Group Title: Counselors' goals and roles to assist older persons in federally supported programs /
Title: Counselors' goals and roles to assist older persons in federally supported programs
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Title: Counselors' goals and roles to assist older persons in federally supported programs
Physical Description: xiv, 209 leaves; 28 cm.
Language: English
Creator: Johnson, Richard P.
Publication Date: 1980
Copyright Date: 1980
 Subjects
Subject: Student counselors -- United States   ( lcsh )
Goal (Psychology)   ( lcsh )
Role expectation   ( lcsh )
Old age assistance -- United States   ( lcsh )
Counselor Education thesis Ph. D
Dissertations, Academic -- Counselor Education -- UF
Genre: bibliography   ( marcgt )
non-fiction   ( marcgt )
 Notes
Thesis: Thesis (Ph. D.)--University of Florida, 1980.
Bibliography: Bibliography: leaves 196-207.
General Note: Typescript.
General Note: Vita.
Statement of Responsibility: by Richard P. Johnson.
 Record Information
Bibliographic ID: UF00099105
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 - 000099864
oclc - 07194631
notis - AAL5324

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COUNSELORS' GOALS AND ROLES TO ASSIST OLDER PERSONS
IN
FEDERALLY SUPPORTED PROGRAMS




BY


RICHARD P. JOHNSON


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







UNIVERSITY OF FLORIDA






































For My Loving Wife, Sandra





































This research was made possible by a grant from the

Administration on Aging (AoA), Dissertation Program, 1979

Department of Health, Education and Welfare

D.H.E.W.

















ACKNOWLEDGEMENTS


Dr. Harold C. Riker, my doctoral chairman, has served as my

initiator, my motivator, and my moderator in this project. His

positive influence and refined example greatly encouraged my work

in the field of aging. Dr. Riker's tireless tenacity has always

been a standard for me to emulate. I regard Dr. Riker as my mentor

in the full meaning of the word. The pleasure of working with him

has invariably proved a delightful challenge.

Dr. Robert 0. Stripling's abilities to cut to the core of

the issue and to project the consequences of an action, which he

exercises in a powerfully quiet yet always genuinely concerned manner,

have consistently been an inspiration for me. It is an honor to

work with such a gentleman. Dr. James L. Wattenbarger has been

gracious in providing me with personal assistance and support through-

out this project.

I would like to thank the participants in this study, both

those in academic settings and those administrators in the aging

services network who gave of their time and talent to assist this

project toward its completion. To these persons I owe very much.

This research would not have been possible to the depth or

caliber which it was without the wonderful financial assistance

given to me by the Administration on Aging (AoA). Again, I give my

deepest appreciation.









Lastly, and most importantly, I wish to express my loving

gratitude to my wife Sandra whose marvelous personal dedication,

thankless commitment to cause, and unshaking support of me, has en-

abled me to achieve this lifelong goal. My appreciation, thanks,

and depth of devotion is simply inexpressible. I dedicate this

work to her.















TABLE OF CONTENTS



Page


ACKNOWLEDGEMENTS..................... ................... iv

LIST OF TABLES ............................................. x

ABSTRACT ................................................. xii

CHAPTER

I INTRODUCTION..................... ................. 1

Background Information ...................... 1
Purpose of the Study..... ................. .. 5
Rationale.................................... 6
Definitions ................... ............... 11

II REVIEW OF THE LITERATURE.......................... 13

The Counseling Needs of Older Persons....... 13
Goal Theory................................ .. 17
Counseling Goals for the Aged................. 21
Role Theory................................ .. 30
Counselor Roles............................... 31
Gerontological Counselor Roles................ 34
Summary of Related Literature................. 53

III METHODOLOGY....................................... 55

Introduction................................. 55
Research Objectives......................... 56
Sample Selection and Research Procedures.... 57
Analysis of the Data.......................... 60

IV RESULTS.......................................... .. 62

Demographic Information Relating to the
Panel of Experts ..................... ...... 62
Demographic Information Relating to the
Executive Directors of Area Agencies
on Aging (AAA) ............................. 79
Evaluation of Experts Confirmation of
Goals, Roles and Sites..................... 80






vi








Page
Evaluation of Goals, Roles and
Sites by AAA Directors.................... 90
An Analysis and Comparison of Goals,
Roles, and Sites as Rated by
Counseling Experts and AAA Directors.... 97
Comparison of Evaluations of Goals, Roles,
and Sites by Experts and AAA Executive
Directors................................ 123
Factor Analysis.............................. 124

V SUMMARY, DISCUSSION, CONCLUSIONS, IMPLICATIONS
AND SUGGESTIONS FOR FURTHER RESEARCH.......... 147

Summary of the Study......................... 147
Discussion................................... 149
How Gerontological Counselors Assist
Older Persons in Federally Supported
Programs................................. 153
Conclusions.................................. 161
Implications................................. 164
Suggestions for Further Research............. 166

APPENDICES

A LETTER AND SURVEY TO COUNSELOR EDUCATION
DEPARTMENT CHAIRPERSONS....................... 169

B FIRST ROUND LETTER AND SURVEY TO GERONTOLOGICAL
COUNSELING EXPERTS........................... 170

C SECOND ROUND LETTER AND SURVEY TO GERONTOLOGICAL
COUNSELING EXPERTS........................... 175

D FIRST REMINDER LETTER TO GERONTOLOGICAL
COUNSELING EXPERTS ........................... 179

E SECOND REMINDER LETTER TO GERONTOLOGICAL
COUNSELING EXPERTS........................... 180

F LETTER AND SURVEY TO AAA DIRECTORS................ 181

G REMINDER LETTER TO AAA DIRECTORS.................. 185

H CROSSTABULATION OF EXPERTS' CHARACTERISTICS:
REGIONAL AREA BY NUMBER OF GERONTOLOGY
COURSES TAUGHT.... ......................... .. 186

I CROSSTABULATION OF EXPERTS' CHARACTERISTICS:
REGIONAL AREA BY NUMBER OF CONTRIBUTIONS
TO GERONTOLOGY ............................... 187


vii








Page


J CROSSTABULATION OF EXPERTS' CHARACTERISTICS:
REGIONAL AREA BY GERONTOLOGY PREPARATION.... 188

K CROSSTABULATION OF EXPERTS' CHARACTERISTICS:
REGIONAL AREA BY HIGHEST DEGREE HELD........ 189

L CROSSTABULATION OF EXPERTS' CHARACTERISTICS:
REGIONAL AREA BY NUMBER OF SPECIALITIES
OTHER THAN GERONTOLOGY....................... 190

M CROSSTABULATION OF EXPERTS' CHARACTERISTICS:
SEX BY NUMBER OF CONTRIBUTIONS TO
GERONTOLOGY.................................. 191

N CROSSTABULATION OF EXPERTS' CHARACTERISTICS:
NUMBER OF GERONTOLOGY COUSRES TAUGHT BY
GERONTOLOGY PREPARATION...................... 192

O CROSSTABULATION OF AAA DIRECTORS'
CHARACTERISTICS: REGIONAL AREA BY PUBLIC
SERVICE AREA ...... .......................... 193

P CROSSTABULATION OF AAA DIRECTORS'
CHARACTERISTICS: SEX BY HIGHEST DEGREE
HELD.......................................... 194

Q CROSSTABULATION OF AAA DIRECTORS'
CHARACTERISTICS: HIGHEST DEGREE BY
PUBLIC SERVICE AREA.......................... 195

REFERENCES................................................. 196

BIOGRAPHICAL SKETCH... ................................ .. 208














LIST OF TABLES


Page

TABLE

1 SUMMARY OF DEMOGRAPHIC CHARACTERISTICS OF
COUNSELING EXPERTS................ .......... 66

2 SUMMARY OF DEMOGRAPHIC CHARACTERISTICS OF
SAMPLE OF AAA DIRECTORS....................... 70

3 CROSSTABULATION OF EXPERTS' CHARACTERISTICS:
REGIONAL AREA BY SEX.......................... 72

4 CROSSTABULATION OF EXPERTS' CHARACTERISTICS:
REGIONAL AREA BY DEGREE AREA................... 73

5 CROSSTABULATION OF EXPERTS' CHARACTERISTICS:
SEX BY TEACH GERONTOLOGY COURSE................ 74

6 CROSSTABULATION OF AAA DIRECTORS'
CHARACTERISTICS: REGIONAL AREA BY SEX........ 75

7 CROSSTABULATION OF AAA DIRECTORS'
CHARACTERISTICS: REGIONAL AREA BY DEGREE..... 77

8 CROSSTABULATION OF AAA DIRECTORS'
CHARACTERISTICS: SEX BY PUBLIC SERVICE AREA.. 78

9 FREQUENCY OF RESPONSE CHOICES, MEAN AND STANDARD
DEVIATION OF GOALS, ROLES, AND SITES FOR
EXPERTS (N=41) .............................. .. 82

10 SUMMARY OF F RATIOS FOR ONE-WAY ANALYSIS OF
VARIANCE FOR GOALS, ROLES, AND SITES, AND
DEMOGRAPHIC ITEMS AS RESPONDED BY COUNSELING
EXPERTS....................................... 84

11 SUMMARY OF MEANS OF GOALS, ROLES, AND SITES, AND
DEMOGRAPHIC ITEMS FOUND TO BE SIGNIFICANT BY
F RATIOS FOR COUNSELING EXPERTS................ 86

12 FREQUENCY OF RESPONSE CHOICES, MEAN AND STANDARD
DEVIATION OF GOALS, ROLES, AND SITES FOR AAA
DIRECTORS (N=168)............................. 91

13 SUMMARY OF F RATIOS FOR ONE-WAY ANALYSIS OF
VARIANCE FOR GOALS, ROLES AND SITES, AND
DEMOGRAPHIC ITEMS AS RESPONDED BY AAA
DIRECTORS.................................... ... 94









Page

14 SUMMARY OF MEANS OF GOALS, ROLES AND SITES AND
DEMOGRAPHIC ITEMS FOUND TO BE SIGNIFICANT
BY F RATIOS FOR AAA DIRECTORS.................. 96

15 SUMMARY OF MEANS, STANDARD DEVIATIONS, RANK
ORDER OF AND CORRELATION BETWEEN GROUPS
(EXPERTS AND AAA DIRECTORS) FOR GERONTOLOGICAL
COUNSELING GOALS, ROLES AND SITES.............. 101

16 SUMMARY OF F RATIOS FOR ONE-WAY ANALYSIS OF
VARIANCE FOR SURVEY GOALS BY GROUP, EXPERTS
AND AAA DIRECTORS ............................. 103

17 SUMMARY OF MEANS OF CONFIRMING GOALS AND ROLES
AS COMPARED TO ASSISTING GOALS AND ROLES FOR
AAA DIRECTORS WITH CORRELATION MEASURE........ 125

18 INTERCORRELATIONS OF GOALS FOR EXPERTS............. 126

19 INTERCORRELATIONS OF ROLES FOR EXPERTS............. 127

20 INTERCORRELATIONS OF SITES FOR EXPERTS............. 130

21 INTERCORRELATIONS OF GOALS FOR AAA DIRECTORS...... 132

22 INTERCORRELATION OF ROLES FOR AAA DIRECTORS........ 133

23 INTERCORRELATION OF SITES FOR AAA DIRECTORS....... 136

24 PRIMARY FACTOR LOADINGS FOR EXPERT RATED
COUNSELING GOALS RESPONSES FOLLOWING A
PRINCIPAL-AXES FACTOR ANALYSIS WITH AN OBLIQUE
ROTATION TO SIMPLE SOLUTION..................... 139

25 PRIMARY FACTOR LOADINGS FOR AAA DIRECTORS
COUNSELING GOALS RESPONSES FOLLOWING A
PRINCIPAL-AXES FACTOR ANALYSIS WITH AN OBLIQUE
ROTATION TO SIMPLE SOLUTION..................... 140

26 PRIMARY FACTOR LOADINGS FOR EXPERTS' COUNSELING
ROLES RESPONSES FOLLOWING A PRINCIPAL-AXES
FACTOR ANALYSIS WITH AN OBLIQUE ROTATION TO
SIMPLE SOLUTION................................ 141

27 PRIMARY FACTOR LOADINGS FOR AAA DIRECTORS'
COUNSELING ROLES RESPONSES FOLLOWING A
PRINCIPAL-AXES FACTOR ANALYSIS WITH AN
OBLIQUE ROTATION TO SIMPLE SOLUTION............ 142









Page


28 PRIMARY FACTOR LOADINGS FOR EXPERTS'
SITE RESPONSES FOLLOWING A PRINCIPAL-
AXES FACTOR ANALYSIS WITH AN OBLIQUE
ROTATION TO SIMPLE SOLUTION.................. 143

29 PRIMARY FACTOR LOADINGS FOR AAA DIRECTORS'
RESPONSES FOLLOWING A PRINCIPAL-AXES
FACTOR ANALYSIS WITH AN OBLIQUE ROTATION
TO SIMPLE SOLUTION.......................... 144
















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





COUNSELORS' GOALS AND ROLES TO ASSIST OLDER PERSONS
IN
FEDERALLY SUPPORTED PROGRAMS


By



Richard P. Johnson



August, 1980



Chairman: Harold C. Riker
Major Department: Counselor Education


This study has assisted the specialty of gerontological counsel-

ing by specifying and confirming the most appropriate goals and the po-

tential roles for counselors of older persons. Additionally, this study

identified and rank ordered the possible placement sites within the

federally supported aging network, where gerontological counselors could

be of greatest assistance to older persons.

A panel of 41 gerontological counseling experts was assembled

after each counselor education department (N=448) in the nation was

asked for nominations. Each expert was asked to react, on a seven point

Likert scale, to 18 gerontological counselor roles and five counselor










goals which the researcher abstracted from the literature. Experts

confirmed all goals and roles, and added 2 additional goals and 3

additional roles for a total of 7 and 21, respectively. Experts also

rated, on a seven point Likert scale, 13 possible placement sites for

counselors within the aging network.

A clustered, random sample of Area Agency on Aging (AAA) execu-

tive directors (N=253) was asked to react in two ways to the newly con-

firmed lists of goals and roles. The first was the degree of conformity

each goal and role had to the present objectives of their AAA office.

The second was the degree to which each goal and role could assist older

persons in their public service area. One hundred sixty-eight AAA

directors responded to the survey. Like the experts, AAA directors also

rated the 13 possible placement sites for counselors within the aging

network.

Directors of AAAs endorsed each goal and each role confirmed by

the panel of experts as relevant for aging network. Goals and roles

which were rated as highly conforming to present AAA objectives were

likewise rated as of generally greater value to older persons by AAA

directors. Directors ranked the site of "senior centers" as their number

one potential placement location for gerontological counselors.

Experts and AAA directors generally agreed with respect to the

goals and roles for counselors, but disagreed with respect to the prior-

ities for these goals and roles. Directors of AAAs tended to rank

higher those goals and roles which had direct application to existing

AAA programs, while experts ranked higher those goals and roles which

focused directly on the individual, rather than on programs. Experts and

AAA directors were in greater agreement with respect to the priority

of placement sites for counselors within the aging network.


xiii










This study helped to define further the specialty of gerontological

counseling by identifying the appropriate goals and roles for its

professionals. Gerontological counseling experts favor a preventative,

developmental approach to counseling older persons, but recognize the

need for remedial counseling as well.

A relatively high degree of conformity exists between the confirmed

goals and roles for gerontological counselors and the present objectives

of the aging network. Directors of AAAs perceive the goals and roles

of gerontological counselors as of great benefit and high need to older

persons. Directors of AAAs rated the roles of medical outreach support

counselor, counselor of the terminally ill, pre-retirement counselor,

family counselor, bereavement counselor, marital and sex counselor, and

financial counselor as being of immediate need in the aging network.

This study demonstrated that counseling services are directly

applicable to and needed in the federally supported aging network. This

study generated an operational definition of counseling as it relates to

older persons. Because of this clear definition and measure of need,

federal and state legislation can now more confidently address older

persons' psychosocial concerns which impact so greatly on their ability

to take full advantage of existing programs.













CHAPTER I

INTRODUCTION


Background Information

In 1965 The Older Americans Act was passed into law (H.E.W., 1965).

This landmark legislation recognized the elderly population of this

country as having special, aged-related needs, and appropriated funds

to provide four general categories of services to elderly in need:

(1) housing, (2) transportation, (3) homemaker services, and (4) legal

and other counseling. The language of the Act did not indicate that

any one of these four service categories would carry a higher priority

than another (Murphey, 1979). The intent of the legislation was to

establish national priorities and programs to remedy the recognized

negative effects of aging.

Numerous writers and researchers have attempted to enumerate the

complex problems of older persons (Brine, 1979; Buckley, 1972; Cottrell,

1974; Fine and Therrien, 1977, Fleer, 1975; Manney, 1975; Uroda, 1977).

Butler (1975) recognized widowhood, late life marital and sexual

problems, retirement, sensory loss, aging, disease, pain, hospital-

ization, surgery, institutionalization, and dying as major crises

in old age. -The Department of Health, Education, and Welfare

(H.E.W., 1974) identified these problems, in perhaps wider terms, as

physical decline, resistance to change, sense of isolation and loneliness,

reduced or fixed income and lack of access to adequate social services.











A division of D.H.E.W., the Administration on Aging (AoA), was created

by the Older Americans Act to establish national guidelines and policies,

and carry out public programs designed to address the problems associated

with age.

Other legislation designed to meet specific aging problems has been

passed. There are presently seven federal legislative actions relating

in whole, or in part, to health care for the elderly; six federal acts

concerning elderly housing problems; 10 involving social service programs

for the aging; five covering elderly income maintenance; and five acts,

or sections of acts, authorizing research and training in the aging

field (Odell, 1979). Both houses of Congress have established committees

on the elderly. The Senate has a Special Committee on Aging, currently

chaired by Senator Lawton Chiles (D. Florida), with units on housing,

employment, community services, consumer interests, health, retirement,

and long term care (Sinick, 1977). The House has a Select Committee

on Aging presently chaired by Congressman Claude Pepper (D. Florida).

This massive federal effort has, however, created its own problems.

Kerschner and Herschfield (1975, p. 357) have asserted that:

Aging legislation has been caught in a morass of conflicting
and competing interests and issues. The result of these frag-
mented approaches is that in most cases involving major aging
legislation, policy makers have abdicated moral responsibility
by passing laws based on flimsy and often inaccurate data.

Birren and Woodruff (1975) reinforced the Kerschner and Herschfield posi-

tion when they stated that the "aging landscape is dotted with specialized

divisions: Institutional Care, Home Health Care, Supplemental Security In-

come, Nutrition and Recreation" (p. 355). They have called for a unifying

aging philosophy upon which could be based well coordinated public policies











and programs for the older American. Birren and Woodruff (1975, pp.

371-72) advocated aging programs which were specified, holistic, rational,

and based on long range planning rather than programs which are ill-

defined, segmented, crisis oriented, or forged as the expediency of the

"prevailing political atmosphere."

In 1973 the Older Americans Comprehensive Service Amendments

created a new community-based organizational network called the Areawide

Agency on Aging (AAA). The AAAs were designed to emphasize planning the

coordination of programs for the aged. They were "charged with developing

plans for a comprehensive and coordinated network of services to older

people and with offering facilitating services in the areas of information

and referral, escort, transportation, and outreach" (Atchley, 1977, p.

262). The intent of the amendments were to create, on a nationwide basis,

a structure capable of offering basic services to all elderly in need.

Presently, there are over 600 AAAs established nationally (Cone, 1979)

with several dozen more yet to be organized. This concept of community

level planning and coordination recognizes the need for regional var-

iation in program implementation. The AAA structure is still in its

nativity state and "it will be some time before the effectiveness of the

community approach to federal programs can be assessed" (Atchley, 1977, p.

263). Each AAA is administered by a director whose job it is to contract

and monitor all federally funded aging programs in the district. Among

functions, this position includes the roles of policy maker and policy

implementor. On the area level, the director plays a key role in negoti-

ating and monitoring contracted services for the elderly. On the

community level, the AAA director, together with the AAA Advisory Board,

community representatives, and state agency services administrators,











conducts needs assessments and decides aging services priority. The

AAA director is also in a unique position to affect aging program policy

on a state and national level. The AAA structure maintains direct

administrative lines to both the State Agency on Aging and the Federal

Administration on Aging. Suggestions and needs identified "in the

field" by the AAA director and staff are communicated to the state and

federal level. The director plays vital policy making roles in both

a direct way on the area level, and in an indirect way on the state and

national levels (Odell, 1979).

\ Concern for the problems associated with age and legislation

designed to remedy the problems of the aged are not likely to decrease

in the future (H.E.W., 1978; Murphey, 1979; Vasey, 1975). The aged

population in the United States is growing in actual numbers and in

proportion to the total population (Atchley, 1977; Birren and Woodruff, 1975;

Blake & Peterson, 1979, Puner, 1974; Schultz, 1975).

The elderly population in the United States is not homogeneous.

Puner (1974) divided this population into three categories for purposes

of needs and program identification: age 45-59, "middle aged;" age

60-74, "elderly;" and age 75 and over, "aged." Neugarten (1968)

postulated two divisions of older persons: "young-old," those 55-70;

and old-old," 70 and over. Individual exceptions naturally exist within

these broad categories since age is regulated by a social rather than

a biological clock (Neugarten, 1968). Aging programs must, therefore,

be guided by an overarching philosophy which allows for the variety of

needs expressed by older Americans. Individualization of services

within a broad framework of programs and policies seems mandatory in











view of a population characterized by heterogeniety (Toward a National

Policy on Aging, 1971).



Purpose of the Study

This research sought, first to compile a list of gerontological

counselors' goals and roles, which would be confirmed by a nationally

identified panel of gerontological counseling experts. Confusion exists

with regard to the specific goals and roles of the professional counselor

(Garfinkel, 1975). Research questions such as what are the capabilities,

the priorities and the objectives of the professional counselor of the

aged, are clarified by this study.

-The second purpose of this study was to determine the degree of

relevancy that the goals and roles confirmed by the panel of experts

have for federally supported aging programs as perceived by executive

directors of AAA, to determine the need for gerontological counselors,

and to identify their appropriate placement sites within the aging

network. Specifically, three research questions were used to achieve

this second purpose.

1. To what extent do the confirmed goals and roles which

gerontological counselors assume in working with the

elderly, conform to and assist the objectives of current

programs for the aged as perceived by AAA directors?

2. What is the expressed need for gerontological counselors,

as perceived by AAA directors?

3. Where can gerontological counselors be placed within

aging programs to be of greatest benefit to the older

population, as perceived by AAA directors?











Rationale

Many authors have recognized the part that professional counselors

can play in assisting older persons to adjust to the aging process

(Brine, 1979; Buckley, 1972; Butler, 1975; Harris and Associates, 1975;

Lombana, 1976; Quirk, 1976; Riker, 1979). \Counselors, with professional

education in the needs and problems of aging can do much to alleviate

the discomforts caused by the losses experienced by older persons (Pressey,

1973; Pressey and Pressey, 1972). The specific goals and roles of the

counselor in a gerontological service site have been implied by those

writing in the profession of gerontological counseling (Butler and Lewis,

1973; Goodyear, 1976; Pfeiffer, 1976; Schmidt, 1976; Sinick, 1977; Ullman,

1976). \These goals and roles are based upon perceived and quantified needs,

as assessed in various studies (Fleer, 1975; Ganikos, 1977; Myers, 1978).

Counseling has been advocated to assist older persons living alone

(Berry, 1976; Lopata, 1970); those in the bereavement process (Insel,

1976; Uroda, 1976); those with depression and other mental health problems

(Gordon, 1973; Herdell, 1975); those attempting to find suitable employ-

ment (O'Dell, 1957; Riker, 1979; Sinick, 1977); those older persons in

search of meaningful leisure time activities (Goodman et al., 1974; Having-

hurst, 1961); and those with marital and sexual concerns (Medley, 1977;

McKain, 1979). LCounseling has been used to assist nursing home and age-

segregated housing residents (Kelly, 1976; Pressey, 1972) to help in the

preparation for death (Carey, 1976; Jackson, 1977; Kubler-Ross, 1979); to

prepare maturing persons for retirement roles (Monk, 1971; Riker, 1979;

Ullman, 1976), and to help older persons effectively utilize the maze of ser-

vices and programs presently available (Lewis and Lewis, 1977; Miller, 1971).











In none of the research and writing on gerontological counseling

have the specific goals and roles of the counselor been enumerated. Yet,

defining goals and roles is a desirable and necessary task for any

profession to accomplish. The professional identity of the gerontological

counselor is an ambiguous one without concrete goals and succinctly

enumerated roles. Role confusion and conflict experienced by the

counselor of the elderly might have the negative results of diminished

effectiveness and inadequate evaluative criteria for accountability.

Without specific goal and role knowledge, it is difficult to communicate

the potential impact of counseling services for older persons to aging

services administrators and policy makers. Blake and Peterson (1979,

p. 23) have stated:

Older people are attracting a lot of attention and if pro-
fessional counseling is to be a part of the service system
for older people, counselor organizations, counselor educa-
tion programs and individual counselors should react quickly
and qualitatively.

Gerontological counseling has not developed into a specialty

within the larger counseling profession (Vontress, 1975). Its present

maturity level may be likened to the state attained by school counseling

in the late 1950s and early 60s when the need to define the role of the

professional school counselor was apparent (Boy, 1968). School counse-

ling was suffering from an "identity crisis" which required resolution

before the profession could attain the next developmental state and

solidify its position in the schools. According to Shertzer and

Stone (1973, p. 687), "confusion surrounding the school counselor's

role stems from the contradictory and conflictng expectancies of his

various publics."











The need for role definition prompted the American Personnel and

Guidance Association (APGA), to assemble a committee to create a statement

outlining the roles of the school counselor. The APGA statement of policy,

i"The Counselor: Professional Preparation and Role," was passed by the APGA

Senate in March of 1964 (Loughary, Stripling and Fitzgerald, 1964). This

document enumerated the broad working guidelines and roles for counselors,

thereby providing a model for professional behavior and appropriate

accountability. Such a policy statement with a succinct identification of

goals and roles has yet to be accomplished for professional counselors

functioning with or preparing to work with the elderly populations.

Myers (1978, p. 40) defined the goal of counseling as "achieving

individual well being." The concept of life satisfaction can become an

index of adjustment and well being. Adams (1979) described the satisfied

person as one who has a zest for life, high resolution and fortitude, a

sense of accomplishment, high self-concept and one who is generally happy

and optimistic. The symptoms of low life satisfaction might be: apathy,

resignation, sense of uselessness, low self-regard, and pessimism. These

negative symptoms describe some segments of the elderly population

(Butler, 1975). Lemon (1972, p. 512) viewed life satisfaction as a goal

of counseling and defined it as "the degree to which an individual is

presently content or pleased with his or her general life situation."

Personal adjustment could also be viewed as a counseling goal.

Britton (1963) described a well adjusted older person as acting respon-

sibly, maintaining health, activity, independence, self-sufficiency and

interpersonal relationships. She defined the goal of counseling as

"intervention that will enable people to take control, and to feel in

control of their lives" (p. 85).











Lombana (1976)categorized counseling services for the elderly into

those which are remedial and those which are preventative. She defines

remedial counseling as providing services to older persons with problems,

while preventative counseling concerns itself with providing information

programs to the elderly and pre-elderly population. Examples of pre-

ventative counseling could be pre-retirement programs, life-long health

education, avocational opportunities, resources information, counseling

for families of senior citizens, and educational opportunities (p. 144).

Shertzer and Stone (1978, 1974) classified counseling goals in five gener-

alized categories: increased personal effectiveness, problem resolution,

positive mental health, behavioral change, and decision making (pp. 88-90).

If counseling is to secure a place in the services network for

older persons, the specific goals for gerontological counseling must be

agreed upon and communicated to policy makers who have the capability of

generating the resources necessary for counseling services to become a

reality. The goals of gerontological counseling and the goals expressed

in legislation must converge at strategic points and be perceived as

working in concert before policy makers will seek the services and skills

of counselors.

Among the goals of the Older Americans Act of 1965 are: "Freedom,

independence, and the free exercise of individual initiative in planning

and managing their (older Americans) own lives" (Sinick, 1977, p. 92).

These goals were probably articulated more functionally four years earlier

when the 1961 White House Conference on Aging passed a list of Rights of

Senior Citizens. Some of the rights .are usefulness, freedom frc want,

ability to secure employment, fair share of community resources, decent

housing, independence, and death with dignity (Sinick, 1977, p. 82).











The congruence between the goals and roles of gerontological counselors

and the objectives of public programs for the elderly has yet to be

determined.

For the purposes of this study, counselor role will be defined as

"expectations and directives for behavior connected with the position"

(Shertzer and Stone, 1968, 1974, p. 131). The concept of counseling

"goal" will be defined as, "the end result sought or, the objective which

counseling strives to accomplish" (Shertzer and Stone, 1974, p. 87).

Several needs assessment surveys have been conducted to identify

and measure the counseling needs of older persons (Fleer, 1975, Ganikos,

1977, Myers, 1979). The next step for the profession in establishing

accountability criteria is to state goals and performance objectives

(Burck and Peterson, 1970, p. 120). This role and goal defining step

is requisite to any further steps of devising program designs, improving

programs, or reporting outcomes (Burck and Peterson, 1970). Leadership

must be exercised in establishing goals and roles if the services of the

gerontological counseling profession are to remain organized and

coordinated (Butler, 1975).

Administrators of programs providing services to the elderly have

not been given a clear statement describing the ways that the special

skills and services of gerontological counselors can assist aging ser-

vices programs in achieving their objectives. It will be possible to

draw statements concerning the capabilities of gerontological counselors

from the study, and to generate a measurement of the level of assistance

counselors can give to current aging network program objectives.

The local AAA director is a services administrator and policy maker

who can exercise decisive power in securing the services and skills of











professional gerontological counselors. Only when directors are assured

that the services gerontological counselors can offer will augment the

goals of the AAA structure, will professional counselors be able to

exercise their specialized capabilities on behalf of the elderly.

In the maze of legislation and consequent services presently

being offered to the elderly, in what physical sites and as part of what

programs would gerontological counselors be most helpful in addressing

the needs of the elderly? The 1973 Amendments to the Older Americans

Act sought increased planning and coordination of programs and services

offered to the elderly. This research sought to identify the most bene-

ficial placement of gerontological counselors within the contracted

services offered through AAAs.



Definitions

Area Agency on Aging (AAA) Executive Director--The chief administrative

officer of an AAA. The person responsible for all activities of

the particular AAA, and the person called upon to provide policy

making information to state and federal agencies concerned with

the older population. The position of AAA executive director is

referred to as AAA director in this study.

Aging network--The term used to describe the total configuration of

federally supported services for older persons which are con-

tracted and monitored through Area Agencies on Aging.

Area Agency on Aging (AAA)--The name of the administrative office which

is charged by the Older American Act and its amendments with the

responsibility of contracting and monitoring services for older

persons within a specific geographic area called a public service











area (PSA). There are over 600 AAAs currently organized and

operating within the United States and its territories and

possessions.

Counseling--"A learning process in which individuals learn about them-

selves, their interpersonal relationships, and behaviors that

advance personal development" (Shertzer and Stone, 1974, p. 162).

Counseling goal--"The end result sought or the objective which

counseling strives to accomplish" (Shertzer and Stone, 1974, p. 87).

Counseling role--"Expectations and directives for behavior connected

with the counseling position" (Shertzer and Stone, 1974, p. 131).

Gerontological counseling--"The process through which a professionally

educated counselor assists an individual or group to make satis-

fying and responsible decisions concerning personal, educational,

and vocational adjustments" (HR. 1118, p. 36).

Gerontological counseling expert--An academic member who has competencies

and knowledge in both gerontology and counseling and who has,

or is currently teaching one or more courses in the area of

counseling older persons.

Gerontological site--the physical location of any one of a number of

aging network programs contracted and monitored by AAA.

Older person--any person 60 years of age or older (H.E.W., 1975).

Public service area (PSA)--a specified geographic area under the

director of an Area Agency on Aging Executive Director for the

purposes of contracting and monitoring services for older persons

as outlined in the Older Americans Act. Public service area is

referred to as PSA in this study.
















CHAPTER II

REVIEW OF THE LITERATURE



The Counseling Needs of Older Persons

Goals and roles specification for any profession is dependent upon

a sharp identification of the needs of the clientele who are to be served

(Burck & Peterson, 1970). Gerontological counseling has thus far produced

three such needs assessment studies (Fleer, 1975; Ganikos, 1977; Myers,

1979). These studies have surveyed separate populations. 'Fleer (1975)

chose members of the Gerontological Society and counselors currently

functioning in gerontological sites as separate Delphi panels to determine

aging needs in two categories: (1) physical needs and (2) psychological

needs of the elderly. Each need category produced clusters of needs when

the results from the Delphi rounds were analyzed. Identified clusters in

the physical category were health, income, housing, personal enhancement

(i.e., work activity, status, safety and personal grooming), recreation

and services (i.e., transportation and homemaker) (Fleer, 1975, p. 60-64).

In the psychological category three clusters emerged: internal, external,

and a combination of internal and external. Internal psychological needs

included (in rank order) sense of self-worth, feeling productive, control

in decision making, overcoming loneliness and ability to cope (Fleer,

1975, p. 66). External needs included close family ties, opportunities

for growth, satisfying relationships with children, supportive counseling,

and help in preparing for change. Examples of the inter-external cluster











were to have at least one close friend, reduction of agism, feeling

involved, and feeling useful (Fleer, 1975, p. 66-67). A priority

breakdown of expressed psychological needs revealed that "internal"

and "internal-external" needs were rated as most necessary. The highest

rated needs were (1) sense of worth, (2) to have at least one close friend,

(3) to feel productive,(4) reduction of societal agism,(5) meaningful

roles and a sense of belonging, (6) control of decision making, (7) to

feel useful, and (8) to overcome loneliness (Fleer, 1975, p. 66). Fleer

concluded that "psychological needs are identifiable as they contribute

to the central need of a sense of self-worth, ego strength, and person-

hood" (Fleer, 1975, p. 85).

Ganikos (1977) conducted a counseling needs assessment of a Florida

sample of elderly community college students. This sample represented

a segment of the elderly population which was relatively active and

healthy. Ganikos identified counseling needs in six categories:

educational, adjustment to life situation, personal adjustment, socio-

interpersonal adjustment, vocation, and family relationships. The

"adjustment to life" and personall adjustment" categories emerged as

those containing the counseling needs of highest priority. The specific

needs of discovering new interests, exploring new life options, finding

more meaning in life, learning to make better decisions, adjusting to a

new life style, developing new personal goals, and learning to be more

self-accepting were identified as the most urgent counseling needs. Two

other needs outside the categories of "adjustment to life" and "personal

adjustment" received significantly high need scores; these were learning

about new course offerings at the college and learning better communica-

tion skills (Ganikos, 1977). Ganikos (1977, p. 121) concluded, "about











half of the older adult students expressed needs with which a counselor

could be of help."

Myers (1978) randomly sampled a cross section of elderly persons

from a number of gerontological sites and a variety of socio-economic

and racial backgrounds. She divided the concerns of older people, as

expressed by her sample, into four categories: personal concerns, social

concerns, activity concerns and environmental concerns. The sample rated

"self-acceptance" as their most urgent concern, followed by health, trans-

portation, income, legal services, peer group interaction, and activities

(Myers, 1979). The "personal concerns" category emerged as the area of

greatest expressed needs of the elderly, followed by the environmental

concerns of transportation and legal services. Myers (1978, p. 243) con-

cluded that "counseling should be directed towards an impact upon general

need states, rather than attempting to alleviate one or more specific

problem areas."

These three counseling needs assessments clearly demonstrated the

demand for supportive counseling services among older persons. Their

findings confirmed the suppositions by Butler (1975) and others (Blake,

1972; Brine, 1979; Buckley, 1972, Harris, 1974; Pressey, 1972; Sinick,

1977) that older persons need and want professional counseling services.

In all three studies, intrapsychic needs emerged as those most pressing

the older individual. Fleer (1975) called such needs "inter psycho-

logical;" Ganikos (1977) identified counseling needs which she labeled

"personal concerns." In each study, needs which can be described best

as "affective needs," "psycho-social concerns" or, "personal concerns"

emerged as most urgent for the elderly populations.











The finding that the emotional and psychological needs of older

adults are "real" and personal, and that they require professional

concern has been well documented in the gerontological literature.

Kastenbaum (1969, p. 699) chided professional psychologists interested

in gerontology for neglecting the intrapsychic realm of older American

life, ". . old people do have their inner lives and we do not have a

comprehensive gerontology unless we know something about this realm."

Culbertson (1974, p. 84) indicated that "the various investigators

suggest that the major problems of the elderly are affective in nature."

He lamented, however, that limited research had been accomplished in the

area. Hickey, Davies and Davies (1972, p. 235) criticized the 1971

White House Conference on Aging for avoiding the obvious needs of the

affective/experiental domain of the elderly. They found the level of

participation and discussion on these subjects to be insufficient, and

that which did take place lacked resolution.

Studies which identify lowered self-esteem as an aging problem,

seem quick to suggest services of an external and physical nature to

elevate the depressed emotional state of the aging individual rather

than services of an affective nature. Zubin (1973, p. 6) stated this

succinctly; "The lowered self-image of the aged is one of the most

pervasive findings in gerontological surveys." Lowered self-image is

a depressed psychic-emotional state, quite "personal" and "internal,"

characterized by withdrawal, pessimism, and apathy. Counseling could

directly address these negative states of mind, Lowenthal and Havens

(1972, p. 304) expressed a dismaying hypothesis about successful aging

when they stated "the dull may be the most likely to grow old gracefully











and happily in our culture." The high suicide rate among older persons

suggests dramatic testimony to this distressful suggestion.

Affective needs and concerns of the elderly are a part of a

complex of interdependent and interconsequential needs which arise as a

result of the losses experienced by the elderly (Myers, 1979). The

needs of the elderly are not simplistic, nor can unilateral programs

designated to alleviate the stress caused by one loss find solution to

the multi-faceted needs of the aging population. The material needs

of the elderly are critical and can be the presenting problem for a

counseling session (Buckley, 1972). Yet the emotional reactions to the

material loss is the subject matter which gerontological counseling can

focus upon and bring to personal resolution. The physical needs of the

elderly are more obvious and have attracted the bulk of the legislative

effort to assist older persons. "Counseling type needs may require more

action from counselor organizations if they are to be recognized and

counselors' potential contributions better known" (Blake, 1979, p. 23).

Erikson's (1959) description of growth in old age as a struggle between

ego integration and despair speaks to an internal perception of the basic

purpose and meaning in life as opposed to a empty psychic life of useless-

ness. Services designed to stimulate emotional health are no less

necessary than are services designed to maintain physical health,



Goal Theory

It has been suggested that men can agree upon goals but will

differ in the approach they use to accomplish the goal. The specific

priority of goals for counselors has yet to be determined by the

counseling profession. If agreement could be reached regarding what the











specialty of gerontological counseling is attempting to accomplish,

the roles of the counselor could be more easily defined and hence

communicated to the various segments which constitute the counselor's

public.

Shertzer and Stone (1968, 1974, pp 242-243) differentiated among

nine different counseling approaches with respect to 10 common character-

istics. One of these characteristics was "counseling goals." The goals

ranged from "to mature, to grow to take responsibility for one'e life,"

(Gestalt), to "self-understanding and self-management" (Trait/Factor).

Other goal statements included "self-actualization," "preservation of

mental health," "relief of suffering and removal of causes," "solution

of problems," "personality reorganization," "self-direction and fully

functioning of client," and "develop a commitment." Glad (1959) regarded

the goals of the different counseling approaches to be so diverse that

one therapist might view a counseling sequence to have been a success

while another would regard it as a failure. Such nonconformity of goals

presents a dilemma for the counselor seeking guidelines for behavior

and to supervisors seeking criteria upon which to assist and evaluate

the counselor.

Knapper (1978), in an effort to stimulate counselors to develop

evaluative criteria for their positions, recognized the necessity for

accountability in a cost-conscious milieu, and encouraged counselors to

develop skills lists in the broad areas of counseling, consultation and

coordination. Such lists, he asserted will "specify predetermined goals,

activities, and expected outcomes" (p. 28). The precise connection between

skills lists and counseling goals remained unclarified.











The behaviorists have been quite vocal in insisting upon clearly

defined, observable counseling goals. Krumboltz (1968, p. 28) asserted,

"I shall argue that stating the goals of counseling in terms of obser-

vable behavior will prove more useful than stating goals on terms of

inferred mental states." Other writers agreed with the behaviorist

position that behavioral change is a necessary goal of counseling, but

are more comfortable with goals stated in less immediate and more

affective terms. They question whether the behaviorists are simply

treating symptoms rather than seeking insight into the causes of the

unwanted behavior (Patterson, 1964). Wrenn (1965, p. 60) arched the

chasm between the behaviorists and the client-centered approaches when

he stated,

It is important that the counselor assist the student in better
self-understanding . but I see this more as a means to an end
rather than an end in itself. The outcomes should include ob-
servable behavior changes as well as changes in self-attitudes.

Such a position is not a compromise between the two camps, but rather

an additive response, enhancing and clarifying each position. Indeed,

Samler (1968, p. 68) offered accommodating words, "we should be able

to accept without quibbling the objective in counseling of modification

of client behavior and therefore of attitudes and values." Perhaps

the furor rests upon a sequential question, does behavior change cause a

resultant modification in self-concept or vice versa? Samler (1968,

p. 62), however, was definitive in his appraisal of what happens in

counseling when he enumerated personality appraisal, evaluation of

misconception, examination of self-acceptance, change in behavior,

acceptance of responsibility, and assumption of independence as common

elements in all counseling.











Counseling goals have been categorized in several different ways.

Krumboltz (1968, p. 31) divided goals into three categories: goals

which alter maladaptive behavior, goals which teach decision making, and

goals which aim at problem prevention. Another classification of goals

was used by Byrne (1963). He stated that goals can be either immediate,

those which require almost spontaneous intervention; intermediate, goals

which concern themselves with the presenting problem of the client; or

ultimate, those which deal with self-responsibility, concern for others

and self-actualization. Dolliver (1965) used the terms "expressive" and

instrumental" to describe the differences between counseling goals which

describe self-fulfillment or potential dimensions of counseling (expressive)

as opposed to the more specific task oriented goals (instrumental). Self-

actualization would therefore be an expressive goal, while successively

desensitizing a phobia would involve a sequential chain of instrumental

goals.

Still another classification of goals has been postulated by

London (1964) who categorized counseling goals on a continuum ranging

from insight goals on the one hand to action goals on the other. Insight

goals would include such goals as self-acceptance, accurate perception

of one's place in the environment and understanding of personal worth;

while action goals would include cutting down on cigarette consumption,

speaking to at least three persons in one day, or scheduling an evening

yoga session.

An underlying tension, or perhaps a natural distinction, seems to

exist between those counseling goals which arc objectively identifiable

in physical reality and those goals which focus on internal, quite

subjective perceptual modifications,











Counseling Goals for the Aged

Gerontological counseling currently lacks comprehensive and

functional goals which could form the basis for theory building and

serve as a blueprint for service providers and policy makers. The purpose

of professional counselors working with the aged seems to be shrouded in

uncertainty and ambiguity. Hoyer (1973, p 18) suggested the need to move

away from an overreliancee on intuition, emotionalism, and rhetoric in

developing remedial strategies for the elderly." He advocated a behavioral

modification approach which could clearly define what the counselor is

attempting to accomplish. One of the blocks to effective goals identifica-

tion is the controversy as to whether to accept a developmental model of

aging, or a "problems" model. Should the goals of gerontological counseling

focus on fostering personal growth by devising strategies and interventions

which would facilitate development, or should counselors concentrate on

solving problems as they arise in the elderly population?

Erickson (1950) first postulated a succession of developmental tasks

over the life span. Developmental tasks are those life events which must

be learned and mastered in each life stage. Unless mastery is achieved,

life satisfaction and resolved adjustment will remain low. Erikson (1960,

p. 235) postulated a series of life crisis dichotomies which defined

health on the one hand and disease on the other. His last stage (of eight)

was "ego integration versus despair" (Erickson, 1950, p. 235). Ego

integration defined a state of developmental growth which involved life

resolution and recognition that one's life has been meaningful and is

worth living. Havinghurst (1949, 1972) pioneered the work of specifying

the developmental tasks of old age. He identified six tasks: (1) adjusting

to decreased physical strength and health, (2) adjusting to retirement and











reduced income, (3) adjusting to the death of a spouse, (4) establishing

affiliation with one's own age group, (5) meeting civic and social obli-

gations, and (6) establishing satisfactory living arrangements. The

developmental approach recognizes the necessary role transformation of

aging (Rosow, 1973) in a context of positive growth with new opportunities

for personal development emerging even from the continual losses which

characterize the life of the older person (Kurtz and Wolk, 1975). Ponzo

(1978, p. 144) described how agism assails the concept of positive develop-

ment for the aged. Agism defines the older person in terms of "less vital,

less potent, and less romantic." He asserted that, "We need to encourage

people to see themselves and others for what they are without looking

through the distorted filter of age," Harris et al. (1975) identified

the fact that agism not only is practiced by the young but is also an

internalized construct for many elderly, preventing them from engaging in

activities which may seem restricted to younger persons.

Several suggestions have been postulated regarding the directions

gerontological counseling goals could pursue. Schlossberg (1977)

suggested that counselors need to understand the decision making process

in order to help clients regain a sense of control over their lives.

Britton (1963) viewed life adjustment as a natural goal for social

services. He defined the adjusted person as one who is reasonably

satisfied with life, healthy, active, independent, self-sufficient, and

adept at interpersonal relations. The White House Conference on Aging

(Toward a National Policy on Aging, 1971, p. 9) seemed to take a life

adjustment viewpoint when it stated, "older people tend to change more

rapidly and to be called upon to make more adjustments in their lives

than at any other time except childhood." The concept of life satisfaction











is also seen as the logical goal of gerontological counselors (Adams,

1969; Lemon, Bengston and Peterson, 1972; Myers, 1979). Being pleased

with one's life in general would include a zest for life, fortitude to

go on, internal congruence between desired and achieved goals, high self-

concept, and optimistic mood (Adams, 1969). A final gerontological

counseling goal is independence. Brine (1979) recognized the predis-

position of older persons to become increasingly dependent as they face

multiple losses. Macione (1979, p. 59) asserted, "Independence and

assertiveness are ideal goals." She advocated counseling for stress

removal so that older persons could again function more freely.

These identified gerontological goal descriptors remain unspecified

and lacking in the depth necessary to construct counseling theory frame-

works and to direct counselors in their everyday activities working with

the elderly. Shertzer and Stone (1968, 1972) have outlined five

counseling goal categories which seem to have applicability for the aging

network and assist in the search for goal congruence between public aging

programs and gerontological counseling.

Problem Resolution

The counseling goal of problem resolution is the first category

recognized by Shertzer and Stone (1974, p. 88). This performance goal

seeks to identify the problem or problems currently giving stress to

the client and to remediate the stress by attempting to find a solution

to the problem. The assumption generating the goal is well stated by

Krumboltz (1965, p. 383-384). "The central reason for the existence of

counseling is based on the fact that people have problems that they are

unable to solve themselves." Those who view aging as a problem, or

believe that aging generates problems for the persons who are experiencing











the losses associated with the process, find this counseling goal

attractive. The problems created by aging are generally those caused by

losses which are irrevocable. The loss of youth, the loss of physical

strength and capabilities, the loss of community status due to retirement,

the loss of a spouse, or friends, are all examples of aging problems which

cannot be reversed.

There exists no way to remove these losses. The loss itself however

is not the problem; the problem is a result of the reactive behavior

exhibited by the individual. Feeling the effects of the loss stimulates

behavioral responses which might be best described by "life was better

back when." Counseling can do little to eliminate the loss from occurring;

counseling, however, can allow the older person the opportunity to assess

his/her objective world, express the intense emotions surrounding the

loss, identify behavioral alternatives, establish goals, and support the

individual in pursuing a life of meaning and purpose beyond the loss.

Behavioral Change

The second counseling goal outlined by Shertzer and Stone (1974)

is "behavioral change." They defined the concept as "redirection of

typical responses to frustrations or different attitudes toward other

people or self" (p. 89). The idea of behavioral change as a counseling

goal has caused no small amount of discussion among proponents from

different theoretical foundations. The behaviorist view sees behavioral

change as the only goal which counseling should pursue; "the behavioral

counselor is primarily interested in helping the client change whatever

behavior the client wishes to change . he makes no pretenses of

working toward high sounding and elaborate goals which involve a whole

restructuring of the client's personality" (Krumboltz, 1964, p. 121).











Krumboltz's reference to elaborate and high sounding goals refers to

the client-centered counseling approach which advocates self-understand-

ing and self-acceptance as goals. Even Rogers (1951) himself, founder

of the client-centered counseling model, appreciated the value of

behavioral change in the counseling process when he stated: "This therapy

produces a change in personality organization and structure and a change

in behavior, both of which are relatively permanent" (Rogers, 1951, p. 125).

Patterson chided the behaviorists, however, by asserting that their

goal approach is simplistic and produces "dependence, short-term gratifi-

cation or accomplishment, or removal of symptoms" (Patterson, 1964, p.

125), rather than attempting to resolve the cause of the stress. Shertzer

and Stone (1974, p. 87) defined behavioral change as change "which will

enable the counselee to live a more productive life as he defines it within

society's limitations." This goal of behavioral change has direct

applicability for gerontological counseling. Edwards and Klemmack (1973)

described the process of growing old as one which involved a complex and

interdependent exchange between the self and the environment, involving

behavioral change. Rose and Peterson (1965, p. 4) indicated that older

persons are becoming behavioral minorities; "the greater the separation

of older people from other categories . the greater the extent and

depth of subculture development." Aging involves role transformation

(Rosow, 1973) resulting in behavioral change which can be either growth

enhancing or withdrawing in nature.

Decision Making

The third overall goal of counseling as described by Shertzer and

Stone (1974, p. 90) is that of "decision making." The goal of the

counselor is "to enable the individual to make decisions that are of











critical importance to him" (Shertzer and Stone, 1974, p. 90). Reaves

and Reaves (1965, p. 663) stated this same goal in another way, "The

primary objective of counseling is that of stimulating the individual

to evaluate, make, accept and act upon his choice." Planning consists

of making decisions and setting goals, The developmental tasks faced

by aging individuals require many decisions which pertain to both short

term and long term behavior (Havinghurst, 1972). The crisis in time

which characterizes the aging process as described by Havinghurst (1961)

necessitates personal decisions of many dimensions. Many of the crises

of old age, from retirement to preparation for death are life events

which can be either prepared for through adequate decision making, or

more healthfully resolved with the aid of competent decision making;

"the purpose of counseling is to facilitate wise choices of the sort on

which the person's later development depends" (Tyler, 1969, p. 13).

Positive Mental Health

Counseling goal number four is "the goal of achieving and maintain-

ing positive mental health" (Shertzer and Stone, 1974, p, 88). Positive

mental health includes such dimensions as: emotional adjustment, positive

identification with others, learning to accept responsibility, independence,

and behavioral integration (Shertzer and Stone, 1974). Counseling repre-

sents the most viable means of fostering mental health in old age (Dorfman,

1970; Kobrynski, 1975). "Attack, restraint, and stress lead to signifi-

cant psychological stress for the older American (Levin, 1963, p. 307).

Working with older persons in groups has been demonstrated to be a

beneficial means of promoting positive mental health (Klein, LeShan and

Furman, 1965), not only for the severely distressed individual but also

for the "normal" older person for the purpose of maintaining healthy











attitudes. Butler and Lewis (1973) advocated counseling for both

preventative and remedial purposes for older persons.

Personal Effectiveness

The last goal suggested by Shertzer and Stone was personal

effectiveness (1974, p. 89). "Closely related to preservation of good

mental health is the goal of improving personal effectiveness." Butler

and Lewis (1973, p. 18) indicated that one of the approaches to reversing

the predicament of the older American was to adopt the World Health

Organization's definition of health: "a state of complete physical,

mental and social well-being and not merely the absence of disease or

infirmity." The authors suggested that there must be an attempt to

"enable humans to thrive and not merely survive."

One of the dimensions of personal effectiveness is learning coping

mechanisms of assertiveness to obtain the community resources which many

older persons are denied (Butler, 1975). Many older persons experience

difficulty in securing services from public agencies (Donahue, et al. 1953;

Murphey, 1979). Learning strategies and developing perspectives of

positive self-esteem would enhance the personal effectiveness of the

elderly. Counseling could assist older persons in developing the needed

resources and skills to adequately address their environment (Butler,

1975). Continued personal growth of the individual has not been a

priority issue in public legislation for the elderly. The potential for

gerontological counseling to become a cost effective service by facili-

tating personal effectiveness for the elderly has not yet been recognized

in federal and state policy initiatives and recommendations. "Clearly much

remains to be done in convincing policymakers of the necessity to accept











the concept of life-span policies as a foundation of social policy"

(Quirk, 1976, p. 142).

Social policy goals for the elderly, as evidenced in aging

legislation, seems to be the elimination of or the alleviation of the

problems associated with age. The resultant services created have

addressed the physical needs of the elderly: nutrition, transportation,

housing and the like. There seems to be a marked deficit in programs

designed to eliminate or alleviate the emotional stress produced by the

problems of aging. This oversight represents a grave omission in terms

of the holistic health of the individual.

Remediation-Prevention

A theme which runs through much of the aging literature is indepen-

dence of the individual (Fact Book, 1978; Kalish, 1972; Lopata, 1970, Myers,

1978; Roscoe, 1970). The goal statement of the Older Americans Act of

1965 stressed the maintenance of independence. Brine (1979, p. 73) stated

that, "Elderly clients experience multiple losses. One of the aspects

of such losses is the client's predisposition to become more dependent."

The question is to what degree should gerontological counselors pursue goals

which are reactive, that is responding in a remedial sense to current

needs, and what level of services should be proactively offered in a

preventative sense, anticipating needs and preparing clients for the

inevitable losses they will encounter? This question has yet to be

adequately answered.

Should gerontological counseling be remedial or preventative?

Lombana (1976, p. 143) shed light on this question by specifying

gerontological counseling services which she considered to be remedial and

those which could be provided in a preventative mode. She identified four











areas of remedial counseling: (1) personal counseling for persons with

mental health problems, most notably depression, (2) supportive counseling

for persons with health problems,(3) adjustment counseling for persons

living alone or in institutions, and (4) avocational counseling and

retraining. Preventative counseling includes information services such

as preretirement programs, counseling to families of older persons,

educational and recreational opportunities, life-long health education,

and environmental resources training. Preventative counseling involves

any effort to raise the personal understanding and insight level of the

individual as a preparation for the role changes ahead. Burdman (1974, p.

36) urged preventative type counseling to forestall the social disability

which so often accompanies role loss. He indicated that "this implies

giving help to persons still active in their social roles; it is essentially

preparation for facing the future with dignity." Schaie (1973) carried the

concept of preventative counseling beyond the elderly population when he

argued for intervention not only with the older population but with the

middle aged category as well, as a way of revising present stereotypic

images of aging.

Boyd and Oakes (1973) proposed the creation of "well-aging"

clinics as elderly community care centers which would focus on preventa-

tive measures. The interfacing of the gerontological counseling goals

of independence and prevention are well summarized by Macione (1979,

p. 60). She wrote, "once the sources of stress are removed, an older

adult may be capable of functioning in a more independent capacity."

Early intervention by a qualified counselor could be the key to pre-

venting crises that may diminish the quality and length of later life.

Zubin (1973, p. 6) reinforced the independence-prevention connection;











"If we could prevent a lowering of the self-image by proper behavioral

therapy, perhaps much of the so-called aging effects on behavior could

be prevented."



Role Theory

"Role is what a person actually does" (Bentley, 1965, p. 13).

Role might also be "used vaguely to describe what one does or is expected

to do" (Bentley, 1968, p. 71). Role is a perceptual phenomenon in that

its definition changes with each evaluator for any given position. Roles

are inextricably connected with expectations; "roles provide a method of

organizing expectations by reference to a social structure" (Ivey and

Robin, 1966, p. 30). Yinger (1965) suggested that expectations formalize

into role requirements which range from mandatory to optional depending

upon their perceived urgency. "Role is a unit of culture; it refers to the

rights and duties, the normatively approved patterns of behavior for the

occupants of a given position" (Yinger, 1965, p. 99). Bentley (1968,

pp. 74-75) identified four components of role. Role performance refers

to what the position occupant actually does. Role expectations consist

of what is expected of a person. Role conception refers to expectations

the position occupant holds for him/herself, while role acceptance refers

to the degree of identity and commitment demonstrated by the position

occupant.

If any of these dimensions of role may for some reason become

misaligned, role conflict can result. "Conflict and ambiguity represent

the discrepancy between the perception of the determiner . and the

expectations of the focal person" (Bentley, 1968, p. 78). Role conflict

is distinguished by Yinger (1965) as either internal or external. External











role conflict is caused when incompatible expectations are held by two

or more individuals. Internal role conflict refers to the internaliza-

tion of personally contradicting expectations, Bentley (1968, p. 75)

categorized role conflict further by pointing out: (1) the role

definer may be inconsistent in his/her expectations, (2) situations

where experts cannot agree, (3) the role has inherent contradictions,

(4) too high a psychological price is paid by the position occupant, and

(5) the occupant refuses to accept the defined role.

Roles have been further defined through comparison and categori-

zation. Roeber (1968, p. 312) identified three categories: "ultimate"

roles, i.e., where do you eventually want to go, "intermediate" roles, i.e.,

your plan or strategy, and "immediate" roles which translate into specific

functions. This hierarchy of roles is useful in that specific functions,

i.e., what I do right now, are dependent upon ultimate roles. Gross (1958)

classified roles into two groups, normative roles which represent expected

standards and behavioral roles which describe actual action.



Counselor Roles

"The role of the counselor is most simply defined as the expec-

tations and directives for behavior connected with his position. As

such it is the counselor's blueprint for action" (Shertzer and Stone,

1974, p. 131). The APGA policy statement, "The Counselor: Professional

Preparation and Role" stated: "The role of the counselor is influenced

by his professional skills, his professional interests, the environment

in which he works, and the definition of function established by the

profession" (Loughary, Stripling and Fitzgerald (eds.), 1965, p. 78).

It is clear that the counselor does not shoulder the responsibility alone











for defining the roles which will in turn constitute the position's job

description. Assistance is seen as coming both from the environment and

from the profession. Expectations for role performance arise from the

individual counselor and from those persons directly or indirectly con-

cerned with the position. "Other individuals in the social structure

interact with and desire certain behavior from the role occupant"

(Shertzer and Stone, 1974, p. 131).

The resultant performance of the role occupant is a combination

of that behavior which is unique to the counselor and his/her interpreta-

tions of role expectancies from the surrounding social structure (Hill,

1977; Sarbin, 1958). Role conflict results when a counselor behaves in

a manner which is perceived to be inconsistent with what is anticipated.

Conflicting expectancies from the various publics of the counselor has

created much of the confusion surrounding the roles of the counselor.

Bentley (1968, p. 77) urged counselors to remember that they function

as part of a total social system. "By accepting the systems concept as

applicable to the process of defining the counselor role . much

more progress can be achieved."

Roles are not to be confused with the concept of counselor function

(Shertzer and Stone, 1974, p. 129); "role and function have been

erroneously used in the literature as being synonymous." Both Wrenn (1965)

and Roeber (1965) distinguished between role and function. "A role is

seen as a purpose or as an end, while a function is a process or a means"

(Wrenn, 1965, p. 235). Roeber (1965, p. 6) echoed, "role is the part

taken by the professional worker, while function refers to the way in

which the worker carries out his role." Roles are implemented by the

counselor when specific functions are exercised. Function identifies











a smaller behavioral segment than does role. Identification of roles

assists the counselor in specifying functions which will best carry out

the role.

Accurately defining roles is beneficial not only for the individual

counselor but it also educates the various counseling publics to what

expectancies are realistic and potential. Boy (1968, p. 221) urged

the professional counselor associations to provide leadership in role

definition and to circulate these roles among their members for con-

firmation. He stated "Counselors have long existed without such a

role definition coming from an official body . our job function has

become rather nebulous because of (the) lack of role concept." Stevic

(1963) argued that because counselors lack adequate role definitions

they lack a clear role commitment, which has the effect of reducing their

effectiveness to reactions to situational pressures. Others have expressed

similar lamentation: "Counselors have allowed their work tasks to be

largely defined by others, as if they were a group of "reactors" (Hannam,

1977, p. 50). The obligation of the profession to define counselors'

roles was acted upon by the American Personnel and Guidance Association

(APGA) in 1964 (Loughary, Stripling and Fitzgerald, 1965.) As early as

1973, however, the cry for further role definition was already heard

(Banks, 1973). Indeed, Shertzer and Stone (1974, p. 143) expressed the

continued need for role definition. "The role of the counselor . is

but in the formative stages in most work settings." The increased call

from the public for accountability of publicly financed professions is

an obvious and demanding requirement to perform needs assessments and

to define both the goals and roles of the profession (Burck and Peterson,

1970). Walton (1969) suggested that accountability questions should be











addressed even before the professional counselor begins any formalized

practice. Knapper (1978, p. 17) warned that without clearly defined role

statements the decision makers who control resources ". .are left to

their subjective judgments of counselor performance and worth." He went

on, "the existence of counseling profession depends upon the ability of

the profession to adapt realistically to society's needs and goals."



Gerontological Counseling Roles

The profession of gerontological counseling has yet to define

roles for its practitioners. The dangers inherent in this omission

have been previously stated. Steffire (1964, p. 654) in explaining the

identity crisis of many school counselors made a poignant statement

which may express the position gerontological counselors find themselves

in today.

In this marginal man-- the school counselor--- simply a
teacher who has a new assignment; is he a psychologist who
has strayed temporarily from his clinic; is he a sub-admin-
istrator who has managed to place himself on the administrative
salary schedule; or is he a kind of office worker who is giving
prestige and dignity to what are essentially clerical tasks?

It is clearly the time to identify the roles which gerontological

counselors can play. The aging network is in its nativity stage, but

is fast becoming solidified into proving services of a material

nature, seemingly disregarding the affective needs of its target

populations. Unless the profession of gerontological counseling defines

itself and identifies those areas of service overlap between itself and

the present aging network, its effectiveness and perhaps even existence

as a viable profession will be held in question. "One of the crucial

problems for any emerging profession lies in its efforts to communicate











itself to other related groups and so establish some degree of pro-

fessional identity" (Blocker, et al., 1968, p. 211).

The following section of this literature review outlines geron-

tological counselors' roles which have been identified in the abstract.

Counseling literature has advocated and implied many roles for the

gerontological counselor; the following is an attempt to organize and

summarize the pieces into discrete and definable roles.

Provider of Services to Persons Living Alone

A consequence of increased longevity and a differential mortality

rate between males and females is that large numbers of older persons

are living alone. The findings of Harris et al. (1975) indicated that

older persons are hesitant to live with their children and preferred to

live independently as long as possible. The number of single person

households has risen among the elderly population, to the extent that

fewer than half of all women 60 years of age and older are currently

living with their spouse (Califano et al. 1978). The need for home

services is expected to increase. Murphey (1979, p. 21) stated that

"most aging legislation has a goal of mandatory maintenance of independ-

ent living," Kent and Matson (1972) maintained that wodows, especially,

have special problems and that, due to their contrasting social world,

loneliness becomes a chief cause of depression among the aged (Richardson,

1964; Roscoe, 1970). Berry (1976) identified ways that counselors can

be effective in working with elderly widows. Among these is organization

of wodow support groups, informational services, assertiveness training,

communication skills training, employment counseling and guidance, as well

as support in seeking new social contacts. Many widows and persons living

alone are reluctant to take the necessary risks required to make new











relationships (Buckley, 1972). They may lack the social skills necessary

to develop friendships outside of the security of marriage. Many view

their situation as irreversible and see no alternatives. Counselors are

uniquely qualified to intervene in such cases to prevent a continued

withdrawal from society. Schmidt (1976) identified the counselor role of

building coping skills to deal with loneliness as a primary one for those

working with the aged.

Bereavement Counselor

The death of a loved one has dramatic effects upon survivors.

Often they experience a great sense of personal and environmental

disorganization and an inner life questioning of the value of living

(Insel, 1976). The process of grief has been defined by Kubler-Ross

(1969) as a five step phenomenon where counseling skills of empathy

and support leading to acceptance can be beneficial (Altameir, 1957;

Uroda, 1977). Salisbury (1974) described the grief process as a natural

role focus for the counselor. The event of widowhood has the negative

social effect of breaking social ties at a time when the support from a

friendship network is most needed (Lopata, 1970). "During the period of

intense grief soon after the death of a spouse the most pressing need is

usually for empathy and strong emotional support in returning to a normal

social life" (Koff, 1979, p. 132).

Withdrawal and isolation are natural reactions to and symptoms of

the bereavement process (Insel, 1976). Should these withdrawal symptoms

persist a process of mental deterioration may ensue, setting the stage for

a complex of further life problems to debut (Amster, 1974). Older persons

can experience a succession of mourning periods due to the loss of others

significant in their lives. These periods may overlap in time, creating











a situation which Kastenbaum (1969) calls "bereavement overload."

The symptoms of this "disease" are the same as with "normal" bereavement

only more so; loneliness and susceptibility to life stress are heightened.

Insel (1976, p. 127) wrote, "anxiety generated by such a separation and

the nature of the grief reaction become the issues of the professional

counselor in counseling the bereaved."

Change Agent

Older persons suffer in a society which maintains negative myths

about the capabilities, the intelligence and social skills, the life

style and usefulness of the aged (Cotrell, 1974; Kimmel, 1974). Counselors

can assume a proactive role in attempting to dispel these myths at

strategic places where they have the most deleterious effect upon the life

satisfaction of the elderly (O'dell, 1976). Counseling literature is

abundant with encouragement for counselors to act in the capacity of

societal change agent as another level and means of assisting their

clients (Friend, 1977). Need for change agents with regard

to aging is of particular importance because of the stereotypic

perceptions which are overlaid upon older persons. Murphey (1979, p. 42)

asserted that "there is . a viable role for counselors' leadership in

interrupting the cycle of negative attitudes held by service providers.

Prejudice against age can be broken into three categories: (1) age

restrictedness, i.e., age grading behavior; (2) age distortion, i.e.,

assumption of capabilities on the basis of age, and (3) agism, i.e.,

dislike based on age along (Ponzo, 1978). Ponzo (1978) outlined specific

behavioral objectives that counselors can use in their counseling and

training to combat age prejudice. "Counselors should be in the forefront











as change agents and as practitioners reaching out to middle aged and

older persons as a new challenge" (O'dell, 1976, p. 147).

Personal Counselor

The fact that personal counseling is needed and desired by older

persons has been well documented (Blake, 1975; Fleer, 1975; Murphey, 1979;

Myers, 1978). Older persons are effectively denied access to counseling

services as a result of a complex of problems and events (Fact Book, 1978).

Murphey (1979) has documented that the negative attitude toward the

elderly held by social service practitioners and administrators manifests

itself in the lowered level of services offered to older people. The

acronym YAVIS was created by Butler (1975) to describe the type of clients

that counselors preferred: young, active, verbal, intelligent and successful.

Of all the psychiatric services offered in the United States, older persons

participate in only about 2%, while their absolute numbers range to 10% of

the population (Fact Book, 1978). The attitude that psychological and

emotional distress is a normal part of aging has been purported as a reason

for this poor delivery record (Fact Book, 1978). Harris et al. (1975)

found that the societal conception of old age as inevitably producing

mental problems is shared by a large proportion of older persons themselves.

Rosow (1967, p. 34) sees role loss as the basic contributor to

the negative social and individual perception of the elderly. The loss

of major life roles and the loss of identity in group membership, result

in the older person becoming a "marginal participant in his own world."

Lowenthal and Haven (1968) suggested that the ability to cope with losses

and trauma can be enhanced by an intimate relationship which provides

emotional sustenance.











Depression has been recognized in many elderly persons (Fleer,

1975). Depression is caused by what Rosow (1967, p. 33) cited as the

"essence of the aging problem," that being "socialization to the loss of

status." Herdell and Kidd (1975) researched non-senile and moderately

senile persons 60 and over, with respect to the degree of depression

present in each group. They stated that "depressed geriatric patients

may be those who always have been somewhat depressed and who become more

seriously so when faced with the actual problems of aging" (Herdell and

Kidd, 1975, p. 645). Their research findings included that moderately

senile persons scored significantly higher on the Zung Self-Rating

Depression Scale (SRDS) than did non-senile persons. This research is

not strong enough to establish a positive correlation between senility and

depression, nor can it conclude a causal relationship between depression

and senility; the implications, however, will generate more research.

Consultant

Professional counselors are trained in the techniques of consulta-

tion. Professional gerontological counselors are therefore uniquely

qualified to offer consultive services to the aging network in whatever

geographic or community area they operate. Bellak and Karasu (1976) found

that devaluation of the older person is a common problem in agencies

offering services to the elderly. A process consultation approach as

outlined by Shien (1969) would be most helpful to an agency which was

experiencing either personnel or functional problems. The counselor/

consultant could focus on the presenting problem, regardless of how

nebulous, and work within the agency group structure to bring the problems)

to resolution, thereby enhancing the client sensitivity of the staff and

the efficiency of the agency. Murphey (1979, p. 15) recognized this











consultive role of counselors when he stated, "Counselors and counseling

techniques could facilitate and humanize agency procedures as well as

educate social workers to the needs and sensitivities of older persons."

Counselors could also be available to the local aging network to

perform third party or mental health consultation (Caplan, 1970; Walton,

1969). Professionals who experience a problem in dealing with an older

person could call on the services of the mental health consultant who

could focus on the interplay between the consultee and the client with

the aim of enhancing the human relationship between the two. Fine and

Therrien (1977) outlined the part played by the use of empathy in the

doctor-patient relationship. Such concerns are the province of the mental

health consultant who could offer his/her services to the medical,

educational, social service, and other communities within a given area.

Specialist in Psychological Education

Closely related to, but qualitatively different from, the consul-

tation role of the gerontological counselor is the role of psychological

educator. There are two populations which require continued educational

opportunities in the human communication and understanding areas where

counselors are qualified to teach (Grabowski, 1972). The first group is

the professional and paraprofessional population who either deal directly

or peripherally with the elderly. Ernst and Shore (1975) found that the

exposure to gerontological information has the effect of improving

unfavorable attitudes toward the elderly, Kinlaw (1978, p. 10) concluded

that "helping skills training should be included in programs designed to

prepare professionals." Counselors, especially counselor educators, are

trained in curriculum development and can well execute this educational

role (Ivey, 1976),











The second group who would benefit from the psychological educator

role of the counselor are the older persons themselves. A number of

developmental psychologists have noted that personal and social skills

are essential to successful coping with the last stages of life (Waters et al.,

1976). The problems which are of particular impact among the elderly,

including suicide and alcoholism, could be specific targets for educa-

tional programs offered by the counselor through the aging network

(Lee, 1976). Life-long learning, both in the instrumental and the

expressive areas, has been advocated by many educators (Geron, 1976;

Havinghurst, 1976; Wasserman, 1976). Educational programs dealing with

these mental health problems associated with aging, which are character-

ized by changes and adjustments, are ideal topics for the counselor

educator to handle (Buckley, 1972).

Employment Counselor

"As older persons change careers, or enter and reenter the labor

force, they can be helped to evaluate their motivations and character-

istics toward finding self-actualizing occupational roles" (Sinick,

1977, p. 19). O'Dell (1957) outlined that the employment needs of the

elderly are likely to increase. This is true because of the increased

longevity and health of older persons who desire the status a job can

give, the need for additional financial resources, the desire to

structure time and to find meaningful activity (Palmore, 1976).

Current career developmental theory makes little note of the

employment needs of older persons (Super, 1957). Carp (1968) discovered,

however, that older persons who held part time jobs scored significantly

higher on a life satisfaction instrument than did equally healthy persons

who volunteered their time a corresponding number of hours per week.











Carp concluded that the status and money provided by work are variables

of high value to most older people.

Quirk (1976, p. 141) estimated that there are over three million

persons over the age of 65 who would be interested in some kind of

second career training. Vocational training programs seem to be offered

to those who have the longest working life ahead, which has the effect

of barring older workers (Murphey, 1979). "There is a decline in the

proportion of aid services, including counseling, provided by employment

services to older age groups as compared with those provided to younger

applicants" (Quirk, 1976, p. 141). Gerontological counselors in the

role of employment counselor would represent a needed addition to the

services provided to older persons (Sinick, 1977).

Services Coordinator--Services Enhancer--Client Advocate

It is difficult to draw sharp distinctions among the roles of

services coordinator, services enhancer, and client advocate. Each role

has functions which overlap with the others, yet no single role des-

criptor adequately summarizes the three roles in concert.

Pfeiffer (1976) suggested that the role of services coordinator,

one which could facilitate the creation of a "services mix" to meet the

individual needs of a client, is a needed one in the aging network.

The network tends to be fragmented, disorganized, seemingly uncaring,

and complicated to an elderly client (Butler, 1975; Ohio, 1960). The

heterogeneity of the population demands that unique and personalized

services "packages" be created for each client. Such a role requires

not only the knowledge of the aging network, but also demands the

communication of caring, genuineness, and respect to the service user,

in an attempt to recognize and deal with the actual presenting problem.











Goodyear (1976) examined the viability of using community psychology to

provide a framework for unifying the diverse activities of the counseling

profession.

A service enhancer is one who maximizes the amount and quality of

assistance any agency or program is capable of providing. In the compli-

cated social services system it is sometimes difficult to procure the

level of service necessary to remediate a problem (Butler, 1975; Murphey,

1979). Lewis (1977) identified the role of community developer. The

functions of broker and referral agent are subsumed in this role. A

counselor could enhance the use of social services by helping to dispel

fear and by building self-confidence in the client so that maximum benefit

could be derived from the system (Murphey, 1979). Community resources

availability is a function of the assertiveness with which the older person

pursues and has the resources to use the aging network (Miller, 1971).

Acting as older person client advocate is a role which has appeared

frequently in gerontological counseling literature (Griswold, 1971; Lewis,

1977; Macione, 1979). Elderly service seekers may lack the knowledge, the

energy and fortitude, and the assertiveness sometimes needed to penetrate

the aging network of services. They require not only informational assist-

ance but emotional supportive help as well. Fleer (1975) has pointed out

that the elderly may regard public assistance as a charitable hand-out.

They may either find the process personally demeaning, since they have never

used such agencies before, or assess themselves as ineligible by virture

of past perceptions. Advocates who can deal with such clients using

positive regard and empathy can enhance the use of existing programs. The

need for an advocate, a guide, or a coordinator to lead older persons

through existing agencies has been noted (Murphey, 1979, p. 43).











Financial Counselor and Manager

Within the limits of the counseling relationship and according to

the knowledge and training of each counselor, the elderly have financial

management needs which often require attention (Myers, 1978). The refer-

ence here is not to high level finance, but rather to the daily money

skills that may be viewed as elementary by younger persons. The account-

ing procedures in today's computerized economy are many times baffling to

older persons (and younger too) who are restricted by income, mobility and

financial inexperience.

Two areas of special consideration are health care and residential

planning. Myers (1978, p. 32) stated that the "elderly need to understand

their physical changes in order to react appropriately and to maximize their

health dollar." Without adequate health insurance plans, a sense of

vulnerability can cause stress on the elderly person which may distort

perception of reality. The trauma caused by sudden losses can isolate the

older person to the extent that matters of financial necessity somehow

slip away unnoticed only to emerge later as knotty problems which require

assistance. Wolff and Meyer (1979, p. 188) assert that, "too often no

deliberate, thoughtful planning is given to long term living and the

'choice' becomes the least objectionable crisis solution for older adults

and their families."

In-Service Counselor--Educator

Staff members working in existing agencies and institutions can

benefit from the counselor--educator role played by the gerontological

counselor. Hurst (1977, p. 61) used the term skills dissemination to

refer to "therapeutic interventions which train individuals in human

development process skills for their own benefit and that of those around











them." The term intervention refers to in-service, educational settings.

In-service education can also be provided to persons who desire to become

peer counselors. Waters, Reiter, White and Dates (1979) have devised an

in-service peer counselor program which includes recruitment, selection,

training, supervision and assessment. Perhaps Maddox (1972, p. iii)

dramatized the importance of the in-service role when he wrote:

Special environments for vulnerable aging persons will not be
satisfactory no matter how much money is spent, until all the
personnel in these settings are technically and socially com-
petent to help and find personal satisfaction in helping.

Leisure Time Counselor

Havinghurst (1961) described retirement as a crisis in the meaning-

ful use of time. Older people have an abundance of free time and seek to

fill it with life enhancing activities (Alston, 1973). The loss of the

work role represents not only the loss of financial stability and status

in the community, but also the loss of purposeful activities which pre-

viously structured time for the individual. This "loss of dignity" produces

a corresponding depression when activities become too limited (IIallack,

1971, p. 222). "It is possible to predict that the future contentment of

a retired person will be directly related to how active he remains"

(Hallack, 1971, p. 222). The activity theory of aging posits a positive

relationship between meaningful life activity and life satisfaction (Lemon,

et al., 1972). Time management skills, especially time sequencing and

planning, take on a heightened value in later years. ..Avocational pursuits

take on the importance after retirement that vocational activities held

prior to the event. Counselors can use a variety of techniques and mater-

ials to assist the older person in finding leisure interests which are

pleasing and purposeful. Lowered activity levels indicate the first signs











of social and psychological withdrawal which marks entry into a less

effective life state characterized by disengagement and decline (Super,

1957).

Once counselors understand what leisure is and what it can do
they should be alert to the variety of related client needs.
One major need may be for information. Another . the need
for clarification of preferences . a third might be to
develop skills for leisure activities. (Riker, 1979, p. 112)

Marital and Sex Counselor

The role adjustments necessary after retirement often have conse-

quent impact upon the relationship of the retired couple. Excess free time

can lead to invasions on the "territorial right" of each partner and

necessitate a modification in the informal marriage contract. Medley

(1977) has devised a program designed to enrich the marital lives of older

persons. The program stresses relationship analysis and goal setting as

requisite components to marital adjustment in the post-retirement years.

Issues involving sexual activity have been addressed in the litera-

ture. Many older persons remain sexually active, according to the avail-

ability of partners (Hess, 1974). Many older couples require reassurance

and accurate information that sex remains a natural and normal part of the

relationship and should not be regarded as unhealthy (deBeanoir, 1972;

Neugarten et'al., 1961).

In those cases where the older person has moved in with married

children, marriage counseling of the host couple by a professional

gerontological counselor is often helpful for the continued growth of the

couple and the elderly parent (Bock, 1972). This function of assistance

to adult children goes beyond marital counseling. Ideally the counselor

could act as an informational agent for aging problems in terms of remed-

iation, personal communications, referral, and support. Such a function











is very much in keeping with aging policy thrusts attempting to prolong

independent living and postponing institutionalization as long as possible.

Living in the knowledgeable and supportive atmosphere of an adult child's

home may be an attractive alternative to the nursing home for many older

persons and their children.

Counselor and Outreach Agency to Minorities

The elderly as a group tend to exhibit characteristics which con-

form to the definition of minority: defensiveness, self-hatred, sensi-

tivity and self-consciousness (Myers, 1978, p. 22). Palmore (1976)

suggested that because the elderly have been negatively sterotyped, they

have developed a group consciousness of inferiority, which he associated

with the tendency to reduce activity with advancing age. The stereotypes

as listed by Busse and Pfeiffer (1969, pp 47-52) center around illness,

sexual activity and interest, mental abilities, morale, activities in

general, productivity and isolation. Busse and Pfeiffer (1969, p. 29)

wrote: "There is little doubt that the elderly American can be identified

as belonging to a deprived minority."

The second dimension of the minority status of the elderly concerns

itself with those older persons who are in "double jeopardy" (Hill, 1971),

first because of their age and second because of their race, Solomon

(1979, p. 154) cited Blacks, Hispanic Americans, Indian elderly, and

Asian-American elderly as those groups who are suffering from "cultural

barriers, language problems and a general erosion of resistance to the

negative effects of age due to life in a dual culture." The U.S. Commission

on Civil Rights; The Age Discrimination Study points out that: "Being black

and aged frequently means the piling up of life problems associated with











each characteristic . less education . less income . less

adequate medical services . fewer family supports." (USGPO, 1977, p. 17)

Counselors can assist those suffering in this multiple discrimin-

ation by first understanding their complex need structure, and then by

taking a proactive posture in reaching out to these people who may be

reluctant to identify themselves by living and suffering in silence

(Furgess, 1976). Racial differences among the various minorities do

exist; the implication for gerontological counseling, however, is in the

depth rather than the type of services required (Ehrlick, 1975).

Provider of Services to Nursing Home and Housing Complex Residents

Fewer than 5% of the elderly population live in a nursing home

at any given time, yet 19% die in nursing homes (Manney, 1975; Montgomery,

1972). Many authors have called for the services of gerontological

counselors in nursing homes (Boyd and Oakes, 1973;Freidman, 1975; Salisbury,

1974; Vontress, 1975). Fear of extended illness which would deplete re-

maining financial reserves is, according to Shanas (1962), the single

greatest threat and cause of stress among the elderly. Butler (1975)

refers to this fear of nursing homes when he describes that they are per-

ceived by the elderly as being "halfway houses between life and death"

(Butler, 1975, p. 263). Adjusting to health care training, leisure

counseling, life review and peer counselor education are only some of

the functional services gerontological counselors can bring to the nursing

home (Friedman, 1975).

Age segregated housing is becoming increasingly popular and is

expected to grow in the future (Pressey, 1973). Kelly (1976, p. 522)

outlined the many functions that professional counselors are currently

performing in a housing complex in Norfolk, Virginia. These include:











direct services, consultation and coordination, guidance and counseling,

advocacy, referrals, and administration. He concluded (p. 523), "these

services offer hope and help to severely pressed clients and are an

example that counseling is a broad service that can operate beneficially

in a setting closely tied to the community it is serving." Pressey and

Pressey (1972, p. 356), themselves in their 80s and living in an age

segregated housing complex, advocated the role of what they call the

resident gerontological counselor. Such a person could greatly aid in

"developing a helpful neighborhood," fostering "mutual understanding"

among the residents, reshaping "attitudes toward death," and attend-

ing to the welfare of the dying and their families."

Preparation for Death Counselor

Erikson (1950) spoke of the fear of death as a failure to achieve

ego transcendence and a consequent unhealthy focus on self. Many authors

have commented upon and urged that the services of counselors be made

available to dying persons (Buckley, 1972; Carey, 1976; Dickstein, 1966;

Jackson, 1977; Koff, 1979; Kubler-Ross, 1969).

Personal freedom in decision making, the availability of
alternatives, and opportunities for independence should be
considered innate human rights that may require special
effort to safeguard and sustain for the dying. The dying
person may need the support of a counselor to maintain control
over his/her own life and therefore his/her own dying. (Koff,
1979, p. 129)

Dying is the ultimate life crisis and individuals need to find the coping

skills necessary so that they can deal with it (Jackson, 1977). Persons

near death many times become overburdened with concerns, doubts, and

questions which require an understanding, yet impartial, "other" with

whom they can relate. Death has become a social taboo in our society,

eventuating in an inability to deal with it in realistic terms (Feifel,











1963). "Counselors can help with regard to many matters that dying persons

care about, from the mundane to the immortal" (Sinick, 1977, p. 123).

Buckley (1972, p. 756) suggested that dying is a solitary exper-

ience but that the quality and meaning of death can be heightened by

someone who cares, who supports, and who can empathize deeply. The goal

of death counseling, as outlined by Carey (1976, p. 124) "is in assisting

each patient to live each day as joyfully and peacefully as possible."

The five states of grief, as conceived by Kubler-Ross (1969), apply as

well to the terminally ill patient who is anticipating death. Sinick

(1977, p. 69) maintained that "counselors can pick up communications

crucial in identifying suicidal individuals" and play a preventative

function as well as an enrichment function as part of their role as

counselor for the dying.

Pre-retirement Counselor and Educator

The importance of work in our society is underscored by the trauma

which envelopes some persons when they move from the structure and status

of the work role to the role-ambiguity of retirement. Manion (1976,

p. 119) described retirement as the "first insult of aging . it is

tangible evidence that one is publicly recognized as an 'older' person, a

'senior citizen.'" Retirement sometimes brings lowered finances, de-

creased time structure, loss or uncertainty of status in the community,

lowered life meaning, and decreased association with fellow workers.

Adequate retirement planning is a requisite to accommodate the losses

incurred by the retirement event.

Many pre-retirement programs have been created (Greene, 1969).

Ullman (1976, p. 118) suggested, however, that, "most retirement programs

focus on the economic factor because they can deal with these problems











successfully." Siegel and Reaves (1978) and Manion (1976) both echoed

this supposition. Manion (1976, p. 119) divided all pre-retirement

programs into four categories: coping, prescriptive, pedagogical, and

T-group. He evaluated each and singled out the T-group format as the

one which deals most comprehensively with the pre-retiree because it

usually deals with such intangibles as: development, attitudes,

awareness, options, and life planning skills, -Ullman (1976, p. 118)

stated that the "central function of the retirement counselor is to

understand the meaning of work and leisure in the dynamics of the

individual."

Riker (1979, p. 117), in a comprehensive statement on pre-retire-

ment counseling identified 14 separate counselor functions for the

pre-retirement setting. Among these are: training in decision making,

person-to-person relationship training, presenting information on

financial and housing concerns and referring people for remedial education.

Sheldon et al. (1975, p. 148) questioned whether pre-retirement programs

of any kind or mode can adequately prepare a person for the life shock

of retirement and advocated the creation of post-retirement programs

to deal with the "strains generated in the family, the cessation of inter-

personal supports . and the way in which a community reinforces

and degenerates status." According to Sinick, "The developmental state

of retirement calls for stock-taking, preparation for role adjustments,

planning for optional use of time and managing matters such as income,

housing and health" (Sinick, 1977, p. 39). All of these concerns are

the natural domain of the professional gerontological counselor.











Public Relations Provider

The public has a need to know about the special problems associated

with aging, both as citizens who can be encouraged to help older persons,

and as future older persons themselves so that they can begin to prepare

for old age. This public relations role is targeted at both the middle-

aged and the elderly populations. Public relations constitutes outreach to

persons who are ignorant of or who are too timid to approach the aging

network. Buckley (1972, p. 756) understood this when she said, "counselors

need a counseling model based on the recognition that the unique problems

of these persons mitigate against their seeking help."

Public relations to the non-elderly community alerts them to the

current problems of aging, may educate them to the needs of their aging

parents, and could stimulate them to begin to prepare for their own

elderly years. Butler and Lewis (1973, p. 24) urged the creation of GAPS,

"Group for Advancement of Psychiatry," in all mental health centers and

argued that each GAPS should contain an advocate fdr the elderly. Public

relations is important for gerontological counselors from the standpoint

of generating support for the profession. "Counselors must communicate

their role . in the community . to gain support for their work"

(Braden, 1975, p. 25).

Gerontological Researcher

More information regarding the counseling needs, the counseling

strategies, the intervention points, and the service sites for the

elderly is needed before counselors can adequately carry out the task of

providing comprehensive gerontological counseling services. Virtually

every study on gerontological counseling urges that a heightened research











effort be undertaken (Fleer, 1975; Ganikos, 1977; Murphey, 1979, Myers,

1978; Sinick, 1977; Wolff and Meyer, 1979).

Pressey (1973, p. 356) called for the "furtherance of highly

personalized research." Case studies and on-site observations, as well

as historical sketches and individual needs assessments, constitute the

mechanics of "personalized research." "An old age counselor, especially

if so functioning in an institution and preferably in some relationship

with a university, has research opportunities now almost unrecognized,"

according to Pressey and Pressey (1972, p. 366). The role of the resident

gerontological counselor, who is in an ideal position to research the

possibilities "to investigate potentials regarding longevity, maintained

ability, and personality" is well stated by Pressey and Pressey (1972,

p. 366).



Summary of Related Literature

This literature review has presented a comprehensive survey of

available research and writing dealing with the identification of the

goals and roles of gerontological counselors. A summary of three

gerontological counseling needs assessments was presented. It can be

concluded that the elderly express a need for counseling to deal with

the affective dimensions of their lives. An overview of goal theory was

then presented as it applies to professional counseling in general and

gerontological counseling in particular. The survey addressed the problems

associated with counseling goal specification. It then identified the

five goals of counseling as outlined by Shertzer and Stone (1974) with

particular reference to gerontological counseling. These five goals are:











1. problem resolution

2. behavioral change

3. decision making

4. positive mental health

5. personal effectiveness

An overview of role theory followed with discussion of counselor

roles and a section on the roles of the gerontological counselor. A

total of 18 gerontological counselor roles was then identified. These

are:

1. provider of services to persons living alone

2. bereavement counselor

3. change agent

4. personal counselor

5. consultant

6. specialist in psychological education

7. employment counselor

8. services coordinator/enhancer/client advocate

9. financial counselor and manager

10. in-service counselor educator

11. leisure time counselor

12. marital and sex counselor

13. counselor and outreach agent to minorities

14. provider of services to nursing homes and housing complexes

15. preparation for death counselor

16. pre-retirement counselor and educator

17. public relations provider

18. gerontological researcher














CHAPTER III

METHODOLOGY



Introduction

From the preceding review of literature one might conclude that

older persons have needs which can be satisfied through receiving pro-

fessional counseling. The profession of gerontological counseling has

developed to the level where a need exists among its practitioners to

specify the goals and roles of the professional counselor of the aged.

It has been demonstrated further that the aging services network has

evolved into a system most directly concerned with providing services of

a physical and material nature. Those needs and concerns of the elderly

which are best described as "affective" have been given scant attention by

the aging network.

In Chapter II the researcher has specified both the goals and the

roles of the professional gerontological counselor as they appear in the

literature. This identification in the abstract required evaluation and

confirmation from experts in the profession of gerontological counseling.

In order to determine the utility of these newly confirmed goals and

roles, this study was designed to communicate them to aging network

administrators for their evaluation. This study, therefore, generated

identification, confirmation, evaluation, and utilization data concerning

the roles and goals of gerontological counselors.







55











Research Objectives

The objectives of this descriptive research study were to: compile

a confirmed list of gerontological counselors goals and a confirmed list

of gerontological counselors roles. The confirmation process was accomp-

lished by a panel of gerontological counseling experts identified through

counselor education department chairperson on a national basis. A goal

or role was considered "confirmed" if the responses given it by the panel

of counseling experts attained a mean score of 3.5 or above on a 7 point

Likert scale.

Determine the degree of relevance that the goals and roles confirmed

by the panel of gerontological counseling experts have for federally

supported aging programs as perceived by Area Agency on Aging Executive

Directors. Three specific research questions were used to achieve this

objective.

1. To what extent did the identified and confirmed goals

and roles of gerontological counselors conform to and

assist the objectives of current programs for the aged

as these services are contracted and monitored through

Area Agencies on Aging?

2. What was the need for gerontological counselors?

3. Where can gerontological counselors be most beneficially

placed within the aging services network to assist older

persons? What were the most appropriate sites for

gerontological counselors?











Sample Selection and Research Procedures

Two sample groups were necessary to conduct this study. The first

was a panel of gerontological counseling experts. The second sample re-

quired by the study was one composed of administrators in the aging network.

For this purpose, a national clustered randomized sample of AAA directors

was taken, Ci253).

Statements of cooperation were secured from the Adult Development

and Aging Committee of APGA, and the Center for Gerontological Studies

and Programs at the University of Florida. These agencies assisted this

study by enhancing subject participation and by offering credibility and

consultive services to the researcher throughout this study.

An eight phase process constituted the mechanics of the study:

Phase one. A letter and survey form were sent to all counselor

education department chairpersons nationwide (N=448). This letter and

survey (Appendix A) outlined the purpose of the study and asked each

chairperson to identify any gerontological counseling experts that may

be residing at his or her college or university. A gerontological

counseling expert was defined as an academic faculty member who had

competencies and knowledge in both counseling and gerontology, and who

had taught, or was currently teaching, a course exclusively devoted to

the content area of counseling older persons. A total of 253 (56.4%)

department chairpersons responded to the survey.

Phase two. Of the 253 responding department chairpersons, 160

indicated that no persons conforming to the criteria of the definition

could be identified on their campuses. A total of 93 counselor education

department chairpersons did identify 99 persons whcmthey reported as

satisfying the definition of gerontological counselor.











Phase three. A mailing was sent to the identified 99 authorities

in gerontology. Each of these received a letter (Appendix B) which

described the purpose and sequence of the study and provided participation

instructions. Along with this letter was a list of 18 goals and five

roles for gerontological counselors which had been, abstracted from the

literature by the researcher, and which are outlined in Chapter II,

(Appendix B). Participants were asked to react to the valueof

each goal and each role for gerontological counselors, by rating them

on a seven point Likert scale. Particpants were also asked to list any

other goals or roles they perceived as viable and important for geronto-

logical counselors.

Phase four. The researcher compiled the responses. A goal or

role which received a 3.5 or above rating on the seven point Likert scale

was considered to be a confirmed role or goal. All 18 goals and all

five roles were rated above 3.5 and were therefore considered confirmed

goals and roles. Participants also added a total of two additional goals

and three additional roles for counselors which were added to the original

lists. A new list of seven goals and 21 roles resulted. A total of 25

of the originally identified 99 authorities in gerontology either did not

respond or self-selected themselves out of the study indicating that they

did not consider themselves to be gerontological counseling experts.

Phase five. A second mailing was sent to each of the 74 remaining

authorities in gerontology who responded to the round one survey. This

second mailing (Appendix C) indicated the mean scores and standard

deviations given to each goal and role by the group, as well as the

numerical rating given in the first round by that participant. Respondents

were again asked to rate each goal and each role on the newly created lists











on a seven point Likert scale, according to their importance for

gerontological counselors. Respondents were also asked to rate on a

seven point Likert scale each of the 13 potential sites where gerontological

counselors could assist older persons within the aging network. These

13 sites were identified by the researcher from the literature and from

his experience, and represented all possible location sites within a

public service area (PSA).

Phase six. The researcher computed the ratings of each goal and

role on both lists according to the responses given by the authorities in

gerontology. Through analysis of the demographic data of the 68 res-

pondents of round two, it was determined that 27 did not, in fact, satisfy

the criteria of the definition of gerontological counseling expert.

Therefore, 41 respondents were retained and used as the panel of experts.

The data from these 41 were used to confirm the goals and roles of

gerontological counselors.

Phase seven. A letter and survey (Appendix F) was sent to a

national random sample of Area Agency on Aging executive directors (N=253).

The random sample was compiled from the National Directory of Area Agencies

on Aging by use of a random numbers table. The letter outlined the purpose

of the study, summarized what had already transpired, and requested the

AAA directors' participation. All sampled AAA directors were requested to

perform three evaluations on the information provided them:

1. Appraise, on a seven point Likert scale, the degree to which

each expert panel confirmed goal and confirmed role conformed

to the objectives of the total aging network services currently

contracted and monitored in their PSA.











2. Appraise, on a seven point Likert scale, the degree to which

each confirmed goal and role could assist older persons in

their particular PSA.

3. Rate the 13 potential gerontological counseling sites with

regard to the degree of benefit the AAA directors perceive

gerontological counselors could be to older persons at those

sites.

Phase eight. The researcher computed mean scores and rank ordered

each goal and each role on the basis of responses on the survey form as

returned by AAA directors. These responses were, first, the degree of

conformity of each goal and role to the objectives of existing services,

and second, the degree to which each goal and role could assist older

persons. Additionally, the researcher rank ordered the gerontological sites

identified as those where gerontological counselors would be most likely to

have maximum impact.



Analysis of the Data

A number of demographic items was requested of each gerontological

counseling expert: geographic area of employment, sex, academic department,

college affiliation, number of gerontology courses taught, contributions

made to gerontology, preparation in gerontology, preparation in counseling,

degree attained, and other specialty areas. Likewise, AAA directors were

requested to provide the following demographic items: geographic area of

employment, sex, age, number of years of schooling, degree level and

population density characteristics of their public service area (PSA).

Various statistical manipulations of the resulting data were

accomplished. A percentage breakdown of all demographic categories was











undertaken (Tables 1 and 2). Crosstabulations between demographic items

for both experts and AAA directors were produced (Tables 4 through 9 and

appendices H through Q). Frequency response for goals, roles and sites,

as given by the panel of experts and the sample of AAA directors, appear

in Tables 9 and 12. A one-way analysis of variance procedure was under-

taken for each goal, each role, and each site in relation to each demo-

graphic item for both experts and AAA directors. These appear in Tables

10 and 13. Means scores standard deviations, and rank order for all goals,

roles and sites responses for both experts and AAA directors, as well as

correlations between the two groups, appear in Table 15. A one-way analysis

of variance between experts' and AAA directors' responses is found in

Table 16. Finally, factor analysis of all goal role, and site responses

results were computed and appear in Tables 18 through 29. Chapter IV

is an indepth presentation of the results of these statistical manipu-

lations.















CHAPTER IV

RESULTS



The data results of the eight phase survey of 41 gerontological

counseling experts and 253 Area Agency on Aging (AAA) directors are pre-

sented in this chapter. Phases one through six involved the selection

of the panel of gerontological counseling experts and the confirmation

process of the goals and roles of gerontological counselors. Phases

seven and eight involved selecting the sample of the AAA directors,

their appraisal of the degree to which gerontological counselors' goals

and roles conformed to the objectives of the aging network, and their

evaluation of the degree to which these same goals and roles could

assist older persons in their public service areas (PSA). Both the panel

of counseling experts and the sample of AAA directors also were asked to

rate 13 sites within PSAs with regard to the degree each site could serve

as a possible physical location for the placement of gerontological

counselors to best serve older persons. This chapter further describes

the characteristics of each of the samples, gerontological counseling

experts and AAA directors, and contains the analysis of the responses made

by all participants.



Demographic Information Relating to the Panel of Experts

Area, Sex, and Academic Department

Table 1 displays the frequency data for the experts for all

demographic characteristics. For the purposes of this study, the nation











was divided into six sections: Northeast, South, Midwest, Southwest, West,

and non-continental. The Northeast included the states of Maine, New

Hampshire, Vermont, Maryland, Rhode Island, Connecticut, New York, New

Jersey, Pennsylvania, Ohio, Delaware, and Massachusetts. A total of 16

(38%) of the "expert" sample resided here. The South included the states

of Virginia, West Virginia, Kentucky, North Carolina, South Carolina,

Tennessee, Georgia, Alabama, Mississippi, Louisana, Arkansas, and Florida.

A total of five, or 12.2% of the sample resided in the South. The Mid-

west included the states of Indiana, Michigan, Illinois, Wisconsin,

Missouri, Iowa, Minnesota, Oklahoma, Kansas, Nebraska, North Dakota, and

South Dakota, where nine (22.0%) of the sample resided. The Southwest,

Texas, New Mexico, Arizona, and Nevada, included six (14.6%) of the sample.

The West, Utah, Wyoming, Montana, Idaho, California, Oregon, and Washington,

included a total of five (12.2%) of the sample. No department chairpersons

resided in the non-continental United States, which included the states

of Alaska and Hawaii, and all possessions, identified any gerontological

counseling experts.

Of the 41 experts, 12 or 29.3% were female and 29 or 70.7% were

male. When asked to which department do you most closely identify, 34

(82.9%) indicated "counselor education." Three experts (7.3%) said the

psychology department. One expert each (2.4%) identified the departments

of gerontology, educational psychology, continuing education, or other.

Thirty-six expert respondents (87.8%) identified the College of

Education as the college to which they belonged. Two experts indicated

the College of Arts & Sciences, one identified the College of Medicine,

One indicated an interdisciplinary appointment, and one did not respond

to this item.











Experts were asked to list any contributions they had made to the

field of gerontology. These data were reduced to six categories:

dissertations, professional journal articles, texts or parts of texts,

service projects, presentations at professional conventions, and others.

A total of three dissertations, eight articles, eight texts or parts of

texts, 21 service projects and five presentations were contributed to

the field by the experts. Ten respondents did not report any contribu-

tions. Experts also listed the number of contributions each had made to

gerontology. Ten (24.4%) indicated that they had not contributed to the

field. Fourteen (34.1%) listed one contribution; seven (17.1%) listed

two; six (14.6%), three to the field; two (4.9%), four contributions; and

two (4.9%), listed six contributions.

Academic Preparation, Degree, and Specialties

Experts indicated the following types of preparation in the field:

seven (17.1%) listed seminars; 14 (34%) stated that they were self-

taught; 10 (24.4%) indicated they had taken post graduate courses; two

(4.9%) listed experience; and two (4.9%) responded that they had been

graduated from formal gerontology programs. Experts also reported their

preparation in counseling. Four (9.8%) responded that they had taken post

graduate courses in the subject, while 37 (90.2%) reported that they had

a formal graduate degree in counseling.

Experts listed their highest degree. Four (9.8%) responded that the

master's degree was their highest degree. Twenty-two (53.7%), held the

Ed.D. degree, and 15 (36.6%), held the Ph.D. degree. Experts also listed

the content area of their highest degree. Nineteen (46.3%) indicated that

counseling was their highest degree; eight experts (19.5%) responded

counseling psychology; six (14.6%) answered educational psychology;











four (9.8%) student personnel; two (4.9%) answered education; and one

(2.4%) each responded sociology, and "other."

Experts were asked to list their specialities other than geron-

tology. One (2.4%) listed no other specialities; eight (19.5%) listed

one speciality; 18 (43.9%) listed two other specialities, five (12.2%)

listed three specialities; four (9.8%) listed four specialities, and

three experts (9.3%) listed five additional specialities other than

gerontological counseling. A wide variety of specialities were listed.

These specialities seem no different from what could be expected from

any sample of counselor educators. No comparative data, however, could

be found by the researcher.

Crosstabulation Analysis of Selected Demographic and Other Characteristics
of the Panel of Gerontological Counseling Experts.

Table 3 displays the crosstabulation of geographic area and sex

characteristics of the counseling experts. Of the 12 female experts,

seven were from the Northeast; one from the South; two from the Midwest;

and two from the Southwest, No female experts responded from the West.

Of the 29 male experts, nine resided in the Northeast; four in the South;

seven in the Midwest; four in the Southwest; and five in the West. No

counseling experts responded from any non-continental sections of the

United States.

Table 4 displays the crosstabulation of the geographic area and

highest degree subject area of all counseling experts. Nineteen (46.3%)

of the responding experts listed counseling as their highest degree. Of

these 19, five were from the Northeast; six from the South; eight from the

Midwest, and three came from the Southwest. None came from the West. One

expert listed sociology as his highest degree area. Eight experts









TABLE 1

SUMMARY OF DEMOGRAPHIC CHARACTERISTICS
OF COUNSELING EXPERTS


Characteristics N % Total




1. Area of Country
Northeast 16 39.0
South 5 12.2
Midwest 9 22.0
Southwest 6 14.6
West 5 12.2
Non-Continental 0 0

2. Sex
Female 12 29.3
Male 29 70.7

3. Department
Counseling 34 82.9
Psychology 3 7.3
Gerontology 1 2.4
Educational Psychology 1 2.4
Continuing Education 1 2.4
Other 1 2.4

4. College
Education 36 87.8
Arts & Sciences 2 4.9
Medicine 1 2.4
Interdisciplinary 1 2.4
Other 1 2.4

5. Gerontology Course
Counseling Oriented 40 97.6
Non-counseling oriented 0 0
Both 1 2.4












TABLE 1--Continued


Characteristics N % Total


6. Number of Gerontology Courses
One
Two
Three
Four
Five

7. Gerontology Contributions
Dissertations
Articles
Texts
Service
Presentations
None

8. Number of Contributions
None
One
Two
Three
Four
Six

9. Gerontology Preparation
Seminar
Self-Taught
Post Graduate Courses
Gerontology Program Graduate
Experience
None

10. Counseling Preparation
Post Graduate Courses
Counseling Program Graduate


53.6
24.4
9.8
9.8
2.4


6.6
17.7
17.7
46.6
11.1
22.2


24.4
34.1
17.1
14.6
4.9
4.9


17.1
34.1
24.4
4.9
4.9
14.6


9.8
90.2









TABLE 1--Continued


Characteristic N % Total




11. Degree
Masters 4 9.8
Ed.D. 22 53.7
Ph.D. 15 36.6

12. Degree Field
Counseling 19 46.3
Sociology 1 2.4
Counseling Psychology 8 19.5
Educational Psychology 6 14.6
Student Personnel 4 9.8
Education 2 4.9
Other 1 2.4

13. Specialities
None 1 2.4
One 8 19.5
Two 18 43.9
Three 5 12.2
Four 4 9.8
Five 3 7.3











indicated that counseling psychology was their highest degree area. Of

these, five came from the Northeast, one from the Midwest; and two from

the West. No counseling psychology degree holders reported from the

South or the Southwest. Six experts listed educational psychology as the

content area of their highest degree. Two of these were from the

Northeast; one from the South; one from the Southwest; and two were from

the West. Four experts listed student personnel as their highest degree.

One each of these came from the Northeast and the South, while two came

from the Southwest. Two experts listed education as their highest degree;

one came from the Northeast and one came from the West. The one expert

who listed "other" as the highest content area came from the Northeast.

Table 5 is a crosstabulation of the sex and the number of gerontology

courses taught characteristics. Twenty-one experts indicated that they

taught one gerontology course, seven females and 14 males. Of the 10

(24.4%) who listed that they taught two courses, four were female and six

were male. All four experts responding that they taught four courses were

male. One female and three males responded that they taught five geron-

tology courses. One male did not respond to this item and consequently

was listed as teaching no gerontology course.

Additional crosstabulation tables for the counseling experts can

be found in appendices H through N. These crosstabulations cover

characteristics such as contributions to the field of gerontology, pre-

paration in gerontology and number of additional specialties.

Crosstablulation Analysis of Selected Demographic Characteristics of the
Sample of AAA Executive Directors

Table 6 is the crosstabulation of the geographic area and sex

characteristics of the sample of AAA Executive Directors. Of the 82










TABLE 2

SUMMARY OF DE:IOGRAPHIC CHARACTERISTICS
OF SAMPLE AAA DIRECTORS


Characteristic N % Total


1. Area of Country
Northeast
South
Midwest
Southwest
West
Non-Continental

2. Sex
Female
Male

3. Age
25-34
35-44
45-54
55-64
65+

4. Number of Years of School
9
12
13
14
15
16
17
18
19
20
21
22
23
26


28.9
21.1
25.9
7.2
14.5
2.4


50.6
49.4


32.9
34.8
15.2
14.0
3.0


0.6
1.8
0.6
1.8
5.5
27.0
22.1
25.2
3.7
6.1
1.8
1.8
0.6
1.2










TABLE 2--Continued


Characteristic N % Total



5. Degree
Bachelors 47 28.8
Masters 84 51.5
Specialist 5 3.1
Doctorate 7 4.3
Other 19 11.7

6. Area of PSA
Urban 14 8.4
Suburban 6 3.6
Rural 82 49.4
Mixed 63 38.0
Missing 1 0.6













TABLE 3

CORSSTABULATIONS OF EXPERTS' CHARACTERISTICS:
REGIONAL AREA BY SEX


Area Sex

N
% Total Female Male



Northeast 7 9
17.07 21.95


South 1 4
2.44 9.76


Midwest 2 7
4.88 17.07


Southwest 2 4
4.88 9.76


West 0 5
0.00 12.20


Total 12 29
29.27 70.73








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TABLE 6

CROSSTABULATION OF AAA DIRECTORS' CHARACTERISTICS:
REGIONAL AREA BY SEX









Area Sex

N
% Total Female Male



Northeast 25 22
15.24 13.41


South 24 10
14.63 6.10


Midwest 12 31
7.32 18.90


Southwest 7 5
4.27 3.05


West 11 13
6.71 7.93


Non-Continental 3 1
1.83 0.61


Total 82 82
50.00 50.00











females or 50% of the sample responding, 25 came from the Northeast;

24, the South; 12, the Midwest; seven, the Southwest; 11, the West; and

three, non-continental. Of the 82 males responding or 50% of the sample,

22 listed the Northeast as their PSA area; 10, the South; 31, the Midwest;

five, the Southwest; 13, the West; and one, non-continental. Two directors

did not respond to this item.

Table 7 is the crosstabulation of the geographic area and highest

degree level characteristics of the AAA Directors. Forty-six directors

(28.5%) indicated they had earned a bachelor's degree. Of these 46, 13

came from the Northeast; nine, the South; 14, the Midwest; four the

Southwest; 11, the West; and two, non-continental. Five directors (3.1%)

have sixth-year degrees. Of these five, two came from the Northeast;

two, the Midwest; and one, the Southwest. Seven (4.3%) AAA Directors hold

doctoral degrees, of these, two came from the Northeast; one, the Midwest;

one, the Southwest; and three, the West. A total of 19 directors (11.9%)

indicated that they hold other degrees; these degrees are most probably

associate degrees from two year institutions. Of these 19, four came

from the Northeast; six, the South; two, the Midwest; one, non-continental.

Five respondents indicated that they have no educational degree.

Table 8 displays the crosstabulation of the sex and public service

area (PSA) characteristics. Of the 83 females responding to this item,

eight listed their PSA as predominantly urban; two, suburban; 42 rural; and

30 "mixed." Eighty-one males described their PSA district. Six listed

urban; four, suburban; 39, rural; and 32 "mixed." Two directors, one male

and one female, did not respond to the PSA item.

Additional information regarding the remaining demographic

characteristics of the AAA Executive Director sample can be found in























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TABLE 8

CROSSTABULATION OF AAA DIRECTORS'CHARACTERISTICS:
SEX BY PUBLIC SERVICE AREA


Sex Public Service Area

N
% Total Urban Suburban Rural Mixed




Female 8 2 42 30
4.88 1.22 25.61 18.29



Male 6 4 39 32
3.66 2.44 23.78 19.51



Total 14 6 81 62
8.54 3.66 49.39 37.80











appendices 0 through Q. These appendices are crosstabulation tables

between geographic area and PSA, sex and highest degree and PSA.



Demographic Information Relating Executive Directors
of Area Agencies on Aging (AAA)

Table 2 displays data showing the demographic characteristics of

all AAA directors responding to the survey (N=168).

Geographic Area, Sex, Education, and Public Service Area (PSA)

Directors were identified by geographic area. The same six geo-

graphic regions (Northeast, South, Midwest, Southwest, West, and non-

continental) used to identify counseling experts were used to categorize

the AAA directors. Forty-eight (28.9%) directors resided in the Northeast;

25 (21.1%) in the South; 43 (25.9%) in the Midwest; 12 (7.2%) in the

Southwest; 24 (14.5%) in the West; four (2.4%), non-continental.

The sample of AAA Director respondents was almost evenly divided

between males and females. Eighty-four (50.6%) were female, while 82

(49.4%) were male.

Directors of AAAs reported their age in five categories. Fifty-four

(32.9%) listed their age as between 25 and 34 years old; 57 (34.8%) listed

between 35 and 44 years of age; 25 (15.2%) answered between 45 and 54

years old; 23 (14%) were between the ages of 55 and 64, and five (3%)

were 65 and older.

Directors of AAAs reported the number of years of education. The

range of responses was from nine to 26 years, The mode response was 16

years reported by 44 (27%) of the respondents. These responses were made

regarding years of school: 41 (25.2%), 18 years of schooling; 36, (22.1%),

17 years; 10 (6.1%), 20 years; nine (5.5%), answered 15 years. A small











number of respondents listed other numbers of years of school-

ing.

Nineteen AAA directors (..17%) indicated they held an "other"

or an associate's degree; 47 (28.8%) had a bachelor's degree; 84 (51.5%),

a master's degree, five (3.1%), specialist's degree, and 7 (4.3%) held

the doctorate degree.



Evaluation of Experts Confirmation of Goals, Roles and Sites

The responses given by the panel of gerontological counseling

experts are outlined in this section. Responses listed and discussed are

those received from the second round survey sent to the experts. These

second round responses include the two additional goals and three addi-

tional roles compacted by the researcher after examination of the first

round solicited additions. Second round goals and roles are regarded as

confirmed goals and roles because each achieved an expert panel rating of

3.5 or higher on a seven point Likert scale, as specified for confirmation

in Chapter I. All goals, roles, and sites listed in round two achieved

confirmation by the expert panel. The complete lists of confirmed goals,

roles and sites appear below.

Confirmed goals

1. Problem resolution
2. Behavioral change
3. Decision making
4. Positive mental health
5. Personal effectiveness
6. Knowledge of the aging process
7. Self-advocacy

Confirmed roles

1. Service provider to persons living alone
2. Bereavement counselor
3. Change agent











4. Personal counselor
5. Consultant
6. Specialist in psychological education
7. Employment counselor
8. Services coordinator--services enhancer--client advocate
9. Financial counselor and manager
10. In-service counselor educator
11. Leisure time counselor
12. Marital and sex counselor
13. Outreach agent to minorities
14. Service provider to nursing home and housing project residents
15. Counselor of the terminally ill
16. Pre-retirement counselor and educator
17. Public relations worker
18. Gerontological researcher
19. Family counselor
20. Educational counselor
21. Medical support outreach counselor

Confirmed sites

1. Senior centers
2. Area agencies on aging
3. Mental health centers
4. Nursing homes
5. Adult congregate living facilities
6. Adult congregate nutrition sites
7. Retirement projects
8. Day care centers
9. Hospice programs
10. Homemaker's programs
11. Respite care programs
12. Housing projects
13. Physician's offices

Three tables describe the responses of the experts regarding goals,

roles and sites. Table 9 shows a frequency distribution, Table 10 outlines

F-ratios for selected demographic characteristics for all goal, role, and

site ratings, while Table 11 displays the mean score breakdown for each

F-ratio which achieved significance. These three tables together give a

comprehensive overview of the responses made by the panel of gerontological

experts.

Table 9 summarizes the response frequencies of the experts for

ratings of all goals, roles and sites, along the seven point Likert scale.
































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