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An examination of the effects of pre-counseling treatment strategies on prospective client self-efficacy and readiness for change in counseling

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An examination of the effects of pre-counseling treatment strategies on prospective client self-efficacy and readiness for change in counseling
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AN EXAMINATION OF THE EFFECTS OF PRE-COUNSELING TREATMENT
STRATEGIES ON PROSPECTIVE CLIENT SELF-EFFICACY AND READINESS
FOR CHANGE IN COUNSELING












By

DAVID KENT COX


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


2002































Copyright 2002

by

DAVID KENT COX














ACKNOWLEDGMENTS

I honor the following with great appreciation and gratitude. Their help, guidance,

wisdom and leadership served to sustain me through this extremely rewarding and

challenging doctoral process.

First and foremost, I honor God; without the power of his creation, and his

guidance and wisdom, none of any of this would have been possible. Second, I honor and

thank my wife, Alison. Her great love and support throughout my seven years of graduate

school are beyond measure; language fails to capture how much her support meant to me

during the more trying moments of this protracted process. Third, I honor my children,

Jordyn and Kyle. Jordyn entered this world three weeks before I began my doctoral

studies; her entrance into this world has made my life experiences so much more loving,

rich and meaningful. To Kyle, my son, whose endless love, smiles and laughter served

and continue to serve as a gentle reminder to enjoy the journey while not focusing so

much on the destination.

Special thanks go to Dr. Jim Archer, my advisor, whose expert guidance and

instruction helped me navigate through the intricacies and difficulties of my dissertation.

Thanks also go to Dr. David Miller, Dr. Harry Daniels, and Dr. Marshall Knudson, who

all served on my committee and were eager to help. I thank Marshall for his

understanding and support. Very special thanks go to Sara Summerfield for her

dedication and work in helping me format my dissertation and helping me enter my data









and to Beverly Buckley for her ideas and help regarding the graphic design of my

literature treatment group.

Special thanks also go to Dr. James Algina, whose time, patience, willingness to

help and classroom instruction served me tremendously with the rigor of statistics while

shaping my thinking as a scientific researcher. Special thanks also go to former

professors Dr. J. Walter Weingart at Whitman College, Dr. John Meany, Seattle

University, and Dr. Sonny Cytrynbaum and Dr. John Lyons at Northwestern University,

who were all instrumental in promoting my early academic development regarding

improved study habits, critical thinking and overall, scholastic excellence.

Very special thanks go to personal and deep friend, Dr. Mark Gignac, whose

shared love of Eastern philosophy, Rumi, spirituality, psychology, and the spacious

questions of the cosmos helped keep me true and focused to what really matters. And

special thanks go to friend William Corley, whose academic excellence during my high

school years in Seattle and college days at Whitman served to model greater scholarship

in myself. I thank Bryan Robinson for his great friendship over the years while diverting

me away from my studies, toward talk of hoops, the Lakers and MJ. And I thank Jim and

Diana for putting up with me for nine months while putting me up at their residence

while traveling to Chicago to finish my masters at Northwestern.

Lastly, with special love to my mother, whose unconditional love and support

over the years has been wonderful. We go way back Mom. And to my father, who

indirectly showed me how important it is for generations to improve, how critical it is to

become a good father and husband, how never to quit, and how true that if we imagine,

like John Lennon, that the .world is one, that in the end, all we need is love.















TABLE OF CONTENTS

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

A B ST RA C T ........................................ ................................................ viii

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

Statement of the Problem............................................................. I
Need for the Study...................................................................... 3
Purpose of the Study.................................................................. 5
Background of the Problem................................... 7
Organization of the Study............................................................ 13
General Research Questions......................................................... 13
Definition of Terms................................................................... 14

2 REVIEW OF THE LITERATURE..................................................... 16

Self-Efficacy.............................................................................. 16
Self-Efficacy Research................................................................ 16
Counseling Self-Efficacy Research................................................ 17
Theoretical Framework of Self-Efficacy.......................................... 18
Studies to Increase Theoretical Components of Self-Efficacy.................. 19
The Role of Self-Efficacy on Coping Performance............................... 21
Social-Cognitive Theory............................................................. 23
The Level, Strength, and Generality of Self-Efficacy............................ 24
The Role of Personal Agency in Counseling...................................... 30
The Association of Self-Efficacy with Motivation in Counseling.............. 32
M otivation................................................................................. 33
Motivation and Personality Theory................................................ 34
Different Theories on Motivation................................................... 35
Motivation and Cognitive Dissonance............................................. 37
Motivational Interviewing............................................................ 37
Motivation and Personal Expectations............................................. 39
Motivation and Goal Setting......................................................... 39
Motivation in Stages/Prochaska.................................................... 40
Motivation and Measurement Studies/Prochaska, DiClemente, Isenhart...... 42
General Training Strategies............................................................... 47
Date Rape Awareness................................................................. 48
Pre-test HIV/AIDS Counseling...................................................... 51
Prospective Faculty Training............................................... 51
RA Training............................................................................ 52




v









Specific Pre-Counseling Treatment Methods.................................... 54
Videotape in Counseling............................................................ 54
R ole-Plays............................................................................. 57
Counseling Literature............................................................ 62
C conclusion ............................................................................. 64

3 METHODOLOGY....................................................................... 71

Statement of Purpose..................................................................... 71
H ypotheses................................................................................ 71
Delineation of Relevant Variables..................................................... 73
Dependent Variables............................................................ 73
Independent Variables........................................................ 73
Population................................................................................. 74
Sampling Procedures..................................................................... 74
Experimental Procedures................................................................. 76
Data Collection Procedures............................................................. 78
Instrumentation........................................................................... 78
C SEB S .............................. ................... .......................... 78
U R IC A ....................................... ........................ .. .......... 79
Data Analytic Procedures............................................................... 82
Limitations of the Study.................................................................. 84

4 DATA ANALYSIS AND RESULTS.................................................. 86

Summary and Chapter Overview...................................................... 86
Data Collection and Response Rates................................................... 86
Descriptive Data.......................................................................... 88
Reliability Estimates for CSEBS and URICA....................................... 86
Analysis Procedures...................................................................... 89
Results of Hypotheses Tests ............................................................ 100
Sum m ary.................................................................................. 102

5 DISCUSSION.......................................................... ............... 105

Sum m ary .................................................................................. 105
Discussion of Results..................................................................... 106
Theoretical Implications of the Study.................................................. 111
Clinical Implications of the Study...................................................... 113
Limitations of the Study.................................................................. 115
Research Implications ............................... ................................... 118
Future Recommendations for Research................................................. 118
C conclusion .......................................... .................. ....... ........... .... 120

A PPEN D IX ........................................................................................... 121

A INFORMED CONSENT................................................................ 121

B ROLE-PLAY SCRIPT................................................................... 122

C VIDEO SCRIPT OF ROLE-PLAY.................................................... 123










D COUNSELING LITERATURE........................................................ 125

E COUNSELING BROCHURE........................................................... 128

F COUNSELING QUIZ.................................................................... 131

G SURVEY.................................................................................... 132

H IRB FORM................................................................................. 133

I ROLE-PLAY INSTRUCTIONS........................................................ 135

J FOLLOW-UP SURVEY TO SEEK COUNSELING................................ 136

K URICA MEASURE....................................................................... 137

REFERENCES...................................................................................... 139














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

AN EXAMINATION OF THE EFFECTS OF PRE-COUNSELING TREATMENT
STRATEGIES ON PROSPECTIVE CLIENT SELF-EFFICACY AND READINESS
FOR CHANGE IN COUNSELING

By

David Kent Cox

December 2002


Chairperson: James Archer, Jr.
Major Department: Counselor Education

In order that clients maximize the services offered to them, it is crucial that

counselors focus on methods of increasing client self-efficacy and motivation early in

counseling. Thus, the purpose of this study was to document the effectiveness of three

pre-counseling treatments on prospective client self-efficacy and motivation, as a

function of readiness for counseling. The majority of research on self-efficacy has

emerged from social-cognitive theory and contexts other than counseling. Further, much

of our understanding of motivation and readiness for counseling has its genesis in

substance abuse research. Studies examining both self-efficacy and motivation together

are often restricted to attrition. Therefore, empirical studies that link treatments on

improving prospective client self-efficacy and readiness to counseling appear warranted.

Empirical research focusing on these two important clinical variables can also be









improved with greater sample sizes, participants that are randomly assigned, and more

reliable and valid measures.

Approximately 400 students were surveyed to assess willingness to discuss a

problem in counseling. After attrition, 119 students were selected from exclusionary

criteria in-order to approximate real clients. Participants were randomly assigned to one

of four groups: three treatment groups--counseling role-play, a counseling video, and

counseling literature--or a fourth, no treatment control group, to examine treatment

effects on prospective subject self-efficacy and readiness for counseling, as a function of

motivation. Also, gender, treatment, counseling self-efficacy and readiness for change

were analyzed separately to determine follow-up interest in seeking counseling as a direct

result of student participation in this study.

Results were generated from five models. Results from four different 2x4

ANOVA models indicated no significant treatment interaction with gender in predicting

counseling readiness and self-efficacy. Separately, female gender significantly predicted

readiness for counseling, and self-efficacy predicted total readiness score. In the fifth

model, treatment, self-efficacy and readiness for counseling separately predicted

willingness to seek post-test counseling; gender was not significant. However, when

readiness for counseling was added, the treatment effect became non-significant in

predicting follow-up, thus demonstrating the mediating effect of readiness on treatment in

seeking post-test counseling. Limitations, implications of the study and directions for

future research were also discussed.














CHAPTER 1
INTRODUCTION

Statement of the Problem

One challenge that clinicians currently encounter is providing cost-effective

counseling in a managed care environment (Lyons, 1997; Hoyt, 1995). As a result, there

is a profound need for counselors to utilize resources and treatment planning as

efficiently and effectively as possible. Thus, empirically driven treatments that increase

prospective client self-efficacy and motivation to change (Longo, Lent and Brown, 1992;

Longo, 1991) early in the counseling process appear warranted. Additionally, empirical

research that informs treatment providers on how to increase client self-efficacy and

motivation (Longo et al., 1992; Mennicke, 1988) is needed in order to minimize

premature termination.

Theories on self-efficacy have wide application in counseling. Self-efficacy

(Bandura, 1997, 1986, 1977), defined as one's belief in one's capability to execute a

specific task or series of tasks, has been examined and applied to counseling outcome

research regarding alcohol consumption (Tran, Haaga and Chambless, 1997) substance

abuse (Burke, 1998; Walton, 1995), stress management (Wiedenfeld et al. 1990), positive

self-concept (Harrison et al, 1997), motivation and client attrition (Longo, Lent and

Brown, 1992).

The majority of counseling self-efficacy research targets substance abuse treatment

contexts (DiClemente and Norcross 1992; Miller and Rollnick, 1991; Prochaska,









Prochaska and DiClemente 1986). Within the substance abuse field, self-efficacy

research relates to client attrition (Longo, Lent and Brown, 1992), self-efficacy and

motivation to change (Prochaska and DiClemente, 1986), motivation toward recovery

(Heather, 1992) relapse prevention, self-efficacy and client resistance (Miller and

Rollnick, 1991). Group approaches that favor motivational interviewing (Miller and

Rollnick, 1991) aim at client, coping self-efficacy as a favorable group outcome of

substance abuse counseling. Further studies related to counseling but not client self-

efficacy include numerous outcome studies generated from clinical supervision that

illustrate counselor and supervisee self-efficacy development (Ray, 2000; Larson, 1998;

Daniels, 1997; Watkins, 1997; Holloway, 1995).

Since many clients in the substance abuse field are characterized by denial of their

problem (Prochaska, 1992; 1986), motivation to change is also closely related to self-

efficacy in the counseling literature. Traditionally, the most effective means of

motivating clients was to confront them (Miller and Rollnick, 1991). Historically, Miller

(1991; 1983) suggests that many treatment strategies aimed at first attacking and tearing

away at a client's defenses in order to, secondarily, rebuild and motivate the client.

However, current substance abuse treatment protocols reflect more gentle and empathic

(Miller, et al., 1993) methods in combination with more brief and time-limited

approaches (Lyons, 1997; Hoyt, 1995). Yet one of the many challenges continuing to

face clinicians is how best to motivate clients toward improvement and substantive, long-

term change.

Thus, understanding a client's motivation is a primary importance to counseling

professionals. Bauman (1999) wrote that motivation is an internal state that illustrates a









client's strength, direction and persistence of goal-directed behavior. Miller and

Rollnick (1991) suggest one of the central tasks of a counselor is to motivate clients by

specifically helping clients achieve targeted goals and desired change, since many clients

initiate counseling with limited experience and little confidence in the counseling

process. As a result, motivation to change is perceived as a crucial variable so that clients

do not prematurely terminate from counseling, become passive bystanders in counseling,

or fail to effectively maximize the counseling services offered to them (Longo, Lent, and

Brown 1992; Longo, 1991).

Need for the study

Although counseling theories and therapies (Lent et al., 1997) have produced research

on the correlates and precepts of self-efficacy and motivation (Sutton, 1998; Longo,

1991) in a variety of contexts, few studies have specifically compared the effectiveness of

different treatment strategies that increase a prospective client's self-efficacy and

motivation for change, prior to initiating counseling. (Client self-efficacy and motivation

in counseling reflects primarily the belief and desire that one can become a successful

client. Client success is operationally defined as illustrating the client's belief and

motivation in the importance of attending and committing to counseling sessions, asking

questions to clarify session material when needed, doing assigned homework when given,

persevering in counseling during times of emotional discomfort, and not prematurely

terminating, etc.)

Most of the research on self-efficacy and motivation is from other contexts. For

instance, self-efficacy and medical treatment typically reflect studies on outcome

satisfaction with counseling of multiple sclerosis patients (Wingerson, 2000), types of








counseling with overweight adults (Steptoe, 2000), self-efficacy and medication

compliance (Brus, 1999), self-efficacy and its role in dietary adherence (Burke, 1998),

self-efficacy and HIV prevention (Hume, 1999). Motivation has been researched

extensively in education (Higbee, 1996; Locke and Latham, 1994) and counseling (Miller

and Rollnick, 1991) but little research in counseling considers these two variables

together outside of studies related to client attrition (Longo, Lent and Brown, 1992).

Additional research focuses on self-efficacy related to student achievement, but not

self-efficacy and client achievement in counseling. Studies on self-efficacy implicated in

academic performance include but are not limited to self-efficacy and math achievement

(Luzzo, 1999; Pajares and Miller, 1994); goal setting on achievement and perception of

self-efficacy in inner city children (Paslay, 1996); goal setting interventions on self-

efficacy for self-regulated learning (Schwartz 1996); self-efficacy enhancing

interventions on math and science, career interests (Luzzo, 1999); and the effects of high

school career education on social cognitive variables (McWhirter, 1999).

Self-efficacy research also includes measurement studies. Sherman (1998) looked at

the relationship between addiction and pregnancy with a measure of self-efficacy applied

to pregnant women in recovery. Sherer and Maddux (1982) developed a self-efficacy

scale for measurement of the construct. Larson et al. (1998) generated five empirical,

research studies on the development and validation of a popular self-efficacy measure for

counselors (COSE), which is helpful in predicting counselor-trainee performance.

Tinsley's et al. (1980) counseling, brief form (EAC-B) implicates a client's expectations

of counseling with the correlates of self-efficacy (motivation) in counseling.

However, some counseling research on self-efficacy has been questioned due to









design flaws that compromise the internal validity of the studies. For instance, Lent and

Maddux (1997) mention research designs on counseling-related self-efficacy that

historically employ correlational, quasi-experimental designs with small sample sizes

without random assignment of treatment subjects. As a result, treatment groups are non-

equivalent prior to initiation of treatment. Therefore, it is nearly impossible to exclude the

potentially confounding effects of other variables that may produce spurious treatment

results. Lent and Maddux (1997) suggest the value in examining through experimentation

different means for modifying clinically important aspects of self-efficacy.

Although the majority of both self-efficacy and motivational research emerges from

contexts other than counseling, there is reason to believe that research on self-efficacy

and motivation has application to counseling. Clearly, empirical research that targets

client self-efficacy and motivation in counseling, with larger sample sizes, is needed.

Bandura's work and the research line generated from applications of self-efficacy to other

contexts provide a broad theoretical and empirical foundation for this type of counseling

research.

Purpose of the Study

Thus, the purpose of this research study is to increase and extend the body of

theoretical and empirical knowledge of social-cognitive theory and two related variables,

self-efficacy and readiness for counseling, into the counseling domain. The effectiveness

of three pre-treatment strategies (counseling literature, video, role play) that may

potentially increase client self-efficacy and motivation, in comparison to a no treatment,

control group will be examined.

Different treatment interventions to increase self-efficacy and motivation have been









applied in a variety of research contexts. One method of increasing self-efficacy is to

provide literature to clients to increase coping strategies. Hannes (1999) utilized literature

as part of a psychoeducational intervention targeted at increasing efficacy coping with

HIV. Telch (1985) used literature as part of a support group to enhance coping among

cancer patients. Some researchers utilize literature to increase self-efficacy in regards to

learning. Schunk (1994) examined the effects of goal-setting instructions on self-efficacy

for self-regulated learning. Others have incorporated literature as part of building self-

efficacy in developing counselors. Johnson (1989) showed how literary information is

applied to increasing self-efficacy and counseling competence in prepracticum training.

Hamilton (1999) applied literature to a control group to study the differences in factual

content of three vignettes in comparison to an experimental group exposed to videotaped

instruction.

Intervention studies designed to increase counseling self-efficacy in counselors have

typically used a combination of video instruction, role-play or modeling. Larson et al.

(1998) compared a fifteen-minute mock interview to a fifteen-minute counseling session

on tape. Munson et al. (1986) compared the effectiveness of role playing and modeling

versus modeling and visual imagery. Sutton (1998) utilized video in fostering client

engagement through role manipulation. Jones (1995) studied the effectiveness of video

on marital therapy. Sullivan and Mahalik (2000) used video and other counseling

interventions (role-play and positive feedback) to increase career self-efficacy among

women.

Additional inquiry for examining self-efficacy and motivation together is supported

by counseling research and treatment approaches that illustrate the link between these









two variables. Longo, Lent and Brown (1992) showed the correlation between the two

constructs in predicting client attrition rates. Bandura (1997) elaborates on the implicated

role of motivation on self-efficacy. Regarding treatment approaches that target

motivation to improve client self-efficacy, Milller (1994) suggests focusing on quality of

counselor feedback, client responsibility, client acceptance of the problem, the mutuality

of counselor and client working together, offering of counselor empathy, and improving

client self-efficacy. Isenhart (1997) examined the role of motivation in increasing client

commitment and confidence toward recovery in substance abusers as a function of

pretreatment readiness for change.

Thus, the purpose of this study emerges from the theoretical and empirical role of

self-efficacy and motivation in counseling. Clearly, the theoretical literature supports the

hypothesized role of self-efficacy and motivation in influencing behavioral change

(Bandura, 1997; Pajares and Miller, 1994; Prochaska, 1982). In addition, the utility of

applying role-play, video, and literature as pre-treatment strategies to increase self-

efficacy and motivation in other contexts has been documented extensively in the

research literature (Sullivan and Mahalik, 2000; Heppner, 1994). Further, the relatively

high correlation between motivation to change and self-efficacy has been documented to

increase understanding among counselors on how best to minimize premature termination

(Longo, Lent, and Brown, 1992). Studies with larger sample sizes that attempt to increase

self-efficacy and motivation to change early in the counseling process are clearly

warranted in a clinical, managed care environment.









Background of the Problem

Additionally, Bandura (1997, 1986, 1977) suggests that many psychological

processes are governed by self-efficacy and its related theoretical precepts of motivation,

goal achievement, and outcome expectations. Self-efficacy and its precepts are embedded

within larger theoretical frames, notably social-learning theory (Bandura, 1977; Miller

and Dollard, 1941) and social-cognitive theory (Bandura, 1986). These theories delineate

the influence of social observation and modeling on human learning, specifically

examining the role of self-efficacy as one cognitive variable in the learning of new

behaviors.

Counseling research on self-efficacy (Bandura, 1977) traditionally targeted the role of

self-efficacy to anxiety, anxiety related disorders such as phobias (agoraphobias, snake

phobias), and how they were developed and treated. Historically, avoidant behavior was

explained by an anxiety drive (Freud, 1961). It was believed that autonomic arousal and

its subsequent anxiety motivated individuals to specifically avoid the behavior that

manifested the original impulse. However, this premise was later challenged by

empirical research documenting the role of perceived efficacy in predicting outcome

performance, independent of anticipatory anxiety. Williams, Dooseman and Kleinfield

(1984, in Bandura, 1997, pg. 327) noted the specific role of perceived coping efficacy on

agoraphobics who received treatment of guided mastery vs. exposure. Williams and

Rapaport (1983, in Bandura, 1997, pg. 325) extended the influence of perceived coping

on outcome by illustrating the effect of coping efficacy on coping skills when

anticipatory anxiety was controlled. Thus, as a result of early research on coping and

anxiety (Bandura, 1986, 1977), Bandura included emotional states in influencing self-









efficacy development. However, of the four sources that compose self-efficacy, Bandura

(1997) considered one's emotional arousal to be the least influential on efficacy

development.

As a theoretical construct, self-efficacy emerges out of the larger framework of

social-cognitive theory (Bandura, 1986). According to Bandura (1997), self-efficacy is

composed of four sources: prior experiences, vicarious learning experiences, verbal

encouragement, and emotional arousal. Experience of competency is the most powerful

source of one's self-efficacy. As a result, one's prior experiences in performance

contexts have important implications for one's beliefs regarding self-worth and

confidence in that area. For instance, in their path analysis, Pajares and Miller (1994)

suggested that interventions to increase mathematical problem solving in students are

implicated with math self-efficacy.

The second theoretical source that influences self-efficacy development is vicarious

experience. Although this source is not as powerful as mastery experiences on self-

efficacy, vicarious learning appears particularly malleable when people have limited prior

experience or they underestimate their own competence abilities. Schunk (1994)

illustrated that academic competency models are particularly relevant in this regard. A

powerful and positive model can have lasting effects on one's life, self-efficacy

development and understanding of competence. Additionally, peer influences on

modeling and social interaction have influential positive and negative consequences as

well. For instance, a model's failure has tremendous impact if the rater perceives

him/herself as being inferior to the model (in Schunk, 1994, Brown and Inouye, 1978).

Third, people also develop perceived self-efficacy based upon verbal encouragement








and persuasion. Verbal encouragement reflects the power of feedback on self-esteem

development and perceived competence as well (Daniels, 1997). Likewise, as positive

encouragement can support and bolster self-efficacy, so can negative feedback decrease

self-efficacy or perceived beliefs in one's capability to perform in a particular context

(Larson, 1998; Bandura, 1986).

The last theoretical source of self-efficacy development is emotional arousal. Such

states as mood, anxiety, and fatigue can certainly influence one's self-efficacy and its

development. Since people have the capacity to alter what they think, self-efficacy beliefs

have a powerful and reciprocal influence on thought patterns and subsequent emotional

stimulation. Social-cognitive theory (Bandura, 1986) suggests that people anticipate the

quality of their performance based upon how they feel prior to the event in question. In

other words, one's confidence in the moment is reflected in one's prospective anxiety

regarding what lies ahead. Calm emotion in anticipation of performance reflects

confidence. High anxiety and arousal illustrate lowered confidence and decreased self-

efficacy. Early research on self-efficacy generated studies to empirically document how

to increase self-efficacy to improve coping performance, in order to lower anxiety while

treating related disorders (phobias).

However, it is significant to note that the four sources of self-efficacy do not directly

link to and compose self-efficacy as a construct. Yet the manner in which an individual

processes, weighs, selects, and attends to the information generated from the four

theoretical sources of efficacy determines the application of one's self-efficacy toward a

similar, particular task in the future.

Social-cognitive theory (1986) was an extension and further application of social-









learning theory. Bandura (1977) incorporated both interpersonal and intrapersonal

variables into explanations of human learning in a variety of contexts. Further, self-

efficacy was explicated as a cognitive variable within the larger construct of personal

agency and social-cognitive theory (Bandura, 1986). Fundamentally, social-cognitive

theory (Bandura 1986) predicts that people behave in ways that are consistent with their

belief systems. The theory suggests that behavior is more easily influenced and driven by

people's beliefs about their capabilities than personal knowledge and skills alone; thus,

changes in one's beliefs are a powerful predictor of the selection, initiation, persistence

and maintenance of a selected behavior. Therefore, theoretically speaking, if counseling

professionals wish to change the behavior of a given client, the belief system of the client

about his/her ability to become a successful client must first be altered. Pajares and Miller

(1994) conclude by suggesting that if counseling interventions are needed to the degree in

which they change targeted behaviors, than interventions must be applied that target the

belief system of the client as well.

In addition, social-cognitive theory (Bandura, 1986) describes personal agency as an

extension of one's self-efficacy while including affective, cognitive, and motivational

components that manifest from both interpersonal and intrapsychic sources. Personal

agency is one factor that helps explain the interactional nature between one's self, one's

environment and one's actions. These three contexts and their interaction with each other

are collectively referred to as triadic, reciprocal causation within social-cognitive theory

(1986).

Counseling has personal, behavioral, and environmental influences that interact in a

recursive fashion to govern a client's personal agency as well. Yet interestingly, most of









the counseling research literature on personal agency and its determinants in behavior

targets a counselor's personal agency, not the client. Larson (1998) reflects that

Bandura's definition of operative efficacy would include the counselor's ability to

simultaneously understand one's person, actions and environment, to achieve high levels

of counseling performance. One would infer that similar skills for clients would be

necessary to achieve a similar performance result. In fact, Bandura defines operative

efficacy specifically as "continuously improvising multiple sub skills to manage ever

changing circumstances, most of which contain ambiguous, unpredictable, and often

stressful elements" (Larson, 1998 pg. 237). Similarly, a client's increased self-efficacy

from personal agency determinants would improve tolerance for the inherent ambiguity,

unpredictability and stress encountered for clients in counseling too.

With further delineation and expansion of the construct over the last twenty-five

years, research on self-efficacy has increased. Relatedly, self-efficacy and its correlates

drive outcome research in multiple and diverse areas, such as optimal health, self-efficacy

and its role in dysfunctional relationships, the psychological adjustment to novelty,

smoking cessation, goal achievement and student motivation in mathematics, athletic

performance, and dietary adherence (Burke, 1998; Lent and Maddux, 1992). However,

regarding client attributes of self-efficacy in counseling research, Larson (1998) suggests

"very little attention has been given to this area within the counseling self-efficacy

literature" (pg. 243).

Currently, the use of self-efficacy research has practical application and treatment

implications for mental health professionals in a managed care environment. One

challenge that counselors encounter is how to help clients in the recovery and adjustment









process, whether coping and recovering from addiction (Sherman, 1998), adjusting to life

following relapse (Miller, 1991) or motivating toward recovery (Prochaska, 1982) in a

brief format. Further, Longo, Lent and Brown (1992) mentioned the need for research

examining the impact of different treatments on self-efficacy and motivation early in the

counseling process. One suggestion is to provide simple, cost-effective interventions that

illustrate how best to increase client self-efficacy and motivation. Thus, this dissertation

study focuses on the treatment impact of a counseling role-play, counseling video, and

counseling literature aimed at increasing prospective client self-efficacy and readiness to

change for counseling. In addition, a follow-up measure will be given to examine the

separate and interaction effects of treatment, gender, self-efficacy and readiness for

counseling on a dichotomous variable, follow-up interest to seek counseling, as a direct

result of subject participation in this study.

Organization of the Study

This study is organized into five chapters. Chapter 1 serves to introduce the topic

and the theoretical framework, the background of the topic, the need for the study, and its

purpose. Chapter 2 reviews the related literature of the topic. Chapter 3 contains the

research methodology, including a description of the population and sample, the

instruments used, sampling procedures, and data collection methods. Chapter 4 includes

data analysis procedures and the results of the study. Chapter 5 provides a general

discussion of the implications and limitations of the study with future directions for

research.









General Research Questions

The following research questions will be examined in this study:

1. Will different pre-counseling interventions (role-play, video observation or

counseling literature) increase prospective client self-efficacy and motivation for

counseling within any of the three treatment groups compared to the fourth, no-treatment,

control group?

2. Will three different pre-counseling interventions (role-play, video observation or

counseling literature) produce statistically significant differences between either gender

on prospective client self-efficacy and motivation, compared to a no treatment, control

group?

3. Will three different pre-counseling interventions (role-play, video observation or

counseling literature) produce a statistically significant interaction between gender and

treatment on either of the three dependent variables, counseling self-efficacy, readiness

for counseling, or desire to seek follow-up counseling as a result of subject participation

in the study?

4. Will gender, treatment, self-efficacy or readiness for counseling separately produce

a statistically significant association in predicting likelihood to seek follow-up counseling

as a direct result of subject participation in this study?

Definition of Terms

The following terms used in this study are defined below.

Managed Care: A third-party payer system introduced into the health care arena in the

early 1990's; in essence, the goal of managed care companies was to introduce

themselves as an insurance negotiator between provider of clinical services and client, in









order to determine and establish the most cost-effective services for the highest quality of

professional health-care service, for any given health-care market providing both medical

and mental health services. (See Lyons, 1997; Hoyt, 1995.)

Motivation: In relation to counseling, motivation tends to reflect a client's strength,

direction, and persistence of any goal-directed behavior (Bauman, 1999). Certainly, one

task of any counselor is to help the client motivate toward achieving targeted goals and

desired change.

Self-determination theory: Deci and Ryan (1985) illustrate that the self-determination

of any individual is a personal expression of will, generated internally, and directed

toward the future in determining likely outcomes of any selected and initiated behavior.

Self-efficacy: This is a cognitive construct that mediates the relationship between

personal knowing and doing, while reflecting one's belief in one's capability to execute a

specific task, or series of sub-tasks related to one specific context (doing math, driving a

car, becoming a successful client, reading well, etc.; see Bandura, 1997).

Social-Cognitive theory (Bandura, 1986): This theory refers to a further extension and

modification of social-learning theory that postulates that self-determination, individual

learning and behavioral change is a cognitive, mediating process that can result in greater

personal control of one's environment and surroundings. Self-efficacy is one cognitive

variable within social-cognitive theory that helps explain how one selects, alters or

modifies a behavior.















CHAPTER 2
LITERATURE REVIEW


In this chapter, research literature related to client self-efficacy and motivation for

counseling will be examined. In addition, general training strategies and specific pre-

counseling treatment methods designed to increase client self-efficacy and motivation

that support the hypotheses of the study, will be reviewed. The purpose of this review is

to integrate different lines of research literature that validate the usage of a counseling

role-play, counseling video, and counseling literature as useful pre-counseling treatment

strategies to increase prospective client self-efficacy and motivation to change for

counseling.

Self-Efficacy

The majority of self-efficacy research targets variables on student achievement in

learning. Studies in these areas include investigations of self-efficacy and math

achievement (Pajares and Miller, 1994; Luzzo, 1994); the role of goal setting on

achievement and perception of self-efficacy in inner city children (Paslay, 1996); self-

efficacy interventions for self-regulated learning (Schwartz 1996); the effects of self-

efficacy interventions on math and science, career interests (Luzzo, 1999); and the role of

modeling on self-efficacy development (Schunk, 1994). McWhirter (2000) examined the

effects of high school career education on self-efficacy and other social cognitive

variables. Other research on self-efficacy includes the role of self-efficacy on athletic









achievement, (Stidwell, 1994), self-efficacy and its influence on organizational

performance (Mitchell, 1990), and the implications of using medical videotape to

increase coping self-efficacy with patients with diseases such as AIDS (Everett, 2000;

Hannes, 1999) and cancer.

Although the majority of self-efficacy research has been generated in contexts other

than counseling, nevertheless, counseling self-efficacy research has wide application.

Self-efficacy (Bandura, 1997; 1986; 1977), defined as one's belief in one's capability to

execute a specific task or series of tasks, has been examined and applied to counseling

outcome research regarding alcohol consumption (Tran, Haaga and Chambless, 1997)

substance abuse (Burke, 1998; Walton et al. 1995), stress management (Wiedenfeld et al.

1990), positive self-concept (Harrison et al., 1997), motivation and client attrition

(Longo, Lent and Brown, 1992). In fact, the majority of client self-efficacy research in

counseling often targets substance abuse treatment Prochaska, DiClemente and Norcross

1992; Miller and Rollnick, 1991; Prochaska and DiClemente 1986). Within this area,

self-efficacy research relates to client attrition (Longo, Lent and Brown, 1992), self-

efficacy and motivation to change for the client (Prochaska and DiClemente, 1986),

motivation toward recovery (Heather, 1992) and relapse prevention and client resistance

on client self-efficacy (Miller, 1991). In addition, group approaches that include

motivational interviewing (Miller and Sanchez, 1994) aim at client, coping self-efficacy

as a favorable, group outcome of substance abuse counseling.

Counseling, self-efficacy research also involves outcome studies related to counselor

and supervisee, self-efficacy development (Ray, 2000; Larson, 1998; Watkins, 1997;

Holloway, 1995). Studies of self-efficacy in counseling also include the examination of








particular treatment types on client self-efficacy. Allumbaugh (1999) studied grief

counseling on coping self-efficacy and loss. Warner (1996) illustrated the impact of

short-term counseling on client self-efficacy and its relationship to a client's satisfaction

in counseling.

Generally speaking, self-efficacy (Bandura, 1997; 1986; 1977) reflects one's belief in

one's capability to perform a task or series of related tasks. Essentially, the construct of

self-efficacy reflects one's perceived ability to cope and perform specific tasks in a given

situation. However, Bandura (1977) wrote little about the direct role of self-efficacy in

counseling. Yet he implied that self-efficacy was an important aspect of psychotherapy

by suggesting, "psychological procedures serve as a means of creating and strengthening

expectations of self-efficacy" (Bandura, 1977, p. 195).

According to Bandura (1997; 1986; 1977), one's self-efficacy toward a particular task

is derived from four sources: one's prior experience of the specific task, event or exercise

in question, vicarious learning through modeling or observation, verbal encouragement or

support, and one's emotional arousal in anticipation of the task. Prior experiential

learning is the most powerful influence on the development of one's self-efficacy, since

previous experience powerfully shapes both positive and negative beliefs about one's

ability to perform similar tasks in the future. Research studies that illustrate the strong

influence of positive and negative perceptions of prior counseling experience on future

development of counseling student self-efficacy are useful in order to target student

beliefs about their own counseling performance.

Larson's empirical study (1998) demonstrates the strength of positive versus negative

student beliefs on developing efficacy in graduate student counselors. Larson (1998)









examined the comparative value of a mock interview as a role-play, compared to a

fifteen-minute counseling session on tape with sixty-seven students using hierarchical

regression to predict post-test counselor self-efficacy. Interestingly, those students that

perceived there counseling performance as below average after the role-play decreased

their counseling self-efficacy almost by one standard deviation below the mean. In

contrast, those students that perceived their role-plays as being successful scored just

one-half a standard deviation above the mean. Often used as an adjunct toward increasing

awareness of the counseling process, role-plays appear instrumental in enhancing self-

efficacy from the vantage of performance accomplishment (Johnson, 1989). Additionally,

the experiential aspects of simulating counseling interventions in a role-play context may

serve to highlight what students like and dislike about their respective counseling

performances. Also, this study reveals the importance of counseling faculty to remain

sensitive to student beliefs about their counseling performance (Larson, 1998).

The second theoretical concept that shapes the development of self-efficacy is

vicarious learning. Although not as influential on self-efficacy development as prior

experiences, vicarious learning from modeling appears particularly significant when

people have limited prior experience or underestimate their own competency to perform.

Schunk (1994) suggests that models geared toward social or peer explanations of

academic competency are particularly relevant in this regard. Peers often rate the

academic performance of others relative to their own personal standards of competency.

For instance, peers in school are strongly influenced by the effects of modeling,

especially if the rater perceives him/herself as being similar or inferior to the model while

exhibiting a strong, emotional attachment to the model (Schunk, 1994).









Interestingly, research on self-efficacy and vicarious experience has shown that

modeling is not nearly as influential if the rater perceives his/her competence relative to

the model as being equal or superior to the model (Brown and Inouye, 1978, in Schunk,

1994). The relevance of modeling as a source of client self-efficacy in counseling is

crucial since counselors act as vicarious models for client learning (Munson, Zoemrnik and

Stadulis, 1986). These authors found with forty-eight students that role plays and

modeling together were much more effective in lowering performance anxiety in

beginning counseling students when compared to a wait-listed control group (Munson, et

al. 1986).

By multivariate analysis, Luzzo (1999) investigated the separate and combined

aspects of performance accomplishment with modeling on career science interests of

ninety-four college age students. He found that a statistically significant interaction

existed between student math/science performances for students who watched videotape

of other successful students decisively disclose their math/science career aspirations,

compared to a student performance group that witnessed other students model indecision

regarding their career aspirations. Luzzo (1999) concluded that although vicarious

learning is less influential on self-efficacy development than performance

accomplishments in academic contexts, both the relative contribution of vicarious

learning and performance experiences is important to examine in self-efficacy research.

Clients also develop perceived self-efficacy based upon verbal encouragement

and persuasion. Verbal encouragement is the third theoretical source of self-efficacy

(Bandura, 1977). Social/cognitive theory (Bandura, 1986) suggests that as positive

encouragement can support and bolster self-efficacy, negative persuasions decrease self-









efficacy or perceived beliefs in one's capability to perform (Daniels, 1997; Bandura,

1986). Verbal encouragement to a counseling client can be powerful in altering self-

efficacy, and is offered usually through empathy (Scharf, 2000). In an ANCOVA study

designed to evaluate the effectiveness of different modeling strategies on counselor self-

efficacy, Daniels (1997) studied forty-five beginning counseling practicum students and

concluded that prepracticum trainees that received positive feedback on counseling

performance had substantially higher results on post-tests counselor self-efficacy when

controlling for pretest counselor self-efficacy and post-test anxiety. Results from this

study showed prepracticum students that received positive feedback demonstrated

significant increases in counselor self-efficacy, compared to those who received negative

feedback after controlling for variance due to pre-test performance (Daniels, 1997).

The last theoretical source of self-efficacy development is one's emotional arousal.

Self-efficacy research (Bandura, 1997) suggests that states of mood, anxiety, and fatigue

can influence one's self-efficacy and its development. Since people have the capacity to

alter what they think, self-efficacy beliefs have a powerful and reciprocal influence on

thought patterns and subsequent emotional feeling and stimulation. Self-efficacy

(Bandura, 1986) research suggests that people anticipate quality of performance and

competency based upon how they feel just prior to the event. In other words, one's

confidence in the present reflects one's prospective anxiety regarding what one

anticipates. Thus, calm emotion in anticipation of performance reflects confidence. High

anxiety and arousal illustrates lowered confidence and decreased self-efficacy.

An early line of research that investigated the impact of emotional arousal on self-

efficacy examined the treatments of snake phobias (Bandura, 1997). Traditional









counseling research on self-efficacy (Bandura, 1977) targeted how self-efficacy was

implicated in anxiety and its related disorders, specifically phobias (agoraphobias, snake

phobias). Much of the early self-efficacy research in this area attempted to understand the

relationship between coping performance to anxiety and avoidant behaviors. Historically

avoidant behavior was explained by an anxiety drive (Freud, 1961). Freud believed that

autonomic arousal and its subsequent anxiety motivated individuals to specifically avoid

the behavior that manifested the original impulse.

However, the role of anxiety on avoidant behavior and performance was later

challenged by empirical research that documented that success of self-efficacy in

predicting outcome performances. For instance, Williams, Dooseman and Kleinfield

(1984, as cited in Bandura, 1997) noted the specific role of perceived coping efficacy on

agoraphobics who received separate treatments of guided mastery and exposure in

comparison to a no-treatment, control group. Both treatment groups showed significant

gains in successful performance as a function of self-efficacy, compared to the control

group.

Williams and Rapaport provide another example of the role of self-efficacy on coping

outcomes (1983, as cited in Bandura, 1997). These authors extended the influence of

perceived coping efficacy on outcome by illustrating the comparison between perceived

self-efficacy and coping behaviors when anticipatory anxiety was controlled versus the

effect of anxiety on coping when self-efficacy was controlled. Almost all studies by

Bandura (1997) et al., in this area of research have demonstrated a positive correlation

between perceived efficacy on coping performance in comparison to studies that only

correlated anxiety to performance. Although early research on snake phobias









demonstrated the more primary role of prior coping experience on the development of

coping efficacy, Bandura (1997, 1986, 1977) nevertheless included the role of emotional

arousal in self-efficacy composition. Of the four theoretical sources of self-efficacy,

Bandura (1997) considered one's emotion to be the least impactful on self-efficacy

construction and development.

Further elaboration on the composition of self-efficacy (Schunk, 1994) has also

illustrated that the relationship between self-efficacy and performance-based treatments is

perceptual. For instance, people who judged themselves high on self-efficacy perceive

their performance resulting from a combination of effort and skill, not chance or random

variation (Bandura, 1997). Specifically, how one perceives and subsequently integrates

the combination of one's prior experiences, vicarious modeling, verbal encouragement

and emotional arousal is what promotes individual self-efficacy development. However,

the four sources of self-efficacy do not directly compose self-efficacy as a construct. The

construct's composition is inferred from the four theoretical sources of self-efficacy that

determines how one's self-efficacy toward a particular task is perceived and applied

toward future performances in any given context. For instance, one's ability to act on

stage would be inferred from multiple sources of the quality of prior acting performances,

the quality of previous modeling offered in this area, the quality of verbal encouragement

and support offered, and lastly, the degree to which one's emotional arousal was

controlled in order to optimize performance.

Social-cognitive theory (Bandura, 1986) suggests that one's anticipation of outcome

as either potentially positive or negative, influences outcome expectations. Outcome

expectations are subsumed under social-cognitive theory (Bandura, 1986). They are









related to one's persistence or motivation with finishing a given task but are considered

secondary in importance to efficacy expectations toward the initiation of a behavior.

However, due to the closeness of theoretical relationship between self-efficacy and

outcome expectations, operationally separating the two constructs has been challenging.

Maddux and Barnes (1984) highlighted how other authors of studies have specified

clearly the definition of each construct regarding outcome research. Others suggest

separating the two constructs to develop measures and instruments that "reflect their

theoretical differentiation and that subjects can respond to differentially" (pg. 13; in

Manning and Wright, 1983, as cited in Maddux and Barnes, 1984).

Bandura (1997) established that operational changes of self-efficacy are separate from

other related constructs in the literature. Further, self-efficacy alone is a powerful

predictor of outcome (Longo, Lent and Brown, 1992; Longo, 1991), above and beyond

that of outcome expectations. In fact, Bandura's (1997; 1986) numerous empirical

analyses on the construct supports the integral role of self-efficacy expectations

(Bandura, Reese and Adams, 1982) as a viable theoretical extension of self-efficacy

independent of other similar constructs inherent within personal agency theory (Bandura;

1997). For instance, Bandura et al. (1982) demonstrated the role of efficacy expectations

on fear arousal and coping behavior on 20 selected snake phobics. The hypothesis that

fear arousal is largely a derivative of perceived coping inefficacy and one's low

expectations was generally supported by the results as subjects that tested high in blood

pressure elevation tended to be less efficacious in their coping.

Bandura (1986) extended the theoretical definition and complexity of self-efficacy

by suggesting that self-efficacy varies in level, strength, and generality. The level









dimension refers to the difficulty of task. For instance, some people only feel efficacious

in completing very demanding tasks, others if the task is easy. The strength component to

efficacy refers to the effort expended for task completion. High dimensions of effort are

associated with high strength efficacy; low aspects of efficacy, low strength.

Generality of efficacy refers to the range of application of the construct, which

theoretically, is specified to context. In other words, students with high reading self-

efficacy do not necessarily exhibit high math self-efficacy. Thus, Bandura (1986)

hypothesized that an individual's variance in self-efficacy would be attributable to

differences in levels, strength and generality with regard to specific tasks. Although some

generalizability of self-efficacy to various contexts has been seen, the discriminant

validity of the construct supports its task-specific, theoretical nature.

The discriminant validity of the construct (Longo, Lent and Brown 1992; Bandura,

1986) illustrates that the concept of self-efficacy is task specific regarding context, and

not a global personality trait. As a result, the construct appears mutable and relative,

which may account for its wide application in the research literature (Bandura; 1997).

Further, the task-specific nature of self-efficacy partially accounts for why the construct

contributes more to behavioral change than other theoretical precepts (Longo, Lent and

Brown, 1992; Longo, 1991; Bandura, 1977) inherent within social-cognitive theory

(Bandura, 1986). For instance, Longo, Lent and Brown (1992) used regression techniques

to evaluate which counseling related variables are most likely to correlate with

engagement to the counseling process and persistence in session, in order to understand

how to minimize attrition rates in university counseling centers. Utilizing a sample size of

139 from a Midwestern university counseling center, these authors found that client self-









efficacy and motivation to change were most predictive of client persistence in

counseling and most inversely associated with premature termination. Further, Longo

(1991) found in his discriminant analysis that when six variables incorporated to predict

client attrition were summed and weighted into a discriminant function, self-efficacy was

most highly correlated with the discriminant function more than any other variable.

Other researchers have examined the stability of the construct. Although

empirical research confirms Bandura's original hypothesis on self-efficacy (1997; 1986;

1977) that reflects that the construct is malleable before firmly developed, self-efficacy

tends to become more resilient and stable regarding performance once established over

time. Larson (1993) noted the influence of increasing self-efficacy among beginning

practicum students by charting counseling self-efficacy development over twenty-three

weeks in comparison to a control group. All eight-student scores on counselor self-

efficacy improved relative to subjects in the control group.

As a theoretical construct, self-efficacy emerges out of the larger framework of

social-cognitive theory (Bandura, 1986). Social-cognitive theory emerged as an extension

and revision of social-learning theory (Bandura, 1977; Miller and Dollard, 1941). Social

learning theory emphasized the influence of different personal and cognitive variables on

human learning and behavior (Bandura, 1986; Mischel, 1973; Rotter, 1954). However,

Bandura (1986) further synthesized and integrated environmental and personal variables

of learning into specific explanations of how cognitive pathways alter human behavior.

Bandura (1986) suggested that cognitive pathways (for example, the mediating role of

self-efficacy on decision making) are typically governed by self-efficacy in the selection,

initiation, and persistence of a chosen behavior.









The emphasized role of self-efficacy within social-cognitive theory (Bandura, 1986)

united two previously disparate, theoretical trends of behavior. Behavioral theory

traditionally emphasized that behavior was solely a mechanistic outcome of

reinforcement, and punishment, consequence and reward (Skinner; 1953). On the other

hand, cognitive theory recognized that information alone is enough to change, mediate

and modify human behavior (Beck; 1977, cited in Scharf, 2000).

However, Bandura (1997; 1986; 1977) synthesized both aspects of cognition and

performance of human behavior into one unified branch of social-learning theory, by

particularly emphasizing the influence of cognitive constructs on learning, and the

implications of modeling on human behavior. Bandura (1986) highlighted the specific

influence and impact of self-efficacy on behavioral change as one crucial cognitive

variable. He later modified social-learning theory with further extension and revision into

the development of his own theory, social-cognitive theory (Bandura, 1986). Most

notably, self-efficacy research was applied to further advance empirical understanding of

self-efficacy on performance and behavioral change, specifically in academic, athletic

and health maintenance (Bandura, 1997; 1997; 1986; 1982) contexts.

Additional research that emphasized the influence of either knowledge or prior

experience on behavioral change was synthesized with subsequent empirical,

investigation. For instance, Schunk's (1994) research suggested that clients still persist in

unwanted behavior (weight gain, smoking, drinking) despite information to the contrary

that the selected behavior (prior experience) is potentially harmful to the client. Such

insight led researchers to believe that more than just knowledge or the behavioral

reinforcement of a habit would motivate a behavior. For it appeared that possibly another









variable was operative, linking both cognition and performance with behavioral change.

Bandura's (1997; 1986) synthesis of social-cognitive theory placed self-efficacy as a

significant construct that mediates between knowledge and performance in governing the

selection and initiation of behavior. Social-cognitive theory (Bandura 1997; 1986) and

related research predicts that people behave in ways that are consistent with their belief

systems. Thus, behavior is more easily influenced and driven by people's beliefs about

their capabilities than personal knowledge and skills alone. It is predicted from social-

cognitive theory (Bandura, 1997; 1986) that changes in one's beliefs are a powerful

predictor of the initiation, persistence and maintenance of a selected behavior.

Social-cognitive theory (Bandura, 1986) predicts that the greater the client self-

efficacy or personal belief in the benefits of counseling, the more probable a client would

initiate, persist and succeed in counseling, despite obstacles and emotional distress

potentially encountered during counseling. Therefore, theoretically speaking, if

counseling professionals wish to change the behavior of a given client, the belief systems

of the client must first be examined. Even ancillary research on self-efficacy outside of

counseling has concluded with similar suggestions. In their path analysis relating self-

efficacy to mathematical competency, Pajares and Miller (1994) concluded if counseling

interventions are needed to the degree in which they change targeted behaviors, than

interventions must be applied that target the belief system of the client as well.

Extensions of Bandura's research (1997, 1986, 1977) suggest that many

psychological processes are governed by self-efficacy and its related theoretical precepts

of motivational properties, goal achievement, and outcome expectations (McWhirter,

2000; Paslay, 1996; Pajares and Miller, 1994). Self-efficacy and its precepts are








embedded within larger theoretical frames, notably social-cognitive theory (Bandura,

1986) as an extension and revision of social-learning theory (Bandura, 1977). Social-

cognitive theory and research (Bandura, 1986) summarize and predict the outcome role

of self-efficacy as one construct, manifesting from both interpersonal and intrapersonal

contexts of emotion, cognition, and biology.

Important assumptions of social-cognitive theory converge from the disparate work of

multiple authors (Lent and Maddux, 1997; Bandura, 1986; Mischel 1973; Rotter, 1954)

that drive current, self-efficacy research. First, it is recognized that people have the

capacity for symbolization. Essentially, the ability to symbolize allows one to convert

experience into internal meaning, while deciphering understanding from language;

human symbolization further includes the capacity and ability for personal, self-

reflection. A second assumption of social-cognitive theory is that behavior is purposeful

and directed. The ability for intentional behavior is acknowledged to generate from one's

ability to symbolize and decipher meaning from action. A third assumption is that people

are self-regulating; in other words, they have the capacity to direct and control their

respective environments. In order to control one's environment, social-cognitive theory

postulates that individuals incorporate personal standards to guide and direct behavior.

Such standards allow for goal setting and the motivation necessary to achieve goal-

directed behavior. A fourth assumption is that one's environment, one's personality and

one's behavior converge in a mutually interacting manner to determine the initiation,

persistence and completion of a selected, goal-directed behavior. From this theoretical

perspective, it is assumed that clinicians understand client difficulties to arise from an

insufficient ability to mobilize internal cognitive, affective, and motivational resources in









the service of interpersonal relations.

Social-cognitive research also explicitly refers to variables of cultural and social

influences on individual behavior and development. For instance, specific branches of

research tend to concentrate on the role of self-efficacy and women in careers (Sullivan

and Mahalik, 2000; Lent, Brown and Hackett, 1994), and self-efficacy and gay and

lesbian issues (Lent and Maddux, 1997). Sullivan and Mahalik (2000) investigated

whether or not women engaged in a career group designated to increase career-related

self-efficacy would demonstrate improvements on career decision making self-making

and vocational commitment compared to a control group. Thirty-one women participated

in a six-week treatment group. Those in the treatment group showed gains over those in

the control group at a six-week follow up; however the results appear preliminary, as the

groups were non-equivalent prior to the initiation of treatment.

Social-cultural research on women and minorities highlight the interactional

components of individuals with their environment and how their interaction influences to

contribute or hinder optimal, efficacious development (Bandura, 1997). Social-cognitive

theory (Bandura, 1986) and research further recognizes that change occurs through a

social-cultural lens. Such theoretical meaning illustrates that any interpersonal situation,

whether counseling or another context (work, family, school), is influenced by individual

and social forces. Thus, the potential for individual change is maximized when

interpersonal and intrapersonal variables are recognized and examined. Both

interpersonal and intrapersonal (Bandura, 1986) contexts and variables influence and

interact in generating personal agency.

Personal agency highlights the interactive component of individual self-efficacy in









relation to one's environment, self, and actions, and represents an extension of Bandura's

original social-learning theory (Bandura, 1977). These three aspects of personal agency

operate in complex, reciprocal fashion to contribute to individual, self-efficacy

development. Social-cognitive theory (Bandura, 1997; 1986) delineates personal agency

as an extension of one's self-efficacy beliefs and also includes affective (anxiety),

cognitive (self-efficacy), and motivational processes (goal-directed behavior) that arise

from personal, behavioral and environmental sources.

Bandura (1986) suggests that affective, cognitive and motivational processes are self-

determining influences that allow for human beings to adapt to changing circumstances

and complicated environments. Specifically, personal agency includes self-efficacy and

its precepts (choices made, selection and initiation of behavior, effort expenditure),

outcome expectations (considered anticipatory in nature), personal goals (motivational in

essence), cognitive and affective processes, and lastly, self-evaluation as an index of

emotional arousal. But it is the interactional and reciprocal nature between one's self,

one's environment and one's actions that defines personal agency.

Personal agency is an important component of counseling training (Larson 1998; Lent

and Maddux 1997) and is composed of counseling related knowledge, counseling self-

efficacy, outcome expectations, cognitive processing, affective processing, and self-

evaluation. Research in counselor training related to personal agency illustrates how

counselors' perceptions of their training impacts the quality of their counseling

experiences and overall personal, agentic development. In applying counselor training to

counseling self-efficacy development (Larson, 1998), counselor educators evaluate the

extent to which they are able to improve student personal agency related to clinical









performance.

Similarly, counseling has personal, behavioral, and environmental influences that

interact in a recursive fashion to govern a client's personal agency as well. Yet

interestingly, most of the counseling research literature on personal agency and its

determinants in behavior target a counselor's personal agency, not that of the client.

Larson (1998) reflects that Bandura's definition of operative efficacy would include the

counselor's ability to simultaneously understand one's person, actions and environment,

to achieve high levels of counseling performance. One would infer that similar skills for

clients would be necessary to achieve a similar performance result. In fact, Bandura

defines operative efficacy specifically as "continuously improvising multiple sub-skills to

manage ever changing circumstances, most of which contain ambiguous, unpredictable,

and often stressful elements" (as cited in Larson, pg. 327). Similarly, a client's increased

self-efficacy from personal agency determinants would likely improve tolerance for the

inherent ambiguity, unpredictability, and stress encountered for clients in counseling too.

Thus, applications of self-efficacy research in counseling implicate many different

variables. One variable in counseling that is particularly related to self-efficacy in

counseling is motivation (Bandura 1997; 1986; 1977; Longo, Lent, and Brown, 1992;

Longo, 1991). Due to its relatively high correlation with self-efficacy in the research

literature, motivation appears important to examine secondarily in this study. For

purposes of clarity, motivation will be operationally defined in this study as reflecting

client readiness for change (Prochaska 1992; 1986) and commitment toward the

counseling process (Longo, Lent and Brown 1992).









Motivation

The majority of motivational research in counseling targets clients who initiate

counseling with limited experience and little confidence in the counseling process. As a

result, motivation to change is perceived as a crucial variable for counseling professionals

to research and understand so clients do not prematurely terminate from counseling,

become passive bystanders in the process, or fail to effectively maximize counseling

services (Smith, Subich and Kalodner 1995; Longo, Lent, and Brown 1992; Longo, 1991;

Mennicke, 1988; Jakes, 1982).

Research on motivation in counseling has wide application. Jakes (1982)

demonstrated the role of video on client motivation in a university counseling center.

Mennicke (1988) systematically reviewed literature on variables (motivation) that predict

client attrition. Longo et al. (1992) examined the predictive role of self-efficacy and

motivation on attrition in a university counseling center by regression analysis. Smith,

Subich and Kalodner (1995) investigated the application of Prochaska's (1982) stage

model of change to differentiate premature terminators from counseling compared to

those not likely to prematurely terminate.

Historical understanding of motivation was rooted in personality theory. Hall and

Lindzey (1970) stated that motivation has always preoccupied personality theorists as a

central force in human nature and personality. Freud suggested (as cited in Greenberg and

Mitchell, 1983) that the construct of motivation was originally derived from his first

drive/structural model of the human mind in 1923. Strachey (1966) suggested Freud's use

of the term drive originated from the German word trieb, for instinct.

Murray (1938, as cited in Hall and Lindzey, 1970) suggested that human motivation









is a derivative of one's needs. A need to Murray (1938) was defined as a biological force

in the brain that provides integration of effort with action to satisfy an urge or demand.

Murray's (1938) listing of human needs include needs for achievement, affiliation, order

or organization, play, sentience, and sex.

Skinner's (1953, as cited in O'Neil and Drillings, 1994) notions on motivation were

illustrated in reinforcement/operant theory, thus representing a conceptual shift regarding

how motivation was conceptualized in the literature. Skinner (1953) was the first

behaviorist to suggest that motivation was primarily rooted in external reinforcers that

influence the likelihood of repeated action or performance. Atkinson (1966, as cited in

Miller, 1987) described a number of personality traits that appear primary in isolating and

predicting human motivation. Such traits included confidence, belonging, feelings of

independence, a concern for humanity and agreeableness. Most of these traits correlate

with motivation and have been combined to establish the taxonomic, global model of the

five-factor model of personality (McCrae and Costa; 1987). Such a taxonomic approach

to motivation anticipates future regression research studies illustrating the role of

motivation in minimizing attrition (Longo, 1992).

Connally (1980) suggested that motivation is directly linked to the personality

dimension of locus of control. Locus of control models (Connally (1980), as cited in

O'Neil and Drillings, 1994; Rotter; 1954) of motivation suggests that the more

internalized one's personal control over the environment, the greater the strength of

motivation in pursuing a desired behavior. As a derivative of motivation, locus of control

research (Connally, 1980) can inform clinical practice. For instance, counselors need to

be sensitive to locus of control dynamics and their implications in order to help motivate









clients toward change. This line of research suggests that counselors should pay attention

to client statements of blame, expressions of weakness or rigidity that can inform clinical

assessment. Thus, the more internal the source of such client statements, the more likely a

client would be motivated to change. In contrast, the more external one's locus of control,

the less likely one is motivated to change (Rotter, 1954). Consequently, the counselor

with a client of external expectancies of control would adopt strategies to encourage

client insight and awareness of his/her expectations and how expectations motivate or

retard a client's behavior. With Connally's (1980) research, the influence of the

interaction between counselor and client on motivation is highlighted. Therefore, the shift

in how motivation is conceptualized from more classic to modem to post-modem theories

anticipates the relative and increasing influence of the counselor and treatment strategies

as instrumental to client motivation.

Since many clients in the substance abuse field are characterized by denial of their

problem (Prochaska, 1992; 1986), motivation for changing such denial is closely related

to self-efficacy or one's beliefs about change (Miller, 1991). Historically, the most

effective means of motivating clients was to confront them (Miller, 1991). Miller (1991;

1983) suggests that many prior treatment strategies developed from research aimed at

first attacking and tearing away at a client's defenses in order to secondarily, rebuild and

motivate the client. However, current substance abuse research reflects gentle and

empathic (Miller, 1995) treatment approaches in combination with brief, time-limited,

managed care models (Lyons, 1997; Hoyt, 1995). Yet one of the many challenges

continuing to face clinicians is how best to motivate clients toward substantive, long-term

change.









Traditionally, the research literature suggests the examination of motivation in varied

contexts reflects the dichotomy between internal and external motivation. However, more

contemporary lines of research support motivation as being composed of both internal

and external sources. For instance, Deci and Ryan (1985) support empirical research that

operationalizes motivation as composed of both external and internal sources. In self-

determination theory, (Deci and Ryan, 1985) motivation is conceptualized as an inherent

factor that drives action and change, while also is influenced by external influences. In

counseling, client behavior is interpreted as being motivated from within the client

(internal and interpreted as a function of desire) and partially driven by counselor style

and treatment choice (external) in the clinical setting. Additionally, the research of

Hamert (1995) and Deci and Ryan (1985) elaborate how counselor style can impact client

perception of treatment. Thus, the literature emphasizes that self-determination theory

and research (Deci and Ryan, 1985) confirms the increasing influence of counselor-client

interaction on motivation as rooted in both internal and external causes (Miller, 1991).

The influence of the counselor-client interaction represents a significant conceptual shift

in how motivation is researched.

With regards to self-determination theory (Deci and Ryan; 1985), these authors

suggested that intrinsically motivated actions are self-determined and manifest in the

absence of external award. An example would be reading a book; the behavior is

motivated internally and is absent of external reinforcers. External motivation

(Kruglanski, 1978) however is rooted in extrinsic reward and reflects a wide spectrum of

human action and behavior. Previously, it was thought that external motivation was

understood to manifest from external reinforcers alone, in the absence of self-









determination and internal sources.

Another construct that highlights how motivation is researched is cognitive

dissonance. Festinger's (1957) research (as cited in Brehm, 1976) revealed two important

themes on cognitive sources of motivation. One, that a person can entertain two mutually

incompatible ideas for a brief period. Two, as a result of the dissonance generated from

conflicted ideation, one is likely to modify a given behavior and the consequent thoughts

around the behavior, to reduce the dissonance generated. However, Festinger (1957) did

not predict that one would be successful in producing alternatives to dissonance that are

interpreted as more internally satisfying. But cognitive dissonance research does suggest

that an individual will be more motivated in order to reduce the generated dissonance

resulting from conflicting ideation. Cognitive dissonance anticipates post-modern

practices and research, as well as motivational interviewing (Miller, 1991).

The implications of the relationship between cognitive dissonance and motivational

research in counseling are notable. Miller's original ideas on motivational interviewing

(1983, as cited in Miller, 1991) were extended from Festinger's (1957) early line of

motivation research. Miller (1983) suggested that one method of interpreting cognitive

dissonance is to empirically evaluate present client functioning in contrast to ideal future

functioning. Thus, construction and assessment of a cost-benefit analysis links a client's

present behavior to future goals. Miller's research (1991) states that incongruity between

behavior and goals can be predictive of client motivation to change. Therefore, the goal

of motivational interviewing (Miller, 1991) is to motivate the client to change by

amplifying or increasing the tension around the cognitive dissonance until the attachment

to unwanted, present behavior is attenuated. Driving this assumption of motivational









interviewing toward client change (Miller; 1991) is the notion that inherent within us is

the tendency to motivate toward problem resolution to reduce tension.

Other considerations of research on motivation have concentrated on demographics.

For instance, the interaction between gender and client expectations has been studied to

predict motivation. Hardin and Yanico (1983) reported significant differences in client

gender regarding one's expectations in counseling. Women scored higher in expectations

to be motivated, to be open, to be genuine and immediate. Men reported higher scores for

expecting advice, direction and self-disclosure to occur. However, Schaub and Tokar

(1999) suggest that much of the current literature on demographical variables has

revealed little consensus as to the significance of these variables in session.

Additional research on motivation relates to personal expectations. For example,

Schaub and Tokar (Spring, 1999) suggest further inquiry into the examination of the

relationship linking client expectations with motivation. These authors factor analyzed

the five major personality variables (McCrae and Costa, 1987) and combined the traits of

openness, conscientiousness, extraversion, agreeableness, and neuroticism into clusters

according to how they scored on the EAC-B, Expectations about Counseling Measure

(Tinsley, et al., 1980). In correlating the EAC with the five-factor model, Schaub and

Tokar (1999) found significant, empirical differences to exist between personality and

motivation in one cluster of factor analyzed variables.

Others have examined the theoretical role of motivation with expectations.

Expectation value theory (Rotter, 1982; Atkinson, 1966) is linked with personality

research and motivation (Schaub and Tokar, 1999; McCrae and Costa 1987; Tinsley,

1980). This area of research concludes that people are motivated to behave and act upon









expectations of a given outcome. For instance, one's high, moderate or low expectations

motivate a given behavior based on expectations of a desired outcome. An aspiring client

with the expectations that working together and remaining motivated through couples

counseling in order to save a troubled marriage would be one example.

Counseling research related to motivation also targets goal setting. Locke and Latham

(1990) and Mento, Karen and Steel (1990, cited in O'Neil and Drillings, 1994) examined

how personal goals require motivational potential. From these authors, much of their

research drives goal setting theory, which investigates the relationship between one's

explicit goals and personal standards of motivation. One example would be to change

how one communicates with a partner in order to become a better partner. This line of

theoretical inquiry and research suggests for example that the relative degree of one's

prior performance or behavior (one partner suggests in couples counseling that the other

partner is not sensitive when angry and the other partner agrees) in contrast to one's

current standards of becoming an improved partner actually determines future

motivational state. Thus, from this model, the motivational source for behavior change is

considered retrospective.

Another line of research that targets motivation in counseling emerged from

attribution theory (Weiner, 1985). Attribution theory (Weiner; 1985) suggests that prior

judgments of one's performance have predictive utility in demonstration of future

motivation on performance outcomes. In other words, outcomes are considered highly

dependent upon how people perceive and attribute prior motivation upon future

performance. Thus, similar to self-efficacy and social-cognitive theory, attribution theory

suggests that former motivational precepts impact performance and achievement









strivings, additionally contributing to the retrospective nature of motivation on the

success or failure of future outcomes (Weiner, 1985).

Prochaska (1992; 1986; 1982) examined the role of motivation and readiness for

change in counseling stages. Beginning with smoking cessation, Prochaska (1982)

developed a transtheoretical research model to capture how clients and non-clients

motivate toward action in counseling treatment to achieve goals. Currently, the model is

applied to substance abuse populations as an assessment tool in determining client stage

of change. In fact, the majority of Prochaska's (1986; 1982) model provides the

theoretical framework for the URICA measure, University of Rhode Island Change

Assessment instrument, which will be used in this study. Prochaska's (1986; 1982) model

includes four significant stages and a fifth and sixth stage, which are quite brief.

The first stage is precontemplation. Precontemplators are clients in denial of their

problem. Unwilling to identify they have a problem, these clients are very unlikely to

commit to counseling. As a result, they are not ready for change and are very difficult

clients.

The second stage of the model is contemplation. The defining aspect of

contemplation is ambivalence. Clients in this stage are actively contemplating both

reasons to change and reasons not to change a targeted behavior. Consequently, these

clients are often conflicted by choice. Counselors working with clients in contemplation

attempt to shift clients toward compliance of desired and positive treatment goals by

overriding a contemplator's attachment from a present behavior to a positive alternative

(for example, helping the client realize the advantages of moving from drug use to

abstinence).









Determination is the third stage of the model. This stage is characterized by a client's

determination to act but without a plan. Therefore working with a client in this stage

involves developing a treatment agenda and corresponding interventions to help

implement the chosen plan. The fourth stage is action, the stage where a client is highly

motivated to change behavior and not just talk about reasons for change. At this point

client change has been carefully considered, a plan generated and the application of the

plan is occurring. The fifth and sixth stages are maintenance and relapse, respectively.

Clients in maintenance continue the chosen prescribed course of action selected by

counselor and client. The last stage of the model, relapse, reflects the circular and relative

nature of this particular model while normalizing that relapse is an inherent component of

recovery (Prochaska, 1992).

Prochaska's (1986; 1982) model implicitly acknowledges and thereby normalizes that

many substance abusers will relapse no matter how advanced in their treatment protocol

regimen. However, instead of a client regressing toward initial stages of

precontemplation and denial again, the model suggests that a given client may return to

earlier stages of positive development (contemplation) and then proceed again,

vacillating through various stages of change. The spiraling through stages of change

gives the theory its characteristic circularity of clientele development and change.

The measurement of the various stages of change has been derived from the

theoretical perspectives of Prochaska (1992; 1986). Measurement of motivation is

reflected as a function of readiness for change prior to the initiation of counseling. Two

such instruments measuring change in this capacity is the University of Rhode Island

Change Assessment (Prochaska and DiClemente, 1992) and the Stages of Change,









Readiness and Treatment Eagerness Scale (Isenhart, 1997; Carbonari, 1996). In fact, both

these instruments have confirmed the theoretical predictions of Prochaksa's (1982) stage

model of change with smoking clients. In a 1992 study with a sample size of 570,

Prochaska showed that clients that remained abstinent from smoking over eighteen

months were those clients most likely to be measured in maintenance and action stages of

change, not precontemplation.

Another researcher that has examined the matching of treatment type to client

readiness for change in counseling is DiClemente (1990). DiClemente (1990) used the

URICA measure (change assessment instrument) to evaluate 224 adults entering alcohol

outpatient treatment. Participant scores on the precontemplation, contemplation, action

and maintenance clusters yielded very distinct scores on variables of benefits to drinking

(social, mental, relational), style of drinking (gregarious or loner), consequences to

drinking (loss of control, marital conflict), and concerns with drinking (seeking help,

general worry). Thus, it was concluded that cluster analytic techniques designed to isolate

treatment readiness within each stage of change is consistent with the theoretical and

predictive power of Prochaska's stage change model (DiClemente and Hughes, 1990).

Another stage-change treatment strategy revealed in the research literature is to

provide realistic goals for brief meetings with clients at each interval of change

(Prochaska, 1992). For instance, Prochaska (1992) suggests that the results of some

longitudinal studies illustrate that if clients can move one stage in one month, often they

are more likely to move and progress through a full treatment regimen in six months

time. In fact, when looking at the empirical literature collectively on stage models applied

to medical and counseling related treatment, Prochaksa (1998) maintained that over









4000-health professionals evaluated stage based, incremental treatments as very useful

and helpful with a majority of clients and patients. This information contrasts to the

typically quoted figure of 20% of clients that are thought of being capable of taking

immediate action toward behavioral change (Prochaska, 1998).

Perceiving motivation as a function of client readiness is relatively new in the

research literature. Isenhart (1997) suggests professionals traditionally perceived

motivation as a dichotomous construct. Either a client was motivated to change or not.

However, current research reflects theoretical considerations (Bandura, 1997; Miller,

1991; Prochaska, 1986; Deci and Ryan, 1985) that incorporate client motivation as

relative, existing on a continuum, and highly contextually dependent. For instance,

motivation in substance abuse populations often appears influenced by external variables

of family concerns, legal pressure, and environmental demands (Prochaska, 1992). As a

result, treatment staff presently considers readiness for change among a variety of

dimensions. Current research on motivation reflects the understanding that motivation

has multiple meaning and varies with context.

Isenhart's (1997) research provides an example of how motivation is measured as a

process of change with multiple meaning. Pretreatment readiness for change was assessed

in over 100 substance-abusing males in the Navy by using a modified version of the

SOCRATES scale, an acronym for stages of change readiness and treatment eagerness

scale. Scores were correlated with four variables: age, education, diagnostic criteria met,

and Q-F measures, or quantity and frequency of drinking. Testing for pretreatment

readiness for change yielded three measures of outcome: high action scores revealed no

alcohol use during one year post treatment period, high determination scores showed









affiliation with sponsor during one year post treatment period and having a sponsor at

pretreatment and those scoring low on contemplation also showed having a sponsor at

follow up. Isenhart (1997) concluded that a correlation existed between pretreatment

readiness for change and both a decision to drink and commitment to recovery activities.

However it was suggested that other factors such as poor coping, limited resources

available to a client, and acute stressors can override motivation to change once drinking

begins, thereby decreasing a client's commitment toward long-term change. Thus,

motivation is not simply construed as either internal or external but interpreted as

complex with multiple implications.

Others reflect the importance of matching a client's level of readiness for counseling

with treatment selection. Annis, Schober and Kelly (1996) provided a comprehensive

summary of an outpatient counseling program, that included motivational interviewing,

assessment, treatment planning, preparation for counseling, and maintenance of change

strategies. These treatment components converged with a client's stage of readiness to

change precontemplationn, contemplation, determination, action, maintenance) in

describing how individual counseling is tailored to each client. Ohlsen (1973) examined

client readiness for membership in a counseling group and concluded that willingness to

prepare, participate and commit to counseling is often interpreted as a sign of

motivational readiness.

Counseling research on motivation also relates to therapy types. Baer, Kivilhan, and

Donovan (1999) integrated skills training with motivational therapies. Historically, skills

training (client motivated but without resources) and motivational therapies (AA,

confrontational models) were based upon distinct premises (client in denial) and were









described without overlap. Traditionally, skills training were applied for correcting skills

deficits. Motivational therapies were used for enhancing motivation in substance abuse

clients. Baer et al.'s (1999) skills training (ST) research dates from the mid sixties and

the work of Lazurus (1965, as cited in Miller, 1991). The central premise with ST is to

improve a client's coping skills to improve the stress of addiction. ST traditionally

assumes the client is motivated to change but he/she lacks the necessary skills to change.

Sills training incorporates post-modem, solution-focused (Hoyt; 1995) assumptions into

treatment.

Baer's et al. (1999) research demonstrated that the integration of skills training and

motivational interviewing is possible by understanding three fundamental premises: one,

that motivation for change is critical for successful treatment outcome; two, wide

differences exist in all clients in the nature, degree, and application of coping skills, and

three, coping skills need to be assessed in counseling, independent of motivational level

for change. For instance, if a client is motivated to change but lacks the coping skills to

tolerate unpleasant affect, it is assumed that a client's chances for successful behavioral

change will be decreased. Consequently, client skill and motivational level are never

viewed in isolation. Thus, integrative aspects of this model could be applied to a high-risk

yet potentially common situation for an alcoholic to use, and relapse, due to peer

pressure. For example, peer pressure to drink and ultimately consume is considered in

this context as reflecting either a lack of assertiveness (skill) and/or perceived shift in the

desire to not remain abstinent (motivation). Therefore, integrating treatment options is a

necessary consideration in motivating clients toward a successful, brief treatment

outcome for substance abuse clients.









Motivational therapies (Miller, 1991) are rooted in motivational interviewing (MI).

The primary assumption with MI is to analyze how people change and then help the

client support change in their life. In MI, a client's problems persist because clients are

ambivalent about making change, not because they lack the skills to do so. In essence, MI

focuses on helping clients resolve ambivalence about behavioral change in order to

motivate the client. By integrating aspects of skills training and motivational interviewing

in clinical treatment, motivation is perceived as universal, internal, and modified by

external forces (counselor style, counselor personality, and treatment approach/setting)

while best elicited within a collaborative, co-constructed treatment context between

clinician and client.

Regarding variance in motivation and treatment, Miller, Benefield, and Tonigan

(1993) considered the empirical impact of treatment styles on client motivation. Miller et

al. (1993) examined the relationship between a confrontational, aggressive style with

alcoholic clients as opposed to a more empathic, non-confrontational style, characterized

by reflective listening with a sample-size of forty-two. A confrontational, counseling

style toward clients with drinking problems was shown to be statistically significant in

predicting the likelihood of relapse twelve months after the study. Additionally, four

clients that received counseling from a non-confrontational counselor remained totally

abstinent one year later. Miller et al. (1993) concluded that the level of client resistance is

a key component in determining whether or not a successful outcome is considered

likely. However, the relatively small sample size limits the conclusion of the results of

this study as preliminary rather than confirmatory.









General Training Strategies

The remainder of this literature review will highlight how general training methods

are applied to a variety of educational contexts to enhance prospective client self-efficacy

and motivation in counseling. A general review on training strategies will first be

examined; then, the specific application of a role-play, video observation, and counseling

literature as pre-counseling, treatment methods will be investigated. The terms

pretreatment and training are used interchangeably to suggest any educational program or

informational service designed to increase prospective client, student, employee or

faculty effectiveness.

Training methods to increase coping self-efficacy and motivation for change have

wide application in the medical field (Mickler, 1999; Cook; 1991). Training procedures

in this area have been applied to increase assertiveness training with college students

(Williams and Hall; 1988), enhance confidence in prospective college faculty (Heppner;

1994), and increase career self-efficacy for women (Sullivan and Mahalik, 2000). Other

lines of inquiry regarding treatment methods that increase confidence in coping and

motivation among prospective faculty and students include and HIV protesting

counseling (Gibson et al.; 1989) alcohol education programs (Chassey et al., 1988) date

rape awareness (Buhrke; 1988); and college residential assistant education (Jakobsen and

Krager; 1988). Another line of research that supports counseling training methods for

prospective clients is reported in the attrition literature. Longo, Lent and Brown (1992),

Mennicke (1988) and Tinsley (1980) all concluded that preparatory education that orients

the client to the client role could potentially attenuate premature termination. For

instance, studies that examine attrition in counseling often target a particular variable that








subsequently has clinical application. In their regression analysis, Longo, Lent and

Brown (1992), focused on self-efficacy and motivation to predict client attrition. Their

results supported the use of preparatory aides designed to reduce attrition by increasing

client self-efficacy and motivation. Deane et al. (1992) suggested that even though the

majority of clients attend counseling for only a few sessions, the use of preparatory aides

in counseling appears warranted to foster client readiness and commitment to counseling,

independent of the duration of counseling treatment.

One training method to increase counseling skills, counseling efficacy and counselor

motivation toward performance is counselor modeling. Modeling can help facilitate

novice counselors and prospective clients understanding of the counseling process. Baum

and Gray (1992) empirically evaluated the effectiveness of an interview on counselor

subjects self-modeling to aid in learning listening skills. Training groups watched an

experienced counselor in action compared to a trainee attempting to demonstrate

beginning listening skills. Results reflected that subjects improved on both listening skill

development and feeling reflection.

Other training strategies focus on providing counseling trainees evaluative criteria

prior to performance review. The function with such instructional training is to increase

skill development while minimizing potential novice counselor anxiety by cueing them to

prospective material ahead. Rennie and Quartaro (1983) examined the results of trainee

expectations and specific instructions on counseling skill acquisition. These authors

found that instructional pretreatment methods aimed at developing awareness of how

counselor style can impact client listening, was effective on future skill development.

Related research to counseling training includes Lawe, Home and Taylor's (1983)









study that examined the effects of training on client self-exploration. Clients listened to

audiotapes of potential issues and concerns that could be encountered in counseling.

Subjects in both general and specific audio groups scored significantly higher than the

control, no-treatment group on a client-self exploration scale. Similar studies have

investigated the role of training as an adjunct to instructional models aimed at increasing

verbal expression of emotion of clients seeking counseling. Shaw et al. (1985) found that

different self-taught modeling, an audiotape, or workbook alone or in some combination

all increased verbal communication skills of client emotion, significantly above a control

group.

Others have looked at preparatory training for increasing job skills and confidence

related to counseling. Elkins and Cohen (1982) evaluated the comparison of the effects of

pre-job training and job experience on nonprofessional, crisis phone workers. These

authors found that counselor related skills on the phone (paraphrasing, empathy,

summarization, feeling reflection) improved dramatically with training in preparing the

phone workers for prospective calls, although little long term gain was achieved at a five

month follow up.

Another important avenue of preparatory training has served crisis counselors

specifically working with victims of date rape (Burke, 1988; Thomas, 1982). Typically,

volunteers who commit to working in crisis centers with this population receive

instruction using film, presentations, national speakers, discussions, and individual role-

plays. Participants usually show less blame of the victim after the incident than before

while improving on dimensions of counseling-related, listening skills (Thomas, 1982).

Burke (1988) demonstrated the effectiveness of a date rape-videotape on a college









population. Videotapes that highlight the impact of date rape on victims can serve to

foster discussion, heighten awareness, and maximize prevention strategies while

extending tremendous compassion to the victims and their families. Videotape in this

context also furthers the need for additional planning and development of educational

models for residential assistant training in college dorms across the nation.

The use of preparatory training has application in areas ancillary to crisis

management. One area where training programs are offered readily is in psychiatry to

increase confidence and motivation among medical staff cope in successfully managing,

assaultive patients. Flannery and Penk (1999) looked at elements of preparatory crisis

intervention from the vantage of critical incident stress management (CISM). Such an

approach serves both prospective and current professional medical staff to help minimize

and prevent assaultive behavior with this population. The CISM model has been used as a

forum for further planning and development of crisis training models nationwide.

Another illustration of how training strategies can be effective is the use of HIV

and AIDS pretest counseling. Pretest counseling training programs include educating

counselors and clients to the etiology of AIDS and how HIV transmission occurs. A

secondary purpose to pretest counseling is to minimize the probability of viral

contraction. Pretest counseling also serves clients that seek and receive HIV testing to

modify their anxiety about likely test results. It also provides a safe forum for discussion

of diagnosis, offers professional examination of different medication and treatment

options while motivating clients toward changing sexual behaviors to safer, less risky

alternatives (Hicks and Rundell, 1996). Due to the lethality of the disease, H1IV pretest

counseling is considered a very important prospective strategy in the fight against AIDS.









Seese (1998) addressed methods to improve teaching for prospective faculty. She

examined the effects of two different counseling interventions on perceptions of teaching

efficacy. Seese (1998) hypothesized that both a didactic training intervention for

prospective faculty and an emotional process group would exhibit a significant impact on

perceived teacher efficacy. Both groups showed significant gains over a no-treatment

control group.

Heppner (1994) reflected the value of Bandura's theory on self-efficacy (1997;

1986; 1977) by demonstrating the utility of feedback of teaching methods to prospective

faculty in both verbal and video contexts. Graduate students in this study rated all four

theoretical sources of Bandura's self-efficacy and concluded that both performance

attainment (lecture experience) and verbal persuasion were instrumental in the

development of prospective teaching faculty. Heppner (1994) concluded by noting that

understanding teacher self-efficacy development is one vital aspect toward advancing

designs in improved, college teacher protocols.

Related to education, Luzzo et al. (1999) demonstrated the effectiveness of

videotape as a treatment strategy designed to improve math and science self-efficacy in

college students. The function of this study was to examine the separate and combined

results of performance and vicarious learning on math and science self-efficacy

development. Videotape was chosen and operationalized according to prior studies that

noted the influence of video on career student development (Foss and Slaney, 1986),

along with its practical aspects of short duration, ease of standardization, and relatively

low cost of production.

From Bandura's theory on self-efficacy (1997; 1986; 1977) it was hypothesized









that the combined results from students in both performance testing and video groups

would show increases in career self-efficacy over that of each group separately. As a

result, its was concluded from Luzzo's et al. (1999) study that the separate influences of

each theoretical component in Bandura's self-efficacy theory warrant further empirical

investigation, whether relating self-efficacy to career decision-making or counseling.

Further research in this area demonstrating the effectiveness of appropriate measures

designed to improve the internal validity of self-efficacy studies was also recommended.

Training strategies and interventions utilized to increase prospective self-efficacy

and motivation for performance have been applied widely in other contexts. One example

has been resident assistance education in college dormitories. Jakobsen and Krager

(1988) noted that over the last twenty years, program manuals that identify the objectives

of residential education are typically subsumed under training criteria for residence

assistants. Much attention is paid prior to the first week of school, highlighting for

prospective resident assistants such questions as, why do we exist, what exactly do we

do, what is most important about our role as resident assistants in the dorms, and how do

we accomplish our training objectives? Typically such training includes role plays, video,

teaching models, and selected readings that help to anticipate life and expected behaviors

residence assistants are likely to encounter in the dormitories.

Another training venue utilized to increase prospective faculty/student self-

efficacy and motivation is alcohol education programs at universities. Chassey and

Clifford (1988) document the alarming increase of alcohol consumption on college

campuses. As a result of increased frequency of drinking on college campuses, most

universities have an alcohol policy. If the policy on campus is violated, a student can be








required to attend counseling at the university-counseling center. One means of

attenuating counseling-center staff workload and the concurrent need for students to

attend counseling is to first have them participate in educational training programs. Such

programs are designed to increase awareness about the dangers of abusing alcohol and

other drugs on campus.

Workshops are developed around the premises that most students drink relatively

frequently on campus and consequently, students must take responsibility for drinking

behavior. Typically, training workshops on campus are divided into biweekly, 2-hour

sessions for two weeks, where videos are shown, literature is distributed, and group

discussions on the presenting issues occur. The goal of these programs is educational and

thus preventative, in hope that violations of campus policies that could lead to legal

action are averted.

Specific Pre-Counseling Treatment Methods

Thus far this literature review has targeted general applications of training

methods designed to increase prospective client, student, or faculty coping efficacy and

motivation from a variety of contexts other than counseling. The remainder of the chapter

will focus on specific pre-treatment counseling methods of counseling video, role play

and counseling literature that have been effective in both counselor and client

development and will be subsumed and examined under sub-headings for each pre-

counseling treatment method.

Pre-treatment methods for counseling and client development are typically

referred to as role-induction (not to be confused with the common term, role-play)

methods (Friedlander and Kaul, 1983; Childress and Gillis, 1977) or an advanced








organizer (Goldstein, Heller and Sechrest, 1966). Such methods prior to counseling help

prepare clients for their role (Johnson and Baker, 1989). Numerous methods can be

applied to help the client anticipate the complexities of his/her prospective, counseling

experience. Such methods include but are not limited to general workshops, briefings,

role-playing, person to person interviews, audiotape, counseling videotape on motivation

(Sutton, 1998; Jakes, 1982) didactic instruction, counseling literature (Helibrun, 1972),

films describing counseling experiences and vicarious learning models (Zwick, 1985;

Heilter, 1976). One popular avenue for enhancing prospective client self-efficacy and

motivation for the client role is a pre-counseling videotape (Sutton, 1998).

Videotape in Counseling

Jakes (1982) showed a video to twenty, female non-clients to positively effect

their expectations and motivation for counseling. The video provided information

regarding a non-directive, counseling style in the form of a dialogue between client and

counselor. Twenty other participants viewed neutral videotape. Results indicated that the

videotape did significantly alter behavioral and cognitive ways of approaching

prospective interviews, but also suggested that motivation for counseling may be

independent of counseling related knowledge.

Deroche (1990) investigated the role of a counseling orientation videotape on

children' attitudes and knowledge of counseling. 143 children participated in the study;

70 children observed the video. Results indicated that children who viewed the videotape

developed greater knowledge and realistic expectations of the counseling process.

Additionally, those children were more likely to reveal positive feelings toward

counseling and counselors than the control group.









Diviak (1999) examined video as a pretreatment method with 200 former patients

of a smoking cessation group to help them remain abstinent. Of those, only seventy-three

agreed to participate at a three-month follow-up, but of those participants, former

smokers who reviewed the video pre-treatment showed higher levels of efficacy and

motivation to quit at a three month follow up when compared to the control group.

Regarding counselor self-efficacy development, D'Rozariso (1996) looked at the

effect of a counseling video on relating differences in counseling style to counselor

effectiveness in different cultures. Significant differences in gender response among

counselor practicum students were found. This conclusion supports Bandura's (1997)

argument that self-efficacy can differ in gender with regard to how decisions are made

from efficacy beliefs about performance (although specific differences in self-efficacy

and gender tend to be contextual and usually related to career decision-making, Bandura

1997). Further, it is recommended that each theoretical component of self-efficacy theory

(Bandura, 1997; 1986; 1977) be analyzed separately with other variables (gender) for

their relative and independent contribution to outcome (Luzzo, 1996).

Sipps, Sugden and Faiver (1988) utilized video to investigate the role of counselor

training level and verbal response type to efficacy and outcome expectations. As

expected, with an increase in graduate training, increases in counselor self-efficacy were

shown. Carter (1998) examined the relationship between different versions of videotaped

training on counselor development to perceived self-efficacy. Effects of training on areas

in clinical interviewing included how to ask open-ended questions, the ability to

paraphrase content and reflect feelings. Interestingly, scores on self-efficacy were high on

all groups, independent of video training.









Other studies incorporate video and the application of a role-play as pre-

counseling treatment methods for purposes of comparing the effectiveness of the

different formats. Larson et al. (1998) examined the effectiveness of video compared to

role-play in counseling self-efficacy development. Interestingly, it was found that the

role-play group showed significant increases in counseling self-efficacy in comparison to

the group exposed to the counseling video. The authors agreed with Bandura's contention

that experiential aspects of performance and mastery accomplishments tend to contribute

most to self-efficacy development, above and beyond other theoretical sources (Bandura,

1997).

Strupp and Bloxom (1979) attempted to enhance motivation for counseling

among lower-class participants through a counseling video. Further, many of the

prospective counselor-client interactions in treatment centers often include videotape as a

predominant, educational format to orient clients to the counseling process (Sutton, 1998;

Jakes, 1982). Due to its low cost and ease of broad application, it is believed that one

video shown to thirty potential clients might be more cost-effective than the time

consumed by therapists individually interviewing thirty separate clients (Zwick and

Atkinson 1985).

Sutton (1998) examined the effectiveness of two different videotaped

presentations on prospective clients' self-efficacy, expectations and anxiety. Prospective

clients were shown a videotaped presentation that included a counseling role-play and

added information about the counseling process. In this study it was hypothesized that a

significant increase in client expectations, self-efficacy, and concomitant decrease in

anxiety would occur. In general, no treatment effects were shown. However it was









recommended that future research examine related hypotheses to investigate the

hypothesized role of self-efficacy on client behavioral change in counseling.

Role-Plays

Another useful strategy applied to increase client awareness and participation for

counseling is the application of a role-play. In counseling, role-plays for prospective

clients are typically thought of as a "role-induction" interview (Rabinowitz, 1997;

Friedlander and Kaul, 1983). Such interviews were developed from Ome and Wender's

(1968) classic description of the anticipatory socialization interview and were initially

designed to foster congruence of expectations between counselor and client. Typically

role preparation procedures tend to explain and discuss the purposes of counseling while

subsequently modeling appropriate interview behaviors. Such training can take the form

of a structured-interview (Hoehn-Saric; 1964), a role-play format (Rabinowitz, 1997) or

video (Jakes, 1982). Positive effects of role induction methods also include counselor

self-efficacy development (Larson, 1998). Other studies show clients often report feeling

more satisfied and confident during counseling (Hoehn-Saric, 1964) as a result of such

procedures.

In a study of counselor development, Larson (1998) evaluated the comparative

value of a mock interview as a role-play compared to a fifteen-minute counseling session

on tape with sixty-seven students using hierarchical regression to predict post-test

counselor self-efficacy. Interestingly, those students who perceived there counseling

performance as below average after the role-play showed decreases in their reported

counseling self-efficacy by almost one standard deviation below the mean. Larson et al.

(1998) concluded that one primary reason for the training impact of role-plays on









counseling students similar in training and age may be due to more realistic appraisals of

efficacy beliefs and feedback generated from peers in the role-play in contrast to

feedback offered from a perceived expert in counseling (Larson, 1998; Bandura, 1997;

Landis and Young, 1994).

Traditionally, it was believed that a primary reason for unsuccessful outcomes in

counseling was due to poor or low client expectations of the counseling process (Tinsley,

1980; Garfield, 1978; Frank, 1968.) In an attempt to rectify such clinical concerns

regarding client expectations of counseling, it was thought that efforts to concentrate

learning for clients regarding the expected roles of both counselor and client might be one

partial remedy at addressing this problem. Consequently, much of the early research on

manipulation strategies designed at improving pre-counseling performance targeted client

expectations in counseling. As a result, initial role-induction interviews were developed

to help clients realistically appraise their expectations of the counseling process.

A prospective role-play reflects the assumption that contact between the counselor

and client prior to the initiation of counseling helps prepare the client for the client role.

Many researchers have examined the effectiveness of role-plays designed to increase

client expectations of counseling, but with many of the same methodological concerns as

mentioned previously. An initial instrument that records a client's initial expectations for

counseling after a precounseling interview is typically conducted in role-play studies. A

follow-up measure is then given afterwards (Mac, 1973; Klepac, 1970; Galinsky, 1971;

Appel, 1959).

Variations on formats of role-induction procedures include Kaiser's (1971)

lengthening of the initial interview to two sessions to determine the impact of role-play









on long-term retention of learning. Cundick (1962) and Gladstein (1969) obtained an

initial finding regarding client expectations and then measured expectations again, after

the counseling relationship had terminated. Post-measurement was done in order to

evaluate possible effects of ending the relationship on client expectations. Other "role-

induction" formats include interviews that can occur after a video has been shown, or in

some combination with another treatment (written material) after an initial interview

(Kemmerling, 1972).

Role-induction procedures that specifically include a role-play have been

examined in a variety of counseling related, helping contexts (Alexander, 1999; Williams

and Hall, 1988; Twentyman, 1979). Alexander (1999) studied the effects of a self-

efficacy enhancement program on condom usage in college students. In this study it was

hypothesized that an AIDS prevention model, based on the implicated role of self-

efficacy in medical health (Bandura; 1997) would enhance HIV and AIDS prevention by

increasing condom use. Although increases in self-efficacy were reported in the treatment

group, current sexual practices were not altered.

Williams and Hall (1998) noted the influence of role-plays on assertiveness

training in college students. These authors examined methods to enhance assertiveness

related to peer requests that included drug use, cheating, loaning money to a friend,

protesting others that cut in line, etc. In three, two-hour sessions (Williams and Hall;

1998) students observed assertive yet appropriate responses while receiving performance

feedback once the imagined role-play scenario was completed. The role-play training

proved beneficial to all members in the exercise subsequent to its conclusion.

Twentyman (1979) examined the influence of role-plays as a rehearsal treatment









on participant anxiety. Subjects that identified themselves as non-assertive prior to

treatment were randomly assigned to two groups, one with assertiveness training and the

other group without training. As expected non-assertive subjects exposed to assertiveness

training exhibited more assertive behaviors and less anxiety over time than those not

exposed to the role-play treatments.

Saitz, Sullivan and Samet (2000) studied the effects of role-plays related to

continuing education with clinicians that screen and provide brief interventions to clients

that suffer from substance abuse problems and motivation. Clinicians interviewed after

the role-plays suggested that they felt more sensitive to initial screening and assessment

methods designed to target client substance abuse in relation to motivation to change

while asking about possible continued substance use at follow up.

The problem resolution format (Cummings, 1992) is another theoretical variation

on the effects of a role-play. This format allows clients to explore through role-play a

prior stimulating situation in order to contact previous thoughts and feelings about the

event. In this case, being able to provide a context in which feelings and thoughts related

to the original situation is important along with being able to identify and label what

exactly is being thought. The ultimate goal of role-play training is to assist and further

educate either the novice counseling student or client by helping them orient to their

prospective role. Ideally the experiential format of the role-play allows for a gradual yet

increasing ability to transfer learning from counseling/academic student to professional or

one as prospective client to actual confident client in session (Friedlander and Kaul,

1983).









Further, Cummings (1992) provided a teaching model for clinical faculty

instructing counseling practicum students on how best to teach and model experiential

counseling, interventions. She looked at the influential yet theoretical role of both a

gestalt technique and a problem resolution format. The gestalt approach (Greenberg;

1984) requires a two-chair intervention that allows students to assume the top dog and

underdog roles inherent in gestalt theory (Cummings, 1992). Identified students or clients

use two chairs in order to assume different parts of personality, one strong, the other

weak. Such an approach, allows in theory that stronger parts of self become more

conscious in order to be softened while less developed and weaker parts of one's

personality become strengthened. The goal is an eventual reordering and stabilization of

personality at a higher, more integrated level of functioning.

Interestingly, some studies have compared the relative influence of a video

intervention to a role-play on counselor self-efficacy, development. However, few studies

have demonstrated the comparative significance of a role-play, video, and counseling

literature on multiple instruments that capture both prospective, client self-efficacy and

motivation to change in counseling. Munson, Zoemik and Stadulis (1986) examined the

effects of a role-play and modeling, to that of modeling and visual imagery on counselor

self-efficacy. Both groups showed significant results over a wait-listed control group

while the two treatment groups exhibited null effects. Johnson and Seem (1989)

compared beginning practicum students to advanced students on counselor self-efficacy.

These authors showed improvements in self-efficacy in the beginning group but not the

advanced group.

However, despite their utility in scope and application, it remains uncertain








exactly how various role-plays positively influence the client once counseling begins

(Friedlander and Kaul, 1983). Certainly, role-induction procedures can experimentally

manipulate client experiences, verbal encouragement, vicarious learning, and reductions

in emotional arousal. The use of a role-play as one treatment strategy in this study will

simulate a prospective counseling experience designed to improve prospective client self-

efficacy and motivation to change while derived theoretically from self-efficacy

components (Bandura, 1997; 1986; 1977).

Counseling Literature

Verbal interventions vary in their experimental application although they are less

likely to be utilized than either a video or role-play as a pre-counseling, treatment

method. The majority of verbal interventions appear as instructions, pamphlets,

brochures, reading counseling vignettes, and/or narratives. Such strategies have typically

been explored in the counseling literature to increase client expectations of the counseling

process.

Gibson et al. (1989) noted the effectiveness of utilizing brochures in brief

counseling to reduce the AIDS risk among intravenous drug users and their sexual

partners. Cook et al. (1991) demonstrated the utility of literature in the form of a

brochure in an osteoporosis patient education program. The literature provided was

considered educational and one component of a workshop designed to help patients cope

with the initial screening and prospective diagnosis of osteoporosis.

Donovan (1998) examined the relationship between potential and professional

ethical violations of psychologists to client perception of counselor expertise by using a

written intervention. Subjects attended simulated counseling sessions in which counselors









committed two ethical infractions that were presented as a treatment in a reading,

literature group. Although participants in an active recall session showed improved

performance over a control group on understanding the gravity of potential ethical

violations in counseling, being able to translate subject knowledge of ethical practice into

behavioral change or confrontation with therapist did not occur later at follow up.

Gordon (1982) developed a patient preparation brochure for the purpose of

studying the effects of literature as a pre-psychotherapy intervention on client

expectations. Few significant effects were reported. Gordon (1982) suggested one reason

for lack of empirical support of the brochure was due to the lack of measurement of the

severity of client problems.

Tinsley (1988) suggested that one such form of a verbal intervention requires the

alteration of verbal procedures as one manipulation strategy. For instance, some

investigators (Ziemelis, 1974, as cited in Tinsley, 1988) have applied a matching

procedure whereby research subjects were told that they had been or not been favorably

matched with a desired counselor. The function of these studies was to determine whether

or not client expectations generated from such information modified existing client

expectations of the counseling process. Ziemelis (1974) looked at the relationship

between manipulations of client information to expectations of counselor selection by

randomly assigning participants to either positive, negative, or no pre-treatment interview

information. Helms (1975, as cited in Tinsley, 1988) had participants read empathy-

reducing, empathy increasing or empathy neutral information regarding potential

interactions of attraction and anxiety with a counselor. Non-significant results were

found.









Shelton et al. (1991) examined the role of test anxiety, locus of control, and self-

efficacy as predictors of treatment preference by providing two brochures to two

treatment groups consisting of college students. In one group, the brochure described how

counseling could help prospective clients specifically cope with anxiety. The other

brochure described performance techniques (active listening, paraphrasing) in session

that clients potentially find helpful. Interestingly, results indicated that subjects assigned

to the performance group had higher levels of self-efficacy regarding performance in

counseling and lowered anxiety, than the anxiety-focused group. One interpretation of the

results can be inferred from self-efficacy theory (Bandura, 1997; 1986; 1977), as efficacy

levels typically increase with interventions that relate efficacy more specifically to

performance-based interventions and not just targeted emotional arousal. In fact usual

correlations between efficacy beliefs and performance tend to be congruent unless

indicative of more defensive dynamics that manifest from personal underlying insecurity

(Bandura, 1997), often witnessed in clinical supervision (Larson, 1998; Holloway, 1995).

Despite the application of counseling literature as a valid, verbal intervention,

Tinsley (1988) suggested that written documents were only successful in 4 of the 11 of

the studies he reviewed (McKee and Smouse, 1983; Gill and Taylor, 1982; Falcone,

1980; Randall, 1969, as cited in Tinsley, 1988). However, he concluded that the future

examination of counseling literature as an intervention in counseling studies with solid

methodological designs was warranted.

Conclusion

In conclusion, this review of the research literature has included an examination

of the empirical role of self-efficacy, motivation for counseling, general training methods,









and specific pre-treatment counseling methods designed to increase prospective client

self-efficacy and motivation to change in counseling.

Support for this study includes counseling research on self-efficacy applied to

contexts outside of counseling, such as academic achievement (Pajares and Miller, 1994),

athletic achievement (Stidwell, 1994), and self-efficacy and medical health (Everett,

2000; Hannes, 1999). Within counseling, much of the self-efficacy research has been

applied to counselor student, self-efficacy development (Larson, 1998; Daniels 1997)

substance abuse treatments (Miller and Rollnick, 1991; Prochaska and DiClemente,

1986) and supervisee self-efficacy development within supervision (Ray, 2000; Daniels,

1998; Holloway, 1995). However, in counseling research, very few empirical studies

have investigated treatment effects on gender, in predicting self-efficacy and readiness

for counseling, independent of counselor supervision, student development, and

substance abusing contexts and populations.

Further, social-cognitive theory (1986) emphasizes both the interpersonal role of

individual self-efficacy and personal agency, combined with environmental variables

(clinical context and clinician) that influence behavioral choice (for example, the

selection, initiation, and maintenance of counseling.) Thus, counseling research on self-

efficacy and motivation support treatments that capture the interpersonal nature of

counseling (Bandura, 1997). The treatments in this study emerge from the theoretical

components of self-efficacy and the interpersonal nature of social-cognitive theory, with

secondary emphasis placed upon readiness for counseling, as a function of motivation for

change.

With regards to motivation, research in this area is complicated by its broad









association with many factors: personality (McCrae and Costa, 1987), different theories

(cognitive dissonance, social-cognitive; Scharf, 2000) different types of motivation (Deci

and Ryan, 1985; Skinner, 1953), the relationship of motivation and client attrition to

other variables (Longo, 1991); motivation and counselor interventional style (Bandura,

1997; 1986; Hamert, 1995; Miller, et al., 1993); motivation and demographics (Kunkel,

1990); motivation and duration of treatment (short vs. long term; Hoyt, 1995); and

motivation and recovery (Isenhart, 1997).

The research indicates that little understanding of the empirical role of motivation in

counseling has resulted from analysis of demographic variables and intake data. Thus,

due to the confounding and complicated nature of motivation, many research conclusions

on motivation have been inconsistent (Kunkel, 1990; Hardin, 1983). Therefore, the

majority of research on motivation extends primarily into treatment domains,

concentrating on motivation and substance abuse treatments (AA models to more post-

modem, motivational therapies) to Prochaska's stage model (1982), the post-modem

theory and practices of Miller (1991) to specific, field research (Isenhart, 1997; Hamert,

1995; Miller, et al., 1993). Further, since much of the counseling research on motivation

relates to the addictions field, the research focus has traditionally targeted how best to

help treatment professionals work with low motivated, more resistant clients (Miller,

1993, Miller, 1991) solely in this context.

Additional research applications toward motivation have primarily focused on

substance-abusing populations (Prochaska, 1992; 1986; Miller, 1991) and attrition

(Longo, 1991) but not on the treatment impact on client motivation and client self-

efficacy considered together outside of these contexts. Thus, there appears a need for









future research inquiry that empirically documents various methods to increase client

self-efficacy and motivation jointly in other counseling-related contexts as well. For it

appears incumbent upon counseling professionals to advance the understanding of these

two variables in relation to each other to better understand their correlated nature in a

variety of counseling treatment contexts. Since many clinicians practice in varied

contexts, it appears warranted that counseling professionals empirically document how

best to motivate and increase prospective client self-efficacy early in the counseling

process, in order that clients maximize the services offered to them in all counseling

related areas (Longo, Lent and Brown, 1992; Longo, 1991). Furthermore, training

methods that support the usage of prospective training designed to increase coping

efficacy and motivation appear needed in more general client populations since few

studies on client self-efficacy in counseling and motivation together exist outside of

substance abuse treatment contexts.

Even counseling treatments that isolate various components of self-efficacy alone

appear justified in order to understand how the theoretical components to self-efficacy

relate to each other. For instance, Luzzo (1999) concluded that although vicarious

learning is less influential on self-efficacy development than performance in academic

contexts, both the relative contribution of each theoretical component is important to

examine in self-efficacy research in general. With regards to the need for interventions,

Larson (1998) argued that constructive aspects of prospective client performance might

be more readily identified from both student counselor and client in a role-play format

that might not be as observable on videotape alone. Specific treatments that illustrate the

empirical value of a counseling role-play on prospective client performance appear









needed as well.

Thus, the three treatments in this study (counseling role-play, video, and

literature) emerge from Bandura's (1997) theoretical components that define self-efficacy

(approximating performance experience with a counseling role play, including modeling,

verbal encouragement and deductions in emotional arousal), a counseling video (thus

isolating the modeling and vicarious learning component of self-efficacy) and a

counseling literature group (isolating the verbal and cognitive aspects of self-efficacy). In

studies that utilize literature as an intervention to improve client self-efficacy and

motivation to change, one common suggestion offered to improve the methodology

would include providing a small quiz to insure that the subjects read and process the

literature provided.

Additional suggestions in the research literature that justify the need for this study

include how prior research by Prochaska (1992; 1986) and Festinger (1957) have

demonstrated the role of motivation in reducing cognitive dissonance that can accompany

problem severity. One suggestion in capturing problem severity is to include a measure of

client motivation that implies client willingness and readiness to disclose current

behaviors as problematic in counseling. Such a measure will be included in this study, the

URICA change assessment instrument. However, although treatment applications

involving literature as a function of a verbal/cognitive intervention have been

documented outside of counseling, the exact role of how literature may translate into

client action or positive behavioral change remains ambiguous and is suggested for

further exploration and empirical study (Tinsley, 1988). This study attempts to partially

address this concern by presenting a brief quiz to each participant in the counseling,









literature treatment group. It is expected that each participant will answer the quiz, after

he/she reads the brochure, counseling scenarios, and counseling narrative that are

presented in each respective packet.

Another measurement concern to be addressed in this study is illustrated in

Sullivan and Mahalik's (2000) empirical study examining the effectiveness of increasing

career self-efficacy for women. Due to the non-equivalency of treatment groups from

failure to randomly assign participants prior to initiation of treatment, treatment effects

were considered highly preliminary. Mennicke's (1998) review of the counseling

research literature on attrition as its relates partially to motivation demonstrated that

many studies regarding attrition and lack of client motivation area are beset by problems

with internal validity, small sample sizes and measurement issues as well. Future research

that targets variables associated with attrition, such as self-efficacy and motivation to

change, with improvements in research design is recommended in the research literature.

Separating training effects from client motivation has been another concern in the

empirical literature. Duckro (1979) and LaTorre (1977) noted this specific confounding

influence was generally due to poor reliability of measurement. Thus, reliable

measurement of very specific, theoretical variables in counseling (self-efficacy and

motivation) is one partial remedy toward correcting the design issues previously noted in

the literature. Surprisingly, despite the application of training programs for increasing

self-efficacy and motivation among counseling students and clients in multiple contexts,

research in areas of general training and pre-treatment counseling methods have been

criticized for having many design issues and concerns regarding internal validity. In their

systematic review of the literature, Tinsley, Bowman and Ray (1988) noted that









approximately 75% of the training application studies failed to demonstrate adequate

internal validity. Added methodology concerns with training methods include empirical

studies that fail to incorporate relevant theoretical variables that can influence preparatory

effects. For instance, Deane (1992) showed that further preparatory influences from

training can be mediated by anxiety alone and that related variables need to be accounted

for in empirical studies of preparatory programs and studies.

Other measurement issues in this area include the potential for confounding

variables that obscure conclusions about treatment effects. Counseling research

illustrating pre-counseling orientation is rich with articles that cite the complexity of

human interaction and the multitude of confounding and situational factors to even an

initial, preassessment interview (Larson, 1998; Deane, 1992; Tinsley, 1980). Future

research studies are justified in relating how specific pre-treatment counseling methods

can be applied to increase prospective self-efficacy and motivation for change in

counseling clients, without the previous measurement issues mentioned.














CHAPTER 3
METHODOLOGY

Statement of Purpose

The purpose of this study was to assess the experimental influence of a role play,

a counseling video, and counseling literature on prospective clients' self-efficacy and

readiness for change as a function of motivation for counseling. In this chapter, the

research hypotheses, relevant variables, population, sampling procedures, data collection,

and data analytic procedures are described. Additionally, the instrumentation and the

study's limitations are discussed.


Hypotheses

The following null hypotheses were investigated in this study:

Hol: There is no statistically significant association between the role play,

treatment group, (group 1) and the no-treatment control group, (group 4) on either the

CSEBS, client self-efficacy, behavior scale measure, and/or the URICA, University of

Rhode Island, change assessment instrument.

Ho2: There is no statistically significant association between the video,

treatment group, (group 2) and the no-treatment control group, (group 4) on either the

CSEBS, client self-efficacy, behavior scale measure, and/or the URICA, University of

Rhode Island, change assessment instrument.

Ho3: There is no statistically significant association between the counseling

literature group, (group 3) and the no-treatment control group, (group 4) on either the









CSEBS, client self-efficacy, behavior scale measure, and/or the URICA,

University of Rhode Island, change assessment instrument.

Ho4: There is no statistically significant association between the role play,

treatment group, (group 1) and the video, treatment group, (group 2) on either the

CSEBS, client self-efficacy, behavior scale measure, and/or the URICA, University of

Rhode Island, change assessment instrument.

Ho5: There is no statistically significant association between the role play,

treatment group, (group 1) and the counseling literature group, (group 3) on either the

CSEBS, client self-efficacy, behavior scale measure, and/or the URICA, University of

Rhode Island, change assessment instrument.

Ho6: There is no statistically significant association between the video

treatment group (group 2), and the counseling literature group (group 3), on either the

CSEBS, client self-efficacy, behavior scale measure, and/or the URICA, University of

Rhode Island, change assessment instrument.

Ho7: There is no statistically significant interaction between gender and

treatment type (group 1, group 2, group 3, group 4) on either the CSEBS, client self-

efficacy, behavior scale measure, and/or the URICA, University of Rhode Island, change

assessment instrument.

Ho8: There is no statistically significant association between genders on either

the CSEBS, client self-efficacy behavior scale, and/or the URICA, University of Rhode

Island, change assessment instrument.









Delineation of Relevant Variables

Dependent Variables

The first two measures, the CSEBS, client self-efficacy behavior scale, and the

URICA, University of Rhode Island change assessment instrument, were utilized to

calculate prospective client self-efficacy and secondarily, prospective client readiness for

change in counseling. The CSEBS score, or client self-efficacy behavior scale score is

calculated by summing the 20 items responses collectively into one score. The URICA

score, is composed from 4 subscales, measuring precontemplation, contemplation, action

and maintenance (see Prochaska, 1986), thus yielding a 32 item self-report score that is

used to assess and analyze readiness for change at entrance to counseling treatment. A

third dependent, dichotomous variable was also incorporated into the study to measure

follow-up interest in seeking counseling as a result of subject participation in this

dissertation study. Gender, treatment, self-efficacy, and readiness for counseling were

evaluated separately. The interaction between gender and treatment was also examined.

Independent Variables

Gender and treatment were the two independent variables in the study. Student

volunteers were randomly assigned to four, treatment groups. Treatment one consisted of

volunteer participants experiencing an individual, scripted, counselor-client role-play

with students in the prospective, client role and a trained graduate student, in the

counselor role. Treatment two participants observed a simulated counseling session on

video, role-played by a trained graduate student counselor and a trained graduate student

client. Participants in the third treatment group read counseling literature. Treatment three

composed of three case studies of simulated yet likely scenarios potentially encountered









in counseling and a brochure identifying how counseling could potentially be helpful to a

college population. To insure that participants read and process the literature, they were

asked to complete a simple quiz on the material. Assigned subjects in group 4 (no-

treatment control group) read part of a chapter from a general, counseling theories book.

Gender

Male and female scores from the CSEBS and URICA measures were assessed to

determine if a statistically significant interaction exists between gender and treatment

type or if gender alone separately reflected statistical significance on either dependent

variable.

Population

The research population consisted of the undergraduate, college student body at

the University of Florida. Research participants were selected from four undergraduate

courses in the college of education. Approximately 400 potential participants were

surveyed. Participants in the study were contacted by email and phone and then randomly

assigned to one of four groups.

Sampling Procedure

The research sample was composed from four undergraduate courses in the

College of Education: drug and alcohol awareness, stress management, interpersonal

communication, and career development. A graduate student instructor taught each

course from the department of counselor education. Instructors offered extra credit to

students willing to participate in the study; students were informed of this option prior to

the sampling procedure.

Students from each of the four classes mentioned above were first given a consent









sheet that informed participants of the potential risks and benefits of participation. An

emphasis was placed on the confidentiality of the study and that participants had no

obligation to participate. The informed consent form is provided as appendix A. Extra

credit was given to participants at the discretion of the course instructor. In order to

facilitate participation, different times for administration of the treatments were proposed.

Subsequently, all students were given a short survey, asking them to identify whether or

not they have an interest in participating in a research study regarding their attitudes

toward counseling. The survey was composed of a five-point, likert scale, indicating

subject willingness to seek counseling (one indicating little interest for counseling; three

indicating a moderate interest for counseling; and five revealing a high or strong interest

to seek counseling). The rationale for using the likert scale on the survey was to generate

exclusionary criteria to approximate "real" clients in order to enhance the external

validity of the study. Students who indicated a moderate to strong desire to seek

counseling (by selecting three or higher on the likert scale) reflected the total group of

students in the study.

Participating students in the study were contacted by phone or email regarding the

physical location and times of the experiment. Those participants selected were then

informed that they were randomly assigned to different groups in the study. One group

required students to role-play a written, standardized counseling format, between

counselor and prospective client (treatment group 1). Other participants were randomly

assigned to group 2 (video observation), group 3 (reading counseling literature), and

group 4 (a no-treatment control group).










Experimental Procedures

Experimental procedures were applied to all four groups. Group 1 consisted of

assigned group participants that role-played a likely scenario that clients could encounter

in counseling. Assigned participants in group 1 arrived at predetermined times in the

counselor education department. Upon arrival, each participant in group 1 was greeted by

a graduate student, trained counselor and was given a packet. The packet contained the

following: instructions on how to do a role play, a role-play script illustrating the acting

content of a prospective counseling client, and two measures that were completed after

the role play was finished. The purpose of the role-play instructions were to help each

prospective student become more comfortable and knowledgeable with their assigned,

role-play task, since it was understood that not all students would be familiar with a role-

play exercise.

Next, each participant in group one read the standardized script of a role-play

provided in their packet. Once finished reading the script, each participant simulated a

real, counseling session with the counselor, a trained, graduate student. The role-play

lasted no longer than 10-15 minutes in length. A script of the role-play enacted by each

subject in group one is provided as appendix B. Upon completion of the role-play, each

participant in group one completed both measures provided in each packet.

Participants in group 2 met in the counselor education department at a

predetermined location and time. Group 2 consisted of assigned participants that

observed a counseling session on video. Upon arrival, each participant in group 2 was

presented with a packet of two measures that were completed after treatment. Each

participant was exposed to a video presentation of a counseling scenario that was role-









played by two counselor education graduate students. The video lasted approximately 10-

15 minutes in length. Upon completion of the video observation, each subject in group 2

completed the two measures provided in each packet. A script of the video is provided as

an appendix C to this study.

Participants in assigned group 3 also met at a predetermined location and time in

the counselor education department. Each student was given a packet with two measures

to be completed at the end of the experiment. Assigned participants to group 3 were

asked to read the counseling literature that was provided as a treatment; three counseling

scenarios were detailed in the literature, as well as a brochure, describing the basic

process and benefits to being a counseling client. Students in this group were asked to

complete a simple quiz consisting of five questions; the purpose of the quiz was to insure

that each subject reads the literature. The scenarios, the brochure, and the quiz are

detailed as appendices D, E, and F respectively. It took no longer than 30 minutes for

students to read the literature provided. Instructions were given in each packet, detailing

the steps of the paperwork to be completed. Participants in group consisted of a no-

treatment, control group. Each participant in group 4 was provided with a packet

consisting of a generic reading exercise and two measures. The no-treatment control

exercise consisted of students reading five pages from R.S. Sharf, Theories of

Counseling, 2000.

After completing both measures, participants then filled out a third measure

reflecting subject interest to seek follow-up counseling as a result of participation in this

study.









Data Collection Procedures

Data collection consisted of participants being randomly assigned to one of four-

treatment groups. Upon arriving at the assigned experimental location, each participant

received a packet with a code number on the upper right of the packet. The code number

of each packet served to identify each packet individually for purposes of data analysis

while protecting the confidentiality of each participant. Each packet consisted of a

consent form and two measures, the CSEBS, client self-efficacy behavior for counseling,

and the URICA, readiness for change instrument and a follow-up survey, to determine

interest in seeking follow-up counseling after treatment. The survey was a brief, ancillary

measure asking participants to rate whether or not they had an interest in seeking

counseling as a result of their participation in this study. Follow-up interest was the third

dependent variable in this study.

If subjects marked yes to having a desire to seek counseling as result of their

participation in this study, participants were then asked to quantify on a likert continuous

scale, from 1-5, their degree of interest in seeking counseling within the next year. The

rationale of the follow-up measure was to provide the researcher with additional data by

showing derivatives of any potential, longitudinal impact of the treatments. Since long-

term follow up of the research subjects on their prospective client self-efficacy and

readiness for change could not be monitored, it was thought that a brief measure

capturing any likely longitudinal effects between an additional third dependent variable

in analogue form, would strengthen the study in its final analysis.









Instrumentation

The CSEBS or client self-efficacy behavior scale measure (Longo; 1991) was

developed to assess a client's self-efficacy for counseling related tasks. In this study the

CSEBS was given to assess a prospective client's self-efficacy for counseling, or one's

belief in his/her capability that he/she can become a successful client. The CSEBS is a 20

item, self-report instrument that can be either administered individually or in a group

format. The alpha-coefficient (.91) of the measure (Longo, 1991) illustrates the

instrument's high reliability or internal consistency of measurement. Further, the high

alpha suggests that the measure is relatively stable and that participants remain uniform

regarding the measurement of client self-efficacy.

With regard to the measure's construct validity, the CSEBS was utilized to

measure client self-efficacy as one social-cognitive variable in the prediction of

counseling attrition (Longo, Lent, and Brown, 1992; Longo, 1991). In both studies a

discriminant analysis of variables related to counseling attrition was performed in order

to assess the structure coefficient of each variable measured. Six variables from gender to

motivation were summed and weighted to yield one variable, calculated as a discriminant

function. The discriminant function was statistically significant in predicting counseling

attrition between groups that had high attrition rates compared to low attrition rates.

Interestingly, the discriminant function in each study was most highly correlated (r = .91,

table 3; pg.451, Longo, Lent and Brown, 1992; r =.95, Longo, 1991) with self-efficacy as

measured by the CSEBS. Thus it can be argued that this high bivariate correlation

between the discriminant function and the CSEBS measure in the two studies above

provides additional credibility to the construct validity of the CSEBS instrument used in









this dissertation study.

To further strengthen the construct validity of the CSEBS measure, three experts

in self-efficacy and counseling research independently evaluated the instrument; all three

independently agreed that the measure's construct validity warranted its usage for future

research purposes. The experts consisted of Dr. Bob Lent, currently at the University of

Maryland. Dr. Lent is considered a national expert on counseling applications of self-

efficacy and social cognitive theory. Dr. Lent formerly served as the chairperson for

Danielle Longo, who initially developed the CSEBS measure in his dissertation in 1991,

at Michigan State. Dr. Lent approved the CSEBS measure for dissertation research

purposes. The second expert contacted was Dr. John Lyons, currently the director of

social science research and policy at Northwestern University. Dr. Lyons currently

teaches research and statistics in the counseling/psychology department at Northwestern

and is considered a national expert in statistics and research governing clinical outcomes

of managed care practices and public policy. Dr. Lyons has much expertise in the field of

self-efficacy and its role in counseling-related research. Lastly, Dr. Frank Pajares at

Emory University reviewed and approved the CSEBS measure for dissertation purposes.

Dr. Pajares is a distinguished professor and national expert on self-efficacy and its role in

social science and academic research. He has numerous, national publications on self-

efficacy.

The original University of Rhode Island Change Assessment Scale

(McConnaughy, DiClemente, Prochaska, and Velicer; 1989) consisted of a 24 and 32

item, self-report scale that assessed an individual's readiness for change prior to entering

counseling. The 32-item URICA scale was utilized in this dissertation study. Items on the









measure were developed for potential modification of any identified problem behavior.

The instrument can be administered individually or in a group format. The URICA

utilizes a 5-point likert-scale format in which subjects assess the degree to which they

agree or disagree with the presented items.

Regarding the construct validity of the instrument, four item subscales measure

stages of change in the counseling process: precontemplation, contemplation, action and

maintenance. A total of seven item scores for each subscale, with each item score ranging

from one to five, are added and then divided by seven to obtain a mean for each readiness

subscale. Contemplation, action, and maintenance subscale mean scores are then added

cumulatively to yield one score. The precontemplation subscale mean score is then

subtracted from the three subscale combined mean scores of the contemplation, action

and maintenance scales (C+A+M-P) to yield a secondary score to assess readiness for

change at entrance to counseling.

Initial psychometric properties of the instrument encouraged the utility of the

measure with a wide range of alcohol, dependent individuals. As Carbonari et al. (1996),

states, "further research supported a second-order readiness factor and also validated a

single continuous readiness scale constructed by combining subscale scores" (Pg. 2). As a

result, one combined 24-item measure was also constructed, composed of two

comparable 12-item readiness measures, ALCREADI-A, and the ALCREADI-B. These

two separate forms were combined into the 24-item URICA measure, known as

ALCREADI-AB, a cousin of the 32-item measure. For each 12-item version of measure

A and measure B, confirmatory factor analysis was conducted to fit the model with the

four manifest stage variables precontemplationn, contemplation, maintenance, action) into









a single factor of readiness for change. Each form of the measure is then correlated with

that factor to interpret the goodness of fit of the model with the theoretical model

(Carbonari et al., 1996).

The authors suggest that a very good fit is indicated for each scale with the model

proposed (ALCREADI-A, CFI = .960, GFI = .984; ALCREADI-B, CFI = .945, GFI =

.981). The CFI or confirmatory fit index, provides a statistic that adjusts for the normed

fit index (NFH), comparing the model fit to that of another model with the same data,

presuming independence of measured variables. A range of .9-.95 specifies a good fit.

The GFI or goodness of fit index, compares the model's data with that expected of a

theoretical model; further the GFI compares the ability of the model to reproduce the

variance-covariance matrix (generally speaking, the magnitude of strength and direction

between two measures) to no model at all. The correlations of the two separate versions,

A and B, of the URICA with the 32 item full measure lend further credibility to the

construct validity of the 24 item measure (A-B, r = .84; A-AB, r = .96; B-AB, r = .96).

The obtained alpha coefficients for each split half measure of the URICA,

respectively measured at (.8), and (.78), and the full measure, of (.89), suggest the

reliability of the instrument is relatively stable. The alpha coefficient for each subscale

documents the instrument's consistency as well; (.74) for the precontemplation scale,

(.79) for contemplation, (.815) for action, and (.738) for the maintenance stage

(Carbonari et al., 1996).

Data Analytic Procedures

A 2 x 4 ANOVA factorial design was applied to three separate models in order to

examine between variance between the two independent variables and the two dependent









variables. The first ANOVA model examined two independent variables, treatment type

(group 1, 2, 3, or 4) and gender, and their interaction, in predicting the first dependent

variable, total self-efficacy score for counseling. The second ANOVA model evaluated

treatment groups 1, 2, 3, and control group 4 and gender, and their interaction, in

predicting the second dependent variable, prospective client readiness for counseling.

Additionally, in the first two ANOVA models, the statistical main effects were examined

at the marginal means of the independent variable without the interaction term included.

The third ANOVA model examined the interaction effects of gender on treatment group

(1, 2, 3, 4) and gender and treatment separately in predicting willingness to follow-up

with counseling. The third model also investigated self-efficacy and readiness for

counseling separately in predicting follow-up to counseling. A chi-squared analysis and a

logistical regression analysis was performed in order to assess the statistical significance

of the variables in predicting post-treatment interest in counseling as a direct result of

subject participation in this study.

Since Bandura (1997) cites the mediation role of self-efficacy on gender, prior

performance, and anxiety (Miller and Pajares, 1994), a pathway analysis examined

whether or not self-efficacy revealed a statistically significant mediation effect on

treatment type and gender in predicting prospective client readiness as a function of

motivation for counseling. Path analyses by correlating treatment type to self-efficacy

and then self-efficacy with motivation, in comparison to correlations of gender with self-

efficacy and self-efficacy to motivation were also examined to illustrate possible

mediation pathway effects of self-efficacy on the variables studied. The mediational role

of self-efficacy on the interaction between treatment type and gender in predicating client









readiness was additionally analyzed as well.



Limitations of Study

This dissertation is an analogue study. As a result, it is limited in its external

validity (Heppner, 1989). Although those that volunteered for participation in the study

(majority being Caucasian, female, 18-22 age range) were randomly assigned to treatment

groups, the results of the study must be weighed against the relatively narrow definition of

a college-age population. Consequently, the reader's ability to apply the results to the

general population is limited. Further, the fact that student participants were identified as

prospective clients and not "real" clients reduces extrapolation and external validity of the

results to a true "client"-based population. However, the advantages of analogue research

are well known. By doing research in laboratory university settings, the internal validity of

the study is usually enhanced and tightened between the independent and dependent

variables due to greater experimental control over subjects and levels of independent

variables (Heppner, 1989). Another advantage to analogue research is that the researcher is

not overly concerned nor burdened with conflicts of interest and confidentiality that can

exist between the goals of the client and clinician (Kazdin, 1978). Third, analogue research

typically does not have the issues with client attrition that often can plague research in

clinical settings (Mennicke et al., 1988).

In addition, although the reliability and validity of the URICA measures is

relatively high, the original version was normalized against a substance abusing population,

quite different from the sample in this study. Although the authors of the URICA suggest

that the instrument is reliable and valid for measuring readiness for change of any problem






85


behavior, perhaps the results from this study are interpretable as more preliminary rather

than confirmatory of the measure's reliability and validity when administered in contexts

outside of a substance-abusing population. Finally, the CSEBS or the client self-efficacy

behavior scale was a novel measure and has only been used in three prior studies (Sutton,

1998; Longo, Lent and Brown, 1992; Longo, 1991).














CHAPTER 4
DATA ANALYSIS AND RESULTS

Summary and Chapter Overview

The purpose of this study was to assess through empirical investigation the relative

influence of a counseling role-play, a counseling video, and counseling literature on

prospective clients' self-efficacy and secondarily, readiness for change. Four different

ANOVA models were applied to analyze the data relevant to the eight hypotheses of the

study. The first ANOVA model analyzed the treatment interaction with gender in

predicting counseling self-efficacy and is applied to the first seven hypotheses of the

study. The second ANOVA model analyzed the effects of gender and treatment separately

on self-efficacy for counseling and corresponds to the first six hypotheses and hypothesis

eight of the study. The third ANOVA model evaluated the treatment effects on gender in

predicting readiness for counseling and corresponds to the first seven hypotheses. The

fourth ANOVA model examined the separate effects of treatment and gender in predicting

counseling readiness and corresponds to hypotheses one through six, and hypothesis

eight. Lastly, the fifth model of the study combined a chi-squared analysis and a logistical

regression procedure to detect statistical significance of either gender, treatment,

counseling readiness or self-efficacy in predicting post-test, follow-up interest to seek

counseling.

Data Collection and Response Rates

During the summer B term, 2002, approximately 400 students from seven different








undergraduate courses in the college of Education were sampled for this study. Of those

students sampled, all students were given a likert scale continuum (1-5) whereby

prospective subjects indicated their willingness to discuss a personal problem of any

nature in counseling. The rationale behind the use of the continuous scale was to

approximate real clients for the study as much as possible in order to enhance the external

validity of the results. Of those 400 students sampled, 185 students or 46% indicated a

three or higher on the survey and were selected for the study. After attrition, 120 students

actually participated and were then randomly assigned to one of four groups. Of those 120

students, 64 were female (53%) and 56 or (47%) were male. However, one subject within

the data set produced extreme values on both the motivation readiness score and self-

efficacy score and was deleted from the analysis to minimize possible confounding effects

of an outlier data point. As a result of that deletion, officially 119 subjects composed N or

the sample size. 55 males participated in the study with 14 in the role-play group, 14 in the

video group, 14 in the literature group and 13 in the control group. 64 females participated

in the study with 16 in the role-play group, 16 in the video group, 16 in the video group

and 16 in the control group. Results below in table 1 list the mean self-efficacy scores for

male and female participants in all four groups.









Table 1
Descriptive Statistics for Gender and Treatment with Counseling Self-Efficacy as the
Dependent Variable


Role Play


Video


Literature


Control


Grand SE Score


Male M 127.92 124.02 134.57 123.58 Mean
SD 25.39 27.25 20.75 20.43 128.83193


Female M 127.62 134.56 122.00 135.37 Std.Dev
SD 9.61 25.99 9.03 22.59 25.31139


Results below in table 2 provide the mean scores for gender and each treatment group

with counseling readiness score as the dependent variable.


Table 2
Descriptive Statistics for Gender and Treatment Group with Counseling Readiness Score
as the Dependent Variable


Role Play


Video


Literature


Control


Grand RScore


Male M 7.79 8.56 8.49 8.03 Mean
SD 2.78 1.44 1.65 2.33 8.74630


Female M 9.61 9.15 9.03 8.99 Std. Dev
SD 1.08 1.48 2.31 1.98 1.96419


Reliability Estimates for the CSEBS and URICA

Cronbach's alpha was applied to both instruments in order to assess the reliabilities

of each measure. Coefficient values range from 0 to 1, with 1 being a perfectly uniform

and consistent instrument. The value obtained for the CSEBS or client self-efficacy

behavior score (Longo, 1991) in this study was .92 and is similar to other reliability









findings previously reported (Sutton 1998; Longo et al., 1992). This finding indicates that

approximately 92 % of the total score variance from this measure is due to true score

variance and not random variance or measurement error. The Cronbach's alpha value

achieved for the URICA was .78 and is similar to other reliability estimates derived from

substance abuse populations (Carbonari et al., 1996). This figure indicates that 78% of the

total score variance is attributable to true score variance and not random variance or

measurement error.

Analysis Procedures

Data was analyzed for this study through the use of the SAS General Linear

Model (GLM) and SPSS. Four separate ANOVA models and a fifth logistic

regression/chi-squared model were run in order to test the specific eight hypotheses of the

study. All models are listed on the following page, in table 3. The first model designated

the total self-efficacy score as the dependent variable, with gender and treatment by

group (1, 2, 3) and their interaction, as separate input variables. The second model

designated the total self-efficacy score as the output variable. Gender and treatment were

analyzed separately as main effects. The third model reflected the total readiness score as

the dependent, output variable. The treatment interaction with gender and self-efficacy

were entered separately as independent, input variables. In the fourth model, gender,

treatment group, and self-efficacy were entered separately as input variables and the

readiness variable was the output, dependent variable. The fifth model examined the

influence of gender, treatment, and their interaction, along with self-efficacy and desire to

seek post-test counseling, through the use of a chi-squared analysis and logistic

regression procedure.









For purposes of assessing statistical significance, the type I error rate of .05 was

designated. A decision to accept or reject the specific null hypotheses was based on this

predetermined significance level. Source data are rounded to the nearest ten-thousandth.

The specific variables for the four ANOVA models and the fifth, chi-squared, logistic

regression follow-up model are designated in table 3.



Model 1

Results in table 4 illustrate the non-significant effect of gender on counseling self-

efficacy, F (1, 118) = .253, p >.05, with the significance value at .616; results also

indicate the non-significant treatment effect on counseling self-efficacy, F (3, 118) =

.030, p >.05 with the significance value at .993. Additional results reveal the non-

significant effect of the GT interaction on counseling self-efficacy, F (3, 118) = 1.45, P

>.05 with the significance value at .230. Thus, the results support the first seven null-

hypotheses, since no significant differences were found for the treatment by gender

interaction, (GT), or treatment separately, for total self-efficacy score as the dependent

variable.









Table 3
Variables Included in ANOVA models 1, 2, 3,4


ANOVA MODEL 1
Input Variables


Gender
Treatment


Role Play
Video
Literature
Gender Treatment Interaction

Output Variable Model 1
Total Self-Efficacy Score

ANOVA MODEL 3 A

Input Variables

Gender
Treatment
Role Play
Video
Literature
Gender Treatment Interaction
Self-Efficacy


ANOVA MODEL 2
Input Variables


Gender
Treatment


Role Play
Video
Literature


Output Variable Model 2
Total Self-Efficacy Score

NOVA MODEL 4

Input Variables

Gender
Treatment
Role Play
Video
Literature

Self-Efficacy


Output Variable Model 3
Readiness Score


Output Variable Model 4
Readiness Score


LOGISTICAL REGRESSION/ CHI-SQUARED ANALYSIS
MODEL 5
Input Variables

Gender
Treatment
Role Play
Video
Literature
Gender*Treatment Interaction
Total Self-Efficacy score
Total Counseling Readiness Score
Output Variable Model 5
Follow up interest to seek counseling




Full Text
APPENDIX A
INFORMED CONSENT
Dear Student:
I am a doctoral student in counselor education at the University of Florida. My supervisor of this research
project is James Archer, Jr. Ph.D., professor in the counselor education department. I am conducting a
research study to examine student attitudes toward counseling.
Participation in this research project involves the completion of two measures/questionnaires. You do not
have to answer any question you do not wish to answer. Your total participation should last about one hour.
Any inquiries regarding this study should be directed to the phone number and address of the principal
investigator below, the research supervisor or the UFIRB, University of Florida, Institutional Review
Board.
As part of this study, you may be asked to act in a counseling scenario, watch a counseling video, or read
literature on counseling. You also may be asked to complete a short quiz to ensure that you read and
understood the material.
To protect your confidentiality, a code number will be used to identify participants. The names of
participants will not be used in any fashion. There will be no monetary compensation for participation in
this study. There are no physical risks involved in this research. Benefits may include extra credit at no
more than 2% of your total grade, to be offered at the discretion of your instructor. Participation in the
counseling scenario, the viewing of the video or reading counseling literature may provide a minimal level
of anxiety and emotional discomfort.
Student counseling services can be provided by contacting the University Counseling Center at 392-1575.
If you have any questions about this research, please contact me at (352) 337-2971 or my research
supervisor, Dr. Jim Archer at (352) 392-0731, ext. 231; the address for both the principle investigator and
the research supervisor is 1215 Norman Hall; Box 117046; University of Florida, Gainesville, Florida;
32611. Questions or concerns about your rights pertaining to this study should be directed to the UFIRB
office, University of Florida, Box 112250, Gainesville, Florida, 32611, (352) 392-0433.
My signature below indicates that:
1. The nature and purpose of this research has been explained and that I have been given the
opportunity to ask any questions regarding my participation.
2. I understand that this investigation is used for educational purposes, which may include
publication; your identity will be kept confidential to the extent provided by law.
3. I understand that participation in this research study is voluntary and that I may withdraw my
consent at any time or discontinue participation in this study without consequence.
4. I understand that I will receive a copy of this informed consent form.
Signed:
Date:
121


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
AN EXAMINATION OF THE EFFECTS OF PRE-COUNSELING TREATMENT
STRATEGIES ON PROSPECTIVE CLIENT SELF-EFFICACY AND READINESS
FOR CHANGE IN COUNSELING
By
David Kent Cox
December 2002
Chairperson: James Archer, Jr.
Major Department: Counselor Education
In order that clients maximize the services offered to them, it is crucial that
counselors focus on methods of increasing client self-efficacy and motivation early in
counseling. Thus, the purpose of this study was to document the effectiveness of three
pre-counseling treatments on prospective client self-efficacy and motivation, as a
function of readiness for counseling. The majority of research on self-efficacy has
emerged from social-cognitive theory and contexts other than counseling. Further, much
of our understanding of motivation and readiness for counseling has its genesis in
substance abuse research. Studies examining both self-efficacy and motivation together
are often restricted to attrition. Therefore, empirical studies that link treatments on
improving prospective client self-efficacy and readiness to counseling appear warranted.
Empirical research focusing on these two important clinical variables can also be
viii


10
and persuasion. Verbal encouragement reflects the power of feedback on self-esteem
development and perceived competence as well (Daniels, 1997). Likewise, as positive
encouragement can support and bolster self-efficacy, so can negative feedback decrease
self-efficacy or perceived beliefs in ones capability to perform in a particular context
(Larson, 1998; Bandura, 1986).
The last theoretical source of self-efficacy development is emotional arousal. Such
states as mood, anxiety, and fatigue can certainly influence ones self-efficacy and its
development. Since people have the capacity to alter what they think, self-efficacy beliefs
have a powerful and reciprocal influence on thought patterns and subsequent emotional
stimulation. Social-cognitive theory (Bandura, 1986) suggests that people anticipate the
quality of their performance based upon how they feel prior to the event in question. In
other words, ones confidence in the moment is reflected in ones prospective anxiety
regarding what lies ahead. Calm emotion in anticipation of performance reflects
confidence. High anxiety and arousal illustrate lowered confidence and decreased self-
efficacy. Early research on self-efficacy generated studies to empirically document how
to increase self-efficacy to improve coping performance, in order to lower anxiety while
treating related disorders (phobias).
However, it is significant to note that the four sources of self-efficacy do not directly
link to and compose self-efficacy as a construct. Yet the manner in which an individual
processes, weighs, selects, and attends to the information generated from the four
theoretical sources of efficacy determines the application of ones self-efficacy toward a
similar, particular task in the future.
Social-cognitive theory (1986) was an extension and further application of social-


120
path analysis research has been done outside of counseling. Future path analyses
examining the mediating role of efficacy on readiness for counseling prior to initiating
treatment would be helpful in clarifying direct and indirect relationships between social-
cognitive variables during the assessment phase of counseling. Such studies would also
help to clarify theoretical distinctions and measurement issues between readiness and
motivation for counseling in general counseling populations apart from substance abusing
populations and studies specifically related to attrition.
In conclusion, this analogue, empirical study illustrates the crucial need for
counseling professionals to pay particular attention to efficacy beliefs about counseling
and client readiness to change early in their clinical assessment of client potential and
aptitude for counseling success. Specifically this study empirically validates and further
extends the importance of social-cognitive theory and its related variables, self-efficacy
and motivation, as a derivative of readiness for change among prospective clients seeking
counseling.


19
examined the comparative value of a mock interview as a role-play, compared to a
fifteen-minute counseling session on tape with sixty-seven students using hierarchical
regression to predict post-test counselor self-efficacy. Interestingly, those students that
perceived there counseling performance as below average after the role-play decreased
their counseling self-efficacy almost by one standard deviation below the mean. In
contrast, those students that perceived their role-plays as being successful scored just
one-half a standard deviation above the mean. Often used as an adjunct toward increasing
awareness of the counseling process, role-plays appear instrumental in enhancing self-
efficacy from the vantage of performance accomplishment (Johnson, 1989). Additionally,
the experiential aspects of simulating counseling interventions in a role-play context may
serve to highlight what students like and dislike about their respective counseling
performances. Also, this study reveals the importance of counseling faculty to remain
sensitive to student beliefs about their counseling performance (Larson, 1998).
The second theoretical concept that shapes the development of self-efficacy is
vicarious learning. Although not as influential on self-efficacy development as prior
experiences, vicarious learning from modeling appears particularly significant when
people have limited prior experience or underestimate their own competency to perform.
Schunk (1994) suggests that models geared toward social or peer explanations of
academic competency are particularly relevant in this regard. Peers often rate the
academic performance of others relative to their own personal standards of competency.
For instance, peers in school are strongly influenced by the effects of modeling,
especially if the rater perceives him/herself as being similar or inferior to the model while
exhibiting a strong, emotional attachment to the model (Schunk, 1994).


69
literature treatment group. It is expected that each participant will answer the quiz, after
he/she reads the brochure, counseling scenarios, and counseling narrative that are
presented in each respective packet.
Another measurement concern to be addressed in this study is illustrated in
Sullivan and Mahaliks (2000) empirical study examining the effectiveness of increasing
career self-efficacy for women. Due to the non-equivalency of treatment groups from
failure to randomly assign participants prior to initiation of treatment, treatment effects
were considered highly preliminary. Mennickes (1998) review of the counseling
research literature on attrition as its relates partially to motivation demonstrated that
many studies regarding attrition and lack of client motivation area are beset by problems
with internal validity, small sample sizes and measurement issues as well. Future research
that targets variables associated with attrition, such as self-efficacy and motivation to
change, with improvements in research design is recommended in the research literature.
Separating training effects from client motivation has been another concern in the
empirical literature. Duckro (1979) and LaTorre (1977) noted this specific confounding
influence was generally due to poor reliability of measurement. Thus, reliable
measurement of very specific, theoretical variables in counseling (self-efficacy and
motivation) is one partial remedy toward correcting the design issues previously noted in
the literature. Surprisingly, despite the application of training programs for increasing
self-efficacy and motivation among counseling students and clients in multiple contexts,
research in areas of general training and pre-treatment counseling methods have been
criticized for having many design issues and concerns regarding internal validity. In their
systematic review of the literature, Tinsley, Bowman and Ray (1988) noted that


5
design flaws that compromise the internal validity of the studies. For instance, Lent and
Maddux (1997) mention research designs on counseling-related self-efficacy that
historically employ correlational, quasi-experimental designs with small sample sizes
without random assignment of treatment subjects. As a result, treatment groups are non
equivalent prior to initiation of treatment. Therefore, it is nearly impossible to exclude the
potentially confounding effects of other variables that may produce spurious treatment
results. Lent and Maddux (1997) suggest the value in examining through experimentation
different means for modifying clinically important aspects of self-efficacy.
Although the majority of both self-efficacy and motivational research emerges from
contexts other than counseling, there is reason to believe that research on self-efficacy
and motivation has application to counseling. Clearly, empirical research that targets
client self-efficacy and motivation in counseling, with larger sample sizes, is needed.
Banduras work and the research line generated from applications of self-efficacy to other
contexts provide a broad theoretical and empirical foundation for this type of counseling
research.
Purpose of the Study
Thus, the purpose of this research study is to increase and extend the body of
theoretical and empirical knowledge of social-cognitive theory and two related variables,
self-efficacy and readiness for counseling, into the counseling domain. The effectiveness
of three pre-treatment strategies (counseling literature, video, role play) that may
potentially increase client self-efficacy and motivation, in comparison to a no treatment,
control group will be examined.
Different treatment interventions to increase self-efficacy and motivation have been


105
CHAPTER 5
DISCUSSION
In this study, the researcher examined the effects of three different treatment
methods on prospective client self-efficacy and readiness for counseling. The researcher
sought to extend the line of social-cognitive theory (Bandura, 1986), specifically
counseling self-efficacy, into counseling. A secondary goal of the study was to
empirically test treatments designed to improve a clients readiness for counseling, prior
to initiating counseling. A third goal was to determine the impact of any of the variables,
gender, treatment, readiness, and self-efficacy, on willingness to seek follow-treatment in
counseling as a result of subject participation in the study. In this chapter, a summary of
the study, a discussion of the results, the implications of the study for theory, research
and clinical practice, the studys limitations, and recommendations for future research
will be presented.
Summary
This empirical study applied social-cognitive theory and related constructs of self-
efficacy and motivation into the counseling domain. Client self-efficacy was
operationally defined as the belief that counseling can help the prospective client
successfully manage and persist through the counseling process, despite potential
hardship or emotional pain that can be encountered in counseling (Longo, Lent and
Brown, 1992). Prospective client readiness for counseling was defined as a prospective
client having the motivation or desire to enter into counseling, ready to identify any


43
4000-health professionals evaluated stage based, incremental treatments as very useful
and helpful with a majority of clients and patients. This information contrasts to the
typically quoted figure of 20% of clients that are thought of being capable of taking
immediate action toward behavioral change (Prochaska, 1998).
Perceiving motivation as a function of client readiness is relatively new in the
research literature. Isenhart (1997) suggests professionals traditionally perceived
motivation as a dichotomous construct. Either a client was motivated to change or not.
However, current research reflects theoretical considerations (Bandura, 1997; Miller,
1991; Prochaska, 1986; Deci and Ryan, 1985) that incorporate client motivation as
relative, existing on a continuum, and highly contextually dependent. For instance,
motivation in substance abuse populations often appears influenced by external variables
of family concerns, legal pressure, and environmental demands (Prochaska, 1992). As a
result, treatment staff presently considers readiness for change among a variety of
dimensions. Current research on motivation reflects the understanding that motivation
has multiple meaning and varies with context.
Isenharts (1997) research provides an example of how motivation is measured as a
process of change with multiple meaning. Pretreatment readiness for change was assessed
in over 100 substance-abusing males in the Navy by using a modified version of the
SOCRATES scale, an acronym for stages of change readiness and treatment eagerness
scale. Scores were correlated with four variables: age, education, diagnostic criteria met,
and Q-F measures, or quantity and frequency of drinking. Testing for pretreatment
readiness for change yielded three measures of outcome: high action scores revealed no
alcohol use during one year post treatment period, high determination scores showed


58
counseling students similar in training and age may be due to more realistic appraisals of
efficacy beliefs and feedback generated from peers in the role-play in contrast to
feedback offered from a perceived expert in counseling (Larson, 1998; Bandura, 1997;
Landis and Young, 1994).
Traditionally, it was believed that a primary reason for unsuccessful outcomes in
counseling was due to poor or low client expectations of the counseling process (Tinsley,
1980; Garfield, 1978; Frank, 1968.) In an attempt to rectify such clinical concerns
regarding client expectations of counseling, it was thought that efforts to concentrate
learning for clients regarding the expected roles of both counselor and client might be one
partial remedy at addressing this problem. Consequently, much of the early research on
manipulation strategies designed at improving pre-counseling performance targeted client
expectations in counseling. As a result, initial role-induction interviews were developed
to help clients realistically appraise their expectations of the counseling process.
A prospective role-play reflects the assumption that contact between the counselor
and client prior to the initiation of counseling helps prepare the client for the client role.
Many researchers have examined the effectiveness of role-plays designed to increase
client expectations of counseling, but with many of the same methodological concerns as
mentioned previously. An initial instrument that records a clients initial expectations for
counseling after a precounseling interview is typically conducted in role-play studies. A
follow-up measure is then given afterwards (Mac, 1973; Klepac, 1970; Galinsky, 1971;
Appel, 1959).
Variations on formats of role-induction procedures include Kaisers (1971)
lengthening of the initial interview to two sessions to determine the impact of role-play


104
efficacy remained significant in predicting follow-up when counseling readiness was
added to model 5, the treatment effect became non-significant when readiness was added,
thereby demonstrating the mediating effect of readiness or motivation for counseling on
treatment, in seeking follow-up counseling.


149
Ray, Dee. (September 2000). Effectiveness of group supervision versus combined and
individual supervision. Counselor Education and Supervision, 40,1,19-30.
Rest, J., Narvaez, D., Bebeau, M., Thoma, S. (December, 1999). A neo-Kohlbergian
approach; The DIT and schema theory. Educational Psychology Review, 11, 4, 291-324.
Rotter, J.B. (1954). Social learning and clinical psychology. New York: Prentice Hall.
Saitz, R., Sullivan, L. and Samet, J. (2000). Training community-based clinicians in
screening and brief intervention for substance abuse problems: Translating evidence into
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Schaub, M. and Tokar, D. (Spring, 1999). Patterns of Expectations about Counseling:
Relations to the Five-Factor Model of Personality. Journal of Counseling and
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Scharf, R.S. (2000). Theories of Psychotherapy and Counseling: Concepts and Cases.
(2nd ed.). Pacific Grove, CA. Brooks/Cole.
Schunk, D.H. (1994). Goal setting and self-efficacy during self-regulated learning.
Educational Psychologist. 25.71,71 -86.
Schwartz, L. (1996). The effects of a goal-setting instructional intervention on
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International, 57, (3-A), 1020.
Seese, C. (1998). The effects of counseling techniques on perceptions of teaching
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University. Microfilms International, 58, (7-B), 3953.
Sexton, T. (1996). The relevance of counseling outcome research: Current trends and
practical implications. Journal of Counseling and Development, 74. 590-600.
Shanklin, A. (1995). The development of a role-induction procedure for novice
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Shaw, D. (1985). Pretraining clients in specific counseling communication skills. Journal
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Shelton, D. and Mallinckrodt, B. (1991). Test Anxiety, locus of control, and self-efficacy
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Sherer, M. and Maddux, J. (1982). The Self-Efficacy Scale: Construction and
Validation. Psychological Reports, 51. 663-671.


APPENDIX I
ROLE-PLAY INSTRUCTIONS
Role-playing is an educational activity in which students assume the role of another
person and act out that specific role. Role-plays are designed to promote empathy and
understanding of others. Specifically, you will have the unique experience of acting out a
client role in counseling to further your understanding of what it might be like to be a
counseling client, seeking the benefits of counseling. Recall, you are seeking counseling to
help you process and resolve the personal issues mentioned in your current life story.
It is important to act out your counseling client role in a manner that makes you feel
the most comfortable while being as realistic as possible. Remember, there are no right or
wrong answers; just try to get into a free space in which you feel somewhat comfortable
playing out the role of the person in the scenario. What part of the story do you connect
with the most? For instance, what is it like for you to be 20 years old? If so, do you wish
you were older or younger than 20? Or what part of the story do you identify with the
most? Your grandmother, your father, mother, or your friends? Try to identify the part of
the story that you connect with the most, and act out that part, exploring ways counseling
could help you in this area of your life.
Simply try to get into the experience of this individual from the role-play script
provided. Try to relax and look at this as a learning experience; be imaginative, play with
the role. Think and feel how you might act if you were actually that person, in that
situation, seeking counseling today. Thank you for your participation in this study.
135


62
exactly how various role-plays positively influence the client once counseling begins
(Friedlander and Kaul, 1983). Certainly, role-induction procedures can experimentally
manipulate client experiences, verbal encouragement, vicarious learning, and reductions
in emotional arousal. The use of a role-play as one treatment strategy in this study will
simulate a prospective counseling experience designed to improve prospective client self-
efficacy and motivation to change while derived theoretically from self-efficacy
components (Bandura, 1997; 1986; 1977).
Counseling Literature
Verbal interventions vary in their experimental application although they are less
likely to be utilized than either a video or role-play as a pre-counseling, treatment
method. The majority of verbal interventions appear as instructions, pamphlets,
brochures, reading counseling vignettes, and/or narratives. Such strategies have typically
been explored in the counseling literature to increase client expectations of the counseling
process.
Gibson et al. (1989) noted the effectiveness of utilizing brochures in brief
counseling to reduce the AIDS risk among intravenous drug users and their sexual
partners. Cook et al. (1991) demonstrated the utility of literature in the form of a
brochure in an osteoporosis patient education program. The literature provided was
considered educational and one component of a workshop designed to help patients cope
with the initial screening and prospective diagnosis of osteoporosis.
Donovan (1998) examined the relationship between potential and professional
ethical violations of psychologists to client perception of counselor expertise by using a
written intervention. Subjects attended simulated counseling sessions in which counselors


31
relation to ones environment, self, and actions, and represents an extension of Banduras
original social-learning theory (Bandura, 1977). These three aspects of personal agency
operate in complex, reciprocal fashion to contribute to individual, self-efficacy
development. Social-cognitive theory (Bandura, 1997; 1986) delineates personal agency
as an extension of ones self-efficacy beliefs and also includes affective (anxiety),
cognitive (self-efficacy), and motivational processes (goal-directed behavior) that arise
from personal, behavioral and environmental sources.
Bandura (1986) suggests that affective, cognitive and motivational processes are self-
determining influences that allow for human beings to adapt to changing circumstances
and complicated environments. Specifically, personal agency includes self-efficacy and
its precepts (choices made, selection and initiation of behavior, effort expenditure),
outcome expectations (considered anticipatory in nature), personal goals (motivational in
essence), cognitive and affective processes, and lastly, self-evaluation as an index of
emotional arousal. But it is the interactional and reciprocal nature between ones self,
ones environment and ones actions that defines personal agency.
Personal agency is an important component of counseling training (Larson 1998; Lent
and Maddux 1997) and is composed of counseling related knowledge, counseling self-
efficacy, outcome expectations, cognitive processing, affective processing, and self-
evaluation. Research in counselor training related to personal agency illustrates how
counselors perceptions of their training impacts the quality of their counseling
experiences and overall personal, agentic development. In applying counselor training to
counseling self-efficacy development (Larson, 1998), counselor educators evaluate the
extent to which they are able to improve student personal agency related to clinical


25
dimension refers to the difficulty of task. For instance, some people only feel efficacious
in completing very demanding tasks, others if the task is easy. The strength component to
efficacy refers to the effort expended for task completion. High dimensions of effort are
associated with high strength efficacy; low aspects of efficacy, low strength.
Generality of efficacy refers to the range of application of the construct, which
theoretically, is specified to context. In other words, students with high reading self-
efficacy do not necessarily exhibit high math self-efficacy. Thus, Bandura (1986)
hypothesized that an individuals variance in self-efficacy would be attributable to
differences in levels, strength and generality with regard to specific tasks. Although some
generalizability of self-efficacy to various contexts has been seen, the discriminant
validity of the construct supports its task-specific, theoretical nature.
The discriminant validity of the construct (Longo, Lent and Brown 1992; Bandura,
1986) illustrates that the concept of self-efficacy is task specific regarding context, and
not a global personality trait. As a result, the construct appears mutable and relative,
which may account for its wide application in the research literature (Bandura; 1997).
Further, the task-specific nature of self-efficacy partially accounts for why the construct
contributes more to behavioral change than other theoretical precepts (Longo, Lent and
Brown, 1992; Longo, 1991; Bandura, 1977) inherent within social-cognitive theory
(Bandura, 1986). For instance, Longo, Lent and Brown (1992) used regression techniques
to evaluate which counseling related variables are most likely to correlate with
engagement to the counseling process and persistence in session, in order to understand
how to minimize attrition rates in university counseling centers. Utilizing a sample size of
139 from a Midwestern university counseling center, these authors found that client self-


12
the counseling research literature on personal agency and its determinants in behavior
targets a counselors personal agency, not the client. Larson (1998) reflects that
Banduras definition of operative efficacy would include the counselors ability to
simultaneously understand ones person, actions and environment, to achieve high levels
of counseling performance. One would infer that similar skills for clients would be
necessary to achieve a similar performance result. In fact, Bandura defines operative
efficacy specifically as continuously improvising multiple sub skills to manage ever
changing circumstances, most of which contain ambiguous, unpredictable, and often
stressful elements (Larson, 1998 pg. 237). Similarly, a clients increased self-efficacy
from personal agency determinants would improve tolerance for the inherent ambiguity,
unpredictability and stress encountered for clients in counseling too.
With further delineation and expansion of the construct over the last twenty-five
years, research on self-efficacy has increased. Relatedly, self-efficacy and its correlates
drive outcome research in multiple and diverse areas, such as optimal health, self-efficacy
and its role in dysfunctional relationships, the psychological adjustment to novelty,
smoking cessation, goal achievement and student motivation in mathematics, athletic
performance, and dietary adherence (Burke, 1998; Lent and Maddux, 1992). However,
regarding client attributes of self-efficacy in counseling research, Larson (1998) suggests
very little attention has been given to this area within the counseling self-efficacy
literature (pg. 243).
Currently, the use of self-efficacy research has practical application and treatment
implications for mental health professionals in a managed care environment. One
challenge that counselors encounter is how to help clients in the recovery and adjustment


109
Certainly this finding is expected, since participants believing that counseling can help
them would be more motivated and ready to seek counseling prior to treatment. In
addition, the partial correlation calculated between counseling self-efficacy and
readiness, controlling for the effects of gender and treatment was calculated at .30. This
correlation of .30 demonstrates the moderate to low strength of relationship between self-
efficacy and readiness in this study. One interpretation of this result is that since
treatment and gender were non-significant in their interaction in predicting prospective
counseling readiness, then controlling for the effects of gender and treatment did little to
strengthen the correlated relationship between self-efficacy and readiness. Another
possibility is that the URICA instrument is designed to tap client readiness for change
prior to counseling. In this study, it was used to evaluate readiness for pre-counseling
treatment not actual counseling treatment. Since the instrument was constructed for
clinical settings and not with prospective clients, perhaps this explains the lower than
expected correlation between readiness and efficacy.
The fifth model utilized a logistical regression and chi-squared procedure to
evaluate the influence of gender, treatment, self-efficacy and readiness in predicting
follow-up. After completing the treatments, all participants in the four groups were
surveyed and asked to rate whether or not they would seek counseling due to their
participation in the study. Thus, the fourth general question of the study asked whether
any of the variables of the study, gender, treatment, self-efficacy or readiness for
counseling, would significantly predict follow-up counseling. Gender was the only
variable not significant in predicting follow-up.
86 out of 119 or (72%) said yes to having a desire to seek follow-up counseling.


37
determination and internal sources.
Another construct that highlights how motivation is researched is cognitive
dissonance. Festingers (1957) research (as cited in Brehm, 1976) revealed two important
themes on cognitive sources of motivation. One, that a person can entertain two mutually
incompatible ideas for a brief period. Two, as a result of the dissonance generated from
conflicted ideation, one is likely to modify a given behavior and the consequent thoughts
around the behavior, to reduce the dissonance generated. However, Festinger (1957) did
not predict that one would be successful in producing alternatives to dissonance that are
interpreted as more internally satisfying. But cognitive dissonance research does suggest
that an individual will be more motivated in order to reduce the generated dissonance
resulting from conflicting ideation. Cognitive dissonance anticipates post-modem
practices and research, as well as motivational interviewing (Miller, 1991).
The implications of the relationship between cognitive dissonance and motivational
research in counseling are notable. Millers original ideas on motivational interviewing
(1983, as cited in Miller, 1991) were extended from Festingers (1957) early line of
motivation research. Miller (1983) suggested that one method of interpreting cognitive
dissonance is to empirically evaluate present client functioning in contrast to ideal future
functioning. Thus, construction and assessment of a cost-benefit analysis links a clients
present behavior to future goals. Millers research (1991) states that incongruity between
behavior and goals can be predictive of client motivation to change. Therefore, the goal
of motivational interviewing (Miller, 1991) is to motivate the client to change by
amplifying or increasing the tension around the cognitive dissonance until the attachment
to unwanted, present behavior is attenuated. Driving this assumption of motivational


and to Beverly Buckley for her ideas and help regarding the graphic design of my
literature treatment group.
Special thanks also go to Dr. James Algina, whose time, patience, willingness to
help and classroom instruction served me tremendously with the rigor of statistics while
shaping my thinking as a scientific researcher. Special thanks also go to former
professors Dr. J. Walter Weingart at Whitman College, Dr. John Meany, Seattle
University, and Dr. Sonny Cytrynbaum and Dr. John Lyons at Northwestern University,
who were all instrumental in promoting my early academic development regarding
improved study habits, critical thinking and overall, scholastic excellence.
Very special thanks go to personal and deep friend, Dr. Mark Gignac, whose
shared love of Eastern philosophy, Rumi, spirituality, psychology, and the spacious
questions of the cosmos helped keep me true and focused to what really matters. And
special thanks go to friend William Corley, whose academic excellence during my high
school years in Seattle and college days at Whitman served to model greater scholarship
in myself. I thank Bryan Robinson for his great friendship over the years while diverting
me away from my studies, toward talk of hoops, the Lakers and MJ. And I thank Jim and
Diana for putting up with me for nine months while putting me up at their residence
while traveling to Chicago to finish my masters at Northwestern.
Lastly, with special love to my mother, whose unconditional love and support
over the years has been wonderful. We go way back Mom. And to my father, who
indirectly showed me how important it is for generations to improve, how critical it is to
become a good father and husband, how never to quit, and how true that if we imagine,
like John Lennon, that the world is one, that in the end, all we need is love.
IV


8
Background of the Problem
Additionally, Bandura (1997, 1986, 1977) suggests that many psychological
processes are governed by self-efficacy and its related theoretical precepts of motivation,
goal achievement, and outcome expectations. Self-efficacy and its precepts are embedded
within larger theoretical frames, notably social-learning theory (Bandura, 1977; Miller
and Dollard, 1941) and social-cognitive theory (Bandura, 1986). These theories delineate
the influence of social observation and modeling on human learning, specifically
examining the role of self-efficacy as one cognitive variable in the learning of new
behaviors.
Counseling research on self-efficacy (Bandura, 1977) traditionally targeted the role of
self-efficacy to anxiety, anxiety related disorders such as phobias (agoraphobias, snake
phobias), and how they were developed and treated. Historically, avoidant behavior was
explained by an anxiety drive (Freud, 1961). It was believed that autonomic arousal and
its subsequent anxiety motivated individuals to specifically avoid the behavior that
manifested the original impulse. However, this premise was later challenged by
empirical research documenting the role of perceived efficacy in predicting outcome
performance, independent of anticipatory anxiety. Williams, Dooseman and Kleinfield
(1984, in Bandura, 1997, pg. 327) noted the specific role of perceived coping efficacy on
agoraphobics who received treatment of guided mastery vs. exposure. Williams and
Rapaport (1983, in Bandura, 1997, pg. 325) extended the influence of perceived coping
on outcome by illustrating the effect of coping efficacy on coping skills when
anticipatory anxiety was controlled. Thus, as a result of early research on coping and
anxiety (Bandura, 1986, 1977), Bandura included emotional states in influencing self-


24
related to ones persistence or motivation with finishing a given task but are considered
secondary in importance to efficacy expectations toward the initiation of a behavior.
However, due to the closeness of theoretical relationship between self-efficacy and
outcome expectations, operationally separating the two constructs has been challenging.
Maddux and Barnes (1984) highlighted how other authors of studies have specified
clearly the definition of each construct regarding outcome research. Others suggest
separating the two constructs to develop measures and instruments that reflect their
theoretical differentiation and that subjects can respond to differentially (pg. 13; in
Manning and Wright, 1983, as cited in Maddux and Barnes, 1984).
Bandura (1997) established that operational changes of self-efficacy are separate from
other related constructs in the literature. Further, self-efficacy alone is a powerful
predictor of outcome (Longo, Lent and Brown, 1992; Longo, 1991), above and beyond
that of outcome expectations. In fact, Banduras (1997; 1986) numerous empirical
analyses on the construct supports the integral role of self-efficacy expectations
(Bandura, Reese and Adams, 1982) as a viable theoretical extension of self-efficacy
independent of other similar constructs inherent within personal agency theory (Bandura;
1997). For instance, Bandura et al. (1982) demonstrated the role of efficacy expectations
on fear arousal and coping behavior on 20 selected snake phobics. The hypothesis that
fear arousal is largely a derivative of perceived coping inefficacy and ones low
expectations was generally supported by the results as subjects that tested high in blood
pressure elevation tended to be less efficacious in their coping.
Bandura (1986) extended the theoretical definition and complexity of self-efficacy
by suggesting that self-efficacy varies in level, strength, and generality. The level


79
Instrumentation
The CSEBS or client self-efficacy behavior scale measure (Longo; 1991) was
developed to assess a clients self-efficacy for counseling related tasks. In this study the
CSEBS was given to assess a prospective clients self-efficacy for counseling, or ones
belief in his/her capability that he/she can become a successful client. The CSEBS is a 20
item, self-report instrument that can be either administered individually or in a group
format. The alpha-coefficient (.91) of the measure (Longo, 1991) illustrates the
instruments high reliability or internal consistency of measurement. Further, the high
alpha suggests that the measure is relatively stable and that participants remain uniform
regarding the measurement of client self-efficacy.
With regard to the measures construct validity, the CSEBS was utilized to
measure client self-efficacy as one social-cognitive variable in the prediction of
counseling attrition (Longo, Lent, and Brown, 1992; Longo, 1991). In both studies a
discriminant analysis of variables related to counseling attrition was performed in order
to assess the structure coefficient of each variable measured. Six variables from gender to
motivation were summed and weighted to yield one variable, calculated as a discriminant
function. The discriminant function was statistically significant in predicting counseling
attrition between groups that had high attrition rates compared to low attrition rates.
Interestingly, the discriminant function in each study was most highly correlated (r = .91,
table 3; pg.451, Longo, Lent and Brown, 1992; r =.95, Longo, 1991) with self-efficacy as
measured by the CSEBS. Thus it can be argued that this high bivariate correlation
between the discriminant function and the CSEBS measure in the two studies above
provides additional credibility to the construct validity of the CSEBS instrument used in


42
Readiness and Treatment Eagerness Scale (Isenhart, 1997; Carbonari, 1996). In fact, both
these instruments have confirmed the theoretical predictions of Prochaksas (1982) stage
model of change with smoking clients. In a 1992 study with a sample size of 570,
Prochaska showed that clients that remained abstinent from smoking over eighteen
months were those clients most likely to be measured in maintenance and action stages of
change, not precontemplation.
Another researcher that has examined the matching of treatment type to client
readiness for change in counseling is DiClemente (1990). DiClemente (1990) used the
URICA measure (change assessment instrument) to evaluate 224 adults entering alcohol
outpatient treatment. Participant scores on the precontemplation, contemplation, action
and maintenance clusters yielded very distinct scores on variables of benefits to drinking
(social, mental, relational), style of drinking (gregarious or loner), consequences to
drinking (loss of control, marital conflict), and concerns with drinking (seeking help,
general worry). Thus, it was concluded that cluster analytic techniques designed to isolate
treatment readiness within each stage of change is consistent with the theoretical and
predictive power of Prochaskas stage change model (DiClemente and Hughes, 1990).
Another stage-change treatment strategy revealed in the research literature is to
provide realistic goals for brief meetings with clients at each interval of change
(Prochaska, 1992). For instance, Prochaska (1992) suggests that the results of some
longitudinal studies illustrate that if clients can move one stage in one month, often they
are more likely to move and progress through a full treatment regimen in six months
time. In fact, when looking at the empirical literature collectively on stage models applied
to medical and counseling related treatment, Prochaksa (1998) maintained that over


CHAPTER 2
LITERATURE REVIEW
In this chapter, research literature related to client self-efficacy and motivation for
counseling will be examined. In addition, general training strategies and specific pre
counseling treatment methods designed to increase client self-efficacy and motivation
that support the hypotheses of the study, will be reviewed. The purpose of this review is
to integrate different lines of research literature that validate the usage of a counseling
role-play, counseling video, and counseling literature as useful pre-counseling treatment
strategies to increase prospective client self-efficacy and motivation to change for
counseling.
Self-Efficacy
The majority of self-efficacy research targets variables on student achievement in
learning. Studies in these areas include investigations of self-efficacy and math
achievement (Pajares and Miller, 1994; Luzzo, 1994); the role of goal setting on
achievement and perception of self-efficacy in inner city children (Paslay, 1996); self-
efficacy interventions for self-regulated learning (Schwartz 1996); the effects of self-
efficacy interventions on math and science, career interests (Luzzo, 1999); and the role of
modeling on self-efficacy development (Schunk, 1994). McWhirter (2000) examined the
effects of high school career education on self-efficacy and other social cognitive
variables. Other research on self-efficacy includes the role of self-efficacy on athletic
16


95
significant, t, (1, 118) = 3.383, p <. 05 at .001. The fact that gender is significant rejects
the eighth null hypothesis of the study, since there is a statistically significant association
between gender and total readiness for counseling score.
Table 10
2x4 ANOVA Model without the Interaction Term, with Self-Efficacy Score as the
Independent Variable, and Counseling Readiness as the Dependent Variable
Unstandardized
Coefficients
Standardized
Coefficients
Model
B
Std. Error
Beta
T
Sig.
Constant
5.085
.952
5.341
.000
Gender
.340
.236
2.716
.008*
Role Play
.924
.482
.061
.569
.571
Video
.274
.482
.076
.714
All
Literature
.344
.482
.063
.586
.559
Self-Efficacy
.283
2.280E-02
.007
.294
3.383
.001*
*p < .05.
Model 5
Frequency results below in table 11 illustrate greater differences between those
subjects who indicated yes to no in seeking follow-up counseling in all three-treatment
groups in comparison to the no-treatment, control group.
Table 11
Frequency results for follow up treatment by group
Follow Up
Treatment Group
Total
1
Role Play
2
Video
3
Literature
4
Control
N
5
7
7
14
33
Y
25
23
23
15
86
Total
30
30
30
29
119


76
Experimental Procedures
Experimental procedures were applied to all four groups. Group 1 consisted of
assigned group participants that role-played a likely scenario that clients could encounter
in counseling. Assigned participants in group 1 arrived at predetermined times in the
counselor education department. Upon arrival, each participant in group 1 was greeted by
a graduate student, trained counselor and was given a packet. The packet contained the
following: instructions on how to do a role play, a role-play script illustrating the acting
content of a prospective counseling client, and two measures that were completed after
the role play was finished. The purpose of the role-play instructions were to help each
prospective student become more comfortable and knowledgeable with their assigned,
role-play task, since it was understood that not all students would be familiar with a role-
play exercise.
Next, each participant in group one read the standardized script of a role-play
provided in their packet. Once finished reading the script, each participant simulated a
real, counseling session with the counselor, a trained, graduate student. The role-play
lasted no longer than 10-15 minutes in length. A script of the role-play enacted by each
subject in group one is provided as appendix B. Upon completion of the role-play, each
participant in group one completed both measures provided in each packet.
Participants in group 2 met in the counselor education department at a
predetermined location and time. Group 2 consisted of assigned participants that
observed a counseling session on video. Upon arrival, each participant in group 2 was
presented with a packet of two measures that were completed after treatment. Each
participant was exposed to a video presentation of a counseling scenario that was role-


11
learning theory. Bandura (1977) incorporated both interpersonal and intrapersonal
variables into explanations of human learning in a variety of contexts. Further, self-
efficacy was explicated as a cognitive variable within the larger construct of personal
agency and social-cognitive theory (Bandura, 1986). Fundamentally, social-cognitive
theory (Bandura 1986) predicts that people behave in ways that are consistent with their
belief systems. The theory suggests that behavior is more easily influenced and driven by
peoples beliefs about their capabilities than personal knowledge and skills alone; thus,
changes in ones beliefs are a powerful predictor of the selection, initiation, persistence
and maintenance of a selected behavior. Therefore, theoretically speaking, if counseling
professionals wish to change the behavior of a given client, the belief system of the client
about his/her ability to become a successful client must first be altered. Pajares and Miller
(1994) conclude by suggesting that if counseling interventions are needed to the degree in
which they change targeted behaviors, than interventions must be applied that target the
belief system of the client as well.
In addition, social-cognitive theory (Bandura, 1986) describes personal agency as an
extension of ones self-efficacy while including affective, cognitive, and motivational
components that manifest from both interpersonal and intrapsychic sources. Personal
agency is one factor that helps explain the interactional nature between ones self, ones
environment and ones actions. These three contexts and their interaction with each other
are collectively referred to as triadic, reciprocal causation within social-cognitive theory
(1986).
Counseling has personal, behavioral, and environmental influences that interact in a
recursive fashion to govern a clients personal agency as well. Yet interestingly, most of


110
However, neither gender nor the interaction between treatment and gender were
significant in prediction of follow-up. Yet treatment alone was significant on those likely
to seek follow-up counseling, with p< .05, p = .0373. One interpretation is that any of the
treatments had some impact on prospective clients desire to seek follow-up counseling
as a result of their participation in the study, beyond the control group and independent of
gender. Such results would support the prior contention that gender tends to produce
mixed results in different studies. In addition, it appears that any of the three treatments
when applied to prospective clients already moderately high in readiness and efficacy had
a significant effect in predicting likelihood to seek post-test counseling.
Each of the treatment groups were significant, with treatment group 1, role play,
the most significant of any of the three treatments, p< .05, p =. 0117. Treatment group 2
(video) was significant in predicting follow-up desire for counseling treatment, with p<
.05, p =. 0474. Treatment group three (counseling literature) was significant, with p <. 05,
p= .0474. One possibility is that the role-play treatment simulates the experiential and
affective components of the counseling relationship more directly than the video or
literature treatment, although those treatments as well were significant and equal in their
treatment effect, beyond the control group.
Readiness for counseling also was significant regarding follow-up, with readiness
score, pc. 05, .0001. Readiness for counseling mediated the treatment effect on follow
up, rendering treatment non-significant. When readiness score for counseling was entered
into the fifth model, treatment became non-significant, with p >.05, p = .0729. One
interpretation is that high scores on readiness or motivation for prospective clients
entering pre-counseling treatments may override the impact of treatment in predicting


Specific Pre-Counseling Treatment Methods 54
Videotape in Counseling 54
Role-Plays 57
Counseling Literature 62
Conclusion 64
3 METHODOLOGY 71
Statement of Purpose 71
Hypotheses 71
Delineation of Relevant Variables 73
Dependent Variables 73
Independent Variables 73
Population 74
Sampling Procedures 74
Experimental Procedures 76
Data Collection Procedures 78
Instrumentation 78
CSEBS 78
URICA 79
Data Analytic Procedures 82
Limitations of the Study 84
4 DATA ANALYSIS AND RESULTS 86
Summary and Chapter Overview 86
Data Collection and Response Rates 86
Descriptive Data 88
Reliability Estimates for CSEBS and URICA 86
Analysis Procedures 89
Results of Hypotheses Tests 100
Summary 102
5 DISCUSSION 105
Summary 105
Discussion of Results 106
Theoretical Implications of the Study 111
Clinical Implications of the Study 113
Limitations of the Study 115
Research Implications 118
Future Recommendations for Research 118
Conclusion 120
APPENDIX 121
A INFORMED CONSENT 121
B ROLE-PLAY SCRIPT 122
C VIDEO SCRIPT OF ROLE-PLAY 123
vi


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.
M^fshall Knudson
(djunct Assistant Professor
of Counselor Education
This dissertation was submitted to the Graduate Faculty of the College of
Education and to the Graduate School and was accepted as partial fulfillment of the
requirements for the degree of Doctor of Philosophy.
Dean, Graduate School


118
Research Implications
Implications for future research in this area illustrate the need for similar studies
with greater sample sizes, different models, and modifications in design. For example, the
use of a pre-test incorporated as the covariate into an ANCOVA model would increase
statistical power beyond an ANOVA model by enhancing detection of significance
between treatments and gender in the prediction of dependent variables.
Daniels (1997) empirical study illustrates the increase in power provided by an
ANCOVA model to detect similar treatment effects, with a sample size of only forty-five.
In that study, prepracticum counseling students were randomly assigned to two
counseling, role-play groups. After performing the role-play, one group was given
positive feedback regarding their performance; the second group was given negative
feedback about their performance. With three covariates controlling for pretest anxiety,
self-evaluation, and counseling self-efficacy, counseling students from the first group that
received positive feedback on performance demonstrated much higher scores on post-test
counseling self-efficacy scores. Not only do these results demonstrate the influence of
feedback on self-efficacy but this study also reveals how much more statistical power is
provided to detect treatment effects with an ANCOVA model.
Future Recommendations for Research
Research directions from this study are twofold. One, future replication of this
study is warranted with greater sample size and data analysis incorporated into an
ANCOVA model. Such a model could incorporate pretest results as a grand mean on the
covariate between all treatments groups and the control group. Incorporation of the
covariate controls for both individual and group differences prior to treatment while also


88
Table 1
Descriptive Statistics for Gender and Treatment with Counseling Self-Efficacy as the
Dependent Variable
Role Play
Video
Literature
Control
Grand SE Score
Male
M
127.92
124.02
134.57
123.58
Mean
SD
25.39
27.25
20.75
20.43
128.83193
Female
M
127.62
134.56
122.00
135.37
Std. Dev
SD
9.61
25.99
9.03
22.59
25.31139
Results below in table 2 provide the mean scores for gender and each treatment group
with counseling readiness score as the dependent variable.
Table 2
Descriptive Statistics for Gender and Treatment Group with Counseling Readiness Score
as the Dependent Variable
Role Play
Video
Literature
Control
Grand RScore
Male
M
7.79
8.56
8.49
8.03
Mean
SD
2.78
1.44
1.65
2.33
8.74630
Female
M
9.61
9.15
9.03
8.99
Std. Dev
SD
1.08
1.48
2.31
1.98
1.96419
Reliability Estimates for the CSEBS and URICA
Cronbachs alpha was applied to both instruments in order to assess the reliabilities
of each measure. Coefficient values range from 0 to 1, with 1 being a perfectly uniform
and consistent instrument. The value obtained for the CSEBS or client self-efficacy
behavior score (Longo, 1991) in this study was .92 and is similar to other reliability


87
undergraduate courses in the college of Education were sampled for this study. Of those
students sampled, all students were given a likert scale continuum (1-5) whereby
prospective subjects indicated their willingness to discuss a personal problem of any
nature in counseling. The rationale behind the use of the continuous scale was to
approximate real clients for the study as much as possible in order to enhance the external
validity of the results. Of those 400 students sampled, 185 students or 46% indicated a
three or higher on the survey and were selected for the study. After attrition, 120 students
actually participated and were then randomly assigned to one of four groups. Of those 120
students, 64 were female (53%) and 56 or (47%) were male. However, one subject within
the data set produced extreme values on both the motivation readiness score and self-
efficacy score and was deleted from the analysis to minimize possible confounding effects
of an outlier data point. As a result of that deletion, officially 119 subjects composed N or
the sample size. 55 males participated in the study with 14 in the role-play group, 14 in the
video group, 14 in the literature group and 13 in the control group. 64 females participated
in the study with 16 in the role-play group, 16 in the video group, 16 in the video group
and 16 in the control group. Results below in table 1 list the mean self-efficacy scores for
male and female participants in all four groups.


94
Marginal mean differences for gender in predicting total counseling readiness score are
seen below in table eight. All other comparisons are non-significant.
Table 8
Marginal Means for Gender with Total Counseling Readiness Score as the Dependent
Variable
Gender
Readiness Score
Males
8.22
Females
9.20
Model 3
Results from the ANOVA omnibus model in table 9 below indicate significance
of the model, F (5, 118) = 4.029, *p < .05, at .002, when self-efficacy is entered as an
independent variable in predicting counseling readiness.
Table 9
Readiness as the Dependent Variable, without the Interaction Term
Model
Sum of Squares
Df
Mean Squares F
Sig.
Regression
68.87
5
13.775 4.029
.002 *
Residual
Total
386.372
455.249
113
118
3.419
*p < .05.
Predictors: Gender, Role-Play, Video, Literature, and Self-Efficacy
Model 4
Results below from table 10 illustrate the separate and significant t values for
gender and self-efficacy in predicting counseling readiness, with the t statistic for gender
significant, t (1, 118) = 2.716, p< .05 at .008; and the t statistic for self-efficacy


33 .
Motivation
The majority of motivational research in counseling targets clients who initiate
counseling with limited experience and little confidence in the counseling process. As a
result, motivation to change is perceived as a crucial variable for counseling professionals
to research and understand so clients do not prematurely terminate from counseling,
become passive bystanders in the process, or fail to effectively maximize counseling
services (Smith, Subich and Kalodner 1995; Longo, Lent, and Brown 1992; Longo, 1991;
Mennicke, 1988; Jakes, 1982).
Research on motivation in counseling has wide application. Jakes (1982)
demonstrated the role of video on client motivation in a university counseling center.
Mennicke (1988) systematically reviewed literature on variables (motivation) that predict
client attrition. Longo et al. (1992) examined the predictive role of self-efficacy and
motivation on attrition in a university counseling center by regression analysis. Smith,
Subich and Kalodner (1995) investigated the application of Prochaskas (1982) stage
model of change to differentiate premature terminators from counseling compared to
those not likely to prematurely terminate.
Historical understanding of motivation was rooted in personality theory. Hall and
Lindzey (1970) stated that motivation has always preoccupied personality theorists as a
central force in human nature and personality. Freud suggested (as cited in Greenberg and
Mitchell, 1983) that the construct of motivation was originally derived from his first
drive/structural model of the human mind in 1923. Strachey (1966) suggested Freuds use
of the term drive originated from the German word trieb, for instinct.
Murray (1938, as cited in Hall and Lindzey, 1970) suggested that human motivation


9
Prochaska and DiClemente 1986). Within the substance abuse field, self-efficacy
research relates to client attrition (Longo, Lent and Brown, 1992), self-efficacy and
motivation to change (Prochaska and DiClemente, 1986), motivation toward recovery
(Heather, 1992) relapse prevention, self-efficacy and client resistance (Miller and
Rollnick, 1991). Group approaches that favor motivational interviewing (Miller and
Rollnick, 1991) aim at client, coping self-efficacy as a favorable group outcome of
substance abuse counseling. Further studies related to counseling but not client self-
efficacy include numerous outcome studies generated from clinical supervision that
illustrate counselor and supervisee self-efficacy development (Ray, 2000; Larson, 1998;
Daniels, 1997; Watkins, 1997; Holloway, 1995).
Since many clients in the substance abuse field are characterized by denial of their
problem (Prochaska, 1992; 1986), motivation to change is also closely related to self-
efficacy in the counseling literature. Traditionally, the most effective means of
motivating clients was to confront them (Miller and Rollnick 1991). Historically, Miller
(1991; 1983) suggests that many treatment strategies aimed at first attacking and tearing
away at a clients defenses in order to, secondarily, rebuild and motivate the client.
However, current substance abuse treatment protocols reflect more gentle and empathic
(Miller, et al., 1993) methods in combination with more brief and time-limited
approaches (Lyons, 1997; Hoyt, 1995). Yet one of the many challenges continuing to
face clinicians is how best to motivate clients toward improvement and substantive, long
term change.
Thus, understanding a clients motivation is a primary importance to counseling
professionals. Bauman (1999) wrote that motivation is an internal state that illustrates a


75
sheet that informed participants of the potential risks and benefits of participation. An
emphasis was placed on the confidentiality of the study and that participants had no
obligation to participate. The informed consent form is provided as appendix A. Extra
credit was given to participants at the discretion of the course instructor. In order to
facilitate participation, different times for administration of the treatments were proposed.
Subsequently, all students were given a short survey, asking them to identify whether or
not they have an interest in participating in a research study regarding their attitudes
toward counseling. The survey was composed of a five-point, likert scale, indicating
subject willingness to seek counseling (one indicating little interest for counseling; three
indicating a moderate interest for counseling; and five revealing a high or strong interest
to seek counseling). The rationale for using the likert scale on the survey was to generate
exclusionary criteria to approximate real clients in order to enhance the external
validity of the study. Students who indicated a moderate to strong desire to seek
counseling (by selecting three or higher on the likert scale) reflected the total group of
students in the study.
Participating students in the study were contacted by phone or email regarding the
physical location and times of the experiment. Those participants selected were then
informed that they were randomly assigned to different groups in the study. One group
required students to role-play a written, standardized counseling format, between
counselor and prospective client (treatment group 1). Other participants were randomly
assigned to group 2 (video observation), group 3 (reading counseling literature), and
group 4 (a no-treatment control group).


97
.05. The likelihood ratio is similar to the F statistic and applied when the dependent or
outcome variable is dichotomous. The fourth general question of the study, regarding
whether or not any of the variables, gender, treatment, counseling readiness, or self-
efficacy, predicts desire to seek follow-up counseling, is supported by the results on the
next page in table 13.
Table 13
Summary Results of Chi-Squared Tests Predicting Likelihood to Follow-Up Treatment
into Counseling
CHI-SQUARE TESTS
VALUE
DF
Asymp. Sig.
(2-sided)
Chi-Square
8.519
3
.036*
Likelihood Ratio
8.120
3
.044*
N of Valid Cases
119
* p <.05.
Model 5
Results in table 14 below illustrate the significance of treatment (T) in predicting
desire to seek follow-up counseling, (T) for %2 = 8.46, and pr < .05, .0373. Gender (G)
and the gender by treatment interaction (GT) are non-significant in predicting desire to
seek counseling follow-up.
Table 14
Interaction, Logistic Regression Model with Gender and Treatment Type Predicting
Desire to Follow-Up
Source
Df
X
Pr>x"
Gender (G)
1
0.49
0.4860
Treat (T)
3
8.46
0.0373*
Gender*Treat (GT)
3
1.58
0.6631
* p sig. at < .05


35
clients toward change. This line of research suggests that counselors should pay attention
to client statements of blame, expressions of weakness or rigidity that can inform clinical
assessment. Thus, the more internal the source of such client statements, the more likely a
client would be motivated to change. In contrast, the more external ones locus of control,
the less likely one is motivated to change (Rotter, 1954). Consequently, the counselor
with a client of external expectancies of control would adopt strategies to encourage
client insight and awareness of his/her expectations and how expectations motivate or
retard a clients behavior. With Connallys (1980) research, the influence of the
interaction between counselor and client on motivation is highlighted. Therefore, the shift
in how motivation is conceptualized from more classic to modem to post-modem theories
anticipates the relative and increasing influence of the counselor and treatment strategies
as instrumental to client motivation.
Since many clients in the substance abuse field are characterized by denial of their
problem (Prochaska, 1992; 1986), motivation for changing such denial is closely related
to self-efficacy or ones beliefs about change (Miller, 1991). Historically, the most
effective means of motivating clients was to confront them (Miller, 1991). Miller (1991;
1983) suggests that many prior treatment strategies developed from research aimed at
first attacking and tearing away at a clients defenses in order to secondarily, rebuild and
motivate the client. However, current substance abuse research reflects gentle and
empathic (Miller, 1995) treatment approaches in combination with brief, time-limited,
managed care models (Lyons, 1997; Hoyt, 1995). Yet one of the many challenges
continuing to face clinicians is how best to motivate clients toward substantive, long-term
change.


17
achievement, (Stidwell, 1994), self-efficacy and its influence on organizational
performance (Mitchell, 1990), and the implications of using medical videotape to
increase coping self-efficacy with patients with diseases such as AIDS (Everett, 2000;
Hannes, 1999) and cancer.
Although the majority of self-efficacy research has been generated in contexts other
than counseling, nevertheless, counseling self-efficacy research has wide application.
Self-efficacy (Bandura, 1997; 1986; 1977), defined as ones belief in ones capability to
execute a specific task or series of tasks, has been examined and applied to counseling
outcome research regarding alcohol consumption (Tran, Haaga and Chambless, 1997)
substance abuse (Burke, 1998; Walton et al. 1995), stress management (Wiedenfeld et al.
1990), positive self-concept (Harrison et al., 1997), motivation and client attrition
(Longo, Lent and Brown, 1992). In fact, the majority of client self-efficacy research in
counseling often targets substance abuse treatment Prochaska, DiClemente and Norcross
1992; Miller and Rollnick, 1991; Prochaska and DiClemente 1986). Within this area,
self-efficacy research relates to client attrition (Longo, Lent and Brown, 1992), self-
efficacy and motivation to change for the client (Prochaska and DiClemente, 1986),
motivation toward recovery (Heather, 1992) and relapse prevention and client resistance
on client self-efficacy (Miller, 1991). In addition, group approaches that include
motivational interviewing (Miller and Sanchez, 1994) aim at client, coping self-efficacy
as a favorable, group outcome of substance abuse counseling.
Counseling, self-efficacy research also involves outcome studies related to counselor
and supervisee, self-efficacy development (Ray, 2000; Larson, 1998; Watkins, 1997;
Holloway, 1995). Studies of self-efficacy in counseling also include the examination of


80
this dissertation study.
To further strengthen the construct validity of the CSEBS measure, three experts
in self-efficacy and counseling research independently evaluated the instrument; all three
independently agreed that the measures construct validity warranted its usage for future
research purposes. The experts consisted of Dr. Bob Lent, currently at the University of
Maryland. Dr. Lent is considered a national expert on counseling applications of self-
efficacy and social cognitive theory. Dr. Lent formerly served as the chairperson for
Danielle Longo, who initially developed the CSEBS measure in his dissertation in 1991,
at Michigan State. Dr. Lent approved the CSEBS measure for dissertation research
purposes. The second expert contacted was Dr. John Lyons, currently the director of
social science research and policy at Northwestern University. Dr. Lyons currently
teaches research and statistics in the counseling/psychology department at Northwestern
and is considered a national expert in statistics and research governing clinical outcomes
of managed care practices and public policy. Dr. Lyons has much expertise in the field of
self-efficacy and its role in counseling-related research. Lastly, Dr. Frank Pajares at
Emory University reviewed and approved the CSEBS measure for dissertation purposes.
Dr. Pajares is a distinguished professor and national expert on self-efficacy and its role in
social science and academic research. He has numerous, national publications on self-
efficacy.
The original University of Rhode Island Change Assessment Scale
(McConnaughy, DiClemente, Prochaska, and Velicer; 1989) consisted of a 24 and 32
item, self-report scale that assessed an individuals readiness for change prior to entering
counseling. The 32-item URICA scale was utilized in this dissertation study. Items on the


9
efficacy development. However, of the four sources that compose self-efficacy, Bandura
(1997) considered ones emotional arousal to be the least influential on efficacy
development.
As a theoretical construct, self-efficacy emerges out of the larger framework of
social-cognitive theory (Bandura, 1986). According to Bandura (1997), self-efficacy is
composed of four sources: prior experiences, vicarious learning experiences, verbal
encouragement, and emotional arousal. Experience of competency is the most powerful
source of ones self-efficacy. As a result, ones prior experiences in performance
contexts have important implications for ones beliefs regarding self-worth and
confidence in that area. For instance, in their path analysis, Pajares and Miller (1994)
suggested that interventions to increase mathematical problem solving in students are
implicated with math self-efficacy.
The second theoretical source that influences self-efficacy development is vicarious
experience. Although this source is not as powerful as mastery experiences on self-
efficacy, vicarious learning appears particularly malleable when people have limited prior
experience or they underestimate their own competence abilities. Schunk (1994)
illustrated that academic competency models are particularly relevant in this regard. A
powerful and positive model can have lasting effects on ones life, self-efficacy
development and understanding of competence. Additionally, peer influences on
modeling and social interaction have influential positive and negative consequences as
well. For instance, a models failure has tremendous impact if the rater perceives
him/herself as being inferior to the model (in Schunk, 1994, Brown and Inouye, 1978).
Third, people also develop perceived self-efficacy based upon verbal encouragement


52
that the combined results from students in both performance testing and video groups
would show increases in career self-efficacy over that of each group separately. As a
result, its was concluded from Luzzos et al. (1999) study that the separate influences of
each theoretical component in Banduras self-efficacy theory warrant further empirical
investigation, whether relating self-efficacy to career decision-making or counseling.
Further research in this area demonstrating the effectiveness of appropriate measures
designed to improve the internal validity of self-efficacy studies was also recommended.
Training strategies and interventions utilized to increase prospective self-efficacy
and motivation for performance have been applied widely in other contexts. One example
has been resident assistance education in college dormitories. Jakobsen and Krager
(1988) noted that over the last twenty years, program manuals that identify the objectives
of residential education are typically subsumed under training criteria for residence
assistants. Much attention is paid prior to the first week of school, highlighting for
prospective resident assistants such questions as, why do we exist, what exactly do we
do, what is most important about our role as resident assistants in the dorms, and how do
we accomplish our training objectives? Typically such training includes role plays, video,
teaching models, and selected readings that help to anticipate life and expected behaviors
residence assistants are likely to encounter in the dormitories.
Another training venue utilized to increase prospective faculty/student self-
efficacy and motivation is alcohol education programs at universities. Chassey and
Clifford (1988) document the alarming increase of alcohol consumption on college
campuses. As a result of increased frequency of drinking on college campuses, most
universities have an alcohol policy. If the policy on campus is violated, a student can be


Kunkel, M. (1990). Expectations about counseling in relation to acculturation in
Mexican-American and Anglo-American student samples. Journal of Counseling
Psychology. 37, 3, 286-292.
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Landis, L. and Young, M. (1994). The Reflecting Team in Counselor Education.
Counseling Education and Supervision. 33, 210-217.
Larson, L. (1998). The SCMCT making it to the show: four criteria to consider. The
Counseling Psychologist, 26, 2, 324-328.
Larson, L., Clark, M., Wesely, L., Koraleski, S., Daniels, J., Smith, P. (1999). Video
versus Role Plays to increase Counseling Self-efficacy in Prepractical Trainees.
Counselor Education and Supervision, 38, 4, 237-248.
LaTorre, R. (1977). Pretherapy role induction procedures. Canadian Psychological
Review, 18. 308-321.
Lawe, C., Home, A., Taylor, S. (1983). Effects of pretraining procedures for clients in
counseling. Psychological Reports, 53, 1. 327-334.
Lent, Robert (1992). Social Cognitive Mechanisms in the Client Recovery Process:
Revisiting Hagiology. Journal of Mental Health Counseling, 14, 2, 196-207.
Lent, R. and Maddux, J. (1997). Self-Efficacy: Building a Sociocognitive Bridge
between Social and Counseling Psychology. Counseling Psychologist, 25, 2, 240-255.
Locke, E. and Latham, G. (1994). Goal Setting Theory. In ONeil, H. and Drillings, M.
Motivation, Theory and Research (pp. 13-30). Hillsdale: Lawrence Erlabaum Associates.
Longo, D. (1991). Relation of self-efficacy and outcome expectations to client
engagement in a university counseling center. (Doctoral dissertation, Michigan State
University, 1991). Dissertation Abstracts International, order number: 9129474.
Longo, D., Lent, R. and Brown, S. (1992). Social Cognitive Variables in the Prediction
of Client Motivation and Attrition. Journal of Personality and Social Psychology, 52. 81-
90.
Luzzo, D. (1999). Effects of Self-Efficacy Enhancing Interventions on the Math/Science
Self-Efficacy and Career Interests, Goals, and Actions of Career Undecided College
Students. Journal of Counseling Psychology, 46, 2, 233-243.
Lyons, J. (1997). The Measurement and Management of Clinical Outcomes in Mental
Health. New York: John Wiley and Sons.


36
Traditionally, the research literature suggests the examination of motivation in varied
contexts reflects the dichotomy between internal and external motivation. However, more
contemporary lines of research support motivation as being composed of both internal
and external sources. For instance, Deci and Ryan (1985) support empirical research that
operationalizes motivation as composed of both external and internal sources. In self-
determination theory, (Deci and Ryan, 1985) motivation is conceptualized as an inherent
factor that drives action and change, while also is influenced by external influences. In
counseling, client behavior is interpreted as being motivated from within the client
(internal and interpreted as a function of desire) and partially driven by counselor style
and treatment choice (external) in the clinical setting. Additionally, the research of
Hamert (1995) and Deci and Ryan (1985) elaborate how counselor style can impact client
perception of treatment. Thus, the literature emphasizes that self-determination theory
and research (Deci and Ryan, 1985) confirms the increasing influence of counselor-client
interaction on motivation as rooted in both internal and external causes (Miller, 1991).
The influence of the counselor-client interaction represents a significant conceptual shift
in how motivation is researched.
With regards to self-determination theory (Deci and Ryan; 1985), these authors
suggested that intrinsically motivated actions are self-determined and manifest in the
absence of external award. An example would be reading a book; the behavior is
motivated internally and is absent of external reinforcers. External motivation
(Kruglanski, 1978) however is rooted in extrinsic reward and reflects a wide spectrum of
human action and behavior. Previously, it was thought that external motivation was
understood to manifest from external reinforcers alone, in the absence of self-


6
applied in a variety of research contexts. One method of increasing self-efficacy is to
provide literature to clients to increase coping strategies. Hannes (1999) utilized literature
as part of a psychoeducational intervention targeted at increasing efficacy coping with
HTV. Telch (1985) used literature as part of a support group to enhance coping among
cancer patients. Some researchers utilize literature to increase self-efficacy in regards to
learning. Schunk (1994) examined the effects of goal-setting instructions on self-efficacy
for self-regulated learning. Others have incorporated literature as part of building self-
efficacy in developing counselors. Johnson (1989) showed how literary information is
applied to increasing self-efficacy and counseling competence in prepracticum training.
Hamilton (1999) applied literature to a control group to study the differences in factual
content of three vignettes in comparison to an experimental group exposed to videotaped
instruction.
Intervention studies designed to increase counseling self-efficacy in counselors have
typically used a combination of video instruction, role-play or modeling. Larson et al.
(1998) compared a fifteen-minute mock interview to a fifteen-minute counseling session
on tape. Munson et al. (1986) compared the effectiveness of role playing and modeling
versus modeling and visual imagery. Sutton (1998) utilized video in fostering client
engagement through role manipulation. Jones (1995) studied the effectiveness of video
on marital therapy. Sullivan and Mahalik (2000) used video and other counseling
interventions (role-play and positive feedback) to increase career self-efficacy among
women.
Additional inquiry for examining self-efficacy and motivation together is supported
by counseling research and treatment approaches that illustrate the link between these


74
in counseling and a brochure identifying how counseling could potentially be helpful to a
college population. To insure that participants read and process the literature, they were
asked to complete a simple quiz on the material. Assigned subjects in group 4 (no
treatment control group) read part of a chapter from a general, counseling theories book.
Gender
Male and female scores from the CSEBS and URICA measures were assessed to
determine if a statistically significant interaction exists between gender and treatment
type or if gender alone separately reflected statistical significance on either dependent
variable.
Population
The research population consisted of the undergraduate, college student body at
the University of Florida. Research participants were selected from four undergraduate
courses in the college of education. Approximately 400 potential participants were
surveyed. Participants in the study were contacted by email and phone and then randomly
assigned to one of four groups.
Sampling Procedure
The research sample was composed from four undergraduate courses in the
College of Education: drug and alcohol awareness, stress management, interpersonal
communication, and career development. A graduate student instructor taught each
course from the department of counselor education. Instructors offered extra credit to
students willing to participate in the study; students were informed of this option prior to
the sampling procedure.
Students from each of the four classes mentioned above were first given a consent


151
Sutton, J. (1998). Fostering client engagement in counseling through the use of
videotaped role induction. Dissertation Abstracts International Section A: Humanities
and Social Sciences, 59, (4-A), 1082.
Telch, C and M. (1985). Psychological approaches for enhancing coping among cancer
patients: A review. Clinical Psychological Review, 5, 4, 352-344.
Thomas, R. (1982). Training volunteer to provide crisis counseling to rape victims: An
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20
Interestingly, research on self-efficacy and vicarious experience has shown that
modeling is not nearly as influential if the rater perceives his/her competence relative to
the model as being equal or superior to the model (Brown and Inouye, 1978, in Schunk,
1994). The relevance of modeling as a source of client self-efficacy in counseling is
crucial since counselors act as vicarious models for client learning (Munson, Zoemik and
Stadulis, 1986). These authors found with forty-eight students that role plays and
modeling together were much more effective in lowering performance anxiety in
beginning counseling students when compared to a wait-listed control group (Munson, et
al. 1986).
By multivariate analysis, Luzzo (1999) investigated the separate and combined
aspects of performance accomplishment with modeling on career science interests of
ninety-four college age students. He found that a statistically significant interaction
existed between student math/science performances for students who watched videotape
of other successful students decisively disclose their math/science career aspirations,
compared to a student performance group that witnessed other students model indecision
regarding their career aspirations. Luzzo (1999) concluded that although vicarious
learning is less influential on self-efficacy development than performance
accomplishments in academic contexts, both the relative contribution of vicarious
learning and performance experiences is important to examine in self-efficacy research.
Clients also develop perceived self-efficacy based upon verbal encouragement
and persuasion. Verbal encouragement is the third theoretical source of self-efficacy
(Bandura, 1977). Social/cognitive theory (Bandura, 1986) suggests that as positive
encouragement can support and bolster self-efficacy, negative persuasions decrease self-


116
were randomly assigned to treatment, the results must be weighed against the relatively
narrow definition of a college-age population, considering variables of age, gender, and
race. Consequently, the readers ability to apply the results to the general population is
limited. Further, the fact that student participants were identified as prospective clients
and not actually real clients reduces extrapolation and external validity of the results to
a true, client population. Yet the use of the initial survey to approximate real clients
attempted to compensate for this phenomenon.
Another concern that might limit this study concerns the student population
sampled. For instance, the reader may wonder if this study specifically generalizes to the
clinical field from the analogue situation that was investigated. However, it is argued that
the majority of students taking classes from personal growth and counseling related fields
from which they were sampled helped to approximate a true client population while
simulating the variance in prospective client response to each of the three, separate
treatment groups.
The advantages of analogue research are well documented. By doing research in
laboratory university settings, the internal validity of the study is usually enhanced and
tightened between the independent and dependent variables due to greater experimental
control over subjects and levels of independent variables (Heppner, 1989). Another
advantage to analogue research is that the researcher is not overly concerned with
conflicts of interest and confidentiality that can exist between client and clinical
researcher (Kazdin, 1978). Third, analogue research typically does not have the issues
with client attrition that can often plague research in clinical settings (Mennicke et al.,
1988).


AN EXAMINATION OF THE EFFECTS OF PRE-COUNSELING TREATMENT
STRATEGIES ON PROSPECTIVE CLIENT SELF-EFFICACY AND READINESS
FOR CHANGE IN COUNSELING
By
DAVID KENT COX
A DISSERTATION PRESENTED TO THE GRADUATE SCHOOL OF THE
UNIVERSITY OF FLORIDA IN PARTIAL FULFUILLMENT OF THE
REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY
UNIVERSITY OF FLORIDA
2002


126
CASE STUDIES
Jim is 20 year-old, junior, at the university. He was referred to the counseling center
by the dean of the college for two mandatory counseling sessions; he reported that he
had consumed 12 beers over a four-hour period. To Jim, this amount of alcohol did not
seem like much to consume. After all, he was used to drinking that much on an empty
stomach. However, last Saturday evening, after some commotion in the residence hall,
the residence assistant was notified. Upon arriving at the scene to investigate, the
resident assistant saw Jim vomiting over the stairwell in the fire escape. The residence
assistant notified Jim that he would be written up for abusing the college alcohol policy
and that he would have to attend counseling for two sessions.
Jim was anxious during his initial meeting in counseling. He appeared quite mystified
about the nature of counseling and how specifically it could help him cope with this
embarrassing incident. Although Jim felt ashamed and frustrated that he drank so much
that it led to his vomiting, Jim was also blamed the residence assistant. Jim felt that the
resident assistant was too quick and judgmental in writing him up, while violating his
right to privacy.
Counseling involved providing a safe forum for Jim to express his thoughts and
feelings over the incident; Jims counselor and he also explored the relationship between
choice and consequence, freedom and responsibility. The counselor was able to help Jim
understand that part of becoming an adult is accepting and owning ones responsibility
for ones behavior. Counseling also explored the social context in which his drinking had
occurred, in order that Jim might understand how peer influences may have contributed
to his over consumption of alcohol. In the final analysis, after two sessions, Jim assured
his counselor that the event was an isolated one, and that it would not occur again.
Counseling appeared to help provide Jim some insight into his behavior, and that he
would not want to do anything reckless that could potentially jeopardize his bright future
at the university.
Karen is an 18 year-old freshman at the university; she is an only child. She
presented at the university-counseling center, with symptoms of depression. She reported
having difficulties concentrating on her schoolwork, has had trouble making new friends,
has problems sleeping, and has little appetite. She stated her hurt and concern over her
parents impending divorce. She is angry that her parents are making her feel this way yet
she does not feel safe in telling either one of them exactly how she feels. Karen feels very
alone and confused.
Counseling involved getting Karen to explore her thoughts and feelings over her
parents divorce and how such feelings may contribute to her current feelings of
depression. Being able to discuss such intimate, emotional material in a safe, non-
judgmental forum has allowed Karen to slowly open herself in session by trusting an
authority figure. Developing trust has allowed Karen to become more comfortable with


4
counseling with overweight adults (Steptoe, 2000), self-efficacy and medication
compliance (Brus, 1999), self-efficacy and its role in dietary adherence (Burke, 1998),
self-efficacy and HIV prevention (Hume, 1999). Motivation has been researched
extensively in education (Higbee, 1996; Locke and Latham, 1994) and counseling (Miller
and Rollnick, 1991) but little research in counseling considers these two variables
together outside of studies related to client attrition (Longo, Lent and Brown, 1992).
Additional research focuses on self-efficacy related to student achievement, but not
self-efficacy and client achievement in counseling. Studies on self-efficacy implicated in
academic performance include but are not limited to self-efficacy and math achievement
(Luzzo, 1999; Pajares and Miller, 1994); goal setting on achievement and perception of
self-efficacy in inner city children (Paslay, 1996); goal setting interventions on self-
efficacy for self-regulated learning (Schwartz 1996); self-efficacy enhancing
interventions on math and science, career interests (Luzzo, 1999); and the effects of high
school career education on social cognitive variables (McWhirter, 1999).
Self-efficacy research also includes measurement studies. Sherman (1998) looked at
the relationship between addiction and pregnancy with a measure of self-efficacy applied
to pregnant women in recovery. Sherer and Maddux (1982) developed a self-efficacy
scale for measurement of the construct. Larson et al. (1998) generated five empirical,
research studies on the development and validation of a popular self-efficacy measure for
counselors (COSE), which is helpful in predicting counselor-trainee performance.
Tinsleys et al. (1980) counseling, brief form (EAC-B) implicates a clients expectations
of counseling with the correlates of self-efficacy (motivation) in counseling.
However, some counseling research on self-efficacy has been questioned due to


89
findings previously reported (Sutton 1998; Longo et al., 1992). This finding indicates that
approximately 92 % of the total score variance from this measure is due to true score
variance and not random variance or measurement error. The Cronbachs alpha value
achieved for the URICA was .78 and is similar to other reliability estimates derived from
substance abuse populations (Carbonari et al., 1996). This figure indicates that 78% of the
total score variance is attributable to true score variance and not random variance or
measurement error.
Analysis Procedures
Data was analyzed for this study through the use of the SAS General Linear
Model (GLM) and SPSS. Four separate ANOVA models and a fifth logistic
regression/chi-squared model were run in order to test the specific eight hypotheses of the
study. All models are listed on the following page, in table 3. The first model designated
the total self-efficacy score as the dependent variable, with gender and treatment by
group (1, 2, 3) and their interaction, as separate input variables. The second model
designated the total self-efficacy score as the output variable. Gender and treatment were
analyzed separately as main effects. The third model reflected the total readiness score as
the dependent, output variable. The treatment interaction with gender and self-efficacy
were entered separately as independent, input variables. In the fourth model, gender,
treatment group, and self-efficacy were entered separately as input variables and the
readiness variable was the output, dependent variable. The fifth model examined the
influence of gender, treatment, and their interaction, along with self-efficacy and desire to
seek post-test counseling, through the use of a chi-squared analysis and logistic
regression procedure.


29
embedded within larger theoretical frames, notably social-cognitive theory (Bandura,
1986) as an extension and revision of social-learning theory (Bandura, 1977). Social-
cognitive theory and research (Bandura, 1986) summarize and predict the outcome role
of self-efficacy as one construct, manifesting from both interpersonal and intrapersonal
contexts of emotion, cognition, and biology.
Important assumptions of social-cognitive theory converge from the disparate work of
multiple authors (Lent and Maddux, 1997; Bandura, 1986; Mischel 1973; Rotter, 1954)
that drive current, self-efficacy research. First, it is recognized that people have the
capacity for symbolization. Essentially, the ability to symbolize allows one to convert
experience into internal meaning, while deciphering understanding from language;
human symbolization further includes the capacity and ability for personal, self
reflection. A second assumption of social-cognitive theory is that behavior is purposeful
and directed. The ability for intentional behavior is acknowledged to generate from ones
ability to symbolize and decipher meaning from action. A third assumption is that people
are self-regulating; in other words, they have the capacity to direct and control their
respective environments. In order to control ones environment, social-cognitive theory
postulates that individuals incorporate personal standards to guide and direct behavior.
Such standards allow for goal setting and the motivation necessary to achieve goal-
directed behavior. A fourth assumption is that ones environment, ones personality and
ones behavior converge in a mutually interacting manner to determine the initiation,
persistence and completion of a selected, goal-directed behavior. From this theoretical
perspective, it is assumed that clinicians understand client difficulties to arise from an
insufficient ability to mobilize internal cognitive, affective, and motivational resources in


47
General Training Strategies
The remainder of this literature review will highlight how general training methods
are applied to a variety of educational contexts to enhance prospective client self-efficacy
and motivation in counseling. A general review on training strategies will first be
examined; then, the specific application of a role-play, video observation, and counseling
literature as pre-counseling, treatment methods will be investigated. The terms
pretreatment and training are used interchangeably to suggest any educational program or
informational service designed to increase prospective client, student, employee or
faculty effectiveness.
Training methods to increase coping self-efficacy and motivation for change have
wide application in the medical field (Mickler, 1999; Cook; 1991). Training procedures
in this area have been applied to increase assertiveness training with college students
(Williams and Hall; 1988), enhance confidence in prospective college faculty (Heppner;
1994), and increase career self-efficacy for women (Sullivan and Mahalik, 2000). Other
lines of inquiry regarding treatment methods that increase confidence in coping and
motivation among prospective faculty and students include and HTV pretesting
counseling (Gibson et al.; 1989) alcohol education programs (Chassey et al., 1988) date
rape awareness (Buhrke; 1988); and college residential assistant education (Jakobsen and
Krager; 1988). Another line of research that supports counseling training methods for
prospective clients is reported in the attrition literature. Longo, Lent and Brown (1992),
Mennicke (1988) and Tinsley (1980) all concluded that preparatory education that orients
the client to the client role could potentially attenuate premature termination. For
instance, studies that examine attrition in counseling often target a particular variable that


152
Williams, J. and Hall, D. (1988). Conformity to Peer Influence: The Impact of Assertion
Training on College Students. Journal of College Student Development, 29, 466-471.
Wingerson, Nikki W. (Summer, 2000). The mental health, self-efficacy, and satisfaction
outcomes of a community counseling demonstration for multiple sclerosis patients.
Journal of Applied Rehabilitation Counseling, 31,2, 11-17.
Ziemelis, A. (1974). Effects of client preference and expectancy upon initial interview.
Journal of Counseling Psychology. 21, 23-30.
Zwick, R. (1985). Effectiveness of a Client Pretherapy Orientation Videotape. Journal of
Counseling Psychology, 32, 4, 514-524.


77
played by two counselor education graduate students. The video lasted approximately 10-
15 minutes in length. Upon completion of the video observation, each subject in group 2
completed the two measures provided in each packet. A script of the video is provided as
an appendix C to this study.
Participants in assigned group 3 also met at a predetermined location and time in
the counselor education department. Each student was given a packet with two measures
to be completed at the end of the experiment. Assigned participants to group 3 were
asked to read the counseling literature that was provided as a treatment; three counseling
scenarios were detailed in the literature, as well as a brochure, describing the basic
process and benefits to being a counseling client. Students in this group were asked to
complete a simple quiz consisting of five questions; the purpose of the quiz was to insure
that each subject reads the literature. The scenarios, the brochure, and the quiz are
detailed as appendices D, E, and F respectively. It took no longer than 30 minutes for
students to read the literature provided. Instructions were given in each packet, detailing
the steps of the paperwork to be completed. Participants in group consisted of a no
treatment, control group. Each participant in group 4 was provided with a packet
consisting of a generic reading exercise and two measures. The no-treatment control
exercise consisted of students reading five pages from R.S. Sharf, Theories of
Counseling, 2000.
After completing both measures, participants then filled out a third measure
reflecting subject interest to seek follow-up counseling as a result of participation in this
study.


93
model without the interaction term on counseling readiness, F (8, 118) = 2.84, p < .05,
with the significance level = .007.
Table 6
Dependent Variable
Model
Sum of Squares
df
Mean Square
F
Sig-
Regression
78.025
8
9.753
2.844
.007
Residual
377.223
110
3.429
Total
455.249
118
* p <.05.
Model 4
Results from the 2x4 ANOVA in table 7 below illustrate the significant effect of
gender on counseling readiness, F (1, 118) = 7.48, *p < .05. Results demonstrate the
non-significance of treatment on counseling readiness, F (3, 118) = .166, p >.05 and the
non-significant interaction between gender and treatment (GT) on counseling readiness, F
(3, 118) = .702, p >.05.
Table 7
2x4 ANOVA with the Interaction Term with Total Counseling Readiness Score as the
Dependent Variable
Model
Sum of Squares
df
Mean Square
F
Sig.
Gender (G)
28.159
1
28.159
7.485
.007*
Treat (T)
1.869
3
.623
.166
.919
Gender*Treat
7.921
3
2.640
.702
.553
(GT)
Error
417.592
111
3.762
Corrected Total
455.249
118
* p sig. at < .05.


60
on participant anxiety. Subjects that identified themselves as non-assertive prior to
treatment were randomly assigned to two groups, one with assertiveness training and the
other group without training. As expected non-assertive subjects exposed to assertiveness
training exhibited more assertive behaviors and less anxiety over time than those not
exposed to the role-play treatments.
Saitz, Sullivan and Samet (2000) studied the effects of role-plays related to
continuing education with clinicians that screen and provide brief interventions to clients
that suffer from substance abuse problems and motivation. Clinicians interviewed after
the role-plays suggested that they felt more sensitive to initial screening and assessment
methods designed to target client substance abuse in relation to motivation to change
while asking about possible continued substance use at follow up.
The problem resolution format (Cummings, 1992) is another theoretical variation
on the effects of a role-play. This format allows clients to explore through role-play a
prior stimulating situation in order to contact previous thoughts and feelings about the
event. In this case, being able to provide a context in which feelings and thoughts related
to the original situation is important along with being able to identify and label what
exactly is being thought. The ultimate goal of role-play training is to assist and further
educate either the novice counseling student or client by helping them orient to their
prospective role. Ideally the experiential format of the role-play allows for a gradual yet
increasing ability to transfer learning from counseling/academic student to professional or
one as prospective client to actual confident client in session (Friedlander and Kaul,
1983).


TABLE OF CONTENTS
ACKNOWLEDGEMENTS i
ABSTRACT viii
CHAPTER
1 INTRODUCTION 1
Statement of the Problem 1
Need for the Study 3
Purpose of the Study 5
Background of the Problem 7
Organization of the Study 13
General Research Questions 13
Definition of Terms 14
2 REVIEW OF THE LITERATURE 16
Self-Efficacy 16
Self-Efficacy Research 16
Counseling Self-Efficacy Research 17
Theoretical Framework of Self-Efficacy 18
Studies to Increase Theoretical Components of Self-Efficacy 19
The Role of Self-Efficacy on Coping Performance 21
Social-Cognitive Theory 23
The Level, Strength, and Generality of Self-Efficacy 24
The Role of Personal Agency in Counseling 30
The Association of Self-Efficacy with Motivation in Counseling 32
Motivation 33
Motivation and Personality Theory 34
Different Theories on Motivation 35
Motivation and Cognitive Dissonance 37
Motivational Interviewing 37
Motivation and Personal Expectations 39
Motivation and Goal Setting.. 39
Motivation in Stages/Prochaska 40
Motivation and Measurement Studies/Prochaska, DiClemente, Isenhart 42
General Training Strategies 47
Date Rape Awareness 48
Pre-test HIV/AIDS Counseling 51
Prospective Faculty Training 51
RA Training 52
i
v


150
Sherman, B. (1998.) Addiction and Pregnancy: Empowering recovery through peer
counseling. New York: Guilford Press.
Shimamoto, J. (1996). An experimental study on the fitness of counselor response
directiveness to the clients expressed states of mind. Japanese Journal of Counseling
Science. 29. 1, 9-18.
Sipps, G., Sugden G., and Faiver, C. (1988). Counselor training level and verbal
response type: Their relationship to efficacy and outcome expectations. Journal of
Counseling Psychology. 35. 4, 397-401.
Skinner, B.F. (1953). Science and Human Behavior. New York: MacMillan.
Sloane, R.B. (1970). Role of preparation and expectation of improvement in
psychotherapy. Journal of Nervous and Mental Disease. 150. 18-26.
Smith, A.H. (1984). Psychotherapy pretraining using an introductory document offering
a choice as to therapeutic framework. Dissertation Abstracts International, 44, (8-B),
2569-2570. (University Microfilms Number DA8327064).
Smith, K., Subich, L., and Kalonder, C. ( 1995). The transtheoretical models stages and
processes of change and their relation to premature termination. Journal of Counseling
Psychology, 42, 1, 34-39.
Steptoe, A. (August 2000). Psychosocial predictors of changes in physical activity in
overweight sedentary adults following counseling in primary care. Preventive Medicine:
An International Journal Devoted to Practice and Theory. 31, 2-pt.l, 183-194.
Stidwill, H. (1994). Application of self-efficacy theory: A treatment approach for sport
performance phobias. Journal of Mental Health Counseling, 16. 2 196-204.
Strachey, J. (1966). The Standard Edition of the Complete Psychological Works of
Sigmund Freud. 2nd ed. Vol, 1. London: Hogarth Press.
Strupp, H. and Bluxom, A.L. (1973). Preparing lower class patients for group
psychotherapy. Development and Evaluation of a role-induction film. Journal of
Consulting and Clinical Psychology, 41, 3, 373-384.
Subich, L.M. (1983). Expectancies for counselors as a function of counselor gender
specification and subject sex. Journal of Counseling Psychology, 30, 421-424.
Sullivan, K. and Mahalik, J. (2000). Increasing Career Self-Efficacy for Women:
Evaluating a Group Intervention. Journal of Counseling and Development. 78. 54-62.


50
population. Videotapes that highlight the impact of date rape on victims can serve to
foster discussion, heighten awareness, and maximize prevention strategies while
extending tremendous compassion to the victims and their families. Videotape in this
context also furthers the need for additional planning and development of educational
models for residential assistant training in college dorms across the nation.
The use of preparatory training has application in areas ancillary to crisis
management. One area where training programs are offered readily is in psychiatry to
increase confidence and motivation among medical staff cope in successfully managing,
assaultive patients. Flannery and Penk (1999) looked at elements of preparatory crisis
intervention from the vantage of critical incident stress management (CISM). Such an
approach serves both prospective and current professional medical staff to help minimize
and prevent assaultive behavior with this population. The CISM model has been used as a
forum for further planning and development of crisis training models nationwide.
Another illustration of how training strategies can be effective is the use of HIV
and AIDS pretest counseling. Pretest counseling training programs include educating
counselors and clients to the etiology of AIDS and how HTV transmission occurs. A
secondary purpose to pretest counseling is to minimize the probability of viral
contraction. Pretest counseling also serves clients that seek and receive HIV testing to
modify their anxiety about likely test results. It also provides a safe forum for discussion
of diagnosis, offers professional examination of different medication and treatment
options while motivating clients toward changing sexual behaviors to safer, less risky
alternatives (Hicks and Rundell, 1996). Due to the lethality of the disease, HTV pretest
counseling is considered a very important prospective strategy in the fight against AIDS.


66
association with many factors: personality (McCrae and Costa, 1987), different theories
(cognitive dissonance, social-cognitive; Scharf, 2000) different types of motivation (Deci
and Ryan, 1985; Skinner, 1953), the relationship of motivation and client attrition to
other variables (Longo, 1991); motivation and counselor interventional style (Bandura,
1997; 1986; Hamert, 1995; Miller, et al., 1993); motivation and demographics (Kunkel,
1990); motivation and duration of treatment (short vs. long term; Hoyt, 1995); and
motivation and recovery (Isenhart, 1997).
The research indicates that little understanding of the empirical role of motivation in
counseling has resulted from analysis of demographic variables and intake data. Thus,
due to the confounding and complicated nature of motivation, many research conclusions
on motivation have been inconsistent (Kunkel, 1990; Hardin, 1983). Therefore, the
majority of research on motivation extends primarily into treatment domains,
concentrating on motivation and substance abuse treatments (AA models to more post
modern, motivational therapies) to Prochaskas stage model (1982), the post-modem
theory and practices of Miller (1991) to specific, field research (Isenhart, 1997; Hamert,
1995; Miller, et al., 1993). Further, since much of the counseling research on motivation
relates to the addictions field, the research focus has traditionally targeted how best to
help treatment professionals work with low motivated, more resistant clients (Miller,
1993, Miller, 1991) solely in this context.
Additional research applications toward motivation have primarily focused on
substance-abusing populations (Prochaska, 1992; 1986; Miller, 1991) and attrition
(Longo, 1991) but not on the treatment impact on client motivation and client self-
efficacy considered together outside of these contexts. Thus, there appears a need for


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139


APPENDIX C
VIDEO SCRIPT OF ROLE PLAY
Hello; thank you for participating in this research study; the purpose of this video
presentation is to provide you with some general information regarding what counseling
involves, what it can provide to you as a potential client, and how it can empower you to
better manage and improve personal areas of your life.
You will witness two counseling sessions in the video; the first session will introduce you
to the client and counselor and to the clients identified issues. The second video segment
will capture counseling in the third session, focusing on counseling methods to help the
client improve their current life situation. The video will last approximately 10-15
minutes in length. You have been advised that you may experience a minimal or mild
amount of emotional discomfort when watching the video. The role-play of the counselor
will include highly skilled listening, empathy, and general support of the client situation.
Observed on Video
You are 20 years old. You are an only child. You live with two friends in a small
apartment off campus. You are aware that your mother and father have a stormy
relationship; when you visit them you notice that their arguments appear to have
increased in frequency. There seems to be more yelling in the house. You care deeply for
both of them and feel increasingly pressured to take sides in their arguments.
Lately, your father has been drinking more. Since your father left the house one week ago
in a fit of anger, you have not seen him since. You are increasingly concerned about the
welfare of your mother and how you may have to cope without your fathers income if he
leaves the family permanently.
Since your father left, you notice your mother appears more controlling; she appears to
discourage your independence. She desires that you visit her more often. You also notice
that you and your mother appear to fight more too; and the more you fight, the more you
wish to stay away from her. You simply wish that your dad would return home and that
he and your mom would make up.
Your only real confidant in your family is your grandmother, your fathers mother who
lives in an apartment down the street from you. She however, has terminal cancer, and
only has a few months to live. You wish to spend more time with her yet feel angry over
how she appears to tease her son, your father, about his drinking. Although you do not
123


134
8.POTENTIAL BENEFITS AND ANTICIPATED RISK: (If risk of physical, psychological or
economic harm may be involved, describe the steps taken to protect the participant.)
The protocol involves no more than a minimal risk to the participant. Specifically, the risks
involved in this study are no greater than those ordinarily encountered in daily life or during the
routine performance of physical or psychological examinations or tests.
9.DESCRIBE HOW PARTICIPANT (S) WILL BE RECRUITED, THE NUMBER AND AGE OF
THE PARTICIPANTS, AND PROPOSED COMPENSATION (if any):
Students will be surveyed from four classes in the College of Education: drug and alcohol
awareness, career development, stress management, and interpersonal communication. They will
be asked if they have an interest participating in a research study exploring their general attitudes
toward counseling. If an interest is indicated, those students will then be surveyed to determine
their current willingness to seek counseling. If a moderate to strong interest in seeking counseling
is indicated, those participants will be selected to participate in the study. The approximate age of
the participants will range from 18-22 years of age. Proposed compensation may include extra
credit for each participant; however this is up to the discretion of each individual course instructor.
10.DESCRIBE THE INFORMED CONSENT PROCESS. INCLUDE A COPY OF THE
INFORMED CONSENT DOCUMENT.
Informed consent allows for research participants to freely and consciously choose to participate
in a research study while fully satisfied that there is minimal risk to the research protocol and
knowing that the confidentiality of each participant is guaranteed.
Principal Investigator: David Cox
Principal Investigators signature and date:
Research Supervisor/ Committee Chairperson: Dr. James Archer, Jr.; Ph.D.; Professor
Research Supervisor/Committee Chairpersons signature and date:
I approve this protocol for submission to the UFIRB:
Department Chair: Dr. Harry Daniels; Ph.D.; Professor
Department Chair signature and date:


115
However, there appear two remedies for this situation. One possibility is to
redesign the three treatments used in this study into one treatment, combining all
elements of the construct and thus investigating only two groups, one treatment and one
control group. Or secondarily, one could recreate the study as it is, but include an
additional treatment group and then compare and contrast results from other treatments
restricted to one isolated component of the construct to one treatment group that
combined all parts of the construct. Thus, from this modification in design, there would
be four treatments, not three. One treatment would isolate the experiential component of
efficacy and be compared with another treatment with the modeling component and to
another treatment with the feedback aspect of efficacy included. The fourth treatment
would combine all four factors of the construct. All four-treatment groups could then be
compared to a fifth, no treatment control group.
However, the critical implication of this study is that clinical assessment of
prospective client efficacy and readiness would appear more important to a favorable
counseling outcome than specific choice of intervention applied during counseling.
Again, one possibility is that the relatively strict exclusionary criteria in this study helped
to funnel prospective clients into this study that were already moderately high in levels of
efficacy and readiness. Thus, in the final analysis, results from this study suggest that if
clients are motivated to begin counseling and possess moderately high efficacy beliefs,
than treatment selection or intervention appears relatively independent of outcome.
Limitations of the Study
This dissertation is an analogue study. As a result it is limited in its external
validity (Heppner, 1989). Although those that volunteered for participation in the study


22
counseling research on self-efficacy (Bandura, 1977) targeted how self-efficacy was
implicated in anxiety and its related disorders, specifically phobias (agoraphobias, snake
phobias). Much of the early self-efficacy research in this area attempted to understand the
relationship between coping performance to anxiety and avoidant behaviors. Historically
avoidant behavior was explained by an anxiety drive (Freud, 1961). Freud believed that
autonomic arousal and its subsequent anxiety motivated individuals to specifically avoid
the behavior that manifested the original impulse.
However, the role of anxiety on avoidant behavior and performance was later
challenged by empirical research that documented that success of self-efficacy in
predicting outcome performances. For instance, Williams, Dooseman and Kleinfield
(1984, as cited in Bandura, 1997) noted the specific role of perceived coping efficacy on
agoraphobics who received separate treatments of guided mastery and exposure in
comparison to a no-treatment, control group. Both treatment groups showed significant
gains in successful performance as a function of self-efficacy, compared to the control
group.
Williams and Rapaport provide another example of the role of self-efficacy on coping
outcomes (1983, as cited in Bandura, 1997). These authors extended the influence of
perceived coping efficacy on outcome by illustrating the comparison between perceived
self-efficacy and coping behaviors when anticipatory anxiety was controlled versus the
effect of anxiety on coping when self-efficacy was controlled. Almost all studies by
Bandura (1997) et al in this area of research have demonstrated a positive correlation
between perceived efficacy on coping performance in comparison to studies that only
correlated anxiety to performance. Although early research on snake phobias


85
behavior, perhaps the results from this study are interpretable as more preliminary rather
than confirmatory of the measures reliability and validity when administered in contexts
outside of a substance-abusing population. Finally, the CSEBS or the client self-efficacy
behavior scale was a novel measure and has only been used in three prior studies (Sutton,
1998; Longo, Lent and Brown, 1992; Longo, 1991).


BIOGRAPHICAL SKETCH
David K. Cox was bom on December 13, 1966, in Lawrence, Kansas. After
graduating from high school in Seattle, in June 1984, David then attended Whitman
College, in Walla Walla, Washington, where he studied history. After graduating in May
1988, with a Bachelor of Arts degree in history, David returned to Seattle. After six years
of extended undergraduate education in the physical and social sciences at Seattle
University and the University of Washington, David applied to graduate school in
psychology. He attended Antioch University-Seattle for two quarters, before transferring
to Northwestern University in Evanston, Illinois. David graduated with a Masters of Arts
degree in counseling psychology from Northwestern University in June 1999. That fall,
he began the doctoral program in counselor education at the University of Florida, in
Gainesville, Florida. He completed his Specialist in Education degree in December 2000,
while studying toward the doctoral degree.
Although a national board certified counselor, David is currently working toward
clinical licensure; once licensed, he plans to work in private practice, specializing in a
variety of issues: mens needs, leadership, how best to increase professional performance,
and how to cope with loss. David has a very special interest in examining the interface
between spirituality, philosophy, and psychology. David markets himself as a personal
trainer for the mind. His hobbies include golf, chess, exercise, eastern philosophy, skiing
and traveling.
153


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UNIVERSITY OF FLORIDA


45
described without overlap. Traditionally, skills training were applied for correcting skills
deficits. Motivational therapies were used for enhancing motivation in substance abuse
clients. Baer et al.s (1999) skills training (ST) research dates from the mid sixties and
the work of Lazurus (1965, as cited in Miller, 1991). The central premise with ST is to
improve a clients coping skills to improve the stress of addiction. ST traditionally
assumes the client is motivated to change but he/she lacks the necessary skills to change.
Sills training incorporates post-modern, solution-focused (Hoyt; 1995) assumptions into
treatment.
Baers et al. (1999) research demonstrated that the integration of skills training and
motivational interviewing is possible by understanding three fundamental premises: one,
that motivation for change is critical for successful treatment outcome; two, wide
differences exist in all clients in the nature, degree, and application of coping skills, and
three, coping skills need to be assessed in counseling, independent of motivational level
for change. For instance, if a client is motivated to change but lacks the coping skills to
tolerate unpleasant affect, it is assumed that a clients chances for successful behavioral
change will be decreased. Consequently, client skill and motivational level are never
viewed in isolation. Thus, integrative aspects of this model could be applied to a high-risk
yet potentially common situation for an alcoholic to use, and relapse, due to peer
pressure. For example, peer pressure to drink and ultimately consume is considered in
this context as reflecting either a lack of assertiveness (skill) and/or perceived shift in the
desire to not remain abstinent (motivation). Therefore, integrating treatment options is a
necessary consideration in motivating clients toward a successful, brief treatment
outcome for substance abuse clients.


112
precontemplation or contemplation, respectively.
Interestingly, when total counseling readiness score was entered into the fifth
model to analyze the treatment effects on follow-up, the treatment effect became non
significant. The mediating effect of readiness on treatment and not self-efficacy on
treatment contrasts with social-cognitive theory. Social-cognitive theory predicts that
self-efficacy mediates the effects of motivation and related constructs on performance
outcomes (Bandura, 1997; Pajares and Miller, 1994). However in this study, self-efficacy
remained significant in predicting likelihood to seek follow-up counseling when total
counseling readiness score was added to the fifth model. This finding illustrates the lack
of mediation of efficacy on readiness in predicting follow-up.
Another theoretical implication of this study involves path analysis research. Most
path analysis research on efficacy and motivation has been done in academic contexts
outside of counseling (Bandura, 1997; Miller and Pajares, 1994). One suggestion for
future research would be to replicate this study doing a path analysis between efficacy
and readiness in predicting follow-up, specifically examining the theoretical role of how
efficacy mediates the effects of gender, treatment and readiness in counseling. Further,
distinguishing performance motivation in counseling, separate from other contexts might
be helpful in illuminating specifically how social-cognitive constructs contribute to direct
and indirect mediating pathways on clinical outcomes. Such research could be a
promising avenue toward empirical validation of the theoretical pathways of these two
variables in counseling. Lastly, as mentioned in chapter one, most of the research on self-
efficacy and motivation relates to attrition in substance-abusing populations. This study
empirically validates and illuminates the specific role of social-cognitive theory and its


73
Delineation of Relevant Variables
Dependent Variables
The first two measures, the CSEBS, client self-efficacy behavior scale, and the
URICA, University of Rhode Island change assessment instrument, were utilized to
calculate prospective client self-efficacy and secondarily, prospective client readiness for
change in counseling. The CSEBS score, or client self-efficacy behavior scale score is
calculated by summing the 20 items responses collectively into one score. The URICA
score, is composed from 4 subscales, measuring precontemplation, contemplation, action
and maintenance (see Prochaska, 1986), thus yielding a 32 item self-report score that is
used to assess and analyze readiness for change at entrance to counseling treatment. A
third dependent, dichotomous variable was also incorporated into the study to measure
follow-up interest in seeking counseling as a result of subject participation in this
dissertation study. Gender, treatment, self-efficacy, and readiness for counseling were
evaluated separately. The interaction between gender and treatment was also examined.
Independent Variables
Gender and treatment were the two independent variables in the study. Student
volunteers were randomly assigned to four, treatment groups. Treatment one consisted of
volunteer participants experiencing an individual, scripted, counselor-client role-play
with students in the prospective, client role and a trained graduate student, in the
counselor role. Treatment two participants observed a simulated counseling session on
video, role-played by a trained graduate student counselor and a trained graduate student
client. Participants in the third treatment group read counseling literature. Treatment three
composed of three case studies of simulated yet likely scenarios potentially encountered


92
Table 4
A 2x4 Analysis of Variance for Gender (G) and Treatment (T) Interaction, Between
Subjects Model with Counseling Self-Efficacy as the Dependent Variable
Source
df
F
Sig.
Gender (G)
1
(165.097)
.253
.616
Treatment (T)
3
(58.379)
.030
.993
GT Interaction (GT)
3
(2855.173)
1.458
.230
Error
111
(72463.954)
Corrected Total
118
(75598.639)
Note. Values enclosed in parentheses represent mean square error terms. *p >.05 not
significant.
Model 2
Results below in table 5 illustrate the non-significance of the 2x4 ANOVA
omnibus model without the interaction term, of the dependent variables entered in
predicting counseling self-efficacy, F (4, 118) = .106, g > .05, with the significance level
= .980. Such non-significance of results supports all eight, null hypotheses of the study.
Table 5
witnuui me interaction wun xoiai aeir-nincacv ocore as tne Dependent
Variable
Model
Sum of Squares
df
Mean Square
F
Sig-
Regression
279.511
4
69.878
.106
.980
Residual
75319.127
114
660.694
Total
75598.639
118
Predictors: (Constant), LIT, GENDER, VIDEO, ROLE,
p>.05; non-significant
Model 3
Results below in table 6 reflect the significance of the 2x4 ANOVA, omnibus


114
standard deviation compared to the video group. Further, Bandura considered personal
and prior experience (1997) to be the most influential source of self-efficacy
development, above and beyond other theoretical components of efficacy. Considering
the effectiveness of role-plays at simulating the positive and experiential benefits of
counseling while increasing participant self-efficacy in a variety of helping related
contexts (Alexander, 1999; Larson, 1998; Williams and Hall, 1988; Twentyman, 1979),
the significant finding of the role-play treatment on willingness to seek follow-up
counseling was expected. In addition, it is possible that the positive and experiential
impact of counseling from one counseling session or involuntary counseling appears
more likely to generate a positive follow-up response than either the vicarious component
of video or the cognitive influence of literature on prospective clients. However, any of
the three treatments were significant above and beyond the control group. The fact that
the video and literature treatment groups were equally significant on students likely to
seek follow-up counseling demonstrates the relative worth of either intervention. Thus
even the use of simple videos or brochures to educate prospective clients to the
counseling process appears helpful in the initial and earliest stages of counseling.
Another clinical implication of this study to emerge from the analysis was that
creating treatments that isolate the various components of self-efficacy may be misguided
and may indeed have contributed to the non-significance of the treatments on both
dependent variables. By dividing the construct into its separate components, perhaps
something in the translation is lost when converting each component of efficacy into one
separate treatment. In other words, the whole of the construct appears greater than the
sum of its parts and perhaps future treatments in studies need to reflect this possibility.


59
on long-term retention of learning. Cundick (1962) and Gladstein (1969) obtained an
initial finding regarding client expectations and then measured expectations again, after
the counseling relationship had terminated. Post-measurement was done in order to
evaluate possible effects of ending the relationship on client expectations. Other role-
induction formats include interviews that can occur after a video has been shown, or in
some combination with another treatment (written material) after an initial interview
(Kemmerling, 1972).
Role-induction procedures that specifically include a role-play have been
examined in a variety of counseling related, helping contexts (Alexander, 1999; Williams
and Hall, 1988; Twentyman, 1979). Alexander (1999) studied the effects of a self-
efficacy enhancement program on condom usage in college students. In this study it was
hypothesized that an AIDS prevention model, based on the implicated role of self-
efficacy in medical health (Bandura; 1997) would enhance HTV and AIDS prevention by
increasing condom use. Although increases in self-efficacy were reported in the treatment
group, current sexual practices were not altered.
Williams and Hall (1998) noted the influence of role-plays on assertiveness
training in college students. These authors examined methods to enhance assertiveness
related to peer requests that included drug use, cheating, loaning money to a friend,
protesting others that cut in line, etc. In three, two-hour sessions (Williams and Hall;
1998) students observed assertive yet appropriate responses while receiving performance
feedback once the imagined role-play scenario was completed. The role-play training
proved beneficial to all members in the exercise subsequent to its conclusion.
Twentyman (1979) examined the influence of role-plays as a rehearsal treatment


130
6. The relationship between counselor and client differs in important ways from that
of doctor and patient or social friendships. In counseling, the counselor tends to
act more like a skilled listener, rather than give advice. In addition, counseling
helps you prioritize what you want to do with your life, while empowering you
from choice in how to manage and handle your problems.
7. It may take some time to get used to counseling. It is normal at times to have
doubts about the counseling process; however, one should stay in counseling a
few times and discuss these concerns with their counselor before making a
decision to not attend.
8. Clients may experience difficult periods while counseling; clients may be tempted
to skip their appointments. To make positive, long-lasting changes, one should
continue to attend even when things are difficult.
9. Progress in counseling does not always occur right away, nor is progress often
steady.
10. Most clients who commit to counseling for a few sessions and are willing to
actively participate find that counseling can help them feel less stressed and
troubled while empowering them to pursue personal goals in their life.
In a 1994, national consumer reports survey, over 4000 adults who had sought
professional counseling the previous year, were surveyed about their attitudes toward
counseling. 54% said that counseling helped significantly with the management of
personal issues in their life, while an additional 33% said that counseling helped them to
some extent. (Consumer Reports, November 1995)


71
CHAPTER 3
METHODOLOGY
Statement of Purpose
The purpose of this study was to assess the experimental influence of a role play,
a counseling video, and counseling literature on prospective clients self-efficacy and
readiness for change as a function of motivation for counseling. In this chapter, the
research hypotheses, relevant variables, population, sampling procedures, data collection,
and data analytic procedures are described. Additionally, the instrumentation and the
studys limitations are discussed.
Hypotheses
The following null hypotheses were investigated in this study:
Hoi: There is no statistically significant association between the role play,
treatment group, (group 1) and the no-treatment control group, (group 4) on either the
CSEBS, client self-efficacy, behavior scale measure, and/or the URICA, University of
Rhode Island, change assessment instrument.
Ho2: There is no statistically significant association between the video,
treatment group, (group 2) and the no-treatment control group, (group 4) on either the
CSEBS, client self-efficacy, behavior scale measure, and/or the URICA, University of
Rhode Island, change assessment instrument.
Ho3: There is no statistically significant association between the counseling
literature group, (group 3) and the no-treatment control group, (group 4) on either the


124
miss your fathers yelling, you do wish he were around more. You feel obligated to
defend him. Your conflict is extended between desiring to spend more time with your
grandmother (after all she is deteriorating and you are scared to lose her), yet you also
yearn for more independence and autonomy in college, away from your family and its
pain.
Noting that your grades have begun to slip, while your friends report that you seem
distant and upset, your increasingly troubled and confused emotional state leaves you
wondering what options you have. A friend recommends that you see a counselor and
share your concerns with her. Feeling alone and stressed, you agree with your friend to
see a counselor.


ACKNOWLEDGMENTS
I honor the following with great appreciation and gratitude. Their help, guidance,
wisdom and leadership served to sustain me through this extremely rewarding and
challenging doctoral process.
First and foremost, I honor God; without the power of his creation, and his
guidance and wisdom, none of any of this would have been possible. Second, I honor and
thank my wife, Alison. Her great love and support throughout my seven years of graduate
school are beyond measure; language fails to capture how much her support meant to me
during the more trying moments of this protracted process. Third, I honor my children,
Jordyn and Kyle. Jordyn entered this world three weeks before I began my doctoral
studies; her entrance into this world has made my life experiences so much more loving,
rich and meaningful. To Kyle, my son, whose endless love, smiles and laughter served
and continue to serve as a gentle reminder to enjoy the journey while not focusing so
much on the destination.
Special thanks go to Dr. Jim Archer, my advisor, whose expert guidance and
instruction helped me navigate through the intricacies and difficulties of my dissertation.
Thanks also go to Dr. David Miller, Dr. Harry Daniels, and Dr. Marshall Knudson, who
all served on my committee and were eager to help. I thank Marshall for his
understanding and support. Very special thanks go to Sara Summerfield for her
dedication and work in helping me format my dissertation and helping me enter my data
iii


145
Hoehn-Saric, R., Frank, J., Imber, S., Nash, E., Stone, A., and Battle, C. (1964).
Systematic preparation of patients for psychotherapy: Effects of therapy behavior and
outcome. Journal of Psychiatric Research. 2, 267-281.
Holloway, E. (1995). Clinical Supervision: A Systems Approach. Thousand Oaks, Ca:
Sage Publications.
Hoyt, M. (1995). Brief Therapy and Managed Care. San Francisco: Jossey-Bass
Publishers.
Hume, D. (1999). Empowering Women: Developing skills and building self-efficacy for
dealing with verbal sexual coercion. Dissertation Abstracts International: Section B: The
Sciences and Engineering University. Microfilms International. 60. (4-B), 1855.
Isenhart, C. (July, 1997). Pretreatment Readiness for Change in Male Alcohol Dependent
Subjects: Predictors of One-Year Follow-Up Status. Journal of Studies on Alcohol, 351-
356.
Jakes, A. L. (1982). Effects of a pre-psychotherapy videotape induction upon subject
expectation, motivation, and participation. Dissertation Abstracts International. 43. (6-
B),1984-1985. (University Microfilms No. DA8226397).
Jakobsen, L., Krager, L. (1988). A Mission for Residential Education. Journal of
College Student Development. 29. 476-477.
Johnson, E, Baker, S.B. Kopala, M., Kiselica, M.S. and Thomson, E.C. (1989).
Counseling self-efficacy and counseling competence in prepracticum training. Counselor
Education and Supervision. 28. 205-218.
Johnson, E. and Seem, S.R. (1989, August). Supervisory style and the development of
self-efficacy in counseling training. Presented at the annual meeting of the American
Psychological Association, New Orleans.
Kazdin, A. (1978). Evaluating the generality of findings in analogue therapy research.
Journal of Consulting and Clinical Psychology, 46. 4, 673-686.
Kemmerling, R.G. (1972). The effect of the intake interview on client expectations: A
study utilizing videotape treatments to manipulate client expectancies. Dissertation
Abstracts International, 33. 3387. (University Microfilms no. 73-644).
Klepac, R. (1970). An experimental analogue of psychotherapy involving client
behavior as a function of confirmation and disconfirmation of expectations of therapist
directiveness. Dissertation Abstracts International. 30. 5690-5691. (University
Microfilms No. 70-11, 348.)


49
study that examined the effects of training on client self-exploration. Clients listened to
audiotapes of potential issues and concerns that could be encountered in counseling.
Subjects in both general and specific audio groups scored significantly higher than the
control, no-treatment group on a client-self exploration scale. Similar studies have
investigated the role of training as an adjunct to instructional models aimed at increasing
verbal expression of emotion of clients seeking counseling. Shaw et al. (1985) found that
different self-taught modeling, an audiotape, or workbook alone or in some combination
all increased verbal communication skills of client emotion, significantly above a control
group.
Others have looked at preparatory training for increasing job skills and confidence
related to counseling. Elkins and Cohen (1982) evaluated the comparison of the effects of
pre-job training and job experience on nonprofessional, crisis phone workers. These
authors found that counselor related skills on the phone (paraphrasing, empathy,
summarization, feeling reflection) improved dramatically with training in preparing the
phone workers for prospective calls, although little long term gain was achieved at a five
month follow up.
Another important avenue of preparatory training has served crisis counselors
specifically working with victims of date rape (Burke, 1988; Thomas, 1982). Typically,
volunteers who commit to working in crisis centers with this population receive
instruction using film, presentations, national speakers, discussions, and individual role-
plays. Participants usually show less blame of the victim after the incident than before
while improving on dimensions of counseling-related, listening skills (Thomas, 1982).
Burke (1988) demonstrated the effectiveness of a date rape-videotape on a college


144
Hannes, J. (1999). An analysis of the efficacy of HIV/AIDS education with three
methods of delivery: Interactive video, psychoeducational counseling, and group
education via pamphlets. Dissertation Abstracts International: Section B: The Sciences
and Engineering University. Microfilms International, 59,(8-B), 4536.
Hardin, S.I. and Yanico, B.J. (1983). Counselor gender, type of problem, and
expectations about counseling. Journal of Counseling Psychology, 30, 294-297.
Hartfield, M.T., Cason, C.L., and Cason, G. J. (1982). Effects of information about a
threatening procedure on patients expectations and emotional distress. Nursing
Research, 31, 202-206.
Harrison, A.W., Rainier, R.K., Hochwater, W.A., and Thompson, K.R. (1997). Testing
the self-efficacy performance linkage of social-cognitive theory. Journal of Social
Psychology, 137, 79-87.
Heather, N. (1992). Addictive Disorders are essentially motivational problems. British
Journal of Addictions, 87, 828-830.
Heilbrun, A.B. (1972). Effects of briefing upon client satisfaction with the initial
counseling contact. Journal of Consulting and Clinical Psychology, 38, 50-56.
Heilter, J.B. (1973). Preparation of lower-class patients for expressive group
psychotherapy. Journal of Consulting and Clinical Psychology, 41, 251-260.
Heilter, J.B. (1976). Preparatory techniques in initiating expressive psychotherapy with
lower class, unsophisticated patients. Psychological Bulletin, 83, 339-352.
Helms, J.E. (1975). Differential effects of prestructuring clients expectations of
counselor empathy on clients anxiety and evaluation of the counselor using two types of
analogues. Dissertation Abstracts International, 36, 2472-2773. (University Microfilms
Number 75-25, 331).
Heppner, M. (1994). An Empirical Investigation of the Effects of a Teaching Practicum
on Prospective Faculty. Journal of Counseling and Development. 72, 500-508.
Heppner, P. Paul (1989). Social influence research in counseling: A review and critique.
Journal of Counseling Psychology, 36, 3, 365-387.
Hicks, D. and Rundell, J. (1996). HIV testing and counseling. International Review of
Psychiatry, 8, (2-3). 177-184.
Higbee, J. (1996). Ability, Preparation, or Motivation? Research and Teaching in
Developmental Education, 13, 1, 93-96.


72
CSEBS, client self-efficacy, behavior scale measure, and/or the URICA,
University of Rhode Island, change assessment instrument.
Ho4: There is no statistically significant association between the role play,
treatment group, (group 1) and the video, treatment group, (group 2) on either the
CSEBS, client self-efficacy, behavior scale measure, and/or the URICA, University of
Rhode Island, change assessment instrument.
Ho5: There is no statistically significant association between the role play,
treatment group, (group 1) and the counseling literature group, (group 3) on either the
CSEBS, client self-efficacy, behavior scale measure, and/or the URICA, University of
Rhode Island, change assessment instrument.
Ho6: There is no statistically significant association between the video
treatment group (group 2), and the counseling literature group (group 3), on either the
CSEBS, client self-efficacy, behavior scale measure, and/or the URICA, University of
Rhode Island, change assessment instrument.
Ho7: There is no statistically significant interaction between gender and
treatment type (group 1, group 2, group 3, group 4) on either the CSEBS, client self-
efficacy, behavior scale measure, and/or the URICA, University of Rhode Island, change
assessment instrument.
Ho8: There is no statistically significant association between genders on either
the CSEBS, client self-efficacy behavior scale, and/or the URICA, University of Rhode
Island, change assessment instrument.


63
committed two ethical infractions that were presented as a treatment in a reading,
literature group. Although participants in an active recall session showed improved
performance over a control group on understanding the gravity of potential ethical
violations in counseling, being able to translate subject knowledge of ethical practice into
behavioral change or confrontation with therapist did not occur later at follow up.
Gordon (1982) developed a patient preparation brochure for the purpose of
studying the effects of literature as a pre-psychotherapy intervention on client
expectations. Few significant effects were reported. Gordon (1982) suggested one reason
for lack of empirical support of the brochure was due to the lack of measurement of the
severity of client problems.
Tinsley (1988) suggested that one such form of a verbal intervention requires the
alteration of verbal procedures as one manipulation strategy. For instance, some
investigators (Ziemelis, 1974, as cited in Tinsley, 1988) have applied a matching
procedure whereby research subjects were told that they had been or not been favorably
matched with a desired counselor. The function of these studies was to determine whether
or not client expectations generated from such information modified existing client
expectations of the counseling process. Ziemelis (1974) looked at the relationship
between manipulations of client information to expectations of counselor selection by
randomly assigning participants to either positive, negative, or no pre-treatment interview
information. Helms (1975, as cited in Tinsley, 1988) had participants read empathy-
reducing, empathy increasing or empathy neutral information regarding potential
interactions of attraction and anxiety with a counselor. Non-significant results were
found.


23
demonstrated the more primary role of prior coping experience on the development of
coping efficacy, Bandura (1997, 1986, 1977) nevertheless included the role of emotional
arousal in self-efficacy composition. Of the four theoretical sources of self-efficacy,
Bandura (1997) considered ones emotion to be the least impactful on self-efficacy
construction and development.
Further elaboration on the composition of self-efficacy (Schunk, 1994) has also
illustrated that the relationship between self-efficacy and performance-based treatments is
perceptual. For instance, people who judged themselves high on self-efficacy perceive
their performance resulting from a combination of effort and skill, not chance or random
variation (Bandura, 1997). Specifically, how one perceives and subsequently integrates
the combination of ones prior experiences, vicarious modeling, verbal encouragement
and emotional arousal is what promotes individual self-efficacy development. However,
the four sources of self-efficacy do not directly compose self-efficacy as a construct. The
constructs composition is inferred from the four theoretical sources of self-efficacy that
determines how ones self-efficacy toward a particular task is perceived and applied
toward future performances in any given context. For instance, ones ability to act on
stage would be inferred from multiple sources of the quality of prior acting performances,
the quality of previous modeling offered in this area, the quality of verbal encouragement
and support offered, and lastly, the degree to which ones emotional arousal was
controlled in order to optimize performance.
Social-cognitive theory (Bandura, 1986) suggests that ones anticipation of outcome
as either potentially positive or negative, influences outcome expectations. Outcome
expectations are subsumed under social-cognitive theory (Bandura, 1986). They are


Copyright 2002
by
DAVID KENT COX



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APPENDIX D
COUNSELING LITERATURE
Essentially, counseling helps people cope and handle problems of an emotional and
stressful nature. People tend to have a general ideal of what areas of their lives they
would like to improve, but they may have difficulty knowing how to make that positive,
first step in resolving emotional problems that tend to leave people feeling stuck.
The counseling experience can help you develop new learning and new self-awareness
while helping you build an increased understanding of your specific strengths and
weaknesses.
Counseling is a professional relationship between a professional counselor and a client.
The hallmark of a counseling relationship is the confidentiality shared between counselor
and client. This allows clients to freely and openly express themselves in a safe manner.
Confidentiality also expands the lines of communication where previous shame or
embarrassment may have existed for the client. Such genuine, honest, open
communication between counselor and a client helps to build trust, the cornerstone of any
relationship, personal or professional.
The counselor/client relationship differs in important ways from that of a doctor/patient
relationship. In counseling, the counselor serves more as a skilled listener, rather than
advisor. Further, it is normal to have doubts about the effectiveness of the counseling
process. However, the client should attend more than one session and discuss his/her
concerns with the counselor before deciding whether or not to continue in counseling.
Progress in counseling is not always consistent, nor does progress tend to occur right
away. Counseling can be a lot of hard work and entails often working through stressful
emotional material. Thus, clients may continue to experience difficult periods during
counseling. However, this does not mean the counseling process is not working. To make
positive, long-lasting changes, one should plan and commit to attending more than one
session. Most clients who commit to and actively participate in counseling find that
counseling can help them feel less stressed while leaving them feeling empowered to set
and achieve positive, personal goals.
125


106
problem-behavior and being able to work toward resolution of the identified issue so that
behavioral change may occur (Carbonari, 1990; McConnaughy et al., 1989).
Three different counseling treatments were created from the four theoretical
components of self-efficacy: experiential learning, modeling, verbal feedback and
emotional arousal. The first treatment group was subject to a counseling role-play in
order to promote a positive, prospective experience of the counseling relationship. A role-
play was designed to capture the experiential and affective components of counseling for
prospective clients. The second treatment consisted of a counseling video, reflecting the
vicarious, modeling aspect of self-efficacy. A counseling literature intervention captured
the verbal and cognitive elements inherent to self-efficacy and social-cognitive theory
(Bandura, 1986). All three treatments were compared and contrasted to a fourth, no
treatment, control group. 119 randomly assigned participants composed the sample size.
Discussion of Results
The first general question of this study examined differences among any of the
three treatment groups on the CSEBS and URICA, independent of gender, in comparison
to a fourth, no treatment, control group. The CSEBS was created to capture a clients
self-efficacy for counseling. The URICA or change assessment instrument was designed
to assess a prospective clients readiness for change prior to entering into a pre
counseling treatment group.
The first null hypothesis specifically examined the relationship between treatment
group 1 (counseling role-play) and group 4 (control). No significant treatment effect was
found for either measure. One interpretation of this result is since self-efficacy is
relatively stable once established, perhaps the treatment effect was not potent enough to


96
Model 5
The descriptive data in table 12 below supports the fourth general research
question of the study, from chapter one, on whether or not gender, treatment, self-
efficacy or readiness for counseling separately produce a statistically significant
association in predicting likelihood to seek follow-up counseling. For example, group
mean differences in readiness score are illustrated. A t test was also performed in order to
determine significance between the two groups seeking follow-up counseling. The
reported t value was significant, with t (117) = 6.85, a reported significance value of
.0001, and p significant, less than <. 05.
Table 12
Results Illustrating Mean Differences for R Score between Yes and No Group to Follow-
Ud Treatment with Counseling
Variable
Follow Up
N
Lower CL
Upper CL
Mean
Mean
Mean
R Score
N
33
6.38
7.05
7.72
R Score
Y
86
9.05
9.39
9.73
R Score
Diff (1-2)
-3.01
-2.33
-1.66
Model 5
Summary results below in table 13, model 5, indicate significant differences
between all three treatment groups and the control group in willingness to seek post-test,
counseling follow-up, with y = .036, p <. 05, and the likelihood ratio (LR) =.036, p <


40
strivings, additionally contributing to the retrospective nature of motivation on the
success or failure of future outcomes (Weiner, 1985).
Prochaska (1992; 1986; 1982) examined the role of motivation and readiness for
change in counseling stages. Beginning with smoking cessation, Prochaska (1982)
developed a transtheoretical research model to capture how clients and non-clients
motivate toward action in counseling treatment to achieve goals. Currently, the model is
applied to substance abuse populations as an assessment tool in determining client stage
of change. In fact, the majority of Prochaskas (1986; 1982) model provides the
theoretical framework for the URICA measure, University of Rhode Island Change
Assessment instrument, which will be used in this study. Prochaskas (1986; 1982) model
includes four significant stages and a fifth and sixth stage, which are quite brief.
The first stage is precontemplation. Precontemplators are clients in denial of their
problem. Unwilling to identify they have a problem, these clients are very unlikely to
commit to counseling. As a result, they are not ready for change and are very difficult
clients.
The second stage of the model is contemplation. The defining aspect of
contemplation is ambivalence. Clients in this stage are actively contemplating both
reasons to change and reasons not to change a targeted behavior. Consequently, these
clients are often conflicted by choice. Counselors working with clients in contemplation
attempt to shift clients toward compliance of desired and positive treatment goals by
overriding a contemplators attachment from a present behavior to a positive alternative
*
(for example, helping the client realize the advantages of moving from drug use to
abstinence).


143
Galinsky, R.C. (1971). The effects of pre-counseling treatments and initial counseling
interviews on university counseling center clients role-expectation. Dissertation
Abstracts International. 32. 736. (University Microfilms Number 71-19, 978).
Garfield, S.L. (1978). Research on client variables in psychotherapy. In A.E. Bergin and
S.L. Garfield (Eds.) Handbook of psychotherapy and behavior change: An empirical
analysis (2nd ed., pp 191-232). New York: Wiley.
Gebert, N. (1998). Efficacy of a self-management program for childhood asthmaA
prospective controlled study. Patient Education and Counseling, 35. 3, 213-220.
Gibson, D., Wermuth, L., Lovelle-Drache, J., and Ham, J. (1989). Brief Counseling to
reduce AIDS risk in intravenous drug users and their sexual partners: Preliminary results.
Counseling Psychology Quarterly, 2, 1, 15-19.
Gill, S. J. and Taylor, S.H. (1982, August). The effects of a counselor professional
disclosure statement on client expectations, behavior and satisfaction. Paper presented at
the meeting of the American Psychological Association, Washington, DC.
Goldstein, A.P., Heller, K. and Sechrest, L.B. (1966). Psychotherapy and the psychology
of behavior change. New York: Wiley.
Gordon, K. (1982). The Development and Validation of a Pre-Psychotherapy
Intervention Designed to Increase Patients Realistic Expectations of Treatment.
Dissertation Abstracts International, 44, (5-B), 1593.
Gray, H. and Tindall, J. (1974). Communication training study: A model for training
junior high school peer counselors. School Counselor, 22. 2, 107-112.
Grace, M. (1995). The effect of nonverbal skills training on counselor trainee nonverbal
sensitivity and responsiveness on session impact and working alliance ratings. Journal of
Counseling and Development, 73. 5, 547-552.
Greenberg, J. and Mitchell, S. (1983). Object Relations in Psychoanalytic Theory.
London: Harvard University Press.
Hackett, G. and Betz, N.E. (1992). Gender, ethnicity and social cognitive factors
predicting the academic achievement of students in engineering. Journal of Counseling
Psychology. 39. 527-538.
Hall, C. and Lindzey,. G. (1970). Theories of Personality (2nd Ed.). New York: John
Wiley and Sons.
Hamilton, R. (1999). A comparison of two approaches of symbolic modeling and self-
efficacy. Dissertation Abstracts International, 60. 12-B, 6390.


28
variable was operative, linking both cognition and performance with behavioral change.
Banduras (1997; 1986) synthesis of social-cognitive theory placed self-efficacy as a
significant construct that mediates between knowledge and performance in governing the
selection and initiation of behavior. Social-cognitive theory (Bandura 1997; 1986) and
related research predicts that people behave in ways that are consistent with their belief
systems. Thus, behavior is more easily influenced and driven by peoples beliefs about
their capabilities than personal knowledge and skills alone. It is predicted from social-
cognitive theory (Bandura, 1997; 1986) that changes in ones beliefs are a powerful
predictor of the initiation, persistence and maintenance of a selected behavior.
Social-cognitive theory (Bandura, 1986) predicts that the greater the client self-
efficacy or personal belief in the benefits of counseling, the more probable a client would
initiate, persist and succeed in counseling, despite obstacles and emotional distress
potentially encountered during counseling. Therefore, theoretically speaking, if
counseling professionals wish to change the behavior of a given client, the belief systems
of the client must first be examined. Even ancillary research on self-efficacy outside of
counseling has concluded with similar suggestions. In their path analysis relating self-
efficacy to mathematical competency, Pajares and Miller (1994) concluded if counseling
interventions are needed to the degree in which they change targeted behaviors, than
interventions must be applied that target the belief system of the client as well.
Extensions of Banduras research (1997, 1986, 1977) suggest that many
psychological processes are governed by self-efficacy and its related theoretical precepts
of motivational properties, goal achievement, and outcome expectations (McWhirter,
2000; Paslay, 1996; Pajares and Miller, 1994). Self-efficacy and its precepts are


127
her ability to talk confidently about her parents and her feelings for them. As a result of
being more open, Karen feels more comfortable and free being herself with others. After
eight weeks of counseling, she has been able to meet more friends, and consequently
feels less isolated. She also feels less dependent upon her parents for them to express and
validate her own feelings. Karens symptoms of depression have appeared to lessen in
severity. In counseling, Karen is learning to emotionally care for herself for the first time
in her life. She is beginning to understand that her parents relationship is not a personal
reflection of herself. Counseling has left Karen feeling truly liberated and understood for
the first time in her life.
Nicole had just been unexpectedly dumped into a crisis. Her partner of four years
at college just left her. Since her father was a professor in the counseling department, he
recommended that Nicole go see a counselor. Nicole alternated between crying and rage
over the situation. One minute she wanted him back, the next she wanted to pull his hair
out. How could my partner do this, she thought. After four weeks, she thought she
would give counseling a try; after all, what did she have to lose. She even had a close
friend recommend counseling too.
When the counselor asked Nicole what her goals were for the first few counseling
sessions, Nicole responded angrily that she simply wanted her old life back, her friends,
her confidence as a student, her ability to concentrate on gymnastics but without the pain.
She was ready and committed to move on with her life. By focusing on positive solutions
in counseling, Nicole was able to simultaneously grieve the loss of her old relationship
while working toward her promising future. Her counselor was able to help Nicole realize
that she had choices: choices to move on, choices to hang out with her friends, choices to
start over. Over time, in counseling, Nicole was able to realize that she was fine just the
way she was. She was truly ok with just being herself; she had never known this feeling
outside of a serious relationship. Nicole was able to empower herself over her new found
sense of autonomy; counseling had definitely helped her become more confident and
hopeful regarding her future.


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.
fames Archer, Jr.
Professor of Counselor Education
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.
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.
David M. Miller
Professor of Educational Psychology


129
Title: 10 Steps on How Counseling can help you cope with the stress of being in
college
1.Counseling can help you manage and cope with your stress levels.
Some stress is actually good; it helps you stay motivated and focused
But too much stress can leave you feeling tense, hurried, anxious and tired.
Sometimes, people try to cope with stress that make it worse, like using
alcohol, tobacco, or other drugs,
2. Counseling can help you identify what stresses you out. Some things that cause
stress are:
Feeling too busy
Not having the time to get what you need done
Coping with the daily pressures of work and school
Problems with family
Conflict with friends, boyfriend, girlfriend, partners
Struggles with personal identity, fitting in
Sexual, ethnic, racial concerns, issues, identity
Financial problems
3. Counseling can help you recognize the signs of stress, which include:
Feeling anxious
Not being able to concentrate
Forgetting important things
Getting sick more than usual
Using alcohol, or other drugs
Feeling depressed or overwhelmed
4. Counseling can help you identify what you can control and what you cannot
Some things that cause stress are easy to change; for instance, if you tend to
forget your homework, you can make yourself a reminder to put it in your
backpack the night before
Of course, you cannot always change things like getting the flu, having a
cold, preventing your parents from getting a divorce, but counseling can help
you manage and cope through stressful times.
5. Counseling is a learning process; the goal is to help any client cope and manage
their problems more effectively.


13
process, whether coping and recovering from addiction (Sherman, 1998), adjusting to life
following relapse (Miller, 1991) or motivating toward recovery (Prochaska, 1982) in a
brief format. Further, Longo, Lent and Brown (1992) mentioned the need for research
examining the impact of different treatments on self-efficacy and motivation early in the
counseling process. One suggestion is to provide simple, cost-effective interventions that
illustrate how best to increase client self-efficacy and motivation. Thus, this dissertation
study focuses on the treatment impact of a counseling role-play, counseling video, and
counseling literature aimed at increasing prospective client self-efficacy and readiness to
change for counseling. In addition, a follow-up measure will be given to examine the
separate and interaction effects of treatment, gender, self-efficacy and readiness for
counseling on a dichotomous variable, follow-up interest to seek counseling, as a direct
result of subject participation in this study.
Organization of the Study
This study is organized into five chapters. Chapter 1 serves to introduce the topic
and the theoretical framework, the background of the topic, the need for the study, and its
purpose. Chapter 2 reviews the related literature of the topic. Chapter 3 contains the
research methodology, including a description of the population and sample, the
instruments used, sampling procedures, and data collection methods. Chapter 4 includes
data analysis procedures and the results of the study. Chapter 5 provides a general
discussion of the implications and limitations of the study with future directions for
research.


83
variables. The first ANOVA model examined two independent variables, treatment type
(group 1, 2, 3, or 4) and gender, and their interaction, in predicting the first dependent
variable, total self-efficacy score for counseling. The second ANOVA model evaluated
treatment groups 1, 2, 3, and control group 4 and gender, and their interaction, in
predicting the second dependent variable, prospective client readiness for counseling.
Additionally, in the first two ANOVA models, the statistical main effects were examined
at the marginal means of the independent variable without the interaction term included.
The third ANOVA model examined the interaction effects of gender on treatment group
(1, 2, 3,4) and gender and treatment separately in predicting willingness to follow-up
with counseling. The third model also investigated self-efficacy and readiness for
counseling separately in predicting follow-up to counseling. A chi-squared analysis and a
logistical regression analysis was performed in order to assess the statistical significance
of the variables in predicting post-treatment interest in counseling as a direct result of
subject participation in this study.
Since Bandura (1997) cites the mediation role of self-efficacy on gender, prior
performance, and anxiety (Miller and Pajares, 1994), a pathway analysis examined
whether or not self-efficacy revealed a statistically significant mediation effect on
treatment type and gender in predicting prospective client readiness as a function of
motivation for counseling. Path analyses by correlating treatment type to self-efficacy
and then self-efficacy with motivation, in comparison to correlations of gender with self-
efficacy and self-efficacy to motivation were also examined to illustrate possible
mediation pathway effects of self-efficacy on the variables studied. The mediational role
of self-efficacy on the interaction between treatment type and gender in predicating client


65
and specific pre-treatment counseling methods designed to increase prospective client
self-efficacy and motivation to change in counseling.
Support for this study includes counseling research on self-efficacy applied to
contexts outside of counseling, such as academic achievement (Pajares and Miller, 1994),
athletic achievement (Stidwell, 1994), and self-efficacy and medical health (Everett,
2000; Hannes, 1999). Within counseling, much of the self-efficacy research has been
applied to counselor student, self-efficacy development (Larson, 1998; Daniels 1997)
substance abuse treatments (Miller and Rollnick, 1991; Prochaska and DiClemente,
1986) and supervisee self-efficacy development within supervision (Ray, 2000; Daniels,
1998; Holloway, 1995). However, in counseling research, very few empirical studies
have investigated treatment effects on gender, in predicting self-efficacy and readiness
for counseling, independent of counselor supervision, student development, and
substance abusing contexts and populations.
Further, social-cognitive theory (1986) emphasizes both the interpersonal role of
individual self-efficacy and personal agency, combined with environmental variables
(clinical context and clinician) that influence behavioral choice (for example, the
selection, initiation, and maintenance of counseling.) Thus, counseling research on self-
efficacy and motivation support treatments that capture the interpersonal nature of
counseling (Bandura, 1997). The treatments in this study emerge from the theoretical
components of self-efficacy and the interpersonal nature of social-cognitive theory, with
secondary emphasis placed upon readiness for counseling, as a function of motivation for
change.
With regards to motivation, research in this area is complicated by its broad


64
Shelton et al. (1991) examined the role of test anxiety, locus of control, and self-
efficacy as predictors of treatment preference by providing two brochures to two
treatment groups consisting of college students. In one group, the brochure described how
counseling could help prospective clients specifically cope with anxiety. The other
brochure described performance techniques (active listening, paraphrasing) in session
that clients potentially find helpful. Interestingly, results indicated that subjects assigned
to the performance group had higher levels of self-efficacy regarding performance in
counseling and lowered anxiety, than the anxiety-focused group. One interpretation of the
results can be inferred from self-efficacy theory (Bandura, 1997; 1986; 1977), as efficacy
levels typically increase with interventions that relate efficacy more specifically to
performance-based interventions and not just targeted emotional arousal. In fact usual
correlations between efficacy beliefs and performance tend to be congruent unless
indicative of more defensive dynamics that manifest from personal underlying insecurity
(Bandura, 1997), often witnessed in clinical supervision (Larson, 1998; Holloway, 1995).
Despite the application of counseling literature as a valid, verbal intervention,
Tinsley (1988) suggested that written documents were only successful in 4 of the 11 of
the studies he reviewed (McKee and Smouse, 1983; Gill and Taylor, 1982; Falcone,
1980; Randall, 1969, as cited in Tinsley, 1988). However, he concluded that the future
examination of counseling literature as an intervention in counseling studies with solid
methodological designs was warranted.
Conclusion
In conclusion, this review of the research literature has included an examination
of the empirical role of self-efficacy, motivation for counseling, general training methods,


39
expectations of a given outcome. For instance, ones high, moderate or low expectations
motivate a given behavior based on expectations of a desired outcome. An aspiring client
with the expectations that working together and remaining motivated through couples
counseling in order to save a troubled marriage would be one example.
Counseling research related to motivation also targets goal setting. Locke and Latham
(1990) and Ment, Karen and Steel (1990, cited in ONeil and Drillings, 1994) examined
how personal goals require motivational potential. From these authors, much of their
research drives goal setting theory, which investigates the relationship between ones
explicit goals and personal standards of motivation. One example would be to change
how one communicates with a partner in order to become a better partner. This line of
theoretical inquiry and research suggests for example that the relative degree of ones
prior performance or behavior (one partner suggests in couples counseling that the other
partner is not sensitive when angry and the other partner agrees) in contrast to ones
current standards of becoming an improved partner actually determines future
motivational state. Thus, from this model, the motivational source for behavior change is
considered retrospective.
Another line of research that targets motivation in counseling emerged from
attribution theory (Weiner, 1985). Attribution theory (Weiner; 1985) suggests that prior
judgments of ones performance have predictive utility in demonstration of future
motivation on performance outcomes. In other words, outcomes are considered highly
dependent upon how people perceive and attribute prior motivation upon future
performance. Thus, similar to self-efficacy and social-cognitive theory, attribution theory
suggests that former motivational precepts impact performance and achievement


82
a single factor of readiness for change. Each form of the measure is then correlated with
that factor to interpret the goodness of fit of the model with the theoretical model
(Carbonari et al., 1996).
The authors suggest that a very good fit is indicated for each scale with the model
proposed (ALCREADI-A, CFI = .960, GFI = .984; ALCREADI-B, CFI = .945, GFI =
.981). The CFI or confirmatory fit index, provides a statistic that adjusts for the normed
fit index (NFI), comparing the model fit to that of another model with the same data,
presuming independence of measured variables. A range of .9-.95 specifies a good fit.
The GFI or goodness of fit index, compares the models data with that expected of a
theoretical model; further the GFI compares the ability of the model to reproduce the
variance-covariance matrix (generally speaking, the magnitude of strength and direction
between two measures) to no model at all. The correlations of the two separate versions,
A and B, of the URICA with the 32 item full measure lend further credibility to the
construct validity of the 24 item measure (A-B, r = .84; A-AB, r = .96; B-AB, r = .96).
The obtained alpha coefficients for each split half measure of the URICA,
respectively measured at (.8), and (.78), and the full measure, of (.89), suggest the
reliability of the instrument is relatively stable. The alpha coefficient for each subscale
documents the instruments consistency as well; (.74) for the precontemplation scale,
(.79) for contemplation, (.815) for action, and (.738) for the maintenance stage
(Carbonari et al., 1996).
Data Analytic Procedures
A 2 x 4 ANOVA factorial design was applied to three separate models in order to
examine between variance between the two independent variables and the two dependent


70
approximately 75% of the training application studies failed to demonstrate adequate
internal validity. Added methodology concerns with training methods include empirical
studies that fail to incorporate relevant theoretical variables that can influence preparatory
effects. For instance, Deane (1992) showed that further preparatory influences from
training can be mediated by anxiety alone and that related variables need to be accounted
for in empirical studies of preparatory programs and studies.
Other measurement issues in this area include the potential for confounding
variables that obscure conclusions about treatment effects. Counseling research
illustrating pre-counseling orientation is rich with articles that cite the complexity of
human interaction and the multitude of confounding and situational factors to even an
initial, preassessment interview (Larson, 1998; Deane, 1992; Tinsley, 1980). Future
research studies are justified in relating how specific pre-treatment counseling methods
can be applied to increase prospective self-efficacy and motivation for change in
counseling clients, without the previous measurement issues mentioned.


108
variable, prospective counseling self-efficacy or readiness for change. Thus it is
concluded that gender had no significant effect on treatment. However, regarding
hypothesis eight, there was a significant effect for female gender in predicting higher
readiness scores, without the treatment interaction.
The significance of female gender on readiness was expected. Longo (1991)
reported the significance of gender on motivation in predicting client attrition. Hardin and
Yanico (1983) and Tinsley (1980) showed how client expectations and gender are linked
to motivation. Perhaps the effects of socialization on women render them more likely to
disclose the need to seek help over men in counseling and other relational, help-seeking
contexts.
Similar to motivation, results of gender on self-efficacy have also been
inconsistent. Sullivan and Mahalik (2000) showed the significance of female gender and
efficacy on career development in women. Pajares and Miller (1994) demonstrated
greater gender differences in efficacy relating math performance to men. Hackett and
Betz (1992) showed gender differences in career choice among women. However, the
non-significance of gender in predicting self-efficacy has also been documented (Schaub
and Tokar, 1999; Longo, Lent and Brown, 1992). Thus, results from this study suggest
that the variance of gender results must not be considered independently from contextual
influences and related variables that govern the construction and design of any study.
The third and fourth ANOVA models examined the independent variables in
predicting readiness, both with and without the interaction term between gender and
treatment. Self-efficacy was also entered as a third independent variable to determine
significance in predicting counseling readiness, (p= .001 and <. 05, t (1, 118) = 3.383).


147
Maddux J. and Bames, J. (1984). Cognitive Processes in Psychotherapy and Behavior
Change: Self-Efficacy Expectancy, Outcome Expectancy, and Outcome Value. Found in
ERIC Microfiche, University of Florida, Education Library; Document Number:
ED251738.
McConnaughy, E.A., DiClemente, C.C., Prochaska, J.O., and Velicer, W.F. (1989).
Stages of change in psychotherapy: A follow-up report. Psychotherapy: Theory. Research
and Practice. 4. 494-503.
McCrae, R.R. and Costa, P.T. (1987). Validation of the five-factor model of personality
across instruments and observers. Journal of Personality and Social Psychology, 52. 81-
90.
McKee, K. and Smouse, A.D. (1983). Clients perceptions of counselor expertness,
attractiveness, and trustworthiness: Initial impact of counselor status and weight. Journal
of Counseling Psychology 30. 332-338.
McWhirter, B. (1999). Effects of anger management and goal setting group
interventions on state-trait anger and self-efficacy beliefs among high-risk adolescents.
Current Psychology: Developmental. Learning Personality and Social, 18, 2, 223-237.
Mennicke, S.A., Lent, R.W., and Burgoyne, K.L. (1988). Premature termination from
university counseling centers: A review. Journal of Counseling and Development, 66,
458-465.
Mickler, T. (1999). A Comparison of three methods of teaching skin self-examinations.
Journal of Clinical Psychology in Medical Settings, 6, 3, 273-286.
Miller, H. (1987). The Miller Motivation Scale: A New Counseling and Research Tool.
Microfiche. Saskatchewan, Canada; Document Number ED 280879; Education Library,
University of Florida.
Miller, N. and Dollard, J. (1941). Social Learning and Imitation. New Haven, CT: Yale
University Press.
Miller, W., Benefield, G. and Tonigan, J.S. (1993). Enhancing Motivation for Change in
Problem Drinking: A Controlled Comparison of Two Therapist Styles. Journal of
Consulting and Clinical Psychology, 61. 455-461.
Miller, W. and Rollnick, S. (Eds.) (1991). Motivational Interviewing: Preparing People
to change addictive behaviors. New York: Guildford Press.
Miller, W.R. (1983). Motivational Interviewing with problem drinkers. Behavioral
Psychotherapy, 11, 147-172.


100
was the dependent variable. The overall omnibus model was not significant at F (4, 114),
p >.05, with the significance level = .980. The statistical main effects for gender, role-
play, video, and literature were not significant.
From table 10, the third model-tested hypothesis seven, by examining the
interaction between gender and treatment, with self-efficacy as an independent variable in
predicting prospective counseling readiness score. The overall model was significant at
p <. 05, =.007. The main effect for gender in the interaction model was significant at
p <. 05 = .007; the main effect for self-efficacy in the interaction model was significant
with p <. 05, = .001.
In the fourth ANOVA model without the interaction term included, hypotheses 1,
2, 3, 4, 5, 6, and 8 were examined with gender, treatment, and self-efficacy entered
separately as independent variables; counseling readiness was the dependent variable.
The overall model was significant at p <. 05, with p =.002. Gender was significant as a
statistical main effect at p <. 05, p =. 008; self-efficacy was a significant main effect at p
<. 05, p = .001. Follow up tests were also calculated to determine group differences
between those who indicated yes to no to seek counseling within a year of the study as a
result of their participation. The chi-squared value was significant at p <. 05, with the p
value =. 036. The likelihood ratio was also significant, p = .004. Finally, from table 15,
the follow up readiness, mean scores were also substantially higher than those mean
scores of subjects that indicated no to follow up; lower mean scores in the no to follow
up group were 6.38, compared to those in the yes group of 9.05.
The following is a summary of hypotheses test results:
Hypothesis 1: There are no mean differences between the group 1 treatment


107
modify the counseling self-efficacy of prospective clients. Another possibility is that
subjects were not exposed to the treatment long enough to modify pre-existing efficacy
beliefs (Bandura, 1997). Thus, given the time constraints of each treatment, the challenge
and difficulty of modifying efficacy beliefs once formed appears supported. In addition,
due to the relatively strict exclusionary criteria for entrance into the study, it is possible
that efficacy and readiness for counseling were already high, thus less likely to reveal a
treatment effect beyond the control group. Regarding self-efficacy specifically, since the
construct is composed of different theoretical components, one could argue that the
construction of three treatments from each separate theoretical component (experience in
the role-play, vicarious learning and modeling in the video, and feedback in the literature
treatment) did not significantly increase self-efficacy as a whole. One explanation is that
treatments designed to improve self-efficacy need to account for all of its theoretical
components simultaneously. Dividing the construct into its separate components and then
testing each component to others appears relatively non-significant with regard to
statistical power.
Since no significant treatment effects were found between any of the three
treatment groups, all results from this section of the data analysis support the eight null
hypotheses of the study. It is concluded that due to the incorporation of relatively strict
exclusionary criteria to approximate real clients to enhance the external validity of the
study, the probability of detecting treatment effects were minimized.
Gender results were mixed for both dependent variables. Interestingly, with
regard to general question two and hypothesis seven, there was no significant treatment
by gender interaction in either the first or third ANOVA models on either dependent


APPENDIX J
FOLLOW-UP SURVEY TO SEEK COUNSELING
* Please fill out this measure AFTER completing *
* the other two instruments *
Circle your gender: male female
As a result of your participation in this counseling research study, would you have an
interest in seeking counseling within the next year?
Circle: yes no
If you circled yes to the above question, please indicate below your degree of interest in
seeking counseling within the next year:
1 2 3 4 5
little some moderate likely very
THANK YOU FOR YOUR PARTICIPATION!
136


90
For purposes of assessing statistical significance, the type I error rate of .05 was
designated. A decision to accept or reject the specific null hypotheses was based on this
predetermined significance level. Source data are rounded to the nearest ten-thousandth.
The specific variables for the four ANOVA models and the fifth, chi-squared, logistic
regression follow-up model are designated in table 3.
Model 1
Results in table 4 illustrate the non-significant effect of gender on counseling self-
efficacy, F (1, 118) = .253, p >.05, with the significance value at .616; results also
indicate the non-significant treatment effect on counseling self-efficacy, F (3, 118) =
.030, p >.05 with the significance value at .993. Additional results reveal the non
significant effect of the GT interaction on counseling self-efficacy, F (3, 118)= 1.45, p
>.05 with the significance value at .230. Thus, the results support the first seven null-
hypotheses, since no significant differences were found for the treatment by gender
interaction, (GT), or treatment separately, for total self-efficacy score as the dependent
variable.


56
Other studies incorporate video and the application of a role-play as pre
counseling treatment methods for purposes of comparing the effectiveness of the
different formats. Larson et al. (1998) examined the effectiveness of video compared to
role-play in counseling self-efficacy development. Interestingly, it was found that the
role-play group showed significant increases in counseling self-efficacy in comparison to
the group exposed to the counseling video. The authors agreed with Banduras contention
that experiential aspects of performance and mastery accomplishments tend to contribute
most to self-efficacy development, above and beyond other theoretical sources (Bandura,
1997).
Strupp and Bloxom (1979) attempted to enhance motivation for counseling
among lower-class participants through a counseling video. Further, many of the
prospective counselor-client interactions in treatment centers often include videotape as a
predominant, educational format to orient clients to the counseling process (Sutton, 1998;
Jakes, 1982). Due to its low cost and ease of broad application, it is believed that one
video shown to thirty potential clients might be more cost-effective than the time
consumed by therapists individually interviewing thirty separate clients (Zwick and
Atkinson 1985).
Sutton (1998) examined the effectiveness of two different videotaped
presentations on prospective clients self-efficacy, expectations and anxiety. Prospective
clients were shown a videotaped presentation that included a counseling role-play and
added information about the counseling process. In this study it was hypothesized that a
significant increase in client expectations, self-efficacy, and concomitant decrease in
anxiety would occur. In general, no treatment effects were shown. However it was


30
the service of interpersonal relations.
Social-cognitive research also explicitly refers to variables of cultural and social
influences on individual behavior and development. For instance, specific branches of
research tend to concentrate on the role of self-efficacy and women in careers (Sullivan
and Mahalik, 2000; Lent, Brown and Hackett, 1994), and self-efficacy and gay and
lesbian issues (Lent and Maddux, 1997). Sullivan and Mahalik (2000) investigated
whether or not women engaged in a career group designated to increase career-related
self-efficacy would demonstrate improvements on career decision making self-making
and vocational commitment compared to a control group. Thirty-one women participated
in a six-week treatment group. Those in the treatment group showed gains over those in
the control group at a six-week follow up; however the results appear preliminary, as the
groups were non-equivalent prior to the initiation of treatment.
Social-cultural research on women and minorities highlight the interactional
components of individuals with their environment and how their interaction influences to
contribute or hinder optimal, efficacious development (Bandura, 1997). Social-cognitive
theory (Bandura, 1986) and research further recognizes that change occurs through a
social-cultural lens. Such theoretical meaning illustrates that any interpersonal situation,
whether counseling or another context (work, family, school), is influenced by individual
and social forces. Thus, the potential for individual change is maximized when
interpersonal and intrapersonal variables are recognized and examined. Both
interpersonal and intrapersonal (Bandura, 1986) contexts and variables influence and
interact in generating personal agency.
Personal agency highlights the interactive component of individual self-efficacy in


117
A final limitation of the study is that although the reliability and validity of the
URICA measure is relatively high, the original version of the instrument was normalized
against a substance abusing population, quite different from the sample in this study.
Although the authors of the URICA suggested that the instrument is reliable and valid for
measuring readiness for change of any problem behavior, perhaps the results from this
study are interpretable as preliminary rather than confirmatory of the measures reliability
and validity when administered in contexts outside of substance abusing populations. In
addition, since the URICA emerged from transtheoretical perspective there may be some
questions regarding translating measurement of a circular model to that of linear research
and analysis. For instance, the means of the URICA were calculated by adding the
contemplation, action and maintenance scales and then subtracting the precontemplation
mean to obtain a mean readiness score for each prospective client. Such a process to
determine an overall readiness score would appear linear and not circular, raising
questions about the translation of circular models into linear, research methodologies.
Rest et al. (1999) has helped to clarify the link between doing research with stage models
to that of linear problem-solving models. Rest et al. (1999) has empirically investigated
the structure and development of morality to help clarify this link between stage model
research to linear modeling methods.
Another limitation of the study is that the CSEBS, or the client self-efficacy
behavior scale was a novel measure and has only been used in three prior studies (Sutton,
1998; Longo, Lent and Brown, 1992; Longo, 1991). Future studies utilizing both
instruments would only enhance its statistical reliability and validity. Lastly this study
appears limited in its sample size and design.


APPENDIX K
URICA MEASURE
Counseling can help solve personal problems. Each statement below describes how a person might feel when starting counseling
and/or approaching problems in their lives. Please indicate the extent to which you tend to agree or disagree with each statement
below. In each case, make your choice In terms of how you feel right now, not what you felt in the past or would like to feel. For all
the statements below that refer to your "problem", answer In terms of a problem or personal issue you might be willing to discuss
in counseling.
Please Circle Your Gender: Male Female
There are FIVE possible responses to each of the items in the questionnaire:
1 Strongly Disagree (SD)
2 Disagree (D)
3 Undecided (U)
4 Agree (A)
5 Strongly Agree (SA)
Circle the number that best describes how much you agree or disagree with each statement
1. As far as I'm concerned, I don't have any problems that need changing
2. I think I might be ready for some self-improvement
3. I am doing something about the problems that had been bothering me
4. It might be worthwhile to work on my problem
5. I'm not the problem one. It doesn't make much sense for me to be here
6. It worries me that I might slip back on a problem I have already changed, so I am
here to seek help
7. I am finally doing some work on my problem
8. I've been thinking that I might want to change something about myself
9. I have been successful in working on my problem but I'm not sure I can keep up
the effort on my own
10. At times my problem is difficult, but I'm working on it
11. Being here is pretty much a waste of time for me because the problem doesnt
have to do with me
12. I'm hoping this place will help me better understand myself
13. I guess I have faults, but there's nothing that I really need to change
14. lam really working hard to change
15. I have a problem and I really think I should work on it
SD D U A SA
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5
1 2 3 4 5
137


61
Further, Cummings (1992) provided a teaching model for clinical faculty
instructing counseling practicum students on how best to teach and model experiential
counseling, interventions. She looked at the influential yet theoretical role of both a
gestalt technique and a problem resolution format. The gestalt approach (Greenberg;
1984) requires a two-chair intervention that allows students to assume the top dog and
underdog roles inherent in gestalt theory (Cummings, 1992). Identified students or clients
use two chairs in order to assume different parts of personality, one strong, the other
weak. Such an approach, allows in theory that stronger parts of self become more
conscious in order to be softened while less developed and weaker parts of ones
personality become strengthened. The goal is an eventual reordering and stabilization of
personality at a higher, more integrated level of functioning.
Interestingly, some studies have compared the relative influence of a video
intervention to a role-play on counselor self-efficacy, development. However, few studies
have demonstrated the comparative significance of a role-play, video, and counseling
literature on multiple instruments that capture both prospective, client self-efficacy and
motivation to change in counseling. Munson, Zoemik and Stadulis (1986) examined the
effects of a role-play and modeling, to that of modeling and visual imagery on counselor
self-efficacy. Both groups showed significant results over a wait-listed control group
while the two treatment groups exhibited null effects. Johnson and Seem (1989)
compared beginning practicum students to advanced students on counselor self-efficacy.
These authors showed improvements in self-efficacy in the beginning group but not the
advanced group.
However, despite their utility in scope and application, it remains uncertain


3
clients strength, direction and persistence of goal-directed behavior. Miller and
Rollnick (1991) suggest one of the central tasks of a counselor is to motivate clients by
specifically helping clients achieve targeted goals and desired change, since many clients
initiate counseling with limited experience and little confidence in the counseling
process. As a result, motivation to change is perceived as a crucial variable so that clients
do not prematurely terminate from counseling, become passive bystanders in counseling,
or fail to effectively maximize the counseling services offered to them (Longo, Lent, and
Brown 1992; Longo, 1991).
Need for the study
Although counseling theories and therapies (Lent et al., 1997) have produced research
on the correlates and precepts of self-efficacy and motivation (Sutton, 1998; Longo,
1991) in a variety of contexts, few studies have specifically compared the effectiveness of
different treatment strategies that increase a prospective clients self-efficacy and
motivation for change, prior to initiating counseling. (Client self-efficacy and motivation
in counseling reflects primarily the belief and desire that one can become a successful
client. Client success is operationally defined as illustrating the clients belief and
motivation in the importance of attending and committing to counseling sessions, asking
questions to clarify session material when needed, doing assigned homework when given,
persevering in counseling during times of emotional discomfort, and not prematurely
terminating, etc.)
Most of the research on self-efficacy and motivation is from other contexts. For
instance, self-efficacy and medical treatment typically reflect studies on outcome
satisfaction with counseling of multiple sclerosis patients (Wingerson, 2000), types of


113
related constructs, specifically self-efficacy and readiness for counseling as a function of
motivation, for application into the counseling domain in predicting follow-up in a non-
clinical population.
Clinical Implications of the Study
This study has two primary clinical implications regarding client readiness and
self-efficacy for counseling. First, with regard to readiness, the fact that readiness scores
mediated the effects of pre-counseling treatment on desire to seek follow-up counseling
suggests that treatment selection during counseling becomes relatively independent of
client desire to seek follow-up care. Related to self-efficacy, results also confirm
Banduras (1997) writings, as the construct appears clinically stable and uniform once
established. Thus, the clinical implication is if clients have positive efficacy beliefs and
are high in readiness to begin pre-counseling treatment, then those beliefs and high
readiness will remain consistent into follow-up care. Therefore, it appears imperative that
counselors assess for client strength of readiness and efficacy beliefs as early as possible
in the counseling relationship in order to determine if and how clients will initiate,
engage, and persist with counseling and follow-up care.
The second clinical implication of this study directly relates to treatment. Of the
three treatments, the role-play treatment had the greatest impact on desire to seek follow
up care. The video and literature group were equal but secondary in their respective
significance in predicting follow-up. Such results are consistent with results from other
studies. For instance, Larson (1998) evaluated the influence of a counseling role-play on
practicum students in comparison to those who watched video. Participants in the role-
play groups increased their counseling self-efficacy scores by almost one-half of one


68
needed as well.
Thus, the three treatments in this study (counseling role-play, video, and
literature) emerge from Banduras (1997) theoretical components that define self-efficacy
(approximating performance experience with a counseling role play, including modeling,
verbal encouragement and [eductions in emotional arousal), a counseling video (thus
isolating the modeling and vicarious learning component of self-efficacy) and a
counseling literature group (isolating the verbal and cognitive aspects of self-efficacy). In
studies that utilize literature as an intervention to improve client self-efficacy and
motivation to change, one common suggestion offered to improve the methodology
would include providing a small quiz to insure that the subjects read and process the
literature provided.
Additional suggestions in the research literature that justify the need for this study
include how prior research by Prochaska (1992; 1986) and Festinger (1957) have
demonstrated the role of motivation in reducing cognitive dissonance that can accompany
problem severity. One suggestion in capturing problem severity is to include a measure of
client motivation that implies client willingness and readiness to disclose current
behaviors as problematic in counseling. Such a measure will be included in this study, the
URICA change assessment instrument. However, although treatment applications
involving literature as a function of a verbal/cognitive intervention have been
documented outside of counseling, the exact role of how literature may translate into
client action or positive behavioral change remains ambiguous and is suggested for
further exploration and empirical study (Tinsley, 1988). This study attempts to partially
address this concern by presenting a brief quiz to each participant in the counseling,


103
counseling readiness. When self-efficacy was entered in the third and fourth ANOVA
models as a separate independent variable, self-efficacy was significant in predicting
counseling readiness. This finding is not surprising, since those participants with strong
efficacy beliefs that counseling can help, would be more ready to motivate toward change
of targeted, desired outcomes in counseling (Longo, Lent, and Brown, 1992; Longo,
1991). However, the partial correlation between self-efficacy and readiness, controlling
for the effects of gender and treatment was somewhat lower than expected. This
correlation was calculated at .30 and is lower than other correlations reported between
these two variables (Longo, Lent and Brown, 1992; Longo, 1991). One possible
explanation for this finding is that there may have been an indirect selection effect of
willingness on readiness for counseling that was generated from the exclusionary criteria
of the survey given to students prior to entering the study. By only selecting clients
moderately high to high on willingness to discuss a personal problem of any nature in
counseling, those not moderately high were excluded from the sample. Thus, by
restricting the range of those prospective clients sampled on willingness to enter
counseling, perhaps attenuation of the correlation between self-efficacy and readiness for
counseling was indirectly produced.
With regard to follow-up procedures, there was no statistically significant
interaction between gender and treatment on post-test counseling, nor was gender
significant in separately predicting likelihood to follow-up. Further, chi-squared and
logistical regression analyses from model 5 provided evidence that each of the three
treatments, along with self-efficacy and readiness significantly influenced post-test,
follow-up desire to seek counseling, when evaluated separately. However, although self-


7
two variables. Longo, Lent and Brown (1992) showed the correlation between the two
constructs in predicting client attrition rates. Bandura (1997) elaborates on the implicated
role of motivation on self-efficacy. Regarding treatment approaches that target
motivation to improve client self-efficacy, Milller (1994) suggests focusing on quality of
counselor feedback, client responsibility, client acceptance of the problem, the mutuality
of counselor and client working together, offering of counselor empathy, and improving
client self-efficacy. Isenhart (1997) examined the role of motivation in increasing client
commitment and confidence toward recovery in substance abusers as a function of
pretreatment readiness for change.
Thus, the purpose of this study emerges from the theoretical and empirical role of
self-efficacy and motivation in counseling. Clearly, the theoretical literature supports the
hypothesized role of self-efficacy and motivation in influencing behavioral change
(Bandura, 1997; Pajares and Miller, 1994; Prochaska, 1982). In addition, the utility of
applying role-play, video, and literature as pre-treatment strategies to increase self-
efficacy and motivation in other contexts has been documented extensively in the
research literature (Sullivan and Mahalik, 2000; Heppner, 1994). Further, the relatively
high correlation between motivation to change and self-efficacy has been documented to
increase understanding among counselors on how best to minimize premature termination
(Longo, Lent, and Brown, 1992). Studies with larger sample sizes that attempt to increase
self-efficacy and motivation to change early in the counseling process are clearly
warranted in a clinical, managed care environment.


140
Bauman, S. (1999). The development and validation of a scale to assess motivation to
change in substance-abusing adolescents. Dissertation Abstracts International, Section B:
Sciences and Engineering, Sept. 1999, 60, 3-B, 1345.
Brehm, W. (1976). Perspectives on Cognitive Dissonance. New York: John Wiley and
Sons.
Brewer, R.E. (1974). The effects of client expectations on the initial counseling
relationship. Dissertation Abstracts International, 35. 2671. (University Microfilms
Number 74-25, 492).
Brus, H. (1999). Determinants of compliance with medication in patients with
rheumatoid arthritis: The importance of self-efficacy expectations. Patient Education and
Counseling, 36.1. 57-64.
Buhrke, R. (1988). Date Rape Awareness Program: A model for educating and
consciousness raising. Journal of College Student Development. 29. 478-479.
Burke, L. (1998). Improving adherence to a cholesterol-lowering diet: A behavioral
intervention study. Dissertation Abstracts International: Section B: The Sciences and
Engineering. 58. (10-B), 5326.
Carbonari, J., DiClemente, C., Addy, R., and Poliak, K. (1996, March 15). Alternate
Short Forms of the Alcohol Readiness to Change Scale. Paper presented at the fourth
International Congress on Behavior Medicine.
Carter, J. (1998). The Systematic Development of a video-based self-instructional
interview training package. Dissertation Abstracts International. 58. (11-B), 6229.
Chassey, R. and Clifford, D. (1988). Responsibility Versus Choice: A Different
Approach to Alcohol Education. Journal of College Student Development. 29. 275-276.
Childress, R. and Gillis, J.S. (1977). A study of pretherapy role induction as a influence
process. Journal of Clinical Psychology. 33. 540-544.
Collins, C. (1998). Effects of individual leisure counseling on perceived freedom in
leisure, perceived self-efficacy, depression, and abstinence of adults in a residential
program for substance dependence. Dissertation Abstracts International. Section A:
Humanities and Social Sciences, 58, 10-A, 4064.
Connolly, S. (November, 1980). Changing Expectancies: A Counseling Model Based on
Locus of Control. The Personnel and Guidance Journal, 176-180.
Cook, B. (1991). An osteoporosis patient education and screening program: Results and
implications. Patient Education and Counseline 17. 2, 135-145.


138
SD D
16. I'm not following through with what I had already changed as well as I had hoped,
and I'm here to prevent a relapse of the problem 1 2
17. Even though Im not always successful in changing, I'm at least working on my problem 1 2
18. I thought once I had resolved the problem I would be free of it, but sometimes I still
find myself struggling with it 1 2
19. I wish I had more ideas on how to solve my problem 1 2
20. I have started working on my problem but I would like help 1 2
21. Maybe counseling will be able to help me 1 2
22. I may need a boost right now to help me maintain the changes I've already made 1 2
23. I may be part of the problem, but I dont really think I am 1 2
24. I hope that someone here will have some good advice for me 1 2
25. Anyone can talk about changing; I'm actually doing something about it 1 2
26. All this talk about psychology is boring. Why can't people just forget about their problems? 1 2
27. Im here to prevent myself from having a relapse of my problem 1 2
28. It is frustrating, but I feel I might be having a recurrence of a problem I thought
I had resolved 1 2
29. I have worries but so does the next guy. Why spend time talking about them? 1 2
30. I am actively working on my problem : 1 2
31. I would rather cope with my faults than try to change them 1 2
32. After all I had done to try and change my problem, every now and again it comes
back to haunt me 1 2
U A SA
3 4 5
3 4 5
3 4 5
3 4 5
3 4 5
3 4 5
3 4 5
3 4 5
3 4 5
3 4 5
3 4 5
3 4 5
3 4 5
3 4 5
3 4 5
3 4 5
3 4 5


CHAPTER 1
INTRODUCTION
Statement of the Problem
One challenge that clinicians currently encounter is providing cost-effective
counseling in a managed care environment (Lyons, 1997; Hoyt, 1995). As a result, there
is a profound need for counselors to utilize resources and treatment planning as
efficiently and effectively as possible. Thus, empirically driven treatments that increase
prospective client self-efficacy and motivation to change (Longo, Lent and Brown, 1992;
Longo, 1991) early in the counseling process appear warranted. Additionally, empirical
research that informs treatment providers on how to increase client self-efficacy and
motivation (Longo et al., 1992; Mennicke, 1988) is needed in order to minimize
premature termination.
Theories on self-efficacy have wide application in counseling. Self-efficacy
(Bandura, 1997, 1986, 1977), defined as ones belief in ones capability to execute a
specific task or series of tasks, has been examined and applied to counseling outcome
research regarding alcohol consumption (Tran, Haaga and Chambless, 1997) substance
abuse (Burke, 1998; Walton, 1995), stress management (Wiedenfeld et al. 1990), positive
self-concept (Harrison et al, 1997), motivation and client attrition (Longo, Lent and
Brown, 1992).
The majority of counseling self-efficacy research targets substance abuse treatment
contexts (DiClemente and Norcross 1992; Miller and Rollnick, 1991; Prochaska,
1


46
Motivational therapies (Miller, 1991) are rooted in motivational interviewing (MI).
The primary assumption with M3 is to analyze how people change and then help the
client support change in their life. In MI, a clients problems persist because clients are
ambivalent about making change, not because they lack the skills to do so. In essence, MI
focuses on helping clients resolve ambivalence about behavioral change in order to
motivate the client. By integrating aspects of skills training and motivational interviewing
in clinical treatment, motivation is perceived as universal, internal, and modified by
external forces (counselor style, counselor personality, and treatment approach/setting)
while best elicited within a collaborative, co-constructed treatment context between
clinician and client.
Regarding variance in motivation and treatment, Miller, Benefield, and Tonigan
(1993) considered the empirical impact of treatment styles on client motivation. Miller et
al. (1993) examined the relationship between a confrontational, aggressive style with
alcoholic clients as opposed to a more empathic, non-confrontational style, characterized
by reflective listening with a sample-size of forty-two. A confrontational, counseling
style toward clients with drinking problems was shown to be statistically significant in
predicting the likelihood of relapse twelve months after the study. Additionally, four
clients that received counseling from a non-confrontational counselor remained totally
abstinent one year later. Miller et al. (1993) concluded that the level of client resistance is
a key component in determining whether or not a successful outcome is considered
likely. However, the relatively small sample size limits the conclusion of the results of
this study as preliminary rather than confirmatory.


91
Table 3
Variables Included in ANOVA models 1, 2, 3,4
ANOVA MODEL 1
ANOVA MODEL 2
Input Variables
Input Variables
Gender
Gender
Treatment
Treatment
Role Play
Role Play
Video
Video
Literature
Literature
Gender Treatment Interaction
Output Variable Model 1
Output Variable Model 2
Total Self-Efficacy Score
Total Self-Efficacy Score
ANOVA MODEL 3
ANOVA MODEL 4
Input Variables
Input Variables
Gender
Gender
Treatment
Treatment
Role Play
Role Play
Video
Video
Literature
Literature
Gender Treatment Interaction
Self-Efficacy
Self-Efficacy
Output Variable Model 3
Output Variable Model 4
Readiness Score
Readiness Score
LOGISTICAL REGRESSION/ CHI-SQUARED ANALYSIS
MODEL 5
Input Variables
Gender
Treatment
Role Play
Video
Literature
Gender *T reatment Interaction
Total Self-Efficacy score
Total Counseling Readiness Score
Output Variable Model 5
Follow up interest to seek counseling


102
Hypothesis 7: There is no statistically significant interaction between gender and
any of the treatment groups on either of the dependent variables. ANOVA model 1 tested
this hypothesis. Gender was not significant in predicting self-efficacy, thus the null
hypothesis was not rejected. However, ANOVA model 3 and ANOVA model 4 also
tested this hypothesis, with gender significant in predicting counseling readiness in the
omnibus, ANOVA model 3, at p=. 007. Also gender was significant at p=. 008 in
ANOVA model 4, when including self-efficacy as an independent variable and
counseling readiness as the dependent variable.
Hypothesis 8: There is no association between gender and treatment type
separately, on either self-efficacy or counseling readiness. ANOVA model 4 tested this
hypothesis and results present statistical evidence that the null hypothesis was rejected. In
other words, female gender was significant when separately predicting counseling
readiness, with a p value =.008, significant, at p <. 05.
Summary
Since there was not an interaction between treatment and gender, the treatment
effect did not vary as a function of gender in predicting either prospective counseling
self-efficacy or counseling readiness. However, gender and self-efficacy predicted
counseling readiness separately and this appears consistent with Sullivan and Mahalik
(2000), Bandura (1997), Hardin and Yanico (1983) and Tinsley (1980). However, since
the interaction between treatment and gender was not significant in this study, tables
listing the marginal means only for gender were provided. Since added marginal means
were not significant, additional pair wise comparisons were not made.
However, one interesting finding was the significance of self-efficacy on


119
highlighting increased estimation of differences in treatment effects. In addition, due to
more precise estimation of treatment effects in an ANCOVA model, the overall power to
detect statistical significance among dependent variables could be improved due to a
reduction in the standard error of estimate. Additional correlations provided by an
ANCOVA model between pretest and posttest performance would be useful to examine
as well. Thus future replication of this study might include a pretest measure of both
readiness and efficacy as two covariates in lieu of a survey that incorporates relatively
strict exclusionary criteria.
However, a survey utilized for exclusionary criteria purposes could still be used
as a future covariate in a related ANCOVA study. Plus, using a survey to approximate
client interest on social-cognitive variables of efficacy and motivation increases the
external validity of the study to the general population. But the use of a survey needs to
be carefully weighted against the value of detecting treatment effects. By not using
relatively strict exclusionary criteria, future analogue studies in this area could also
incorporate students from non-clinical populations with greater numbers of participants
lower in readiness and efficacy. Such participants might be more likely to illustrate
treatment effects designed to increase readiness and efficacy for counseling. One remedy
to this problem would be to examine the inter-item correlations from the CSEBS and/or
URICA and embed those items structurally into a pretest and then use the pretest as a
covariate, one for each variable studied. Such embedded language into a pretest survey
might disguise potential reactive effects to treatment that can be generated from a pre
test.
The second important implication for future research from this study is that most


34
is a derivative of ones needs. A need to Murray (1938) was defined as a biological force
in the brain that provides integration of effort with action to satisfy an urge or demand.
Murrays (1938) listing of human needs include needs for achievement, affiliation, order
or organization, play, sentience, and sex.
Skinners (1953, as cited in ONeil and Drillings, 1994) notions on motivation were
illustrated in reinforcement/operant theory, thus representing a conceptual shift regarding
how motivation was conceptualized in the literature. Skinner (1953) was the first
behaviorist to suggest that motivation was primarily rooted in external reinforcers that
influence the likelihood of repeated action or performance. Atkinson (1966, as cited in
Miller, 1987) described a number of personality traits that appear primary in isolating and
predicting human motivation. Such traits included confidence, belonging, feelings of
independence, a concern for humanity and agreeableness. Most of these traits correlate
with motivation and have been combined to establish the taxonomic, global model of the
five-factor model of personality (McCrae and Costa; 1987). Such a taxonomic approach
to motivation anticipates future regression research studies illustrating the role of
motivation in minimizing attrition (Longo, 1992).
Connally (1980) suggested that motivation is directly linked to the personality
dimension of locus of control. Locus of control models (Connally (1980), as cited in
ONeil and Drillings, 1994; Rotter; 1954) of motivation suggests that the more
internalized ones personal control over the environment, the greater the strength of
motivation in pursuing a desired behavior. As a derivative of motivation, locus of control
research (Connally, 1980) can inform clinical practice. For instance, counselors need to
be sensitive to locus of control dynamics and their implications in order to help motivate


53
required to attend counseling at the university-counseling center. One means of
attenuating counseling-center staff workload and the concurrent need for students to
attend counseling is to first have them participate in educational training programs. Such
programs are designed to increase awareness about the dangers of abusing alcohol and
other drugs on campus.
Workshops are developed around the premises that most students drink relatively
frequently on campus and consequently, students must take responsibility for drinking
behavior. Typically, training workshops on campus are divided into biweekly, 2-hour
sessions for two weeks, where videos are shown, literature is distributed, and group
discussions on the presenting issues occur. The goal of these programs is educational and
thus preventative, in hope that violations of campus policies that could lead to legal
action are averted.
Specific Pre-Counseling Treatment Methods
Thus far this literature review has targeted general applications of training
methods designed to increase prospective client, student, or faculty coping efficacy and
motivation from a variety of contexts other than counseling. The remainder of the chapter
will focus on specific pre-treatment counseling methods of counseling video, role play
and counseling literature that have been effective in both counselor and client
development and will be subsumed and examined under sub-headings for each pre
counseling treatment method.
Pre-treatment methods for counseling and client development are typically
referred to as role-induction (not to be confused with the common term, role-play)
methods (Friedlander and Kaul, 1983; Childress and Gillis, 1977) or an advanced


18
particular treatment types on client self-efficacy. Allumbaugh (1999) studied grief
counseling on coping self-efficacy and loss. Warner (1996) illustrated the impact of
short-term counseling on client self-efficacy and its relationship to a clients satisfaction
in counseling.
Generally speaking, self-efficacy (Bandura, 1997; 1986; 1977) reflects ones belief in
ones capability to perform a task or series of related tasks. Essentially, the construct of
self-efficacy reflects ones perceived ability to cope and perform specific tasks in a given
situation. However, Bandura (1977) wrote little about the direct role of self-efficacy in
counseling. Yet he implied that self-efficacy was an important aspect of psychotherapy
by suggesting, psychological procedures serve as a means of creating and strengthening
expectations of self-efficacy (Bandura, 1977, p. 195).
According to Bandura (1997; 1986; 1977), ones self-efficacy toward a particular task
is derived from four sources: ones prior experience of the specific task, event or exercise
in question, vicarious learning through modeling or observation, verbal encouragement or
support, and ones emotional arousal in anticipation of the task. Prior experiential
learning is the most powerful influence on the development of ones self-efficacy, since
previous experience powerfully shapes both positive and negative beliefs about ones
ability to perform similar tasks in the future. Research studies that illustrate the strong
influence of positive and negative perceptions of prior counseling experience on future
development of counseling student self-efficacy are useful in order to target student
beliefs about their own counseling performance.
Larsons empirical study (1998) demonstrates the strength of positive versus negative
student beliefs on developing efficacy in graduate student counselors. Larson (1998)


141
Crutchfield, L.B. and Borders, L.D. (1997). Impact of two clinical peer supervision
models on practicing school counselors. Journal of Counseling and Development, 75,
219-230.
Cummings, A. (1992). A Model for Teaching Experiential Counseling Interventions to
Novice Counselors. Counselor Education and Supervision, 32, 23-31.
Daniels, J. A. (1997). The influence of performance feedback and casual attributions
upon ratings of counseling self-efficacy. Unpublished doctoral dissertation. University
of Nebraska, Lincoln.
Deane, F., Spicer, J. and Leathern, J. (1992). Effects of Videotaped Preparatory
Information on Expectations, Anxiety, and Psychotherapy Outcome. Journal of
Consulting and Clinical Psychology, 60, 6, 980-984.
Deci, E.L. and Ryan, R.M. (1985). Intrinsic Motivation and Self-Determination in
Human Behavior. New York: Plenum Press.
Deroche, T. (1990). The effects of a counseling orientation videotape upon childrens
knowledge and attitudes regarding mental health counseling. Dissertation Abstracts
International, 52 (1-A), p. 80.
DeRosenroll, D. A. (1988). Peer Counseling: Implementation and Program Maintenance
Issues. Found in Eric Microfiche, Education Library, University of Florida; Document
Number: ED 298361.
DiClemente, C. and Hughes, S. (1990). Stages of Change Profiles in Outpatient
Alcoholism Treatment. Journal of Substance Abuse. 2, 217-235.
DiClemente, C. and Prochaska, J. (1998). Toward a Comprehensive, Transtheoretical
Model of Change: Stages of Change and Addictive Behaviors. In Treating Addictive
Behaviors (Miller and Heather eds.). Plenum Press: New York.
Diviak, K. (1999). Smoking Cessation: The effect of a brief motivation enhancement
intervention. Dissertation Abstracts International, 60 (12-B), 6358.
Donovan, C. (1998). Teaching client about professional ethics: The role of counselor
expertness and method of education. Dissertation Abstracts International, 58, (8-B),
4442.
Dowrick, P.W. (1993; as cited in Bandura, 1997). Video Forwarding: Promoting self-
efficacy in swimming. Submitted for publication.
DRozario, V.A. (1996). Singaporean and United States college students worldviews,
expectations, of counseling, and perceptions of counselor effectiveness based on directive
and nondirective counseling styles. Dissertation Abstracts International, 56 (7-A), 2564.


44
affiliation with sponsor during one year post treatment period and having a sponsor at
pretreatment and those scoring low on contemplation also showed having a sponsor at
follow up. Isenhart (1997) concluded that a correlation existed between pretreatment
readiness for change and both a decision to drink and commitment to recovery activities.
However it was suggested that other factors such as poor coping, limited resources
available to a client, and acute stressors can override motivation to change once drinking
begins, thereby decreasing a clients commitment toward long-term change. Thus,
motivation is not simply construed as either internal or external but interpreted as
complex with multiple implications.
Others reflect the importance of matching a clients level of readiness for counseling
with treatment selection. Annis, Schober and Kelly (1996) provided a comprehensive
summary of an outpatient counseling program, that included motivational interviewing,
assessment, treatment planning, preparation for counseling, and maintenance of change
strategies. These treatment components converged with a clients stage of readiness to
change (precontemplation, contemplation, determination, action, maintenance) in
describing how individual counseling is tailored to each client. Ohlsen (1973) examined
client readiness for membership in a counseling group and concluded that willingness to
prepare, participate and commit to counseling is often interpreted as a sign of
motivational readiness.
Counseling research on motivation also relates to therapy types. Baer, Kivilhan, and
Donovan (1999) integrated skills training with motivational therapies. Historically, skills
training (client motivated but without resources) and motivational therapies (AA,
confrontational models) were based upon distinct premises (client in denial) and were


32
performance.
Similarly, counseling has personal, behavioral, and environmental influences that
interact in a recursive fashion to govern a clients personal agency as well. Yet
interestingly, most of the counseling research literature on personal agency and its
determinants in behavior target a counselors personal agency, not that of the client.
Larson (1998) reflects that Banduras definition of operative efficacy would include the
counselors ability to simultaneously understand ones person, actions and environment,
to achieve high levels of counseling performance. One would infer that similar skills for
clients would be necessary to achieve a similar performance result. In fact, Bandura
defines operative efficacy specifically as continuously improvising multiple sub-skills to
manage ever changing circumstances, most of which contain ambiguous, unpredictable,
and often stressful elements (as cited in Larson, pg. 327). Similarly, a clients increased
self-efficacy from personal agency determinants would likely improve tolerance for the
inherent ambiguity, unpredictability, and stress encountered for clients in counseling too.
Thus, applications of self-efficacy research in counseling implicate many different
variables. One variable in counseling that is particularly related to self-efficacy in
counseling is motivation (Bandura 1997; 1986; 1977; Longo, Lent, and Brown, 1992;
Longo, 1991). Due to its relatively high correlation with self-efficacy in the research
literature, motivation appears important to examine secondarily in this study. For
purposes of clarity, motivation will be operationally defined in this study as reflecting
client readiness for change (Prochaska 1992; 1986) and commitment toward the
counseling process (Longo, Lent and Brown 1992).


27
The emphasized role of self-efficacy within social-cognitive theory (Bandura, 1986)
united two previously disparate, theoretical trends of behavior. Behavioral theory
traditionally emphasized that behavior was solely a mechanistic outcome of
reinforcement, and punishment, consequence and reward (Skinner; 1953). On the other
hand, cognitive theory recognized that information alone is enough to change, mediate
and modify human behavior (Beck; 1977, cited in Scharf, 2000).
However, Bandura (1997; 1986; 1977) synthesized both aspects of cognition and
performance of human behavior into one unified branch of social-learning theory, by
particularly emphasizing the influence of cognitive constructs on learning, and the
implications of modeling on human behavior. Bandura (1986) highlighted the specific
influence and impact of self-efficacy on behavioral change as one crucial cognitive
variable. He later modified social-learning theory with further extension and revision into
the development of his own theory, social-cognitive theory (Bandura, 1986). Most
notably, self-efficacy research was applied to further advance empirical understanding of
self-efficacy on performance and behavioral change, specifically in academic, athletic
and health maintenance (Bandura, 1997; 1997; 1986; 1982) contexts.
Additional research that emphasized the influence of either knowledge or prior
experience on behavioral change was synthesized with subsequent empirical,
investigation. For instance, Schunks (1994) research suggested that clients still persist in
unwanted behavior (weight gain, smoking, drinking) despite information to the contrary
that the selected behavior (prior experience) is potentially harmful to the client. Such
insight led researchers to believe that more than just knowledge or the behavioral
reinforcement of a habit would motivate a behavior. For it appeared that possibly another


14
General Research Questions
The following research questions will be examined in this study:
1. Will different pre-counseling interventions (role-play, video observation or
counseling literature) increase prospective client self-efficacy and motivation for
counseling within any of the three treatment groups compared to the fourth, no-treatment,
control group?
2. Will three different pre-counseling interventions (role-play, video observation or
counseling literature) produce statistically significant differences between either gender
on prospective client self-efficacy and motivation, compared to a no treatment, control
group?
3. Will three different pre-counseling interventions (role-play, video observation or
counseling literature) produce a statistically significant interaction between gender and
treatment on either of the three dependent variables, counseling self-efficacy, readiness
for counseling, or desire to seek follow-up counseling as a result of subject participation
in the study?
4. Will gender, treatment, self-efficacy or readiness for counseling separately produce
a statistically significant association in predicting likelihood to seek follow-up counseling
as a direct result of subject participation in this study?
Definition of Terms
The following terms used in this study are defined below.
Managed Care: A third-party payer system introduced into the health care arena in the
early 1990s; in essence, the goal of managed care companies was to introduce
themselves as an insurance negotiator between provider of clinical services and client, in


98
Model 5
Results from table 15 below illustrate the significance of both the treatment effect
on all three treatment groups, (1, 2, 3) and total counseling self-efficacy score on
likelihood to seek counseling, as a direct result of participation in this research study.
Treatment was significant with %2 (3) = 9.56, p < .05. Total Counseling Self-Efficacy
was significant with % (1) =6.97, p <.05. The gender by treatment interaction (GT) was
not significant. Treatment remains significant in predicting follow-up when self-efficacy
is added to the model, which is consistent with the lack of mediation by self-efficacy on
treatment.
Table 15
Interaction Model with Self-Efficacy Predicting Follow-Up
Source
Df
x2
Pr>X2
Gender (G)
1
0.42
0.5175
Treat (T)
3
9.56
0.0227*
Gender *Treat (GT)
3
1.29
0.7305
Self-Efficacy Total
1
6.97
0.0083*
* p < .05.
Model 5
Results from table 16 below indicate the significance of the three treatments
compared to the control group, group 4, on desire to seek post-test, follow-up counseling,
The counseling role-play was significant at %2 = 6.35, p < .05. The video treatment was
significant in predicting follow-up at %2 = 3.93, p < .05, and the literature treatment was
significant at x2 = 3.93, p < .05.


15
order to determine and establish the most cost-effective services for the highest quality of
professional health-care service, for any given health-care market providing both medical
and mental health services. (See Lyons, 1997; Hoyt, 1995.)
Motivation: In relation to counseling, motivation tends to reflect a clients strength,
direction, and persistence of any goal-directed behavior (Bauman, 1999). Certainly, one
task of any counselor is to help the client motivate toward achieving targeted goals and
desired change.
Self-determination theory: Deci and Ryan (1985) illustrate that the self-determination
of any individual is a personal expression of will, generated internally, and directed
toward the future in determining likely outcomes of any selected and initiated behavior.
Self-efficacy: This is a cognitive construct that mediates the relationship between
personal knowing and doing, while reflecting ones belief in ones capability to execute a
specific task, or series of sub-tasks related to one specific context (doing math, driving a
car, becoming a successful client, reading well, etc.; see Bandura, 1997).
Social-Cognitive theory (Bandura, 1986): This theory refers to a further extension and
modification of social-learning theory that postulates that self-determination, individual
learning and behavioral change is a cognitive, mediating process that can result in greater
personal control of ones environment and surroundings. Self-efficacy is one cognitive
variable within social-cognitive theory that helps explain how one selects, alters or
modifies a behavior.


57
recommended that future research examine related hypotheses to investigate the
hypothesized role of self-efficacy on client behavioral change in counseling.
Role-Plays
Another useful strategy applied to increase client awareness and participation for
counseling is the application of a role-play. In counseling, role-plays for prospective
clients are typically thought of as a role-induction interview (Rabinowitz, 1997;
Friedlander and Kaul, 1983). Such interviews were developed from Ome and Wenders
(1968) classic description of the anticipatory socialization interview and were initially
designed to foster congruence of expectations between counselor and client. Typically
role preparation procedures tend to explain and discuss the purposes of counseling while
subsequently modeling appropriate interview behaviors. Such training can take the form
of a structured-interview (Hoehn-Saric; 1964), a role-play format (Rabinowitz, 1997) or
video (Jakes, 1982). Positive effects of role induction methods also include counselor
self-efficacy development (Larson, 1998). Other studies show clients often report feeling
more satisfied and confident during counseling (Hoehn-Saric, 1964) as a result of such
procedures.
In a study of counselor development, Larson (1998) evaluated the comparative
value of a mock interview as a role-play compared to a fifteen-minute counseling session
on tape with sixty-seven students using hierarchical regression to predict post-test
counselor self-efficacy. Interestingly, those students who perceived there counseling
performance as below average after the role-play showed decreases in their reported
counseling self-efficacy by almost one standard deviation below the mean. Larson et al.
(1998) concluded that one primary reason for the training impact of role-plays on


148
Mischel, W. (1973). Toward a cognitive social-learning reconceptualization of
personality. Psychological Review. 80, 252-283.
Mitchell, L.K., Brodwin, M., Benoit, R. (1990). Strengthening the workers
compensation system by increasing client self-efficacy. Journal of Applied
Rehabilitation Counseling. 21. 4, 22-26.
Munson, W.W., Zoemik, D.A., and Stadulis, R.E. (1986). Training potential therapeutic
recreators for self-efficacy and competence in interpersonal skills. Therapeutic
Recreation Journal, 20, 53-62.
Ohlsen, M. (1973). Readiness for membership in a counseling group. Educational
Technology, 13. 1, 58-60.
ONeil, H. and Drillings, M. (1994). Motivation, Theory and Research (pp. 13-30).
Hillsdale: Lawrence Erlbaum Associates.
Ome, M.T. and Wender, P.H. (1968). Anticipatory socialization for psychotherapy:
Method and rationale. American Journal of Psychiatry, 124, 1202-1212.
Pajares, F. and Miller, D. (1994). Role of Self-efficacy and Self-Concept Beliefs in
Mathematical Problem Solving: A Path Analysis. Journal of Educational Psychology, 86,
2, 193-203.
Paslay, C. (April, 1996). The influence of goal setting on achievement and perception of
self-efficacy on inner city high schools students. Dissertation Abstracts International
Section A: Humanities and Social Sciences University Microfilms International, 56, (10-
A), 3902.
Phillips, S. and Blustein, D. (September, 1994). Readiness for career choices: Planning,
exploring, and deciding. Career Development Quarterly, 43, 1, 63-73.
Prochaska, J.O. and DiClemente, C.C. (1986). Toward a comprehensive model of
change. In W.R. Miller and N. Heather (Eds.), Treating addictive behaviors: Processes of
change. New York: Plenum Press.
Prochaska, J.O., DiClemente,C.C., and Norcross, J. (1992). In search of how people
change: Applications to addictive behaviors. American Psychologist, 47, 1102-1114.
Quartaro, G. and Rennie, D. (1983). Effects of trainee expectancies and specific
instructions on counseling skill acquisition. Canadian Journal of Behavioral Science, 15,
2, 174-185.
Rabinowitz, F. (1997). Teaching Counseling Through a Semester Long Role Play.
Counselor Education and Supervision, 36, 216-223.


78
Data Collection Procedures
Data collection consisted of participants being randomly assigned to one of four-
treatment groups. Upon arriving at the assigned experimental location, each participant
received a packet with a code number on the upper right of the packet. The code number
of each packet served to identify each packet individually for purposes of data analysis
while protecting the confidentiality of each participant. Each packet consisted of a
consent form and two measures, the CSEBS, client self-efficacy behavior for counseling,
and the URICA, readiness for change instrument and a follow-up survey, to determine
interest in seeking follow-up counseling after treatment. The survey was a brief, ancillary
measure asking participants to rate whether or not they had an interest in seeking
counseling as a result of their participation in this study. Follow-up interest was the third
dependent variable in this study.
If subjects marked yes to having a desire to seek counseling as result of their
participation in this study, participants were then asked to quantify on a likert continuous
scale, from 1-5, their degree of interest in seeking counseling within the next year. The
rationale of the follow-up measure was to provide the researcher with additional data by
showing derivatives of any potential, longitudinal impact of the treatments. Since long
term follow up of the research subjects on their prospective client self-efficacy and
readiness for change could not be monitored, it was thought that a brief measure
capturing any likely longitudinal effects between an additional third dependent variable
in analogue form, would strengthen the study in its final analysis.


101
group, role play, and group 4, the no-treatment control group, for either self-efficacy or
readiness for counseling. ANOVA models 1, 2, 3, and 4 tested this hypothesis and the
results did not present statistical evidence to reject the null hypothesis.
Hypothesis 2: There are no mean differences between the group 2 treatment
group, video, and group 4, the control group for either self-efficacy or counseling
readiness. ANOVA models 1, 2, 3, and 4 tested this hypothesis and the results did not
present statistical evidence to reject the null hypothesis.
Hypothesis 3: There are no mean differences between the group 3 treatment
group, counseling literature group, and group 4 for either self-efficacy or counseling
readiness. ANOVA models 1, 2, 3, and 4 tested this hypothesis and the results did not
present statistical evidence to reject the null hypothesis.
Hypothesis 4: There are no mean differences between group 1, role-play, and
group 2, video, for either self-efficacy or counseling readiness. ANOVA models 1, 2, 3,
and 4 tested this hypothesis and the results did not present statistical evidence to reject
the null hypothesis.
Hypothesis 5: There are no mean differences between group 1, role-play, and
group 3, literature, for either self-efficacy or counseling readiness. ANOVA models 1, 2,
3, and 4 tested this hypothesis and the results did not present statistical evidence to reject
the null hypothesis.
Hypothesis 6: There are no mean differences between group 2, video, and group
3, literature for either self-efficacy or counseling readiness. All four ANOVA models
tested this hypothesis and the results did not present statistical evidence to reject the null
hypothesis.


54
organizer (Goldstein, Heller and Sechrest, 1966). Such methods prior to counseling help
prepare clients for their role (Johnson and Baker, 1989). Numerous methods can be
applied to help the client anticipate the complexities of his/her prospective, counseling
experience. Such methods include but are not limited to general workshops, briefings,
role-playing, person to person interviews, audiotape, counseling videotape on motivation
(Sutton, 1998; Jakes, 1982) didactic instruction, counseling literature (Helibrun, 1972),
films describing counseling experiences and vicarious learning models (Zwick, 1985;
Heilter, 1976). One popular avenue for enhancing prospective client self-efficacy and
motivation for the client role is a pre-counseling videotape (Sutton, 1998).
Videotape in Counseling
Jakes (1982) showed a video to twenty, female non-clients to positively effect
their expectations and motivation for counseling. The video provided information
regarding a non-directive, counseling style in the form of a dialogue between client and
counselor. Twenty other participants viewed neutral videotape. Results indicated that the
videotape did significantly alter behavioral and cognitive ways of approaching
prospective interviews, but also suggested that motivation for counseling may be
independent of counseling related knowledge.
Deroche (1990) investigated the role of a counseling orientation videotape on
children attitudes and knowledge of counseling. 143 children participated in the study;
70 children observed the video. Results indicated that children who viewed the videotape
developed greater knowledge and realistic expectations of the counseling process.
Additionally, those children were more likely to reveal positive feelings toward
counseling and counselors than the control group.


142
Duckro, P., Beal, D. and George, C. (1979). Research on the effects of disconfirmed
client role expectations in psychotherapy: A critical review. Psychological Bulletin. 86.
264-275.
Elkins, R. and Cohen, C. (1982). A comparison of the effects of pre-job training and job
experience on nonprofessional telephone crisis counselors. Suicide and Life Threatening
Behavior, 12, 2, 84-89.
Everett, T. (2000). The effectiveness of a brief videotaped intervention on colorectal
cancer screening using peer educators. Dissertation Abstracts International: Section B:
The Sciences and Engineering University. Microfilms International, 60, (7-B), 3561.
Falcone, A. M. (1980). The efficacy of pre-intake readings for priming psychotherapy
candidates. Dissertation Abstracts International, 41, (7-B), 2755. (University Microfilms
Number 8101785).
Farley, F. (1991). Type T theory: A new approach to facilitating marriage change.
Family Psychologist, 7, 1, 6-9.
Flannery, Jr., R., and Penk, W. (1999). Critical Incident Stress Management (CISM): The
assaultive psychiatric patient. International Journal of Emergency Mental Health, 3, 1,
169-174.
Foss, C. J. and Slaney, R.B. (1986). Increasing nontraditional career choices in women:
Relation of attitudes toward women and Reponses to a career intervention. Journal of
Vocational Behavior, 28, 191-202.
Frank, J.D. (1968). The influence of patients and therapists expectations on the
outcome of psychotherapy. British Journal of Medical Psychology, 41, 349-356.
Frank, J.D. (1973). Persuasion and Healing: A Comparative Study of Psychotherapy.
Baltimore: John Hopkins Press.
Freud, S. (1961). The Ego and the Id. In J. Strachey (Ed. and Trans.). The Standard
Edition of the Complete Psychological Works of Sigmund Freud (Vo. 19). London:
Hogarth Press. (Original work published in 1923).
Friedlander, M.H. and Kaul, T.J. (1983). Preparing clients for counseling: Effects of role
induction on counseling process and outcome. Journal of College Student Personnel, 24,
207-214.
Gagliano, M. (1988). A literature review on the efficacy of video in patient education.
Journal of Medical Education. 63. 10, 785-792.


55
Diviak (1999) examined video as a pretreatment method with 200 former patients
of a smoking cessation group to help them remain abstinent. Of those, only seventy-three
agreed to participate at a three-month follow-up, but of those participants, former
smokers who reviewed the video pre-treatment showed higher levels of efficacy and
motivation to quit at a three month follow up when compared to the control group.
Regarding counselor self-efficacy development, DRozariso (1996) looked at the
effect of a counseling video on relating differences in counseling style to counselor
effectiveness in different cultures. Significant differences in gender response among
counselor practicum students were found. This conclusion supports Banduras (1997)
argument that self-efficacy can differ in gender with regard to how decisions are made
from efficacy beliefs about performance (although specific differences in self-efficacy
and gender tend to be contextual and usually related to career decision-making, Bandura
1997). Further, it is recommended that each theoretical component of self-efficacy theory
(Bandura, 1997; 1986; 1977) be analyzed separately with other variables (gender) for
their relative and independent contribution to outcome (Luzzo, 1996).
Sipps, Sugden and Faiver (1988) utilized video to investigate the role of counselor
training level and verbal response type to efficacy and outcome expectations. As
expected, with an increase in graduate training, increases in counselor self-efficacy were
shown. Carter (1998) examined the relationship between different versions of videotaped
training on counselor development to perceived self-efficacy. Effects of training on areas
in clinical interviewing included how to ask open-ended questions, the ability to
paraphrase content and reflect feelings. Interestingly, scores on self-efficacy were high on
all groups, independent of video training.


improved with greater sample sizes, participants that are randomly assigned, and more
reliable and valid measures.
Approximately 400 students were surveyed to assess willingness to discuss a
problem in counseling. After attrition, 119 students were selected from exclusionary
criteria in order to approximate real clients. Participants were randomly assigned to one
of four groups: three treatment groupscounseling role-play, a counseling video, and
counseling literatureor a fourth, no treatment control group, to examine treatment
effects on prospective subject self-efficacy and readiness for counseling, as a function of
motivation. Also, gender, treatment, counseling self-efficacy and readiness for change
were analyzed separately to determine follow-up interest in seeking counseling as a direct
result of student participation in this study.
Results were generated from five models. Results from four different 2x4
ANOVA models indicated no significant treatment interaction with gender in predicting
counseling readiness and self-efficacy. Separately, female gender significantly predicted
readiness for counseling, and self-efficacy predicted total readiness score. In the fifth
model, treatment, self-efficacy and readiness for counseling separately predicted
willingness to seek post-test counseling; gender was not significant. However, when
readiness for counseling was added, the treatment effect became non-significant in
predicting follow-up, thus demonstrating the mediating effect of readiness on treatment in
seeking post-test counseling. Limitations, implications of the study and directions for
future research were also discussed.
IX


41
Determination is the third stage of the model. This stage is characterized by a clients
determination to act but without a plan. Therefore working with a client in this stage
involves developing a treatment agenda and corresponding interventions to help
implement the chosen plan. The fourth stage is action, the stage where a client is highly
motivated to change behavior and not just talk about reasons for change. At this point
client change has been carefully considered, a plan generated and the application of the
plan is occurring. The fifth and sixth stages are maintenance and relapse, respectively.
Clients in maintenance continue the chosen prescribed course of action selected by
counselor and client. The last stage of the model, relapse, reflects the circular and relative
nature of this particular model while normalizing that relapse is an inherent component of
recovery (Prochaska, 1992).
Prochaskas (1986; 1982) model implicitly acknowledges and thereby normalizes that
many substance abusers will relapse no matter how advanced in their treatment protocol
regimen. However, instead of a client regressing toward initial stages of
precontemplation and denial again, the model suggests that a given client may return to
earlier stages of positive development (contemplation) and then proceed again,
vacillating through various stages of change. The spiraling through stages of change
gives the theory its characteristic circularity of clientele development and change.
The measurement of the various stages of change has been derived from the
theoretical perspectives of Prochaska (1992; 1986). Measurement of motivation is
reflected as a function of readiness for change prior to the initiation of counseling. Two
such instruments measuring change in this capacity is the University of Rhode Island
Change Assessment (Prochaska and DiClemente, 1992) and the Stages of Change,


84
readiness was additionally analyzed as well.
Limitations of Study
This dissertation is an analogue study. As a result, it is limited in its external
validity (Heppner, 1989). Although those that volunteered for participation in the study
(majority being Caucasian, female, 18-22 age range) were randomly assigned to treatment
groups, the results of the study must be weighed against the relatively narrow definition of
a college-age population. Consequently, the readers ability to apply the results to the
general population is limited. Further, the fact that student participants were identified as
prospective clients and not real clients reduces extrapolation and external validity of the
results to a true client-based population. However, the advantages of analogue research
are well known. By doing research in laboratory university settings, the internal validity of
the study is usually enhanced and tightened between the independent and dependent
variables due to greater experimental control over subjects and levels of independent
variables (Heppner, 1989). Another advantage to analogue research is that the researcher is
not overly concerned nor burdened with conflicts of interest and confidentiality that can
exist between the goals of the client and clinician (Kazdin, 1978). Third, analogue research
typically does not have the issues with client attrition that often can plague research in
clinical settings (Mennicke et al., 1988).
In addition, although the reliability and validity of the URICA measures is
relatively high, the original version was normalized against a substance abusing population,
quite different from the sample in this study. Although the authors of the URICA suggest
that the instrument is reliable and valid for measuring readiness for change of any problem


38
interviewing toward client change (Miller; 1991) is the notion that inherent within us is
the tendency to motivate toward problem resolution to reduce tension.
Other considerations of research on motivation have concentrated on demographics.
For instance, the interaction between gender and client expectations has been studied to
predict motivation. Hardin and Yanico (1983) reported significant differences in client
gender regarding ones expectations in counseling. Women scored higher in expectations
to be motivated, to be open, to be genuine and immediate. Men reported higher scores for
expecting advice, direction and self-disclosure to occur. However, Schaub and Tokar
(1999) suggest that much of the current literature on demographical variables has
revealed little consensus as to the significance of these variables in session.
Additional research on motivation relates to personal expectations. For example,
Schaub and Tokar (Spring, 1999) suggest further inquiry into the examination of the
relationship linking client expectations with motivation. These authors factor analyzed
the five major personality variables (McCrae and Costa, 1987) and combined the traits of
openness, conscientiousness, extraversin, agreeableness, and neuroticism into clusters
according to how they scored on the EAC-B, Expectations about Counseling Measure
(Tinsley, et al., 1980). In correlating the EAC with the five-factor model, Schaub and
Tokar (1999) found significant, empirical differences to exist between personality and
motivation in one cluster of factor analyzed variables.
Others have examined the theoretical role of motivation with expectations.
Expectation value theory (Rotter, 1982; Atkinson, 1966) is linked with personality
research and motivation (Schaub and Tokar, 1999; McCrae and Costa 1987; Tinsley,
1980). This area of research concludes that people are motivated to behave and act upon


APPENDIX G
SURVEY
Please circle your gender: male or female
For the following statement below, circle the number on the 5-point scale that best reflects how
likely you would be to seek counseling if you had a personal problem of any nature.
1
2
3
4
5
Not Moderately Very
Likely Likely Likely
Please list name, e-mail address, home phone number, and check all times you are available to
meet for the study.
Name:
E-Mail: Home Phone:
Monday
Tuesday
Wednesday
Thursday
Friday
5:30 P.M.
6:00 P.M.
6:30 P.M.
3:00 P.M.
1:00 P.M.
6:00 P.M.
6:30 P.M.
7:00 P.M.
3:30 P.M.
1:30 P.M.
6:30 P.M.
7:00 P.M.
7:30 P.M.
4:00 P.M.
2:00 P.M.
7:00 P.M.
7:30 P.M.
8:00 P.M.
4:30 P.M.
2:30 P.M.
7:30 P.M.
8:00 P.M.
8:30 P.M.
5:00 P.M.
3:00 P.M.
8:00 P.M.
8:30 P.M.
9:00 P.M.
5:30 P.M.
3:30 P.M.
The study will be conducted in Norman Hall. Further information regarding the specific location
in Norman Hall and the time of the study will be provided to you in the near future by E-mail or
phone.
132


D COUNSELING LITERATURE 125
E COUNSELING BROCHURE 128
F COUNSELING QUIZ 131
G SURVEY 132
H IRB FORM 133
I ROLE-PLAY INSTRUCTIONS 135
J FOLLOW-UP SURVEY TO SEEK COUNSELING 136
K URICA MEASURE 137
REFERENCES 139
vii


86
CHAPTER 4
DATA ANALYSIS AND RESULTS
Summary and Chapter Overview
The purpose of this study was to assess through empirical investigation the relative
influence of a counseling role-play, a counseling video, and counseling literature on
prospective clients self-efficacy and secondarily, readiness for change. Four different
ANOVA models were applied to analyze the data relevant to the eight hypotheses of the
study. The first ANOVA model analyzed the treatment interaction with gender in
predicting counseling self-efficacy and is applied to the first seven hypotheses of the
study. The second ANOVA model analyzed the effects of gender and treatment separately
on self-efficacy for counseling and corresponds to the first six hypotheses and hypothesis
eight of the study. The third ANOVA model evaluated the treatment effects on gender in
predicting readiness for counseling and corresponds to the first seven hypotheses. The
fourth ANOVA model examined the separate effects of treatment and gender in predicting
counseling readiness and corresponds to hypotheses one through six, and hypothesis
eight. Lastly, the fifth model of the study combined a chi-squared analysis and a logistical
regression procedure to detect statistical significance of either gender, treatment,
counseling readiness or self-efficacy in predicting post-test, follow-up interest to seek
counseling.
Data Collection and Response Rates
During the summer B term, 2002, approximately 400 students from seven different


26
efficacy and motivation to change were most predictive of client persistence in
counseling and most inversely associated with premature termination. Further, Longo
(1991) found in his discriminant analysis that when six variables incorporated to predict
client attrition were summed and weighted into a discriminant function, self-efficacy was
most highly correlated with the discriminant function more than any other variable.
Other researchers have examined the stability of the construct. Although
empirical research confirms Banduras original hypothesis on self-efficacy (1997; 1986;
1977) that reflects that the construct is malleable before firmly developed, self-efficacy
tends to become more resilient and stable regarding performance once established over
time. Larson (1993) noted the influence of increasing self-efficacy among beginning
practicum students by charting counseling self-efficacy development over twenty-three
weeks in comparison to a control group. All eight-student scores on counselor self-
efficacy improved relative to subjects in the control group.
As a theoretical construct, self-efficacy emerges out of the larger framework of
social-cognitive theory (Bandura, 1986). Social-cognitive theory emerged as an extension
and revision of social-learning theory (Bandura, 1977; Miller and Dollard, 1941). Social
learning theory emphasized the influence of different personal and cognitive variables on
human learning and behavior (Bandura, 1986; Mischel, 1973; Rotter, 1954). However,
Bandura (1986) further synthesized and integrated environmental and personal variables
of learning into specific explanations of how cognitive pathways alter human behavior.
Bandura (1986) suggested that cognitive pathways (for example, the mediating role of
self-efficacy on decision making) are typically governed by self-efficacy in the selection,
initiation, and persistence of a chosen behavior.


21
efficacy or perceived beliefs in ones capability to perform (Daniels, 1997; Bandura,
1986). Verbal encouragement to a counseling client can be powerful in altering self-
efficacy, and is offered usually through empathy (Scharf, 2000). In an ANCOVA study
designed to evaluate the effectiveness of different modeling strategies on counselor self-
efficacy, Daniels (1997) studied forty-five beginning counseling practicum students and
concluded that prepracticum trainees that received positive feedback on counseling
performance had substantially higher results on post-tests counselor self-efficacy when
controlling for pretest counselor self-efficacy and post-test anxiety. Results from this
study showed prepracticum students that received positive feedback demonstrated
significant increases in counselor self-efficacy, compared to those who received negative
feedback after controlling for variance due to pre-test performance (Daniels, 1997).
The last theoretical source of self-efficacy development is ones emotional arousal.
Self-efficacy research (Bandura, 1997) suggests that states of mood, anxiety, and fatigue
can influence ones self-efficacy and its development. Since people have the capacity to
alter what they think, self-efficacy beliefs have a powerful and reciprocal influence on
thought patterns and subsequent emotional feeling and stimulation. Self-efficacy
(Bandura, 1986) research suggests that people anticipate quality of performance and
competency based upon how they feel just prior to the event. In other words, ones
confidence in the present reflects ones prospective anxiety regarding what one
anticipates. Thus, calm emotion in anticipation of performance reflects confidence. High
anxiety and arousal illustrates lowered confidence and decreased self-efficacy.
An early line of research that investigated the impact of emotional arousal on self-
efficacy examined the treatments of snake phobias (Bandura, 1997). Traditional


48
subsequently has clinical application. In their regression analysis, Longo, Lent and
Brown (1992), focused on self-efficacy and motivation to predict client attrition. Their
results supported the use of preparatory aides designed to reduce attrition by increasing
client self-efficacy and motivation. Deane et al. (1992) suggested that even though the
majority of clients attend counseling for only a few sessions, the use of preparatory aides
in counseling appears warranted to foster client readiness and commitment to counseling,
independent of the duration of counseling treatment.
One training method to increase counseling skills, counseling efficacy and counselor
motivation toward performance is counselor modeling. Modeling can help facilitate
novice counselors and prospective clients understanding of the counseling process. Baum
and Gray (1992) empirically evaluated the effectiveness of an interview on counselor
subjects self-modeling to aid in learning listening skills. Training groups watched an
experienced counselor in action compared to a trainee attempting to demonstrate
beginning listening skills. Results reflected that subjects improved on both listening skill
development and feeling reflection.
Other training strategies focus on providing counseling trainees evaluative criteria
prior to performance review. The function with such instructional training is to increase
skill development while minimizing potential novice counselor anxiety by cueing them to
prospective material ahead. Rennie and Quartaro (1983) examined the results of trainee
expectations and specific instructions on counseling skill acquisition. These authors
found that instructional pretreatment methods aimed at developing awareness of how
counselor style can impact client listening, was effective on future skill development.
Related research to counseling training includes Lawe, Home and Taylors (1983)


Ill
desire to seek follow-up counseling, once the pre-counseling intervention has been
selected. In other words, perhaps the statistics demonstrate the relative impact of
readiness for pre-counseling as much as readiness for counseling. For instance, if scores
are moderately high when beginning treatment, than higher readiness scores in
comparison to lower scores controls for the effects of any significance or differences
between treatment in predicting desire to seek follow-up counseling, beyond the control
group.
Theoretical Implications of the Study
The significance of theoretical stages of change models (Prochaska, 1992;
Carbonari, 1990) incorporating counseling readiness as an independent variable in
predicting likelihood to seek follow-up treatment is consistent with other longitudinal
studies in this domain (Isenhart, 1997; DiClemente, 1990). Specifically, the
transtheoretical stages of change model postulated by Prochaska (1992) suggests that
clients in more advanced stages of readiness are more likely to persist with treatment
goals and follow-up care once treatment is completed. Likewise, results from this study
remain consistent with Prochaskas (1992) conclusion that clients in more advanced
stages of change are more likely to achieve counseling goals and seek follow-up care
once counseling is completed. Such a conclusion is also consistent with the exclusionary
criteria utilized in this study since more motivated students were used to begin the study.
Thus the implication is that the majority of those students would be more likely to seek
follow-up care. Further, Isenharts (1997) regression models predicting AA sponsorship
following treatment illustrates how client stages to change are congruent with behavioral
phases to change. For example, clients in maintenance and action phases of change are
more likely to seek post-treatment than clients in denial or ambivalent stages of


67
future research inquiry that empirically documents various methods to increase client
self-efficacy and motivation jointly in other counseling-related contexts as well. For it
appears incumbent upon counseling professionals to advance the understanding of these
two variables in relation to each other to better understand their correlated nature in a
variety of counseling treatment contexts. Since many clinicians practice in varied
contexts, it appears warranted that counseling professionals empirically document how
best to motivate and increase prospective client self-efficacy early in the counseling
process, in order that clients maximize the services offered to them in all counseling
related areas (Longo, Lent and Brown, 1992; Longo, 1991). Furthermore, training
methods that support the usage of prospective training designed to increase coping
efficacy and motivation appear needed in more general client populations since few
studies on client self-efficacy in counseling and motivation together exist outside of
substance abuse treatment contexts.
Even counseling treatments that isolate various components of self-efficacy alone
appear justified in order to understand how the theoretical components to self-efficacy
relate to each other. For instance, Luzzo (1999) concluded that although vicarious
learning is less influential on self-efficacy development than performance in academic
contexts, both the relative contribution of each theoretical component is important to
examine in self-efficacy research in general. With regards to the need for interventions,
Larson (1998) argued that constructive aspects of prospective client performance might
be more readily identified from both student counselor and client in a role-play format
that might not be as observable on videotape alone. Specific treatments that illustrate the
empirical value of a counseling role-play on prospective client performance appear


51
Seese (1998) addressed methods to improve teaching for prospective faculty. She
examined the effects of two different counseling interventions on perceptions of teaching
efficacy. Seese (1998) hypothesized that both a didactic training intervention for
prospective faculty and an emotional process group would exhibit a significant impact on
perceived teacher efficacy. Both groups showed significant gains over a no-treatment
control group.
Heppner (1994) reflected the value of Banduras theory on self-efficacy (1997;
1986; 1977) by demonstrating the utility of feedback of teaching methods to prospective
faculty in both verbal and video contexts. Graduate students in this study rated all four
theoretical sources of Banduras self-efficacy and concluded that both performance
attainment (lecture experience) and verbal persuasion were instrumental in the
development of prospective teaching faculty. Heppner (1994) concluded by noting that
understanding teacher self-efficacy development is one vital aspect toward advancing
designs in improved, college teacher protocols.
Related to education, Luzzo et al. (1999) demonstrated the effectiveness of
videotape as a treatment strategy designed to improve math and science self-efficacy in
college students. The function of this study was to examine the separate and combined
results of performance and vicarious learning on math and science self-efficacy
development. Videotape was chosen and operationalized according to prior studies that
noted the influence of video on career student development (Foss and Slaney, 1986),
along with its practical aspects of short duration, ease of standardization, and relatively
low cost of production.
From Banduras theory on self-efficacy (1997; 1986; 1977) it was hypothesized


APPENDIX E
COUNSELING BROCHURE
As part of research group #3, assigned participants will be asked to read various
components of counseling literature. One aspect of the literature provided in the study is
a brochure summarizing the counseling process for clients.
The brochure includes how counseling can help one identify signs of stress, including
feeling overly anxious, being nervous, not being able to concentrate, getting sick more
than often, having trouble concentrating, feeling depressed or overwhelmed.
The brochure then goes on to mention how counseling can help one manage stress levels,
while identifying that some stress is actually good to keep us motivated. However, it is
also mentioned that too much stress can leave us feeling hurried, rushed, anxious, tired or
even ill.
Further, the brochure suggests how counseling can further aid one in understanding the
roots of stress: feeling too busy, daily pressures of work/school, social problems,
struggles with personal identity, sexual concerns, financial problems, etc.
It is also illustrated how counseling can help one identify what one can control and what
one cannot, like ones parents getting a divorce. The brochure stresses the commitment
needed to succeed in counseling, by highlighting that most clients who commit to and
actively participate in counseling find that the counseling relationship can help them feel
less stressed and troubled, while empowering them to set and achieve personal, and
positive goals.
Finally, three important points of the counseling process are identified as well: first,
various aspects of the professional relationship between counselor and client are covered;
second, how it is normal for clients to have doubts about the counseling process, and
third, how progress for clients is not always steady nor does progress occur right away.
128


Table 16
Interaction Model with Treatment Group (1, 2, 3) Predicting Post-Test Follow-Up
99
Treatment Group
Df
x2
Pr>x2
1 Role Play
1
6.35
0.0117*
2 Video
1
3.93
0.0474*
3 Literature
1
3.93
0.0474*
* p < .05.
Model 5
Results below in table 17 illustrate the significance of counseling readiness on
treatment and post-test, follow-up, with R score significant at x2 = 36.18, p < .05.
Gender (G), treatment (T), and the gender by treatment interaction (GT) remain non
significant when counseling readiness score is added to the model.
Table 17
Interaction Model with Counseling Readiness Predicting Follow-Up
Source
Df
x2
Pr>X
Gender(G)
1
1.02
0.3134
Treat (T)
3
6.97
0.0729
Gender*Treat (GT)
3
1.35
0.7180
R Score
1
36.18
0.0001*
* p < .05.
Results of Hypotheses Tests
Four different ANOVA Hypotheses tests hypotheses 1, 2, 3, 4, 5, 6, 7, and 8. The
first model tested all 8 hypotheses, with gender, treatment, and their interaction entered as
separate independent variables. Total self-efficacy was the dependent variable in
ANOVA model one. The overall omnibus model was not significant in the first model,
with F (7, 118), p >.05, significance level = .684. The second model tested the first seven
hypotheses, with gender and treatment as the independent variables. Total self-efficacy


APPENDIX H
IRB FORM
1. TITLE OF PROTOCOL: An Examination of Pre-treatment Strategies on Prospective Client Self-
Efficacy and Readiness for Change in Counseling.
2. PRINCIPAL INVESTIGATOR:
David K. Cox, Ph.D. candidate; 5517 SW 69th Terrace; Gainesville, Florida; (352) 337-2971
home; (352) 372- 0294 office; (352) 339-7776 pager; (352) 377-8714 fax
3. SUPERVISOR: (If PI is student)
James Archer, Jr. Ph.D.; Professor; Department of Counselor Education, College of Education,
1215 Norman Hall; Gainesville, Florida; (352) 392-0731; iarcher@coel5.ufl.edu
4. DATES OF PROPOSED PROTOCOL: April 1. 2002 to March 31. 2003
5. SOURCES OF FUNDING FOR THE PROTOCOL: No external funding.
6. SCIENTIFIC PURPOSE OF THE INVESTIGATION:
The purpose of the study is to determine if different pre-treatment strategies in counseling (role-
play, video observation, counseling literature) statistically influence a prospective clients self-
efficacy and readiness for change in counseling, compared to a no-treatment, control group.
7. DESCRIBE THE RESEARCH METHODOLOGY IN NON-TECHNICAL LANGUAGE
Participants will be randomly assigned and asked to participate in one of four treatment groups:
role-play, video observation, counseling literature, or a no-treatment, control group. All
participants will engage in either an individual, treatment format (role play) or a group treatment
(video observation, counseling literature, or no-treatment control group). After treatment, all
participants will be asked to fill out two measures. One measure is the client self-efficacy behavior
scale for counseling (CSEBS); the other measure is the University of Rhode Island change
assessment instrument, (URICA), measuring a prospective clients readiness and motivation for
counseling.
Participants will also be asked to fill out an informed consent form and a short survey prior to the
initiation of treatments. If selected for the study, each student will complete the treatments and 2
measures, which should take approximately one hour. Each participant may receive extra-credit
compensation for no more than 2% of the total grade, but the offering of extra-credit is under the
control of the each individual instructors discretion.
The names of the participants will be kept confidential; participants will be given a code number
to protect individual anonymity; that number will be on the upper right hand corner of each
respective, individual packet.
133


APPENDIX B
ROLE-PLAY SCRIPT
You are 20 years old. You are an only child. You live with two friends in a small
apartment off campus. You are aware that your mother and father have a stormy
relationship; when you visit them you notice that their arguments appear to have
increased in frequency. There seems to be more yelling in the house. You care deeply for
both of them and feel increasingly pressured to take sides in their arguments.
Lately, your father has been drinking more. Since your father left the house one week ago
in a fit of anger, you have not seen him since. You are increasingly concerned about the
welfare of your mother and how you may have to cope without your fathers income if he
leaves the family permanently.
Since your father left, you notice your mother appears more controlling; she appears to
discourage your independence. She desires that you visit her more often. You also notice
that you and your mother appear to fight more too; and the more you fight, the more you
wish to stay away from her. You simply wish that your dad would return home and that
he and your mom would make up.
Your only real confidant in your family is your grandmother, your fathers mother who
lives in an apartment down the street from you. She however, has terminal cancer, and
only has a few months to live. You wish to spend more time with her yet feel angry over
how she appears to tease her son, your father, about his drinking. Although you do not
miss your fathers yelling, you do wish he were around more. You feel obligated to
defend him. Your conflict is extended between desiring to spend more time with your
grandmother (after all she is deteriorating and you are scared to lose her), yet you also
yearn for more independence and autonomy in college, away from your family and its
pain.
Noting that your grades have begun to slip, while your friends report that you seem
distant and upset, your increasingly troubled and confused emotional state leaves you
wondering what options you have. A friend recommends that you see a counselor and
share your concerns with her. Feeling alone and stressed, you agree with your friend to
see a counselor.
122


APPENDIX F
COUNSELING QUIZ
Treatment group #3; Counseling Literature
1.) From the brochure, please list four signs of stress below.
2.) Counseling helps you identify what you can control in your life by helping you do
what?
3.) How is the counseling relationship different from that of the doctor/patient
relationship?
4.) From the three case studies you read, how did counseling help Jim?
5.) Over time, Karen felt safe to openly discuss emotional material in counseling;
feeling safe in session with her counselor gave Karen the ability to do what?
131


81
measure were developed for potential modification of any identified problem behavior.
The instrument can be administered individually or in a group format. The URICA
utilizes a 5-point likert-scale format in which subjects assess the degree to which they
agree or disagree with the presented items.
Regarding the construct validity of the instrument, four item subscales measure
stages of change in the counseling process: precontemplation, contemplation, action and
maintenance. A total of seven item scores for each subscale, with each item score ranging
from one to five, are added and then divided by seven to obtain a mean for each readiness
subscale. Contemplation, action, and maintenance subscale mean scores are then added
cumulatively to yield one score. The precontemplation subscale mean score is then
subtracted from the three subscale combined mean scores of the contemplation, action
and maintenance scales (C+A+M-P) to yield a secondary score to assess readiness for
change at entrance to counseling.
Initial psychometric properties of the instrument encouraged the utility of the
measure with a wide range of alcohol, dependent individuals. As Carbonari et al. (1996),
states, further research supported a second-order readiness factor and also validated a
single continuous readiness scale constructed by combining subscale scores (Pg. 2). As a
result, one combined 24-item measure was also constructed, composed of two
comparable 12-item readiness measures, ALCREADI-A, and the ALCREADI-B. These
two separate forms were combined into the 24-item URICA measure, known as
ALCREADI-AB, a cousin of the 32-item measure. For each 12-item version of measure
A and measure B, confirmatory factor analysis was conducted to fit the model with the
four manifest stage variables (precontemplation, contemplation, maintenance, action) into