

be pointed out that this level is not overly low, in terms

of previous research that has been conducted. For example,

in a study by Mitchell, Bozarth, Truax, and Krauft (1973),

therapists (all of whom were practicing professionals) were

found to have an accurate empathy mean of only 2.30. In

view of the results of that study, accurate empathy scores

in the present study are quite respectable.

Implications and Conclusions

Implications. The present study has two major impli-

cations for counselor training:

1. There appears to be a need in rehabilitation coun-

selor education for counselor trainees to learn how to

respond to a broad range of feelings, and develop skill in

understanding that strong emotional undercurrents may exist

in a client, even though he or she may allude to feelings

only minimally. For example, the levels of counselor trainee

accurate empathy, when nonthreatening topics were presented,

were low (the mean was 2.01). Thus, counselor trainees

would benefit from increased training designed to sensitize

them to veiled or not readily obvious feelings.

2. Counselor trainees did not approach an accurate

empathy level of five (the minimum level of facilitativeness

on the nine point scale) in any part of the study.

These results demonstrate that counselor trainee accu-

rate empathy levels must be upgraded in general, in order

for clients to be counseled adequately.








Conclusions. Replication is needed to verify the in-

fluence of client topic area, affective presentation, sex,

and their interaction effects on counselor trainees'

accurate empathy levels. Particular attention should be

given to the limitations noted above, regarding the follow-

ing:

1. Counselor trainee quarter in the program.

2. The mean accurate empathy level of the entire

sample.

Finally, the present study achieved results in which

sex was not significant. However, the study should be

replicated with a larger sample size, in order to determine

if an increase in sample size might prove sex to become

statistically significant. Such a finding could have im-

portant implications for counseling in the future.













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APPENDIX A

Role Descriptions for Clients

As stated, two dramatists (one male and one female)

portray each of the following areas: (A) Clients who

present a nonthreatening topic in a nonthreatening manner;

(B) Clients who present a nonthreatening topic in a

threatening manner; (C) Clients who present a threaten-

ing topic in a nonthreatening manner; (D) Clients who

present a threatening topic in a threatening manner.

SCRIPT I

Problem to be Presented Academic Information Seeking

The client in this interview is a fourth quarter

freshman at the University of Florida. He (*) states a

desire to enroll in Rehabilitation Counseling in graduate

school, and thus would like to begin exploring the area of

which upper division major might be the most useful in

helping him to eventually be accepted into the Masters pro-

gram in Rehabilitation Counseling.

The client is interested in the social sciences. He

would like to know if the counselor trainee feels that

majoring in one of the social sciences would be a good

choice for a major.



(*) In order to facilitate the reading of this appen-
dix, only the male pronoun will be used, although both a
male and female dramatistpresented the problem.





84

Specifically, the client voices a preference for

either psychology or sociology. He has never taken a

course in either, but has read several course descrip-

tions in each area, and finds them both very interesting.

As far as grades are concerned, the client has a 3.9

grade point average. He has consistently done well academ-

ically throughout his high school years and first year of

college. Thus, he feels capable of majoring in most pro-

grams without difficulty.

Client Behavior During the Interview

During the interview the clients present their prob-

lems in a very straightforward manner, simply stating their

questions and asking the counselor trainees' advice.

These clients are in rather good spirits and exhibit

little or no overt anxiety. They smile often, and show no

animosity or aggression towards the counselor trainee.

After having received the information they need, these

clients thank the counselor trainee in a pleasant manner,

and leave the room.

SCRIPT II

Problem to be Presented Academic Information Seeking

The client in this interview is a fourth quarter

freshman at the University of Florida. He states a desire

to enroll in Rehabilitation Counseling in graduate school,

and thus would like to begin exploring the area of which

upperdivision major might be the most useful in helping

him to eventually be accepted into the Masters program in









Rehabilitation Counseling.

This client is interested in the social sciences. He

would like to know if the counselor trainee feels that ma-

joring in one of the social sciences would be a good choice

for a major.

Specifically, the client voices a preference for

either psychology or sociology. He has never taken a

course in either, but has read several course descriptions

in each area, and finds them both very interesting.

As far as grades are concerned, the client has a 3.9

grade point average. He has consistently done well academ-

ically throughout his high school years and first year of

college. Thus, he feels capable of majoring in most pro-

grams without difficulty.

Client Behavior During the Interview (B)

During this interview clients present themselves in

a demanding, dependent, and yet aloofly defiant manner to

their counselors. That is, clients take part in little

self exploration or introspection, but rather ask such

questions as, "Well, what do you think I should major in,

psychology or sociology?" or make the demand, "Just

tell me which one you'd choose if you were an undergrad-

uate!"

The attitude of these clients is that they have come

to the counselor trainee for professional services, and

that these services should include decisions in the area

of academic information seeking.









These clients are very resentful of any comments made

by the counselor trainee which suggest that they take any

responsibility for their own behavior or decision making.

They berate the counselor trainee's responses to feelings,

and challenge his professional ability, in both a facetious

and an angry manner.

SCRIPT III

Problem to be Presented Intent of Suicide

The problem to be presented in this section is that

the client is contemplating suicide. He has had a long

series of emotionally burdening circumstances, which are

now culminating in a feeling of overwhelming unhappiness

and dejection. Some of the precipitating events are as

follows:

The previous evening the client had been told by his

girl friend that she was deserting him for another man.

She feels that he has become too dependent on her and thus

is making her feel "tied down." The client feels that this

is the final blow in a long series of events which have

shown him that he is a worthless person, who is undesire-

able both sexually and socially.

This client's history includes the following informa-

tion: His father is a career Marine officer, and is pre-

sently stationed in Germany. The client has never been

close to his father. His mother, whom he had been close

to, passed away three years ago.

A childhood spent in numerous parts of the globe left








the client with neither longlasting friends, nor a consis-

tent educational background. These two problems constantly

plague the client, who is, at this time, a college sopho-

more at the University of Florida. He presently suffers

from (1) a fear of forming new friendships and relation-

ships and (2) failing grades in two courses. These fac-

tors, he also feels are indications of his overall failure

as a human being.

The culmination of all of these events leaves the cli-

ent in a position of depression and interminable hopeless-

ness. He sees all avenues of escape sealed off. However,

the client claims to have sufficient resolve to determine

his own fate. For this reason, he plans, this very evening,

to visit his father's hunting lodge in nearby community

and use a captured German luger, still loaded, to commit

suicide.

The client claims to have come to the counselor trainee

not to be stopped, but only to clear his conscience before

going through with self destruction. He admits to being de-

pressed, but states that his resolve is firm.

Behavior During the Interview

During the interview, the clients speak in a manner

which is submissive and somewhat depressed. Their state-

ments are low in volume and lack assertiveness.

These clients make no demands upon their respective

counselor trainees, other than to quietly ask their opinions

on one or two occasions.




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