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Clients' perceived trust, trustworthiness, and expectations in the therapeutic relationship

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Clients' perceived trust, trustworthiness, and expectations in the therapeutic relationship factors in satisfaction with counseling received
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Caesar, Celia Andersen, 1964-
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xii, 169 leaves : ; 29 cm.

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African Americans ( jstor )
Client satisfaction ( jstor )
College students ( jstor )
Nurturance ( jstor )
Psychological counseling ( jstor )
Psychotherapy ( jstor )
Questionnaires ( jstor )
School counseling ( jstor )
School counselors ( jstor )
School dropouts ( jstor )
Dissertations, Academic -- Psychology -- UF
Psychology thesis, Ph. D
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non-fiction ( marcgt )

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Thesis:
Thesis (Ph. D.)--University of Florida, 1996.
Bibliography:
Includes bibliographical references (leaves 159-168).
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Typescript.
General Note:
Vita.
Statement of Responsibility:
by Celia Andersen Caesar.

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Copyright [name of dissertation author]. Permission granted to the University of Florida to digitize, archive and distribute this item for non-profit research and educational purposes. Any reuse of this item in excess of fair use or other copyright exemptions requires permission of the copyright holder.
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CLIENTS' PERCEIVED TRUST, TRUSTWORTHINESS, AND EXPECTATIONS
IN THE THERAPEUTIC RELATIONSHIP: FACTORS IN SATISFACTION
WITH COUNSELING RECEIVED














BY


CELIA ANDERSEN CAESAR















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



UNIVERSITY OF FLORIDA

1996



UrI ERSIT OF FLORICA LIBRARIES































To JOHNNY,

the wind beneath my wings















ACKNOWLEDGEMENTS


First of all, I would like to thank and acknowledge the

Creator through Whom all things are possible.

I extend a warm appreciation to my committee, Dr.

Carolyn Tucker, Dr. Ronald Akers, Dr. Shae Kosch, Dr.

Jaquelyn Resnick, and Dr. Robert Ziller, for their patience,

guidance, and support. I especially thank Dr. Tucker for her

unfailing belief that I would succeed in this endeavor, and

for her uniqueness in combining teaching, consultation, and

guidance with warmth, humor, and genuine concern for me

throughout my graduate career.

Acknowledgements are due to all those who in some way

contributed to this study. The University of Florida

Counseling Center's Research Committee, and former Director

Dr. James Archer, are affectionately thanked for allowing the

study to be conducted at the Center. Special thanks are

extended to the counselors and staff who implemented the

study, and without whom data collection would not be

possible. Likewise, the Director of Student Mental Health

Services, Dr. Jackie Ayers, and the counselors there are

gratefully acknowledged for their support of the study. To

the clients who graciously accepted to take part in the

study, I sincerely extend my appreciation for their


iii









willingness to put down in writing their feelings about the

counseling process.

I sincerely thank the students who volunteered to help

with the scoring of the data, and my friend, Deborah Brady

for helping with the verification of the data. I am deeply

grateful to Dr. John Dixon for his time, effort, and

expertise in the statistical analyses of the data.

I extend my heartfelt love and appreciation to my

parents Carmen Lydia Andersen and Marcus Criminatus Andersen

for their undying support and encouragement in my academic

pursuits. I warmly acknowledge my sister and brothers whose

love and support keep me grounded. I sincerely thank my

large extended family of aunts, uncles, cousins, and in-laws

who in one way or another have been impactful in my life. I

affectionately thank the family at St. Augustine's Catholic

Student Center, and especially the 9:30, choir for being my

spiritual support.

In a special way, I honor my grandparents: Gregorio

Belardo, Vicenta O'Neill de Belardo, Natividad Monell de

Andersen, and Henry Andersen. Theirs are the shoulders upon

which I stand.

A ray of sunshine entered my life three years ago, my

son Andres Malcolm. He is acknowledged for his uncomplicated

way of experiencing life, which keeps me centered on the

truly important things. The newest addition to our family is

Camille Breana, whose pure beauty brightens every day.

Finally, all my love to my husband, my friend, Johnny R.









Caesar, for everything: love, support, understanding,

patience, encouragement, and taking care of Andres and

Camille. I would certainly not have been able to complete

this dissertation without him by my side.
















TABLE OF CONTENTS


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

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

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

CHAPTERS

1 INTRODUCTION ........................................... 1

Statement of the Problem ...............................1
Social Influence Theory ............................. 1
The Therapeutic Relationship ........................4
Purpose of the Study ................................... 7
Clients' Expectations About Counseling ..............8
Trust/Trustworthiness ............................... 9
Clients' Satisfaction with Counseling ..............10
Significance of the Study ............................. 10

2 LITERATURE REVIEW .................................... 13

Expectations About Counseling .........................13
Trust in Counseling................................... 22
Premature Termination ................................. 33
Satisfaction with Counseling ..........................40

3 METHODOLOGY ........................................... 46

Subjects .............................................. 46
Instruments .............................................47
Procedure ............................................. 51
Hypotheses .......... ...................................56

4 RESULTS ................................................59

Preliminary Analyses .................................. 61
The Repeated Measures Analysis of Variance with
Counselor Trustworthiness as the Dependent
Variable ......................................... 63
The Repeated Measures Analysis of Variance with
Counseling Evaluation as the Dependent
Variable ......................................... 65
Tests of the Hypotheses ............................... 66










5 DISCUSSION................. ................... ..... 109

Summary of the Results ................................109
Discussion of the Results ............................117
Limitations of the Study ..............................129
Suggestions for Future Research....................... 131
Conclusion ........................................... 135
Implications .................................... ...... 137

APPENDICES

A EXPECTATIONS ABOUT COUNSELING (BRIEF FORM) ...........139

B LIKERT TRUST SCALE .................................. 140

C COUNSELING EVALUATION INVENTORY .......................141

D CLIENT SATISFACTION QUESTIONNAIRE .................... 145

E COUNSELOR SUMMARY SHEET ............................... 147

F CLIENT SUMMARY SHEET ................................. 148

G COVER LETTER (FIRST ADMINISTRATION) .................. 150

H INFORMED CONSENT FORM ............................... 151

I MEMORANDUM TO/FROM COUNSELORS .........................154

J COVER LETTER (SECOND ADMINISTRATION) ................. 155

K REMINDER LETTER ............ .......... ............. 156

L COVER LETTER (THIRD ADMINISTRATION) .................. 157

REFERENCES .. ................. ............................ 159

BIOGRAPHICAL SKETCH ..................... .................. 169
















LIST OF TABLES


Table page

4-1 Simple Statistics for the Expectation Factors........ 70

4-2 Simple Statistics for the Trust Variables ............ 72

4-3 Pearson Correlation Coefficients Among the Expectation
Factors and the Counseling/Counselor
Satisfaction Measures ............................. 74

4-4 Multiple Regression for Counseling Evaluation at Time2
with the Expectation Factors at Time2 as
Predictors ........................................ 76

4-5 Multiple Regression for Counseling Evaluation at Time3
with the Expectation Factors at Time3 as
Predictors ........................................ 78

4-6 Pearson Correlation Coefficients Among the Trust
Variables and the Counseling/Counselor
Satisfaction Measures ............................. 81

4-7 Multiple Regression for Client Satisfaction at Time2
with the Trust Variables at Time2 as Predictors ... 83

4-8 Multiple Regression for Client Satisfaction at Time3
with the Trust Variables at Time3 as Predictors ... 84

4-9 Multiple Regression for Counseling Evaluation at Time2
with the Trust Variables at Time2 as Predictors ... 85

4-10 Multiple Regression for Counseling Evaluation at Time3
with the Trust Variables at Time3 as Predictors ... 87

4-11 A Comparison of the Differences Between the Counselors'
and Clients' Perspectives of the Clients'
Termination Status ................................ 90

4-12 Analysis of Variance for Client Satisfaction at Time2
Based on the Counselors' Perspectives of the
Clients' Termination Status ....................... 95


viii









4-13 Simple Statistics Comparing Mutual Terminators and
Dropouts on the Client Satisfaction and
Counseling Evaluation Measures .................... 95

4-14 Analysis of Variance for Client Satisfaction at Time3
Based on the Counselors' Perspectives of the
Clients' Termination Status ....................... 96

4-15 Analysis of Covariance for Counseling Evaluation at
Time3 Based on the Counselors' Perspectives of
the Clients' Termination Status ................... 98

4-16 Multiple Regression for Client Satisfaction at Time3
Using Predictors from Timel ....................... 100

4-17 Multiple Regression for Client Satisfaction at Time3
Using Predictors from Time2 ....................... 102

4-18 Multiple Regression for Counseling Evaluation at Time3
Using Predictors from Timel ....................... 104

4-19 Multiple Regression for Counseling Evaluation at Time3
Using Predictors from Time2 ....................... 105

4-20 Perceived Client Similarity Ratings to Counselors for
Mutual Terminators and Dropouts ................... 108
















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


CLIENTS' PERCEIVED TRUST, TRUSTWORTHINESS, AND EXPECTATIONS
IN THE THERAPEUTIC RELATIONSHIP: FACTORS IN
SATISFACTION WITH COUNSELING RECEIVED


By

Celia Andersen Caesar

August, 1996


Chairperson: Carolyn M. Tucker
Major Department: Psychology

This study examined clients' expectations about

counseling, and perceived trust/trustworthiness before

receiving counseling. Changes in these variables and in

clients' satisfaction with counseling/counselors over time in

counseling were investigated. Also investigated were

differences between mutual terminators and dropouts regarding

the variables of study. Clients' perceptions of similarity

to their counselors were examined relative to clients'

satisfaction in counseling.

Seventy-seven clients seeking counseling at two

university counseling centers were administered the

Expectations About Counseling-Brief Form and the Likert Trust

Scale before counseling. These questionnaires were

readministered after the clients' first and sixth/last









counseling sessions along with the Client Satisfaction

Questionnaire and Counseling Evaluation Inventory.

The first four hypotheses stated that clients'

expectations, and perceptions of trust/trustworthiness, would

increase over the three specified time periods. T-tests and

repeated measures analyses of variance and covariance

revealed no significant changes in these variables over time.

Correlations indicated that number of counseling sessions

attended was not significantly related to clients'

expectations, or perceptions of trust/trustworthiness.

Hypotheses five and six combined stated that clients'

expectations and perceptions of trust/trustworthiness would

be significantly associated with clients' satisfaction with

counseling. Multiple regressions indicated that neither of

these variables were significant predictors of clients'

satisfaction with counseling.

Hypothesis seven stated that compared to dropouts,

mutual terminators would evidence higher expectations,

perceptions of trust/trustworthiness, and satisfaction with

counseling. Multivariate and univariate analyses of variance

and covariance revealed no significant differences between

the two groups on their expectations or perceptions of

trust/trustworthiness. However, based on the counselors'

designations of the clients' termination status, mutual

terminators were more satisfied with counseling than

dropouts.









Hypothesis eight stated that compared with precounseling

expectations and perceptions of trust/trustworthiness,

expectations, trust, and satisfaction early in counseling

would be better predictors of satisfaction later in

counseling. Regressions indicated that expectations, trust,

and satisfaction early in counseling accounted for sixty-

seven percent of the total variance in clients' satisfaction

with their counselors later in counseling.

Lastly, hypothesis nine stated that there would be

significant positive associations between clients' perceived

similarity to their counselors, and clients' satisfaction

with their counseling/counselors. Correlations supported this

hypothesis. Considerations for future research are

discussed.















CHAPTER 1
INTRODUCTION


Statement of the Problem


The goal of counseling is to help people change (Heppner

& Claiborn, 1989). Questions as to how to facilitate this

change is at the heart of the work of counseling

practitioners. Some therapists believe that client change

occurs naturally as a result of the therapeutic relationship

itself. Others maintain that a good relationship is

important inasmuch as it allows the counselor to exert

influence and use certain techniques to bring about change in

the clients' attitudes and behaviors. Regardless of their

therapeutic style, practitioners and theoreticians "probably

all currently agree that the counselor client relationship is

important to the outcome of most or all therapeutic efforts"

(Gelso & Carter, 1985, p. 155).


Social Influence Theory


Social influence theory offers an explanation of the

change process in counseling. This theory suggests that

there are two stages involved in this change process. First,

the counselor needs to establish herself/himself as a useful

resource. Second, after this perception has been









established, the counselor has the leverage needed to

influence clients therapeutically. Social influence theory,

therefore, conceptualizes counseling as an interpersonal

influence process. This process is defined as the ability of

one person to influence the actions, attitudes, or feelings

of another.

The social influence theory grew out of the social

psychology literature. Writers, such as Levy (1963), and

Goldstein, Heller, and Sechrest (1966), advocated a

connection between social psychological and psychotherapeutic

research. However, it was Strong's (1968) article that

introduced social influence as a viable theory of the

counseling process, and spearheaded research in counseling

based on the social influence theory.

In addition to proposing a two-stage model of the

counseling process, social influence theory also delineates

specific counselor variables that contribute to the

counselor's power to influence change in counseling. These

variables are perceived counselor expertness, attractiveness

and trustworthiness. A substantial amount of research has

been conducted to determine the effect of a range of

counselor-related variables (e.g., objective evidence of the

counselor's training, counselor verbal and nonverbal

behaviors, counselor attire, and office decor) on clients'

perceptions of their counselors' expertness, attractiveness,

and trustworthiness. As a tribute to the proliferation of

research in this area, three reviews of the social influence









literature have been published; two at the end of only the

first decade of social influence research (Corrigan, Dell,

Lewis, & Schmidt, 1980; Heppner & Claiborn, 1989; Heppner &

Dixon, 1981).

Social influence, therefore, has emerged as a major

research area in the counseling psychology literature within

the last twenty years. However, Heppner and Claiborn (1989)

have articulated several criticisms of this research First,

these researchers asserted that of the 56 empirical

investigations reviewed about social influence by them, 45

(80%) continued to examine the effect of certain counselor

behaviors and cues on perceptions of counselor expertness,

attractiveness, and trustworthiness. These studies,

therefore, examined only the first stage of Strong's (1968)

model. Most of the research has tended to ignore the

influence process, Strong's (1968) second stage.

Second, Heppner and Claiborn (1989) also asserted that

not enough attention has been given to client individual

difference variables in the social influence process. The

social influence research has historically treated the client

as a passive recipient of information. Heppner and Claiborn,

(1989) recommended that the client be conceptualized as an

active processor of information within the influence process.

As such, client characteristics should become more prominent

variables in the change process.

Finally, a third major criticism of social influence

research raised by Heppner and Claiborn (1989) is that the









majority of research in this area has been based on analogue

studies. These researchers urged movement away from the

overuse of brief analogue methodologies. They see as

absolutely essential the need for the social influence

process to be examined in realistic counseling situations.

In order to determine the research variables that would

be important in extending the knowledge base of the influence

process in counseling, an examination of the therapeutic

relationship was undertaken. The client-counselor

relationship is the vehicle through which counselors have the

ability to exert influence in promoting client change.

Therefore, it seemed essential to consider the determinants

of the therapeutic relationship.


The Therapeutic Relationship


It was from the client-centered therapy tradition that

much of the research about the therapeutic relationship

emanated. The late 1960s and early 1970s saw an abundance of

research and theory stemming from client-centered therapy.

The focus of this research was on the facilitative conditions

as being both necessary and sufficient for positive

counseling outcomes. However, more recently, research in

this area has diminished. Gelso and Carter (1985) suggested

that there is a natural cycle in the life of scientific

paradigms and that research on the facilitative conditions

has obtained its natural limit. Furthermore, Gelso and

Carter (1985) proposed that "what is now needed is a new









paradigm, a new way of thinking about the relationship in

counseling and psychotherapy" (p. 157). Consistent with the

idea of a new paradigm, an effort was made to empirically

define the therapeutic relationship.

It was Greenson (1967) who first suggested that the

therapeutic relationship could be divided into three

components: 1) the working alliance, 2) the transference

relationship, and 3) the real relationship. His work had a

major impact on analysis and analytic therapy. However, it

was Gelso and Carter (1985) who proposed that these three

components are not specific to psychoanalysis, but rather

exist in all therapeutic relationships. Moreover, the

theoretical perspectives and practices of the therapist

determines the importance a given component plays in therapy.

The working alliance is defined as the "alignment that

occurs between counselor and client...(based on) an emotional

bond between the participants, an agreement about the goals

of counseling, and agreement about the tasks of the work"

(Gelso & Carter, 1985). In order for a strong positive

working alliance to be formed, the client must have the

capacity to trust. As an essential part of the therapeutic

relationship, trust must be established between counselor and

client before any therapeutic changes can occur.

Furthermore, trust needs to develop early in the relationship

otherwise clients may terminate counseling prematurely or

remain resistant, sharing only superficial issues with the

counselor (Fong & Cox, 1983).









The transference relationship, also defined as the

"unreal" relationship, is a core construct in psychoanalytic

theory and as such was originally defined in terms of Oedipal

issues. However, as counseling psychologists began to

explore the potential value of this construct, it became

evident that a redefinition was needed. Consequently, Gelso

and Carter (1985) proposed the following definition: "a

repetition of past conflicts (usually but not always

beginning in early childhood) with significant others such

that feelings, behaviors, and attitudes belonging rightfully

in those early relationships are displaced; in therapy, the

displacement is onto the therapist." These misperceptions or

misinterpretations of the therapist may be positive or

negative and are only a part of the total relationship.

Gelso and Carter (1985) further suggest, that transference

occurs from the moment of first contact with the helping

person, and often even prior to that, in terms of

anticipations about the intervention and the helping person.

They label this type of transference as preformed

transferences or transference "expectancies" (Gelso & Carter,

1985). It would appear, therefore, that as clients come in

to counseling, they already have preformed ideas about their

counselor and the counseling process. Regardless, of where

these ideas find their origin or whether or not they are

within the client's conscious awareness, they greatly impact

on the therapeutic relationship.









Whereas transference is a core issue in psychoanalysis,

the real relationship is at the heart of humanistic

therapies. Unlike the transference relationship, the real

relationship consists of the counseling participants'

realistic perceptions of and reactions to each other. From

the moment of their first encounter, both parties actively

contribute to the real relationship. It exists alongside and

enmeshed with the transference relationship and is a part of

all therapies. The expectations counselors and clients have

for the real relationship regarding their respective roles

are crucial to successful therapy. If these expectations are

too discrepant, progress in therapy may be jeopardized and

the client may terminate therapy prematurely (Gelso & Carter,

1985).


Purpose of the Study


The purpose of this study, therefore, was to contribute

needed information to social influence theory with regard to

the change process in counseling. A review of the social

influence theory research suggested areas in need of further

investigation. Presented', is an examination of the basic

components of the therapeutic relationship, including

variables that impact the formation of a good client-

counselor relationship. These variables are clients'

expectations about counseling, perceptions of

trust/trustworthiness, and satisfaction with counseling.









Clients' Expectations About Counseling


It has been noted that clients' expectations of the

counseling process and of their counselor both impact on all

three components of the therapeutic relationship: the

working alliance, the transference relationship, and the real

relationship. These client expectations influence the

transference relationship, which as mentioned, exists prior

to and in anticipation of therapy. In turn, the transference

relationship impacts on the working alliance. In addition,

Gelso and Carter (1985) suggested that the working alliance

is the most basic of the components since it contains the

essential reasons for individuals to seek therapy to begin

with, namely their expectations to receive help. The real

relationship is also influenced by expectations in that these

expectations define the roles that the counselor and client

will play in the therapeutic relationship.

The interpersonal influence literature has a dearth of

research investigating the effect of client characteristics

on the interpersonal influence process. Clients'

expectations about counseling is one client variable that has

received substantial attention in the counseling literature

and it has recently found its way into the social influence

literature (Heppner & Heesacker, 1983). Not only is client

expectations an important client variable to be considered in

social influence research, in addition, Heppner and Heesacker

(1983) suggest that research investigate the predictive







9

utility of clients' expectations about counseling on clients'

satisfaction with counseling received (a potential measure of

counselor influence).


Trust/Trustworthiness


Of crucial importance to the working alliance and the

real relationship is the client's ability to trust and their

perception of the counselor as trustworthy. Although

psychoanalytic theory does not place much emphasis on the

working alliance or the real relationship, it is evident that

in all therapies it is essential for clients to believe that

their counselor will not mislead or injure them in any way.

The inability to form a trusting relationship impedes the

progress of therapy since it is doubtful that a working

alliance and a positive real relationship would be

established.

Trustworthiness has been the least frequently examined

variable in the social influence research. This lack of

research on trustworthiness as a component of the influence

process has been criticized as a weakness in the research

literature (Fong & Cox, 1983). Moreover, the research that

has been conducted has focused on trustworthiness as a

counselor characteristic. Social influence research has not

considered trust as a client variable although, as noted in

the therapeutic relationship literature, a client's ability

to trust is crucial in forming a working alliance with

his/her therapist.










Clients' Satisfaction with Counseling


Finally, clients' satisfaction with the counseling

process in early sessions has been shown to be one of the

best predictors of later satisfaction and other outcome

measures (Gomes-Schwartz, 1978). This finding suggests that

client satisfaction with counseling is a key ingredient in

the change process in psychotherapy. Specifically, it

impacts on the quality of the real relationship and is

essential in forging a strong working alliance.

In social influence research, client satisfaction with

counseling has been considered a measure of counselor

influence. Heppner and Claiborn (1989) indicated that

although satisfaction is a global and ambiguous variable, it

is certainly an important outcome, especially from a consumer

advocacy position.

A final important consideration in counseling research

is the applicability of research findings to a wide variety

of clients. Many research studies are limited in that their

findings are specific to the clients who are able to complete

the study. Therefore it is usually not known how dropouts

perceived their counselor or how satisfied they were with

counseling.


Significance of the Study


The current study sought to be a contribution to social

influence theory research. As mentioned before, the majority








11

of previous research in this area has been based on analogue

studies. There is a paucity of real-life counseling studies

investigating the importance of clients' expectations,

clients' trust levels, and clients' satisfaction with

counseling as important variables in the interpersonal

influence process. Therefore, the current research focused

on the importance of these client variables and their impact

on the influence process within a real-life counseling

situation.

More specifically, this study investigated:

1) the relationship among clients' satisfaction with

counseling, expectations about counseling, and perceived

trust/trustworthiness with the clients' decisions to stay in

counseling or to drop out;

2) whether expectations about counseling and perceived

trust/trustworthiness levels change over time and if so,

whether these changes are related to clients' satisfaction

with counseling; and

3) whether expectations about counseling, perceived

trust/trustworthiness, and clients' satisfaction with initial

counseling sessions predict clients' satisfaction with

counseling during later sessions and/or at termination.

It was proposed that the findings from this study would

provide:

1) an impetus for counseling centers to assess their

success at meeting the needs of their clients by obtaining an








12

estimate of the clients' levels of satisfaction with the

services they receive; and

2) information that might stimulate strategies for

increasing the retention of clients in counseling.

Especially for novice clients, it may be important for

counselors to discuss the client's expectations for

counseling, especially the roles of the counselor and the

client, and to intermittently check with the client as to

their satisfaction with the progress of counseling.
















CHAPTER 2
LITERATURE REVIEW



This chapter focused on the relevant literature

pertaining to the research variables that were investigated

in this study. These variables were clients' expectations

about counseling, clients' perceptions of their own and their

counselors' trust/trustworthiness, clients' premature

termination from counseling, and clients' satisfaction with

counseling.


Expectations About Counseling


Clients' expectations about counseling has been an area

of great research interest in the field of counseling

psychology over the past ten years. It has been well

established that clients come to counseling with certain

expectations about what counseling will be like and what

roles they and their counselors will assume (Bordin, 1955;

Patterson, 1958; Rosenthal & Frank, 1956; Strong, 1968;

Tinsley & Harris, 1976). Furthermore, there has been support

for the argument that clients' expectations may either

facilitate or hinder the effectiveness of the counseling

process (Apfelbaum, 1958; Frank, 1968; Goldstein, 1962;

Goldstein, Heller, & Sechrest, 1966).









In 1979, Duckro, Beal, and George noted the failure of

many researchers to distinguish between expectations about

counseling and preferences for counseling. This lack of

distinction has caused many inconsistencies in the

literature. Tinsley, Bowman, and Ray (1988) later reaffirmed

this problem and noted that an additional confound in the

expectancy literature is the use of clients' perceptions of

counseling. In response to this issue Tinsley, et al. (1988)

suggested that the full range of client expectancies be

identified and that a reliable and valid measure of those

expectancies be developed. Tinsley, Workman and Kass (1980)

developed the Expectations About Counseling Questionnaire

(EAC) to address this need. Although this questionnaire has

not been published, it has been used in several studies

(e.g., Craig & Hennessy, 1989; Hardin, Subich, & Holvey,

1988; Heppner & Heesacker, 1983;) and has been shown to

measure constructs unique from those measured by perception

instruments (Hayes and Tinsley, 1989).

Much of the research on expectations about counseling

has focused on the demographic characteristics of

respondents. For example, studies have shown that women

expect that their counselors will be confrontational,

genuine, nurturing, tolerant, trustworthy (Subich, 1983), and

attractive, and expect that they themselves will be more

responsible and self-motivated in counseling than men (Hardin

& Yanico, 1983). However, men expect counselors to be

directive, critical, analytical (Tinsley & Harris, 1976), and










self-disclosing (Subich, 1983). Tinsley and Harris (1976)

found that the longer students remained in college, the less

they anticipated a counselor to be accepting, and an expert.

Richmond (1984) found that compared to clients, nonclients

had significantly higher expectations that counselors would

be genuine, attractive, and trustworthy.

With respect to the influence of cultural factors on

clients' expectations, Yuen and Tinsley (1981) found that

international students expected their counselor to be more

concrete, directive, empathic, nurturant, and expert than did

American students. American students reported a higher

expectancy than international students to take action and to

admit responsibility for counseling progress. Consistent

with this finding, Hector and Fray (1987) also reported that

Asian clients expected their counselor to be directive and

nurturing. Hispanic clients preferred their counselors to be

active and directive. In addition, the client's attitude

about the counselor and not the counselor's ethnic background

was the Hispanic client's most important consideration.

American Indians expected to discuss more school-related

concerns and had a strong preference for Native American

counselors. Compared to American students, African students

studying in the USA expected counselors to be more directive

and nurturing.

In a study by Proctor and Rosen (1981), clients with

definite preferences preferred counselors of their own race.

However, both White clients and Black clients expected their









counselor to be White. Although Blacks had a strong

preference for a counselor of the same race, failure to meet

this preference was not significantly related to premature

termination. In addition, neither groups' satisfaction with

counseling was significantly related to their expectation or

preference with regard to the counselor's race. However,

this study used only White counselors and it cannot be

determined if Blacks fared as well with a White counselor as

they would have with a Black counselor.

Recent studies have focused more on core personality,

attitudinal, and cognitive attributes. For instance Craig

and Hennessy (1989) used the Conceptual Systems Theory (CST)

as "a framework from which to assess the degree to which a

stable, preexisting personality dimension can explain the

variance in precounseling expectations (p. 402)." Conceptual

systems are defined as the predispositions that persons use

to construe and interpret perceptions. The CST holds that

there are four discrete stages of conceptual development.

Eleven subscales of the Expectations About Counseling

Questionnaire (EAC; Tinsley et al., 1980) were subjected to a

discriminant function analysis.

The two significant discriminant functions that

distinguished the four conceptual stages concerned

expectations that clients had about counselor

characteristics, attitudes and behaviors. More simply

stated, compared to each other, individuals in different

stages of conceptual development had different expectations







17

about counselor empathy, directiveness, attractiveness (first

function) and counselor self-disclosure, genuineness, and

nurturance (second function). Craig and Hennessy (1989)

suggested that the degree to which these expectations are

confirmed or refuted can have an impact on the initial

progress of counseling, and the counseling outcome.

A study by Tinsley, Hinson, Holt, and Tinsley (1990)

investigated the relation between students' levels of

psychosocial development and their expectations about

counseling. Results showed that students with more

appropriate educational plans, more mature career plans and

more mature lifestyle plans had more positive expectations

for counseling. The authors suggested that working with less

mature college students, counselors may need to focus early

in the counseling process on helping the students develop a

sense of personal responsibility for the success of

counseling.

Karzmark, Greenfield, and Cross (1983) investigated the

relationship between clients' levels of adjustment and

expectations for therapy. Subjects were 110 new clients at a

university counseling center. Clients estimated their level

of adjustment by completing a questionnaire consisting of 25

items selected from the SCL-90 symptom checklist (Derogatis,

Lepman, & Covi, 1973. Therapists assessed clients'

adjustment at the end of the intake session using the Global

Assessment Scale (GAS; Endicott, Spitzer, Fleiss, & Cohen,

1976). In addition, clients' expectations were assessed by a








18

5-item, factor analytically derived scale. Clients assessed

therapy outcome by completing the Client Satisfaction

Questionnaire (CSQ; Larsen, Attkisson, Hargreaves, & Nguyen,

1979), and therapists evaluated therapy outcome by

reassessing clients with the GAS at termination.

Therapists' assessments of the clients' adjustment with

the GAS were used to predict clients' expectations. The

regression performed revealed a significant but small

positive linear relationship. Clients' own evaluations of

adjustment were not significant predictors of clients'

expectations. Clients' expectations for counseling also bore

a small but significant positive linear relationship to their

satisfaction. Clients' expectations were not related to

therapists' ratings of outcome.

A study by Heppner and Heesacker (1983) examined client

satisfaction in relation to clients' expectations about

counseling and their perception of counselor characteristics.

Seventy-two clients at a university counseling center

completed the study. Clients' perceptions of their

counselors expertness, attractiveness and trustworthiness

were obtained by the Counselor Rating Form (CRF; Barak &

Lacrosse, 1975). Forty-five items, constituting six scales

of the EAC were used to measure clients' expectations of

their own openness and motivation in counseling, and their

expectations of their counselor's acceptance, expertness,

attractiveness, and trustworthiness. Clients' satisfaction

with counseling was measured by the Counseling Evaluation










Inventory (CEI; Linden, Stone, & Shertzer, 1965). Clients

completed the EAC before their initial session and completed

the CRF and CEI two weeks before the end of the semester.

Results indicated that in general, the clients perceived

their counselors as being expert, attractive, and

trustworthy. In addition, clients rated their satisfaction

positively. Clients' perceptions of their counselors'

expertness, attractiveness and trustworthiness were

significantly correlated to clients' satisfaction with

counseling. Moreover, clients' expectations of their

openness and counselors' trustworthiness were also

significantly correlated with clients' satisfaction and

perceived counselor attractiveness, expertness and

trustworthiness. Regression analyses indicated that the CRF

variables were the best predictor of client satisfaction.

However, the EAC variables (acceptance, openness, motivation,

trustworthiness, attractiveness, expertness) did not

significantly predict client satisfaction nor counselor

expertness, attractiveness and trustworthiness (CRF).

These findings suggest that specific precounseling

client expectations were not predictive of client

satisfaction or perceived counselor characteristics after

counseling. One reason for this finding may be that before

entering counseling, clients have little knowledge of what to

expect from counseling, therefore specific clients'

expectations of counseling are based on minimal information,

or are not well founded. As they experience counseling their










expectations may change. These later expectations may be

more reflective of actual therapy experience and thus be more

predictive of client satisfaction than expectations prior to

counseling (Heppner & Heesacker, 1983).

The authors suggested that additional research be

conducted to examine how and to what extent client

expectations change over the course of counseling. In

addition, subjects who terminated prematurely from the study

did not differ on initial EAC scores from subjects who

remained. However, it is unknown how these individuals

perceived their counselor or how satisfied they were with

their counseling. Again the authors suggested that research

in this area would extend the present findings by examining

premature terminators.

Tinsley et al. (1980) conducted a study that factor

analyzed client expectancies as measured by the EAC. The

factors obtained were Personal Commitment, Facilitative

Conditions, Counselor Expertise and Nurturance. The authors

believe that moderately high scores on these factors may be

more desirable than extremely high scores. Extremely high

scores on the Personal Commitment factor may indicate

compulsive, perfectionistic tendencies on the part of the

client, whereas low scores may characterize naive clients who

expect the counselor to cure them without any effort on their

part. Extremely high scores on the Facilitative Conditions

factor may indicate that the client expects the counselor to

act in some idealistic but unobtainable manner, whereas low








21

scores may indicate a defensive, guarded client who may avoid

any revelation of affect. High scores on the Counselor

Expertise factor may be indicative of magical thinking by

clients, whereas low scores may indicate fatalism or

pessimism regarding the counselor's ability to really help

the client. On the Nurturance factor, extremely high scores

may represent a desire to escape to a warm pain-free

environment and low scores may represent a client's

difficulty in believing that the counselor or anyone else

could actually care for him or her.

In summary, the expectation literature has contributed

valuable information directly related to the process and

outcome of counseling. Research has addressed demographic

variables relative to client expectations for counseling and

have proceeded to examine more core personality factors.

Researchers have suggested that there needs to be a clear

delineation between counseling expectations, and perceptions

and preferences in order to avoid ambiguities and

inconsistencies in the literature. In addition, Hayes and

Tinsley (1989) encourage the use of the EAC as a prognostic

indicator, as a measure of client resources and attitudes

that are brought into counseling, and as an indicator of

whether education about what to expect during counseling may

be necessary before therapy is initiated.

Tinsley et al., (1988) suggested that from expectancy

research should come an understanding of the conditions under

which expectancy change might be thought to have beneficial







22

results. Fellows (1985) proposed that measuring differences

in expectations across time may offer a useful method for

studying changes in expectations. Finally, a follow up study

by Tinsley and Benton (1978) to the Tinsley and Harris (1976)

study confirmed that many potential clients may never seek

counseling because of their low expectation that they will be

helped.

An implication of these studies is that counselors need

to explore clients' expectations for counseling. Torey

(1972) believes that Western psychotherapists can learn a

great deal from African witch doctors. He found that witch

doctors typically consider the expectations of their clients

and that these expectations are critical to the success of

the treatment. Richmond (1984) suggests that the initial

counseling relationship should reflect the needs of clients

in response to expectations and that clients with lower

expectations may require additional relationship-building

interactions to move effectively toward change.


Trust in Counseling


The major focus of research on trust has been the

client's perception of the counselor as a trustworthy person.

The interpersonal influence research has contributed much

information in this area. However, there has been very

little research related to clients' ability to trust as a

personality variable. Work in this area has predominantly

investigated demographic differences and differences between









high and low trusters. In relation to race, Terrell in

conjunction with other associates has contributed much needed

information relative to Blacks' mistrust of Whites, including

the development of a scale to measure cultural mistrust

(Terrell, & Terrell, 1981).

It has been well established that the development of

trust is crucial to the effectiveness of counseling (Fong &

Cox, 1983; Johnson & Noonan, 1972; Rogers, 1951; Williams,

1974). Corazzini (1977) describes trust as including several

concepts: expectancy, reliance upon others, faith,

surrendering of control, consistency, mutuality, and utility

for risk. Rotter (1971) defines trust as "an expectancy by

an individual or a group that the word, promise, verbal, or

written statement of another individual or group can be

relied on" (p. 444). In counseling, Fong and Cox (1983) note

that "trust is the client's perception and belief that the

counselor will not mislead or injure the client in any

way"...(and) "is one of the crucial issues in the first stage

of counseling" (p. 163).

A study by Lagace and Gassenheimer (1989) using the

MacDonald, Kessel, and Fuller Self-report Trust Scale (1972)

showed that there were no differences between men and women

on trust. However, differences were found on the Suspicion

scale, with men scoring as more suspicious.

Rotter has been influential in the area of interpersonal

trust with the development of his Interpersonal Trust Scale

(1967). Some demographic data obtained with this instrument









indicated that youngest children were less trusting than

only, oldest, or middle children. Also college students

identifying themselves as atheists or agnostics were

significantly less trusting than others. Students who

perceived their parents as believing in two different

religions were less trusting than those who perceived both

parents as believing in the same religion or lack of religion

(Rotter, 1967).

In addition, a study by Terrell and Barrett (1979)

investigating the differences in interpersonal trust between

lower and upper socioeconomic classes, men and women, and

blacks and whites found that males were more trusting than

females, higher socioeconomic group members were more

trusting than lower ones, and White students were more

trusting than Black students. In relation to gender

differences, a contrasting finding was reported in a study by

Kaplan (1973) in which factors were derived for Rotter's

Trust Scale (1967). Males demonstrated significantly less

trust than females on each of the trust factor dimensions.

Grace and Schill (1986) investigated the differences in

social support and coping styles of subjects high and low in

interpersonal trust. Students in an introductory psychology

class were administered instruments measuring their level of

interpersonal trust, social support during the past month,

perception of social support from friends and family, and

coping style. Results showed that subjects high in trust

viewed both friends and family as more supportive than










subjects low in trust. Subjects high in trust reported

seeking more social support when feeling stressed, and

displayed less dysfunctional behavior than subjects low in

trust. Subjects low in trust became dysfunctional under

stress. The authors concluded that "a pervasive expectancy

that people cannot be trusted very likely negatively colors

the interpretation of reassurance and assistance, and results

in a perception of people as basically unsupportive" (p.

585).

Williams (1974) conducted a study in which Black college

students attended five 60-minute counseling sessions with

either a white male professional counselor, or a black male

or female peer counselor. Subjects completed questionnaires

related to their level of interpersonal trust and self-

disclosure before and after counseling. Subjects'

precounseling data on the self-disclosure and trust

questionnaires were used as a selection criteria to

participate in the study.

Although there were no significant differences between

the two groups on trust and self-disclosure after counseling,

mean differences showed that students established higher

levels of self-disclosure with the peer counselors (I =

133.89; SD = 23.09) than with the professional counselors (M

= 122.67; SD = 23.10) after counseling. This finding was not

obtained with regards to trust (peer group: I = 18.22; SD =

2.35; professional group: M = 19.67; SD = 4.55). In

addition, differences between the professional counselors and








26

peer counselors were not significant. Moreover, both groups

established significantly higher levels of self-disclosure

and trust after counseling treatment.

These findings suggest that the belief that White

professional counselors are less effective than peer

facilitators in promoting self-disclosure and trust in Black

clients is questionable. In addition, Black trained peer

counselors can be effective facilitators of self-disclosure

and trust among Black clients.

In a study by Wright (1975), 65 White and 35 Black male

students were pretested on the Interpersonal Trust Scale and

designated as either high trusters or low trusters based on

one standard deviation above or below the mean of this base

population. Means and standard deviations for the two racial

groups were as follows: Black students M = 61.67, SD =

9.11; White students M = 68.5, SD = 9.69. From the 100

students tested, 24 were chosen as clients; six high trusters

and six low trusters for each race. These students were then

administered the Barrett-Lennard Relationship Inventory

(Barrett-Lennard, 1962) prior to their first counseling

session and at the end of the fifth counseling session. The

counselors were two White, and one Black male with advanced

degrees in counseling, and one Black male psychology

practicum student.

Results from the pretest indicated that Black high

trusters believed that Black counselors would significantly

show a higher level of regard 1 (affection, liking), regard 2









(respect, appreciation, valuation), congruence 1 (freedom

from threat and anxiety), unconditionality 1 (uncritical

acceptance), unconditionality 2 (degree of agreement between

persons in the relationship), empathy 1 (degree of

recognition of another's perceptions or feelings that are

directly communicated), and empathy 2 (ability to place the

immediate experiencing of another in the context of the

objects or persons who produce that experience), than White

counselors. Black low trusters also expected Black

counselors to significantly express higher levels of regard

2, congruence 1, and empathy 1 in the counseling relationship

than White counselors. White high and low trusters did not

have significantly different expectations of the counselors

of the two racial groups prior to counseling.

The pre- and post-ratings of both ethnic groups were

compared to determine if changes in students' perceptions

occurred over time after counseling. There was a significant

difference in counselor race in the congruence 2 (degree of

what is felt and experienced) and unconditionality 3 (degree

of variability in one's affective response to another). Both

races perceived White counselors as communicating a higher

degree of what is expressed in the counseling relationship

than Black counselors. In addition, scores showed a reverse

mean pattern for regard 1 between the races. White

counselors had a higher degree of liking and affection for

Black clients than White clients, and Black counselors

communicated a higher degree of liking and affection for









White clients than Black clients. Empathy 3 (ability to

adopt another's frame of reference) was highly significant

for student race, counselor race, and trust level. High

trusters of both races believed that counselors of both races

could adopt another's frame of reference. Low trusters of

both racial groups perceived White counselors as incapable of

adopting another person's frame of reference. White low

trusters also felt the Black counselors could not adopt

another's frame of reference. However, Black low trusters

believed that Black counselors could adopt another person's

frame of reference.

Results of this study indicate that Black clients and

White clients enter the counseling relationship with

preconceived feelings about the opposite race. Moreover, if

therapy focuses on the here-and now, race does not inhibit

counselors from respecting, uncritically accepting, and

recognizing the perceptions or feelings of a different race.

This is exemplified by the finding that regardless of

counselor race, clients of the opposite race experienced a

change in perceptions (negative to positive), relative to the

counselors ability to show affection and liking, after

counseling. A concern with this study is the question of

whether or not counselors were blind to the purpose of the

study. The author stated that "prior to counseling, the

counselors received the necessary details of the project" (p.

163). The extent of these details was not described.









In an analogue study by Watkins and Terrell (1988),

Black students mistrust level and counseling expectations

were investigated in relation to Black client-White counselor

relationships. In addition to a demographic data

questionnaire, students were administered the Cultural

Mistrust Inventory (CMI; Terrell & Terrell, 1981), indicating

the degree to which they distrust Whites, and the

Expectations About Counseling Questionnaire (EAC; Tinsley et

al., 1980) which was modified for this study. The word

"black" or "white" was placed before counselor in the

instructions that the experimental groups received. Subjects

mistrust levels were considered high or low based on a median

split.

Results indicated that compared to less mistrustful

Blacks, highly mistrustful Blacks expected less from

counseling, regardless of the race of the counselor.

Specifically, highly mistrustful subjects viewed the

counselor as less attractive and expected a diminished focus

on the immediate therapy relationship than less mistrustful

subjects. Moreover, highly mistrustful subjects assigned to

a White counselor expected their counselor to be less

genuine, self-disclosive, accepting, trustworthy, and expert,

and expected counseling to be less successful than if they

were assigned to a Black counselor.

In a follow-up study, Watkins, Terrell, Miller, and

Terrell (1989) once again examined cultural mistrust in

relation to Black client-White counselor relationships. In









this study, instead of the EAC, subjects completed the

Counselor Effectiveness Rating Scale (CERS; Atkinson &

Wampold, 1982) which measures counselor credibility.

Additionally, clients completed the Personal Problem

Inventory (PPI; Schneider, 1985), a 20-item personal problem

list. Subjects rated each problem area in relation to their

perceived confidence in the counselor's ability to help them

with it. A one item measure of clients' willingness to see

the counselor was also used. Responses were made on a 6-

point Likert scale ranging from very unwilling (1) to very

willing (6). Two manipulation checks were employed; one

indicated the degree to which the subjects could identify

with the client role and the other indicated the subjects'

ability to identify the race of the counselor he/she read

about in the experimental manipulations. The counselor

description was identical across experimental groups with the

exception of the words "black" and "white" being placed

alternatingly in front of the word counselor.

Results indicated that highly mistrustful Blacks tended

to view the counselor as less credible when the counselor was

White. In addition, highly mistrustful Blacks viewed the

counselor as less able to help them deal with sexual

functioning concerns, regardless of the counselor's race.

Moreover, Blacks who were highly mistrustful of Whites viewed

the White counselor as being less able to help them deal with

general anxiety, shyness, dating difficulties, and feelings

of inferiority than a Black counselor.









This study and the previous one described, emphasized

the need for counselors to be sensitive to the mistrust issue

and its influence on the Black client-White counselor

relationship. Watkins, et al., (1989) identified specific

ways in which mistrust levels impact Blacks' expectations of

White counselors. The authors have suggested that

sensitivity to the mistrust issues in conjunction with the

specific problem areas identified would be valuable

counseling information for counselors to be aware of. In

addition, future research would need to use actual clients

and assess the effects of mistrust on counseling over time to

address the limitations of the two studies.

Finally, a study by Thompson, Neville, Weathers, Poston,

and Atkinson (1990) investigated cultural mistrust and racism

reactions among African-American students. Eighty-seven

African-American and 70 Euro-American college students took

part in the study. They completed an instrument consisting

of a demographic section, the Racism Reaction Scale and the

Interpersonal Relations, and Education and Training subscales

of the Cultural Mistrust Inventory (CMI; Terrell & Terrell,

1981). The Racism Reaction Scale (RRS) consists of 19 items

that were racism reaction statements by African-American

students and 19 additional items from the California

Psychological Inventory, used as filler items. Students were

categorized as high or low on the CMI using a median-split

method.










This study found that the African-American college

students felt that they were singled out for differential and

inferior treatment more so than their Euro-American

counterparts. The feeling was strongest among highly

mistrustful African-Americans. Although items on the RRS

reflecting generalized reaction to the environment revealed

no significant differences between the two racial groups,

African-American students reported higher means on more

situational/classroom-related items than Euro-Americans.

Moreover, the item on the RRS with the greatest difference in

ratings by African-American respondents and Euro-American

respondents was "I have to be prepared to deal with a

threatening environment."

These findings indicate that counselors need to become

more aware of racism reactions and be capable of

distinguishing these types of statements from statements

reflecting paranoia. In addition, some African-American

students seeking counseling for issues related to racism

reactions may be distrustful of any Euro-American counselor

and may, at least initially, express a preference for an

African-American counselor. Furthermore, the fact that the

staffs of most counseling centers are predominantly or

entirely White (Ponterotto, Anderson, & Greiger, 1986)

underscores the need for counselors to be sensitive to

African-American students' concerns about racism and their

possible reactions to seeing a White counselor. Lack of

sensitivity to these issues, and the application of a "White-










American student standard" to self-disclosures by African-

American students, that may actually be reactions to racism,

may frustrate African-American students in counseling and

further reinforce their feelings of alienation from the

university in general and campus counseling services in

particular (Thompson, et al., 1990)


Premature Termination


Premature termination poses a major obstacle to the

delivery of counseling services. As many as 20% to 25% of

college counseling center clients "no-show" for their first

appointment (Epperson, Bushway, & Warman, 1983) and

approximately 30% to 60% of all outpatient psychotherapy

clients drop out of treatment prematurely (Pekarik, 1983).

Premature termination, in its broadest sense, refers to

clients leaving treatment before their counselors believe

they should. This may be immediately after intake or after

the client has met with his or her counselor for one or more

sessions.

For those individuals who do not show for their first

appointment, the problem may be that of having to wait for a

counselor to pick up the individual as a client. Cochran and

Stamler (1989) suggest that demographic or administrative

variables, such as the client's dissatisfaction with the sex

of the intake counselor, length of the intake interview,

number of days from intake to case assignment, or the

experience level of the assigned counselor, could be more










salient factors in the client's decision to not return after

the intake. Archer (1984) suggests that reciprocal referrals

to other agencies, augmenting services with paraprofessionals

and prepackaged counseling programs and using groups and

workshops in lieu of individual counseling could be used to

reduce waiting lists. For individuals who terminate after

one or more counseling sessions, factors related to the

counseling process might play a more significant role in

nonmutual terminations (Cochran & Stamler, 1989)

Premature termination is typically viewed as a negative

treatment outcome. However several authors have questioned

this belief noting that premature termination does not always

reflect a negative outcome from the client's perspective

(Cochran & Stamler, 1989; Gunzberger, Henggeler, & Watson,

1985; Kokotovic & Tracey, 1987). Clients may feel that their

problem has been solved, their symptoms have been

substantially reduced or they have developed adequate support

systems outside the counseling setting (Mennicke, Lent, &

Burgoyne, 1988).

Although there has been very little research

investigating the welfare of dropouts, one study showed that

for a sample of clients failing to show for their first

appointment after receiving an intake interview and being

placed on a waiting list, only 29% reported having resolved

their presenting problem and 50% had sought help elsewhere

(Christensen, Birk, & Sedlacek, 1977). To the extent that

premature termination does not represent a positive treatment










outcome, it is a viable concern in process and outcome

research. Mennicke et al. (1988) suggest that much

counseling research is being conducted with a biased sample,

because treatment dropouts are often not considered.

In a study investigating differences between mutual and

nonmutual terminators in a university counseling center

(Cochran & Stamler, 1989) clients were mailed a questionnaire

seeking information on the client's satisfaction with

counseling and reasons for terminating counseling. Only

clients who had returned for at least one counseling session

after the intake interview were included in the study.

Clients who terminated counseling prematurely were

significantly less satisfied with the counseling experience

than clients who had planned a termination with their

counselors. In addition, proportionately more mutual

terminators endorsed having met their goals for counseling,

and proportionately more nonmutual terminators did not think

their counselors had the skills to help them. Moreover, none

of the 24 nonmutual terminators had sought help elsewhere and

only 4 (16%) felt that their situation had improved on its

own.

Cochran and Stamler's (1989) study is consistent with a

previous study by McNeill, May, and Lee (1987) that

investigated perceptions of counselor source characteristics

by premature and successful terminators. Fifty-six premature

terminators and 148 successful terminators completed a 2-page

evaluation form including the Client Satisfaction










Questionnaire (CSQ; Larsen et al., 1979), the Counselor

Rating Form (CRF-S; Corrigan & Schmidt, 1983) and a number of

miscellaneous and open-ended items for assessing client

satisfaction with various aspects of the counseling center's

services. Students were given the option of signing the

completed evaluation forms. Premature terminators defined as

clients who initiated their own terminations of counseling

without the knowledge or against the advice of the assigned

counselor, attended an average of 3.04 sessions (range = 0 -

17; mode = 2.0). Successful terminators, defined as clients

who attended three or more sessions and terminated by mutual

agreement with their counselor, attended an average of 7.38

sessions (range = 1-16; mode = 10.0).

The university counseling center clients who terminated

prematurely were significantly less satisfied with counseling

services that they received. In addition, premature

terminators viewed their counselors as significantly less

expert, attractive and trustworthy than did clients who

terminated successfully. However, premature terminators who

continued longer in counseling expressed more satisfaction

regardless of the perceived expertness, attractiveness, and

trustworthiness of their counselors. Subjects who did not

sign their evaluation form viewed their counselors as

significantly less attractive and trustworthy and expressed

less satisfaction with services than those who chose to sign

their forms.










These two studies are at variance with a study by

Gunzberger et al. (1985) which studied factors related to

premature termination of counseling relationships.

Gunzberger, et al. found no differences in client-reported

counseling outcome between clients who mutually terminated

with their counselors and clients who initiated their own

termination, contacted four weeks after termination. The

difference between this study and the two previous studies,

however, is that Gunzberger, et al. used a telephone

interview as opposed to anonymous questionnaires to gather

client information. This procedure may have been more

intrusive and thereby render the findings as less valid. It

has been found that anonymity reduces the high ceiling

effects present in reports of client satisfaction or

evaluation (McNeill, et al., 1987; Soelling & Newell, 1984).

Terrell and Terrell (1984) studied premature termination

as a function of counselor race, client sex, and cultural

mistrust level. One hundred and thirty-five black clients at

a community mental health center completed the Cultural

Mistrust Inventory (CMI; Terrell & Terrell, 1981) before

counseling. Clients were then randomly assigned to either a

Black or White counselor for an intake interview and

continued counseling. Premature terminators were defined as

individuals not returning for the second or any subsequent

counseling sessions.

Results showed that of the 68 clients seen by a Black

counselor, 17 (25%) did not return for a second session. Of










the 67 clients seen by a White counselor, 29 (43%) did not

return for additional counseling. Moreover, hierarchical

regression analyses were used to examine the relation between

the predictor variables of counselor's race, mistrust level,

and clients' sex on the criterion variable of premature

termination for counseling. The main effect of counselor

race accounted for 12% of the variance, and when added, the

main effect of trust, accounted for a significant increase in

the amount of variance (R2 = .18). This finding indicates

that Black clients were more likely to terminate from

counseling prematurely when seen by a White counselor than

when seen by a Black counselor. The trust data indicated

that regardless of counselor race, highly mistrustful clients

terminated treatment prematurely. Moreover, a significant

interaction was found between counselor race and client

mistrust level. Highly mistrustful clients seen by a White

counselor had a higher rate of premature termination than

highly mistrustful clients seen by a Black counselor.

Hardin et al. (1988) examined the relationship between

premature termination and clients' expectations about

counseling. Data for this study were drawn from archival

files at a university counseling center. Half of the

selected files consisted of clients who had come for one

appointment and, despite having made a second appointment,

never returned to the center. The remaining cases consisted

of clients who pursued counseling for two or more sessions (M

= 6.35 sessions, range = 3 19) to a mutually agreed-upon










termination. An equal number of clients reported career

concerns and personal concerns. Prior to their first

session, clients completed the Expectations About Counseling

questionnaire (EAC; Tinsley et al., 1980).

Results showed that precounseling expectations did not

differentiate terminators from nonterminators. In addition,

problem type did not affect expectations. Clients in both

groups, had high expectations about the counseling and

expected to assume a high degree of responsibility for their

counseling experience. Moreover, all clients expected to be

open with the counselor and to be at least moderately

motivated. They also had moderate levels of expectation for

counselor attractiveness, expertness, trustworthiness,

tolerance, nurturance, genuineness, acceptance, and

confrontation. They had lower expectations for counselor

directiveness, empathy, and self-disclosure.

The authors suggested that accepting unequivocally that

precounseling expectations do not affect termination status

is probably premature, sighting that one confounding factor

may result from clients who make subsequent appointments in

order to conform to their counselor's desires although they

themselves may feel satisfied after one interview. In

addition, it may be unwarranted to assume that clients

automatically distinguish between preferences and

expectations when asked to express their expectations. This

confusion between the two variables could have also

influenced the results of the study. Finally, Hardin et al










(1988) suggests that the EAC might be a measure of a global

positive or negative set toward counseling rather than a

number of discrete expectations. This study investigated

differences on each of the 17 subscales of the EAC, wherein

scales may be composed of only three or four items. Factor

scores may have proven more meaningful.

In a review article by Mennicke et al. (1988), it was

noted that studies investigating client satisfaction with

services and subsequent attendance has resulted in mixed

findings. Several researchers have failed to find a

relationship between client satisfaction with counseling and

attrition (Phillips & Fagan, 1982; Zamostny, Corrigan, &

Eggert, 1981). Whereas others have found satisfaction with

services to distinguish persisters from premature terminators

(Cochran & Stamler, 1989; Greenfield, 1983; Kokotovic &

Tracey, 1987; McNeill et al., 1987). Mennicke et al.

attribute this discrepancy to the use of different measures

used to assess client satisfaction. Most studies finding a

relationship between satisfaction and attrition used versions

of the Client Satisfaction Questionnaire (Larsen et al.,

1979), which is a well-validated measure of client

satisfaction with counseling services.


Satisfaction with Counseling


Tanner (1981) conducted a review of quantitative

research in which he studied the factors influencing client

satisfaction with mental health services. This review










summarizes the results of 38 studies which explored the

relationship of 31 variables to client satisfaction.

Variables included client and therapist demographic

variables, and interaction of these variables; behavioral,

stylistic or characterological variables, such as personality

and warmth; miscellaneous variables, such as therapist

assignment and duration of treatment; and finally, outcome or

effectiveness measures.

No client or therapist demographic variables were found

to consistently affect client satisfaction. Two client

characterological variables were found to be significantly

linked to satisfaction. Moberg (1977) found that alcoholic

inpatients were less satisfied on four of 12 scales when they

failed to identify themselves as alcoholics, and on six

scales when they planned to control their drinking rather

than abstain. However, these findings have not been

replicated.

With regard to therapist behaviors and stylistic

variables, clients appear to be more satisfied with

therapists that are active (Anderson, Harrow, Schwartz, &

Kupfer, 1972; Bent, Putnam, Kiesler, & Nowicki, 1976; Derita,

1976), warm (Bent, et al., 1976; McClanahan, 1974) empathic

(Anderson, et al., 1972; Fretz, 1966; McClanahan, 1974;

McNally, 1973) and interested (Anderson, et al., 1972; Fretz,

1966; McClanahan, 1974) in them. It is critical to note,

however, that these characteristics were measured by client

report.









Other significant therapist variables not obtained

through client report were social interest and profanity.

Clients' satisfaction increased as counselor social interest

rose (Zarski, Sweeney, & Barcikowski, 1977). Furthermore, an

experimental manipulation study found that middle class

clients were less satisfied with counselors who used

profanity (Heubush, & Horan, 1977). However, neither of

these studies have been replicated.

Two miscellaneous variables that were significantly

related to satisfaction were type of termination and duration

in treatment. Five studies examining termination type found

that outpatients who self-terminated were less satisfied with

counseling than those who remained in treatment (Balch,

Ireland, McWilliams, & Lewis, 1977; Denner & Halprin, 1974a,

1974b; Kline, Adrian, & Spevak, 1974; Larsen, 1978). In

addition, three studies of outpatients reported a positive

relationship between length of stay in treatment and at least

one satisfaction measure, such that the longer that patients

stayed in treatment, the more satisfied they were (Brown &

Manela, 1977; Frank, Salzman, & Fergus, 1977).

Finally five studies of clients' reports of treatment

effectiveness found a positive relationship to client

satisfaction (Edwards, Yarvis, Mueller, & Langsley, 1978;

Larsen, 1978; Larsen, et al., 1979; Simons, Wade, Morton, &

McSharry, 1978). However, there has been a lack of support

for these findings from related measures. Furthermore,

social desirability may account for a large part of both the







43

satisfaction and outcome ratings. Moreover, client report of

effectiveness of treatment typically accounts for less than

half the variance in satisfaction.

Freeman (1989) examined the influence of client and

counselor characteristics on satisfaction with counseling.

Subjects were 38 clients at a small liberal arts college

counseling center who had been seen for counseling. After

the termination interviews, clients and counselors completed

a questionnaire packet including the Client Satisfactions

Questionnaire (CSQ; Larsen et al., 1979) and two copies of

the Counselor Rating Form (CRF; Corrigan & Schmidt, 1983).

Participants were asked to rate first the other person and

then themselves on the CRF. Only 23 clients returned the

questionnaires.

Both counselors and clients perceived the counselor as

more attractive, expert, and trustworthy than the clients.

Clients rated themselves higher on the CRF dimensions than

the counselors rated their clients. Clients' attractiveness,

expertness and trustworthiness were significantly related to

the counselor's perception of clients' satisfaction. Client

satisfaction with services was significantly related to

client perception of counselor source characteristics and to

client perception of their own attractiveness.

It appears, therefore, that ratings of other was more

highly related to satisfaction than ratings of oneself. Only

in the case of clients' ratings of their own attractiveness

was self-rating significantly correlated with satisfaction.








44

However, in every instance, rating of other was significantly

and positively correlated with satisfaction.

Finally, a study by Neimeyer and Gonzales (1983)

investigated the duration, satisfaction, and perceived

effectiveness of cross-cultural counseling. Forty-nine white

and 21 nonwhite (8 Asian, 7 Black, 3 Hispanic, 1 Native

American, 2 unspecified) clients at a university counseling

center were seen by 13 white and 7 nonwhite (4 Black, 1

Asian, 2 Hispanic) counselors. Counselors and clients

completed a standard Counseling Services Evaluation Form

including demographic data, severity of the presenting

problem, duration of counseling and perceptions concerning

overall satisfaction and perceived effectiveness of services

at intake and 10 weeks after the initial session. Clients

were randomly assigned to therapists, however protesting was

performed to determine the equivalence of the four groups

(counselor race x client race) in terms of age and perceived

severity. No significant difference were found.

Results showed that White counselors provided fewer

sessions than nonwhite counselors. Nonwhite clients

expressed lower satisfaction than White clients, however,

this finding needs to be interpreted cautiously since mean

differences were minimal (M = 4.8, White; M = 4.3, nonwhite).

This result indicates that satisfaction did not vary as a

function of counselor race and was not related to cross-

racial differences. No difference in perceived effectiveness

of counseling was found among the four treatment dyads.







45

Neither counselors nor clients perceived any difference in

the effectiveness of counseling due to racial similarity or

dissimilarity. Therefore, it was concluded that race was not

a barrier to counseling.
















CHAPTER 3
METHODOLOGY


Subjects


Subjects were 75 students and two student spouses at the

University of Florida. The sample included clients being

seen individually (n = 64, 83%), in couples counseling (n =

6, 8%), and in group counseling (n = 7, 9%). Ages ranged

from 17 to 48, with an average age of 24.5 years. However,

62 percent of the sample (n = 47) were between the ages of 17

and 23. There were 58 females and 19 males in the sample.

The ethnic breakdown included 65 Caucasians (84%), four

African-Americans (5%), four Asians/Pacific Islanders (5%),

two Hispanics (3%), and two clients who did not report their

ethnic identity (3%). The sample consisted of graduate

students (n = 25, 32%), juniors (n = 19, 25%), sophomores (n

= 13, 17%), seniors (n = 12, 15%), freshmen (n = 4, 5%), post

baccalaureate students (n = 2, 3%), and student spouses (n =

2, 3%). Fifty-eight percent (n = 45) of the sample had been

in counseling previously, whereas, 42% (n = 32) were

attending counseling for the first time.

Twenty-six counselors (1 = 16 females, 10 males) from

the University of Florida Counseling Center, as well as,

three counselors (n = 3 males) from the University of Florida










Student Mental Health Services participated in the study.

The counselors from the Counseling Center consisted of seven

practicum students, nine interns, three counseling

associates, and seven senior staff members. The counselors

from Student Mental Health Services were a practicum student,

an intern, and a psychiatrist.


Instruments


The Expectations About Counseling-Brief Form (EAC-B;

Tinsley et al., 1980) consists of 66 items that are answered

on a 7-point Likert scale with response options which range

from not true to definitely true (Appendix A). Higher scores

indicate more positive expectations about counseling. Each

item is prefaced by the phrases "I expect to" or "I expect

the counselor to". For the purposes of this study only 53

items were used. The items excluded comprise the Realism

scale which is the most experimental scale of the inventory

and is not included in the factor scores. The remaining 17

scales of the EAC-B measure expectancies in four general

areas: Client Attitudes and Behaviors; Counselor Attitudes

and Behaviors; Counselor Characteristics; and Counseling

Process and Outcome. The internal consistency reliabilities

of the scales, based on the responses of 446 undergraduate

students ranged from .69 to .82 with a median reliability of

.76 (Tinsley, 1982). Test-retest reliabilities for a 2-month

interval ranged from .47 to .87 with a median of .71. All

but the responsibility scale had a test-retest reliability of










.60 or higher. The responsibility scale had a test-retest

reliability of .47 (Tinsley, 1982).

A factor analysis of the client expectancies measured by

the EAC-B (Tinsley et al., 1980) resulted in four factors:

Personal Commitment (EAC-B1), Facilitative Conditions (EAC-

B2), Counselor Expertise (EAC-B3), and Nurturance (EAC-B4).

These factors were used in the data analyses for this study.

The Personal Commitment factor reflect clients' expectancies

to be responsible, open, and motivated, to have an attractive

counselor, to have a counseling experience characterized by

concreteness and immediacy, and to experience a good outcome.

The Facilitative Conditions factor concerns expectancies that

the counselor will be genuine, trustworthy, accepting, and

tolerant, that the counselor will sometimes confront the

client, and also that the counseling experience will be

characterized by concreteness. The Counselor Expertise

factor reflects client's expectancies that the counselor will

by directive, empathic, and an expert. Lastly, the

Nurturance factor concerns client's expectancies that the

counselor will be accepting, self-disclosing, nurturant, and

attractive. The EAC-B also includes questions related to

demographic data, including: age, gender, race, year in

school, and whether the client has seen a professional

counselor before.

The Likert Trust Scale (LTS) was developed for use in

this study (Appendix B). It consists of four questions

answered on a 5-point Likert scale. Two questions relate to










the client's perception of his or her own trustworthiness

(Trustl), and ability to trust others (Trust2). The other two

questions relate to the client's perception of his or her

counselor's trustworthiness (Trust3), and ability to trust

others (Trust4). The response options range from 1-

trustworthy to 5-untrustworthy, and 5-trusting to 1-not

trusting. This type of instrument has been used in previous

research (Strong & Schmidt, 1970; Rothmeier & Dixon, 1980),

however, reliability data was not reported.

The Counseling Evaluation Inventory (CEI; Linden et al.,

1965) consists of 21 Likert items that assess client

satisfaction with counseling (Appendix C). Three scales were

identified through factor analysis : Counseling Climate

(e.g., "I distrusted the counselor"), Counselor Comfort

(e.g., In opening our conversations, the counselor was

relaxed and at ease"), and Client Satisfaction (e.g., I felt

satisfied as a result of my talks with the counselor").

Test-retest reliability estimates over a 14-day period ranged

from .63 to .78 for the three factors, and .83 for the total

inventory. Congruent validity has been demonstrated based on

a positive relationship (2 < .05) between practicum grades

for counselors and their clients' ratings on the CEI (Linden,

et al., 1965). Two scoring methods have been used with this

instrument a weighted scoring system and a standard 5-point

Likert scoring method (1 = always, 5 = never). The Likert

method of scoring, and the total inventory score were used in

this study.










The Client Satisfaction Ouestionnaire (CSQ; Larsen et

al., 1979) is an eight-item questionnaire used to assess

client satisfaction with mental health services (Appendix D).

Internal consistency for the CSQ is reported to be .87 for

university counseling center populations (Greenfield, 1983).

Scores range from 8 to 32, with higher scores indicating

higher satisfaction with services. Therapists' estimates of

how satisfied they believed the client to be were correlated

.56 (2 < .01) (Larsen et al., 1979) with the actual client

rating on the CSQ. This finding provides some evidence of

the scale's concurrent validity.

The Counselor Summary Sheet (CSS) was developed for use

in this study (Appendix E). This form was completed by the

counselors and was used to record the number of sessions

attended by clients (excluding intake), date of termination

(if applicable), reasons) for termination, and clients'

status: continuing counseling, mutual termination, dropout,

or other. Reasons for termination included: client

satisfactorily met his/her goals for counseling, counselor

did not have the skills/resources necessary to help the

client, client's life situation improved on its own, client

sought counseling elsewhere, counselor and client could not

agree on how to approach the client's problems, counselor and

client were not compatible, referred out because the client

needed/wanted more counseling than the Center could provide,

and other reason.










Mutual terminators were those individuals who planned a

termination with their counselors regardless of the number of

counseling sessions they had attended. Dropouts were those

individuals who terminated counseling without the knowledge

or against the advice of their counselor, and who felt that

their goals in counseling were not met.

The Client Summary Sheet (C1SS) was completed by the

clients (Appendix F). It is a parallel form of the Counselor

Summary Sheet. However, additionally, clients were asked to

indicate the degree to which they perceived themselves to be

similar to their counselors by circling a number on a likert

scale ranging from 1 not at all similar to 5 very

similar.


Procedure


Participants were 106 students or student spouses who

sought counseling at the University of Florida Counseling

Center (CC) and five who sought therapy at the University of

Florida Student Mental Health Services (SMHS). Of this

original sample, 77 (69%) subjects actually received

counseling beyond an initial, evaluation interview (intake)

(CC: 74, SMHS: 3). Of the other 34 students, 14 (41%) were

closed after their intake, 11 (32%) were referred to other

facilities on campus or to private practitioners in the

community, and nine (27%) were closed after being on the

waiting list. Walk-in clients, emergency clients, and

clients screening for a particular group did not take part in










the study. In addition, clients seeking career counseling

with the Peer Counselors were not asked to participate in

this study.

When clients arrived for an initial, evaluation

interview (intake) they were given a cover letter (Appendix

G) introducing them to the study, two copies of the Informed

Consent Form (Appendix H), the Expectations About Counseling-

Brief Form (EAC-B), the Likert Trust Scale (LTS), and an

envelope, along with the usual intake forms used by the

Counseling Center (CC) or Student Mental Health Services

(SMHS).

The Informed Consent Form included information about the

purpose of the study, the anticipated risks/benefits of

participation in the study, information about the principal

investigator, and information about the procedure to be used

in the study. Specifically, clients were informed that they

would be asked to complete two questionnaires prior to

beginning counseling, four questionnaires after their first

counseling session (including retaking the first two

completed), and five questionnaires after completing

counseling or after their sixth session (whichever was

first). The latter five questionnaires included retaking the

four completed previously. Completing all five

questionnaires was estimated to take 15 minutes.

Moreover, clients were informed that their participation

in the study was voluntary, and that their refusal to

participate in the study would not affect their access to










counseling. However, the Informed Consent Form also stated

that clients who completed the study would have their names

entered into a lottery from which ten names would be chosen.

The individuals selected would receive a money order for ten

dollars each.

Clients who agreed to participate in the study completed

the Expectations About Counseling-Brief Form and the Likert

Trust Scale prior to their intake and returned these

questionnaires to the receptionist sealed in the envelope

provided, along with one signed copy of the Informed Consent

Form. The other copy of the Consent Form was retained by

each client for his/her records. Those clients who decided

not to participate in the study simply returned the blank

questionnaires to the receptionist.

Upon receipt of the sealed envelope containing the first

two completed questionnaires and the Informed Consent Form,

the receptionist at the Counseling Center stapled a

memorandum to the inside of the client's folder containing

the usual intake forms used by the Counseling Center. After

the intake, the folder was either retained by the counselor

if the counselor had decided to pick up this particular

client for ongoing counseling, or the folder was placed in a

waiting list filing cabinet. The memorandum stapled to the

inside of the client's folder (Appendix I) was used by the

counselors picking up the client to inform the principal

investigator of the date of the client's first scheduled

counseling session, the name of the counselor, and the









client's address. The receptionist forwarded the envelopes

with the completed questionnaires, and consent forms to the

principal investigator. Clients were scheduled for a first

counseling session one or more weeks after their intake.

At Student Mental Health Services there is no waiting

list, such that each client who received an initial,

evaluation interview (intake) and was not referred out

immediately, was scheduled for a first session one week after

his/her intake. Therefore, on a specific day each week the

principal investigator collected the envelopes containing the

completed Expectations About Counseling-Brief Form (EAC-B),

Likert Trust Scale (LTS) questionnaires, and signed consent

forms completed prior to intake, and left envelopes

containing the second set of questionnaires for the

appropriate clients returning the following week for their

first scheduled counseling session.

The questionnaires completed prior to intake were

numerically coded upon receipt by the principal investigator

and separated from the signed Informed Consent Form. Clients

were asked not to write their names on the questionnaires.

Subsequent questionnaires were also numerically coded. This

procedure was used to ensure client confidentiality, and to

match questionnaires completed prior to intake with those

completed by the clients later in the study.

After each client's first counseling session, he/she was

either mailed or hand delivered (by the counselor), an

envelope containing a cover letter, (Appendix J) the










Expectations About Counseling-Brief Form (EAC-B) the Likert

Trust Scale (LTS),. the Client Satisfaction Questionnaire

(CSQ), and the Counseling Evaluation Inventory (CEI).

Clients were asked to complete and return these

questionnaires sealed in the envelope provided when the

client returned for his/her second counseling session.

Clients who did not return their questionnaires at the

appropriate time were mailed a reminder (Appendix K) and

subsequently mailed another set of questionnaires (n = 35,

54%).

The above procedure was also used for the third

administration which occurred after each client's sixth or

last session. Along with the four questionnaires completed

at the second administration, clients were also sent a cover

letter (Appendix L), and the Client Summary Sheet and asked

to complete and return these questionnaires to the principal

investigator. Clients who did not return their

questionnaires at the appropriate time were mailed a reminder

(n = 46, 60%). Clients who continually forgot to return

their questionnaires were telephoned by the principal

investigator and subsequently mailed another set of

questionnaires or came in to the Counseling Center or Student

Mental Health Services to complete questionnaires that were

left at the receptionist desk (n = 29, 38%). Also, after

their clients' sixth or last session, counselors were asked

to complete the Counselor Summary Sheet and return it to the

principal investigator.










After the termination of the project, the names of all

those clients who completed the project were entered into a

lottery. Ten names were chosen at random and ten dollar

money orders were mailed to these individuals. Data was

collected over a period of two semesters, which was

approximately 28 weeks.


Hypotheses


This study examined clients' expectations of their

counselors and the counseling process, and clients' levels of

perceived trust and trustworthiness prior to beginning

counseling. Moreover, changes in these variables and

clients' satisfaction with counseling were investigated in

relation to clients' actual experiences of counseling.

Specific hypotheses were:

1) Clients will exhibit higher positive expectations

(Personal Commitment, Facilitative Conditions, Counselor

Expertise, Nurturance) of their counselors and counseling

after their first session than prior to beginning counseling.

2) Clients will evidence higher levels of perceived

trustworthiness and trust (Client Trustworthiness, Client

Trust, Counselor Trustworthiness, Counselor Trust) after

their first session than prior to beginning counseling.

3) Clients will exhibit higher positive expectations of

their counselors and counseling after two or more sessions

than prior to beginning counseling or after their first

session. There will be a significant positive association







57

between number of counseling sessions attended by clients and

clients' levels of expectations, such that as the number of

sessions increases so will clients' expectations for Personal

Commitment, Facilitative Conditions, Counselor Expertise, and

Nurturance.

4) Clients will evidence higher levels of perceived

trustworthiness and trust after two or more sessions than

prior to beginning counseling or after their first session.

There will be a significant positive association between the

number of counseling sessions attended by clients, and both

clients' reported levels of their own (Client

Trustworthiness, Client Trust) and their counselors'

trustworthiness and trust (Counselor Trustworthiness,

Counselor Trust).

5) As clients' expectations for counseling increase,

clients' satisfaction with counseling (Client Satisfaction;

SATIS) and with their counselors (Counseling Evaluation;

CEVAL) will also increase.

6) As clients' perceived levels of their own and their

counselors' trustworthiness and trust increase, clients'

satisfaction with counseling (SATIS) and with their

counselors (CEVAL) will also increase.

7) Compared to clients who plan a termination with

their counselors, clients who drop out of counseling will

evidence lower expectations of counseling (Personal

Commitment, EAC-Bl; Facilitative Conditions, EAC-B2;

Counselor Expertise, EAC-B3; Nurturance, EAC-B4) and lower









levels of perceived trustworthiness and trust (Client

Trustworthiness, Client Trust, Counselor Trustworthiness,

Counselor Trust) prior to beginning counseling. In addition,

dropouts will have less satisfaction with counseling (SATIS)

and with their counselors (CEVAL) than mutual terminators.

8) Compared to clients' expectations (EAC-B) and levels

of perceived trust/trustworthiness (TRUST) prior to beginning

counseling (timel), clients' expectations, levels of

trust/trustworthiness, and satisfaction with counseling

(SATIS) and with their counselors (CEVAL) early in counseling

timee) will be better predictors of client satisfaction with

counseling/counselors later in counseling timee3.

9) There will be significant positive associations

between clients' levels of perceived similarity to their

counselors (SIM) and clients' satisfaction with their

counseling (Client Satisfaction; SATIS) and their counselors

(Counseling Evaluation; CEVAL).















CHAPTER 4
RESULTS


The major dependent variables of study in this research

were the following: clients' satisfaction with counseling

(SATIS) and clients' satisfaction with their counselors

(CEVAL). The major independent variables were: clients'

expectations about counseling (EAC-B), clients' perceptions

of their own and their counselors' trust/trustworthiness

(Trust), and time in counseling. Clients' expectations were

comprised of four factors: Personal Commitment (EAC-B1),

Facilitative Conditions (EAC-B2), Counselor Expertise (EAC-

B3), and Nurturance (EAC-B4). Clients' perceptions of their

own and their counselors' trust/trustworthiness included four

variables: Client Trustworthiness (Trustl), Client Trust

(Trust2), Counselor Trustworthiness (Trust3), and Counselor

Trust (Trust4). Time in counseling was divided into three

periods: precounseling (timel), after the first counseling

session timee) and after the sixth or last counseling

session timee3.

Due to the inability to control when clients' actually

returned their questionnaires, not all questionnaires were

returned after the first and prior to the second counseling

session for the second administration of the questionnaires,

nor after the sixth and prior to the seventh counseling









session for the third administration of the questionnaires.

Therefore, the first administration of the questionnaires

(timel) was prior to beginning counseling, and thus the

number of sessions attended was zero. For the second

administration timee) the number of sessions attended ranged

from one to five sessions (m = 1.11, SD = 1.38). For the

third administration timee) the number of sessions attended

ranged from one to 19 sessions (m = 4.50, SD = 4.37). Four

clients dropped out of counseling after their first session

and therefore were administered the third set of

questionnaires rather than the second set of questionnaires.

The data for these four clients were not included in the

analyses for the first four hypotheses.

In order to maintain the integrity of the study, only

data obtained from those clients returning their second set

of questionnaires after their first counseling session and

prior to their second session were included in the analyses

for the first four hypotheses (q = 24, 53%). The analyses

for these hypotheses were repeated measures analyses of

variance (ANOVAs) and repeated measures analyses of

covariance (ANCOVAs). Repeated measures designs employ the

use of a subject as his/her own control and follow-up.

Therefore it was necessary to use only the appropriate data

in order to obtain the comparisons stated in the first four

hypotheses: prior to counseling, after the first session,

and after two or more sessions.










To test hypotheses five through nine, regressions,

correlations, and analyses of variance (ANOVAs) procedures

were used. All data obtained regardless of when the

questionnaires were returned could be and were used in these

analyses. The return rates were as follows: time = 73%, n

= 45; time = 83%, n = 64.


Preliminary Analyses


It has been noted that clients come in to counseling

with preformed ideas about their counselor and the counseling

process (Gelso & Carter, 1985). It appeared possible,

therefore, that clients' previous counseling experiences

(PREV) may affect their expectations and perceptions of their

present counselors and counseling experiences. It is further

noted that there have been inconsistent findings in the

counseling research literature pertaining to the influence of

actual counselor experience level (CEXP) on the counseling

process (Heppner & Heesacker, 1982; Auerbach & Johnson,

1977).

Thus, prior to performing the statistical analyses to

test the stated hypotheses, a series of repeated measures

analyses of variance (ANOVAs) were performed to determine

whether the dependent measures covary with clients' previous

counseling experience (PREV: 1 = yes; 2 = no), counselors'

experience levels (CEXP: 1 = prepracticum; 2 = practicum; 3

= intern/associate; 4 = senior staff; 5 = psychiatrist), or

the interaction of these two variables (PREV*CEXP). The









results indicated whether these variables (PREV, CEXP,

PREV*CEXP) needed to be included as covariates in the

analyses to test the stated hypotheses.

Specifically, separate repeated measures ANOVAs were

performed with each of the following variables as the

dependent measure: the four Expectations About Counseling

(EAC-B) factors [Personal Commitment (EAC-B1), Facilitative

Conditions (EAC-B2), Counselor Expertise (EAC-B3), and

Nurturance (EAC-B4)] at each of the three time periods, the

four Likert Trust Scale variables [Client Trustworthiness

(Trustl), Client Trust (Trust2), Counselor Trustworthiness

(Trust3), Counselor Trust (Trust4)] at each of the three time

periods, and the two satisfaction measures [Client

Satisfaction (SATIS), Counseling Evaluation, (CEVAL)] at each

of the last two time periods. The independent variables in

each of these repeated measures ANOVAs were time in

counseling (timel, time time3, clients' previous counseling

experience (PREV), counselors' experience levels (CEXP), and

the interaction of these latter two variables (PREV*CEXP).

In the following sections are the results of the two repeated

measures ANOVAs that proved significant the one with

Counselor Trustworthiness (Trust3) as the dependent variable,

and the one with Counseling Evaluation (CEVAL) as the

dependent variable.










The Repeated Measures Analysis of Variance with Counselor
Trustworthiness as the Dependent Variable


A repeated measures analysis of variance (ANOVA) was

performed with Counselor Trustworthiness (Trust3) as the

dependent measure,and the following as independent variables:

counseling received over three time periods (timel, time,

time3, clients' previous counseling experience (PREV),

counselor experience level (CEXP) and the interaction of the

latter two variables (PREV*CEXP). Results of the between

subjects test revealed a significant overall effect for

PREV*CEXP, F(l, 38) = p < .031. This interaction (PREV*CEXP)

indicates that clients' perceptions of their counselors as

trustworthy were affected by the counselors' experience

levels and whether the client had previously attended

counseling. Those clients with previous counseling

experience did not perceive their counselors as significantly

more or less trustworthy based on the counselors' experience

levels. Whereas, those clients with no previous counseling

experience perceived the more experienced counselors as

significantly less trustworthy than the less experienced

counselors.

Results of the within subjects test revealed a

significant time*CEXP interaction, F(2, 76) = 3.95, p < .023,

indicating that the relationship between Counselor

Trustworthiness (Trust3) and counselors' experience levels

(CEXP) was not the same across the three time periods. There










was no relationship between Counselor Trustworthiness

(Trust3) and counselors' experience levels (CEXP) prior to

beginning counseling (timel). However, early in counseling

timeme, m = 1.11 sessions), F(3, 38) = 3.05, p :.0401], and

later in counseling timeme, m = 4.5 sessions), (3, 38) =

4.88, p S .0058], the more experienced counselors were seen

as less trustworthy.

Pearson correlations confirmed that there was a moderate

but significant negative relationship between CEXP and Trust3

at time (r = -.34, p < .02). The correlations between CEXP

and Trust3 at timel (E = -.04, p < .67) and time (1 = -.18,

p < .16) were also negative, however neither were

significant. These results indicate that as the counselors'

experience levels increased, clients' perceptions of their

counselors as trustworthy decreased. Plots confirmed these

finding showing negative slopes between CEXP and Trust3 at

time, and at time.

Interestingly, the interaction between clients'

previous counseling experience and counselors' experience

levels (PREV*CEXP) was not detected in the within subjects

analysis, although the trend did increase through the three

time periods. Since the effect was found in the between

subjects analysis, the current study may not have had enough

statistical power to detect the three-way interaction

(time*PREV*CEXP).











The Repeated Measures Analysis of Variance with Counseling
Evaluation as the Dependent Variable


A repeated measure ANOVA was performed with Counseling

Evaluation (a measure of clients' satisfaction with their

counselors; CEVAL) as the dependent measure, and the

following as independent variables: counseling received over

two time periods timee, time3, clients' previous counseling

experience (PREV), counselors' experience levels (CEXP), and

the interaction of these two variables (PREV*CEXP). The

between subjects test revealed a significant overall effect

for CEXP, F(l, 37) = 3.86, p < .056. Apparently the

counselors' experience levels also affected the clients'

satisfaction with their counselors.

The within subjects test revealed a significant

time*CEXP*PREV interaction, F(l, 37) = 4.26, a < .0462.

There was no significant effect for CEVAL at time. However,

there was a significant effect for CEVAL at time, (3, 37) =

3.99, Ep .0147. Moreover, CEXP*PREV (p < .0270) was

significantly associated with Counseling Evaluation (CEVAL)

at time. These results indicate that counselors' experience

levels (CEXP) and clients' previous counseling experience

(PREV) were not significant factors in clients' satisfaction

with their counselors (CEVAL) early in counseling timee2.

However, later in counseling timee) an interaction between

CEXP and PREV apparently became impactful in clients'

satisfaction with their counselors (CEVAL).







66

Pearson correlations and plots were conducted separately

for clients with no previous counseling experience and

clients with previous counseling experience. Pearson

correlations revealed that for clients with no previous

counseling experience, there were moderate, but

nonsignificant negative relationships between CEVAL and CEXP

both at time (I = -.42, p s .108), and time (r = -.33, 2

.103). However, for clients with previous counseling

experience, the relationship between CEXP and CEVAL changed

from being negative at time (r = -.10, p < .627) to being

positive at time (r = .28, E < .094). These correlations

were also not significant. Plots confirmed these findings

showing consistent negative slopes at time and time for

clients with no previous counseling experience. In contrast,

for clients with previous counseling experience, plots showed

a negative slope between CEVAL at time and CEXP, but a

positive slope between CEVAL at time and CEXP, which

resulted in the interaction effect.


Tests of the Hypotheses


Since the preliminary analyses revealed that both

Counselor Trustworthiness (Trust3) and Counseling Evaluation

(CEVAL) were significantly affected by clients' previous

counseling experience (PREy), and counselors' experience

levels (CEXP), these two variables and their interaction

(PREV, CEXP, and PREV*CEXP) were included as covariates in

the analyses involving Trust3 and CEVAL. Where results with









the covariates were very similar to results without the

covariates, the simpler models (without the covariates) are

reported.

As previously stated, hypothesis one was that clients

will exhibit higher positive expectations (expectation

factors: Personal Commitment, Facilitative Conditions,

Counselor Expertise, Nurturance) of their counselors and

counseling after their first session than prior to beginning

counseling. The analyses for this hypothesis were t-tests

for dependent samples. Results indicated no significant

differences between the means for the expectation factors

from prior to beginning counseling to after the first

counseling session, failing to support hypothesis one.

Hypothesis two stated that clients will also evidence

higher levels of perceived trust and trustworthiness (Client

Trustworthiness, Client Trust, Counselor Trustworthiness,

Counselor Trust) after their first session than prior to

beginning counseling. T-tests for dependent samples were

conducted for Client Trustworthiness (Trustl), Client Trust

(Trust2), and Counselor Trust (Trust4). Results revealed a

significant (somewhat borderline) difference for Trustl from

prior to beginning counseling to after the first counseling

session (t = -2.01, p < .0558). Means indicated that

clients' perceptions of themselves as trustworthy decreased

from prior to beginning counseling (m = 4.63, SD = 0.58) to

after their first session (m = 4.38, SD = 0.82). However,







68

there were no significant differences in the means for Trust2

or Trust4 over the same time period.

A repeated measures analysis of covariance (ANCOVA) was

conducted with Counselor Trustworthiness (Trust3) as the

dependent variable, time in counseling (timel, time) as the

independent variable, and clients' previous counseling

experience (PREV), counselors' experience levels (CEXP), and

the interaction of these two latter variables (PREV*CEXP) as

covariates. The within subjects test for the entire sample

indicated no overall time effect, and no differences in the

means for Counselor Trustworthiness (Trust3) over time due to

previous counseling experience (PREV), counselor experience

level (CEXP) or the interaction of these two variables

(PREV*CEXP). There was a decrease in clients' perceptions of

their counselors as trustworthy from prior to beginning

counseling (m = 4.71, SD = 0.46) to after their first session

(m = 4.21, SD = 0.98), however, the difference was not

significant. The results obtained failed to support

hypothesis two.

Hypothesis three stated that clients will exhibit higher

positive expectations for Personal Commitment (EAC-Bl),

Facilitative Conditions (EAC-B2), Counselor Expertise (EAC-

B3), and Nurturance (EAC-B4) after two or more sessions than

prior to beginning counseling or after their first session.

Moreover, there will be a significant positive association

between number of counseling sessions attended by clients and

clients' expectations about counseling, such that as number










of sessions increases so will clients' expectations for

Personal Commitment, Facilitative Conditions, Counselor

Expertise, and Nurturance (expectation factors).

To test hypothesis three, separate repeated measures

analyses of variance (ANOVAs) were conducted with each

expectation factor as a dependent measure, and counseling

received over three time periods as the independent measure.

Results of the four repeated measures ANOVAs indicated that

there were no overall effects due to time for any of the

expectation factors, indicating that there were no

significant differences in the means for any of the four

expectation factors from prior to beginning counseling, to

after the first or after two or more counseling sessions.

There was an increase in the means for Nurturance (EAC-B4)

over the three time periods (see Table 4-1, however, the

differences in the means were not significant.

In addition, Pearson correlations were utilized to

determine the type of relationship (positive vs negative)

between number of sessions attended by clients and clients'

expectation for Personal Commitment (EAC-B1), Facilitative

Conditions (EAC-B2), Counselor Expertise (EAC-B3), and

Nurturance (EAC-B4). Results indicated that none of the

correlations were significant, such that clients'

expectations about counseling were not significantly related

to the amount of time clients spent in counseling. The

results of the analyses conducted for hypothesis three,

therefore, failed to support the hypothesis.










Table 4-1

Simple Statistics for the Exoectation Factors


Variable Timela Time2b Time3c

n m SD n m SD n m SD


EAC-Bl 21 5.68 0.75 23 5.63 0.56 24 5.78 0.66

EAC-B2 22 5.41 0.92 24 5.30 0.99 24 5.38 0.76

EAC-B3 24 4.01 1.13 24 3.86 1.43 24 4.19 1.34

EAC-B4 22 4.53 1.03 24 4.59 1.19 24 4.62 1.05



a0 sessions, bl session, cm = 6.33 sessions, SD = 3.45

EAC-B: 7 point Likert scale


Hypothesis four was that clients will also evidence

higher levels of perceived trustworthiness and trust [Client

Trustworthiness, (Trustl); Client Trust, (Trust2); Counselor

Trustworthiness, (Trust3); Counselor Trust, (Trust4)] after

two or more sessions than prior to beginning counseling or

after their first session. Moreover, there will be a

significant positive association between number of counseling

sessions attended by clients and clients' reported levels of

their own trustworthiness and trust as well as clients'

levels of perceived counselor trustworthiness and trust.

The analyses for hypothesis four involved separate

repeated measures ANOVAs with Trustl, Trust2, and Trust4 as

dependent variables, and a repeated measures ANCOVA with

Trust3 as the dependent variable. Counseling received over









three time periods was the independent variable. In

addition, Pearson correlations were utilized to determine the

type of relationship (positive vs negative) between number of

sessions attended by clients and clients' reports of their

own trustworthiness and trust, as well as clients' perceived

counselor trustworthiness and trust. Results of the three

repeated measures ANOVAs with Trustl, Trust2 and Trust4 as

the dependent measures revealed that there were no overall

time effects for any of the three trust variables, indicating

that there were no significant differences in the means for

any of the three Trust variables from prior to beginning

counseling, to after the first or after two or more

counseling sessions. There was an increase in the means for

Counselor Trust (Trust4) over the three time periods (Table

4-2). However, the differences in the means were not

significant.

A repeated measures ANCOVA was conducted with Trust3

(Counselor Trustworthiness) as the dependent measure,

counseling received over three time periods (timel, time,

time) as the independent measure, and clients' previous

counseling experience (PREV), counselors' experience levels

(CEXP), and the interaction of these two variables

(PREV*CEXP) as covariates. The within subjects test of the

repeated measures ANCOVA with Counselor Trustworthiness as

the dependent variable for the entire sample revealed that

there was no overall time effect, nor significant differences

in the means for Trust3 over time due to clients' previous










counseling experience (PREV), the counselors' experience

levels (CEXP) or the interaction of these two variables

(PREV*CEXP).


Table 4-2

Simple Statistics for the Trust Variables



Variable Timela Time2b Time3c

n m SD n m SD n m SD


Trustl 24 4.63 0.58 24 4.38 0.82 24 4.54 0.59

Trust2 24 3.58 0.78 24 3.33 0.92 24 3.33 0.96

Trust3 24 4.71 0.46 24 4.21 0.98 24 4.63 0.71

Trust4 24 3.75 0.74 23 3.87 0.97 24 4.17 0.76



a0 sessions, bl session, cm = 6.33 sessions, SD = 3.45

Trust: 5 point Likert scale


Results of the Pearson correlations between number of

sessions attended by clients and the Trust variables revealed

that none of the correlations were significant, such that

clients' perceptions of themselves and their counselors as

trustworthy and trusting were not significantly related to

the number of counseling sessions attended by the clients.

Therefore, the results of the analyses conducted for

hypothesis four failed to support the hypothesis.

Hypothesis five was that as clients' expectations for

counseling (expectation factors: Personal Commitment,







73

EAC-Bl; Facilitative Conditions, EAC-B2; Counselor Expertise,

EAC-B3; Nurturance, EAC-B4) increase, clients' satisfaction

with counseling (Client Satisfaction, SATIS) and with their

counselors (Counseling Evaluation, CEVAL) will also increase.

Both Pearson correlations between the expectation factors and

SATIS and CEVAL, and multiple regressions were conducted to

test this hypothesis. Only Personal Commitment (EAC-B1) at

time (m = 1.11 sessions) showed moderate but significant

positive correlations with clients' general satisfaction with

counseling (Client Satisfaction; SATIS), and with clients'

satisfaction with their counselors (Counseling Evaluation;

CEVAL) at time. These results indicated that early in

counseling timee2, as clients' expectations for Personal

Commitment to counseling increased, so did their satisfaction

with their counseling (SATIS) and with their counselors

(CEVAL). See Table 4-3 for the results of the Pearson

Correlations.

Four multiple regressions were also conducted. More

specifically, the first regression included Client

Satisfaction (SATIS) at time (m = 1.11 sessions) as the

criterion variable and the following as predictor variables:

the four expectation factors (Personal Commitment, EAC-B1;

Facilitative Conditions, EAC-B2; Counselor Expertise, EAC-B3,

Nurturance, EAC-B4) at time. Results of this regression

revealed that the model itself was not statistically









Table 4-3

Pearson Correlation Coefficients Amona the Expectation
Factors and the Counselina/Counselor Satisfaction Measures



Variables Time2a Time3b



Client Satisfaction and

Personal Commitment .34* .14

Facilitative Conditions .17 -.10

Counselor Expertise .05 -.06

Nurturance .25 -.03

Counseling Evaluation and

Personal Commitment .43** .19

Facilitative Conditions .14 -.04

Counselor Expertise -.04 -.09

Nurturance .12 -.04


am = 1.11 sessions, SD = 1.38

*< p .05 **g < .005


bm = 4.5 sessions, SD = 4.37.


significant (E(4, 38) = 1.47, 2 s .2313) indicating that none

of the expectation factors at time were related to Client

Satisfaction (SATIS) at time. Likewise, the R-square (a2 =

.134) was quite small indicating that the expectation factors

at time did not account for much of the variance in SATIS at









time and, therefore, were poor predictors of Client

Satisfaction (SATIS) with counseling in general at time.

The second regression involved SATIS at time as the

criterion variable, and the four expectation factors at time

(m = 4.5 sessions) as the predictor variables. Results

revealed that the model itself was not significant (E(4, 59)

= 1.90, B .1232), suggesting that none of the expectation

factors at time were related to clients' satisfaction with

counseling (SATIS) at time. Moreover, the R-square (R2 =

.114) was quite small, and Pearson correlations confirmed

that there were minimal relationships between clients'

satisfaction with counseling (SATIS) at time and clients'

expectations about counseling at time (see Table 4-3)

indicating that the expectation factors at time accounted

for only a very small amount of the variance in SATIS at

time and therefore were not good predictors of this

variable.

The third regression included Counseling Evaluation

(CEVAL) at time as the criterion variable and the following

as predictor variables: the four expectations factors

(Personal Commitment, EAC-B1; Facilitative Conditions, EAC-

B2; Counselor Expertise, EAC-B3, Nurturance, EAC-B4) at time

(m = 1.11 sessions), clients' previous counseling experience

(PREV), counselors' experience levels (CEXP), and the

interaction of these two latter variables (PREV*CEXP).

Results of this regression (as shown in Table 4-4) indicated

that the model itself was significant (E(7, 35) = 2.39,










Table 4-4

Multiple Regression for Counseling Evaluation at Time2 with
the Expectation Factors at Time2 as Predictors



Source DF SS MS F


Model

Error

Total


EAC-B1-2

EAC-B2-2

EAC-B3-2

EAC-B4-2

PREV

CEXP

PREV*CEXP

Variable


Intercept

EAC-B1-2

EAC-B2-2

EAC-B3-2

EAC-B4-2

PREV

CEXP

PREV*CEXP


2.58

5.39

7.97

1.77

0.15

0.00

0.02

0.18

0.56

0.15

Parameter
Estimate

2.81

0.59

-0.13

-0.00

-0.05

-0.60

-0.26

0.18


0.37

0.15



1.77

0.15

0.00

0.02

0.18

0.56

0.15

Standard
Error

0.77

0.17

0.13

0.07

0.12

0.55

0.13

0.18


2.39






11.46

0.97

0.01

0.16

1.18

3.66

0.94

T


3.65

3.39

-0.99

-0.08

-0.40

-1.09

-1.98

0.97


B2 = .324 CV = 8.83 Root MSE = .392


.0414





.0018

.3303

.9389

.6920

.2838

.0639

.3386




.0008

.0018

.3303

.9389

.6920

.2838

.0559

.3386

= 4.45










p .0414), suggesting that at least one of the independent

variables was significantly related to clients' satisfaction

with their counselors (CEVAL) at time. Personal Commitment

(EAC-B1) was the only significant predictor variable (p S

.0018) in this model. Interestingly, the R-square obtained

was small (R2 = .324) indicating that the model accounted for

only a small amount of the variance in Counseling Evaluation

(CEVAL). However, Pearson correlations indicated that

Personal Commitment was also the only expectation factor

significantly correlated with CEVAL at time (r = .43, p

.004) suggesting that Personal Commitment may still be a good

predictor of Counseling Evaluation at time, if it (EAC-B1)

accounts for most or all of the variation explained by the

model. The fourth regression included CEVAL at time as the

criterion variable and the following as predictor variables:

the four expectation factors (EAC-B) at time (m = 4.5

sessions), clients' previous counseling experience (PREV),

counselors' experience levels (CEXP), and the interaction of

these two latter variables (PREV*CEXP). Results indicated

that the model was significant (E(7, 56) = 2.14, p S .0542),

suggesting that at least one of the independent variables was

significantly related to clients' satisfaction with their

counselors at time (see Table 4-5).

Personal Commitment (EAC-B1, p < .0081), clients'

previous counseling experience (PREV, p < .0205), and the

interaction of clients' previous counseling experience and











Table 4-5

Multiple Regression for Counseling Evaluation at Time3 with
the Expectation Factors at Time3 as Predictors



Source DF SS MS E


Model 7 5.59 0.80 2.14 .0542


Error

Total


20.94

26.53


EAC-B1-3

EAC-B2-3

EAC-B3-3

EAC-B4-3

PREV

CEXP

PREV*CEXP

Variable


Intercept

EAC-B1-3

EAC-B2-3

EAC-B3-3

EAC-B4-3

PREV

CEXP

PREV*CEXP


2.82

0.12

0.00

0.15

2.13

0.11

2.64

Parameter
Estimate

3.70

0.46

-0.13

-0.01

-0.11

-1.54

-0.34

0.56


0.37


2.82

0.12

0.00

0.15

2.13

0.11

2.64

Standard
Error

0.76

0.17

0.23

0.08

0.17

0.64

0.15

0.21


7.54

0.32

0.01

0.40

5.68

0.30

7.07

T


4.83

2.75

-0.57

-0.07

-0.63

-2.38

-2.21

2.66


E2 = .211 CV = 14.24 Root MSE = .611


.0081

.5709

.9418

.5287

.0205

.5875

.0102

E


.0001

.0081

.5709

.9418

.5287

.0205

.0312

.0102

m= 4.29










counselors' experience levels (PREV*CEXP, P < .0102) appeared

as significant predictors of Counseling Evaluation (CEVAL) at

time. To clarify the interaction effect (PREV*CEXP), the

parameter estimates revealed that both PREV (-1.54) and CEXP

(-0.34) were negatively associated with CEVAL. These

negative associations indicate that clients with previous

counseling experience were more likely to have higher

satisfaction with their counselors (CEVAL). In addition, it

appears that clients were more satisfied with counselors who

had less experience. The interaction between clients'

previous counseling experience and counselors' experience

levels (PREV*CEXP = 0.56) indicates that clients with

previous counseling experience had higher satisfaction with

more experienced counselors. In contrast, clients with no

previous counseling experience had higher satisfaction with

less experienced counselors. Once again, the R-square

obtained was quite small (R2 = .211), indicating that the

predictors in this model only accounted for a small amount of

the variance in CEVAL at time. Therefore, it is doubtful

whether even the significant predictors are very influential

in predicting Counseling Evaluation (CEVAL) at time.

Results of the multiple regressions for hypothesis five

revealed that only small amounts (R2 = .114 to .324) of the

variance in SATIS and CEVAL at time and time were accounted

for by the four expectation factors. These results indicate

that the expectation factors were not highly influential

predictors of clients' satisfaction with their counseling










(SATIS) and with their counselors (CEVAL). However, the

Pearson correlations did reveal significant positive

correlations between Personal Commitment (EAC-B1) at time

and both SATIS (r = .343, p < .0226) and CEVAL (r = .429, 2

.0040) at time, indicating that as clients' expectations for

their Personal Commitment to counseling increased, so did

clients' satisfaction with counseling and with their

counselors giving marginal support to hypothesis five for

EAC-B1

Hypothesis six was that as clients' perceived levels of

their own and their counselors' trustworthiness and trust

(Client Trustworthiness, Trustl; Client Trust, Trust2;

Counselor Trustworthiness, Trust3; Counselor Trust, Trust4)

increase, clients' satisfaction with counseling (Client

Satisfaction, SATIS) and with their counselors (Counseling

Evaluation, CEVAL) will also increase. Both Pearson

correlations between the trust variables and SATIS and CEVAL,

and multiple regressions were utilized to test the

hypothesis.

The Trust variables all showed significant positive

correlations with SATIS and/or CEVAL at one or both time

periods (see Table 4-6), indicating that both clients'

perceptions of themselves and perceptions of their counselors

as trustworthy and trusting were important in clients'

satisfaction with counseling (SATIS) and/or with their

counselors (CEVAL). Moreover, Counselor Trustworthiness










Table 4-6

Pearson Correlation Coefficients Among the Trust Variables
and the Counseling/Counselor Satisfaction Measures



Variables Time2a Time3b


Client Satisfaction and

Client Trustworthiness .37** .10

Client Trust .34* .15

Counselor Trustworthiness .60*** .60***

Counselor Trust .20 .43***

Counseling Evaluation and

Client Trustworthiness .28 .12

Client Trust .31* .10

Counselor Trustworthiness .67*** .64***

Counselor Trust .23 .43***


am = 1.11 sessions, SD = 1.38 m = 4.5 sessions, SD = 4.37.

*g < .05 **D < .01 ***P < .0005


(Trust3) evidenced the highest correlations with both SATIS

(r = .600, p < .0001) and CEVAL (r = .665, ] < .0001) at

time, and time (SATIS: r = .603, Ep .0001; CEVAL: r =

.636, p j .0001). These findings indicate that as clients'

perceptions of their counselors as trustworthy increased, so

did clients' satisfaction with counseling in general and

satisfaction with their counselors.










Four multiple regression were also performed. The first

multiple regression involved Client Satisfaction (SATIS) at

time as the criterion variable and the four Trust variables

at time [Client Trustworthiness, (Trustl); Client Trust,

(Trust2); Counselor Trustworthiness, (Trust3); Counselor

Trust, (Trust4)] as the predictor variables. Results

revealed that the model was significant (E(4, 38) = 6.91, 2 S

.0003), indicating that at least one of the Trust variables

was significantly related to clients' satisfaction with

counseling (SATIS) at time. Counselor Trustworthiness

(Trust3) was the only predictor that reached statistical

significance (p : .0013). The R-square for this model (R2 =

0.421) was moderate, indicating that the predictors in this

model accounted for some of the variance in SATIS at time,

however, over fifty percent of the variance was still

unaccounted for, indicating that collectively the Trust

variables were not very good predictors of SATIS at time.

However, considering the highly significant correlation

between Counselor Trustworthiness (Trust3) and SATIS at time

(r = .600, p c .0001), Trust3 may explain most of the

variation accounted for by the model, and thus may still be a

good predictor of SATIS at time. See Table 4-7 for the

results of this regression.

The second regression included Client Satisfaction

(SATIS) at time (m = 4.5 sessions) as the criterion

variable, and the four Trust variables at time as the











Table 4-7

Multiple Regression for Client Satisfacti
Trust Variables at Time2 as Predictors


Source DF SS MS E P


Model 4 207.88 51.97 6.91 .0003

Error 38 285.75 7.52

Total 42 493.63


Variable DF Parameter Standard I P
Estimate Error


Intercept 1 12.43 3.45 3.60 .0009

Trustl-2 1 0.51 0.70 0.72 .4751

Trust2-2 1 0.75 0.44 1.69 .0985

Trust3-2 1 2.14 0.62 3.46 .0013

Trust4-2 1 -0.16 0.54 -0.29 .7757

R2 = .421 CV = 10.58 Root MSE = 2.74 m = 25.91

Adj. R2 = .360




predictor variables (see Table 4-8). Again results revealed

that the model itself was significant (E(4, 59) = 8.58, s

.0001), and Counselor Trustworthiness (Trust3) was the only

significant predictor (p < .0001). However the R-square for

this model (R2 = .368) was small. Once again it appears that

collectively the predictors in this model only accounted for


on at T me2 w th the


i i










Table 4-8

Multiple Regression for Client Satisfaction at Time3 with the
Trust Variables at Time3 as Predictors



Source DF SS MS F P



Model 4 706.06 190.02 8.58 .0001

Error 59 1306.92 22.15

Total 63 2066.98


Variable DF Parameter Standard T P
Estimate Error


Intercept 1 4.65 5.49 0.85 .4004

Trustl-3 1 -0.17 1.05 -0.16 .8705

Trust2-3 1 0.05 0.58 0.09 .9296

Trust3-3 1 4.21 1.03 4.09 .0001

Trust4-3 1 0.48 0.85 0.56 .5748

R2 = .368 CV = 18.81 Root MSE = 4.71 m = 25.91

Adj. R2 = .325




a small amount of the variance in SATIS at time. Yet, it is

possible that because Trust3 was highly correlated with SATIS

at time (r = .603, p S .0001), Trust3 accounted for most of

the variance in the model and may still be influential in

predicting SATIS at time.

The third regression involved Counseling Evaluation

(CEVAL) at time (m = 1.11 sessions) as the criterion










variable, and the four Trust variables at time [Client

Trustworthiness, (Trustl); Client Trust, (Trust2); Counselor

Trustworthiness, (Trust3); Counselor Trust, (Trust4)] as the

predictor variables (see Table 4-9). Once more, this model


Table 4-9

Multiple ReGression
the Trust Variables


for Counseling Evaluation at Time2 with
at Time2 as Predictors


Source DF SS MS F 2



Model 4 3.55 0.89 8.10 .0001

Error 38 4.16 0.11

Total 42 7.72


Variable DF Parameter Standard T p
Estimate Error

Intercept 1 2.95 0.42 7.07 .0001

Trustl-2 1 -0.03 0.08 -0.38 .7073

Trust2-2 1 0.06 0.05 1.21 .2346

Trust3-2 1 0.34 0.07 4.51 .0001

Trust4-2 1 -0.02 0.06 -0.24 .8074

R2 = .460 CV = 7.47 Root MSE = .331 m = 4.43

Adj. R2 = .403




was also statistically significant ((4, 38) = 8.10, p < =

.0001), and consistently, Counselor Trustworthiness (Trust3)

was the only predictor variable to reach statistical


the Trust Variables








86

significance (2 s .0001). Results revealed that the R-square

for this model (R2 = .460) was moderate, indicating that 46%

of the variance in CEVAL at time was accounted for by the

Trust variables. However, compared to the other trust

variables, Counselor Trustworthiness (CEVAL) appeared to be

the best predictor of clients' satisfaction with their

counselors at time.

The fourth regression included Counseling Evaluation

(CEVAL) at time as the criterion variable, and the four

Trust variables at time as the predictor variables.

Consistent with the other three regressions for this

hypothesis, this model was also significant (E(4, 59) =

10.18, p < .0001), and once again Counselor Trustworthiness

(Trust3) was the only significant predictor variable (p :

.0001). The R-square (R2 = .408) was also moderate

indicating that the Trust variables at time accounted for

approximately 41% of the total variance in clients'

satisfaction with their counselors at time. The consistent

finding that Counselor Trustworthiness was the only

significant predictor in all four regressions indicates that

clients' perceptions of their counselors as trustworthy

(Trust3) may be considered an important predictor of clients'

satisfaction with counseling and with their counselors

Results of this regression model are presented in Table 4-10.

Results of the multiple regressions for hypothesis six

revealed that only moderate amounts (R2 = .368. to .460) of










the variance in SATIS and CEVAL at time and time were

accounted for by the four Trust variables indicating that


Table 4-10

Multiple Regression
the Tst- Valriable a


for Counselino Evaluation at Time3 with
a' Tim= as 0 edTic=tor


Source DF SS MS F



Model 4 10.83 2.71 10.18 .0001

Error 59 15.69 0.27

Total 63 26.53


Variable DF Parameter Standard TI
Estimate Error


Intercept 1 1.85 0.60 3.08 .0032

Trustl-3 1 0.00 0.11 0.02 .9850

Trust2-3 1 -0.03 0.06 -0.45 .6512

Trust3-3 1 0.53 0.11 4.71 .0001

Trust4-3 1 0.03 0.09 0.35 .7302

R2 = .408 CV = 12.01 Root MSE = .516 m = 4.29

Adj. R2 = .368




collectively the Trust variables were not highly influential

predictors of clients' satisfaction with their counseling

(SATIS) and with their counselors (CEVAL). However, the

Pearson correlations revealed several significant positive

correlations between the Trust variables and the satisfaction


t-h= T-t- V-JAIles At- Time3 as P Le__ginrg










measures (SATIS and CEVAL). Counselor Trustworthiness

(Trust3) in particular evidenced highly significant positive

correlations with SATIS and CEVAL at both time and time (r

= .60 to X = .67, p : .0001 ), indicating that as clients'

perceptions of their counselors as trustworthy (Trust3)

increased, so did clients' satisfaction with their counseling

(SATIS) and counselors (CEVAL). Furthermore, Trust3 was the

only significant predictor in all four regressions,

suggesting that Counselor Trustworthiness may in fact be a

good predictor of clients' satisfaction with their counselors

and counseling The results of the analyses, therefore,

provide partial support for hypothesis six.

Hypothesis seven stated that compared to clients who

plan a mutual termination with their counselors, clients who

drop out of counseling will evidence lower expectations of

counseling (Personal Commitment, Facilitative Conditions,

Counselor Expertise, Nurturance) and lower levels of

perceived trust/trustworthiness (Client Trustworthiness,

Client Trust, Counselor Trustworthiness, Counselor Trust)

prior to beginning counseling (timel). In addition, dropouts

will have less positive evaluations of counseling (Client

Satisfaction) and their counselors (Counseling Evaluation)

than mutual terminators.

As originally stated, hypothesis seven required only

analyzing the comparison between mutual terminators and

dropouts at timel (prior to beginning counseling) for the

expectation factors and the trust variables. However, upon




Full Text
102
Table 4-17
Multiple Regression for Client Satisfaction at Time3 Using
Predictors from Time2
Source
DF
SS
MS
F
£
Model
10
398.32
39.83
2.16
.0525
Error
28
515.11
18.40
Total
38
913.43
Variable
DF
Parameter
Estimate
Standard
Error
T
P
Intercept
i
3.34
10.80
0.31
.7596
EAC-B1-2
i
-2.07
2.08
-1.00
.3266
EAC-B2-2
i
-0.92
1.64
-0.56
.5817
EAC-B3-2
i
1.07
0.86
1.24
.2249
EAC-B4-2
i
-0.19
1.37
-0.14
.8928
Trustl-2
i
1.59
1.37
1.16
.2572
Trust2-2
i
0.42
0.78
0.53
.6000
Trust3-2
i
0.38
1.39
0.27
.7856
Trust4-2
i
-0.28
1.05
-0.26
.7939
SATIS-2
i
0.31
0.38
0.82
.4163
CEVAL-2
i
4.36
3.25
1.34
.1899
R2 = .4361
CV
= 16.33
Root MSE =
4.29
m = 26.26
Adj. R2 = .
.2347


122
Commitment factor) was significantly correlated with clients'
satisfaction with counseling.
The four regressions also conducted to test hypothesis
five revealed that the expectation factors (EAC-B) accounted
for only small amounts of the variance (R2 = .114 to .324)
for client satisfaction with counseling (SATIS) and with
their counselors (CEVAL) both early (time2) and later in
counseling (time3). This finding contributes to and extends
research by Heppner and Heesacker (1983) which found that
specific precounseling expectations were not good predictors
of clients1 satisfaction with their counselors (CEVAL) later
in counseling. The findings in this study suggest that in
addition to precounseling expectations, clients' expectations
later in counseling have very little predictive utility for
clients' satisfaction with counseling or with their
counselors.
Hypothesis six was that as clients' perceived levels of
their own (Trustl and Trust3) and their counselors'(Trust2
and Trust4) trustworthiness and trust increase, clients'
satisfaction with counseling (SATIS) and with their
counselors (CEVAL) will also increase. Pearson correlations
and regressions were conducted to test the hypothesis. The
finding that most of the trust variables were moderately
correlated with both SATIS and CEVAL indicates a positive
relationship between clients perception of themselves as
trustworthy (Trustl) and trusting (Trust2) and clients'
satisfaction with counseling (SATIS) early in counseling


88
measures (SATIS and CEVAL). Counselor Trustworthiness
(Trust3) in particular evidenced highly significant positive
correlations with SATIS and CEVAL at both time2 and time3 (r
= .60 to r = .67, p < .0001 ), indicating that as clients'
perceptions of their counselors as trustworthy (Trust3)
increased, so did clients' satisfaction with their counseling
(SATIS) and counselors (CEVAL). Furthermore, Trust3 was the
only significant predictor in all four regressions,
suggesting that Counselor Trustworthiness may in fact be a
good predictor of clients' satisfaction with their counselors
and counseling The results of the analyses, therefore,
provide partial support for hypothesis six.
Hypothesis seven stated that compared to clients who
plan a mutual termination with their counselors, clients who
drop out of counseling will evidence lower expectations of
counseling (Personal Commitment, Facilitative Conditions,
Counselor Expertise, Nurturance) and lower levels of
perceived trust/trustworthiness (Client Trustworthiness,
Client Trust, Counselor Trustworthiness, Counselor Trust)
prior to beginning counseling (timel). In addition, dropouts
will have less positive evaluations of counseling (Client
Satisfaction) and their counselors (Counseling Evaluation)
than mutual terminators.
As originally stated, hypothesis seven required only
analyzing the comparison between mutual terminators and
dropouts at timel (prior to beginning counseling) for the
expectation factors and the trust variables. However, upon


To JOHNNY,
the wind beneath my wings


8
Clients' Expectations About Counseling
It has been rioted that clients' expectations of the
counseling process and of their counselor both impact on all
three components of the therapeutic relationship: the
working alliance, the transference relationship, and the real
relationship. These client expectations influence the
transference relationship, which as mentioned, exists prior
to and in anticipation of therapy. In turn, the transference
relationship impacts on the working alliance. In addition,
Gelso and Carter (1985) suggested that the working alliance
is the most basic of the components since it contains the
essential reasons for individuals to seek therapy to begin
with, namely their expectations to receive help. The real
relationship is also influenced by expectations in that these
expectations define the roles that the counselor and client
will play in the therapeutic relationship.
The interpersonal influence literature has a dearth of
research investigating the effect of client characteristics
on the interpersonal influence process. Clients'
expectations about counseling is one client variable that has
received substantial attention in the counseling literature
and it has recently found its way into the social influence
literature (Heppner & Heesacker, 1983). Not only is client
expectations an important client variable to be considered in
social influence research, in addition, Heppner and Heesacker
(1983) suggest that research investigate the predictive


69
of sessions increases so will clients' expectations for
Personal Commitment, Facilitative Conditions, Counselor
Expertise, and Nurturance (expectation factors).
To test hypothesis three, separate repeated measures
analyses of variance (ANOVAs) were conducted with each
expectation factor as a dependent measure, and counseling
received over three time periods as the independent measure.
Results of the four repeated measures ANOVAs indicated that
there were no overall effects due to time for any of the
expectation factors, indicating that there were no
significant differences in the means for any of the four
expectation factors from prior to beginning counseling, to
after the first or after two or more counseling sessions.
There was an increase in the means for Nurturance (EAC-B4)
over the three time periods (see Table 4-1, however, the
differences in the means were not significant.
In addition, Pearson correlations were utilized to
determine the type of relationship (positive vs negative)
between number of sessions attended by clients and clients1
expectation for Personal Commitment (EAC-B1), Facilitative
Conditions (EAC-B2), Counselor Expertise (EAC-B3), and
Nurturance (EAC-B4). Results indicated that none of the
correlations were significant, such that clients
expectations about counseling were not significantly related
to the amount of time clients spent in counseling. The
results of the analyses conducted for hypothesis three,
therefore, failed to support the hypothesis.


10
Clients' Satisfaction with Counseling
Finally, clients' satisfaction with the counseling
process in early sessions has been shown to be one of the
best predictors of later satisfaction and other outcome
measures (Gomes-Schwartz, 1978). This finding suggests that
client satisfaction with counseling is a key ingredient in
the change process in psychotherapy. Specifically, it
impacts on the quality of the real relationship and is
essential in forging a strong working alliance.
In social influence research, client satisfaction with
counseling has been considered a measure of counselor
influence. Heppner and Claiborn (1989) indicated that
although satisfaction is a global and ambiguous variable, it
is certainly an important outcome, especially from a consumer
advocacy position.
A final important consideration in counseling research
is the applicability of research findings to a wide variety
of clients. Many research studies are limited in that their
findings are specific to the clients who are able to complete
the study. Therefore it is usually not known how dropouts
perceived their counselor or how satisfied they were with
counseling.
Significance of the Study
The current study sought to be a contribution to social
influence theory research. As mentioned before, the majority


167
Thompson, C. E., Neville, H., Weathers, P. L., Poston, W. C.,
& Atkinson, D. R. (1990). Cultural mistrust and racism
reaction among African-American students. Journal of
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Tinsley, D. J., Hinson, J. A., Holt, M. S., & Tinsley, H. E.
A. (1990). Level of psychosocial development,
perceived level of psychological difficulty, counseling
readiness, and expectations about counseling:
Examination of group differences. Journal of Counseling
Psychology. 37 143-148.
Tinsley, H. E. A. (1982). Expectations About Counseling.
Unpublished Test Manual.
Tinsley, H. E. A., & Benton, B. L. (1978). Expectations and
preferences in counseling. Journal of College Student
Personnel 19. 537-543.
Tinsley, H.E. A., Bowman, S. L., & Ray, S. B. (1988).
Manipulation of expectancies about counseling and
psychotherapy: Review and analysis of expectancy
manipulation strategies and results. Journal of
Counseling Psychology. 35., 99-108.
Tinsley, H. E. A., & Harris, D. J. (1976). Client
expectations for counseling. Journal of Counseling
Psychology. 23., 173-177.
Tinsley, H. E. A., Workman, K. R., & Kass, R. A. (1980).
Factor analysis of the domain of client expectancies
about counseling. Journal of Counseling Psychology, 27,
561-570.
Torrey, E. F. (1972). What Western psychotherapists can
learn from witchdoctors. American Journal of
Orthopsychiatry. 42, 69-76.
Watkins, C. E., Jr., & Terrell, F. (1988). Mistrust level
and its effects on counseling expectations in Black
client-white counselor relationships: An analogue study.
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Watkins, C. E., Jr., Terrell, F., Miller, F. S., & Terrell,
S. (1989). Cultural mistrust and its effects on
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relationships. Journal of Counseling Psychology, 36.,
447-450.


166
Rotter, J. B. (1971). Generalized expectancies for
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451.
Schneider, L. J. (1985). Feminist values in announcements
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251.
Soelling, M. E., & Newell, T. G. (1984). Effects of
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1194.
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359-363.


100
Table 4-16
Multiple Regression for Client Satisfaction at Time3 Using
Predictors from Timel
Source
DF
ss
MS
F
P
Model
8
572.67
71.58
2.77
.0126
Error
51
1315.91
25.80
Total
59
1888.58
Variable
DF
Parameter
Standard
T
P
Estimate
Error
Intercept
i
23.40
8.76
2.67
.0101
EAC-B1-1
i
-1.41
1.31
-1.08
.2868
EAC-B2-1
i
0.46
1.72
0.27
.7893
EAC-B3-1
i
-0.07
0.84
-0.08
.9374
EAC-B4-1
i
-1.42
1.53
-0.93
.3583
Trustl-1
i
2.96
1.06
2.79
.0074
Trust2-1
i
1.63
0.72
2.28
.0269
Trust3-1
i
-1.65
1.71
-0.96
.3410
Trust4-1
i
0.83
1.03
0.80
.4269
R2 = .3032
cv
= 20.25
Root MSE =
5.08
m = 25.08
Adj. R2 = .1939
Trust2 (Client Trust: B < .0269). However, the R-square for
this model (R2 = .3032) was small, indicating that the


73
EAC-B1; Facilitative Conditions, EAC-B2; Counselor Expertise,
EAC-B3; Nurturance, EAC-B4) increase, clients' satisfaction
with counseling (Client Satisfaction, SATIS) and with their
counselors (Counseling Evaluation, CEVAL) will also increase.
Both Pearson correlations between the expectation factors and
SATIS and CEVAL, and multiple regressions were conducted to
test this hypothesis. Only Personal Commitment (EAC-B1) at
time2 (m = 1.11 sessions) showed moderate but significant
positive correlations with clients' general satisfaction with
counseling (Client Satisfaction; SATIS), and with clients'
satisfaction with their counselors (Counseling Evaluation;
CEVAL) at time2. These results indicated that early in
counseling (time2), as clients' expectations for Personal
Commitment to counseling increased, so did their satisfaction
with their counseling (SATIS) and with their counselors
(CEVAL). See Table 4-3 for the results of the Pearson
Correlations.
Four multiple regressions were also conducted. More
specifically, the first regression included Client
Satisfaction (SATIS) at time2 (m = 1.11 sessions) as the
criterion variable and the following as predictor variables:
the four expectation factors (Personal Commitment, EAC-B1;
Facilitative Conditions, EAC-B2; Counselor Expertise, EAC-B3,
Nurturance, EAC-B4) at time2. Results of this regression
revealed that the model itself was not statistically


64
was no relationship between Counselor Trustworthiness
(Trust3) and counselors' experience levels (CEXP) prior to
beginning counseling (timel). However, early in counseling
t(time2, m = 1.11 sessions), F(3, 38) = 3.05, E <.0401], and
later in counseling [(time3, m = 4.5 sessions), F(3, 38) =
4.88, E < .0058], the more experienced counselors were seen
as less trustworthy.
Pearson correlations confirmed that there was a moderate
but significant negative relationship between CEXP and Trust3
at time2 (£ = -.34, e < .02). The correlations between CEXP
and Trust3 at timel (r = -.04, e < -67) and time3 (r = -.18,
E < .16) were also negative, however neither were
significant. These results indicate that as the counselors'
experience levels increased, clients' perceptions of their
counselors as trustworthy decreased. Plots confirmed these
finding showing negative slopes between CEXP and Trust3 at
time2, and at time3.
Interestingly, the interaction between clients'
previous counseling experience and counselors' experience
levels (PREV*CEXP) was not detected in the within subjects
analysis, although the trend did increase through the three
time periods. Since the effect was found in the between
subjects analysis, the current study may not have had enough
statistical power to detect the three-way interaction
(time* PREV* CEXP).


87
the variance in SATIS and CEVAL at time2 and time3 were
accounted for by the four Trust variables indicating that
Table 4-10
Multiple Regression for Counseling Evaluation at Time3 with
the Trust Variables at Time3 as Predictors
Source
DF
SS
MS
F
P
Model
4
10.83
2.71
10.18
.0001
Error
59
15.69
0.27
Total
63
26.53
Variable
DF
Parameter
Standard
T
p
Estimate
Error
Intercept
i
1.85
0.60
3.08
.0032
Trustl-3
i
0.00
0.11
0.02
.9850
Trust2-3
i
-0.03
0.06
-0.45
.6512
Trust3-3
i
0.53
0.11
4.71
.0001
Trust4-3
i
0.03
0.09
0.35
.7302
R2 = .408
cv
= 12.01
Root MSE =
.516
m = 4.29
Adj R2 = .368
collectively the Trust variables were not highly influential
predictors of clients' satisfaction with their counseling
(SATIS) and with their counselors (CEVAL). However, the
Pearson correlations revealed several significant positive
correlations between the Trust variables and the satisfaction


45
Neither counselors nor clients perceived any difference in
the effectiveness ,of counseling due to racial similarity or
dissimilarity. Therefore, it was concluded that race was not
a barrier to counseling.


130
counseling. A larger sample size would enhance the stability
and viability of the results presented.
In addition, it is noted that only a very small number
of clients from Student Mental Health Services (SMHS = 3)
participated in the study. A larger sample from this center
would have contributed to more diversity in perceptions about
counseling in this study, and would have lent itself to
comparisons between the clients at SMHS and the clients at
the Counseling Center.
A principal consideration in conducting research in real
life situations is the implementation of the project.
Inherent in research of this nature is the difficulty
involved in ensuring that the established procedure is
actually and accurately being implemented by the support
staff, the counselors and the clients. A major limitation of
the present study was the failure of some clients to return
their questionnaires at the requested times. The impact
being that the sample size was smaller in the analyses using
only those questionnaires that were returned at the
appropriate times (e.g., n = 24 versus 45). The results of
these analyses would therefore be more meaningful and
possibly result in more significant findings with a larger
sample size.
Another limitation of the study directly related to the
sites in which the research was conducted was the time frame
involved in the study. As noted earlier, both counseling
centers provide short-term therapy. It is possible that


APPENDIX I
MEMORANDUM TO/FROM COUNSELORS
Counseling Center
301 Peabody Hall
392-1575
MEMORANDUM:
DATE:
TO: Cel i a Caesar
FROM:
SUBJECT:
This is to notify you that I will be picking up this client
for counseling. Our first appointment is scheduled for
Please return this
schedule your first
Please put address
memo to Celia's mailbox as soon as you
appointment.
on back!
154


142
2. Be sure to answer all the items. Circle N/A if the
statement is not applicable to you.
3. Do not circle more that one number for any one item.
4. There is no time limit; however, work rapidly. Do not
spend too much time on any one item.
Items; Always Often Sometimes Rarely Never
1. I felt the counselor 5 4 3 2 1
accepted me as an
individual.
2. I felt comfortable 5 4 3 2 1
in my interviews with the
counselor.
3. The counselor acted as 5 4 3 21
though he/she thought
my concerns and problems
were important to him/her.
4. The counselor acted 12345
uncertain of himself/herself.
5. The counselor helped 54321
me to see how taking tests
would be helpful to me. ( N/A ).
6. The counselor acted 1 2 3 4 5
cold and distant.
7. I felt at ease 54321
with the counselor.


54
client's address. The receptionist forwarded the envelopes
with the completed questionnaires, and consent forms to the
principal investigator. Clients were scheduled for a first
counseling session one or more weeks after their intake.
At Student Mental Health Services there is no waiting
list, such that each client who received an initial,
evaluation interview (intake) and was not referred out
immediately, was scheduled for a first session one week after
his/her intake. Therefore, on a specific day each week the
principal investigator collected the envelopes containing the
completed Expectations About Counseling-Brief Form (EAC-B),
Likert Trust Scale (LTS) questionnaires, and signed consent
forms completed prior to intake, and left envelopes
containing the second set of questionnaires for the
appropriate clients returning the following week for their
first scheduled counseling session.
The questionnaires completed prior to intake were
numerically coded upon receipt by the principal investigator
and separated from the signed Informed Consent Form. Clients
were asked not to write their names on the questionnaires.
Subsequent questionnaires were also numerically coded. This
procedure was used to ensure client confidentiality, and to
match questionnaires completed prior to intake with those
completed by the clients later in the study.
After each client's first counseling session, he/she was
either mailed or hand delivered (by the counselor), an
envelope containing a cover letter, (Appendix J) the


I would like to receive a summary of the results of your
project.
Mame:
Address:


51
Mutual terminators were those individuals who planned a
termination with their counselors regardless of the number of
counseling sessions they had attended. Dropouts were those
individuals who terminated counseling without the knowledge
or against the advice of their counselor, and who felt that
their goals in counseling were not met.
The Client Summary Sheet (C1SS) was completed by the
clients (Appendix F). It is a parallel form of the Counselor
Summary Sheet. However, additionally, clients were asked to
indicate the degree to which they perceived themselves to be
similar to their counselors by circling a number on a likert
scale ranging from 1 not at all similar to 5 very
similar.
Procedure
Participants were 106 students or student spouses who
sought counseling at the University of Florida Counseling
Center (CC) and five who sought therapy at the University of
Florida Student Mental Health Services (SMHS). Of this
original sample, 77 (69%) subjects actually received
counseling beyond an initial, evaluation interview (intake)
(CC: 74, SMHS: 3). Of the other 34 students, 14 (41%) were
closed after their intake, 11 (32%) were referred to other
facilities on campus or to private practitioners in the
community, and nine (27%) were closed after being on the
waiting list. Walk-in clients, emergency clients, and
clients screening for a particular group did not take part in



PAGE 1

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PAGE 184

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165
Neimeyer, G. J., & Gonzales, M. (1983). Durations,
satisfaction, and perceived effectiveness of cross-
cultural counseling. Journal of Counseling Psychology,
30., 91-95.
Nooney, J. B. & Polansky, N. A. (1962). The influence of
perceived similarity and personality on verbal
accessiblity. Merrill-Palmer Quarterly, j3, 33-40.
Patterson, C. H. (1958). Client expectations and social
conditioning. Personnel and Guidance Journal 37., 136-
138.
Pekarik, G. (1983). Follow up adjustment of outpatient
dropouts. American Journal of Orthopsychiatry, 53., 501-
511.
Phillips, E. L., & Fagan, P. J. (1982). Attrition: Focus
on the intake and first therapy interviews. Paper
presented at the meeting of the American Psychological
Association, Washington, DC.
Ponterotto, J. G., Anderson, W. H., Jr., & Grieger, I. Z.
(1986). Black students' attitudes toward counseling as
a function of racial identity. Journal of Multicultural
Counseling and Development. 14, 50-59.
Proctor, E. K., & Rosen, A. (1981). Expectations and
preferences for counselor race and their relation to
intermediate treatment outcomes. Journal of Counseling
Psychology. 28., 40-46.
Richmond, J. (1984). Comparison of clients' and nonclients'
expectations of counseling. Psychology Reports, 54,
752-754.
Rogers, C. R. (1951). Client-centered therapy. Boston:
Houghton Mifflin.
Rosenthal, R., & Frank, J. D. (1956). Psychotherapy and the
placebo effect. Psychological Bulletin, 53., 294-302.
Rothmeier, R. C. & Dixon, D. N. (1980). Trustworthiness and
influence: A reexamination in an extended counseling
analogue. Journal of Counseling Psychology, 27., 315-
319.
Rotter, J. B. (1967). A new scale for the measurement of
interpersonal trust. Journal of Personality, 35., 651-
665.


9
utility of clients1 expectations about counseling on clients'
satisfaction with counseling received (a potential measure of
counselor influence).
Trus t/Trus tworthiness
Of crucial importance to the working alliance and the
real relationship is the client's ability to trust and their
perception of the counselor as trustworthy. Although
psychoanalytic theory does not place much emphasis on the
working alliance or the real relationship, it is evident that
in all therapies it is essential for clients to believe that
their counselor will not mislead or injure them in any way.
The inability to form a trusting relationship impedes the
progress of therapy since it is doubtful that a working
alliance and a positive real relationship would be
established.
Trustworthiness has been the least frequently examined
variable in the social influence research. This lack of
research on trustworthiness as a component of the influence
process has been criticized as a weakness in the research
literature (Fong & Cox, 1983). Moreover, the research that
has been conducted has focused on trustworthiness as a
counselor characteristic. Social influence research has not
considered trust as a client variable although, as noted in
the therapeutic relationship literature, a client's ability
to trust is crucial in forming a working alliance with
his/her therapist.


61
To test hypotheses five through nine, regressions,
correlations, and analyses of variance (ANOVAs) procedures
were used. All data obtained regardless of when the
questionnaires were returned could be and were used in these
analyses. The return rates were as follows: time2 = 73%, n
= 45; time3 = 83%, n = 64.
Preliminary Analyses
It has been noted that clients come in to counseling
with preformed ideas about their counselor and the counseling
process (Gelso & Carter, 1985). It appeared possible,
therefore, that clients' previous counseling experiences
(PREV) may affect their expectations and perceptions of their
present counselors and counseling experiences. It is further
noted that there have been inconsistent findings in the
counseling research literature pertaining to the influence of
actual counselor experience level (CEXP) on the counseling
process (Heppner & Heesacker, 1982; Auerbach & Johnson,
1977) .
Thus, prior to performing the statistical analyses to
test the stated hypotheses, a series of repeated measures
analyses of variance (ANOVAs) were performed to determine
whether the dependent measures covary with clients previous
counseling experience (PREV: 1 = yes; 2 = no), counselors'
experience levels (CEXP: 1 = prepracticum; 2 = practicum; 3
= intern/associate; 4 = senior staff; 5 = psychiatrist), or
the interaction of these two variables (PREV*CEXP). The


68
there were no significant differences in the means for Trust2
or Trust4 over the same time period.
A repeated measures analysis of covariance (ANCOVA) was
conducted with Counselor Trustworthiness (Trust3) as the
dependent variable, time in counseling (timel, time2) as the
independent variable, and clients' previous counseling
experience (PREV), counselors' experience levels (CEXP), and
the interaction of these two latter variables (PREV*CEXP) as
covariates. The within subjects test for the entire sample
indicated no overall time effect, and no differences in the
means for Counselor Trustworthiness (Trust3) over time due to
previous counseling experience (PREV), counselor experience
level (CEXP) or the interaction of these two variables
(PREV*CEXP). There was a decrease in clients' perceptions of
their counselors as trustworthy from prior to beginning
counseling (m = 4.71, 2D = 0.46) to after their first session
(m = 4.21, 2D = 0.98), however, the difference was not
significant. The results obtained failed to support
hypothesis two.
Hypothesis three stated that clients will exhibit higher
positive expectations for Personal Commitment (EAC-Bl),
Facilitative Conditions (EAC-B2), Counselor Expertise (EAC-
B3), and Nurturance (EAC-B4) after two or more sessions than
prior to beginning counseling or after their first session.
Moreover, there will be a significant positive association
between number of counseling sessions attended by clients and
clients' expectations about counseling, such that as number


4-13 Simple Statistics Comparing Mutual Terminators and
Dropouts on the Client Satisfaction and
Counseling Evaluation Measures 95
4-14 Analysis of Variance for Client Satisfaction at Time3
Based on the Counselors' Perspectives of the
Clients' Termination Status 96
4-15 Analysis of Covariance for Counseling Evaluation at
Time3 Based on the Counselors' Perspectives of
the Clients' Termination Status 98
4-16 Multiple Regression for Client Satisfaction at Time3
Using Predictors from Timel 100
4-17 Multiple Regression for Client Satisfaction at Time3
Using Predictors from Time2 102
4-18 Multiple Regression for Counseling Evaluation at Time3
Using Predictors from Timel 104
4-19 Multiple Regression for Counseling Evaluation at Time3
Using Predictors from Time2 105
4-20 Perceived Client Similarity Ratings to Counselors for
Mutual Terminators and Dropouts 108
ix


77
p < .0414), suggesting that at least one of the independent
variables was significantly related to clients' satisfaction
with their counselors (CEVAL) at time2. Personal Commitment
(EAC-B1) was the only significant predictor variable (p <
.0018) in this model. Interestingly, the R-square obtained
was small (R2 = .324) indicating that the model accounted for
only a small amount of the variance in Counseling Evaluation
(CEVAL). However, Pearson correlations indicated that
Personal Commitment was also the only expectation factor
significantly correlated with CEVAL at time2 (r = .43, p <
.004) suggesting that Personal Commitment may still be a good
predictor of Counseling Evaluation at time2, if it (EAC-B1)
accounts for most or all of the variation explained by the
model. The fourth regression included CEVAL at time3 as the
criterion variable and the following as predictor variables:
the four expectation factors (EAC-B) at time3 (m = 4.5
sessions), clients' previous counseling experience (PREV),
counselors' experience levels (CEXP), and the interaction of
these two latter variables (PREV*CEXP). Results indicated
that the model was significant (F(7, 56) = 2.14, p < .0542),
suggesting that at least one of the independent variables was
significantly related to clients' satisfaction with their
counselors at time3 (see Table 4-5).
Personal Commitment (EAC-B1, p < .0081), clients'
previous counseling experience (PREV, p < .0205), and the
interaction of clients' previous counseling experience and


e
The transference relationship, also defined as the
"unreal" relationship, is a core construct in psychoanalytic
theory and as such was originally defined in terms of Oedipal
issues. However, as counseling psychologists began to
explore the potential value of this construct, it became
evident that a redefinition was needed. Consequently, Gelso
and Carter (1985) proposed the following definition: "a
repetition of past conflicts (usually but not always
beginning in early childhood) with significant others such
that feelings, behaviors, and attitudes belonging rightfully
in those early relationships are displaced; in therapy, the
displacement is onto the therapist." These misperceptions or
misinterpretations of the therapist may be positive or
negative and are only a part of the total relationship.
Gelso and Carter (1985) further suggest, that transference
occurs from the moment of first contact with the helping
person, and often even prior to that, in terms of
anticipations about the intervention and the helping person.
They label this type of transference as preformed
transferences or transference "expectancies" (Gelso & Carter,
1985) It would appear, therefore, that as clients come in
to counseling, they already have preformed ideas about their
counselor and the counseling process. Regardless, of where
these ideas find their origin or whether or not they are
within the client's conscious awareness, they greatly impact
on the therapeutic relationship.


127
time and chose to terminate; she felt better, was minimally
committed to looking at deeper issues, and had increased time
demands on her.
The reasons listed above may not necessarily clarify the
discrepancy found between the nonsignificant findings based
on the clients1 perspective and the significant results based
on the counselors' perspectives of the clients' termination
status. However, it is clear that clients and counselors can
have different experiences in the same counseling
relationship, and further can interpret the termination of
counseling very differently.
The finding that the expectation factors, Trust
variables and satisfaction measures early in counseling (m =
1.11 sessions; time2) were successful in accounting for
sixty-seven percent of the variance in client satisfaction
with their counselors (CEVAL) later in counseling (m = 4.5
sessions; time 3) provides partial support for hypothesis
eight. The joint effect of the independent variables (EAC-B,
Trust, SATIS, CEVAL, ) at time2 accounted for more of the
variance in CEVAL at time3 (R2 =.673) than did the
independent variables at timel (EAC-B, Trust; R2 = .314) .
Counseling Evaluation CEVAL) early in counseling (time2)
appeared as the only significant predictor in the model,
indicating that early satisfaction with the counselors was a
good predictor of later satisfaction with the counselors.
In addition, however, in the case where
multicollinearity does exist (the independent variables are


Hypothesis eight stated that compared with precounseling
expectations and perceptions of trust/trustworthiness,
expectations, trust, and satisfaction early in counseling
would be better predictors of satisfaction later in
counseling. Regressions indicated that expectations, trust,
and satisfaction early in counseling accounted for sixty-
seven percent of the total variance in clients' satisfaction
with their counselors later in counseling.
Lastly, hypothesis nine stated that there would be
significant positive associations between clients1 perceived
similarity to their counselors, and clients' satisfaction
with their counseling/counselors. Correlations supported this
hypothesis. Considerations for future research are
discussed.
Xll


34
salient factors in the client's decision to not return after
the intake. Archer (1984) suggests that reciprocal referrals
to other agencies, augmenting services with paraprofessionals
and prepackaged counseling programs and using groups and
workshops in lieu of individual counseling could be used to
reduce waiting lists. For individuals who terminate after
one or more counseling sessions, factors related to the
counseling process might play a more significant role in
nonmutual terminations (Cochran & Stamler, 1989)
Premature termination is typically viewed as a negative
treatment outcome. However several authors have questioned
this belief noting that premature termination does not always
reflect a negative outcome from the client's perspective
(Cochran & Stamler, 1989; Gunzberger, Henggeler, & Watson,
1985; Kokotovic & Tracey, 1987). Clients may feel that their
problem has been solved, their symptoms have been
substantially reduced or they have developed adequate support
systems outside the counseling setting (Mennicke, Lent, &
Burgoyne, 1988).
Although there has been very little research
investigating the welfare of dropouts, one study showed that
for a sample of clients failing to show for their first
appointment after receiving an intake interview and being
placed on a waiting list, only 29% reported having resolved
their presenting problem and 50% had sought help elsewhere
(Christensen, Birk, & Sedlacek, 1977). To the extent that
premature termination does not represent a positive treatment


105
Table 4-19
Predictors
from Time2
Source
DF
ss
MS
F
P
Model
13
5.98
0.46
3.96
.0015
Error
25
2.90
0.12
Total
38
8.88
Variable
DF
Parameter
Standard
T
P
Estimate
Error
Intercept
i
1.08
0.96
1.12
.2722
EAC-B1-2
i
0.03
0.19
0.16
.8721
EAC-B2-2
i
0.01
0.13
0.09
.9266
EAC-B3-2
i
0.03
0.07
0.43
.6683
EAC-B4-2
i
-0.02
0.12
-0.17
.8702
Trustl-2
i
0.21
0.11
1.86
.0754
Trust2-2
i
-0.01
0.06
-0.20
.8427
Trust3-2
i
-0.10
0.12
-0.87
.3952
Trust4-2
i
-0.00
0.08
-0.04
.9702
CEVAL-2
i
0.81
0.26
3.07
.0050
SATIS-2
i
-0.01
0.03
-0.34
.7372
PREV
i
-0.80
0.53
-1.52
.1403
CEXP
i
-0.28
0.14
-1.98
.0582
PREV*CEXP
i
0.34
0.17
1.96
.0616
R2 = .673
cv
= 7.74
Root MSE =
.341
m = 4.40


Caesar, for everything: love, support, understanding,
patience, encouragement, and taking care of Andres and
Camille. I would certainly not have been able to complete
this dissertation without him by my side.
v


106
Trust variables at time2, CEVAL at time2, SATIS at time2,
PREV, CEXP, and PREV*CEXP. Results of this regression
revealed that the model itself was statistically significant
(F(13, 25) = 3.96, 2 < .0015), however, the only significant
predictor in this model was CEVAL at time2, (p < .005). The
R-square was .673 indicating that the expectation factors.
Trust variables and satisfaction measures early in counseling
(m = 1.11 sessions) were collectively successful in
accounting for sixty-seven percent of the variance in client
satisfaction with their counselors (CEVAL) later in
counseling (m = 4.5 sessions).
However, of the thirteen predictor variables, only early
satisfaction with the counselors (CEVAL-2) significantly
predicted later satisfaction with the counselors (CEVAL-3).
The finding suggests either that the other predictor
variables were not highly influential in predicting CEVAL at
time3, or that because of the number of variables in the
model, and possibly high intercorrelations among the
predictor variables, the unique contribution of each variable
to the model was relatively small and nonsignificant.
Results of the analyses for hypothesis eight indicated
that of the four regressions performed to test the
hypothesis, only one regression accounted for more than fifty
percent of the variance in either of the satisfaction
measures. Specifically, the predictors at time2 (EAC-B,
Trust, SATIS, CEVAL, PREV, CEXP, PREV*CEXP) accounted for
approximately sixty-seven percent of the total variance in


110
significantly covaried with PREV, CEXP, PREV*CEXP and thus,
the latter three Variables should be included in the analyses
for the stated hypotheses involving Counselor Trustworthiness
and Counseling Evaluation. Nine hypotheses were tested. A
summary of the results is presented below.
The first hypothesis was that clients will exhibit
higher positive expectations (Personal Commitment,
Facilitative Conditions, Counselor Expertise, Nurturance) of
their counselors and counseling after their first session
than prior to beginning counseling. Results did not support
this hypothesis. Specifically it was found that there were
no significant differences between the means for any of the
expectation factors from prior to beginning counseling to
after the first counseling session.
The second hypothesis stated that clients will also
evidence higher levels of perceived trustworthiness and trust
(Client Trustworthiness, Client Trust, Counselor
Trustworthiness, Counselor Trust) after their first session
than prior to beginning counseling. Results of the analyses
did not support this hypothesis. Moreover, it was found that
there was a significant (p < .0558) decrease in clients'
perceptions of themselves as trustworthy (Client
Trustworthiness: Trustl) from prior to beginning counseling
to after the clients' first counseling session. There were
no significant differences over time in the means for Client
Trust (Trust2), Counselor Trustworthiness (Trust3), or
Counselor Trust (Trust4).


126
the statisticalanalyses. It is difficult obtaining
information from individuals who have dropped out of
counseling, which affects both the statistical power of
analyses, and the access to information about the reasons for
dropping out.
From the information that was obtained, clients who
labeled themselves as dropouts, gave the following reasons
for termination: Satisfactorily met goals for counseling (n
= 1); Counselor did not have the skills/resources necessary
to help me (n = 5); Situation improved on its own (n = 4);
Client and counselor could not agree on approach (n = 3);
Counselor and client were not compatible (n = 2) and Other (n
= 4). Under other, clients listed the following reasons for
dropping out of counseling: Did not feel comfortable with
how things were going; time restraints; felt invaded by the
unannounced appearance of a second counselor in the sessions.
Counselors gave the following reasons for their clients'
premature terminations: Satisfactorily met goals for
counseling (n = 1); Situation improved on its own (n = 2);
Client sought counseling elsewhere (n = 1); Client and
counselor could not agree on approach (n = 3); Counselor and
client were not compatible (n = 3); Other (a = 5); and No
response (n = 2). Under other, counselors listed the
following reasons: Client and counselor schedules
incompatible; unknown, client made no further contact; client
dropped out of group and did not return counselor's calls;
client is not ready to address her issues in therapy at this


52
the study. In addition, clients seeking career counseling
with the Peer Counselors were not asked to participate in
this study.
When clients arrived for an initial, evaluation
interview (intake) they were given a cover letter (Appendix
G) introducing them to the study, two copies of the Informed
Consent Form (Appendix H), the Expectations About Counseling-
Brief Form (EAC-B), the Likert Trust Scale (LTS), and an
envelope, along with the usual intake forms used by the
Counseling Center (CC) or Student Mental Health Services
(SMHS).
The Informed Consent Form included information about the
purpose of the study, the anticipated risks/benefits of
participation in the study, information about the principal
investigator, and information about the procedure to be used
in the study. Specifically, clients were informed that they
would be asked to complete two questionnaires prior to
beginning counseling, four questionnaires after their first
counseling session (including retaking the first two
completed), and five questionnaires after completing
counseling or after their sixth session (whichever was
first). The latter five questionnaires included retaking the
four completed previously. Completing all five
questionnaires was estimated to take 15 minutes.
Moreover, clients were informed that their participation
in the study was voluntary, and that their refusal to
participate in the study would not affect their access to


counseling sessions along with the Client Satisfaction
Questionnaire and Counseling Evaluation Inventory.
The first four hypotheses stated that clients'
expectations, and perceptions of trust/trustworthiness, would
increase over the three specified time periods. T-tests and
repeated measures analyses of variance and covariance
revealed no significant changes in these variables over time.
Correlations indicated that number of counseling sessions
attended was not significantly related to clients'
expectations, or perceptions of trust/trustworthiness.
Hypotheses five and six combined stated that clients
expectations and perceptions of trust/trustworthiness would
be significantly associated with clients' satisfaction with
counseling. Multiple regressions indicated that neither of
these variables were significant predictors of clients'
satisfaction with counseling.
Hypothesis seven stated that compared to dropouts,
mutual terminators would evidence higher expectations,
perceptions of trust/trustworthiness, and satisfaction with
counseling. Multivariate and univariate analyses of variance
and covariance revealed no significant differences between
the two groups on their expectations or perceptions of
trust/trustworthiness. However, based on the counselors'
designations of the clients' termination status, mutual
terminators were more satisfied with counseling than
dropouts.
xi


APPENDIX E
COUNSELOR SUMMARY SHEET
DATE
NAME
(First) (MI) (Last)
NUMBER OF SESSIONS (excluding intake)
Individual Group
Couples
STATUS
Continuing Therapy
Mutual Termination
Dropped Out
Other (specify)
DATE OF TERMINATION (if applicable)
REASON(S) FOR TERMINATION (check all items that apply)
Client satisfactorily met his/her goals for counseling.
Counselor did not have strengths necessary to help the
client.
Client's life situation improved on its own.
Client sought counseling elsewhere.
Counselor and client could not agree on how to approach
the client1s problems.
Counselor and client did not get along.
Other (please specify)
147


41
summarizes the results of 38 studies which explored the
relationship of 31 variables to client satisfaction.
Variables included client and therapist demographic
variables, and interaction of these variables; behavioral,
stylistic or characterological variables, such as personality
and warmth; miscellaneous variables, such as therapist
assignment and duration of treatment; and finally, outcome or
effectiveness measures.
No client or therapist demographic variables were found
to consistently affect client satisfaction. Two client
characterological variables were found to be significantly
linked to satisfaction. Moberg (1977) found that alcoholic
inpatients were less satisfied on four of 12 scales when they
failed to identify themselves as alcoholics, and on six
scales when they planned to control their drinking rather
than abstain. However, these findings have not been
replicated.
With regard to therapist behaviors and stylistic
variables, clients appear to be more satisfied with
therapists that are active (Anderson, Harrow, Schwartz, &
Kupfer, 1972; Bent, Putnam, Kiesler, & Nowicki, 1976; Derita,
1976), warm (Bent, et al., 1976; McClanahan, 1974) empathic
(Anderson, et al., 1972; Fretz, 1966; McClanahan, 1974;
McNally, 1973) and interested (Anderson, et al., 1972; Fretz,
1966; McClanahan, 1974) in them. It is critical to note,
however, that these characteristics were measured by client
report.


74
Table 4-3
Pearson Correlation Coefficients Among the Expectation
Factors and the Counselinq/Counselor Satisfaction Measures
Variables
Time2a
Time3b
Client Satisfaction and
Personal Commitment
.34*
.14
Facilitative Conditions
.17
-.10
Counselor Expertise
.05
-.06
Nurturance
.25
-.03
Counseling Evaluation and
Personal Commitment
.43**
.19
Facilitative Conditions
.14
-.04
Counselor Expertise
-.04
-.09
Nurturance
.12
-.04
am = 1.11 sessions, SD = 1.38 = 4.5 sessions, SD = 4.37.
*E < .05 **E < .005
significant (F(4, 38) = 1.47, p < .2313) indicating that none
of the expectation factors at time2 were related to Client
Satisfaction (SATIS) at time2. Likewise, the R-square (R2 =
.134) was quite small indicating that the expectation factors
at time2 did not account for much of the variance in SATIS at


APPENDIX B
LIKERT TRUST SCALE
For the purposes of this study:
Trustworthy is defined as: deserving of trust by others.
"I can be trusted by others."
Trusting is
defined as:
inclined
to trust
others. "I trust
others."
1) Please
rate yourself
on the following
scale.
TRUSTWORTHY
UNTRUSTWORTHY
1
2
3
4
5
TRUSTING
NOT TRUSTING
5
4
3
2
1
2) Please
rate your counselor on
the following scale:
TRUSTWORTHY
UNTRUSTWORTHY
1
2
3
4
5
TRUSTING
NOT TRUSTING
5
4
3
2
1
140


APPENDIX H
INFORMED CONSENT FORM
The purpose of this study is to investigate the quality
of counseling individuals receive at the University of
Florida Counseling Center. In order to accomplish this, you
will be asked to complete five questionnaires related to your
expectations about counseling and your satisfaction with
counseling. The results of this study will help the staff
understand how they can better serve the needs of those
individuals using their services.
You will be asked to complete two questionnaires prior
to beginning counseling which will take approximately 8
minutes total (EAC-B, LTS). After your first counseling
session you will be asked to complete two different
questionnaires in addition to retaking the first two you
completed (EAC-B, LTS, CEI, CSQ). Completing these four
questionnaires will take you approximately 12 minutes.
Finally, after completing counseling or after your sixth
session (whichever is first) you will be asked to retake the
four questionnaires which will take approximately 12 minutes
to complete (EAC-B, LTS, CEI, CSQ), and an additional
questionnaire (C1SS) which will take approximately one to
three minutes to complete. If at any time you lose your
questionnaires or forget to return them to the Counseling
151


14
In 1979, Duckro, Beal, and George noted the failure of
many researchers to distinguish between expectations about
counseling and preferences for counseling. This lack of
distinction has caused many inconsistencies in the
literature. Tinsley, Bowman, and Ray (1988) later reaffirmed
this problem and noted that an additional confound in the
expectancy literature is the use of clients' perceptions of
counseling. In response to this issue Tinsley, et al. (1988)
suggested that the full range of client expectancies be
identified and that a reliable and valid measure of those
expectancies be developed. Tinsley, Workman and Kass (1980)
developed the Expectations About Counseling Questionnaire
(EAC) to address this need. Although this questionnaire has
not been published, it has been used in several studies
(e.g., Craig & Hennessy, 1989; Hardin, Subich, & Holvey,
1988; Heppner & Heesacker, 1983;) and has been shown to
measure constructs unique from those measured by perception
instruments (Hayes and Tinsley, 1989).
Much of the research on expectations about counseling
has focused on the demographic characteristics of
respondents. For example, studies have shown that women
expect that their counselors will be confrontational,
genuine, nurturing, tolerant, trustworthy (Subich, 1983), and
attractive, and expect that they themselves will be more
responsible and self-motivated in counseling than men (Hardin
& Yanico, 1983). However, men expect counselors to be
directive, critical, analytical (Tinsley & Harris, 1976), and


99
(time3) in counseling, and they were more satisfied than the
dropouts with their counselors (CEVAL) later in counseling
(time3). The significant results obtained, however, were
only for those analyses based on the counselors' perspectives
of their clients' termination status. No significant results
were obtained based on the clients' perspectives of their own
termination status.
Hypothesis eight stated that compared to clients'
expectations (EAC-B factors) and perceived
trust/trustworthiness (Trust variables) prior to beginning
counseling (timel), clients' expectations, perceived
trust/trustworthiness, and satisfaction with counseling
(SATIS) and their counselors (CEVAL) early in counseling
,(time2, m = 1.11 sessions) will be better predictors of
clients' satisfaction with their counseling and counselors
later in counseling (time3, m = 4.5 sessions). The analyses
for this hypothesis were four separate multiple regressions.
The first regression included SATIS at time3 as the criterion
variable and the following as predictor variables: the four
EAC-B factors at timel, and the four Trust variables at
timel. Results indicated that the model itself was
significant (F(8, 51) = 2.77, p < = .0126) suggesting that at
least one independent variable was significantly related to
clients' satisfaction with counseling (SATIS) at time3 (see
Table 4-16) The only two significant predictors in this
model were Trustl (Client Trustworthiness: p < .0074), and


17
about counselor empathy, directiveness, attractiveness (first
function) and counselor self-disclosure, genuineness, and
nurturance (second function). Craig and Hennessy (1989)
suggested that the degree to which these expectations are
confirmed or refuted can have an impact on the initial
progress of counseling, and the counseling outcome.
A study by Tinsley, Hinson, Holt, and Tinsley (1990)
investigated the relation between students' levels of
psychosocial development and their expectations about
counseling. Results showed that students with more
appropriate educational plans, more mature career plans and
more mature lifestyle plans had more positive expectations
for counseling. The authors suggested that working with less
mature college students, counselors may need to focus early
in the counseling process on helping the students develop a
sense of personal responsibility for the success of
counseling.
Karzmark, Greenfield, and Cross (1983) investigated the
relationship between clients' levels of adjustment and
expectations for therapy. Subjects were 110 new clients at a
university counseling center. Clients estimated their level
of adjustment by completing a questionnaire consisting of 25
items selected from the SCL-90 symptom checklist (Derogatis,
Lepman, & Covi, 1973. Therapists assessed clients'
adjustment at the end of the intake session using the Global
Assessment Scale (GAS; Endicott, Spitzer, Fleiss, & Cohen,
1976). In addition, clients' expectations were assessed by a


L
1780
199
.(LI 3 7
UNIVERSITY OF FLORIDA
3 1262 08554 7775


98
their counselors (m = 4.44, SD = 0.54) at time3 based on the
counselors' perspectives of their clients' termination
status. See Table 4-15 for the results of this ANCOVA.
Table 4-15
Analysis of Covariance for Counseling Evaluation at Time3
Based on the Counselors' Perspectives of the Clients'
Termination Status
Source
DF
SS
MS
F
P
Model
5
6.78
1.355
3.12
.0253
Error
25
10.86
0.434
Total
30
17.64
Source
DF
Typelll
SS
MS
F
£
Co. Drop
i
0.13
0.13
0.30
0.59
Previous
i
0.33
0.33
0.76
0.39
Co.Exp.
i
0.00
0.00
0.00
0.95
Co.Exp*Prev. 1
0.24
0.24
0.56
0.46
o
u
If
0
u
.Drop 1
0.02
0.02
0.04
0.84
R2 = .384
CV
= 16.06 .
Root MSE =
0.66
m = 4.10
The results of the analyses for hypothesis seven,
therefore, provided partial support for hypothesis seven.
Specifically, the results indicate that compared to
dropouts, mutual terminators were more satisfied with
counseling in general (SATIS) both early (time2) and later


76
Table 4-4
Multiple Regression for Counseling Evaluation at Time2 with
the Expectation Factors at Time2 as Predictors
Source
DF
ss
MS
F
£
Model
7
2.58
0.37
2.39
.0414
Error
35
5.39
0.15
Total
42
7.97
EAC-B1-2
1
1.77
1.77
11.46
.0018
EAC-B2-2
1
0.15
0.15
0.97
.3303
EAC-B3-2
1
0.00
0.00
0.01
.9389
EAC-B4-2
1
0.02
0.02
0.16
.6920
PREV
1
0.18
0.18
1.18
.2838
CEXP
1
0.56
0.56
3.66
.0639
PREV*CEXP
1
0.15
0.15
0.94
.3386
Variable
DF
Parameter
Estimate
Standard
Error
T
P
Intercept
i
2.81
0.77
3.65
.0008
EAC-B1-2
i
0.59
0.17
3.39
.0018
EAC-B2-2
i
-0.13
0.13
-0.99
.3303
EAC-B3-2
i
-0.00
0.07
-0.08
.9389
EAC-B4-2
i
-0.05
0.12
-0.40
.6920
PREV
i
-0.60
0.55
-1.09
.2838
CEXP
i
-0.26
0.13
-1.98
.0559
PREV*CEXP
i
0.18
0.18
0.97
.3386
E2 = .324
CV
= 8.83
Root MSE =
.392
m = 4.45


146
4. If a friend
were in need of
similar help, would you
recommend our Center to him/her?
1
2
3
4
No, definitely
not
No, I don11
think so
Yes, I think
so
Yes,definitely
5. How satisfied are you with the amount of help you have
received thus far?
1
2
3
4
Quite
dissatisfied
Indifferent or
mildly
dissatisfied
Mostly
satisfied
Very satisfied
6. Has the counseling you received helped you
to deal more
effectively with your problems?
4
3
2
1
Yes, they
helped a
great deal
Yes, they
helped
somewhat
No, they
really dicin' t
help
No, they
seemed to make
things worse
7. In an overall, general sense
, how satisfied
are you with
the service you
have received thus far?
4
3
2
1
Very satisfied
Mostly
satisfied
Indifferent or
mildly
dissatisfied
Quite
dissatisfied
8. If you were
to seek help again, would you come back to
our Center?
1
2
3
4
No, definitely
not
No, I don't
think so
Yes, I think
so
Yes,definitely
WRITE COMMENTS BELOW:
Copyright c 1989, 1990. Clifford Attkisson, Ph.D. Reprinted
and used with written permission of the publisher.


23
high and low trusters. In relation to race, Terrell in
conjunction with other associates has contributed much needed
information relative to Blacks' mistrust of Whites, including
the development of a scale to measure cultural mistrust
(Terrell, & Terrell, 1981).
It has been well established that the development of
trust is crucial to the effectiveness of counseling (Fong &
Cox, 1983; Johnson & Noonan, 1972; Rogers, 1951; Williams,
1974). Corazzini (1977) describes trust as including several
concepts; expectancy, reliance upon others, faith,
surrendering of control, consistency, mutuality, and utility
for risk. Rotter (1971) defines trust as "an expectancy by
an individual or a group that the word, promise, verbal, or
written statement of another individual or group can be
relied on" (p. 444). In counseling, Fong and Cox (1983) note
that "trust is the client's perception and belief that the
counselor will not mislead or injure the client in any
way"...(and) is one of the crucial issues in the first stage
of counseling" (p. 163).
A study by Lagace and Gassenheimer (1989) using the
MacDonald, Kessel, and Fuller Self-report Trust Scale (1972)
showed that there were no differences between men and women
on trust. However, differences were found on the Suspicion
scale, with men scoring as more suspicious.
Rotter has been influential in the area of interpersonal
trust with the development of his Interpersonal Trust Scale
(1967). Some demographic data obtained with this instrument


66
Pearson correlations and plots were conducted separately
for clients with no previous counseling experience and
clients with previous counseling experience. Pearson
correlations revealed that for clients with no previous
counseling experience, there were moderate, but
nonsignificant negative relationships between CEVAL and CEXP
both at time2 (p = -.42, p < .108), and time3 (r = -.33, p <
.103). However, for clients with previous counseling
experience, the relationship between CEXP and CEVAL changed
from being negative at time2 (r = -.10, p < .627) to being
positive at time3 (p = .28, p < .094). These correlations
were also not significant. Plots confirmed these findings
showing consistent negative slopes at time2 and time3 for
clients with no previous counseling experience. In contrast,
for clients with previous counseling experience, plots showed
a negative slope between CEVAL at time2 and CEXP, but a
positive slope between CEVAL at time3 and CEXP, which
resulted in the interaction effect.
Tests of the Hypotheses
Since the preliminary analyses revealed that both
Counselor Trustworthiness (Trust3) and Counseling Evaluation
(CEVAL) were significantly affected by clients previous
counseling experience (PREV), and counselors' experience
levels (CEXP), these two variables and their interaction
(PREV, CEXP, and PREV*CEXP) were included as covariates in
the analyses involving Trust3 and CEVAL. Where results with


132
that accepting unequivocally that precounseling expectations
do not affect termination status is probably premature,
sighting that one confounding factor may result from clients
who make subsequent appointments in order to conform to their
counselor's desires although they themselves may feel
satisfied after one interview. It may be prudent, therefore,
for future similar research to include a social desirability
scale (i.e.. Marlowe-Crown) as part of the study.
In research that includes the EAC-B for its predictive
utility., it may also be important to educate clients about
the differences between preferences and expectations.
Especially for clients with no previous counseling
experience, who have very little or no information about the
counseling process, these two concepts may be difficult to
differentiate.
Furthermore, it was Tinsley et al. (1980) who first
raised the possibility that clients' expectations about
counseling can be too high (i.e., magical thinking) as well
as too low (i.e., skeptical or pessimistic). This finding
was then substantiated by Tinsley, Bowman, and Barich (1993)
suggesting the "possibility of a curvilinear relation between
expectations about counseling and many constructs of
interest" (p. 51). The authors underscored the possibility
of such a relation as important for future research, rather
than assume a linear relation.
Tinsley (1992) has also proposed that "research on
expectations about counseling would be enhanced by the


24
indicated that youngest children were less trusting than
only, oldest, or middle children. Also college students
identifying themselves as atheists or agnostics were
significantly less trusting than others. Students who
perceived their parents as believing in two different
religions were less trusting than those who perceived both
parents as believing in the same religion or lack of religion
(Rotter, 1967) .
In addition, a study by Terrell and Barrett (1979)
investigating the differences in interpersonal trust between
lower and upper socioeconomic classes, men and women, and
blacks and whites found that males were more trusting than
females, higher socioeconomic group members were more
trusting than lower ones, and White students were more
trusting than Black students. In relation to gender
differences, a contrasting finding was reported in a study by
Kaplan (1973) in which factors were derived for Rotter's
Trust Scale (1967). Males demonstrated significantly less
trust than females on each of the trust factor dimensions.
Grace and Schill (1986) investigated the differences in
social support and coping styles of subjects high and low in
interpersonal trust. Students in an introductory psychology
class were administered instruments measuring their level of
interpersonal trust, social support during the past month,
perception of social support from friends and family, and
coping style. Results showed that subjects high in trust
viewed both friends and family as more supportive than


117
perceived similarity to their counselors increased, so did
the clients' satisfaction with counseling and with their
counselors. It was further shown that compared to dropouts,
mutual terminators viewed themselves as more similar to their
counselors. This finding was based both on the counselors'
and clients' perspectives of the clients' termination status.
Discussion of the Results
The finding that there were no significant increases in
the means for any of the expectation factors over time nor
any significant positive correlations between the number of
counseling sessions attended by clients, and clients
expectations for Personal Commitment, Facilitative
Conditions, Counselor Expertise or Nurturance failed to
support hypotheses one and three. Only one expectation
factor (Nurturance, EAC-B4) showed a consistent increase in
the means from prior to beginning counseling, after the first
session, and after two or more sessions. However, the
differences in the means were not significant. This finding
that there were no significant increases in the means of any
of the expectations factors over time is somewhat difficult
to interpret in that there are no other literature with which
a direct comparison of the present results can be made, nor
is normative data available for this inventory (EAC-B). The
factor scores for the Expectations About Counseling-Brief
Form have not been widely used in research implementing
repeated measures designs. Typically the subscales of the


119
Bl) and Facilitative Conditions (EAC-B2) remained high over
the course of the study (m = 5.30 5.78 on a 7 point Likert
scale), such that there was reduced latitude for the means to
increase further. The Nurturance Factor (EAC-B4; m = 4.53 -
4.62) and particularly the Counselor Expertise Factor (EAC-
B3; m = 3.86 4.19) had lower means across time leaving the
possibility open for increases in these means over time. The
fact that the means for these Factors (EAC-B3 and EAC-B4)
remained low to moderate in comparison to the means for the
first two factors (EAC-B1 and EAC-B2) is an interesting
consideration for future research.
The finding that there were no significant increases in
the means for the Trust variables over time failed to support
hypotheses two and four. Furthermore, there were no
significant positive correlations between number of
counseling sessions attended by clients and clients'
perceptions of their own trust/trustworthiness (Client
Trustworthiness, Client Trust) nor their counselors'
trust/trustworthiness (Counselor Trustworthiness, Counselor
Trust). Again, these results may have been affected by the
small sample size and time frame within which the study was
conducted.
There was a decrease in clients perceptions of
themselves as trustworthy (Client Trustworthiness, Trustl)
from prior to beginning counseling to after the first
counseling session that could be interpreted as significant
(E < -0558), and thus worth noting. However, it is also


18
5-item, factor analytically derived scale. Clients assessed
therapy outcome by completing the Client Satisfaction
Questionnaire (CSQ; Larsen, Attkisson, Hargreaves, & Nguyen,
1979), and therapists evaluated therapy outcome by
reassessing clients with the GAS at termination.
Therapists' assessments of the clients' adjustment with
the GAS were used to predict clients' expectations. The
regression performed revealed a significant but small
positive linear relationship. Clients' own evaluations of
adjustment were not significant predictors of clients'
expectations. Clients expectations for counseling also bore
a small but significant positive linear relationship to their
satisfaction. Clients' expectations were not related to
therapists' ratings of outcome.
A study by Heppner and Heesacker (1983) examined client
satisfaction in relation to clients' expectations about
counseling and their perception of counselor characteristics.
Seventy-two clients at a university counseling center
completed the study. Clients' perceptions of their
counselors expertness, attractiveness and trustworthiness
were obtained by the Counselor Rating Form (CRF; Barak &
Lacrosse, 1975). Forty-five items, constituting six scales
of the EAC were used to measure clients' expectations of
their own openness and motivation in counseling, and their
expectations of their counselor's acceptance, expertness,
attractiveness, and trustworthiness. Clients' satisfaction
with counseling was measured by the Counseling Evaluation


BIOGRAPHICAL SKETCH
Celia Rochelle Andersen was born on April 4, 1964, on
the island of St.Croix, in the United States Virgin Islands.
She is the daughter of Carmen Lydia Belardo and Marcus
Criminatus Andersen. She attended primary school at St.
Mary's School, and high school at St. Joseph High School.
She received her Bachelor of Arts degree, cum laude, from the
University of Tampa, Florida, in April, 1985. She received
her Master of Science degree in psychology from the
University of Florida in December, 1991.
Major milestones in her life include marrying her best
friend of six years on May 7, 1988, Johnny Richardo Caesar.
Five years later she gave birth to a beautiful son, Andres
Malcolm, on April 27, 1993. A daughter was born to her on
February 16, 1995, Camille Breana.
169


25
subjects low in trust. Subjects high in trust reported
seeking more social support when feeling stressed, and
displayed less dysfunctional behavior than subjects low in
trust. Subjects low in trust became dysfunctional under
stress. The authors concluded that "a pervasive expectancy
that people cannot be trusted very likely negatively colors
the interpretation of reassurance and assistance, and results
in a perception of people as basically unsupportive" (p.
585) .
Williams (1974) conducted a study in which Black college
students attended five 60-minute counseling sessions with
either a white male professional counselor, or a black male
or female peer counselor. Subjects completed questionnaires
related to their level of interpersonal trust and self
disclosure before and after counseling. Subjects'
precounseling data on the self-disclosure and trust
questionnaires were used as a selection criteria to
participate in the study.
Although there were no significant differences between
the two groups on trust and self-disclosure after counseling,
mean differences showed that students established higher
levels of self-disclosure with the peer counselors (M =
133.89; SD = 23.09) than with the professional counselors (M
= 122.67; SD = 23.10) after counseling. This finding was not
obtained with regards to trust (peer group: M = 18.22; SD =
2.35; professional group: M = 19.67; SD = 4.55). In
addition, differences between the professional counselors and


20
expectations may change. These later expectations may be
more reflective of actual therapy experience and thus be more
predictive of client satisfaction than expectations prior to
counseling (Heppner & Heesacker, 1983) .
The authors suggested that additional research be
conducted to examine how and to what extent client
expectations change over the course of counseling. In
addition, subjects who terminated prematurely from the study
did not differ on initial EAC scores from subjects who
remained. However, it is unknown how these individuals
perceived their counselor or how satisfied they were with
their counseling. Again the authors suggested that research
in this area would extend the present findings by examining
premature terminators.
Tinsley et al. (1980) conducted a study that factor
analyzed client expectancies as measured by the EAC. The
factors obtained were Personal Commitment, Facilitative
Conditions, Counselor Expertise and Nurturance. The authors
believe that moderately high scores on these factors may be
more desirable than extremely high scores. Extremely high
scores on the Personal Commitment factor may indicate
compulsive, perfectionistic tendencies on the part of the
client, whereas low scores may characterize naive clients who
expect the counselor to cure them without any effort on their
part. Extremely high scores on the Facilitative Conditions
factor may indicate that the client expects the counselor to
act in some idealistic but unobtainable manner, whereas low


22
results. Fellows (1985) proposed that measuring differences
in expectations across time may offer a useful method for
studying changes in expectations. Finally, a follow up study
by Tinsley and Benton (1978) to the Tinsley and Harris (1976)
study confirmed that many potential clients may never seek
counseling because of their low expectation that they will be
helped.
An implication of these studies is that counselors need
to explore clients' expectations for counseling. Torey
(1972) believes that Western psychotherapists can learn a
great deal from African witch doctors. He found that witch
doctors typically consider the expectations of their clients
and that these expectations are critical to the success of
the treatment. Richmond (1984) suggests that the initial
counseling relationship should reflect the needs of clients
in response to expectations and that clients with lower
expectations may require additional relationship-building
interactions to move effectively toward change.
Trust in Counseling
The major focus of research on trust has been the
client's perception of the counselor as a trustworthy person.
The interpersonal influence research has contributed much
information in this area. However, there has been very
little research related to clients' ability to trust as a
personality variable. Work in this area has predominantly
investigated demographic differences and differences between


128
highly correlated with each other) it is difficult to assess
the contribution of individual partial effects. Other
independent variables in the model may in fact have high
predictive utility for clients' satisfaction with their
counselors (CEVAL), however because of the presence of other
highly intercorrelated variables in the model, the net effect
is that the unique contribution of each variable is reduced.
The finding that clients' perception of similarity to
their counselors was positively correlated to clients'
satisfaction with counseling (SATIS) and with their
counselors (CEVAL) later in counseling (time3) provides
support for hypothesis nine. Furthermore, it was found that
compared to dropouts, mutual terminators viewed themselves as
more similar to their counselors. Interestingly, the overall
mean similarity rating was not high (m = 2.84; on a 5 point
scale). This low mean similarity rating was possibly due to
the low ratings given by dropouts, who as shown from the
results of hypothesis seven were also less satisfied with
counseling.
Another possibility is that the low mean similarity
rating was the result of a paradox existing between clients'
perception of similarity to their counselors and various
client personality characteristics. Nooney and Polansky
(1962) found that equalitarian subjects (based on the
California F-Scale) were more verbally accessible to
individuals they perceived as similar to themselves.
Whereas, authoritarian subjects were more verbally accessible


16
counselor to be White. Although Blacks had a strong
preference for a counselor of the same race, failure to meet
this preference was not significantly related to premature
termination. In addition, neither groups' satisfaction with
counseling was significantly related to their expectation or
preference with regard to the counselor's race. However,
this study used only White counselors and it cannot be
determined if Blacks fared as well with a White counselor as
they would have with a Black counselor.
Recent studies have focused more on core personality,
attitudinal, and cognitive attributes. For instance Craig
and Hennessy (1989) used the Conceptual Systems Theory (CST)
as "a framework from which to assess the degree to which a
stable, preexisting personality dimension can explain the
variance in precounseling expectations (p. 402)." Conceptual
systems are defined as the predispositions that persons use
to construe and interpret perceptions. The CST holds that
there are four discrete stages of conceptual development.
Eleven subscales of the Expectations About Counseling
Questionnaire (EAC; Tinsley et al., 1980) were subjected to a
discriminant function analysis.
The two significant discriminant functions that
distinguished the four conceptual stages concerned
expectations that clients had about counselor
characteristics, attitudes and behaviors. More simply
stated, compared to each other, individuals in different
stages of conceptual development had different expectations


60
session for the third administration of the questionnaires.
Therefore, the first administration of the questionnaires
(timel) was prior to beginning counseling, and thus the
number of sessions attended was zero. For the second
administration (time2) the number of sessions attended ranged
from one to five sessions (m = 1.11, SD = 1.38). For the
third administration (time3) the number of sessions attended
ranged from one to 19 sessions (¡n = 4.50, SD = 4.37) Four
clients dropped out of counseling after their first session
and therefore were administered the third set of
questionnaires rather than the second set of questionnaires.
The data for these four clients were not included in the
analyses for the first four hypotheses.
In order to maintain the integrity of the study, only
data obtained from those clients returning their second set
of questionnaires after their first counseling session and
prior to their second session were included in the analyses
for the first four hypotheses (n = 24, 53%). The analyses
for these hypotheses were repeated measures analyses of
variance (ANOVAs) and repeated measures analyses of
covariance (ANCOVAs). Repeated measures designs employ the
use of a subject as his/her own control and follow-up.
Therefore it was necessary to use only the appropriate data
in order to obtain the comparisons stated in the first four
hypotheses: prior to counseling, after the first session,
and after two or more sessions.


11
of previous research in this area has been based on analogue
studies. There is a paucity of real-life counseling studies
investigating the importance of clients' expectations,
clients' trust levels, and clients' satisfaction with
counseling as important variables in the interpersonal
influence process. Therefore, the current research focused
on the importance of these client variables and their impact
on the influence process within a real-life counseling
situation.
More specifically, this study investigated:
1) the relationship among clients' satisfaction with
counseling, expectations about counseling, and perceived
trust/trustworthiness with the clients' decisions to stay in
counseling or to drop out;
2) whether expectations about counseling and perceived
trust/trustworthiness levels change over time and if so,
whether these changes are related to clients' satisfaction
with counseling; and
3) whether expectations about counseling, perceived
trust/trustworthiness, and clients' satisfaction with initial
counseling sessions predict clients' satisfaction with
counseling during later sessions and/or at termination.
It was proposed that the findings from this study would
provide:
1) an impetus for counseling centers to assess their
success at meeting the needs of their clients by obtaining an


63
The Repeated Measures Analysis of Variance with Counselor
Trustworthiness as the Dependent Variable
A repeated measures analysis of variance (ANOVA) was
performed with Counselor Trustworthiness (Trust3) as the
dependent measure,and the following as independent variables:
counseling received over three time periods (timel, time2,
time3), clients' previous counseling experience (PREV),
counselor experience level (CEXP) and the interaction of the
latter two variables (PREV*CEXP). Results of the between
subjects test revealed a significant overall effect for
PREV*CEXP, F (1, 38) = p < .031. This interaction (PREV*CEXP)
indicates that clients' perceptions of their counselors as
trustworthy were affected by the counselors' experience
levels and whether the client had previously attended
counseling. Those clients with previous counseling
experience did not perceive their counselors as significantly
more or less trustworthy based on the counselors' experience
levels. Whereas, those clients with no previous counseling
experience perceived the more experienced counselors as
significantly less trustworthy than the less experienced
counselors.
Results of the within subjects test revealed a
significant time*CEXP interaction, F(2, 76) = 3.95, p < .023,
indicating that the relationship between Counselor
Trustworthiness (Trust3) and counselors' experience levels
(CEXP) was not the same across the three time periods. There


114
evidenced highly significant positive correlations with SATIS
and CEVAL both early and later in counseling, indicating that
as clients' perceptions of their counselors as trustworthy
(Trust3) increased, so did clients' satisfaction with their
counseling (SATIS) and with their counselors (CEVAL).
Furthermore, Trust3 was the only significant predictor in all
four regressions, suggesting that Counselor Trustworthiness
may in fact be a good predictor of clients' satisfaction with
their counselors and counseling The results of the
analyses, therefore, provide partial support for hypothesis
six.
Hypothesis seven stated that compared to clients who
plan a termination with their counselors, clients who drop
out of counseling will evidence lower expectations of
counseling (Personal Commitment, EAC-B1; Facilitative
Conditions, EAC-B2; Counselor Expertise, EAC-B3; Nurturance,
EAC-B4) and lower levels of perceived trustworthiness and
trust (Client Trustworthiness, Client Trust, Counselor
Trustworthiness, Counselor Trust) prior to beginning
counseling (timel). In addition, dropouts will evidence less
satisfaction with counseling (SATIS) and with their
counselors (CEVAL) than mutual terminators.
In addition to the stated hypothesis, mutual terminators
and dropouts were compared on their expectations about
counseling and their perceptions of trustworthiness and trust
early in counseling (time2) and later in counseling (time3).
Results of the analyses for hypothesis seven provided partial


36
Questionnaire (CSQ; Larsen et al., 1979), the Counselor
Rating Form (CRF-S; Corrigan & Schmidt, 1983) and a number of
miscellaneous and open-ended items for assessing client
satisfaction with various aspects of the counseling center's
services. Students were given the option of signing the
completed evaluation forms. Premature terminators defined as
clients who initiated their own terminations of counseling
without the knowledge or against the advice of the assigned
counselor, attended an average of 3.04 sessions (range = 0 -
17; mode = 2.0). Successful terminators, defined as clients
who attended three or more sessions and terminated by mutual
agreement with their counselor, attended an average of 7.38
sessions (range = 1-16; mode = 10.0).
The university counseling center clients who terminated
prematurely were significantly less satisfied with counseling
services that they received. In addition, premature
terminators viewed their counselors as significantly less
expert, attractive and trustworthy than did clients who
terminated successfully. However, premature terminators who
continued longer in counseling expressed more satisfaction
regardless of the perceived expertness, attractiveness, and
trustworthiness of their counselors. Subjects who did not
sign their evaluation form viewed their counselors as
significantly less attractive and trustworthy and expressed
less satisfaction with services than those who chose to sign
their forms.


125
terminators as compared to dropouts, were more satisfied with
counseling in general both early and later in counseling, and
they were more satisfied with their counselors later in
counseling. This finding provides partial support for
hypothesis seven. The finding that dropouts were less
satisfied with counseling than mutual terminators is widely
supported in previous research (Cochran and Stamler, 1989;
Greenfield, 1983; Kokotovic and Tracey, 1987; McNeill et al.,
1987) .
No differences were observed between mutual terminators
and dropouts based on the clients' perspectives of their own
termination status. This interesting finding may be
understood in light of an article written by Gelso and Carter
(1994) on the Components of the Psychotherapy Relationship.
In discussing the "real relationship" (p. 303) the authors
suggest that "because of clients' and therapists' unique and
very different roles, therapists are able to have more
realistic perceptions of the clients than clients have of
therapists" (Gelso and Carter, 1994), and in this case
possibly of themselves. It may be that the clients were in
denial about having dropped out of counseling and therefore
did not label themselves as such.
It is also possible that there were more data involved
in the analyses that were based on the counselors'
perspectives (e.g., 27 mutual; 13 dropouts at timel) as
compared to the data obtained from the clients' perspectives
(e.g., 12 mutual; 7 dropouts at timel), raising the power of


118
inventory (EAC-B) have been used for research purposes, or
the inventory was administered at only one point in other
studies.
However, in speculating about the reason no significant
differences were found in clients' expectations about
counseling over time, several possibilities present
themselves. In the attempt to maintain the integrity of the
study by utilizing only those questionnaires that were
returned after the first session, the size of the sample
decreased significantly (i.e., from 45 to 24). It is
possible that the sample size was not large enough to show a
statistically significant difference in the means for the
Expectation factors over time.
Secondly, it is also possible that the time frame in
which the study was conducted was not adequate in which to
notice a difference in the means for the expectation factors.
The mean number of sessions attended by the clients was 6.33
(SD = 3.45). The particular time frame within which to
conduct this study was chosen because both the Counseling
Center and Student Mental Health Services, where participants
received counseling, provide only short-term therapy. A
different setting in which long term therapy is provided
would allow time for significant differences in clients'
expectations to appear, if in fact clients' expectations
about counseling do change over time.
Lastly, an examination of the means for the Expectation
factors revealed that the means for Personal Commitment (EAC-


37
These two studies are at variance with a study by
Gunzberger et al. ,(1985) which studied factors related to
premature termination of counseling relationships.
Gunzberger, et al. found no differences in client-reported
counseling outcome between clients who mutually terminated
with their counselors and clients who initiated their own
termination, contacted four weeks after termination. The
difference between this study and the two previous studies,
however, is that Gunzberger, et al. used a telephone
interview as opposed to anonymous questionnaires to gather
client information. This procedure may have been more
intrusive and thereby render the findings as less valid. It
has been found that anonimity reduces the high ceiling
effects present in reports of client satisfaction or
evaluation (McNeill, et al., 1987; Soelling & Newell, 1984).
Terrell and Terrell (1984) studied premature termination
as a function of counselor race, client sex, and cultural
mistrust level. One hundred and thirty-five black clients at
a community mental health center completed the Cultural
Mistrust Inventory (CMI; Terrell & Terrell, 1981) before
counseling. Clients were then randomly assigned to either a
Black or White counselor for an intake interview and
continued counseling. Premature terminators were defined as
individuals not returning for the second or any subsequent
counseling sessions.
Results showed that of the 68 clients seen by a Black
counselor, 17 (25%) did not return for a second session. Of


83
Table 4-7
Trust Variables at
Time2 as
Predictors
Source
DF
SS
MS
F
P
Model
4
207.88
51.97
6.91
.0003
Error
38
285.75
7.52
Total
42
493.63
Variable
DF
Parameter
Standard
T
P
Estimate
Error
Intercept
i
12.43
3.45
3.60
.0009
Trustl-2
i
0.51
0.70
0.72
.4751
Trust2-2
i
0.75
0.44
1.69
.0985
Trust3-2
i
2.14
0.62
3.46
.0013
Trust4-2
i
-0.16
0.54
-0.29
.7757
R2 = .421
cv =
10.58
Root MSE =
2.74
m = 25.91
Adj. R2 = .360
predictor variables (see Table 4-8). Again results revealed
that the model itself was significant (F(4, 59) = 8.58, p <
.0001), and Counselor Trustworthiness (Trust3) was the only
significant predictor (p < .0001). However the R-square for
this model (R2 = .368) was small. Once again it appears that
collectively the predictors in this model only accounted for


48
.60 or higher. The responsibility scale had a test-retest
reliability of .47 (Tinsley, 1982).
A factor analysis of the client expectancies measured by
the EAC-B (Tinsley et al., 1980) resulted in four factors:
Personal Commitment (EAC-B1), Facilitative Conditions (EAC-
B2), Counselor Expertise (EAC-B3), and Nurturance (EAC-B4).
These factors were used in the data analyses for this study.
The Personal Commitment factor reflect clients1 expectancies
to be responsible, open, and motivated, to have an attractive
counselor, to have a counseling experience characterized by
concreteness and immediacy, and to experience a good outcome.
The Facilitative Conditions factor concerns expectancies that
the counselor will be genuine, trustworthy, accepting, and
tolerant, that the counselor will sometimes confront the
client, and also that the counseling experience will be
characterized by concreteness. The Counselor Expertise
factor reflects client's expectancies that the counselor will
by directive, empathic, and an expert. Lastly, the
Nurturance factor concerns client's expectancies that the
counselor will be accepting, self-disclosing, nurturant, and
attractive. The EAC-B also includes questions related to
demographic data, including: age, gender, race, year in
school, and whether the client has seen a professional
counselor before.
The Likert Trust Scale (LTS) was developed for use in
this study (Appendix B). It consists of four questions
answered on a 5-point Likert scale. Two questions relate to


112
their own trustworthiness and trust (Client Trustworthiness,
Client Trust) as well as clients' levels of perceived
counselor trustworthiness and trust (Counselor
Trustworthiness, Counselor Trust). Results revealed that
there were no overall effects due to time for any of the
trust variables, indicating that there were no significant
differences in the means for the trust variables over the
three time periods. There was an increase in the means for
Counselor Trust (Trust4); however the increase was not
significant. In addition, there were no significant
correlations between any of the four trust variables and the
number of counseling sessions attended by clients, thereby,
failing to support the hypothesis.
Hypothesis five was that as clients' expectations for
counseling increase, clients' satisfaction with counseling
(Client Satisfaction; SATIS) and with their counselors
(Counseling Evaluation; CEVAL) will also increase. Results
of the analyses for this hypothesis provided only marginal
support for the hypothesis. Specifically it was found that
only small amounts (R2 = .114 to .324) of the variance in
SATIS and CEVAL early in counseling (time2: m = 1.11
sessions) and later in counseling (time3: m = 4.5 sessions)
were accounted for by the four expectation factors indicating
that the expectation factors were not highly influential
predictors of clients' satisfaction with their counseling
(SATIS) and with their counselors (CEVAL). However, the
Pearson correlations did reveal significant positive


28
White clients than Black clients. Empathy 3 (ability to
adopt another's frame of reference) was highly significant
for student race, counselor race, and trust level. High
trusters of both races believed that counselors of both races
could adopt anothers frame of reference. Low trusters of
both racial groups perceived White counselors as incapable of
adopting another person's frame of reference. White low
trusters also felt the Black counselors could not adopt
another's frame of reference. However, Black low trusters
believed that Black counselors could adopt another person's
frame of reference.
Results of this study indicate that Black clients and
White clients enter the counseling relationship with
preconceived feelings about the opposite race. Moreover, if
therapy focuses on the here-and now, race does not inhibit
counselors from respecting, uncritically accepting, and
recognizing the perceptions or feelings of a different race.
This is exemplified by the finding that regardless of
counselor race, clients of the opposite race experienced a
change in perceptions (negative to positive), relative to the
counselors ability to show affection and liking, after
counseling. A concern with this study is the question of
whether or not counselors were blind to the purpose of the
study. The author stated that "prior to counseling, the
counselors received the necessary details of the project (p.
163). The extent of these details was not described.


19
Inventory (CEI; Linden, Stone, & Shertzer, 1965). Clients
completed the EAC before their initial session and completed
the CRF and CEI two weeks before the end of the semester.
Results indicated that in general, the clients perceived
their counselors as being expert, attractive, and
trustworthy. In addition, clients rated their satisfaction
positively. Clients' perceptions of their counselors'
expertness, attractiveness and trustworthiness were
significantly correlated to clients' satisfaction with
counseling. Moreover, clients' expectations of their
openness and counselors' trustworthiness were also
significantly correlated with clients' satisfaction and
perceived counselor attractiveness, expertness and
trustworthiness. Regression analyses indicated that the CRF
variables were the best predictor of client satisfaction.
However, the EAC variables (acceptance, openness, motivation,
trustworthiness, attractiveness, expertness) did not
significantly predict client satisfaction nor counselor
expertness, attractiveness and trustworthiness (CRF).
These findings suggest that specific precounseling
client expectations were not predictive of client
satisfaction or perceived counselor characteristics after
counseling. One reason for this finding may be that before
entering counseling, clients have little knowledge of what to
expect from counseling, therefore specific clients'
expectations of counseling are based on minimal information,
or are not well founded. As they experience counseling their


ACKNOWLEDGEMENTS
First of all, I would like to thank and acknowledge the
Creator through Whom all things are possible.
I extend a warm appreciation to my committee. Dr.
Carolyn Tucker, Dr. Ronald Akers, Dr. Shae Kosch, Dr.
Jaquelyn Resnick, and Dr. Robert Ziller, for their patience,
guidance, and support. I especially thank Dr. Tucker for her
unfailing belief that I would succeed in this endeavor, and
for her uniqueness in combining teaching, consultation, and
guidance with warmth, humor, and genuine concern for me
throughout my graduate career.
Acknowledgements are due to all those who in some way
contributed to this study. The University of Florida
Counseling Center's Research Committee, and former Director
Dr. James Archer, are affectionately thanked for allowing the
study to be conducted at the Center. Special thanks are
extended to the counselors and staff who implemented the
study, and without whom data collection would not be
possible. Likewise, the Director of Student Mental Health
Services, Dr. Jackie Ayers, and the counselors there are
gratefully acknowledged for their support of the study. To
the clients who graciously accepted to take part in the
study, I sincerely extend my appreciation for their
iii


96
more satisfied with counseling in general (SATIS) at time3
than dropouts (m = 18.45, SD = 5.71), based on the
counselors' perspectives of the clients' termination status.
See Table 4-14 for the results of this ANOVA.
Table 4-14
on the Counselors'
Perspectives of the
Clients'
Termination
Status
Source
DF
SS
MS
F
P
Model
i
518.24
518.24
20.07
.0001
Error
29
748.73
25.82
Total
30
1266.97
Source
DF
Typelll
SS
MS
F
p
Co. Drop
i
518.24
518.24
20.07
.0001
R2 = .409
cv
= 21.2
Root MSE =
5.08
m = 23.97
To determine differences between the mutual terminators
and the dropouts on their satisfaction with their counselors
(Counseling Evaluation; CEVAL) four separate ANCOVAs were
performed. The first ANCOVA included CEVAL at time2 as the
dependent measure. The second ANCOVA included CEVAL at time3
as the dependent measure. However, the independent variable
for these two ANCOVAs was clients' termination status (mutual
vs dropout) based on the clients' perspectives of their own


62
results indicated whether these variables (PREV, CEXP,
PREV*CEXP) needed to be included as covariates in the
analyses to test the stated hypotheses.
Specifically, separate repeated measures ANOVAs were
performed with each of the following variables as the
dependent measure: the four Expectations About Counseling
(EAC-B) factors [Personal Commitment (EAC-B1), Facilitative
Conditions (EAC-B2), Counselor Expertise (EAC-B3), and
Nurturance (EAC-B4)] at each of the three time periods, the
four Likert Trust Scale variables [Client Trustworthiness
(Trustl), Client Trust (Trust2), Counselor Trustworthiness
(Trust3), Counselor Trust (Trust4)] at each of the three time
periods, and the two satisfaction measures [Client
Satisfaction (SATIS), Counseling Evaluation, (CEVAL)] at each
of the last two time periods. The independent variables in
each of these repeated measures ANOVAs were time in
counseling (timel, time2 time3), clients' previous counseling
experience (PREV), counselors' experience levels (CEXP), and
the interaction of these latter two variables (PREV*CEXP).
In the following sections are the results of the two repeated
measures ANOVAs that proved significant the one with
Counselor Trustworthiness (Trust3) as the dependent variable,
and the one with Counseling Evaluation (CEVAL) as the
dependent variable.


APPENDIX K
REMINDER LETTER
Date:
Dear:
A few weeks ago you were sent questionnaires regarding
your expectations about counseling and your satisfaction with
counseling. These questionnaires are part of the study that
counseling Center is involved in, and which you agreed to
participate in.
I am still extremely interested in having you complete
these questionnaires. If you have completed and returned
your questionnaires, thank you for your cooperation. If you
have not returned your questionnaires, please do so as soon
as possible. If you have lost your questionnaires, call me
at the Center before your next appointment.
If you have nay questions, concerns, or comments about
the study, please do not hesitate to contact me at the Center
(392-1575) Thank you for your participation.
Sincerely,
Celia Caesar, M.S.
Psychology Intern
156


108
to their counselors (SIM) and both clients' satisfaction with
counseling
(SATIS:
r = .69, p <
.0001), and with their
counselors
(CEVAL:
r = .67, £ <
.0001) at time3
It appears therefore that as clients' perceptions of their
similarity to their counselors increased, clients'
satisfaction with counseling (SATIS), and with their
counselors (CEVAL) also increased. Furthermore, compared to
dropouts (see Table 4-20), mutual terminators viewed
themselves as more similar to their counselors.
Table 4-20
Perceived Client Similarity Ratings to Counselors for Mutual
Terminators and DroDouts
Group
n
Mean
SD
Counselors
' Perspective
Mutual Terminators
20
3.0
1.17
Dropouts
11
1.91
0.83
Clients'
Perspective
Mutual Terminators
13
2.61
1.04
Dropouts
8
1.75
0.89
Similarity Ratings:
1 = Not at all similar to 5
= Very
similar.


160
Bent, R. J., Putnam, D. G., Kiesler, D. J., & Nowicki, S.
(1976). Correlates of successful and unsuccessful
psychotherapy. Journal of Consulting and Clinical
Psychology. 44, 149.
Berry, G. W. & Sipps, G. J. (1991) Interactive effects of
counselor-client similarity and client self-esteem on
termination type and number of sessions. Journal of
Counseling Psychology. 38., 120-125.
Bordin, E. (1955). The implications of client expectations
for the counseling process. Journal of Counseling
Psychology. 2, 17-21.
Brown, P., & Manela, R. (1977). Client satisfaction with
marital and divorce counseling. Family Coordinator. 26,
294-303.
Christensen, K., Birk, J., & Sedlacek, W. (1977). A follow
up of clients placed on a counseling center waiting
list. Journal of College Student Personnel. 18, SOS-
Ill.
Cochran, S. V., Stamler, V. L. (1989). Differences between
mutual and client-initiated nonmutual terminations in a
university counseling center. Journal of College
Student Development, 30, 58-61.
Corazzini, J. G. (1977). Trust as a complex multi
dimensional construct. Psychological Reports. 40., 75-
80.
Corrigan, J. D., Dell, D. M., Lewis, K. N. & Schmidt, L. D.
(1980). Counseling as a social influence process: A
review. Journal of Counseling Psychology. 27. 395-441.
Corrigan, J. D., & Schmidt, L. D. (1983). Development and
validation of revisions in the counselor rating form.
Journal of Counseling Psychology, I£, 64-75.
Craig, S. S., & Hennessy, J. J. (1989). Personality
differences and expectations about counseling. Journal
of Counseling Psychology. 36., 401-407.
Denner, B., & Halprin, F. (1974). Clients and therapists
evaluate clinical services. American Journal of
Community Psychology. 2, 373-386.(a)
Denner, B., & Halprin, F. (1974). Measuring consumer
satisfaction in a community outpost. American Journal
of Community Psychology. 2, 13-22. (b)


143
Always Often Sometimes Rarely Never
8. The counselor seemed 1
restless while talking
to me.
9. In our talks, the 1
counselor acted as if
he/she were better than I.
10. The counselor's 5
comments helped me to see
more clearly what I need
to do to gain my objectives
in life.
11. I believe the 5
counselor had a genuine
desire to be of service to me.
12. The counselor was 1
awkward in starting our
interviews.
13. I felt satisfied as 5
a result of my talks
with the counselor.
14. The counselor was 5
very patient.
15. Other students could 5
be helped by talking with
2
2
4
2
4
4
4
3
3
3
3
3
3
3
3
4 5
4 5
2 1
2 1
4 5
2 1
2 1
2 1
counselors.


CHAPTER 5
DISCUSSION
Summary of the Results
This study was designed to examine clients1 expectations
about their counselors and the counseling process
(expectation factors: Personal Commitment, Facilitative
Conditions, Counselor Expertise, Nurturance), and clients'
reports of their own trustworthiness and trust (Client
Trustworthiness, Client Trust), as well as their perceptions
of their counselors' trustworthiness and trust (Counselor
Trustworthiness, Counselor Trust) prior to beginning
counseling. In addition, changes in these variables over
time in counseling as well as their impact as factors in
clients' satisfaction with counseling in general (Client
Satisfaction) and satisfaction with their counselors
(Counseling Evaluation) were investigated.
Preliminary analyses involved a series of repeated
measures analyses of covariance to determine whether any of
the above specified variables of study significantly covary
with clients' previous counseling experience (PREV),
counselors' experience levels (CEXP) or the interaction of
these two variables (PREV*CEXP). Results revealed that two
variables (Counselor Trustworthiness, Counseling Evaluation)
109


93
termination status for any of the three MANCOVAs indicating
that there were no significant differences between mutual
terminators and dropouts on the four trust variables at any
of the three time periods based on the clients' perspectives
of their own termination status.
The fourth, fifth, and sixth MANCOVAs included the same
dependent variables and covariates as the first three
MANCOVAs (i.e. Trust variables, PREV, CEXP, PREV*CEXP).
However, the independent variable for each of these MANCOVAs
was clients' termination status (mutual, dropout) based on
the counselors' perspectives of the clients' termination
status.
Results again revealed that none of these three MANCOVAs
were significant. There were no overall effects for
termination status for any of the three MANCOVAs indicating
that there were no significant differences between mutual
terminators and dropouts on the trust variables at any of the
three time periods based on the counselors' perspectives of
the clients' termination status.
To compare the mutual terminators versus the dropouts on
the clients' satisfaction with counseling (SATIS), four
separate ANOVAs were performed over two time periods. The
ANOVAs were run based on both the counselors' and clients'
perspectives of the clients termination status.
Specifically, the first ANOVA included SATIS at time2 as the
dependent variable. The second ANOVA included SATIS at time3
as the dependent variable. The independent variable for each


168
Williams, B. M. (1974). Trust and self-disclosure among
black college students. Journal of Counseling
Psychology. 21, 522-525.
Wright, W. (1975). Relationships of trust and racial
perceptions toward therapist-client conditions during
counseling. Journal of Negro Education. 44., 161-169.
Yuen, R. K., & Tinsley, H. E. A. (1981). International and
American students' expectancies about counseling.
Journal of Counseling Psychology. 28, 66-69.
Zamostny, K., Corrigan, J., & Eggert, M. (1981).
Replication and extension of social influence process in
counseling: A field study. Journal of Counseling
Psychology. 28., 481-489.
Zarski, J. J., Sweeney, T. J., & Barcikowski, R. S. (1977).
Counseling effectiveness as a function of counselor
social interest. Journal of Counseling Psychology. 24.
1-5.


2
established, the counselor has the leverage needed to
influence clients therapeutically. Social influence theory,
therefore, conceptualizes counseling as an interpersonal
influence process. This process is defined as the ability of
one person to influence the actions, attitudes, or feelings
of another.
The social influence theory grew out of the social
psychology literature. Writers, such as Levy (1963), and
Goldstein, Heller, and Sechrest (1966), advocated a
connection between social psychological and psychotherapeutic
research. However, it was Strong's (1968) article that
introduced social influence as a viable theory of the
counseling process, and spearheaded research in counseling
based on the social influence theory.
In addition to proposing a two-stage model of the
counseling process, social influence theory also delineates
specific counselor variables that contribute to the
counselor's power to influence change in counseling. These
variables are perceived counselor expertness, attractiveness
and trustworthiness. A substantial amount of research has
been conducted to determine the effect of a range of
counselor-related variables (e.g., objective evidence of the
counselor's training, counselor verbal and nonverbal
behaviors, counselor attire, and office decor) on clients'
perceptions of their counselors' expertness, attractiveness,
and trustworthiness. As a tribute to the proliferation of
research in this area, three reviews of the social influence


4
majority of research in this area has been based on analogue
studies. These researchers urged movement away from the
overuse of brief analogue methodologies. They see as
absolutely essential the need for the social influence
process to be examined in realistic counseling situations.
In order to determine the research variables that would
be important in extending the knowledge base of the influence
process in counseling, an examination of the therapeutic
relationship was undertaken. The client-counselor
relationship is the vehicle through which counselors have the
ability to exert influence in promoting client change.
Therefore, it seemed essential to consider the determinants
of the therapeutic relationship.
The Therapeutic Relationship
It was from the client-centered therapy tradition that
much of the research about the therapeutic relationship
emanated. The late 1960s and early 1970s saw an abundance of
research and theory stemming from client-centered therapy.
The focus of this research was on the facilitative conditions
as being both necessary and sufficient for positive
counseling outcomes. However, more recently, research in
this area has diminished. Gelso and Carter (1985) suggested
that there is a natural cycle in the life of scientific
paradigms and that research on the facilitative conditions
has obtained its natural limit. Furthermore, Gelso and
Carter (1985) proposed that "what is now needed is a new


willingness to put down in writing their feelings about the
counseling process.
I sincerely thank the students who volunteered to help
with the scoring of the data, and my friend, Deborah Brady
for helping with the verification of the data. I am deeply
grateful to Dr. John Dixon for his time, effort, and
expertise in the statistical analyses of the data.
I extend my heartfelt love and appreciation to my
parents Carmen Lydia Andersen and Marcus Criminatus Andersen
for their undying support and encouragement in my academic
pursuits. I warmly acknowledge my sister and brothers whose
love and support keep me grounded. I sincerely thank my
large extended family of aunts, uncles, cousins, and in-laws
who in one way or another have been impactful in my life. I
affectionately thank the family at St. Augustine's Catholic
Student Center, and especially the 9:30, choir for being my
spiritual support.
In a special way, I honor my grandparents: Gregorio
Belardo, Vicenta O'Neill de Belardo, Natividad Monell de
Andersen, and Henry Andersen. Theirs are the shoulders upon
which I stand.
A ray of sunshine entered my life three years ago, my
son Andres Malcolm. He is acknowledged for his uncomplicated
way of experiencing life, which keeps me centered on the
truly important things. The newest addition to our family is
Camille Breana, whose pure beauty brightens every day.
Finally, all my love to my husband, my friend, Johnny R.
IV


113
correlations between Personal Commitment (EAC-B1) at time2
and both SATIS and CEVAL at time2, indicating that, early in
counseling, as clients' expectations for their Personal
Commitment to counseling increased, so did clients'
satisfaction with counseling and with their counselors.
The sixth hypothesis was that as clients' perceived
levels of their own and their counselors' trustworthiness and
trust increase, clients' satisfaction with counseling (SATIS)
and with their counselors (CEVAL) will also increase.
Results of the analyses provided partial support for the
hypothesis. Specifically it was found that only moderate
amounts (R2 = .368. to .460) of the variance in SATIS and
CEVAL early in counseling (time2) and later in counseling
(time3) were accounted for by the four Trust variables
indicating that collectively the Trust variables were not
highly influential predictors of clients' satisfaction with
their counseling (SATIS) and with their counselors (CEVAL).
However, the Pearson correlations revealed several
moderate but significant positive correlations between the
Trust variables and the satisfaction measures (SATIS and
CEVAL). All of the Trust variables showed significant
positive correlations with SATIS and/or CEVAL at one or both
time periods, indicating that both clients' perceptions of
themselves and perceptions of their counselors as trustworthy
and trusting were important in clients' satisfaction with
counseling (SATIS) and/or with their counselors (CEVAL).
Moreover, Counselor Trustworthiness (Trust3) in particular


35
outcome, it is a viable concern in process and outcome
research. Mennicke et al. (1988) suggest that much
counseling research is being conducted with a biased sample,
because treatment dropouts are often not considered.
In a study investigating differences between mutual and
nonmutual terminators in a university counseling center
(Cochran & Stamler, 1989) clients were mailed a questionnaire
seeking information on the client's satisfaction with
counseling and reasons for terminating counseling. Only
clients who had returned for at least one counseling session
after the intake interview were included in the study.
Clients who terminated counseling prematurely were
significantly less satisfied with the counseling experience
than clients who had planned a termination with their
counselors. In addition, proportionately more mutual
terminators endorsed having met their goals for counseling,
and proportionately more nonmutual terminators did not think
their counselors had the skills to help them. Moreover, none
of the 24 nonmutual terminators had sought help elsewhere and
only 4 (16%) felt that their situation had improved on its
own.
Cochran and Stamler's (1989) study is consistent with a
previous study by McNeill, May, and Lee (1987) that
investigated perceptions of counselor source characteristics
by premature and successful terminators. Fifty-six premature
terminators and 148 successful terminators completed a 2-page
evaluation form including the Client Satisfaction


55
Expectations About Counseling-Brief Form (EAC-B) the Likert
Trust Scale (LTS) ,, the Client Satisfaction Questionnaire
(CSQ), and the Counseling Evaluation Inventory (CEI).
Clients were asked to complete and return these
questionnaires sealed in the envelope provided when the
client returned for his/her second counseling session.
Clients who did not return their questionnaires at the
appropriate time were mailed a reminder (Appendix K) and
subsequently mailed another set of questionnaires (n = 35,
54%) .
The above procedure was also used for the third
administration which occurred after each client's sixth or
last session. Along with the four questionnaires completed
at the second administration, clients were also sent a cover
letter (Appendix L), and the Client Summary Sheet and asked
to complete and return these questionnaires to the principal
investigator. Clients who did not return their
questionnaires at the appropriate time were mailed a reminder
(n = 46, 60%). Clients who continually forgot to return
their questionnaires were telephoned by the principal
investigator and subsequently mailed another set of
questionnaires or came in to the Counseling Center or Student
Mental Health Services to complete questionnaires that were
left at the receptionist desk (q = 29, 38%). Also, after
their clients' sixth or last session, counselors were asked
to complete the Counselor Summary Sheet and return it to the
principal investigator.


40
(1988) suggests that the EAC might be a measure of a global
positive or negative set toward counseling rather than a
number of discrete expectations. This study investigated
differences on each of the 17 subscales of the EAC, wherein
scales may be composed of only three or four items. Factor
scores may have proven more meaningful.
In a review article by Mennicke et al. (1988), it was
noted that studies investigating client satisfaction with
services and subsequent attendance has resulted in mixed
findings. Several researchers have failed to find a
relationship between client satisfaction with counseling and
attrition (Phillips & Fagan, 1982; Zamostny, Corrigan, &
Eggert, 1981). Whereas others have found satisfaction with
services to distinguish persisters from premature terminators
(Cochran & Stamler, 1989; Greenfield, 1983; Kokotovic &
Tracey, 1987; McNeill et al., 1987). Mennicke et al.
attribute this discrepancy to the use of different measures
used to assess client satisfaction. Most studies finding a
relationship between satisfaction and attrition used versions
of the Client Satisfaction Questionnaire (Larsen et al.,
1979), which is a well-validated measure of client
satisfaction with counseling services.
Satisfaction with Counseling
Tanner (1981) conducted a review of quantitative
research in which he studied the factors influencing client
satisfaction with mental health services. This review


123
(time2). In addition, a positive relationship appeared
between clients perceptions of their counselors as trusting
(Trust4) and clients' satisfaction with counseling (SATIS)
and with their counselors (CEVAL), but only later in
counseling. These findings indicate that clients'
perceptions of themselves and perceptions of their counselors
as trustworthy and trusting are important in clients'
satisfaction with counseling and with their counselors.
However, as indicated by the regressions, these
variables probably have very little predictive utility for
clients' satisfaction with counseling and with their
counselors. Only low to moderate amounts (E2 = .368 to .460)
of the variance in SATIS and CEVAL both early (time2) and
later in counseling (time3) were accounted for by the Trust
variables. The only trust variable that consistently showed
high positive correlations with both SATIS and CEVAL over
both time periods was Counselor Trustworthiness (Trust3). In
addition. Counselor Trustworthiness was the only variable
that appeared as a highly significant predictor of clients'
satisfaction with counseling and with their counselors.
These findings indicate that clients' perceptions of
their counselors as trustworthy is a very important component
of clients' satisfaction with counseling in general and with
their counselors. Obviously, Counselor Trustworthiness does
not solely predict clients' satisfaction with counseling and
with their counselors, but certainly makes a strong
contribution to the research in terms of a variable that


75
time2 and, therefore, were poor predictors of Client
Satisfaction (SATIS) with counseling in general at time2.
The second regression involved SATIS at time3 as the
criterion variable, and the four expectation factors at time3
(m = 4.5 sessions) as the predictor variables. Results
revealed that the model itself was not significant (F(4, 59)
= 1.90, p <. .1232), suggesting that none of the expectation
factors at time3 were related to clients1 satisfaction with
counseling (SATIS) at time3. Moreover, the R-square (R2 =
.114) was quite small, and Pearson correlations confirmed
that there were minimal relationships between clients1
satisfaction with counseling (SATIS) at time3 and clients'
expectations about counseling at time3 (see Table 4-3)
indicating that the expectation factors at time3 accounted
for only a very small amount of the variance in SATIS at
time3 and therefore were not good predictors of this
variable.
The third regression included Counseling Evaluation
(CEVAL) at time2 as the criterion variable and the following
as predictor variables: the four expectations factors
(Personal Commitment, EAC-B1; Facilitative Conditions, EAC-
B2; Counselor Expertise, EAC-B3, Nurturance, EAC-B4) at time2
(m = 1.11 sessions), clients' previous counseling experience
(PREV), counselors' experience levels (CEXP), and the
interaction of these two latter variables (PREV*CEXP).
Results of this regression (as shown in Table 4-4) indicated
that the model itself was significant (F(7, 35) = 2.39,


50
The Client Satisfaction Questionnaire (CSQ; Larsen et
al., 1979) is an eight-item questionnaire used to assess
client satisfaction with mental health services (Appendix D).
Internal consistency for the CSQ is reported to be .87 for
university counseling center populations (Greenfield, 1983).
Scores range from 8 to 32, with higher scores indicating
higher satisfaction with services. Therapists' estimates of
how satisfied they believed the client to be were correlated
.56 (p < .01) (Larsen et al., 1979) with the actual client
rating on the CSQ. This finding provides some evidence of
the scale's concurrent validity.
The Counselor Summary Sheet (CSS) was developed for use
in this study (Appendix E). This form was completed by the
counselors and was used to record the number of sessions
attended by clients (excluding intake), date of termination
(if applicable), reason(s) for termination, and clients'
status: continuing counseling, mutual termination, dropout,
or other. Reasons for termination included: client
satisfactorily met his/her goals for counseling, counselor
did not have the skills/resources necessary to help the
client, client's life situation improved on its own, client
sought counseling elsewhere, counselor and client could not
agree on how to approach the client's problems, counselor and
client were not compatible, referred out because the client
needed/wanted more counseling than the Center could provide,
and other reason.


30
this study, instead of the EAC, subjects completed the
Counselor Effectiveness Rating Scale (CERS; Atkinson &
Wampold, 1982) which measures counselor credibility.
Additionally, clients completed the Personal Problem
Inventory (PPI; Schneider, 1985), a 20-item personal problem
list. Subjects rated each problem area in relation to their
perceived confidence in the counselor's ability to help them
with it. A one item measure of clients' willingness to see
the counselor was also used. Responses were made on a 6-
point Likert scale ranging from very unwilling (1) to very
willing (6). Two manipulation checks were employed; one
indicated the degree to which the subjects could identify
with the client role and the other indicated the subjects'
ability to identify the race of the counselor he/she read
about in the experimental manipulations. The counselor
description was identical across experimental groups with the
exception of the words "black and "white" being placed
alternatingly in front of the word counselor.
Results indicated that highly mistrustful Blacks tended
to view the counselor as less credible when the counselor was
White. In addition, highly mistrustful Blacks viewed the
counselor as less able to help them deal with sexual
functioning concerns, regardless of the counselor's race.
Moreover, Blacks who were highly mistrustful of Whites viewed
the White counselor as being less able to help them deal with
general anxiety, shyness, dating difficulties, and feelings
of inferiority than a Black counselor.


137
The findings further suggest the importance of continued
research on the factors influencing clients' decisions to
dropout of counseling. The present study revealed that
clients and counselors can have different experiences in the
same counseling relationship, and further can interpret the
termination of counseling very differently, as evidenced by a
discrepancy in clients' and counselors perceptions of the
clients' termination status and reasons for termination.
Lastly, clients' perceptions of similarity to their
counselors appear to be a very interesting aspect of clients'
satisfaction with counseling. The present study found high
significant positive correlations between similarity and
satisfaction with counseling and the counselors. However,
the low overall mean for similarity suggests the possibility
of a paradoxical effect with satisfaction, as reported in
previous research.
Implications
There are three implications of this study. The first
implication is that counselors may be judicious in focusing
on establishing themselves as trustworthy early in
counseling. This may be especially important with new
clients since it appears that they value trustworthiness as
an aspect of their counselors, and possibly question it more
so than experienced clients.
The second implication of this study is that counseling
centers may be able to assess their success at meeting the


94
of these two ANOVAs was the clients' termination status
(mutual, dropout) based on the clients' perspective of their
own termination status. Results of both ANOVAs were not
significant. There were no overall effects for termination
status, indicating that there were no differences between
mutual terminators and dropouts on their general satisfaction
with counseling (SATIS) based on the clients' perspectives of
their termination status at either time2 or time3.
The third and fourth ANOVAs included the same dependent
variables as the the first two ANOVAs (i.e.,3rd: SATIS at
time2; 4th: SATIS at time3), however, the independent
variable for these two ANOVAs was clients' termination status
based on the counselors' perspectives of the clients'
termination status. Results of the ANOVA with SATIS at time2
as the dependent variable to test the hypothesis of no
overall effect for termination status at time2 (see Table 4-
12) revealed a significant difference between groups (mutual
terminators vs dropouts), F(l, 16) = 10.67, p < .0049.
Moreover means (see Table 4-13) indicated that mutual
terminators were more satisfied with counseling in general
(SATIS) at time2 than dropouts.
The ANOVA with SATIS at time3 as the dependent variable
to test the hypothesis of no overall effect for termination
status at time3 also revealed a significant group difference,
E(l, 29) = 20.07, p < .0001. Means (see Table 4-13) again
indicated that mutual terminators (m = 27.0, SD = 4.71) were


7
Whereas transference is a core issue in psychoanalysis,
the real relationship is at the heart of humanistic
therapies. Unlike the transference relationship, the real
relationship consists of the counseling participants'
realistic perceptions of and reactions to each other. From
the moment of their first encounter, both parties actively
contribute to the real relationship. It exists alongside and
enmeshed with the transference relationship and is a part of
all therapies. The expectations counselors and clients have
for the real relationship regarding their respective roles
are crucial to successful therapy. If these expectations are
too discrepant, progress in therapy may be jeopardized and
the client may terminate therapy prematurely (Gelso & Carter,
1985).
Purpose of the Study
The purpose of this study, therefore, was to contribute
needed information to social influence theory with regard to
the change process in counseling. A review of the social
influence theory research suggested areas in need of further
investigation. Presented, is an examination of the basic
components of the therapeutic relationship, including
variables that impact the formation of a good client-
counselor relationship. These variables are clients'
expectations about counseling, perceptions of
trust/trustworthiness, and satisfaction with counseling.


12
estimate of the clients' levels of satisfaction with the
services they receive; and
2) information that might stimulate strategies for
increasing the retention of clients in counseling.
Especially for novice clients, it may be important for
counselors to discuss the client's expectations for
counseling, especially the roles of the counselor and the
client, and to intermittently check with the client as to
their satisfaction with the progress of counseling.


70
Table 4-1
Simple Statistics for the Expectation Factors
Variable Timela Time2b Time3c
n
m
SD
n
m
SD
n
m
SD
EAC-B1
21
5.68
0.75
23
5.63
0.56
24
5.78
0.66
EAC-B2
22
5.41
0.92
24
5.30
0.99
24
5.38
0.76
EAC-B3
24
4.01
1.13
24
3.86
1.43
24
4.19
1.34
EAC-B4
22
4.53
1.03
24
4.59
1.19
24
4.62
1.05
a0 sessions, bl session, cm = 6.33 sessions, SD = 3.45
EAC-B: 7 point Likert scale
Hypothesis four was that clients will also evidence
higher levels of perceived trustworthiness and trust [Client
Trustworthiness, (Trustl); Client Trust, (Trust2); Counselor
Trustworthiness, (Trust3); Counselor Trust, (Trust4)] after
two or more sessions than prior to beginning counseling or
after their first session. Moreover, there will be a
significant positive association between number of counseling
sessions attended by clients and clients' reported levels of
their own trustworthiness and trust as well as clients'
levels of perceived counselor trustworthiness and trust.
The analyses for hypothesis four involved separate
repeated measures ANOVAs with Trustl, Trust2, and Trust4 as
dependent variables, and a repeated measures ANCOVA with
Trust3 as the dependent variable. Counseling received over


21
scores may indicate a defensive, guarded client who may avoid
any revelation of affect. High scores on the Counselor
Expertise factor may be indicative of magical thinking by
clients, whereas low scores may indicate fatalism or
pessimism regarding the counselor's ability to really help
the client. On the Nurturance factor, extremely high scores
may represent a desire to escape to a warm pain-free
environment and low scores may represent a client's
difficulty in believing that the counselor or anyone else
could actually care for him or her.
In summary, the expectation literature has contributed
valuable information directly related to the process and
outcome of counseling. Research has addressed demographic
variables relative to client expectations for counseling and
have proceeded to examine more core personality factors.
Researchers have suggested that there needs to be a clear
delineation between counseling expectations, and perceptions
and preferences in order to avoid ambiguities and
inconsistencies in the literature. In addition, Hayes and
Tinsley (1989) encourage the use of the EAC as a prognostic
indicator, as a measure of client resources and attitudes
that are brought into counseling, and as an indicator of
whether education about what to expect during counseling may
be necessary before therapy is initiated.
Tinsley et al., (1988) suggested that from expectancy
research should come an understanding of the conditions under
which expectancy change might be thought to have beneficial


16. In opening our
conversations, the
counselor was relaxed
144
Always Often Sometimes Rarely Never
5 4 3 2 1
and at ease.
17. I distrusted the 1
counselor.
18. The counselor's 5
discussion of test
results was helpful
to me. ( N/A ).
19. The counselor insisted 1
on being always right.
2 0. The counselor gave 5
the impression of
"feeling at ease."
21. The counselor acted 1
as if he/she had a job
to do and didn't care how
he/she accomplished it.
2
4
2
4
2
3
3
3
3
3
4 5
2 1
4 5
2 1
4 5


131
longer time frames between the administration of the
questionnaires would have resulted in more significant
differences observed in clients' expectations about
counseling and perceptions of their own and their counselors
trust and trustworthiness over time. The particular time
frames were selected in order to maximize the potential for
clients to complete all phases of the study prior to dropping
out or terminating counseling.
Suggestions for Future Research
Future research in this area should involve large
diverse samples so that implications from the research can
extend beyond the limited sample in this study. Of
significant importance are the perceptions and evaluations of
minority clients relative to the counseling process.
Minority clients have been typically underrepresented in
counseling centers and counseling in general. As a result
most research in counseling are conducted with biased
samples.
Although the Expectations About Counseling (EAC-B)
factors did not provide many significant findings in this
study, it may be interesting for future research to
investigate different ways of using the EAC-B more
effectively. Hardin et al. (1988) suggested that
expectations about counseling may be a more global concept
(positive versus negative set) rather than a number of
discrete expectations. Furthermore, the authors suggested


124
should be considered as an important aspect of clients
satisfaction with counseling.
Hypothesis seven compared mutual terminators and
dropouts on their expectations for counseling and perceptions
of their own and their counselors trustworthiness and trust
over the three time periods. It was found that mutual
terminators and dropouts were not differentiated on their
expectations about counseling or their perceptions of their
own or their counselors trustworthiness or trust, either
prior to, early, or later in counseling. The finding that
mutual terminators and dropouts were not differentiated on
their expectations about counseling over time contributes to
and extends research conducted by Heppner and Heesacker
(1983) and Hardin et al. (1988) which found that subjects who
terminated prematurely from the study did not differ on
precounseling EAC (Expectations About Counseling) scores from
subjects who remained in the study. Unlike the present
study, McNeill et al. (1987) did find that premature
terminators viewed their counselors as significantly less
trustworthy than did clients who terminated successfully.
The use of a different inventory in the present study (i.e.,
Likert Trust Scale) versus the McNeill et al. (1987) study
(i.e., Counselor Rating Form), and/or sample sizes (40 versus
204) may be factors in the nonsignificant findings for the
Trust variables in the present study.
However, it was found that based on the counselors'
perspectives of their clients' termination status, mutual


134
videotaped portions of their sessions with a process recaller
and discuss, in addition to the actual occurrences in the
sessions, their own parallel processes.
Moreover, the relationship between clients' perceptions
of similarity to their counselors, and clients' satisfaction
with counseling can be an area of exploration for future
research. Similarity is a complex concept, which can be
interpreted in many different ways. Attempts to clarify
attributions made to this concept may aid in the
understanding of the variables involved in clients'
satisfaction with counseling. In addition, it appears that
further research examining how client personality
characteristics may affect the impact of clients' perceptions
of similarity or dissimilarity to their counselors on the
counseling process is warranted.
Finally, in research using regression procedures,
Agresti and Finlay (1986) suggest that "ideally, for
prediction purposes, one should attempt to model the
dependent variable as a function of independent variables
that are relatively unrelated to each other but have strong
correlations with the dependent variable" (p.332).
Unfortunately, this is not always possible, especially if
there are certain variables that need to be included in the
model for theoretical reasons Agresti and Finlay, (1986)
suggest the use of a procedure such as forward selection for
choosing a subset of the independent variables and omitting


67
the covariates were very similar to results without the
covariates, the simpler models (without the covariates) are
reported.
As previously stated, hypothesis one was that clients
will exhibit higher positive expectations (expectation
factors: Personal Commitment, Facilitative Conditions,
Counselor Expertise, Nurturance) of their counselors and
counseling after their first session than prior to beginning
counseling. The analyses for this hypothesis were t-tests
for dependent samples. Results indicated no significant
differences between the means for the expectation factors
from prior to beginning counseling to after the first
counseling session, failing to support hypothesis one.
Hypothesis two stated that clients will also evidence
higher levels of perceived trust and trustworthiness (Client
Trustworthiness, Client Trust, Counselor Trustworthiness,
Counselor Trust) after their first session than prior to
beginning counseling. T-tests for dependent samples were
conducted for Client Trustworthiness (Trustl), Client Trust
(Trust2), and Counselor Trust (Trust4). Results revealed a
significant (somewhat borderline) difference for Trustl from
prior to beginning counseling to after the first counseling
session (t = -2.01, p < .0558). Means indicated that
clients' perceptions of themselves as trustworthy decreased
from prior to beginning counseling (m = 4.63, SD = 0.58) to
after their first session (m = 4.38, SD = 0.82). However,


I certify that I have read this study and that in my
opinion it conforms to acceptable standards of scholarly
presentation and is fully adequate, in
a dissertation for the degree of Doctc
I certify that I have read this study and that in my
opinion it conforms to acceptable standards of scholarly
presentation and is fully adequate, in scope and quality, as
a dissertation for the degree of Doctor^pf Philosophy.
Ronald L. Akers
Professor of Sociology
I certify that I have read this study and that in my
opinion it conforms to acceptable standards of scholarly
presentation and is fully adequate, in scope and quality,
a dissertation for the degree of Doctor of Philosophy
oph\L.
shae G. Kosch
Professor of Psychology
I certify that I have read this study and that in my
opinion it conforms to acceptable standards of scholarly
presentation and is fully adequate, in scope and quality, as
a dissertation for the degree of Doctor of Philosophy.
Professor of Psychology
I certify that I have read this study and that in my
opinion it conforms to acceptable standards of scholarly
presentation and is fully adequate, in scope and quality,
a dissertation for the degree of Doctor ghilqsop
Robert C. Z
Professor./
ychology


APPENDIX F
CLIENT SUMMARY SHEET
DATE NUMBER.
NUMBER OF SESSIONS
(excluding intake)
Individual
Couples
Group
STATUS
Continuing Therapy
Mutual Termination
Dropped Out
0 ther (specify)
DATE OF TERMINATION (if applicable)
REASON(S) FOR TERMINATION (check all items that apply)
I satisfactorily met my goals for counseling.
I did not think my counselor had the strengths necessary
to help me.
My life situation improved on its own.
I sought counseling elsewhere.
My counselor and I could not agree on how to approach my
problems.
My counselor and I did not get along.
Other (please specify)
148


TABLE OF CONTENTS
ACKNOWLEDGEMENTS iii
LIST OF TABLES viii
ABSTRACT X
CHAPTERS
1 INTRODUCTION 1
Statement of the Problem 1
Social Influence Theory 1
The Therapeutic Relationship 4
Purpose of the Study 7
Clients' Expectations About Counseling 8
Trust/Trustworthiness 9
Clients' Satisfaction with Counseling 10
Significance of the Study 10
2 LITERATURE REVIEW 13
Expectations About Counseling 13
Trust in Counseling 22
Premature Termination 33
Satisfaction with Counseling 40
3 METHODOLOGY 46
Subjects 46
Instruments 47
Procedure 51
Hypotheses 56
4 RESULTS 59
Preliminary Analyses 61
The Repeated Measures Analysis of Variance with
Counselor Trustworthiness as the Dependent
Variable 63
The Repeated Measures Analysis of Variance with
Counseling Evaluation as the Dependent
Variable 65
Tests of the Hypotheses 66
vi


80
(SATIS) and with their counselors (CEVAL). However, the
Pearson correlations did reveal significant positive
correlations between Personal Commitment (EAC-B1) at time2
and both SATIS (p = .343, p < .0226) and CEVAL (p = .429, p <
.0040) at time2, indicating that as clients' expectations for
their Personal Commitment to counseling increased, so did
clients1 satisfaction with counseling and with their
counselors giving marginal support to hypothesis five for
EAC-B1
Hypothesis six was that as clients' perceived levels of
their own and their counselors' trustworthiness and trust
(Client Trustworthiness, Trustl; Client Trust, Trust2;
Counselor Trustworthiness, Trust3; Counselor Trust, Trust4)
increase, clients' satisfaction with counseling (Client
Satisfaction, SATIS) and with their counselors (Counseling
Evaluation, CEVAL) will also increase. Both Pearson
correlations between the trust variables and SATIS and CEVAL,
and multiple regressions were utilized to test the
hypothesis.
The Trust variables all showed significant positive
correlations with SATIS and/or CEVAL at one or both time
periods (see Table 4-6), indicating that both clients'
perceptions of themselves and perceptions of their counselors
as trustworthy and trusting were important in clients
satisfaction with counseling (SATIS) and/or with their
counselors (CEVAL). Moreover, Counselor Trustworthiness


57
between number of counseling sessions attended by clients and
clients' levels of expectations, such that as the number of
sessions increases so will clients' expectations for Personal
Commitment, Facilitative Conditions, Counselor Expertise, and
Nurturance.
4) Clients will evidence higher levels of perceived
trustworthiness and trust after two or more sessions than
prior to beginning counseling or after their first session.
There will be a significant positive association between the
number of counseling sessions attended by clients, and both
clients' reported levels of their own (Client
Trustworthiness, Client Trust) and their counselors'
trustworthiness and trust (Counselor Trustworthiness,
Counselor Trust).
5) As clients' expectations for counseling increase,
clients' satisfaction with counseling (Client Satisfaction;
SATIS) and with their counselors (Counseling Evaluation;
CEVAL) will also increase.
6) As clients' perceived levels of their own and their
counselors' trustworthiness and trust increase, clients'
satisfaction with counseling (SATIS) and with their
counselors (CEVAL) will also increase.
7) Compared to clients who plan a termination with
their counselors, clients who drop out of counseling will
evidence lower expectations of counseling (Personal
Commitment, EAC-B1; Facilitative Conditions, EAC-B2;
Counselor Expertise, EAC-B3; Nurturance, EAC-B4) and lower


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138
needs of their clients, and better retain them by
periodically obtaining estimates of their clients'
satisfaction with the services provided. Instrumental in
this endeavor is the role of the counselors in assessing
clients' satisfaction with counseling early in the counseling
relationship.
The third implication of this study is that there is an
obvious need for counseling centers to continue in their
outreach programming efforts. As indicated by the sample in
the present study, minority students continue to be
underrepresented in counseling center populations.
Regardless of age, race, gender, or ethnicity, all students
need to be made aware of the presence of, and services
offered by their counseling centers. Promoting counseling
centers as positive, useful resources to students is of
utmost importance in attracting all students to the
counseling process.


163
Hayes, T. J., & Tinsley, H. E. A. (1989). Identification of
the latent dimensions of instruments that measure
perceptions of and expectations about counseling.
Journal of Counseling Psychology. 36., 492-500.
Hector, M. A., & Fray, J. S. (1987). The counseling
Process, client expectations, and cultural influence: A
review. International Journal for the Advancement of
Counseling. 10, 237-247.
Heppner, P. P., & Claiborn, C. D. (1989). Social influence
research in counseling: A review and critique. Journal
of Counseling Psychology. 36., 365-387.
Heppner, P. P., & Dixon, D. N. (1981) A review of the
interpersonal influence process in counseling.
Personnel and Guidance Journal. 59, 542-550.
Heppner, P. P., & Heesacker, M. (1983). Perceived counselor
characteristics, client expectations and client
satisfaction with counseling. Journal of Counseling
Psychology. 30., 31-39.
Heubush, N. J., & Horan, J. J. (1977). Some effects of
counselor profanity in counseling. Journal of
Counseling Psychology. 24., 456-458.
Johnson, D. W., & Noonan, M. P. (1972). Effects of
acceptance and reciprocation of self-disclosures on the
development of trust. Journal of Counseling Psychology.
19, 411-416.
Kaplan, R. M. (1973). Components of trust: Note on the use
of Rotter's scale. Psychological Reports. 33., 13-14.
Karzmark, P., Greenfield, T., & Cross, H. (1983). The
relationship between level of adjustment and
expectations for therapy. Journal of Clinical
Psychology. 39, 930-932.
Kline, F., Adrian, A., & Spevak, M. (1974). Patients
evaluate therapists. Archives of General Psychiatry.
31, 113-116.
Kokotovic, A. M., & Tracey, T. J. (1987). Premature
termination at a university counseling center. Journal
of Counseling Psychology. 34, 80-82.
Lagace, R. R., & Gassenheimer, J. B. (1989). A measure of
global trust and suspicion: Replication. Psychological
Reports. 65., 473-474.


31
This study and the previous one described, emphasized
the need for counselors to be sensitive to the mistrust issue
and its influence on the Black client-White counselor
relationship. Watkins, et al., (1989) identified specific
ways in which mistrust levels impact Blacks' expectations of
White counselors. The authors have suggested that
sensitivity to the mistrust issues in conjunction with the
specific problem areas identified would be valuable
counseling information for counselors to be aware of. In
addition, future research would need to use actual clients
and assess the effects of mistrust on counseling over time to
address the limitations of the two studies.
Finally, a study by Thompson, Neville, Weathers, Poston,
and Atkinson (1990) investigated cultural mistrust and racism
reactions among African-American students. Eighty-seven
African-American and 70 Euro-American college students took
part in the study. They completed an instrument consisting
of a demographic section, the Racism Reaction Scale and the
Interpersonal Relations, and Education and Training subscales
of the Cultural Mistrust Inventory (CMI; Terrell & Terrell,
1981). The Racism Reaction Scale (RRS) consists of 19 items
that were racism reaction statements by African-American
students and 19 additional items from the California
Psychological Inventory, used as filler items. Students were
categorized as high or low on the CMI using a median-split
method.


103
The third regression included clients' satisfaction with
their counselors (CEVAL) at time3 as the criterion variable
and the following as predictor variables: the four EAC-B
factors at timel, the four Trust variables at timel, clients'
previous counseling experience (PREV), counselors' experience
levels (CEXP) and the interaction of these two latter
variables (PREV*CEXP). Results of this regression indicated
that the model was significant (£(11, 48) = 2.00, p < .0498).
The only three predictors that were significant were Trustl
(p < .0287), PREV (p < .0146), and CEXP*PREV (p < .0058). As
noted previously (analyses for hypothesis five), parameter
estimates revealed that both PREV and CEXP were negatively
associated with CEVAL. These negative associations indicate
that clients with previous counseling experience were more
likely to have higher satisfaction with their counselors
(CEVAL). In addition, it appears that clients were more
satisfied with counselors who had less experience.
The R-square for this model (R2 = .314) was small,
indicating that only a small percentage of the variance in
clients' satisfaction with their counselors (CEVAL) was
accounted for by the predictor variables. It is therefore
questionable whether even the significant predictors in this
model are good predictors of CEVAL later in counseling
(time3). Table 4-18 presents the results of the regression.
The fourth regression (see Table 4-19) included CEVAL at
time3 as the criterion variable and the following as the
predictor variables: the four EAC-B factors at time2, the


78
Table 4-5
Multiple Regression for Counseling Evaluation at Time3 with
the Expectation Factors at Time3 as Predictors
Source
DF
ss
MS
F
P
Model
7
5.59
0.80
2.14
.0542
Error
56
20.94
0.37
Total
63
26.53
EAC-B1-3
1
2.82
2.82
7.54
.0081
EAC-B2-3
1
0.12
0.12
0.32
.5709
EAC-B3-3
1
0.00
0.00
0.01
.9418
EAC-B4-3
1
0.15
0.15
0.40
.5287
PREV
1
2.13
2.13
5.68
.0205
CEXP
1
0.11
0.11
0.30
.5875
PREV*CEXP
1
2.64
2.64
7.07
.0102
Variable
DF
Parameter
Estimate
Standard
Error
T
P
Intercept
i
3.70
0.76
4.83
.0001
EAC-B1-3
i
0.46
0.17
2.75
.0081
EAC-B2-3
i
-0.13
0.23
-0.57
.5709
EAC-B3-3
i
-0.01
0.08
-0.07
.9418
EAC-B4-3
i
-0.11
0.17
-0.63
.5287
PREV
i
-1.54
0.64
-2.38
.0205
CEXP
i
-0.34
0.15
-2.21
.0312
PREV*CEXP
i
0.56
0.21
2.66
.0102
R2 = .211
cv
= 14.24
Root MSE =
.611
m = 4.29


49
the client's perception of his or her own trustworthiness
(Trustl), and ability to trust others (Trust2). The other two
questions relate to the client's perception of his or her
counselor's trustworthiness (Trust3), and ability to trust
others (Trust4). The response options range from 1-
trustworthy to 5-untrustworthy, and 5-trusting to 1-not
trusting. This type of instrument has been used in previous
research (Strong & Schmidt, 1970; Rothmeier & Dixon, 1980),
however, reliability data was not reported.
The Counseling Evaluation Inventory (CEI; Linden et al.,
1965) consists of 21 Likert items that assess client
satisfaction with counseling (Appendix C). Three scales were
identified through factor analysis : Counseling Climate
(e.g., "I distrusted the counselor), Counselor Comfort
(e.g., In opening our conversations, the counselor was
relaxed and at ease"), and Client Satisfaction (e.g., I felt
satisfied as a result of my talks with the counselor).
Test-retest reliability estimates over a 14-day period ranged
from .63 to .78 for the three factors, and .83 for the total
inventory. Congruent validity has been demonstrated based on
a positive relationship (p < .05) between practicum grades
for counselors and their clients' ratings on the CEI (Linden,
et al., 1965). Two scoring methods have been used with this
instrument a weighted scoring system and a standard 5-point
Likert scoring method (1 = always, 5 = never). The Likert
method of scoring, and the total inventory score were used in
this study.


85
variable, and the four Trust variables at time2 [Client
Trustworthiness, (Trustl); Client Trust, (Trust2); Counselor
Trustworthiness, (Trust3); Counselor Trust, (Trust4)] as the
predictor variables (see Table 4-9). Once more, this model
Table 4-9
Multiple Regression for Counseling Evaluation at Time2 with
the Trust Variables at Time2 as Predictors
Source
DF
SS
MS
F
P
Model
4
3.55
0.89
8.10
.0001
Error
38
4.16
0.11
Total
42
7.72
Variable
DF
Parameter
Estimate
Standard
Error
T
p
Intercept
i
2.95
0.42
7.07
.0001
Trustl-2
i
-0.03
0.08
-0.38
.7073
Trust2-2
i
0.06
0.05
1.21
.2346
Trust3-2
i
0.34
0.07
4.51
.0001
Trust4-2
i
-0.02
0.06
-0.24
.8074
R2 = .460
cv
= 7.47
Root MSE =
.331
m = 4.43
Adj. R2 =
.403
was also statistically significant (F(4, 38) = 8.10, p<=
.0001), and consistently, Counselor Trustworthiness (Trust3)
was the only predictor variable to reach statistical


Ill
Hypothesis three was that clients will exhibit higher
positive expectations of their counselors and counseling
after two or more sessions than prior to beginning counseling
or after their first session. In addition, there will be a
significant positive association between the number of
counseling sessions attended by clients and clients' levels
of expectations, such that as the number of sessions
increases so will clients' expectations for Personal
Commitment, Facilitative Conditions, Counselor Expertise, and
Nurturance (expectation factors). Results failed to support
this hypothesis. Specifically it was found that there were
no overall effects due to time for any of the expectation
factors, indicating that there were no significant
differences in the means for the expectation factors over the
three time periods. There was an increase in the means for
Nurturance over the three time periods; however, the
increase was not significant. In addition, there were no
significant correlations between any of the four expectation
factors and the number of counseling sessions attended by
clients.
Parallel to hypothesis three, hypothesis four was that
clients will also evidence higher levels of perceived
trustworthiness and trust after two or more sessions than
prior to beginning counseling or after their first session.
Furthermore, it was hypothesized that there will be a
significant positive association between number of counseling
sessions attended by clients and clients' reported levels of


89
further reflection, it appeared interesting to have a
comparison of these two groups at each of the time periods.
Mutual terminators and dropouts were also compared on their
satisfaction with their counseling (SATIS), and satisfaction
with their counselors (CEVAL) at time2 (m = 1.11 sessions)
and time3 (m = 4.5 sessions).
Since it became evident that the clients and counselors
did not agree on the clients' termination status, the
analyses were run both from the clients' perspectives of
themselves as mutual terminators or dropouts, and the
counselors' perspectives of the clients' as mutual
terminators or dropouts. Table 4-11 presents a comparison of
the clients' and counselors perspectives on the clients'
termination status. This table lists the total number of
clients labeled mutual terminators or dropouts either by
counselors or clients. Also listed are the number of times
and percentages both counselors and clients agreed on the
clients' termination status (i.e., both gave same labels),
and the number of times and percentages counselors and
clients disagreed (i.e.,gave different labels). A break-down
of the counselors' and clients' perspectives on the clients'
termination status for those clients for whom each gave
different labels (i.e..disagreed) is also presented.
In comparing the mutual terminators versus the dropouts
on the expectation factors, separate multivariate analyses of
variance (MANOVAs) were run with the four expectation factors
for the three time periods based both on the clients' and the


107
Counseling Evaluation (CEVAL) at time3. In addition, CEVAL
at time2 was the only significant predictor in this model,
indicating that early satisfaction with the counselors was
the best predictor of later satisfaction with the counselors.
It is also possible that there were strong
intercorrelations among the independent variables thereby
making it difficult to assess the contributions of the
independent variables. Hypothesis eight is therefore
partially supported for clients' satisfaction with their
counselors (CEVAL) at time3, in that compared to the
predictor variables at timel (R2 = .314) the predictor
variables at time2 (R2 = .673) were better collectively at
predicting CEVAL at time3 (i.e., accounted for more of the
variance in CEVAL at time3).
Hypothesis nine was that there will be significant
positive associations between clients' levels of perceived
similarity (SIM) t.o their counselors and clients' levels of
satisfaction with their counseling (SATIS) and with their
counselors (CEVAL). Pearson correlations between clients'
perceived similarity to their counselors (SIM) and clients'
satisfaction with counseling (SATIS) and with their
counselors (CEVAL) at time3 were used to test this
hypothesis. Results revealed that in general, clients did
not perceive themselves to be highly similar to their
counselors (m = 2.84, SD = 1.13; Scale 1-5: 5 = Very
Similar). However, there were significant positive
correlations between clients' perceptions of their similarity


86
significance (p < .0001). Results revealed that the R-square
for this model (R2' = .460) was moderate, indicating that 46%
of the variance in CEVAL at time2 was accounted for by the
Trust variables. However, compared to the other trust
variables, Counselor Trustworthiness (CEVAL) appeared to be
the best predictor of clients' satisfaction with their
counselors at time2.
The fourth regression included Counseling Evaluation
(CEVAL) at time3 as the criterion variable, and the four
Trust variables at time3 as the predictor variables.
Consistent with the other three regressions for this
hypothesis, this model was also significant (F(4, 59) =
10.18, p < .0001), and once again Counselor Trustworthiness
(Trust3) was the only significant predictor variable (p <
.0001). The R-square (R2 = .408) was also moderate
indicating that the Trust variables at time3 accounted for
approximately 41% of the total variance in clients'
satisfaction with their counselors at time3. The consistent
finding that Counselor Trustworthiness was the only
significant predictor in all four regressions indicates that
clients1 perceptions of their counselors as trustworthy
(Trust3) may be considered an important predictor of clients
satisfaction with counseling and with their counselors
Results of this regression model are presented in Table 4-10.
Results of the multiple regressions for hypothesis six
revealed that only moderate amounts (R2 = .368. to .460) of


CLIENTS' PERCEIVED TRUST, TRUSTWORTHINESS, AND EXPECTATIONS
IN THE THERAPEUTIC RELATIONSHIP: FACTORS IN SATISFACTION
WITH COUNSELING RECEIVED
BY
CELIA ANDERSEN CAESAR
A DISSERTATION PRESENTED TO THE GRADUATE SCHOOL
OF THE UNIVERSITY OF FLORIDA IN PARTIAL FULFILLMENT
OF THE REQUIREMENTS FOR THE DEGREE OF
DOCTOR OF PHILOSOPHY
UNIVERSITY OF FLORIDA
1996
UNIVERSITY OF FLORIDA LIBRARES


REFERENCES
Agresti, A. & Finlay, B. (1986) Statistical methods for
the social sciences. USA: Dellen Publishing Company.
Anderson, C M. Harrow, M., Schwartz, A. H., & Kupfer, D. J.
(1972). Impact of therapist on patients satisfaction in
group psychotherapy. Comprehensive Psychiatry, 13. 33-
40.
Apfelbaum, D. (1958). Dimensions of transference in
nsvchotherapy. Berkeley: University of California
Press.
Archer, J. (1984) Waiting list dropouts in a university
counseling center. Professional Psychology: Research
and Practice. 15., 388-395.
Atkinson, D. R., & Wampold, B. E. (1982). A comparison of
the counselor rating form and the counselor
effectiveness rating scale. Counselor Education and
Supervision. 22, 25-35.
Auerbach, A. H., & Johnson, M. (1977). Research on the
therapist's level of experience. In A. S. Gurman & A.
M. Razin (Eds.), Effective psychotherapy: A handbook of
research. New York: Pergamon Press.
Balch, P., Ireland, J. F., McWilliams, S. A., & Lewis, S. B.
(1977). Client evaluation of community mental health
services: Relation to demographic and treatment
variables. American Journal of Community Psychology, 5.,
243-247.
Barak, A., & Lacrosse, M. B. (1975). Multidimensional
perception of counselor behavior. Journal of Counseling
Psychology. 22. 471-476.
Barrett-Lennard, G. T. (1962). Dimensions of therapist
response as causal factors in therapeutic change.
Psychological Monographs, 16, 34-36.
159


43
satisfaction and outcome ratings. Moreover, client report of
effectiveness of treatment typically accounts for less than
half the variance in satisfaction.
Freeman (1989) examined the influence of client and
counselor characteristics on satisfaction with counseling.
Subjects were 38 clients at a small liberal arts college
counseling center who had been seen for counseling. After
the termination interviews, clients and counselors completed
a questionnaire packet including the Client Satisfactions
Questionnaire (CSQ; Larsen et al., 1979) and two copies of
the Counselor Rating Form (CRF; Corrigan & Schmidt, 1983).
Participants were asked to rate first the other person and
then themselves on the CRF. Only 23 clients returned the
questionnaires.
Both counselors and clients perceived the counselor as
more attractive, expert, and trustworthy than the clients.
Clients rated themselves higher on the CRF dimensions than
the counselors rated their clients. Clients' attractiveness,
expertness and trustworthiness were significantly related to
the counselor's perception of clients' satisfaction. Client
satisfaction with services was significantly related to
client perception of counselor source characteristics and to
client perception of their own attractiveness.
It appears, therefore, that ratings of other was more
highly related to satisfaction than ratings of oneself. Only
in the case of clients' ratings of their own attractiveness
was self-rating significantly correlated with satisfaction.


91
included the four expectation factors (Personal Commitment,
Facilitative Conditions, Counselor Expertise, Nurturance) at
timel as the dependent variables. The second MANOVA included
the four expectation factors at time2 as the dependent
variables. The third MANOVA included the four expectation
factors at time3 as the dependent variables. The independent
variable for each of these MANOVAs was clients1 termination
status (mutual, dropout) based on the clients' perspectives
of their own termination status.
Results revealed that none of the three MANOVAs were
significant. There were no overall effects for termination
status for any of the three MANOVAs indicating that there
were no significant differences between mutual terminators
and dropouts on the expectation factors at any of the three
time periods based on the clients1 perspectives of their own
termination status.
The fourth, fifth, and sixth MANOVAs included the same
dependent variables as the first three MANOVAs (i.e.
Expectation Factors). However, the independent variable for
each of these MANOVAs was- clients termination status
(mutual, dropout) based on the counselors1 perspectives of
their clients' termination status. Results again revealed
that none of these three MANOVAs were significant. There
were no overall effects for termination status indicating
that there were no significant differences between mutual
terminators and dropouts on the expectation factors at any of


42
Other significant therapist variables not obtained
through client report were social interest and profanity.
Clients1 satisfaction increased as counselor social interest
rose (Zarski, Sweeney, & Barcikowski, 1977). Furthermore, an
experimental manipulation study found that middle class
clients were less satisfied with counselors who used
profanity (Heubush, & Horan, 1977). However, neither of
these studies have been replicated.
Two miscellaneous variables that were significantly
related to satisfaction were type of termination and duration
in treatment. Five studies examining termination type found
that outpatients who self-terminated were less satisfied with
counseling than those who remained in treatment (Balch,
Ireland, McWilliams, & Lewis, 1977; Denner & Halprin, 1974a,
1974b; Kline, Adrian, & Spevak, 1974; Larsen, 1978). In
addition, three studies of outpatients reported a positive
relationship between length of stay in treatment and at least
one satisfaction measure, such that the longer that patients
stayed in treatment, the more satisfied they were (Brown &
Manela, 1977; Frank, Salzman, & Fergus, 1977).
Finally five studies of clients1 reports of treatment
effectiveness found a positive relationship to client
satisfaction (Edwards, Yarvis, Mueller, & Langsley, 1978;
Larsen, 1978; Larsen, et al., 1979; Simons, Wade, Morton, &
McSharry, 1978). However, there has been a lack of support
for these findings from related measures. Furthermore,
social desirability may account for a large part of both the


82
Four multiple regression were also performed. The first
multiple regression involved Client Satisfaction (SATIS) at
time2 as the criterion variable and the four Trust variables
at time2 [Client Trustworthiness, (Trustl); Client Trust,
(Trust2); Counselor Trustworthiness, (Trust3); Counselor
Trust, (Trust4)] as the predictor variables. Results
revealed that the model was significant (F(4, 38) = 6.91, p <
.0003), indicating that at least one of the Trust variables
was significantly related to clients' satisfaction with
counseling (SATIS) at time2. Counselor Trustworthiness
(Trust3) was the only predictor that reached statistical
significance (p < .0013). The R-square for this model (R2 =
0.421) was moderate, indicating that the predictors in this
model accounted for some of the variance in SATIS at time2,
however, over fifty percent of the variance was still
unaccounted for, indicating that collectively the Trust
variables were not very good predictors of SATIS at time2.
However, considering the highly significant correlation
between Counselor Trustworthiness (Trust3) and SATIS at time2
(r = .600, p < .0001), Trust3 may explain most of the
variation accounted for by the model, and thus may still be a
good predictor of SATIS at time2. See Table 4-7 for the
results of this regression.
The second regression included Client Satisfaction
(SATIS) at time3 (m = 4.5 sessions) as the criterion
variable, and the four Trust variables at time3 as the


26
peer counselors were not significant. Moreover, both groups
established significantly higher levels of self-disclosure
and trust after counseling treatment.
These findings suggest that the belief that White
professional counselors are less effective than peer
facilitators in promoting self-disclosure and trust in Black
clients is questionable. In addition, Black trained peer
counselors can be effective facilitators of self-disclosure
and trust among Black clients.
In a study by Wright (1975), 65 White and 35 Black male
students were pretested on the Interpersonal Trust Scale and
designated as either high trusters or low trusters based on
one standard deviation above or below the mean of this base
population. Means and standard deviations for the two racial
groups were as follows: Black students M = 61.67, SD =
9.11; White students M = 68.5, SD = 9.69. From the 100
students tested, 24 were chosen as clients; six high trusters
and six low trusters for each race. These students were then
administered the Barrett-Lennard Relationship Inventory
(Barrett-Lennard, 1962) prior to their first counseling
session and at the end of the fifth counseling session. The
counselors were two White, and one Black male with advanced
degrees in counseling, and one Black male psychology
practicum student.
Results from the pretest indicated that Black high
trusters believed that Black counselors would significantly
show a higher level of regard 1 (affection, liking), regard 2


APPENDIX A
EXPECTATIONS ABOUT COUNSELING (FORM B)
Howard E. A. Tinsley
Department of Psychology
Southern Illinois University
Carbondale, IL 62901
Copyright c 1982. Howard E. A. Tinsley, Ph.D. Used with
written permission.
139


121
previous counseling experience, both early (tlme2) and later
(time3) in counseling, clients with no previous counseling
experience rated their counselors with more experience as
less trustworthy than counselors with less experience. In
examining the means for counselor trustworthiness (Trust3) by
group (previous versus no previous counseling), it was found
that both groups rated their counselors highly on the
trustworthy scale over the three time periods (previous
counseling: m = 4.66, 3.91, 4.83; no previous counseling: m
= 4.75, 4.50, 4.41, on a 5-point Likert scale). This finding
indicates that clients with no previous counseling experience
still viewed their counselors as highly trustworthy. It
appears therefore, that for clients with no previous
counseling experience, the negative relationship between
clients' perceptions of their counselors as trustworthy
(Trust3) and counselor experience level (CEXP) may not be as
meaningful as the analyses first indicated.
Hypothesis five was that as clients' expectation about
counseling increase, clients' satisfaction with counseling
(Client Satisfaction; SATIS) and with their counselors
(Counseling Evaluation; CEVAL) will also increase. The
finding that there was a significant positive correlation
between Personal Commitment (EAC-B1) and both SATIS and CEVAL
early in counseling (time2) provided only marginal support
for the hypothesis. This finding is consistent with a study
by Heppner and Heesacker (1983) which found that clients'
expectations of their openness (a subscale of the Personal


136
are more clearly applicable to counseling. Furthermore, the
influence stage of Strong's model was explored by using
client satisfaction measures, which have been proposed as
potential measures of the counselors' therapeutic influence
(Heppner & Heesacker, 1983). Thirdly, the present research
examined clients' expectations, and perceptions of their own
trustworthiness and abilities to trust as client variables in
the influence process. Expectations has been a recent client
variable in the social influence literature, however its
predictive utility for satisfaction with counseling had not
been thoroughly investigated. Moreover, trustworthiness has
been the least frequently examined aspect of the social
influence research, and it had not been examined as a client
variable. Clients' perceptions of themselves or their
counselors as trusting had also not been examined as viable
aspects of the influence process.
The present research findings suggest that clients'
expectations about counseling (as measured by the EAC-B) have
very little relationship to or predictive utility for
clients' satisfaction with their counselors or counseling.
Likewise, the trust variables were not highly predictive of
clients' satisfaction with counseling. However, clients'
perceptions of their counselors as trustworthy may still be
an important variable in the influence process, indicated by
its highly significant correlations with clients'
satisfaction with counseling and with their counselors.


81
Table 4-6
Pearson Correlation Coefficients Among the Trust Variables
and the Counseling/Counselor Satisfaction Measures
Variables
Time2a
Time3b
Client Satisfaction and
Client Trustworthiness
.37**
.10
Client Trust
.34*
.15
Counselor Trustworthiness
.60***
.60***
Counselor Trust
.20
. 43***
Counseling Evaluation and
Client Trustworthiness
.28
.12
Client Trust
.31*
.10
Counselor Trustworthiness
.67***
.64***
Counselor Trust
.23
.43***
am = 1.11 sessions, SD = 1.38 bm = 4.5 sessions, SD = 4.37.
*2 < .05 **p < .01 ***2 < .0005
(Trust3) evidenced the highest correlations with both SATIS
(r = .600, 2 < .0001) and CEVAL (r = .665, 2 < .0001) at
time2, and time3 (SATIS: r = .603, 2 < .0001; CEVAL: £ =
.636, 2 < .0001). These findings indicate that as clients'
perceptions of their counselors as trustworthy increased, so
did clients' satisfaction with counseling in general and
satisfaction with their counselors.


120
interesting to note that the means for Client Trustworthiness
(Trustl) remained high over the course of the study (jb =
4.63, 4.38, 4.54; on a 5 point Likert scale). In addition,
the significant decrease in Trustl appeared only in the
analyses for hypothesis two (timel to time2) and disappeared
in the analyses for hypothesis four (timel to time2 to
time3). It is questionable, therefore, whether the decrease
in the means from prior to beginning counseling to after the
first counseling session is truly an interpretable
difference.
Another interesting finding was the impact counselor
experience level (CEXP) and clients' previous counseling
experience (PREV) had on clients' perceptions of their
counselors as trustworthy. Typically covariates (e.g., CEXP
and PREV) are said to be "controlled for" in statistical
analyses and therefore not mentioned further. However,
because counselor experience (CEXP) and clients' previous
counseling experience (PREV) consistently appeared as
significant in the analyses with Counselor Trustworthiness
(Trust3), the results involving these two covariates seem to
warrant further discussion and clarification.
Although there were no differences in the means for the
trust variables across time, there was a significant group
difference between clients with previous counseling
experience and clients with no previous counseling experience
on their perceptions of their counselors as trustworthy.
Specifically it was found that compared to clients with


15
self-disclosing (Subich, 1983). Tinsley and Harris (1976)
found that the longer students remained in college, the less
they anticipated a counselor to be accepting, and an expert.
Richmond (1984) found that compared to clients, nonclients
had significantly higher expectations that counselors would
be genuine, attractive, and trustworthy.
With respect to the influence of cultural factors on
clients' expectations, Yuen and Tinsley (1981) found that
international students expected their counselor to be more
concrete, directive, empathic, nurturant, and expert than did
American students. American students reported a higher
expectancy than international students to take action and to
admit responsibility for counseling progress. Consistent
with this finding. Hector and Fray (1987) also reported that
Asian clients expected their counselor to be directive and
nurturing. Hispanic clients preferred their counselors to be
active and directive. In addition, the client's attitude
about the counselor and not the counselor's ethnic background
was the Hispanic client's most important consideration.
American Indians expected to discuss more school-related
concerns and had a strong preference for Native American
counselors. Compared to American students, African students
studying in the USA expected counselors to be more directive
and nurturing.
In a study by Proctor and Rosen (1981), clients with
definite preferences preferred counselors of their own race.
However, both White clients and Black clients expected their


115
support for the hypothesis. Specifically it was found that
compared to dropouts, mutual terminators were more satisfied
with counseling in general (SATIS) both early (time2) and
later in counseling (time3), and they were more satisfied
with their counselors (CEVAL) later in counseling (time3).
There were no significant differences between mutual
terminators and dropouts on their expectations about
counseling or their perceptions of their own or their
counselors' trustworthiness and trust at any of the three
time periods. Furthermore, the significant findings were
only for those analyses based on the counselors' perspectives
of their clients' termination status. There were no
significant findings based on the clients' perspectives of
their own termination status.
The eighth hypothesis stated that compared to clients'
expectations about counseling (EAC-B) and levels of perceived
trust/trustworthiness (Trust variables) prior to beginning
counseling (timel), clients' expectations, levels of
trust/trustworthiness, and satisfaction with counseling
(SATIS) and with their counselors (CEVAL) early in counseling
(time2) will be better predictors of client satisfaction with
counseling and with their counselors later in counseling
(time3). Results of the analyses for hypothesis eight
provided partial support for the hypothesis.
It was found that of the four regressions performed to
test the hypothesis, only one regression accounted for more
than fifty percent of the variance in either of the


APPENDIX L
COVER LETTER (THIRD ADMINISTRATION)
Date:
Dear:
Thank you for your participation in my project. Your
time and effort are greatly appreciated.
This is the last set of questionnaires that you will
need to complete for this project. Completion of these
questionnaires should take approximately 13 to 15 minutes.
Please complete and return these questionnaires in the
enclosed envelope to the receptionist at the Center no later
than .
If you would like a copy of the results of this study
sent to you, complete the bottom portion of this letter and
return it with your questionnaires. Thank you once again for
your cooperation. If you have any questions, please do not
hesitate to contact me at 392-1575.
Sincerely,
Celia Caesar, M.S.
Psychology Intern
157


39
termination. An equal number of clients reported career
concerns and personal concerns. Prior to their first
session, clients completed the Expectations About Counseling
questionnaire (EAC; Tinsley et al., 1980).
Results showed that precounseling expectations did not
differentiate terminators from nonterminators. In addition,
problem type did not affect expectations. Clients in both
groups, had high expectations about the counseling and
expected to assume a high degree of responsibility for their
counseling experience. Moreover, all clients expected to be
open with the counselor and to be at least moderately
motivated. They also had moderate levels of expectation for
counselor attractiveness, expertness, trustworthiness,
tolerance, nurturance, genuineness, acceptance, and
confrontation. They had lower expectations for counselor
directiveness, empathy, and self-disclosure.
The authors suggested that accepting unequivocally that
precounseling expectations do not affect termination status
is probably premature, sighting that one confounding factor
may result from clients who make subsequent appointments in
order to conform to their counselor's desires although they
themselves may feel satisfied after one interview. In
addition, it may be unwarranted to assume that clients
automatically distinguish between preferences and
expectations when asked to express their expectations. This
confusion between the two variables could have also
influenced the results of the study. Finally, Hardin et al


38
the 67 clients seen by a White counselor, 29 (43%) did not
return for additional counseling. Moreover, hierarchical
regression analyses were used to examine the relation between
the predictor variables of counselor's race, mistrust level,
and clients' sex on the criterion variable of premature
termination for counseling. The main effect of counselor
race accounted for 12% of the variance, and when added, the
main effect of trust, accounted for a significant increase in
the amount of variance (R2 = .18) This finding indicates
that Black clients were more likely to terminate from
counseling prematurely when seen by a White counselor than
when seen by a Black counselor. The trust data indicated
that regardless of counselor race, highly mistrustful clients
terminated treatment prematurely. Moreover, a significant
interaction was found between counselor race and client
mistrust level. Highly mistrustful clients seen by a White
counselor had a higher rate of premature termination than
highly mistrustful clients seen by a Black counselor.
Hardin et al. (1988) examined the relationship between
premature termination and clients' expectations about
counseling. Data for this study were drawn from archival
files at a university counseling center. Half of the
selected files consisted of clients who had come for one
appointment and, despite having made a second appointment,
never returned to the center. The remaining cases consisted
of clients who pursued counseling for two or more sessions (M
= 6.35 sessions, range =3-19) to a mutually agreed-upon


56
After the termination of the project, the names of all
those clients who .completed the project were entered into a
lottery. Ten names were chosen at random and ten dollar
money orders were mailed to these individuals. Data was
collected over a period of two semesters, which was
approximately 28 weeks.
Hypotheses
This study examined clients' expectations of their
counselors and the counseling process, and clients' levels of
perceived trust and trustworthiness prior to beginning
counseling. Moreover, changes in these variables and
clients' satisfaction with counseling were investigated in
relation to clients' actual experiences of counseling.
Specific hypotheses were:
1) Clients will exhibit higher positive expectations
(Personal Commitment, Facilitative Conditions, Counselor
Expertise, Nurturance) of their counselors and counseling
after their first session than prior to beginning counseling.
2) Clients will evidence higher levels of perceived
trustworthiness and trust (Client Trustworthiness, Client
Trust, Counselor Trustworthiness, Counselor Trust) after
their first session than prior to beginning counseling.
3) Clients will exhibit higher positive expectations of
their counselors and counseling after two or more sessions
than prior to beginning counseling or after their first
session. There will be a significant positive association


164
Larsen, D. L. (1978). Enhancing client utilization of
community mental health outpatient services. (Doctoral
dissertation, University of Kansas, 1977). Dissertation
Abstracts International, 39, 4041B. (University
Microfilms No. 79-04, 220).
Larsen, D. L., Attkisson, C. C., Hargreaves, W. A. & Nguyen,
T. (1979). Assessment of client/patient satisfaction:
Development of a general scale. Evaluation and Program
Planning. 2, 197-207.
Levy, L. H. (1963). Psychological interpretation. New
York: Holt, Rinehart & Winston.
Linden, J. D., Stone, S. C., & Shertzer, B. (1965).
Development and evaluation of an inventory for rating
counseling. Personnel and guidance Journal. 44, 267-
276.
MacDonald, A. P., Kessel, V. S., & Fuller, J. B. (1972).
Self-disclosure and two kinds of trust. Psychological
Reports 30., 143-148.
McClanahan, L. D. (1974). A comparison of professed
counselor techniques and attitudes with client
evaluations of the counseling relationship. (Doctoral
dissertation, Ohio University, 1973). Dissertation
Abstracts International. 34, 5637A. (University
Microfilms No. 74-7649).
McNally, H. A. (1973). An investigation of selected
counselor and client characteristics as possible
predictors of counseling effectiveness. (Doctoral
dissertation, University of Maine, 1972). Dissertation
Abstracts International. 33, 6672-6673A. (University
Microfilms No. 73-13,075).
McNeill, B. W., May, R. J., & Lee, V. E. (1987).
Perceptions of counselor source characteristics by
premature and successful terminators. Journal of
Counseling Psychology. 34 86-89.
Mennicke, S. A., Lent, R. W., & Burgoyne, K. L. (1988).
Premature termination from university counseling
centers: A review. Journal of Counseling and
Development. 66. 458-465.
Moberg, D. P. (1977). Consumer evaluation of an alcoholism
treatment program. In F.A. Seixas (Ed.). Currents in
Alcoholism (Vol. 2). New York: Grue and Stratton.


90
Table 4-11
A Comparison of the Differences Between the Counselors' and
Clients' Perspectives of the Clients' Termination Status
Group
Perspective
n
%
Mutual Terminators
Counselor vs Client
Dropout
Mutual
3
13
Mutual
Dropout
2
8
Mutual
Missing
10
42
Mutual
Other
7
29
Other
Mutual
1
4
Missing
Mutual
1
4
Total
32
100
Agree
8
25
Disagree
24
75
Dropouts
Counselor vs Client
Dropout
Missing
5
46
Dropout
Mutual
3
27
Mutual
Dropout
2
18
Missing
Dropout
1
9
Total
16
100
Agree
5
38
Disagree
11
62
counselors' perspectives of the clients' termination status,
totaling six MANOVAs. Specifically, the first MANOVA


32
This study found that the African-American college
students felt that they were singled out for differential and
inferior treatment more so than their Euro-American
counterparts. The feeling was strongest among highly
mistrustful African-Americans. Although items on the RRS
reflecting generalized reaction to the environment revealed
no significant differences between the two racial groups,
African-American students reported higher means on more
situational/classroom-related items than Euro-Americans.
Moreover, the item on the RRS with the greatest difference in
ratings by African-American respondents and Euro-American
respondents was "I have to be prepared to deal with a
threatening environment."
These findings indicate that counselors need to become
more aware of racism reactions and be capable of
distinguishing these types of statements from statements
reflecting paranoia. In addition, some African-American
students seeking counseling for issues related to racism
reactions may be distrustful of any Euro-American counselor
and may, at least initially, express a preference for an
African-American counselor. Furthermore, the fact that the
staffs of most counseling centers are predominantly or
entirely White (Ponterotto, Anderson, & Greiger, 1986)
underscores the need for counselors to be sensitive to
African-American students' concerns about racism and their
possible reactions to seeing a White counselor. Lack of
sensitivity to these issues, and the application of a "White-


APPENDIX J
COVER LETTER (SECOND ADMINISTRATION)
Date:
Dear:
Thank you for participating in my project. I appreciate
the time and thought you have put into completing the
questionnaires.
Now that you have had your second counseling session,
please complete the enclosed questionnaires. Completion of
these questionnaires should take approximately 12 minutes.
It is important that you complete these questionnaires before
your third counseling session. Please enclose them in the
envelope provided and return them to the receptionist at
Student Mental Health when you return for your third
counseling session.
Thank you once again for your cooperation. If you have
any questions please do not hesitate to contact me at 392-
1575. If you misplace your questionnaires, please contact
the receptionist at Student Mental Health (392-1171) and ask
for another one.
Sincerely,
Celia Caesar, M.S.
Psychology Intern
155


104
Table 4-18
Multiple Regression for Counseling Evaluation at Time3 Using
Predictors
from Timel
Source
DF
SS
MS
F
P
Model
ii
7.87
0.72
2.00
.0498
Error
48
17.21
0.36
Total
59
25.08
Variable
DF
Parameter
Standard
T
P
Estimate
Error
Intercept
1
3.13
1.21
2.58
.0129
EAC-B1-1
1
0.17
0.16
1.07
.2889
EAC-B2-1
1
0.05
0.23
0.21
.8317
EAC-B3-1
1
-0.04
0.10
-0.44
.6603
EAC-B4-1
1
-0.15
0.20
-0.72
.4730
Trustl-1
1
0.28
0.12
2.26
.0287
Trust2-1
1
0.11
0.09
1.24
.2193
Trust3-1
1
-0.03
0.21
-0.15
.8793
Trust4-1
1
0.05
0.13
0.36
.7225
PREV
1
-1.83
0.72
-2.53
.0146
CEXP
1
-0.33
0.16
-2.06
.0445
CEXP*PREV
1
0.64
0.22
2.89
.0058
S2 = .314
cv
= 13.93
Root MSE =
.599
m = 4.30


162
Freeman, H. R. (1989). Influence of client and counselor
characteristics on satisfaction with counseling
services. Journal of Mental Health Counseling. 11. 375-
383.
Fretz, B. R. (1966). Postural movements in a counseling
dyad. Journal of Counseling Psychology. 13 335-343.
Gelso, C. J., & Carter, J. A. (1985). The relationship in
counseling and psychotherapy: Components, consequences,
and theoretical antecedents. The Counseling
Psychologist. 13., 155-243.
Goldstein, A. P. (1962). Therapist-patient expectancies in
psychotherapy. New York: MacMillan.
Goldstein, A. P., Heller, K., & Sechrest, L. B. (1966).
Psychotherapy and the psychology of behavior change.
New York: Wiley.
Gomes-Schwartz, B. (1978) Effective ingredients in
psychotherapy: Prediction of outcome from process
variables. Journal of Consulting and Clinical
Psychology. 46., 1023-1035.
Grace, G. D., & Schill, T. (1986). Social support and
coping style differences in subjects high and low in
interpersonal trust. Psychological Reports. 59., 584-
586.
Greenfield, T. K. (1983). The role of client satisfaction
in evaluating university counseling services.
Evaluation and Program Planning. _6_, 315-327.
Greenson, R. R. (1967) The technique and practice of
psychoanalysis (Vol 1). New York: International
Universities Press.
Gunzberger, D., Henggeler, S., & Watson, S. (1985). Factors
related to premature termination of counseling
relationships. Journal of College Student Personnel.
26, 456-460.
Hardin, S. I., Subich, L. M., & Holvey J. M. (1988).
Expectancies for counseling in relation to premature
termination. Journal of Counseling Psychology. 35 37-
40.
Hardin, S. I., & Yanico, B. J. (1983). Counselor gender,
type of problem, and expectations about counseling.
Journal of Counseling Psychology. 30., 294-297.


3
literature have been published; two at the end of only the
first decade of social influence research (Corrigan, Dell,
Lewis, & Schmidt, 1980; Heppner & Claibom, 1989; Heppner &
Dixon, 1981).
Social influence, therefore, has emerged as a major
research area in the counseling psychology literature within
the last twenty years. However, Heppner and Claiborn (1989)
have articulated several criticisms of this research First,
these researchers asserted that of the 56 empirical
investigations reviewed about social influence by them, 45
(80%) continued to examine the effect of certain counselor
behaviors and cues on perceptions of counselor expertness,
attractiveness, and trustworthiness. These studies,
therefore, examined only the first stage of Strong's (1968)
model. Most of the research has tended to ignore the
influence process, Strongs (1968) second stage.
Second, Heppner and Claibom (1989) also asserted that
not enough attention has been given to client individual
difference variables in the social influence process. The
social influence research has historically treated the client
as a passive recipient of information. Heppner and Claiborn,
(1989) recommended that the client be conceptualized as an
active processor of information within the influence process.
As such, client characteristics should become more prominent
variables in the change process.
Finally, a third major criticism of social influence
research raised by Heppner and Claiborn (1989) is that the


5 DISCUSSION 109
Summary of the Results 109
Discussion of the Results 117
Limitations of the Study 129
Suggestions for Future Research 131
Conclusion 135
Implications 137
APPENDICES
A EXPECTATIONS ABOUT COUNSELING (BRIEF FORM) 139
B LIKERT TRUST SCALE 140
C COUNSELING EVALUATION INVENTORY 141
D CLIENT SATISFACTION QUESTIONNAIRE 145
E COUNSELOR SUMMARY SHEET 147
F CLIENT SUMMARY SHEET 148
G COVER LETTER (FIRST ADMINISTRATION) 150
H INFORMED CONSENT FORM 151
I MEMORANDUM TO/FROM COUNSELORS 154
J COVER LETTER (SECOND ADMINISTRATION) 155
K REMINDER LETTER 156
L COVER LETTER (THIRD ADMINISTRATION) 157
REFERENCES 159
BIOGRAPHICAL SKETCH 169
vii


129
to those they saw as dissimilar. Tessler and Polansky (1975)
found that compared to clients who reported familiarity with
counseling, clients who denied familiarity with counseling
were significantly less open to an interviewer they perceived
as similar to themselves and were less satisfied with the
relationship that had been established with the interviewer.
Berry and Sipps (1991) found in their study on counselor-
client similarity and self-esteem, that the greater the
similarity between counselor and client and the lower the
client's self-esteem, the more likely the client was to
terminate prematurely. It may be possible that both clients
with high and low perception of similarity to their
counselors may be highly satisfied with counseling or vice
versa based on various client characteristics.
Limitations of the Study
The primary limitation of this study and most studies
using actual counseling situations is the availability of a
large diverse sample. The majority of the clients in this
study were young, undergraduate, Caucasian females.
Therefore, the results and implications of this study are
limited to this population.
The sample size was affected by various factors. For
example, it is very difficult obtaining information from
clients who have dropped out of counseling, thus resulting in
small sample sizes for analyses to make comparisons between
this group and mutual terminators, or clients continuing


33
American student standard" to self-disclosures by African-
American students,' that may actually be reactions to racism,
may frustrate African-American students in counseling and
further reinforce their feelings of alienation from the
university in general and campus counseling services in
particular (Thompson, et al., 1990)
Premature Termination
Premature termination poses a major obstacle to the
delivery of counseling services. As many as 20% to 25% of
college counseling center clients "no-show" for their first
appointment (Epperson, Bushway, & Warman, 1983) and
approximately 30% to 60% of all outpatient psychotherapy
clients drop out of treatment prematurely (Pekarik, 1983).
Premature termination, in its broadest sense, refers to
clients leaving treatment before their counselors believe
they should. This may be immediately after intake or after
the client has met with his or her counselor for one or more
sessions.
For those individuals who do not show for their first
appointment, the problem may be that of having to wait for a
counselor to pick up the individual as a client. Cochran and
Stamler (1989) suggest that demographic or administrative
variables, such as the client's dissatisfaction with the sex
of the intake counselor, length of the intake interview,
number of days from intake to case assignment, or the
experience level of the assigned counselor, could be more


153
voluntary and you may choose not to participate in this
study. However, individuals who complete the study will have
their names entered into a lottery from which ten names will
be chosen. These individuals will receive a money order for
ten dollars each. Your counseling will not be affected in any
way by whether or not you choose to participate in this
study. You may withdraw your consent to participate and
discontinue participation in the study at any time without
prejudice. It may be necessary to mail you information if
you cannot be reached at the Center.
Any questions about this study and your participation
will be answered by Celia Caesar, who is the principal
investigator of the study. Celia Caesar is a doctoral
candidate in the Counseling Psychology Program at the
University of Florida and a counselor at the University of
Florida Counseling Center. She can be reached by calling the
Counseling Center (392-1575) during regular operating hours.
I have read and understand the information described
above. I agree to participate in this study and I have
received a copy of this consent form. I give permission to
use my mailing address.
Participant Date
PLEASE PRINT YOUR NAME HERE
Principal Investigator Date
Celia Caesar


27
(respect, appreciation, valuation), congruence 1 (freedom
from threat and anxiety), unconditionality 1 (uncritical
acceptance), unconditionality 2 (degree of agreement between
persons in the relationship), empathy 1 (degree of
recognition of another's perceptions or feelings that are
directly communicated), and empathy 2 (ability to place the
immediate experiencing of another in the context of the
objects or persons who produce that experience), than White
counselors. Black low trusters also expected Black
counselors to significantly express higher levels of regard
2, congruence 1, and empathy 1 in the counseling relationship
than White counselors. White high and low trusters did not
have significantly different expectations of the counselors
of the two racial groups prior to counseling.
The pre- and post-ratings of both ethnic groups were
compared to determine if changes in students' perceptions
occurred over time after counseling. There was a significant
difference in counselor race in the congruence 2 (degree of
what is felt and experienced) and unconditionality 3 (degree
of variability in one's affective response to another). Both
races perceived White counselors as communicating a higher
degree of what is expressed in the counseling relationship
than Black counselors. In addition, scores showed a reverse
mean pattern for regard 1 between the races. White
counselors had a higher degree of liking and affection for
Black clients than White clients, and Black counselors
communicated a higher degree of liking and affection for


CHAPTER 3
METHODOLOGY
Subjects
Subjects were 75 students and two student spouses at the
University of Florida. The sample included clients being
seen individually (n = 64, 83%), in couples counseling (n =
6, 8%), and in group counseling (n = 7, 9%). Ages ranged
from 17 to 48, with an average age of 24.5 years. However,
62 percent of the sample (n = 47) were between the ages of 17
and 23. There were 58 females and 19 males in the sample.
The ethnic breakdown included 65 Caucasians (84%), four
African-Americans (5%), four Asians/Pacific Islanders (5%),
two Hispanics (3%), and two clients who did not report their
ethnic identity (3%). The sample consisted of graduate
students (n = 25, 32%), juniors (n = 19, 25%), sophomores (n
= 13, 17%), seniors (n = 12, 15%), freshmen (n = 4, 5%), post
baccalaureate students (n = 2, 3%), and student spouses (n =
2, 3%). Fifty-eight percent (n = 45) of the sample had been
in counseling previously, whereas, 42% (n = 32) were
attending counseling for the first time.
Twenty-six counselors (n = 16 females, 10 males) from
the University of Florida Counseling Center, as well as,
three counselors (n = 3 males) from the University of Florida
46


CHAPTER 2
LITERATURE REVIEW
This chapter focused on the relevant literature
pertaining to the research variables that were investigated
in this study. These variables were clients' expectations
about counseling, clients' perceptions of their own and their
counselors' trust/trustworthiness, clients' premature
termination from counseling, and clients' satisfaction with
counseling.
Expectations About Counseling
Clients' expectations about counseling has been an area
of great research interest in the field of counseling
psychology over the past ten years. It has been well
established that clients come to counseling with certain
expectations about what counseling will be like and what
roles they and their counselors will assume (Bordin, 1955;
Patterson, 1958; Rosenthal & Frank, 1956; Strong, 1968;
Tinsley & Harris, 1976). Furthermore, there has been support
for the argument that clients' expectations may either
facilitate or hinder the effectiveness of the counseling
process (Apfelbaum, 1958; Frank, 1968; Goldstein, 1962;
Goldstein, Heller, & Sechrest, 1966) .
13


92
the three time periods based on the counselors' perspectives
of the clients' termination status.
To compare the mutual terminators versus the dropouts on
the the trust variables, six separate multivariate analyses
of covariance (MANCOVAs) were run with the four trust
variables (Client Trustworthiness, Client Trust, Counselor
Trustworthiness, Counselor Trust) as the dependent measures,
and clients' termination status (mutual vs dropout) as the
independent variable. The following variables were
covariates: clients' previous counseling experience (PREV),
counselors' experience level (CEXP), and the interaction of
the latter two variables, (PREV*CEXP). The MANCOVAs were run
for each of the three time periods, again based on both the
counselors' and the clients' perspectives of the clients'
termination status.
Specifically, the first MANCOVA included the four trust
variables at timel (0 sessions) as the dependent variables.
The second MANCOVA included the four trust variables at time2
(m = 1.11 sessions) as the dependent variables. The third
MANCOVA included the four, trust variables at time3 (m = 4.5
sessions) as the dependent variables. Each of the three
MANCOVAs included clients' termination status (mutual,
dropout) based on the clients' perspectives of their own
termination status as the independent variable, and PREV,
CEXP and PREV*CEXP as covariates.
Results also revealed that none of these three MANCOVAs
were significant. There were no overall effects for


44
However, in every instance, rating of other was significantly
and positively correlated with satisfaction.
Finally, a study by Neimeyer and Gonzales (1983)
investigated the duration, satisfaction, and perceived
effectiveness of cross-cultural counseling. Forty-nine white
and 21 nonwhite (8 Asian, 7 Black, 3 Hispanic, 1 Native
American, 2 unspecified) clients at a university counseling
center were seen by 13 white and 7 nonwhite (4 Black, 1
Asian, 2 Hispanic) counselors. Counselors and clients
completed a standard Counseling Services Evaluation Form
including demographic data, severity of the presenting
problem, duration of counseling and perceptions concerning
overall satisfaction and perceived effectiveness of services
at intake and 10 weeks after the initial session. Clients
were randomly assigned to therapists, however pretesting was
performed to determine the equivalence of the four groups
(counselor race x client race) in terms of age and perceived
severity. No significant difference were found.
Results showed that White counselors provided fewer
sessions than nonwhite counselors. Nonwhite clients
expressed lower satisfaction than White clients, however,
this finding needs to be interpreted cautiously since mean
differences were minimal (M = 4.8, White; M = 4.3, nonwhite).
This result indicates that satisfaction did not vary as a
function of counselor race and was not related to cross-
racial differences. No difference in perceived effectiveness
of counseling was found among the four treatment dyads.


135
those that explain an insignificant portion of the variation
in the dependent variable, as a form of exploratory research.
Conclusion
The primary goal of counseling is to help people change.
Social influence theory has been influential in offering an
explanation of the change process in counseling. Strong
(1968) suggests that there are two stages involved in this
change process. First the counselor establishes
himself/herself as a useful resource. Second, after this
perception has been established the counselor has the
leverage needed to influence clients therapeutically.
The present study sought to be a contribution to the
social influence theory of the counseling process. As
previously mentioned, there have been three major criticisms
of the research conducted in this area. First, there has
been a preponderance of the use of analogue studies to
conduct research on the counseling process. Second, most of
the research that has been conducted have ignored the second
stage of Strong's model involving the influence process in
counseling and have focused primarily on counselor
characteristics. Lastly, clients have been portrayed as
passive recipients of counseling, such that the importance of
client variables in counseling has been ignored.
The present study addressed these criticisms first by
implementing the research in actual counseling centers with
real clients and counselors, thereby generating results that


APPENDIX G
COVER LETTER (FIRST ADMINISTRATION)
Hello
Thank you for taking the time to read this.
The Counseling Center is involved in a research study.
The informed consent attached gives a detailed explanation of
what is involved in this study. Please take a few minutes
to read the informed consent. After reading it, if you would
like to participate, please sign both of the informed
consents and keep one for yourself. Complete the
questionnaire and return it to the receptionist in the
envelope provided. Time has been allotted before your
appointment to complete the questionnaire. If you decide not
to participate, simply return the blank questionnaire and
informed consents to the receptionist.
Thank you again.
150


APPENDIX D
CLIENT SATISFACTION QUESTIONNAIRE
Please help us improve our Center by answering some
questions about the services you have received at the
University of Florida Counseling Center. We are interested
in your honest opinions, whether they are positive or
negative. Please answer a.ll of the questions. We also
welcome your comments and suggestions. Thank you very much,
we appreciate your help.
CIRCLE YOUR ANSWER:
1.How would you rate the quality of counseling you have
received thus far?
4 3 2
Excellent Good Fair Poor
2.Have you gotten the kind of counseling you wanted?
1 2 3 4
No, definitely No, not really Yes, generally Yes,definitely
not
3.To what extent has our Center met your needs thus far?
4
Almost all of
my needs have
been met
3
Most of my
needs have
been met
Only a few of
my needs have
been met
1
None of my
my needs have
been met
145


counseling experience (PREV), the counselors' experience
levels (CEXP) or the interaction of these two variables
(PREV*CEXP).
72
Table 4-2
Simple Statistics for the Trust Variables
Variable Timela Time2b Time3c
n
m
SD
n
m
SD
n
m
SD
Trust1
24
4.63
0.58
24
4.38
0.82
24
4.54
0.59
Trust2
24
3.58
0.78
24
3.33
0.92
24
3.33
0.96
Trust3
24
4.71
0.46
24
4.21
0.98
24
4.63
0.71
Trust4
24
3.75
0.74
23
3.87
0.97
24
4.17
0.76
a0 sessions, bl session, cm = 6.33 sessions, SD = 3.45
Trust: 5 point Likert scale
Results of the Pearson correlations between number of
sessions attended by clients and the Trust variables revealed
that none of the correlations were significant, such that
clients' perceptions of themselves and their counselors as
trustworthy and trusting were not significantly related to
the number of counseling sessions attended by the clients.
Therefore, the results of the analyses conducted for
hypothesis four failed to support the hypothesis.
Hypothesis five was that as clients' expectations for
counseling (expectation factors: Personal Commitment,


79
counselors' experience levels (PREV*CEXP, p < .0102) appeared
as significant predictors of Counseling Evaluation (CEVAL) at
time3. To clarify the interaction effect (PREV*CEXP), the
parameter estimates revealed that both PREV (-1.54) and CEXP
(-0.34) were negatively associated with CEVAL. These
negative associations indicate that clients with previous
counseling experience were more likely to have higher
satisfaction with their counselors (CEVAL). In addition, it
appears that clients were more satisfied with counselors who
had less experience. The interaction between clients'
previous counseling experience and counselors' experience
levels (PREV*CEXP = 0.56) indicates that clients with
previous counseling experience had higher satisfaction with
more experienced counselors. In contrast, clients with no
previous counseling experience had higher satisfaction with
less experienced counselors. Once again, the R-square
obtained was quite small (R2 = .211), indicating that the
predictors in this model only accounted for a small amount of
the variance in CEVAL at time3. Therefore, it is doubtful
whether even the significant predictors are very influential
in predicting Counseling Evaluation (CEVAL) at time3.
Results of the multiple regressions for hypothesis five
revealed that only small amounts (R2 = .114 to .324) of the
variance in SATIS and CEVAL at time2 and time3 were accounted
for by the four expectation factors. These results indicate
that the expectation factors were not highly influential
predictors of clients' satisfaction with their counseling


133
availability of alternative instruments measuring different
expectations and especially by the existence of instruments
with significantly different approaches to measuring
expectations" (p. 64). Likewise, the availability of
instruments measuring different aspects of trust and
trustworthiness (cultural, interpersonal, characterological)
in a concise manner would greatly enhance research efforts in
this area. A necessary consideration in the present study,
was the use of instruments that were not time consuming,
first in order to obtain approval from the two sites to
conduct the study in their facilities and second, so that
clients would not be deterred from participating in the
project.
Continuing research differentiating mutual terminators
and dropouts seems warranted. Of specific interest are the
differences between counselors' and clients' perspectives
about the counseling relationship, and subsequent
termination, be it mutual or nonmutual. This type of
research would provided needed additional information
concerning the second stage of Strong's (1968) social
influence model, the influence process. More specifically,
it would be impactful in clarifying discrepancies in
perceptions between counselors and clients in relation to
client needs, counselor presentation, unverbalized client and
counselor expectations, etc. A possible avenue for obtaining
information of this nature is the Interpersonal Process
Recall procedure where both counselors and clients view


101
predictor variables were not successful in accounting for
much of the variance in SATIS at time3. Therefore it is
likely that even the significant predictors are not highly
influential in predicting Client Satisfaction (SATIS) later
in counseling (time3).
The second regression included SATIS at time3 as the
criterion variable and the following as the predictor
variables: the four EAC-B factors at time2, the four Trust
variables at time2, SATIS at time2, and CEVAL at time2.
Results of this regression revealed that although the model
itself was significant (F(10, 28) = 2.16, p< .0525),
suggesting that at least one independent variable was
significantly related to SATIS at time3, there were no
significant predictors of SATIS at time3 in this model. This
finding suggests the presence of multicollinearity in which
there are strong intercorrelations among the independent
variables making it difficult to assess the contributions of
individual partial effects. The R-square obtained was
moderate (R2 = .4361) indicating that the expectation
factors, Trust variables and satisfaction measures early
in counseling were moderately useful, predicting
approximately forty-four percent (44%) of the total variance
in Client Satisfaction with counseling in general (SATIS)
later in counseling. Results of this regression are
presented in Table 4-17.


84
Table 4-8
Multiple Regression for Client Satisfaction at Time3 with the
Trust Variables at Time3 as Predictors
Source
DF
SS
MS
F
P
Model
4
706.06
190.02
8.58
.0001
Error
59
1306.92
22.15
Total
63
2066.98
Variable
DF
Parameter
Standard
T
p
Estimate
Error
Intercept
i
4.65
5.49
0.85
.4004
Trustl-3
i
-0.17
1.05
-0.16
.8705
Trust2-3
i
0.05
0.58
0.09
.9296
Trust3-3
i
4.21
1.03
4.09
.0001
Trust4-3
i
0.48
0.85
0.56
.5748
R2 = .368
cv
= 18.81
Root MSE =
4.71
m = 25.91
Adj. R2 =
.325
a small amount of the variance in SATIS at time3. Yet, it is
possible that because Trust3 was highly correlated with SATIS
at time3 (r = .603, p < .0001), Trust3 accounted for most of
the variance in the model and may still be influential in
predicting SATIS at time3.
The third regression involved Counseling Evaluation
(CEVAL) at time2 (in = 1.11 sessions) as the criterion


APPENDIX C
COUNSELING EVALUATION INVENTORY
On the following page are some statements about
counseling. Your task is to rate your own counseling
experience using these statements. Next to each statement
are five numbers. Helping words have been placed above the
numbers to tell you what each number means.
For example, one student rated these sample statements
in the following way:
A.The counselor had Always Often Sometimes Rarely Never
a good sense of humor 54 3 21
B. The counselor did not 12 3 45
listen to what I said.
The person who judged statement"A" thought that his
counselor often had a good sense of humor He marked
statement "B" to indicate that his counselor rarely failed to
listen to what he had to say.
You are to rate all of the statements on the following
page by circling the number which best expresses how you feel
about your own counseling experience.
Here are some suggestions which may be of help to you:
1. This is not a test. The best answer is the one which
honestly describes your own counseling experience.
141


47
Student Mental Health Services participated in the study.
The counselors from the Counseling Center consisted of seven
practicum students, nine interns, three counseling
associates, and seven senior staff members. The counselors
from Student Mental Health Services were a practicum student,
an intern, and a psychiatrist.
Instruments
The Expectations About Counseling-Brief Form (EAC-B;
Tinsley et al., 1980) consists of 66 items that are answered
on a 7-point Likert scale with response options which range
from not true to definitely true (Appendix A) Higher scores
indicate more positive expectations about counseling. Each
item is prefaced by the phrases "I expect to" or "I expect
the counselor to". For the purposes of this study only 53
items were used. The items excluded comprise the Realism
scale which is the most experimental scale of the inventory
and is not included in the factor scores. The remaining 17
scales of the EAC-B measure expectancies in four general
areas: Client Attitudes and Behaviors; Counselor Attitudes
and Behaviors; Counselor Characteristics; and Counseling
Process and Outcome. The internal consistency reliabilities
of the scales, based on the responses of 446 undergraduate
students ranged from .69 to .82 with a median reliability of
.76 (Tinsley, 1982). Test-retest reliabilities for a 2-month
interval ranged from .47 to .87 with a median of .71. All
but the responsibility scale had a test-retest reliability of


LIST OF TABLES
Table page
4-1 Simple Statistics for the Expectation Factors 70
4-2 Simple Statistics for the Trust Variables 72
4-3 Pearson Correlation Coefficients Among the Expectation
Factors and the Counseling/Counselor
Satisfaction Measures 74
4-4 Multiple Regression for Counseling Evaluation at Time2
with the Expectation Factors at Time2 as
Predictors 76
4-5 Multiple Regression for Counseling Evaluation at Time3
with the Expectation Factors at Time3 as
Predictors 78
4-6 Pearson Correlation Coefficients Among the Trust
Variables and the Counseling/Counselor
Satisfaction Measures 81
4-7 Multiple Regression for Client Satisfaction at Time2
with the Trust Variables at Time2 as Predictors ... 83
4-8 Multiple Regression for Client Satisfaction at Time3
with the Trust Variables at Time3 as Predictors ... 84
4-9 Multiple Regression for Counseling Evaluation at Time2
with the Trust Variables at Time2 as Predictors ... 85
4-10 Multiple Regression for Counseling Evaluation at Time3
with the Trust Variables at Time3 as Predictors ... 87
4-11 A Comparison of the Differences Between the Counselors'
and Clients' Perspectives of the Clients'
Termination Status 90
4-12 Analysis of Variance for Client Satisfaction at Time2
Based on the Counselors' Perspectives of the
Clients' Termination Status 95
viii


97
termination status. The covariates for the two ANCOVAs were
clients' previous counseling experience (PREV), counselors'
experience levels (CEXP) and the interaction of these two
variables (PREV*CEXP). Results of these ANCOVAs to test the
hypotheses of no overall effect for termination status
revealed no significant differences between groups at either
time2 or time 3 based on the clients' perspectives of their
own termination status (mutual vs. dropout).
The third and fourth ANCOVAs included the same dependent
variables as the first two ANCOVAs (i.e., 3rd: CEVAL at
time2; 4th: CEVAL at time3), and the same covariates (PREV,
CEXP, PREV*CEXP). The independent variable for each of these
ANCOVAs was clients' termination status (mutual vs dropout)
based on the counselors' perspectives of their clients'
termination status. Results of the third ANCOVA to test the
hypothesis of no overall effect for termination status based
on the counselors' perspectives indicated that there were no
significant group differences between mutual terminators and
dropouts on their satisfaction with their counselors (CEVAL)
at time2.
Results of the fourth ANCOVA to test the hypothesis of
no overall effect for termination status based on the
counselors' perspectives of their clients' termination status
indicated that there was a significant difference between
groups at time3, F(5, 25) = 3.12, p< .0253. Moreover, means
(see Table 4-13) indicated that compared to dropouts (m =
3.50, SD = 0.77), mutual terminators were more satisfied with


161
Derita, D. J. (1976). An evaluation of a telephone
counseling service and its effectiveness within the
mental health community. (Doctoral dissertation,
University of Illinois at Urbana-Champaign, 1976) .
Dissertation Abstracts International, 21, 2499-B,
(University Microfilms No. 76-24,067.
Derogatis, L. R., Lipraan, R. S., & Covi, L. (1973). SCL-90:
An outpatient psychiatric rating scale-preliminary
report. Psvchopharmacoloav Bulletin. 9, 13-28.
Duckro, P, Beal, D, & George C. (1979). Research on the
effects of disconfirmed client role expectations in
psychotherapy: A critical review. Psychological
Bulletin. 86. 260-275.
Edwards, D. W., Yarvis, R. M., Mueller, D. P., T Langsley, D.
G. (1978). Does patient satisfaction correlate with
success? Hospital and Community Psychiatry. 29. 188-
190.
Endicott, J., Spitzer, R. L., Fleiss, J. L., & Cohen, J.
(1976). The global assessment scale: A procedure for
measuring the overall severity of psychiatric
disturbance. Archives of General Psychiatry. 33., 766-
777.
Epperson, D., Bushway, D., & Warman, R. (1983). Client self
terminations after one counseling session: Effects of
problem recognition, counselor gender, and counselor
experience. Journal of Counseling Psychology. 30., 307-
315.
Fellows, A. R. (1985). The relationship of client
expectations to psychotherapy (Doctoral dissertation,
The University of Texas at Austin, 1985). Dissertation
Abstracts International, 46, 4010B.
Fong, M. L., & Cox, B. G. (1983). Trust as an underlying
dynamic in the counseling process: How clients test
trust. The Personnel and Guidance Journal. 62. 163-166.
Frank, J. D. (1968). The influence of patients' and
therapists' expectation on the outcome of psychotherapy.
British Journal of Medical Psychology. 41, 349-356.
Frank, R., Salzman, K., & Fergus, E. (1977). Correlates of
consumer satisfaction with outpatient therapy assessed
by postcard. Community Mental Health Journal. 13., 37-
45.


CHAPTER 4
RESULTS
The major dependent variables of study in this research
were the following: clients' satisfaction with counseling
(SATIS) and clients' satisfaction with their counselors
(CEVAL). The major independent variables were: clients'
expectations about counseling (EAC-B), clients' perceptions
of their own and their counselors' trust/trustworthiness
(Trust), and time in counseling. Clients' expectations were
comprised of four factors: Personal Commitment (EAC-B1),
Facilitative Conditions (EAC-B2), Counselor Expertise (EAC-
B3), and Nurturance (EAC-B4). Clients' perceptions of their
own and their counselors' trust/trustworthiness included four
variables: Client Trustworthiness (Trustl), Client Trust
(Trust2), Counselor Trustworthiness (Trust3), and Counselor
Trust (Trust4). Time in counseling was divided into three
periods: precounseling (timel), after the first counseling
session (time2) and after the sixth or last counseling
session (time3).
Due to the inability to control when clients' actually
returned their questionnaires, not all questionnaires were
returned after the first and prior to the second counseling
session for the second administration of the questionnaires,
nor after the sixth and prior to the seventh counseling
59


152
Center contact Celia Caesar directly at the Center at 392-
1575.
It is of utmost importance that all of the
questionnaires be completed at the respective times in order
to obtain a comparison between your expectations prior to
beginning counseling and your feelings after experiencing
counseling. In order to protect your confidentiality, your
name will not appear on any of the questionnaires and you
will be asked to always return your questionnaires in sealed
envelopes. The information you provide will be identified by
a code number only. This consent form is the only form on
which your name will appear and it will be separated from
your questionnaires. Furthermore, your counselor will not
see your completed questionnaires and will not in any way
know your responses to the questionnaires.
There are no anticipated risks to you as a result of
your participation in this study. However you will be
revealing, in writing, information about your feelings toward
your counselor and counseling. This information will only be
made available to your counselor if vou choose to discuss
your feelings with him or. her. Your questionnaires will be
scored by someone not associated in any way with the
Counseling Center and who will not be able to identify your
questionnaires. Possible benefits of your participation in
this study include gaining increased insight into your
feelings about counseling, and helping to improve counseling
services at the Counseling Center. Your participation is


95
Table 4-12
Analysis of Variance for Client Satisfaction at Time2 Based
on the Counselors' Perspectives of the Clients' Termination
Status?
Source
DF
ss
MS
F
£
Model
i
64.0
64.0
10.67
.0049
Error
16
96.0
6.0
Total
17
160.0
Source
DF
Typelll
SS
MS
F
P
Co. Drop
1
64.0
64.0
10.67
.0049
R2 = .40
CV
= 9.07
Root MSE =
2.45
m = 27.0
Table 4-13
simple Statistics Comparing Mutual Terminators and Dropouts
on the Client Satisfaction and Counseling Evaluation Measures
Variable Time2a Time3b
n
m
SD
n
m
SD
Satisfaction Mutual Term.
12
28.33
2.39
20
27.00
4.71
Dropouts
6
24.33
2.58
11
18.45
5.72
Counseling Mutual Term.
Evaluation
12
4.70
0.23
20
4.44
0.54
Dropouts
6
4.21
0.47
11
3.50
0.77
'm = 1.11 sessions; fyn = 4.5 sessions


116
satisfaction measures. Specifically, the predictors at time2
(EAC-B, Trust variables, SATIS, CEVAL, PREV, CEXP, PREV*CEXP)
accounted for approximately sixty-seven percent of the total
variance in clients' satisfaction with their counselors
(CEVAL) at time3. In addition, CEVAL at time2 was the only
significant predictor in this model, indicating that early
satisfaction with the counselors was the best predictor of
later satisfaction with the counselors.
However, the presence of multicollinearity (strong
intercorrelations among the independent variables) may have
affected the results, thereby making it difficult to
accurately assess the contributions of the independent
variables. Hypothesis eight is therefore partially supported
for CEVAL at time3, in that compared to the predictor
variables at timel, the predictor variables at time2 were
better at predicting CEVAL at time3 (i.e., accounted for more
of the variance in CEVAL at time3).
Finally, hypothesis nine was that there will be a
significant positive association between clients' levels of
perceived similarity to their counselors and their levels of
satisfaction with their counseling (Client Satisfaction;
SATIS) and their counselors (Counseling Evaluation; CEVAL).
Results of the analyses supported this hypothesis.
Specifically it was found that there were significant
positive correlations between clients' perceived similarity
to their counselors and both clients' satisfaction with
counseling and with their counselors. Therefore, as clients'


149
PLEASE INDICATE THE DEGREE TO WHICH YOU FELT/FEEL SIMILAR TO
YOUR COUNSELOR BY CIRCLING A NUMBER ON THE FOLLOWING SCALE:
Not at all Very
Similar Similar
1 2 3 4 5


29
In an analogue study by Watkins and Terrell (1988),
Black students mistrust level and counseling expectations
were investigated in relation to Black client-White counselor
relationships. In addition to a demographic data
questionnaire, students were administered the Cultural
Mistrust Inventory (CMI; Terrell & Terrell, 1981), indicating
the degree to which they distrust Whites, and the
Expectations About Counseling Questionnaire (EAC; Tinsley et
al., 1980) which was modified for this study. The word
"black" or "white" was placed before counselor in the
instructions that the experimental groups received. Subjects
mistrust levels were considered high or low based on a median
split.
Results indicated that compared to less mistrustful
Blacks, highly mistrustful Blacks expected less from
counseling, regardless of the race of the counselor.
Specifically, highly mistrustful subjects viewed the
counselor as less attractive and expected a diminished focus
on the immediate therapy relationship than less mistrustful
subjects. Moreover, highly mistrustful subjects assigned to
a White counselor expected their counselor to be less
genuine, self-disclosive, accepting, trustworthy, and expert,
and expected counseling to be less successful than if they
were assigned to a Black counselor.
In a follow-up study, Watkins, Terrell, Miller, and
Terrell (1989) once again examined cultural mistrust in
relation to Black client-white counselor relationships. In


58
levels of perceived trustworthiness and trust (Client
Trustworthiness, Client Trust, Counselor Trustworthiness,
Counselor Trust) prior to beginning counseling. In addition,
dropouts will have less satisfaction with counseling (SATIS)
and with their counselors (CEVAL) than mutual terminators.
8) Compared to clients' expectations (EAC-B) and levels
of perceived trust/trustworthiness (TRUST) prior to beginning
counseling (timel), clients' expectations, levels of
trust/trustworthiness, and satisfaction with counseling
(SATIS) and with their counselors (CEVAL) early in counseling
(time2) will be better predictors of client satisfaction with
counseling/counselors later in counseling (time3).
9) There will be significant positive associations
between clients' levels of perceived similarity to their
counselors (SIM) and clients' satisfaction with their
counseling (Client Satisfaction; SATIS) and their counselors
(Counseling Evaluation; CEVAL).


CHAPTER 1
INTRODUCTION
Statement of the Problem
The goal of counseling is to help people change (Heppner
& Claiborn, 1989). Questions as to how to facilitate this
change is at the heart of the work of counseling
practitioners. Some therapists believe that client change
occurs naturally as a result of the therapeutic relationship
itself. Others maintain that a good relationship is
important inasmuch as it allows the counselor to exert
influence and use certain techniques to bring about change in
the clients' attitudes and behaviors. Regardless of their
therapeutic style, practitioners and theoreticians "probably
all currently agree that the counselor client relationship is
important to the outcome of most or all therapeutic efforts"
(Gelso & Carter, 1985, p. 155).
Social Influence Theory
Social influence theory offers an explanation of the
change process in counseling. This theory suggests that
there are two stages involved in this change process. First,
the counselor needs to establish herself/himself as a useful
resource. Second, after this perception has been
1


This dissertation was submitted to the Graduate Faculty
of the Department of Psychology in the College of Liberal
Arts and Sciences and to the Graduate School and was accepted
as partial fulfillment of the requirements for the degree of
Doctor of Philosophy.
August, 1996
Dean, Graduate School


53
counseling. However, the Informed Consent Form also stated
that clients who completed the study would have their names
entered into a lottery from which ten names would be chosen.
The individuals selected would receive a money order for ten
dollars each.
Clients who agreed to participate in the study completed
the Expectations About Counseling-Brief Form and the Likert
Trust Scale prior to their intake and returned these
questionnaires to the receptionist sealed in the envelope
provided, along with one signed copy of the Informed Consent
Form. The other copy of the Consent Form was retained by
each client for his/her records. Those clients who decided
not to participate in the study simply returned the blank
questionnaires to the receptionist.
Upon receipt of the sealed envelope containing the first
two completed questionnaires and the Informed Consent Form,
the receptionist at the Counseling Center stapled a
memorandum to the inside of the client's folder containing
the usual intake forms used by the Counseling Center. After
the intake, the folder was either retained by the counselor
if the counselor had decided to pick up this particular
client for ongoing counseling, or the folder was placed in a
waiting list filing cabinet. The memorandum stapled to the
inside of the client's folder (Appendix I) was used by the
counselors picking up the client to inform the principal
investigator of the date of the clients first scheduled
counseling session, the name of the counselor, and the


71
three time periods was the independent variable. In
addition, Pearson correlations were utilized to determine the
type of relationship (positive vs negative) between number of
sessions attended by clients and clients' reports of their
own trustworthiness and trust, as well as clients' perceived
counselor trustworthiness and trust. Results of the three
repeated measures ANOVAs with Trustl, Trust2 and Trust4 as
the dependent measures revealed that there were no overall
time effects for any of the three trust variables, indicating
that there were no significant differences in the means for
any of the three Trust variables from prior to beginning
counseling, to after the first or after two or more
counseling sessions. There was an increase in the means for
Counselor Trust (Trust4) over the three time periods (Table
4-2). However, the differences in the means were not
significant.
A repeated measures ANCOVA was conducted with Trust3
(Counselor Trustworthiness) as the dependent measure,
counseling received over three time periods (timel, time2,
time3) as the independent measure, and clients' previous
counseling experience (PREV), counselors' experience levels
(CEXP), and the interaction of these two variables
(PREV*CEXP) as covariates. The within subjects test of the
repeated measures ANCOVA with Counselor Trustworthiness as
the dependent variable for the entire sample revealed that
there was no overall time effect, nor significant differences
in the means for Trust3 over time due to clients' previous


65
The Repeated Measures Analysis of Variance with Counseling
Evaluation as the Dependent Variable
A repeated measure ANOVA was performed with Counseling
Evaluation (a measure of clients' satisfaction with their
counselors; CEVAL) as the dependent measure, and the
following as independent variables; counseling received over
two time periods (time2, time3), clients' previous counseling
experience (PREV), counselors' experience levels (CEXP), and
the interaction of these two variables (PREV*CEXP). The
between subjects test revealed a significant overall effect
for CEXP, F (1, 37) = 3.86, p < .056. Apparently the
counselors' experience levels also affected the clients'
satisfaction with their counselors.
The within subjects test revealed a significant
time*CEXP*PREV interaction, F(l, 37) = 4.26, p< .0462.
There was no significant effect for CEVAL at time2. However,
there was a significant effect for CEVAL at time3, F(3, 37) =
3.99, p < .0147. Moreover, CEXP*PREV (p < .0270) was
significantly associated with Counseling Evaluation (CEVAL)
at time3. These results indicate that counselors' experience
levels (CEXP) and clients' previous counseling experience
(PREV) were not significant factors in clients' satisfaction
with their counselors (CEVAL) early in counseling (time2).
However, later in counseling (time3) an interaction between
CEXP and PREV apparently became impactful in clients'
satisfaction with their counselors (CEVAL).


5
paradigm, a new way of thinking about the relationship in
counseling and psychotherapy" (p. 157). Consistent with the
idea of a new paradigm, an effort was made to empirically
define the therapeutic relationship.
It was Greenson (1967) who first suggested that the
therapeutic relationship could be divided into three
components: 1) the working alliance, 2) the transference
relationship, and 3) the real relationship. His work had a
major impact on analysis and analytic therapy. However, it
was Gelso and Carter (1985) who proposed that these three
components are not specific to psychoanalysis, but rather
exist in all therapeutic relationships. Moreover, the
theoretical perspectives and practices of the therapist
determines the importance a given component plays in therapy.
The working alliance is defined as the "alignment that
occurs between counselor and client...(based on) an emotional
bond between the participants, an agreement about the goals
of counseling, and agreement about the tasks of the work
(Gelso & Carter, 1985). In order for a strong positive
working alliance to be formed, the client must have the
capacity to trust. As an essential part of the therapeutic
relationship, trust must be established between counselor and
client before any therapeutic changes can occur.
Furthermore, trust needs to develop early in the relationship
otherwise clients may terminate counseling prematurely or
remain resistant, sharing only superficial issues with the
counselor (Fong & Cox, 1983).


Abstract of Dissertation Presented to the Graduate School
of the University of Florida in Partial Fulfillment of the
Requirements for the Degree of Doctor of Philosophy
CLIENTS' PERCEIVED TRUST, TRUSTWORTHINESS, AND EXPECTATIONS
IN THE THERAPEUTIC RELATIONSHIP: FACTORS IN
SATISFACTION WITH COUNSELING RECEIVED
By
Celia Andersen Caesar
August, 1996
Chairperson: Carolyn M. Tucker
Major Department: Psychology
This study examined clients' expectations about
counseling, and perceived trust/trustworthiness before
receiving counseling. Changes in these variables and in
clients' satisfaction with counseling/counselors over time in
counseling were investigated. Also investigated were
differences between mutual terminators and dropouts regarding
the variables of study. Clients' perceptions of similarity
to their counselors were examined relative to clients'
satisfaction in counseling.
Seventy-seven clients seeking counseling at two
university counseling centers were administered the
Expectations About Counseling-Brief Form and the Likert Trust
Scale before counseling. These questionnaires were
readministered after the clients' first and sixth/last
x