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Client dogmatism, therapist leadership and the psychotherapeutic relationship

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Client dogmatism, therapist leadership and the psychotherapeutic relationship
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Blumberg, Richard William, 1942-
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English
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v, 83 leaves. : illus. ; 28 cm.

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Analysis of variance ( jstor )
Anxiety ( jstor )
Clinical psychology ( jstor )
Control groups ( jstor )
Doctrinal theology ( jstor )
Dogmatism ( jstor )
Gene therapy ( jstor )
Medical treatment ( jstor )
Observational research ( jstor )
Psychotherapy ( jstor )
Dissertations, Academic -- Psychology -- UF ( lcsh )
Dogmatism ( lcsh )
Interpersonal relations ( lcsh )
Psychology thesis Ph. D ( lcsh )
Psychotherapy ( lcsh )
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non-fiction ( marcgt )

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Thesis -- University of Florida.
Bibliography:
Bibliography: leaves 80-82.
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Manuscript copy.
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Vita.

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University of Florida
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CLIENT DOGMATISM, THERAPIST LEADERSHIP AND

THE PSYCHOTHERAPEUTIC RELATIONSHIP












By
RICHARD W. BLUMBERG


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















UNIVERSIY OF FLORIDA
1969














ACKNOWLEDGEiET S


The author wishes to thank the members of his

supervisory committee, without whose patient help this

dissertation would not have been possible. In particular,

he wishes to thank the chairman, Dr. Audrey S. Schumacher,

for her many hours of guidance and consultation. He is

also indebted to Drs. Harry Grater, Jacquelin Goldman,

Madelaine Carey, and William Purkey, all of whom have

proven invaluable not only in the preparation of this

dissertation, but in the author's graduate training at

the University of Florida.













TABLE OF CONTENTS

Page
ACYOWLED GEMENTS .................ii

LIST OF TABLES. . ...... . iv

LIST OF FIGURES . . . . . . . .. v

INTRODUCTION . . . . . . . . . 1

HYPOTHESES . . . . . . . . . . 20

vETHOD . . . . . . . . . o 21

Samnle . . . . . . o o o o 21
Measures o o . o o o ... 22
Procedure . . ....... 26

RESULTS . o o o . . o o . 32

Pretreatment Findings . . o . 32
Posttreatment Findings 35

DISCUSSION o . . . . o .. 47

SMT,.ARY . . . . . . . * 67

APPENDICES o . o o . . o .... o 69

REFERENCES .. . . o . . . . .. 80

BIOGRAPHICAL SKETCH a o o .... o o 83











iii













LIST OF TABLES


Table Page

1 Summary of pretreatment findings on
the Rokeach Dogmatism Scale . . . . 33

2 Analysis of variance for therapist
leading responses . . ...... . 36

3 Analysis of variance for client
solution offering .. .... * 38


4 Analysis of variance for PPPS change
scores--immediate and delayed test . . 41


5 Post hoc analysis of PPPS change scores . 42

6 Analysis of variance for AACL change scores 44













lIST OF FIGURES


Figure Page

1 Theraoist X observer interaction for
therapist leading behaviors . . . 37


2 Therapy X dogmatism X observer interaction
for client solution offering .... 40


3 Therapy X dogmatism interaction for
PPPS change scores . . 43


4 Plot of AACL change scores o . 45














EiTRODUCTION


The psychotherapeutic relationship, as referred to

in this paper, consists of the highly personal interaction

between two people who have been brought together specifi-

cally to aid and enhance one of them. In the process of

being together and discussing very personal and meaningful

things, they may come to affect each other's behavior--

they become for each other significant stimuli, eliciting

from each other behaviors that hopefully will become pre-

dictable and controllable. The primary focus of therapy

is the behavioral changes demonstrated by the person seek-

ing help, but since these changes derive from occurrences

within the context of the relationship, they cannot be

understood or controlled without due regard for the behav-

ior of the other member of the therapeutic encounter.

Consequently, a recent trend in psychotherapy research has

been to avoid the isolated study of techniques, diagnostic

categories and particular problems, and to move toward

multifactor experiments which can simultaneously examine

various combinations within the context of the relation-

ship.

This general conception of the therapeutic encounter

is analogous to the statistical notion of interaction.










This notion recognizes that certain main effects may con-

tribute significantly to the end result, but that when

these effects occur in combination, prediction of the

result depends upon close examination of the combinatory

effects. In a therapeutic encounter, the factors are

people, and the interaction suggests that the result of

the relationship will depend upon the unique effects of

therapist X and client Y on each other, in addition to

whatever contributions the therapist's orientation and

personality, and the client's problem and diagnosis might

make.

As already mentioned, the client brings to the

therapeutic encounter his need to be helped. Traditionally,

the therapist also brings specific attributes to the meet-

ing. Among recognized therapists, Carl Rogers (1957) has

defined these attributes as simply as anyone-he has said

that the therapist must be congruent, must have positive

regard for the client, and be able to communicate these to

the client. Most often there are additional requirements

made on the therapist in the form of special training,

supervised experience and, in some cases, certification.

The effect of this combination of one seeking help with

another who, by definition is highly qualified to offer

help, invariably results in the therapist being cast in the

role of authority figure. As with all elements of the

relationship, this affects both parties in somewhat









different "Ics. Th: th:r: ~t, in accordance with his owrn

personality and orientation to therapy, will handle his

role as authority in various ways. In this, he will also

be affected by his client, who brings to the situation a

life style which includes certain basic and patterned ways

of relating to authority and its representatives. Thus

this most pervasive element of the relationship becomes

fundamental to its successful resolution, and also provides

valuable clues as to where to begin an investigation of

the important components of the relationship itself.

Before continuing, it will be valuable to examine

some of the precedents set by others in their study of

psychotherapeutic relationships. Actually, the emphasis

on relationship research is relatively new. In 1949 Seeman

studied the reactions of clients who had been counseled by

directive and non-directive techniques, and found significant

differences in the reactions of counselees counseled by the

same techniques, and non-significant differences among those

counseled by different techniques. He concluded that some-

thing besides therapeutic method was leading to the differ-

ent reactions among the clients. Fiedler (1950a, 1951a,

1953) maintained, and provided data to support the view,

that it was the relationship between the therapist and the

client, and not the methods, that led to successful therapy.

However, he also pointed out (1953) that the method used

might make a particular therapist more comfortable, and










.,-ereby indirectly affect the outcome of the therapy. At

the same time (1950b) Fiedler presented data to support

the notion that theoretical orientation was not an espe-

cially relevant variable, although this too might presuma-

bly affect the outcome by making the therapist more or

less comfortable in the relationship.

Rogers (1957) discusses what he feels are the major

aspects of the good relationship. In terms of the inter-

action Der se, he emphasizes the importance of the thera-

pist experiencing unconditional positive regard and empathic

understanding of the client, and also being able to commu-

nicate this to him. It will be noted that Rogers focuses

on the role of the therapist, whom he sees as a constant

in the situation, and does not discuss the role of the

client in affecting the therapist's behavior. Truax (1966)

has questioned the constancy of the Rogerian therapist, and

shown that Rogers himself reacts differentially to client

behaviors in therapy.

Somewhat later however, Rogers (1965) acknowledges

the client as an elicitor of behaviors in the therapist,

which is much closer to the point of view taken here.

After reviewing some of the Rogerian-oriented studies on

relationship, he concludes:

Without trying to go further into this
very complex research, I will simply say
that it indicates that the attitudinal
qualities I have described are provided










largely by the therapist, but elicited
partly by certain characteristics in the
patient. Thus therapy is an interactional
event. ,(p. 104)

As advanced experimental designs become more wide-

spread, research in the area of therapy relationships has

become more sophisticated. Recently, for instance, Lorr

(1965) has used factor analysis on a collection of client

perceptions of therapy and arrived at five therapist-behav-

ior dimensions: accepting, understanding, authoritarian,

independence-encouraging and critical-hostile. These find-

ings provide clues as to the major ways in which therapists

enter into the relationship, and how they are seen by the

client. It is noteworthy for the point of view expressed

above that one of the five basic perceptions that Lorr's

clients reported having about the therapist's behavior was

the authoritarian dimension. It lends empirical support

to the universality and importance of this aspect of the

relationship.

Recently Moos and Clemes (1967) have simultaneously

studied several therapist and client behaviors in a multi-

variate design. They found, in support of the theoretical

import of the present research, that both therapist and

client behaviors are determined by the therapist, the client,

and the particular therapist by client interaction. In their

study they used five objectively defined behaviors: total

word count, percentage of feeling words emitted, percentage










of action wods, the number of questions asked, and the

number of "Lm-h-ms" emitted. A number of surprising find-

ings came out of their data, including the fact that for

at least one of their behaviors, the effect of the client

upon the therapist was greater than the effect the thera-

pist had upon the client! 7,7hile potentially embarrassing,

such a finding is consistent with the interactionary model

proposed here, and points up the need for further research

to determine what reciprocal effects the therapeutic par-

ticinants have upon each other. -urther, since no outcome

data are reported, it cannot be known from this study what

ultimate beneficial effects the therapist's "versatility"

may have had on the client.

As mentioned above, the concept of authority is an

integral and important element in the psychotherapeutic

relationship, and, as such, it plays a central role in the

present study. In keeping with the notion of relationship

already developed in the preceding pages, the concept of

authority will be examined within the context of the total

interacting unit--the client and the therapist together.

The best reflection of the therapist's reaction to his

authoritarian role is the degree to which he exerts control

or leadership in the relationship. An analogue of this for

the client is his assertiveness or submissiveness in ther-

apy, as well as his general orientation to authority and

typical ways of responding to it. Several measures are










svailc o {~~ ~of ireneral sauthori.-

tarianism or domaiis, has been chosen for this research.

The degree to which any therapist exerts leader-

ship during the course of therapy depends upon his person-

ality, includinE the important effects of his training and

experiences, an on !!e particular client he is seeing at

the moment. Th s2ertion -rov.,s out of the theoretical

conception presented here of the therapeutic relationship,

and can be empirically tested. The ultimate therapeutic

effects of leadership with different clients can also be

tested. Both these questions, along with the effects of

therapist leadership on the client during the course of

the therapeutic encounter, will be examined presently.

It should be pointed out that the interactionary

model proposed applies only to those cases where a free

and spontaneous development of the relationship is fostered.

This precludes a technique-oriented or role-playing stance

on the part of the therapist if his techniques or roles are

to be artificially imposed or "ego-alien." A therapist

with a rigidly programmed set of behaviors to present dur-

ing therapy will probably show little change across dif-

ferent clients, nor should any change be anticipated.

Use of the therapist leadership dimension is not

without precedent. In many ways it is similar to the older

concept of directive versus non-directive counseling. The










main difference is that the latter emphasizes a technique
to be employed by the uherapist--a way of acting toward

the client. leadership refers to a much more general notion,

encompassing more of the therapist's personality than just

his training in the specifics of conducting therapy. It

emphasizes the role of the therapist in interacting with

the client. This does, of course, include the older dimen-

sion--it also goes beyond a focus on technique alone. Its

continuing relation to older concepts does bear testimony

to its significance for all therapy though. Jesse Gordon

(1957), for instance, has pointed out that the relationship

dimension represents a basic split among schools of psycho-

therapy.

Ashby, Ford, Guerney, and Snyder (1957) have organ-

ized a number of studies using the leadership dimension,

and published them in the form of a monograph. They trained

ten therapists in both a leading and a reflective type of

therapy. Interestingly, while these therapists could learn

either technique, their learning experiences did not neces-

sarily take precedence over what they felt to be best, so

that four of their ten therapists did not remain within the

orientation that the experimental design called for. These

authors found that clients could relate satisfactorily not

only to friendly, non-threatening therapists, but also to

authoritarian ones who could engender confidence. The ther-

apists, 90% of whom favored the more leading therapy,










onsistently reported the clients more improved in this

more interpretive therapy. In the leading therapy, the

clients became more positive in their feelings toward

therapy, and were also held in therapy more easily. The

authors concluded that focusing on a problem caused

Mardedness and seeming maladjustment, which they felt

was only temporary.

The use of the leadership dimension raises very

important questions in terms of the personality of the

therapist and the type of techniques he uses in therapy--

either because he is more comfortable with them, prefers

them, was taught them, or believes them to be more effec-

tive. These questions, along with the degree of congruence

between the therapist's techniques and his more basic atti-

tudes and beliefs (personality), perplex any insightful

researcher in the area of psychotherapy. The fact that

almost half of the therapists used in the Ashby et al.

study cited above did not stay within the experimental

requirements indicates that training alone does not account

for the techniques employed by individual therapists. With

this in mind, the therapists used in the present study were

selected with due regard for their natural predilections

in terms of leading or following orientations. In other

words, role playing with techniques was hopefully kept to

a minimum. What was sought in the design of this research

was a maximally congruent, comfortable, and effective










t e-rapist-echnique unit, in order to see to which unit

various subjects would best respond. This is consistent

with suggestions made by Ford (1956), Snyder (1957) and

others, who feel that the therapist and his method must be

viewed as a single unit.

In addition, the Ashby et al. study failed to take

into account the reciprocal effects of the various clients

on the therapists and their styles. By including an analogue

of therapist leadership for the client--namely the clients'

level of general authoritarianism--the present study has

remained truer to the interactional model described above.

As already mentioned, client dogmatism is seen as a

reflection of the client's typical ways of responding to

authority. It is in this sense that it has been used in

the present study as an analogue to therapist leadership.

By so doing, it was hoped that opposite sides of the same

central issue would be tapped, and thus give free expression

to whatever reciprocal effects might exist.

The use of the authoritarian dimension also has its

precedents in the field of therapy research. When this con-

cept was originally popularized in 1950 by Adorno et al. it

first caught the attention of those doing research in social

psychology and personality development. More recently, those

working in the clinical aspects of psychology have begun to

use this dimension. For instance, Jones (1962) found that










high scores on the California F Scale tended to see the

role of the therapist as more directive and advice-giving.

Jones also mentioned that he felt that the differences

between high and low scoring groups had been attenuated by

the inability of the F Scale to discriminate between tol-

erant and intolerant "liberals." In a similar vein,

Wallach (1962) found that high and low scorers on the F

Scale also preferred different types of therapists. Vogel

(1961), using the same measure, found high scores related

to authoritarian attitudes toward therapy in two different

patient groups. These studies suggest that the F Scale is

useful in detecting different attitudes toward therapy and

therapists, but,as Jones (1962) points out, the scale is

not without its critics.

T$lilton Rokeach (1960) has extended and purified

the original notions of the Adorno et al. California group,

and written about the concept of general authoritarianism,

or what he refers to as dogmatism. He has developed and

standardized his own Dogmatism Scale (1960) and criticized

the California F Scale on the grounds that it does not

adequately reflect general authoritarianism. Rokeach says

that general authoritarianism is related to the relative

openness or closedness of a person's belief-disbelief sys-

tem. This system is an intervening variable which includes

all of an individual's beliefs about the world he lives in,

and which also orders and relates these beliefs, one to










another. Openness or closedness depends upon the person's

ability to "receive, .valuate, and act on relevant informa-

tion received from the outside on its own merits, unencum-

bered by irrelevant factors in the situation arising from

within the person or from the outside." (Rokeach, 1960,

p. 57) The more closed this belief system is, the more it

approximates a carefully orchestrated defense system

designed to "shield a vulnerable mind." (p. 70) Rokeach

thus compares the extremely closed cognitive mind with the

classical notion of the rigidly defended neurotic individ-

ual.

Because of its newness, this scale has not yet been

extensively used in clinical work. Several early findings

have been published however, which bear directly on psycho-

therapy. Rokeach himself (1960) reports data to indicate

that high dogmatic subjects are less efficient at problem

solving. Further, Powell (1962) reported thai high dog-

matic subjects were more subject to impression by source

credibility than were low scoring subjects. This tends to

support an hypothesis of Rokeach's to the effect that high

dogmatic people tend to confuse source and message, rather

than evaluate both on their own merits, especially when

authorities are seen as the source of the message. Finally,

Plant, Telford and Thomas (1965) compared high and low dog-

matic persons in terms of their patterns on a standard per-

sonality inventory. These authors characterized the high










natic group as impulsive, defensive and stereotyped in

b eir thinking. These findings, together with those from

the California Scale, suggest that subjects or clients who

differ along the authoritarian dimension will react quite

differently to therapists who differ on the leadership

dimension.

Another relevant dimension within the psychothera-

peutic relationship (and one that will be included in the

present study) is that of anxiety. This includes anxiety

both as it arises as a symptomatic manifestation of the

client's problem, and as it arises and is dealt with within

the context of the leadership-authoritarian relationship

per se. In the latter sense, it is a good index of the

client's subjective reaction to the relationship. Further,

to the extent that the client's problems have caused him

anxiety, it assesses the outcome of therapy in terms of its

effectivenes in reducing that anxiety.

Having established the general area to be studied,

it is now necessary to discuss briefly how the area will

be approached. In this regard there are two relatively

innovative concepts which must be introduced and expanded.

These are the adoption of a "problems in living" model, and

the use of an analogue design, both of which are basic to

the present study. These two notions are also somewhat

related in that the adoption of this model facilitates,










a.. b. t ...he. ..... eels, the applica-

bility of the design.

A most important contribution to the field of psycho-

therapy within the last decade has been Thomas Szasz' sug-

gestion of a "problems in living" approach to psychotherapy.

Szasz tells us (1960, 1961) that the old notion of mental

illness has outlived ryhatever usefulness it may have had.

It is time to recognize that maladjustment is defined in

social, legal and statistical terms, and the treatment of

it by medical means alone is misleading and ineffective.

The logical solution, according to Szasz' point of view,

is to re-orient our thinking in terms of a "problems in

living" paradigm, and abandon the outdated myth of mental

illness. This view is consistent with the present author's,

and is intrinsic to the design of this research.

An excellent paper by Guerney and Stollak (1965)

concerns itself with the application of a "problems in liv-

ing" approach to psychotherapy research. They begin by

summarizing the rationale of the approach:

All individuals have intra- and interpersonal
problems. . Such problems are dynamic and
changing rather than structurally fixed and
static. . All of us are continually
engaged in the process of solving intra- and
interpersonal problems. . There is no hard
and fast line separating neurotic from normal.
Rather, there are patterns of more or less
success in solving these problems. . The
person usually regarded as neurotic may be
viewed as someone who habitually solves a great
many such problems somewhat less well than will










C i1' or he r.- solve only
ot a- -articular
point in time far less well than the majority
of his contemporaries. Such people may be the
ones who have the most to gain from psycho-
therapeutic procedures. But all people prob-
ably can benefit somewhat from some type of
psyrchotherapeutic assistance at any time. (p. 582)

The authors then go on to state a number of heuristic advan-

tages to the adoption of such a rationale in research. They

mention: 1) By reformulating our research questions along

these lines, we will bring our work more closely in line

with the mainstream of general psychology, rather than

restricting it to a particular subgroup of "sick" subjects,

2) On an operational level, it will allow a much wider appli-

cation of experimental procedures, for the subject pool of

the researcher is greatly enlarged when he is not restricted

to the use of patients of this or that diagnostic category,

and 3) The researcher will be more free to experimentally

manipulate his subjects, governed only by the ethics of

dealing with human subjects rather than having to consider

the needs and prognoses of identified patients. By extend-

ing the use of normal subjects as clients, the present

research, using an analogue design, hopes to take advantage

of all the above possibilities.

It is apparent that Guerney and Stollak are suggest-

ing that research proceed with a theoretical reformulation

in keeping with the ideas developed by Szasz. Several stud-

ies on psychotherapy, employing the experimental analogue










desipz, h':e stct'- ... thin the last few years,

and have been reported by Cowen (i9o), Gordon (1957),

Kanfer and Iarston (1964), Levison (1961) and others.

As Cowen (1961) discusses the analogue design, it

is a type of research in which the experimenter in some way

simulates the behavior of a therapist in the process of

givin therapy, while the subject is brought through some

means to feel distress or a symptom comparable to that which

a client might feel. It is also possible to use the anxiety

generated by normal daily problems, although this may not

have reached proportions great enough to motivate the sub-

ject to seek help on his own. It is in this sense that the

adoption of a "problems in living" model relates to the

analogue design--since the major tenet of this model is the

basic similarity of problems across all persons, almost

anyone becomes eligible as a research subject. However,

Zytowski (1966), after having reviewed many of the analogue

studies, concluded that those experiments which utilized

already existing anxiety, rather than inducing it experi-

mentally, less frequently obtained significant results.

This seems to suggest that while most people may have prob-

lems, the anxiety generated may not be sufficient to make

a particular person amenable to therapeutic intervention.

Nevertheless, the present study will draw upon both

the "problems in living" model and the analogue design. The

examination of real problems actually being experienced by









the sutJect is ir-ouotedv oser to ctual therapy con-

ditio 3 than co ld be any ,r-6ficial distress induced by

the experimenter. Further, at least one of the dependent

measures has been designed to tap a specific problem area,

independent of the anxiety level of the subject. This,

together with the inclusion of an anxiety measure, should

help clarify the point Zytowski (1966) raises.

v'Thile the main focus of the present research is the

authoritarian component within the psychotherapeutic rela-

tionship, there are other factors which must be considered,

and which also affect the relationship. As is customary,

some of these have been controlled for in the design of the

study, and some have been allowed to vary randomly.

Among the client variables which were controlled

are age, sex, education and intelligence. These are fre-

quently controlled variables in psychological research,

and it is obvious that they might directly confound any

attempt to isolate relevant effects within the relationship.

Age and intelligence were indirectly controlled by means of

the population from which the sample was drawn--an under-

graduate college group. Sex has been identified as a sig-

nificant component in the therapeutic relationship by Parker

(1967) and Currier (1964) as well as others. Especially in

view of the main focus of this study--the authority aspect-

it was deemed imperative that sex be controlled for.










In addition, whether or not the subject was pres-

ently being counseled was seen as an important variable

to be controlled, for obvious reasons. Since actual prob-

lems were to be used in this study, it would have been

impossible to evaluate the effects of the experimental

treatment if it took place within the context of a much

more extensive therapy program.

Finally, the experience of the therapists was seen

as a mandatory control factor. The pioneer work of Fiedler

(1950a, 1951a) and innumerable others requires such controls

in any psychotherapy research.

The primary uncontrolled variable in the present

study is the type of problem presented by the subjects,

and its objective seriousness. This warrants some discus-

sion. At a theoretical level, one of the most basic assump-

tions of the model used here is the similarity across

individuals of their "problems in living." This rationale

is well presented by Guerney and Stollak (1965) in the sec-

tions cited and quoted above. To classify persons accord-

ing to type of problem--in short, to diagnose--would be

inconsistent with the model chosen. Further, there seems

to be no empirical justification for questioning this

rationale at the present time. On the contrary, Parloff

(1961) found no correlation between initial patient evalua-

tions and subsequent measures of the quality of the thera-

peutic relationship in his group of neurotic patients.










In addition, the nature of the population from

nich the sample was drawn probably exercised some

indirect control over the nature and seriousness of the

problems presented. To have further controlled this

w, ould have required impractical demands in terms of

qualified staff and numbers of subjects to be screened.

At some later time this additional control may seem

justifiable.

To recapitulate, the present study represents an

exploration of an interactionary conception of psycho-

therapy. The salient aspects of the relationship which

were focused on are the degree of leadership shown by

the therapist, and its analogue, the client's typical

ways of relating to authority. The adoption of a "prob-

lems in living" model facilitated the use of normal sub-

ject in an analogue design, which utilized both outcome

and process measures in attempting to evaluate the thera-

peutic relationship.













HYPOTHESES


The following hypotheses are examined:

1) Both the client's and the therapist's behavior will

vary as a function of the particular combination of the

type of therapist the client encounters (leading or fol-

lowing) and the type of client he is (high or low dogmatic).

In particular, it is hypothesized that the therapist will

tend to show more or less leadership depending upon the

client he sees, and that the client will tend to offer

more or fewer solutions to his problem (take the lead or

not take the lead) depending upon the therapist he sees.

2) The client's perception of the seriousness of his

problem will vary as a function of the particular type of

therapy he encounters (leading or following) and the type

of client he is (high or low dogmatic). That is to say,

it is predicted that in the analysis of the outcome data

there will be a significant therapist by client interac-

tion.

3) Similarly, it is predicted that change in the client's

anxiety level will vary as a function of the particular

therapist and client combination.














METHOD
Sample


The subjects used in this study were undergraduate

males at the University of Florida, enrolled in one of two

introductory level courses in psychology. Because the sub-

jects were to be screened by means of the Rokeach Dogmatism

Scale (1960), copies of this scale were handed out in class

after a brief announcement calling for experimental sub-

jects. In all, 122 copies of the scale were given to the

members of the two classes. Of these, 99 were returned to

the author, who then scored them. Either because they were

incorrectly filled out, or because the respondent lacked a

convenient means of being contacted, nine of these were

eliminated. From the final subject pool of 90 subjects,

the author contacted the 15 highest and 15 lowest scorers,

when this was possible. Several people could never be

reached, two declined participation when the outline of

the experiment was presented to them and one person, who

was already being seen at the University Counseling center,

decided, with the author's agreement, that it might be best

for him not to participate. When a person could not be

reached, or declined participation, the next higher (or

lower) person in the pool was called. All of the subjects
21










(30 in total) were contacted by telephone, and given the

same information. This information is presented verbatim

in Appendix A.

The two therapists used were clinical psychology

graduate students at the University of Florida, and were

matched in experience. Approximately 20 students were

considered, and two were finally chosen on the basis of

their-demonstrated propensity to be more, or to be less,

active in the conduct of therapy. Three faculty clini-

cians, who had some knowledge of the students in either

a teaching or supervisory capacity, were consulted in

making the final selection. The control group interviewer

was chosen from a pool of experimental psychology students

so that his age, sex and educational level was in keeping

with the two therapists.


Measures

As stated above, the "clients" were selected by

means of the Rokeach Dogmatism Scale. This scale is

presented in full, and discussed in terms of reliability

and validity in Rokeach's Open and Closed Mind (1960).

He reports a range of reliabilities of from .68 to .93

for Form E of the scale. Among the validity studies

reported is one concurrent measure using groups of high

and low dogmatic subjects, identified as such by fellow

students, and which were differentiated at a significant
level by the scale.










Frequency counts obtained by means of direct obser-
vation were the measures used for testing Hypothesis I.

The observers used were both graduate students in clinical

psychology, presumably with some skill in observation of

a therapy situation. They recorded frequency counts of

both the leading and following behaviors of the therapists

as well as the direction-seeking and solution-offering

behaviors of the clients as observed through a one-way

mirror. The criteria used for identifying leading and

following behaviors were originally described by Ashby

et al. (1957), and are presented below. The client behav-

iors observed are more or less self-explanatory; any active

effort to seek advice or direction from the therapist in

achieving mastery over his problem was scored as direction-

seeking. Conversely, any statement to the effect that the

client had spontaneously produced a tentative solution was

scored as solution-offering. This straightforward approach

to operationalizing behaviors observed in therapy follows

the general suggestions of Glad (1959).

An instrument developed by the author (Blumberg,

1968) was used in testing Hypothesis II. This instrument,

known as the Problem Pathological Potential Scale (PPPS)

has as its aim the assessment of the extent to which the

client sees his problem as being serious, as presenting

real difficulties in overcoming it, as having the potential

to seriously disrupt the client's daily routine, etc. (See










Appendix B for the complete scale.) To the extent that

this problem is perceived as being insurmountable, severely

disabling and insoluble, it is assumed to take on patho-

logical proportions. The scale consists of eight items

which are alternated in terms of pathology, to avoid the

misleading effects of response set in producing false

positives and false negatives. Each item is quantified

to yield a score ranging from 1 to 10, so that the total

score on the scale ranges from 8 to 80, with a high score

indicating a more serious problem. Quantification of the

scale is accomplished by means of a line graph for each

of the items, upon which the client places a check to

indicate the value of his response between two extremes.

It is scored by placing a grid over this line and reading

off equal intervals.

In a pilot study conducted during the summer of

1967 at the University of Florida, the reliability (test-

retest) of this scale was found to be .957 with a half-

hour interval (N=24), and .901 with a one-week interval

(N=22). While no formal validity measure has been obtained,

the scale has considerable face validity. In addition, the

items were chosen to reflect criteria for maladjustment

commonly held by clinical theorists of various persuasions.

In this sense, it possesses some degree of construct valid-

ity as well.









The Zuckerman Affec6 Adjective Check List (AACL)

was used in testing Hypothesis III. This scale was chosen

in part because of its ability to detect short-term var-

iations such as might be reasonably expected in an exper-

iment of this design. Zuckerman (1960) reports a split-

half reliability of .85 with instructions to record

immediate feelings. With this same set in mind, a valid-

ity study was devised wherein the scale was administered

to college students in an elementary psychology class on

both exam and non-exam days. The instrument was able to

distinguish between days at a significant level.

Finally, two scales were administered to the two

therapists used in this study to augment the information

already available as to their natural predilections and

orientations in therapy. These scales were the Strong

Vocational Interest Blank for Men (Strong, 1938) and Berger's

Acceptance of Self and Others Scale (Berger, 1952). The

former is discussed by Strong (1943), who reports relia-

bilities in the range .73-.94 using 285 college seniors.

The latter is actually two scales in one, designed to tap

basic positive attitudes toward both the self and others.

It is discussed by Berger (1952), who reports split-half

reliabilities of .894 or better for the self-acceptance

subscale, and .776-.884 for the acceptance of others.

With respect to validity, the Pearson product moment cor-

relations with essay-type self-descriptions of students'






26



_ttitudes were .897 for seif acceptance, and .727 for

acceptance of others. The scale is also discussed by

Shaw and Wright (1967), who laud its rather thorough

standardization.


Procedure

After the potential subjects had been selected by

means of the Dogmatism Scale, they were contacted by

telephone, and asked if they would like to participate

in the study. Each was told that he would be required

to come into the counseling center with a personal prob-

lem that he might be asked to discuss with a professional

person, that he would be asked to evaluate this problem

on some questionnaires, and that the total procedure would

require two sessions. (See Appendix A for complete instruc-

tions to the subjects.) Ihen the subjects arrived at the

counseling center, they were met individually by the author

and given the PPPS and the AACL to fill out. They were

then brought in to see one of the two therapists or the

control group interviewer, according to the group to which

they had been previously assigned. An equal number (five)

of both high and low dogmatic subjects had been randomly

assigned to the three experimental groups (leading, fol-

lowing and no-therapy control) before this first session.

Immediately following the one-half hour-interview, the

subjects were again given the PPPS and AACL by the author.









One week later, all subjects were again given the PPPS

and a subjective questionnaire asking them to evaluate

their reactions to the total experimental situation (see

Appendix D).

The two therapists were selected according to

their supervisors' or professors' impressions as to a

demonstrated predilection for leading or following behav-

iors in therapy. To accomplish this, the supervisors

and professors were originally informed of the experimental

requirements and then asked if they could suggest two prac-

ticum or intern students who seemed to best fit the bill.

The author then presented these suggestions to the three

clinical members who supervised this research, and together

agreed on the final selection. To further reinforce their

natural predilections for leading or following behaviors,

the author carefully reviewed with the therapists what was

desired in terms of experimental design--that they be a

leader or follower, respectively. In addition, two pilot

interviews were allowed each therapist as training sessions.

After these sessions, the author prompted the therapists

on what would have been more desirable behaviors from the

experimental point of view, i.e., what would have been

the leading or following thing to do, etc. As previously

mentioned, each therapist was given the Strong and Berger

scales, and asked about his own preferred and usual ways

of doing therapy. Both of the therapists were males, of









approximately equal experience--one was working at the

internship level in counseling psychology; the other was

at the practicum level, but with one year's professional

experience in a counselling position.

In the leading treatment (LT) group, the therapist

discussed the client's problem with him as if he (the

therapist) were an expert and authority on such problem

solving. He offered suggestions, gave advice, reassured,

admonished, gave praise when he felt the client deserving

of it, etc. The techniques he used may well be described

as "directive." This situation has been described by Ashby

et al. (1957) as:

[being] composed of directive leads,
interpretations, directive structuring,
approval, encouragement, suggestion, advice,
information giving, and persuasion. ...
The therapist attempts to create a warm,
accepting, understanding non-critical psycho-
logical atmosphere; to contrast the client's
report of his situation and difficulties with
an objective reality as the therapist deduces
it. ...


On the other hand, no such representation as authority was

offered in the following treatment (FT) group--the thera-

pist was friendly, supportive, neutral, accepting of what-

ever suggestions or behavior was given by the client, etc.

The techniques relied upon here for conducting the inter-

view would be aptly described as "non-directive" or "reflec-

tive." The above authors describe this situation as fol-

lows:









This family of responses included restatement
of content, reflection of feeling, non-directive
leads, and non-directive structuring responses.
This therapy was built largely on the Rogerian
approach. (p. 6)

The primary purpose of the control group was to

provide an equal period of discussion and contact with

another person, but to avoid any consideration or discus-

sion of the subject's problem itself. This was to deter-

mine the effects of simply being with another person in

the experimental situation versus actually dealing with

a problem in the controlled conditions designed for this

study. Consequently, the neutral topic of "Highway

Safety" was introduced by the control group interviewer,

and was discussed for one-half hour with the control sub-

jects. It was planned in advance that if the subject

tried to alter the topic and begin discussing his problem,

the interviewer would point out that this phase of the

experiment called for a discussion of highway safety, and

that the topic had to be adhered to. The interviewer for

this group was also a graduate student, but in physio-

logical psychology. He had had the same number of years

training in his specialization as the two therapists had

had in theirs. It should be noted here that the assign-

ment of a discussion topic by the interviewer, and its

enforcement by him, made this group closer in some ways

to the LT group than to the FT group. Such confounding

was unavoidable in ensuring a no-therapy control group,









i.e., a group in which the subject's particular problem

would not be dealt with in any direct way.

Testing Hypothesis I involved the use of frequency

counts, and these were considered as factors themselves

in the analysis of the resultant data (therapy X client

X observers). This analysis applied only to the two

therapy groups, and not to the control group. The proce-

dure for testing Hypothesis II was to take the change

scores on the PPPS for the one-half hour and one-week

intervals, and analyze these data in a three-factor anal-

ysis of variance design (therapy X client X test-retest).

Similarly, the procedure for testing the third hypothesis

was to take the change scores on the AACL over one-half

hour, and analyze these data in a two-factor design

(therapy X client).

To facilitate and augment data collection, the

author observed and recorded on tape all of the experi-

mental sessions through a one-way mirror. No attempt

was made to conceal either the mirror or the microphone

from the subjects, and, if they asked, the entire record-

ing procedure was explained to them. In addition, as

mentioned, two observers were also present in the obser-

vation room during the two treatment groups, but not

during the control group sessions. Finally, both thera-

pists were asked to subjectively evaluate their degree

of liking for the subject, as well as their estimate as





31



to how valuable the session had been, immediately after

seeing each subject.













RESULTS


Pretreatment Findings


The reader will recall that the final subject

pool consisted of 90 college males enrolled in one of

two introductory psychologOr classes at the University

of Florida. These students had been selected for the

study on the basis of their scores on the Rokeach Doga-

tism Scale. The scores obtained ranged from a high of

190 to a low of 82, with the high scores indicating high

dogmatic or closed-minded orientations. This array of

scores yielded a mean of 135.98, with a standard devia-

tion of 18.00, which is consistent with the data presented

by Rokeach (1960).

When the 30 subjects who participated in the study

had been selected, they were randomly assigned to one of

three groups--leading, following, and control, for a total

of 10 people in each group (five high and five low dogmatic

subjects). To insure that a random sort with such small

numbers had not produced a biased sample in one or more

of the groups, dogmatism scale scores were compared across

groups. Table 1 below presents the means of these groups,

the differences between each of these means and the grand










mean, and the equivalent of these differences in standard

deviation units.


Table 1

Summary of pretreatment findings on the
Rokeach Dogmatism Scale

Leading Following Control
Group Group Group

Mean 168.2 163.6 161.0
High Difference 4.0 .66 3.26
Dogmatism SD .36 .06 .34

Mean 105.4 94.2 110.6
Low Difference 2.0 9.2 7.2
Dogmatism SD .26 .73 .57



On the other hand, it was vital to the study that

the high and low dogmatism subjects differed significantly.

Examination of these data indicated that the mean of the

high dogmatic group was 164.3, while the mean for the low

group was 103.4. The means for the two groups were thus

separated by 60.9 points, or 3.38 standard deviations,

indicating a clear difference between them.

Further, in order to justify the use of the analysis

of variance, rather than an analysis of covariance, or some

other design, it was important to demonstrate that the high

and low dogmatic groups did not differ on their initial

scores on either the PPPS or the AACL. The high dogmatic

subjects obtained a mean score of 40.33 on the initial
administration of the PPPS, while the low dogmatic people










tained a mean of 37.00. The grand mean of this dis-

tribution was 38.66, and the standard deviation was 8.00.

Since the difference between the high and low group means

and the grand mean is only 1.67, they differ from the

grand mean by only .21 standard deviations. Similarly,

the mean of the high dogmatic subjects on the initial

administration of the AACL was 8.94, while the low dogmatic

subjects scored a mean of 7.35. The grand mean of the

distribution was 8.17, with a standard deviation of 2.64.

Since the difference between the group means and the grand

mean is only .82, they differ from the grand mean by .30

standard deviations.

Examination of the data collected on both of the

therapists used in the study proved most interesting. The

leading therapist scored a total of 257 on the Berger

Acceptance of Self and Other Scale--143 for Self; 114 for

Other. (The number of items for the two scales are not

equal, so the scores are not directly comparable.) On

the other hand, the following therapist scored a total of

291 (164 Self; 127 Other). The result is thus a small but

consistent tendency for the following therapist to show

greater acceptance of both Self and Others.

The Vocational Interest Blank profiles differed

somewhat for the two therapists. Looking only at the

highest scoring professions (those in the A range of inter-

est compatibility) it was found that the leading therapist










saw himself as closest to mathematicians, lawyers, and

computer programmers. On the other hand, the following

therapist saw himself as closest to psychologists, social

workers, librarians, music performers, music teachers,

and author-journalists.



Posttreatment Findings

Hypothesis I was tested by means of two separate

analyses. The first of these examined the ratio of lead-

ing responses to total responses (leading or following)

observed for each of the two therapists by each of the two

observers. This resulted in a three-factor analysis of

variance, with therapy (leading and following), dogmatism

(high and low), and observers (first and second) as fac-

tors. Proportions were used as a means of statistically

controlling for total productivity of the two observers,

thus ruling out the possible contamination due to one

observer being more active in identifying responses of

both types. Using proportions also had the practical

advantage of eliminating the need for separate analyses

of the two types of responses observed. Table 2 provides

a summary of this analysis.

By far the strongest finding, both across observers

and across levels of "client" dogmatism, was that the pro-

portion of leading responses observed was far greater for

the leading therapist than for the following therapist









(see Appendix E for table jiving total proportions of lead-

Lng responses by therapists). Interestingly, observer

agreement was not nearly so high where following therapy

was concerned, giving rise to a significant observer

effect, which was part of an even stronger interaction

between therapy and observers. Figure 1 graphically pre-

sents the nature of this interaction. This graph, plotted

in terms of total proportions for all subjects, indicates

that while the two observers agreed very closely on lead-

ing therapeutic behavior, there was more disagreement in

the following condition. It also indicates that despite

this effect, neither observer had any difficulty seeing

more leading responses in the leading therapy.



Table 2

Analysis of variance for therapist leading responses

Source Sum of Souares df Mean Square F

Between 4.33 23
Therapy 4.00 1 4.00 242.42*
Dogmatism 0.00 1 0.00 ---
Therapy X Dogmatism 0.00 1 0.00 ---
Error .33 20 .0165

Within .39 24
Observers .07 1 .07 10.77*
Therapy X Observers .18 1 .18 27.69*
Dogmatism XObservers .01 1 .01 1.54
Therapy X Observers
X Dogmatism 0.00 1 0.00
Error .13 20 .0065


* p < .01





















Total

Proportion

Leading

Responses


Observer 2


\Observer 1


Leading


Following


Figure 1. Therapy X observer interaction
for therapist leading behaviors.










The second analysis performed in testing Hypothe-

sis I was on the proportion of observed solution offering

responses by the subjects. The format of this analysis was

identical to the preceding--only the content of the obser-

vations differed. Table 3 presents a summary of this anal-

ysis.


Table 3

Analysis of variance for client

Source Sum of Squares

Between 4.16
Therapy .50
Dogmatism .04
Therapy X Dogmatism .05
Error 3.57

Within 1.33
Observers .03
Therapy X Observers .11
Dogmatism X Observers .02
Therapy X Dogmatism X
Observers .14
Error 1.03


solution offering


Mean Square


.50
.04
.05
.18


.03
.11
.02

.14
.05


* p < .25

Here too, the predicted therapy X dogmatism inter-

action failed to appear. It must be noted also, that those

findings which appeared were not significant. Once again

there is a therapy effect with the leading therapy condition

associated with the lowest proportion of solution offering

on the part of the clients. (See Appendix F for complete

table of total proportions of solution offering by clients.)


2.78*





2.20*


2.80*










A therapy X observer interaction also appeared again, but

this time both the main effect and two-way interaction

were embodied in a complex three-factor interaction. This

is presented graphically in Figure 2. Once again this

graph is plotted in terms of the total proportions across

all subjects in each condition. It can be seen that in

the leading therapy, observers tend to agree more when

the relationship includes a high dogmatism client. Con-

versely, their observations diverge more with a low dog-

matism client. Further, it can be seen that in the fol-

lowing therapy, the observers tend not to show a discrep-

ancy dependent upon the level of dogmatism, and also that

there is some slight tendency for more solution offering

to be observed in this therapy condition across the other

factors, especially with low dogmatic subjects.

Hypothesis II was tested by means of the change in

scores obtained on the PPPS at one-half hour and one week

intervals. Analysis of these data was accomplished

through the application of a three-factor analysis of

variance (3 X 2 X 2) with treatment (leading, following

and control), dogmatism (high and low) and time of test

(immediate and one week follow-up) as factors. Table 4

provides a summary of this analysis.

















Total


Proportion

Solution


Offering


LEADING




Observer 1


FOLLOWING


Observer 2

Observer 1


Observer 2


Hi Dog


Lo Dog


Hi Dog


Lo Dog


Figure 2. Therapy X dogmatism X observer interaction for
client solution offering.










9T>4

,,naysis of a c r _:7: cliaxige scores--
immediate and delayed test

Source Sum of Souares df Mean Square F

Between 1657.40 29
Therapy 42.70 2 21.35 ---
Dogmatism 2.40 1 2.40 ---
Therapy X Dojmatism 181.30 2 90.65 1.52*
Error 1431.00 24 59.63

Within 493.00 30
Time of test 48.60 1 48.60 2.94**
Therapy X Time 7.30 2 3.65 ---
Dogmatism X Time .60 1 .60 ---
Therapy X Dogmatism X
Time 39.90 2 19.95 1.21
Error 396.60 24 16.53

* p < .25
** p < .10

As predicted, a therapy X dogmatism trend did appear,

but was not significant. Interestingly, the time of test

main effect came out at a higher level of probability with

a greater positive (diminution of problem seriousness)

change recorded one week after the treatment (see Appendix G

for complete table of change scores and means). Inspection

of the individual change scores revealedhowever, that while

the mean of the retest scores was higher, the variation was

considerably greater also. Since the therapy X dogmatism

interaction had been tested across both levels of the test

factor, it was concluded that the greater variation in the

retest scores had partially masked the effect predicted in

Hypothesis II. Consequently, a post hoc analysis was con-

ducted using only the change scores obtained from immediately









before to ,ust after the treatment session. Table 5 pre-

sents asu~n{Lry o." *ni pot hoc analysis.



Teble 5

Post hoc analysis of PPPS change scores

Source Sum of Souares df Mean Square F

Therapy 7.8 2 3.9 ---
Dogmatism 2.7 1 2.7 ---
Therapy X Dogmatism 177.8 2 88.9 3.57*
Error Within 598.00 24 24.9

* p < .05


As indicated, the therapy X dogmatism interaction

tested significant at the .05 level in this post hoc anal-

ysis. This interaction is presented in graphic form in

Figure 3, which clearly shows that the high dogmatic sub-

jects showed the greatest positive change with a leading

therapist, and showed a negative change with a following

therapist. Just the opposite occurs with the low dogmatic

subjects. Both high and low dogmatic subjects reported

negligible change in the control treatment, although the

high dogmatic people tended to report a very slight positive

change. An interesting finding was that the greatest posi-

tive change of all was reported in the low dogmatic group

receiving the following treatment. In addition, this was

the only group in which no one reported a negative change.












20


16


12

8


4

0


-4

-8


-12


-16


/

/

/


LEADING


FOLLOWING


CONTROL


Figure 3. Therapy X dogmatism interaction for
PPPS change scores.


Hi Dog











/
/
/
/

Lo Dog






44


Hypothesis III was tested by means of the change

scores over the one-half-hour treatment session on the

AACL. Analysis of these data was accomplished by means

of a two-factor analysis of variance with therapy (lead-

ing, following, and control) and client dogmatism (high

and low) as factors. Table 6 provides a summary of that

analysis.


Table 6

Analysis of variance for AACL change scores

Source Sum of Squares df Nean Souare F

Therapy 40.3 2 20.2 2.38*
Dogratism 0.0 1 0.0 ---
Therapy X Dogmatism 3.2 2 1.6 ---
Error Within 204.4 24 8.5 ---

* p < .25

Contrary to the prediction made, the therapy X dog-

matism interaction failed to reach a significant level in

this analysis. It will be noted that there is a non-signif-

icant main effect in the data, indicating that across both

high and low dogmatic groups there is a tendency for the

leading therapist to produce the greatest positive change

(reduction in anxiety) among the subjects. (See Figure 4

for graphic illustration, and Appendix H for complete table

of change scores and means.)

Examination of the subjective data collected from

both the therapists and the clients did not reveal any strong





























Hi Dog


- Lo Dog


FOLLOWING


CONTROL


Figure 4. Plot of AACL change scores.


3
2.5
2
1.5
1
.5
0
-,5
-1


LEADING









trends, although many of the individual corments made by

subjects were enilighLtcning (see discussion section). It

was interesting that some 87% of the high dogmatism sub-

jects seen by the Leading therapist liked him very much,

while 60% of the lo dogmatism people liked the Following

therapist, and only 50 of the other two groups liked the

therapist they saw. This is especially interesting in view

of the fact that the Following therapist liked 33% of the

high dogmatic people he saw, and only liked 17% of the low

dogmatic subjects. In the same vein, the Following thera-

pist saw the session as not at all valuable for 87% of his

low dogmatic clients, and only 33% of his high dogmatic

people. Just the reverse was true for the Leading thera-

pist, who felt that the experience was not at all valuable

for 67% of his high dogmatic subjects, and for only 17% of

his low dogmatic interviewees.













DISCUSSION


This research explored, in several different ways,

what 7oos and Clemes (1967) have called the "patient-

therapist system." Hypotheses concerning both process and

outcome measures were generated from a point of view about

psychotherapy and counseling which might well be labeled

interactionary. This view, which is more fully developed

in the introduction to this paper, has as its major assump-

tions the following: Both the process and ultimate outcome

of therapy are dependent upon the therapist, the client and

the emergent behaviors induced by the interaction between

these two; Client and therapist behaviors, in the process

of therapy, and their attitudes toward the outcome of ther-

apy, will vary as a function of particular therapist-client

combinations; Therapist leadership, and its analogue, the

client's typical ways of relating to authority, are crucial

components of the therapeutic relationship because of the

conditions under which clients typically seek such an

encounter, i.e., when they are in distress and need "expert"

advice and help.
The results of this study confirm certain of the

hypotheses derived from these assumptions and fail to con-

firm others. The non-confirmingdata tend, at this point,
47









not to weaken the assumptions made, but rather to point

out additional complexities to be considered in subsequent

research. An example of this is the finding that fairly

sophisticated observers differ among themselves as to what

constitutes leadership, and, to an even greater degree,

differ as to what are solution-offering and direction-seek-

ing responses on the part of clients. This latter finding,

for instance, raises the interesting speculation that ther-

apy-wise observers may tend to be overly influenced by the

behavior of the therapist, and thereby overlook the impor-

tant contributions of the client in determining the inter-

action. Further, the subjective data collected indicate

that attitudes toward the encounter tended to be more proc-

ess and outcome oriented for the therapists, and more liking-

disliking oriented for the clients. In a sense this only

demonstrates the well-known principle that what we are

trained or interested in looking for affects what we see.

However, it also adds relevant dimensions to the future

study of therapy relationships. In this way the present

research has broadened the perspective of the concepts

originally proposed, and demonstrated some of the difficul-

ties involved in approaching them empirically.

The presence of a significant interaction between

the type of therapy and the level of client dogmatism, in

terms of change scores on the PPPS, lends considerable sup-

port to the rationale of this study. Iuch of the








multivariate work done which has indicated an interaction

between client and therapist has demonstrated this in terms

of process data, with little mention of how either the

client or the therapist saw the ultimate purpose, or out-

come, of the therapeutic encounter. Such work has been

reported in the past by Moos and Clemes, 1967, Truax, 1966,

Van Der Veen, 1965, and others. The present finding dem-

onstrates that the effects of the interaction extend beyond

the actual process measures, and can and do influence the

client's perception of the seriousness of his problem.

Further, the lack of change in the PPPS scores for the

control group solidifies the finding and attributes it

directly to the counse lor's attempts at therapeutic inter-

vention, eliminating the possibility that this change is

a function of social contact alone.

Several comments must be made regarding this find-

ing. First, there are differences between what these sub-

jects, knowingly participating in an experiment, must have

experienced, and what actual clients seeking help must

experience. This is the toll of authenticity paid by any

analogue study, or, for that matter, any laboratory study

as compared to actual field work. The entire question of

the subject's real involvement is paramount here. While

the instructions asked each subject to bring in a problem

with which he was really concerned, there was no further

control exercised over this variable. Certainly further
research is called for where the degree of involvement can










be ascertained. However, there were certain post hoc checks

which could offer suggestions as to how involved the subject

was with the problem he brought in. These included the

nature of the problem itself, the initial score on the PPPS,

which provided a very subjective estimate of problem serious-

ness, and, in some cases, the comments made by the subjects

at the conclusion of the experiment.

The range of problems dealt with in this study went

from the very frequent vocational or academic concerns, to

marital discord and the threat of alcoholism. In one case

the problem caused enough concern that the subject asked if

he might pursue it further at the counseling center, beyond

the extent of this study. One week later however, this

same subject felt that he had been able to look more care-

fully at his difficulty during that week, and now felt that

he would be able to handle it on his own. Even with such

exceptions, the author often felt that the subjects were

considerably less concerned about their problem than actual

clients would be. This probably contributed to the variance

seen in the outcome measures to a great extent. A future

study might be enlarged to the point where uninvolved sub-

jects, as judged by -a panel of experienced clinicians,

could be eliminated.

As mentioned above, the initial scores on the out-
come measures did not differ significantly for the high or

low dojiatic subjects. In a sense, this insures some









measure of subjective equivalence between problems. The

very subjectivity of the measure builds in the possibility

of tremendous variance however, for what to one person may

seem reasonably problematic, may to another seem a trifle,

or a disaster! Further study, with objective ratings of

problem seriousness, would tighten control of this variable.

In addition, the post-interview comments of the sub-

jects themselves sometimes tell rather convincingly their

levels of involvement. Compare the following two comments,

both made by low dogmatic scorers in the leading therapy

group: "I probably need to take more of a serious interest

in this problem in order to bring about any great change.

I am not ready to do so at this time." The other boy seems

to be writing of a different kind of experience altogether:

"I see my problem from a different standpoint, i.e., it is

not unique. I feel some confidence in tackling the problem

now, knowing that with effort and bravado, I can overcome

my intense self-awareness." It can probably be assumed

that the former boy would not have presented himself in a

real counseling setting--this type of client seems to be a

function of the analogue design employed in the present

study.

Some discussion seems necessary concerning the find-

ing that the change in scores on the PPPS becomes much more

variable after one week, while at the same time the mean

change tends to increase across all subjects. It seems









likely that this finding is best explained in terms of the

discussion above concerning the level of involvement. Then

the subject first learned that he would have to bring in a

problem, it is likely that he gave considerable thought to

such a problem. Such atypical focusing may well have

increased his awareness and concern. At the conclusion of

the treatment session, with its feeling of closure, the

problem was probably restored to its former level of aware-

ness. In the ensuing week, many events, both positive and

negative, may be assumed to have beset the subject. Then

he was again asked to rate this problem, one week later,

it is not surprising that he tended, with considerable

variation across subjects (possibly due to differing degrees

of involvement), to see his problem as less serious.

Such considerations aside, it is interesting to

consider the import of the finding as it stands. As already

mentioned, it supports rather well the model proposed for

the therapeutic relationship. In addition, it extends the

data on the client-therapist system from process measures

to outcome measures in a consistent way. Thirdly, it spells

out the nature of this relationship in two fairly broad

dimensions, and indicates what combination of dimensions

will probably lead to the most favorable results, in terms

of client perceptions or purely subjective ratings. This

would seem to be an important finding vis vis the train-

ing of therapists and, also, the selection of therapists









where individual clients are concerned, i.e., who should

see 1 or 2 C I z s-- .tudy, analysis of

the empirical data and examination of the subjective data

obtained combine to indicate that a favorable outcome to

therapy depends upon the client, the therapist and the com-

bination of the two in a particular unit.

r.ost interesting in this regard were some of the

reactions and comments made by high dogmatic clients to the

three treatment conditions. One is tempted to generalize

from a few cases, and say that the high dogmatic people

were much more demanding and rigid in reacting to the exper-

iment. For instance, one boy who saw a leading therapist

complained: "Upon leaving, I had the feeling that he should

have helped more by giving some suggestions toward solving

my problem. As it turned out, the help came by simple [.:ij]

his listening: a person, outside my family, interested."

Another boy, subjected to the experience of seeing a follow-

ing therapist, was even more expressive. Because he so

adequately gives the high dogmatic reaction, he will be

quoted at length: "I had just related my problem and did

not have adequate time to discuss it. I opened up to the

councelor [sic] and there was not time to get much reaction.

I was thoroughly frustrated, and my problem seemed worse.

Discussion time or counciling [sic] time should not be

strictly regulated. If the discussion is getting repetitious,

no progress is being made and the councilor has other people









to see, he should tactfully make another appointment. The

councilor's time should be flexible." It is rather obvious

that this subject was not happy, and,further, that he was

trying to structure the situation to meet his own needs and

preconceptions.

High dogmatic subjects also reacted strongly to the

no-therapy control group. In one case, a subject interrupted

the control group interviewer and said, "I don't know who

chose this topic (highway safety), but I find it very boring,

and I'd much rather talk about my problem." Another boy

saved his discontentment until after the session, and then

quite angrily told the author that he was very frustrated

at not being asked to discuss this problem he had been think-
ing about for several days. He seemed somewhat upset, and

the author promised to see him individually at the conclu-

sion of the experiment, to discuss his problem and see what

might be done toward getting help for him. An appointment

was arranged at that time. After breaking that appointment

three times, the subject showed up with a rather innocuous

problem in the academic-vocational area. After an hour and

a half of pleasant conversation, he left, concluding that

everything would work out.

In general it can be said that the low dogmatic sub-

jects were able to accept much more readily and agreeably

the conditions imposed by the experimental design. All of

this has convinced the author still more strongly that the









client's level of o(u>ism c general authoritarianism is

a most rce_:vrt v r T!<'e putic relationship,

and that it interacts most directly with what may be con-

sidered its analogue, that is, the degree of leadership

demonstrated by the therapist.

The analysis of the AACL data, while non-significant,

reveals a certain trend in terms of the effects of the var-

ious treatments on subject anxiety levels. Examination of

the treatment means across all subjects (see Appendix H)

shows that there is a tendency for the greatest reduction

in anxiety to occur in the leading treatment group; the

next highest occurs in the control, and the lowest of all

(actually a negative change--that is, an increase in

anxiety) occurs in the following treatment. The fact that

the control group does register a greater positive change

than one of the treatment groups suggests that this measure

(AACL) is responsive in this study to some other variable

than the effects of therapeutic intervention, at which it

was originally aimed. Indeed, this might also explain the

failure of the predicted interaction to appear.

A plausible explanation is that the check list is

responsive in this study not only to the particular problem

presented by the client, but also to the more immediate

stress of having to participate in a rather ambiguous exper-

imental situation. The above comments concerning the level

of the subjects' involvement with their problems make this










assumption doubly tenable. To the extent that it was the

ambicaity of the setting .,f-ch gave rise to the anxiety

tapped by the AACL, then it might be expected that the more

structured and unambiguous treatments, e.g., the leading

and control conditions, would lead to the greatest diminu-

tion in anxiety. Along these lines, the non-significant

results obtained are consistent with the review of analogue

studies by Zytowski (1966). He found that the studies using

already existing anxiety less often showed significant

results than did those which experimentally induced anxiety.

Apparently, all people have problems which cause some anxi-

ety, but this anxiety may not be great enough to show sig-

nificant changes with treatment, or it may be overshadowed

by the situational stresses involved in the treatment proc-

ess itself.

A further note, directed to the large variation in

the data, and the consequent failure of any of the anxiety

findings to reach significance, is the greater generality

of the concept of anxiety. It was for this reason that the

author developed and used the highly focused and specific

PPPS for the assessment of particular problems.

The process data collected have yielded a number of

unexpected and interesting findings. In the main, it was

the results concerning the observer factor that proved most

perplexing, especially in view of the fact that this was

originally conceived of as a control factor.










C;:ccrr~ni .r. r~ic' I: dinn resonses by

the Lu:r a tfft there was a

very strong therapy effect, indicating rather clearly that

the two therapists were, on the whole, acting quite differ-

ently in the experiaental situation. In addition, however,

there was a significant observer effect which combined with

the therapy variable for a rather strong therapy X observer

interaction. It is this interaction which is perplexing,

for either of the two main effects is understandable, and,

in the case of the therapy effect, quite desirable. Since

the nature of the interaction is such that the observers

agreed much more closely when leading therapy was concerned

(see Figure 1), it would seem either that the definition of

terms was faulty in this experiment, or that there is some-

thing intrinsically vague about following behaviors on the

part of psychotherapists. Since both observers received

the same amount of training with both types of therapy, it

does not seem plausible that training differences could

account for the different levels of agreement across therapy.

As stated above, the operationalization of the con-

cepts of leading and following therapy used in this study

were taken directly from Ashby et al. (1957). These authors

have used this system rather succesfully, and have reported

their findings in a monograph cited just above. Further,

it is apparent that the concepts of leading and following

are analogous to the older and widely known dichotomy between









directive and non-directive counseling techniques. In view

of the fact that both observers were graduate students in

clinical psychology, and had both had courses in counseling

techniques, it seems unlikely that faulty specification of

terms can explain the findings. The possibility of an

observer bias exists, but cannot by itself explain the dif-

ferent levels of observer agreement across therapy types.

The most parsimonious explanation seems to be that

in this study, there was something intrinsic to following

behaviors which made them less identifiable to the observers.

This suggests that there may be a general vagueness and

ambiguity about following or non-directive behaviors,

although the small number of observers used here cannot

support such a general statement except as an hypothesis.

Further research might explore this serendipitous finding

and determine, using many more observers, if there is a

general and consistent difference between rater reliabilities

for leading and following behaviors.

In one rather obvious way, following therapy might

well be expected to be more difficult to specify. It is a

less "active" stance, and in some ways its operations approach

non-behaviors, or at least, from the point of view of this

study, non-verbal, and therefore non-scorable, behaviors.

In a leading orientation, a verbal statement is almost a

requirement whereas, in the following mode, a wink, a nod,

an "Mm-hm" or a subtle facial expression will often suffice.









The presence of these additional minimal cues may add appre-

ciably to the variance found in following behaviors.

An interesting study by Truax (1966) seems to

strengthen, by analogy, the assumption that following or

non-directive behaviors are elusive traits. He took excerpts

from a single, successful therapy case, conducted by Rogers,

and analyzed the recordings, testing to see if empathy,

warmth and directiveness were consistently manifested, inde-

pendent of patient behaviors. Rogers (1957, 1965) has, of

course, maintained that such consistency prevails in good

non-directive therapy. Truax found that Rogers responded

differently to five of the nine patient behaviors studied.

Moos and Clemes (1967), noting Truax' work, comment: "If

there is differential responding in empathy and warmth to

different content with one patient, it is but a small step

to suggest that there is also differential responding in

empathy and warmth to different patients." In essence,

these authors are suggesting that Rogers and other leaders

in non-directive counseling may actually be less consistent

than they think they are. Part of their lack of awareness,

and indeed, their lack of emphasis on technique, may be due

to the elusive nature of the operations they employ. This

possibility is consistent with the findings of the present

study.

Unfortunately, the findings concerning the propor-

tion of solution offering by clients are non-significant.









Further, all three factors studied gave rise to an inter-

action--a situation a] ;ays difficult to understand, and

made doubly uncertain by the high chance of a random occur-

rence in this case.

Nevertheless, it is interesting to note that the

leading therapy tended to yield (at the .25 level) less

solution offering than did the following therapy. This

seems to be evolving as a fairly consistent finding. For

instance, Frank and Sweetland (1962) found that directive

therapists tend to elicit fewer statements from their clients

which reflect understanding and insight into their problems.

If this is a general finding, and given that spontaneous

verbalization of insight is valued as a therapeutic process,

then the findings tend to favor a following type of therapy,

especially with low dogmatic clients.

A word must be said regarding the failure of the

predicted interactions to appear, in both the therapist

leadership and client solution-offering data. In addition

to the above-mentioned difficulties in dealing with the

elusive nature of following behaviors, which gave rise to

observer differences, it is very probable that the instruc-

tions and training given to the therapists interfered with

the normal process of therapy for them. For instance,

Rottschafer and Renzaglia (1962), who tried to select
"reflective" and "leading" therapists by direct observation,










- timately found that their therapists were using a com-

bination of the two styles, apparently according to the

particular client they were seeing. It is noteworthy how-

ever, that their therapists were not aware that they were

being chosen as one or the other. In the present study,

the therapists were preselected for leading or following

orientations on the basis of supervisor's or professor's

ratings, but were then further instructed and trained in

their orientations, and asked to be consistent in them.

While this was originally planned to heighten control of

the therapy variable, it apparently "controlled out" the

very effect that was anticipated. The therapists did not

vary as a function of clients seen, because the therapists

tried hard to be as unvariable as possible-,

An incidental observation made by the author during

the course of the experiment supports the notion that the

instructions and training given had unduly constrained the

therapists in their functioning. Immediately after the

first training session with the following therapist, who had

just seen a low dogmatic subject, the therapist complained

at his discomfort during the session, saying that the long

silences and rather redundant conversation had made him feel

very ill-at-ease. He continued, saying that with such a

reticent subject, staying within the confines of his orienta-

tion was difficult, and made him feel quite frustrated. It

was at this point that he said, with telling irony, "Whether









or not I can be following in my therapy depends a lot upon

the client." lamentably, experimental rigor could not be

sacrificed at this point, for the therapists knew nothing

of the aims of the research. The author simply acknowledged

that this might be the case, and supported his efforts at

staying within the paradigm as much as possible.

It seems apparent that if so much emphasis on how

the therapists ought to act had not been built into the

design, at least the following therapist would have acted

in a more flexible manner. The emphasis and training that

was given seems to have restricted the movement of the

therapists, and overpowered an effect that might well have

materialized. Further research should allow more natural

variation to occur, without the constraints of instructions

and training, and observe and report whatever findings

evolve. The interesting comments made in this study by the

following therapist highlight the importance of allowing the

therapist freedom of movement in therapy, so that he does

not feel constrained by any particular orientation.

Another possible, though more speculative explana-

tion for the failure of expected interactions to appear in

these data may be that there was not very much difference

between therapists in terms of the pervasive personality

characteristics which find expression in so many subtle and

often uncontrollable ways. Certainly the numerical differ-

ences obtained on the Berger scale were not extreme, although









they did reflect a predictable variation. On the other

hand, the interest form dCata did present quite a different

picture of the two therapists, again in a way that is theo-

retically meaningful. Once again, additional research is

needed to identify the relevant therapist traits which

covary with leading and following orientations. Parker

(1967), for instance, has recently used a measure of thera-

pist dominance, and found that dominance is positively

related to directive therapist verbalizations, and negatively

related to non-directive statements.

Another possibility is that of an observer set or

bias to see the therapist as the crucial determinant in the

therapeutic relationship, as suggested earlier in the open-

ing paragraphs of this discussion. If one looks only at the

levels of probability of the findings summarized in Tables 2

and 3, regardless of the particular findings themselves, it

is clear that the internal variance, and consequently, the

error terms in the therapist measure (Table 2) are smaller.

This gives rise, in part, to higher probability levels (.01

versus .25) for the findings reported. This smaller varia-

tion in the therapist data may reflect a tendency on the

part of the observers to attend primarily to the therapist,

and neglect the client and his role in determining the

course of the relationship. In this regard, the reader will

recall that the same observers were observing both therapist

and client behaviors simultaneously. The tendency to see









tLe therapist as more "pote y" is probably fostered by

training programs in clinical psychology, in which both

these observers were enrolled. Future research might use

much more experienced observers, or totally naive ones,

in order to achieve enough distance from the observed ther-

apists, and ensure greater objectivity in the observations.

A number of interesting, albeit very tentative

trends emerged from an examination of the subjective data

collected from the subjects and therapists. The reader

will recall that there was some tendency for high dogmatic

subjects to like the leading therapist more than other

groups liked their respective therapist. This was also true

of the following therapist and the low dogmatic group. It

would seem that the personality characteristics associated

with either high or low dogmatism scores in part determined

the subject's reaction to his counselor. Ironically, the

following therapist showed a slight preference for the high

dogmatic group. However, this may well be a function of the

experimental restrictions placed upon him, for it will be

recalled that this therapist was most stressed by the exper-

imental situation vhen he was called upon to be a follower

with a reticent, low dogmatic client. Not so easily explain-

able is the tendency for both leading and following thera-
pists to see as not at all valuable sessions with high and

low dogmatic clients, respectively--the very groups that

reported in higher percentages a liking for their therapists.









It may well be that the same sense of frustration experienced

by the follo'ier ith suach clients caused him to feel that Uie

session had been less valuable. On the other hand, the lead-

ing therapist may have found the high dogmatic subjects less

malleable and more resistant to his leads. In any case, the

discrepancies between the clients' and the therapists' sub-

jective reports su-ggest an interesting possibility. It

seems that to a significant degree, the therapists were "eval-

uating" the sessions, and reacting to them, in terms of proc-

ess and predicted outcome, while the clients evaluated in

terms of their degree of liking and comfort for their thera-

pist and for the total situation. Clearly, additional

research will be required to assess more fully the subjective

reactions of both clients and therapists to various combina-

tions of leadership and dogmatism levels, as well as the sets

and values that are applied to quasi-therapeutic encounters

by each. In its initial stages, such research might prove

most fruitful by gathering anecdotal comments concerning

individual reactions, such as discussed briefly above.

Throughout the course of this discussion, references

have been made to the need for further research, along with

suggestions as to how this future study might be revised and

thereby improved. It was felt that mentioning these sugges-

tions during the course of the discussion, as the points

arose, would make for better reading and continuity of thought.
In closing, however, these suggestions should not obscure the






66


need for cross-validation of the positive findings as they

now stand. Optimally, this should be accomplished by another,

unbiased, and disinterested experimenter.












SUTAARY


The present study attempted to test the primacy of

the therapist-client relationship in determining both the

process and outcome of therapy. A factorial psychotherapy

analogue design was employed. Thirty normal college males

were selected on the basis of either very high or very low

scores on the Rokeach Dogmatism Scale. These subjects were

randomly assigned, within a fully balanced design, to three

treatment conditions: a Leading Therapy, a Following Ther-

apy, or a No-Therapy control group. In each treatment con-

dition, the subjects were interviewed individually for one-

half hour by a different "therapist" (a graduate student in

clinical psychology selected either for his tendency to pur-

sue a leading or a following orientation in therapy). Sub-

jects in the two treatment groups discussed a self-selected

personal problem that the subject was asked to bring in

with him to the session; those in the control group dis-

cussed highway safety.

Outcome data collected consisted of changes in per-

ception of problem seriousness as measured by the Problem

Pathological Potential Scale and change in anxiety as meas-

ured by the Affect adjective Check List. Process data con-

sisted of frequency counts of leading and following behaviors










by therapistE',, -iolution-offering and direction-seeking
behaviors by clients, recorde& ny the sane two observers.


It was hypothesized that all measures would show a sig-

nificant therapy X dognatism interaction. This was sup-

ported by the problem scale data, but not for the others.

Failure of the predicted interaction to occur with the

anxiety check list data was discussed in terms of the

unfocused nature of the feeling assessed, and its higher

dependency upon the whole experimental situation rather

than the specific problem presented. Failure with the

process data was discussed as most probably due to the

required adherence of the therapist to a particular type

of therapy, w-,hich overcontrolled and prevented the inter-

action of therapy and dojmatism from emerging.

A most interesting serendipitous finding was a

strong observer effect, showing that rater agreement was

higher with the Leading Therapy observations than with

the Folaowing. This was discussed in terms of its implica-

tions for traditional conceptions of following or non-

directive counseling.

































APPENDICES










APPENDIX A

Telephoned instructions to subjects


Introduction of author.

"On the basis of the form you filled out for me in class

about a week ago, you have been selected to take part in

the rest of the experiment if you would like to. I thought

- might explain it to you briefly, then have you decide if

you would like to continue."

Response from subject.
"The remainder of the experiment will call for you to come

in to the counseling center with a personal or interpersonal

problem that you are presently experiencing. This problem

can be at any level of seriousness, from roommate conflicts

or vocational dilemmas, on through to very serious problems.

The only thing we ask is that it be a real problem, that is,

that it cause you some concern, and that it be present--

going on at the present time. You will be asked to evaluate

this problem on some questionnaires, and you may be asked

to discuss this problem with a professional person, whom you

will see for one-half hour. One week following this half-

hour session you will be asked to come in again for a few

minutes and fill out the questionnaires once more. You will

receive two hours credit for participating, but you must

agree to come in for both sessions. All that you do or say

in the counseling center will of course be treated with






71



uomost con FiCentii.t-". T ar r 7-eeable, I will set

up an appointment schedule with you now."

Response from subject.

Arrangement of dates and times.

Reminder of dates, times and locations, and farewell.










APPENDIX B

Problem Pathological Potential Scale

Name

You have been asked to bring in a personal problem

that you would be willing to discuss with a professional

person. I would like you to think of that problem now.

Imagine that you planned to seek help in a counseling center,

and that you needed to really assess your problem before you

could start solving it. Give me that assessment by placing

a check somewhere on the lines below.

1. How serious do you feel this problem is?

very not at all

2. Will this problem be good for you in the long run, e.g.,
will it educate you, or make you stronger through
experience, toughen you, etc.?

very much so not at all

3. Do you spend much time thinking about this problem?

a great deal none

4. Do you think many others share this problem?

many others no others

5. To what extent do you feel this problem interferes with
your daily routine?
greatly not at all

6. Would you feel comfortable discussing this problem with
a friend?
very comfortable very uncomfortable

7. Could this problem ever have disasterous consequences?
very probably no





73



8. How readily do you feel you will be able to overcome
this problem?

very readily never









APr2IDIX C

Affect Adjective Check List for the measurement
of anxiety

Name

The following adjectives describe ways in which people

can feel--they describe various emotional states. Think

about the way you feel right now. Circle those adjectives

that apply to you (describe the way you feel) at this moment.


afraid

calm

desperate

cheerful

fearful

contented

frightened

happy

nervous

joyful

panicky


loving

shaky

pleasant

tense

secure

terrified

steady

upset

thoughtful

worrying










APPENDIX D

Subjective evaluations by subjects

Name


Your participation in this experiment is now concluded.

Please answer the remaining few questions as candidly as you

can. Feel free to make additional comments where you wish

to. Circle one of the alternatives.


1. Did you like the person who interviewed you?

very much slightly not at all

2. Did you enjoy the experience of being interviewed?

very much slightly not at all

3. Do you think the experience was valuable?

very much slightly not at all

4. Did it help you to solve, or live better with, your
problem?

yes unsure no

5. Do you think participating in this experiment has made
you more likely to seek professional help should the
occasion ever arise?

yes unsure no


Additional comments:










APPMnDIX E

Table of total proportions of leading
responses by therapists


Observer 1


.88
1.00
.92
1.00
.93
1.00

5.73


.95
.91
.94
.88
1.00
.95

5.63


.08
.25
.31
.35
.25
.28


1.52


.19
.32
.47
0.00
.14
.32

1.44


Observer 2


.98
1.00
.96
1.00
.67
.78

5.39


.95
.97
.95
.90
.83
.84


5.44


.38
.25
.45
.47
.47
.50

2.52


.42
.39
.67
.30
.47
.60

2.85


14.32 16.20


Subject


Total


1.86
2.00
1.88
2.00
1.60
1.78

11.12


L 7
8
9
D 10
11
12


1.90
1.88
1.89
1.78
1.83
1.79

11.07


L D
0
L G


0
0
W L

1 0

N D
-1 0


.46
.50
.76
.82
.72
.78

4.04


.61
.71
1.14
.30
.61
.92

4.29










APPENDIX F

Table of total proportions of solution offering by subjects


Subject


Observer 1


.50
.67
.88
.00
.71
.00

2.76


- D
E 0

A G


* L
0

N

G 0
G


.92
1.00
.23
1.00
.00
.40

3.55


H 13
F 14
I 15
0 16
D 17
L 0 18

L G


0
L
W 0

I D

N 0
G


.67
.50
.83
.50
.33
.71


3.54


.82
.11
.67
.75
1.00
.67

4.02


Observer 2


.85
.73
.86
.00
.33
.00


2.77


.63
.90
.24
.00
.00
.00

1.77


.69
.70
.67
1.00
.00
.50

3.56


.8o
.64
1.00
.50
.67
1.00

4.61


13.87 12.71


Total


1.35
1.40
1.74
0.00
1.04
0.00

5.53


1.55
1.90
.47
1.00
0.00
.40

5.32


1.36
1.20
1.50
1.50
.33
1.21

7.10


1.62
.7 5
1.67
1.25
1.67
1.67

8.63









APPENDIX G

Table of change scores and means on the PPPS


Subject


Test


3
0
4
14
-2
= 3.8


-4
T = -1


-3
-ii

0
-2
M = -3


2
15
1
0
2
=4


-1
7
-4
-5
5
= .4


-4
M = 0


Retest


14
-6
-2
25
-3
M= 5.6


-4
-3
M = 2.4


-3
1
-2
2
9
M = 1.4


8
5
1
1
2


-2
9
-4
-8
6
M= .2


M 2










APPENDIX H

Table of change scores and means on the AACL


Subject


1
L 2
E 3
A 4
D 5
I -
N
G


HI DOG


4
2
6
-1
2

M = 2.6


1
1
1
-7
1

M = -.6


5
-3
3
0
1

M = 1.2


LO DOG


4
1
2
4
2

M = 2.6


0
5
-7
2
1

M = .2


1
1
0
-1
1


M= .4













REFERENCES


Adorno, T. W., Frenkel-Brunswik, E., Levinson, D. J. and
Sandord, R. N. The authoritarian personality.
New York: Harper and Row, 1950.

-Ashby, J. F., Ford, D. H., Guerney, B. G., Guerney, L. F.
and Snyder, W. U. Effects on clients of reflec-
tive and a leading type of psychotherapy. Psychol.
Monogr. 1957, No. 24, 71 (whole no. 453).

Berger, E. The relation between expressed acceptance of
self and expressed acceptance of others. J. abnorm.
soc. Psychol., 1952, 47, 778-782.

Blumberg, R. W. A scale for "problems in living" research.
Psychol. Reports, 1968, 22, 161-162.

Cowen, E. L. The experimental analogue: an approach to
research in psychotherapy. Psychol. Reports, 1961,
8, 9-10.

Currier, C. G. Patient-therapist relationships and the
process of psychotherapy. Dissert. Abst., 1964,
24 (12), 5539-5540.

Fiedler, F. E. A comparison of therapeutic relationships
in psychoanalytic, non-directive and Adlerian
therapy. J. consult. Psychol., 1950, 14, 436-
445 (a).

The concept of an ideal therapeutic relation-
ship. J. consult. Psychol., 1950, 14, 239-245 (b).

Factor analyses of psychoanalytic, non-
directive and Adlerian therapeutic relationships.
J. consult. Psychol., 1951, 15, 32-38 (a).

Quantitative studies on the role of thera-
pists' feelings toward their patients. In 0. H.
Mower (ed.) Psychotherapy: theory and research.
New York: Ronald Press, 1953, 2)96-3J15.

Ford, D. H. An experimental comparison of the relation-
ship between client and therapist in a reflective
and a leading type of psychotherapy. Unpublished
doctoral dissertation, Penn. State Univergity,
1956. Dissert. Abst. 1956, 16, 1490-1491.








Frank, G. H. and Sweetland, A. A study of the process of
psychotherapy: the verbal interaction. J. consult.
Psychol., 1962, 26, 135-138.

Glad, D. D. Operational values in psychotherapy. New York:
Oxford University Press, 1959.

Gordon, J. E. Leading and following psychotherapeutic tech-
niques with hypnotically induced repression and hos-
tility. J. abnorm. soc. Psychol., 1957, 54, 405-410.

Guerney, J. E. and Stollack, G. E. Problems in living,
psychotherapy process research, and an autoanalytic
method. J. consult. Ps chol., 1965, 29, 581-585.

Jones, W. S. Some correlates of the authoritarian personal-
ity in a quasi-therapeutic situation. Dissert.
Abst., 1962, 23 (2), 691-692.
Kanfer, F. H. and Mrarston, A. R. Characteristics of inter-
actional behavior in a psychotherapy analogue. J.
consult. Psychol., 1964, 28, 456-476.

Levison, P. K., Zox, M. and Cowen, E. L. An experimental
analogue of psychotherapy for anxiety reduction.
Psychol. Reports, 1961, 8, 171-178.
Lorr, M. Client perceptions of therapists: a study of the
therapeutic relation. J. consult. Psychol., 1965,
29, 146-149.
Moos, R. H. and Clemes, S. R. Multivariate study of the
patient-therapist system. J. consult. Psychol.,
1967, 31, 119-130.
Parker, G. V. C. Some concomitants of therapist dominance
in the psychotherapy interview. J. consult. Psychol.,
1967, 31, 313-318.
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therapy relationships. J. abnorm. soc. Psychol.,
1961, 25, 29-38.
Plant, W. T., Telford C. W. and Thomas, J. A. Some person-
ality differences between dogmatic and non-dogmatic
groups. J. soc. Psychol., 1965, 67, 67-75.
Powell, F. Open and closed mindedness and the ability to
differentiate source and message. J. abnorm. soc.
Psychol., 1962, 65, 61-64.
Rogers, C. R. The necessary and sufficient conditions of
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1957, 21, 95-103.








Rogers, C. R. The therapeutic relationships: recent theory
and research. Australian J. Psychol., 1965, 17, 95-
108.

Rokeach, M. The open and closed mind. New York: Basic
Books, 1960.
Rottschafer, R. H. and Renzaglia, G. A. The relationship of
dependent-like verbal behaviors to counselor style and
induced set. J. consult. Psychol., 1962, 26, 172-177.
Seeman, J. A study of the process of nondirective therapy.
J. consult. Psychol., 1949, 13, 157-168.
Shaw, IT/. E. and Wright, J. M. Scales for the measurement
of attitudes. New York: McGraw-Hill, 1967.
Snyder, W. U. The psychotherapy research program at the
Penn. State University. J. couns. Psychol., 1957,
4, 9-14.
Strong, E. J., Jr. Strong vocational interest blank for
men. Leland Stanford Junior University, 1938.
Vocational interests of men and women. Stan-
ford: Stanford University Press, 1943.
Szasz, T. S. The myth of mental illness. Am. Psychol., 1960,
15, 113-118.
The uses of naming and the origin of the myth
of mental illness. Am. Psychol., 1961, 16, 59-65.
Truax, C. B. Reinforcement and non-reinforcement in Rogerian
psychotherapy. J. abnorm. Psychol., 1966, 71, 1-9.

Van Der Veen, F. Effects of the therapist and the patient
on each other's therapeutic behavior. J. consult.
Psychol., 1965, 29, 19-26.
Vogel, J. L. Authoritarianism in the therapeutic relation-
ship. J. consult. Psychol., 1961, 25, 102-108.
Wallach, M. S. Authoritarianism and therapist preference.
J. clin. Psychol., 1962, 18, 325-327.
Winer, B. J. Statistical principles in experimental design.
New York: icGraw-Hill, 1962.

Zuckerman, M. The development of an affect adjective check
list for the measurement of anxiety. J. consult.
Psychol., 1960, 24, 457-462.
Zytowski, D. G. The study of therapy outcomes via experi-
mental analogues: a review. J. couns. Psychol.,
1966, 13, 235-240.













BIOGRAPHICAL SKETCH


Richard W. Blumberg was born June 23, 1942, at

Flushing, New York. He was graduated from Brooklyn Tech-

nical High School in June, 1960, and received his bache-

lor's degree from the City College of New York in June,

1964. In September of that year, he enrolled in the

Psychology Department at the University of Florida, where

he received a master's degree in December, 1965. During

that time he held fellowships from The United States

Public Health Service and the Graduate School as well as

an assistantship from the Veterans' Administration. In

addition to his employment at the Coral Gables Veterans'

Administration Hospital, he has worked at The Sunland

Training Center in Gainesville, Florida. He is currently

a Captain in the Medical Service Corps of The United States

Army, and is interning in Clinical Psychology at Letterman

General Hospital in San Francisco, California.

Richard W. Blumberg is single, and presently

resides in Ross Valley, California. He is a member of

Psi Chi National Honorary Society in Psychology, and The

Florida Psychological Association.











This dissertation was prepared under the direction

of the chairman of the candidate's supervisory committee

and has been approved by all members of that committee.

It was submitted to the Dean of the College of Arts and

Sciences and to the Graduate Council, and was approved

as partial fulfillment of the requirements for the degree

of Doctor of Philosophy.

June, 1969




Dean, 9leo.Io --"tand- Sciences






Dean, Graduate School



Supervisory committee:


airman




I 4 C















I











*
* ~ .~
4




Full Text
i
I


5
largely by the therapist, but elicited
partly by certain characteristics in the
patient, 'ihus therapy is an interactional
event. (p. 104)
As advanced experimental designs become more wide
spread, research in the area of therapy relationships has
become more sophisticated. Recently, for instance, Lorr
(1965) has used factor analysis on a collection of client
perceptions of therapy and arrived at five therapist-behav
ior dimensions: accepting, understanding, authoritarian,
independence-encouraging and critical-hostile. These find
ings provide clues as to the major ways in which therapists
enter into the relationship, and how they are seen by the
client. It is noteworthy for the point of view expressed
above that one of the five basic perceptions that Lorrs
clients reported having about the therapists behavior was
the authoritarian dimension. It lends empirical support
to the universality and importance of this aspect of the
relationship.
Recently Moos and Ciernes (1967) have simultaneously
studied several therapist and client behaviors in a multi
variate design. They found, in support of the theoretical
import of the present research, that both therapist and
client behaviors are determined by the therapist, the client,
and the particular therapist by client interaction. In their
study they used five objectively defined behaviors: total
word count, percentage of feeling words emitted, percentage


82
Rogers, C. R. The therapeutic relationships: recent theory
and research. Australian J. Psychol., 1965. 17. 95-
108.
Rokeach, M. The open and closed mind. New York: Basic
Books, I960.
Rottschafer, R. H. and Renzaglia, G. A. The relationship of
dependent-like verbal behaviors to counselor style and
induced set. J. consult. Psychol., 1962, 26, 172-177.
Seeman, J. A study of the process of nondirective therapy.
J. consult. Psychol., 1949, 13, 157-168.
Shaw, M. E. and Wright, J. M. Scales for the measurement
of attitudes. New York: McGraw-Hill, 1967.
Snyder, W. U. The psychotherapy research program at the
Penn. State University. J. couns. Psychol., 1957.
4, 9-14.
Strong, E. J., Jr. Strong vocational interest blank for
men. Leland Stanford Junior University, 1938.
. Vocational interests of men and women. Stan
ford: Stanford University Press, 1943^
Szasz, T. S. The myth of mental illness. Am. Psychol.. 1960.
15, 113-118.
__ The uses of naming and the origin of the myth
of mental illness. Am. Psychol., 1961, 16, 59-65.
Truax, C. B. Reinforcement and non-reinforcement in Rogerian
psychotherapy. J. abnorm. Psychol., 1966, 71, 1-9.
Van Per Veen, P. Effects of the therapist and the patient
on each other's therapeutic behavior. J. consult.
Psychol., 1965, 29, 19-26.
Vogel, J. L. Authoritarianism in the therapeutic relation
ship. J. consult. Psychol., 1961, 25, 102-108.
Wallach, M. S. Authoritarianism and therapist preference.
J. clin. Psychol., 1962, 18, 325-327.
Winer, B. J. Statistical principles in experimental design.
New York: licGraw-Hill, 1962.
Zuckerman, M. The development of an affect adjective check
list for the measurement of anxiety. J, consult.
Psychol., I960, 24, 457-462.
Zytowski, D. G. The study of therapy outcomes via experi
mental analogues: a review. J. couns. Psychol..
1966, 13, 235-240. '


58
directive and non-directive counseling techniques. In view
of the fact that "both observers were graduate students in
clinical psychology, and had both had courses in counseling
techniques, it seems unlikely that faulty specification of
terms can explain the findings. The possibility of an
observer bias exists, but cannot by itself explain the dif
ferent levels of observer agreement across therapy types.
The most parsimonious explanation seems to be that
in this study, there was something intrinsic to following
behaviors which made them less identifiable to the observers.
This suggests that there may be a general vagueness and
ambiguity about following or non-directive behaviors,
although the small number of observers used here cannot
support such a general statement except as an hypothesis.
Further research might explore this serendipitous finding
and determine, using many more observers, if there is a
general and consistent difference between rater reliabilities
for leading and following behaviors.
In one rather obvious way, following therapy might
well be expected to be more difficult to specify. It is a
less "active" stance, and in some ways its operations approach
non-behaviors, or at least, from the point of view of this
study, non-verbal, and therefore non-scorable, behaviors.
In a leading orientation, a verbal statement is almost a
requirement whereas, in the following mode, a wink, a nod,
an "Mm-hm" or a subtle facial expression will often suffice.


29
This family of responses included restatement
of content, reflection of feeling, non-directive
leads, and non-directive structuring responses.
This therapy was built largely on the Rogerian
approach, (p. 6)
The primary purpose of the control group was to
provide an equal period of discussion and contact with
another person, but to avoid any consideration or discus
sion of the subjects problem itself. This was to deter
mine the effects of simply being with another person in
the experimental situation versus actually dealing with
a problem in the controlled conditions designed for this
study. Consequently, the neutral topic of "Highway
Safety" was introduced by the control group interviewer,
and was discussed for one-half hour with the control sub
jects. It was planned in advance that if the subject
tried to alter the topic and begin discussing his problem,
the interviewer would point out that this phase of the
experiment called for a discussion of highway safety, and
that the topic had to be adhered to. The interviewer for
this group was also a graduate student, but in physio
logical psychology. He had had the same number of years
training in his specialization as the two therapists had
had in theirs. It should be noted here that the assign
ment of a discussion topic by the interviewer, and its
enforcement by him, made this group closer in some ways
to the IT group than to the FT group. Such confounding
was unavoidable in ensuring a no-therapy control group,


30
i.e., a group in which the subjects particular problem
would not be dealt with in any direct way.
Testing Hypothesis I involved the use of frequency
counts, and these were considered as factors themselves
in the analysis of the resultant data (therapy X client
X observers). This analysis applied only to the two
therapy groups, and not to the control group. The proce
dure for testing Hypothesis II was to take the change
scores on the PPPS for the one-half hour and one-week
intervals, and analyze these data in a three-factor anal
ysis of variance design (therapy X client X test-retest).
Similarly, the procedure for testing the third hypothesis
was to take the change scores on the AACL over one-half
hour, and analyze these data in a two-factor design
(therapy X client).
To facilitate and augment data collection, the
author observed and recorded on tape all of the experi
mental sessions through a one-way mirror. No attempt
was made to conceal either the mirror or the microphone
from the subjects, and, if they asked, the entire record
ing procedure was explained to them. In addition, as
mentioned, two observers were also present in the obser
vation room during the two treatment groups, but not
during the control group sessions. Finally, both thera
pists were asked to subjectively evaluate their degree
of liking for the subject, as well as their estimate as


APPENDICES


76
APPENDIX E
Table of total proportions of leading
responses by therapists
Subject
Observer 1
Observer 2
Total
H
1
.88
.98
1.86
I
2
1.00
1.00
2.00
3
.92
.96
1.88
L
4
1.00
1.00
2.00
E
D
5
.93
.67
1.60
0
6
1.00
.78
1.78
A
D
G
5.73
5.39
11.12
I
L
7
.95
.95
1.90
N
0
8
.91
.97
1.88
9
.94
.95
1.89
G
D
10
.88
.90
1.78
11
1.00
.83
1.83
0
12
.95
.84
1.79
G
5.63
5.44
11.07
H
13
.08
.38
. 46
F
T
14
.25
.25
.50
0

15
.31
.45
.76
16
.35
.47
.82
D
17
.25
.47
.72
L
0
18
.28
.50
.78
L
G
1.52
2.52
4.04
0
w
L
19
.19
.42
.61
n
20
.32
.39
.71
I
21
.47
.67
1.14
N
22
0.00
.30
.30
D
23
.14
.47
.61
G
0
24
.32
.60
.92
G
1.44
2.85
4.29
14.32
16.20


70
APPENDIX A
Telephoned instructions to subjects
Introduction of author.
"On the basis of the form you filled out for me in class
about a week ago, you have been selected to take part in
the rest of the experiment if you would like to. I thought
I might explain it to you briefly, then have you decide if
you would like to continue."
Response from subject.
"The remainder of the experiment will call for you to come
in to the counseling center with a personal or interpersonal
problem that you are presently experiencing. This problem
can be at any level of seriousness, from roommate conflicts
or vocational dilemmas, on through to very serious problems.
The only thing we ask is that it be a real problem, that is,
that it cause you some concern, and that it be present
going on at the present time. You will be asked to evaluate
this problem on some questionnaires, and you may be asked
to discuss this problem with a professional person, whom you
will see for one-half hour. One week following this half-
hour session you will be asked to come in again for a few
minutes and fill out the questionnaires once more. You will
receive two hours credit for participating, but you must
agree to come in for both sessions. All that you do or say
in the counseling center will of course be treated with


56
assumption doubly tenable. To the extent that it was the
ambiguity of the setting which gave rise to the anxiety
tapped by the AACL, then it might be expected that the more
structured and unambiguous treatments, e.g., the leading
and control conditions, would lead to the greatest diminu
tion in anxiety. Along these lines, the non-significant
results obtained are consistent with the review of analogue
studies by Zytowski (1966). He found that the studies using
already existing anxiety less often showed significant
results than did those which experimentally induced anxiety.
Apparently, all people have problems which cause some anxi
ety, but this anxiety may not be great enough to show sig
nificant changes with treatment, or it may be overshadowed
by the situational stresses involved in the treatment proc
ess itself.
A further note, directed to the large variation in
the data, and the consequent failure of any of the anxiety
findings to reach significance, is the greater generality
of the concept of anxiety. It was for this reason that the
author developed and used the highly focused and specific
PPPS for the assessment of particular problems.
The process data collected have yielded a number of
unexpected and interesting findings. In the main, it was
the results concerning the observer factor that proved most
perplexing, especially in view of the fact that this was
originally conceived of as a control factor.


77
APPENDIX P
Table of total proportions of solution offering by subjects
Subject
Observer 1
Observer 2
Total
H
1
.50
.85
1.35
I
2
.67
.73
1.40
3
.88
.86
1.74
T
4
.00
.00
0.00
-U
D
5
.71
.33
1.04
E
0
6
.00
.00
0.00
A
G
2.76
2.77
5.53
D
L
7
.92
.63
1.55
T
8
1.00
.90
1.90
0
9
.23
.24
.47
N
10
1.00
.00
1.00
D
11
.00
.00
0.00
G
0
12
.40
.00
.40
G
3.55
1.77
5.32
H
13
.67
.69
1.36
F
14
.50
.70
1.20
I
15
.83
.67
1.50
0
16
.50
1.00
1.50
D
17
.33
.00
.33
L
0
18
.71
.50
1.21
L
G
3.54
3.56
7.10
0
L
19
.82
.80
1.62
W
0
20
.11
.64
.7 5
21
.67
1.00
1.67
I
D
22
.75
.50
1.25
23
1.00
.67
1.67
N
0
24
.67
1.00
1.67
G
G
4.02
4.61
8.63
13.87
12.71


METHOD
Sample
The subjects used in this study were undergraduate
males at the University of Florida, enrolled in one of two
introductory level courses in psychology. Because the sub
jects were to be screened by means of the Rokeach Dogmatism
Scale (i960), copies of this scale were handed out in class
after a brief announcement calling for experimental sub
jects. In all, 122 copies of the scale were given to the
members of the two classes. Of these, 99 were returned to
the author, who then scored them. Either because they were
incorrectly filled out, or because the respondent lacked a
convenient means of being contacted, nine of these were
eliminated. From the final subject pool of 90 subjects,
the author contacted the 15 highest and 15 lowest scorers,
when this was possible. Several people could never be
reached, two declined participation when the outline of
the experiment was presented to them and one person, who
was already being seen at the University Counseling center,
decided, with the authors agreement, that it might be best
for him not to participate. When a person could not be
reached, or declined participation, the next higher (or
lower) person in the pool was called. All of the subjects
21


ACKNOWLEDGEMENTS
O
The author wishes to thank the members of his
supervisory committee, without whose patient help this
dissertation would not have been possible. In particular,
he wishes to thank the chairman, Dr. Audrey S. Schumacher,
for her many hours of guidance and consultation. He is
also indebted to Drs. Harry Grater, Jacquelin Goldman,
Madelaine Carey, and William Purkey, all of whom have
proven invaluable not only in the preparation of this
dissertation, but in the author's graduate training at
the University of Florida.
ii


42
before to just after the treatment session. Table 5 pre
sents a summary of this post hoc analysis.
Table 5
Post hoc analysis of PPPS change scores
Source
Sum of Squares df
Mean Square
F
Therapy 7.8
Dogmatism 2.7
Therapy X Dogmatism 177.8
Error Within 598.00
2 3.9
1 2.7
2 88.9
24 24.9
3.57*
* p < .05
As indicated, the therapy X dogmatism interaction
tested significant at the .05 level in this post hoc anal
ysis. This interaction is presented in graphic form in
Figure 3, which clearly shows that the high dogmatic sub
jects showed the greatest positive change with a leading
therapist, and showed a negative change with a following
therapist. Just the opposite occurs with the low dogmatic
subjects. Both high and low dogmatic subjects reported
negligible change in the control treatment, although the
high dogmatic people tended to report a very slight positive
change. An interesting finding was that the greatest posi
tive change of all was reported in the low dogmatic group
receiving the following treatment. In addition, this was
the only group in which no one reported a negative change.


37
Figure 1. Therapy X observer interaction
for therapist leading behaviors.


75
appendix d
Subjective evaluations by subjects
N ame.
Your participation in this experiment is now concluded.
Please answer the remaining few questions as candidly as you
can. Feel free to make additional comments where you wish
to. Circle one of the alternatives.
1. Did you like the person who interviewed you?
very much slightly not at all
2. Did you enjoy the experience of being interviewed?
very much slightly not at all
3. Do you think the experience was valuable?
very much slightly not at all
4. Did it help you to solve, or live better with, your
problem?
yes unsure no
5. Do you think participating in this experiment has made
you more likely to seek professional help should the
occasion ever arise?
yes unsure no
Additional comments:


7
available to tar the lattera measure of general author!-
r>
tarianism or dogmatism has been chosen for this research.
The degree to which any therapist exerts leader
ship during the course of therapy depends upon his person
ality, including the important effects of his training and
experiences, and on the particular client he is seeing at
the moment. This assertion grows out of the theoretical
conception presented here of the therapeutic relationship,
and can be empirically tested. The ultimate therapeutic
effects of leadership with different clients can also be
tested. Both these questions, along with the effects of
therapist leadership on the client during the course of
the therapeutic encounter, will be examined presently.
It should be pointed out that the interactionary
model proposed applies only to those cases v/here a free
and spontaneous development of the relationship is fostered.
This precludes a technique-oriented or role-playing stance
on the part of the therapist if his techniques or roles are
to be artificially imposed or "ego-alien." A therapist
with a rigidly programmed set of behaviors to present dur
ing therapy will probably show little change across dif
ferent clients, nor should any change be anticipated.
Use of the therapist leadership dimension is not
without precedent. In many ways it is similar to the older
concept of directive versus non-directive counseling. The


71
upmost confidentiality. If you are agreeable, I will set
up an appointment schedule with you now."
Response from subject.
Arrangement of dates and times.
Reminder of dates, times and locations, and farewell.


18
In addition, whether or not the subject was pres
ently being counseled was seen as an important variable
to be controlled, for obvious reasons. Since actual prob
lems were to be used in this study, it would have been
impossible to evaluate the effects of the experimental
treatment if it took place within the context of a much
more extensive therapy program.
Finally, the experience of the therapists was seen
as a mandatory control factor. The pioneer work of Fiedler
(1950a, 1951a) and innumerable others requires such controls
in any psychotherapy research.
The primary uncontrolled variable in the present
study is the type of problem presented by the subjects,
and its objective seriousness. This warrants some discus
sion. At a theoretical level, one of the most basic assump
tions of the model used here is the similarity across
individuals of their "problems in living." This rationale
is well presented by Guerney and Stollak (1965) in the sec
tions cited and quoted above. To classify persons accord
ing to type of problemin short, to diagnosewould be
inconsistent with the model chosen. Further, there seems
to be no empirical justification for questioning this
rationale at the present time. On the contrary, Parloff
(1961) found no correlation between initial patient evalua
tions and subsequent measures of the quality of the thera
peutic relationship in his group of neurotic patients.


74
APPENDIX C
Affect Adjective Check List for the measurement
of anxiety
Name
The following adjectives describe ways in which people
can feelthey describe various emotional states. Think
about the way you feel right now. Circle those adjectives
that apply to you
(describe the way you feel) at this moment
afraid
loving
calm
shaky
desperate
pleasant
cheerful
tense
fearful
secure
contented
terrified
frightened
steady
happy
upset
nervous
thoughtful
joyful
worrying
panicky


39
A therapy X observer interaction also appeared again, but
this time both the main effect and two-way interaction
were embodied in a complex three-factor interaction. This
is presented graphically in Figure 2. Once again this
graph is plotted in terms of the total proportions across
all subjects in each condition. It can be seen that in
the leading therapy, observers tend to agree more when
the relationship includes a high dogmatism client. Con
versely, their observations diverge more with a low dog
matism client. Further, it can be seen that in the fol
lowing therapy, the observers tend not to show a discrep
ancy dependent upon the level of dogmatism, and also that
there is some slight tendency for more solution offering
to be observed in this therapy condition across the other
factors, especially with low dogmatic subjects.
Hypothesis II was tested by means of the change in
scores obtained on the PPPS at one-half hour and one week
intervals. Analysis of these data was accomplished
through the application of a three-factor analysis of
variance (3X2X2) with treatment (leading, following
and control), dogmatism (high and low) and time of test
(immediate and one week follow-up) as factors. Table 4
provides a summary of this analysis.


TABLE OF CONTENTS
^ Page
ACKNOWLEDGEMENTS ii
LIST OF TABLES iv
LIST OF FIGURES v
INTRODUCTION 1
HYPOTHESES 20
METHOD 21
Sample 21
Measures 22
Procedure 26
I RESULTS 32
Pretreatment Findings 32
Posttreatment Findings 35
DISCUSSION 47
SUMMARY 67
APPENDICES 69
REFERENCES 80
BIOGRAPHICAL SKETCH 83
iii


34
obtained a mean of 37.00. The grand mean of this dis
tribution was 38.66, and the standard deviation was 8.00.
Since the difference between the high and low group means
and the grand mean is only 1.67, they differ from the
grand mean by only .21 standard deviations. Similarly,
the mean of the high dogmatic subjects on the initial
administration of the AACL was 8.94, while the low dogmatic
subjects scored a mean of 7.35. The grand mean of the
distribution was 8.17, with a standard deviation of 2.64.
Since the difference between the group means and the grand
mean is only .82, they differ from the grand mean by .30
standard deviations.
Examination of the data collected on both of the
therapists used in the study proved most interesting. The
leading therapist scored a total of 257 on the Berger
Acceptance of Self and Other Scale143 for Self; 114 for
Other. (The number of items for the two scales are not
equal, so the scores are not directly comparable.) On
the other hand, the following therapist scored a total of
291 (164 Self; 127 Other). The result is thus a small but
consistent tendency for the following therapist to show
greater acceptance of both Self and Others.
The Vocational Interest Blank profiles differed
somewhat for the two therapists. Looking only at the
highest scoring professions (those in the A range of inter
est compatibility) it was found that the leading therapist


11
high scores on the California F Scale tended to see the
role of the therapist as more directive and advice-giving.
Jones also mentioned that he felt that the differences
between high and low scoring groups had been attenuated by
the inability of the F Scale to discriminate between tol
erant and intolerant liberals. In a similar vein,
Wallach (1962) found that high and low scorers on the F
Scale also preferred different types of therapists. Vogel
(1961), using the same measure, found high scores related
to authoritarian attitudes toward therapy in two different
patient groups. These studies suggest that the F Scale is
useful in detecting different attitudes toward therapy and
therapists, but,as Jones (1962) points out, the scale is
not without its critics.
Milton Rokeach (I960) has extended and purified
the original notions of the Adorno et al. California group,
and written about the concept of general authoritarianism,
or what he refers to as dogmatism. He has developed and
standardized his own Dogmatism Scale (I960) and criticized
the California F Scale on the grounds that it does not
adequately reflect general authoritarianism. Rokeach says
that general authoritarianism is related to the relative
openness or closedness of a person's belief-disbelief sys
tem. This system is an intervening variable which includes
all of an individual's beliefs about the world he lives in,
and which also orders and relates these beliefs, one to


24
Appendix B for the complete scale.) To the extent that
this problem is perceived as being insurmountable, severely-
disabling and insoluble, it is assumed to take on patho
logical proportions. The scale consists of eight items
which are alternated in terms of pathology, to avoid the
misleading effects of response set in producing false
positives and false negatives. Each item is quantified
to yield a score ranging from 1 to 10, so that the total
score on the scale ranges from 8 to 80, with a high score
indicating a more serious problem. Quantification of the
scale is accomplished by means of a line graph for each
of the items, upon which the client places a check to
indicate the value of his response between two extremes.
It is scored by placing a grid over this line and reading
off equal intervals.
In a pilot study conducted during the summer of
1967 at the University of Florida, the reliability (test-
retest) of this scale was found to be .957 with a half-
hour interval (N=24), and .901 with a one-week interval
(N=22). While no formal validity measure has been obtained,
the scale has considerable face validity. In addition, the
items were chosen to reflect criteria for maladjustment
commonly held by clinical theorists of various persuasions.
In this sense, it possesses some degree of construct valid
ity as well.


9
consistently reported the clients more improved in this
more interpretive therapy. In the leading therapy, the
clients became more positive in their feelings toward
therapy, and were also held in therapy more easily. The
authors concluded that focusing on a problem caused
guardedness and seeming maladjustment, which they felt
was only temporary.
The use of the leadership dimension raises very
important questions in terms of the personality of the
therapist and the type of techniques he uses in therapy
either because he is more comfortable with them, prefers
them, was taught them, or believes them to be more effec
tive. These questions, along with the degree of congruence
between the therapist's techniques and his more basic atti
tudes and beliefs (personality), perplex any insightful
researcher in the area of psychotherapy. The fact that
almost half of the therapists used in the Ashby et al.
study cited above did not stay within the experimental
requirements indicates that training alone does not account
for the techniques employed by individual therapists. With
this in mind, the therapists used in the present study were
selected with due regard for their natural predilections
in terms of leading or following orientations. In other
words, role playing with techniques was hopefully kept to
a minimum. What was sought in the design of this research
was a maximally congruent, comfortable, and effective


27
One week later, all subjects were again given the PPPS
and a subjective questionnaire asking them to evaluate
their reactions to the total experimental situation (see
Appendix D).
The two therapists were selected according to
their supervisors' or professors' impressions as to a
demonstrated predilection for leading or following behav
iors in therapy. To accomplish this, the supervisors
and professors were originally informed of the experimental
requirements and then asked if they could suggest two prac-
ticum or intern students who seemed to best fit the bill.
The author then presented these suggestions to the three
clinical members who supervised this research, and together
agreed on the final selection. To further reinforce their
natural predilections for leading or following behaviors,
the author carefully reviewed with the therapists what was
desired in terms of experimental designthat they be a
leader or follower, respectively. In addition, two pilot
interviews were allowed each therapist as training sessions.
After these sessions, the author prompted the therapists
on what would have been more desirable behaviors from the
experimental point of view, i.e., what would have been
the leading or following thing to do, etc. As previously
mentioned, each therapist was given the Strong and Berger
scales, and asked about his own preferred and usual ways
of doing therapy. Both of the therapists were males, of


This dissertation was prepared under the direction
of the chairman of the candidate's supervisory committee
and has been approved by all members of that committee.
It was submitted to the Dean of the College of Arts and
Sciences and to the Graduate Council, and was approved
as partial fulfillment of the requirements for the degree
of Doctor of Philosophy.
June, 1969
Dean, Graduate School
Supervisory committee:


8
main difference is that the latter emphasizes a technique
to he employed by the therapista way of acting toward
the client. leadership refers to a much more general notion,
encompassing more of the therapist's personality than just
his training in the specifics of conducting therapy. It
emphasizes the role of the therapist in interacting with
the client. This does, of course, include the older dimen
sionit also goes beyond a focus on technique alone. Its
continuing relation to older concepts does bear testimony
to its significance for all therapy though. Jesse Gordon
(1957), for instance, has pointed out that the relationship
dimension represents a basic split among schools of psycho
therapy.
Ashby, Ford, Guerney, and Snyder (1957) have organ
ized a number of studies using the leadership dimension,
and published them in the form of a monograph. They trained
ten therapists in both a leading and a reflective type of
therapy. Interestingly, while these therapists could learn
either technique, their learning experiences did not neces
sarily take precedence over what they felt to be best, so
that four of their ten therapists did not remain within the
orientation that the experimental design called for. These
authors found that clients could relate satisfactorily not
only to friendly, non-threatening therapists, but also to
authoritarian ones who could engender confidence. The ther
apists, 90$ of whom favored the more leading therapy,


BIOGRAPHICAL SKETCH
Richard V/. Blumberg was horn June 23, 1942, at
Blushing, New York. He was graduated from Brooklyn Tech
nical High School in June, I960, and received his bache
lors degree from the City College of New York in June,
1964. In September of that year, he enrolled in the
Psychology Department at the University of Florida, where
he received a masters degree in December, 1965. During
that time he held fellowships from The United States
Public Health Service and the Graduate School as well as
an assistantship from the Veterans Administration. In
addition to his employment at the Coral Gables Veterans
Administration Hospital, he has worked at The Sunland
Training Center in Gainesville, Florida. He is currently
a Captain in the Medical Service Corps of The United States
Army, and is interning in Clinical Psychology at Letterman
General Hospital in San Francisco, California.
Richard W. Blumberg is single, and presently
resides in Ross Valley, California. He is a member of
Psi Chi National Honorary Society in Psychology, and The
Florida Psychological Association.
83



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PAGE 90

L ,


36
(see Appendix E for table giving total proportions of lead
ing responses by therapists). Interestingly, observer
agreement was not nearly so high where following therapy
was concerned, giving rise to a significant observer
effect, which was part of an even stronger interaction
between therapy and observers. Figure 1 graphically pre
sents the nature of this interaction. This graph, plotted
in terms of total proportions for all subjects, indicates
that while the two observers agreed very closely on lead
ing therapeutic behavior, there was more disagreement in
the following condition. It also indicates that despite
this effect, neither observer had any difficulty seeing
more leading responses in the leading therapy.
Table 2
Analysis of variance for therapist leading responses
Source Sum of
Squares
df
Mean Square
F
Between
4.33
23
Therapy
4.00
1
4.00
242.42*
Dogmatism
0.00
1
0.00

Therapy X Dogmatism
0.00
1
0.00

Error
.33
20
.0165
Within
.39
24
Observers
.07
1
.07
10.77*
Therapy X Observers
.18
1
.18
27.69*
Dogmatism X Observers
.01
1
.01
1.54
Therapy X Observers
X Dogmatism
0.00
1
0.00

Error
.13
20
.0065
*
P < .01


CLIENT DOGMATISM, THERAPIST LEADERSHIP AND
THE PSYCHOTHERAPEUTIC RELATIONSHIP
By
RICHARD W. BLUMBERG
A DISSERTATION PRESENTED TO THE GRADUATE COUNCIL OF
THE UNIVERSITY OF FLORIDA
IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE
DEGREE OF DOCTOR OF PHILOSOPHY
UNIVERSITY OF FLORIDA
1969


H O W H 3 O O Q^H^OIri^O^
79
.APPEND IX H
Table of change scores and means on the AACL
L
E
A
D
I
Subject HI DOG 10 DOG
1
6
4
4
2
7
2
1
3
8
6
2
4
9
-1
4
5
10
2
2
M = 2.6
M = 2.6
11
16
1
0
12
17
1
5
13
18
1
-7
14
19
-7
2
15
20
1
1
M = -.6
s
it
21
26
5
1
22
27
-3
1
23
28
3
0
24
29
0
-1
25
30
1
1
M = 1.2
M = .4


65
It may well be that the same sense of frustration experienced
by the follower with such clients caused him to feel that ohe
session had been less valuable. On the other hand, the lead
ing therapist may have found the high dogmatic subjects less
malleable and more resistant to his leads. In any case, the
discrepancies between the clients* and the therapists' sub
jective reports suggest an interesting possibility. It
seems that to a significant degree, the therapists were "eval
uating" the sessions, and reacting to them, in terms of proc
ess and predicted outcome, while the clients evaluated in
terms of their degree of liking and comfort for their thera
pist and for the total situation. Clearly, additional
research will be required to assess more fully the subjective
reactions of both clients and therapists to various combina
tions of leadership and dogmatism levels, as well as the sets
and values that are applied to quasi-therapeutic encounters
by each. In its initial stages, such research might prove
most fruitful by gathering anecdotal comments concerning
individual reactions, such as discussed briefly above.
Throughout the course of this discussion, references
have been made to the need for further research, along with
suggestions as to how this future study might be revised and
thereby improved. It was felt that mentioning these sugges
tions during the course of the discussion, as the points
arose, would make for better reading and continuity of thought.
In closing, however, these suggestions should not obscure the


12
another. Openness or closedness depends upon the persons
ability to "receive, evaluate, and act on relevant informa
tion received from the outside on its own merits, unencum
bered by irrelevant factors in the situation arising from
within the person or from the outside." (Rokeach, I960,
p. 57) The more closed this belief system is, the more it
approximates a carefully orchestrated defense system
designed to "shield a vulnerable mind." (p. 70) Rokeach
thus compares the extremely closed cognitive mind with the
classical notion of the rigidly defended neurotic individ
ual.
Because of its newness, this scale has not yet been
extensively used in clinical work. Several early findings
have been published however, which bear directly on psycho
therapy. Rokeach himself (i960) reports data to indicate
that high dogmatic subjects are less efficient at problem
solving. Further, Powell (1962) reported that high dog
matic subjects were more subject to impression by source
credibility than were low scoring subjects. This tends to
support an hypothesis of Rokeachs to the effect that high
dogmatic people tend to confuse source and message, rather
than evaluate both on their own merits, especially when
authorities are seen as the source of the message. Finally,
Plant, Telford and Thomas (1965) compared high and low dog
matic persons in terms of their patterns on a standard per
sonality inventory. These authors characterized the' high


19
In addition, the nature of the population from
which the sample was drawn probably exercised some
indirect control over the nature and seriousness of the
problems presented. To have further controlled this
would have required impractical demands in terms of
qualified staff and numbers of subjects to be screened.
At some later time this additional control may seem
justifiable.
To recapitulate, the present study represents an
exploration of an interactionary conception of psycho
therapy. The salient aspects of the relationship which
were focused on are the degree of leadership shown by
the therapist, and its analogue, the client's typical
ways of relating to authority. The adoption of a "prob
lems in living" model facilitated the use of normal sub
ject in an analogue design, which utilized both outcome
and process measures in attempting to evaluate the thera^
peutic relationship.


62
or not I can be following in my therapy depends a lot upon
the client." lamentably, experimental rigor could not be
sacrificed at this point, for the therapists knew nothing
of the aims of the research. The author simply acknowledged
that this might be the case, and supported his efforts at
staying within the paradigm as much as possible.
It seems apparent that if so much emphasis on how
the therapists ought to act had not been built into the
design, at least the following therapist would have acted
in a more flexible manner. The emphasis and training that
was given seems to have restricted the movement of the
therapists, and overpowered an effect that might well have
materialized. Further research should allow more natural
variation to occur, without the constraints of instructions
and training, and observe and report whatever findings
evolve. The interesting comments made in this study by the
following therapist highlight the importance of allowing the
therapist freedom of movement in therapy, so that he does
not feel constrained by any particular orientation.
Another possible, though more speculative explana
tion for the failure of expected interactions to appear in
these data may be that there was not very much difference
between therapists in terms of the pervasive personality
characteristics which find expression in so many subtle and
often uncontrollable ways. Certainly the numerical differ
ences obtained on the Berger scale were not extreme, although


61
ultimately found that their therapists were using a com
bination of the two styles, apparently according to the
particular client they were seeing. It is noteworthy how
ever, that their therapists were not aware that they were
being chosen as one or the other. In the present study,
the therapists were preselected for leading or following
orientations on the basis of supervisors or professor's
ratings, but were then further instructed and trained in
their orientations, and asked to be consistent in them.
While this was originally planned to heighten control of
the therapy variable, it apparently "controlled out" the
very effect that was anticipated. The therapists did not
vary as a function of clients seen, because the therapists
tried hard to be as unvariable as possible-.
An incidental observation made by the author during
the course of the experiment supports the notion that the
instructions and training given had unduly constrained the
therapists in their functioning. Immediately after the
first training session with the following therapist, who had
just seen a low dogmatic subject, the therapist complained
at his discomfort during the session, saying that the long
silences and rather redundant conversation had made him feel
very ill-at-ease. He continued, saying that with such a
reticent subject, staying within the confines of his orienta
tion was difficult, and made him feel quite frustrated. It
was at this point that he said, with telling irony, "Whether


55
client's level of dogmatism or general authoritarianism is
a most relevant variable in the therapeutic relationship,

and that it interacts most directly with what may be con
sidered its analogue, that is, the degree of leadership
demonstrated by the therapist.
The analysis of the AACL data, while non-significant,
reveals a certain trend in terms of the effects of the var
ious treatments on subject anxiety levels. Examination of
the treatment means across all subjects (see Appendix H)
shows that there is a tendency for the greatest reduction
in anxiety to occur in the leading treatment group; the
next highest occurs in the control, and the lowest of all
(actually a negative changethat is, an increase in
anxiety) occurs in the following treatment. The fact that
the control group does register a greater positive change
than one of the treatment groups suggests that this measure
(AACL) is responsive in this study to some other variable
than the effects of therapeutic intervention, at which it
was originally aimed. Indeed, this might also explain the
failure of the predicted interaction to appear.
A plausible explanation is that the check list is
responsive in this study not only to the particular problem
presented by the client, but also to the more immediate
stress of having to participate in a rather ambiguous exper
imental situation. The above comments concerning the level
of the subjects' involvement with their problems make this


35
saw himself as closest to mathematicians, lawyers, and
computer programmers. On the other hand, the following
therapist saw himself as closest to psychologists, social
workers, librarians, music performers, music teachers,
and author-journalists.
Posttreatment Findings
Hypothesis I was tested by means of two separate
analyses. The first of these examined the ratio of lead
ing responses to total responses (leading or following)
observed for each of the two therapists by each of the two
observers. This resulted in a three-factor analysis of
variance, with therapy (leading and following), dogmatism
(high and low), and observers (first and second) as fac
tors. Proportions were used as a means of statistically
controlling for total productivity of the two observers,
thus ruling out the possible contamination due to one
observer being more active in identifying responses of
both types. Using proportions also had the practical
advantage of eliminating the need for separate analyses
of the two types of responses observed. Table 2 provides
a summary of this analysis.
By far the strongest finding, both across observers
and across levels of "client" dogmatism, was that the pro
portion of leading responses observed was far greater for
the leading therapist than for the following therapist


44
Hypothesis III was tested by means of the change
scores over the one-half-hour treatment session on the
AACL. Analysis of these data was accomplished by means
of a two-factor analysis of variance with therapy (lead
ing, following, and control) and client dogmatism (high
and low) as factors. Table 6 provides a summary of that
analysis.
Table 6
Analysis of variance for AACL change scores
Source
Therapy
Dogmatism
Therapy X Dogmatism
Error Within
* p < .25
Sum of Squares df
40.3 2
0.0 1
3.2 2
204.4 24
Mean Square F
20.2 2.38*
0.0
1.6
8.5
Contrary to the prediction made, the therapy X dog
matism interaction failed to reach a significant level in
this analysis. It will be noted that there is a non-signif
icant main effect in the data, indicating that across both
high and low dogmatic groups there is a tendency for the
leading therapist to produce the greatest positive change
(reduction in anxiety) among the subjects. (See Figure 4
for graphic illustration, and Appendix H for complete table
of change scores and means.)
Examination of the subjective data collected from
both the therapists and the clients did not reveal any strong


2
This notion recognizes that certain main effects may con
tribute significantly to the end result, but that when
these effects occur in combination, prediction of the
result depends upon close examination of the combinatory
effects. In a therapeutic encounter, the factors are
people, and the interaction suggests that the result of
the relationship will depend upon the unique effects of
therapist X and client Y on each other, in addition to
whatever contributions the therapists orientation and
personality, and the clients problem and diagnosis might
make.
As already mentioned, the client brings to the
therapeutic encounter his need to be helped. Traditionally,
the therapist also brings specific attributes to the meet
ing. Among recognized therapists, Carl Rogers (1957) has
defined these attributes as simply as anyonehe has said
that the therapist must be congruent, must have positive
regard for the client, and be able to communicate these to
the client. Most often there are additional requirements
made on the therapist in the form of special training,
supervised experience and, in some cases, certification.
The effect of this combination of one seeking help with
another who, by definition is highly qualified to offer
help, invariably results in the therapist being cast in the
role of authority figure. As with all elements of the
relationship, this affects both parties in somewhat


15
the majority of hie peer::; or he may solve only
a fe- very impera .at problems at a particular 6
point in time far less well than the majority
of his contemporaries. Such people may be the
ones who have the most to gain from psycho
therapeutic procedures. But all people prob
ably can benefit somewhat from some type of
psychotherapeutic assistance at any time. (p. 582)
The authors then go on to state a number of heuristic advan
tages to the adoption of such a rationale in research. They
mention: 1) By reformulating our research questions along
these lines, we will bring our work more closely in line
with the mainstream of general psychology, rather than
restricting it to a particular subgroup of "sick subjects,
2) On an operational level, it will allow a much wider appli
cation of experimental procedures, for the subject pool of
the researcher is greatly enlarged when he is not restricted
to the use of patients of this or that diagnostic category,
and 3) The researcher will be more free to experimentally
manipulate his subjects, governed only by the ethics of
dealing with human subjects rather than having to consider
the needs and prognoses of identified patients. By extend
ing the use of normal subjects as clients, the present
research, using an analogue design, hopes to take advantage
of all the above possibilities.
It is apparent that Guemey and Stollak are suggest
ing that research proceed with a theoretical reformulation
in keeping with the ideas developed by Szasz. Several stud
ies on psychotherapy, employing the experimental analogue


68
by therapists, and solution-offering and direction-seeking
behaviors by clients, recorded by the same two observers.
It was hypothesized that all measures would show a sig
nificant therapy X dogmatism interaction. This was sup
ported by the problem scale data, but not for the others.
Failure of the predicted interaction to occur with the
anxiety check list data was discussed in terms of the
unfocused nature of the feeling assessed, and its higher
dependency upon the whole experimental situation rather
than the specific problem presented. Failure with the
process data was discussed as most probably due to the
required adherence of the therapist to a particular type
of therapy, which overcontrolled and prevented the inter
action of therapy and dogmatism from emerging.
A most interesting serendipitous finding was a
strong observer effect, showing that rater agreement was
higher with the Leading Therapy observations than with
the Following. This was discussed in terms of its implica
tions for traditional conceptions of following or non
directive counseling.


59
The presence of these additional minimal cues may add appre
ciably to the variance found in following behaviors.
An interesting study by Truax (1966) seems to
strengthen, by analogy, the assumption that following or
non-directive behaviors are elusive traits. He took excerpts
from a single, successful therapy case, conducted by Rogers,
and analyzed the recordings, testing to see if empathy,
warmth and directiveness were consistently manifested, inde
pendent of patient behaviors. Rogers (1957, 1965) has, of
course, maintained that such consistency prevails in good
non-directive therapjr. Truax found that Rogers responded
differently to five of the nine patient behaviors studied.
Moos and Ciernes (1967), noting Truax' work, comment: "If
there is differential responding in empathy and warmth to
different content with one patient, it is but a small step
to suggest that there is also differential responding in
empathy and warmth to different patients." In essence,
these authors are suggesting that Rogers and other leaders
in non-directive counseling may actually be less consistent
than they think they are. Part of their lack of awareness,
and indeed, their lack of emphasis on technique, may be due
to the elusive nature of the operations they employ. This
possibility is consistent with the findings of the present
study.
Unfortunately, the findings concerning the propor
tion of solution offering by clients are non-significant.


25
The Zuckerman Affeco Adjective Check List (AACI)
was used in testing Hypothesis III. This scale was chosen
in part because of its ability to detect short-term var
iations such as might be reasonably expected in an exper
iment of this design. Zuckerman (I960) reports a split-
half reliability of .85 with instructions to record
immediate feelings. With this same set in mind, a valid
ity study was devised wherein the scale was administered
to college students in an elementary psychology class on
both exam and non-exam days. The instrument was able to
distinguish between days at a significant level.
Finally, two scales were administered to the two
therapists used in this study to augment the information
already available as to their natural predilections and
orientations in therapy. These scales were the Strong
Vocational Interest Blank for Men (Strong, 1938) and Bergers
Acceptance of Self and Others Scale (Berger, 1952). The
former is discussed by Strong (1943), who reports relia
bilities in the range .73-.94 using 285 college seniors.
The latter is actually two scales in one, designed to tap
basic positive attitudes toward both the self and others.
It is discussed by Berger (1952), who reports split-half
reliabilities of .894 or better for the self-acceptance
subscale, and .776-,884 for the acceptance of others.
With respect to validity, the Pearson product moment cor
relations with essay-type self-descriptions of students'


81
Frank, G. H. and Sweetland, A. A study of the process of
psychotherapy: the verbal interaction. J, consult.
Psychol., 1962, 26, 135-138.
Glad, D. D. Operational values in psychotherapy. Hew York:
Oxford University Press, 1959.
Gordon, J. S. Leading and following psychotherapeutic tech
niques with hypnotically induced repression and hos
tility. J. abnorm. soc. Psychol., 1957, 54, 405-410.
Guerney, J. E. and Stollack, G. E. Problems in living,
psychotherapy process research, and an autoanalytic
method. J. consult. Psychol., 1965, 29, 581-585.
Jones, W. S. Some correlates of the authoritarian personal
ity in a quasi-therapeutic situation. Dissert.
Abst., 1962, 23 (2), 691-692.
Kanfer, F. H. and Marston, A. R. Characteristics of inter
actional behavior in a psychotherapy analogue. J.
consult. Psychol., 1964, 28, 456-476.
Levison, P. K., Zox, M. and Cowen, E. L. An experimental
analogue of psychotherapy for anxiety reduction.
Psychol. Reports, 1961, 8, 171-178.
Lorr, M. Client perceptions of therapists: a study of the
therapeutic relation. J. consult. Psychol., 1965,
29, 146-149.
Moos, R. H. and Ciernes, S. R. Multivariate study of the
patient-therapist system. J. consult. Psychol.,
1967, 31, 119-130.
Parker, G. V. C. Some concomitants of therapist dominance
in the psychotherapy interview. J. consult, Psvchol.
1967, 31, 313-318.
Parloff, M. B. Some factors affecting the quality of psycho
therapy relationships. J. abnorm. soc. Psychol.,
1961, 25, 29-38.
Plant, W. T., Telford C. W. and Thomas, J. A. Some person
ality differences between dogmatic and non-dogmatic
groups. J. soc. Psychol., 1965, 67, 67-75.
Powell, F. Open and closed mindedness and the ability to
differentiate source and message. J. abnorm. soc.
Psychol., 1962, 65, 6I-64.
Rogers, C. R. The necessary and sufficient conditions of
therapeutic personality change. J. consult. Psychol.
1957, 21, 95-103.


3
different ways. The therapist, in accordance with his own
personality and orientation to therapy, will handle his
role as authority in various ways. In this, he will also
be affected by his client, who brings to the situation a
life style which includes certain basic and patterned ways
of relating to authority and its representatives. Thus
this most pervasive element of the relationship becomes
fundamental to its successful resolution, and also provides
valuable clues as to where to begin an investigation of
the important components of the relationship itself.
Before continuing, it will be valuable to examine
some of the precedents set by others in their study of
psychotherapeutic relationships. Actually, the emphasis
on relationship research is relatively new. In 1949 Seeman -
studied the reactions of clients who had been counseled by
directive and non-directive techniques, and found significant
differences in the reactions of counselees counseled by the
same techniques, and non-significant differences among those
counseled by different techniques. He concluded that some
thing besides therapeutic method was leading to the differ
ent reactions among the clients. Fiedler (1950a, 1951a,
1953) maintained, and provided data to support the view,
that it was the relationship between the therapist and the
client, and not the methods, that led to successful therapy.
However, he also pointed out (1953) that the method used
might malee a particular therapist more comfortable, and


13
a gmatic group as impulsive, defensive and stereotyped in
their thinking. These findings, together with those from
the California Scale, suggest that subjects or clients who
differ along the authoritarian dimension will react quite
differently to therapists who differ on the leadership
dimension.
Another relevant dimension within the psychothera
peutic relationship (and one that will be included in the
present study) is that of anxiety. This includes anxiety
both as it arises as a symptomatic manifestation of the
clients problem, and as it arises and is dealt with within
the context of the leadership-authoritarian relationship
per se. In the latter sense, it is a good index of the
client's subjective reaction to the relationship. Further,
to the extent that the client's problems have caused him
anxiety, it assesses the outcome of therapy in terms of its
effectivenes in reducing that anxiety.
Having established the general area to be studied,
it is now necessary to discuss briefly how the area will
be approached. In this regard there are two relatively
innovative concepts which must be introduced and expanded.
These are the adoption of a "problems in living" model, and
the use of an analogue design, both of which are basic to
the present study. These two notions are also somewhat
related in that the adoption of this model facilitates,


78
APPENDIX G
Table of change scores and means on the PPPS
Subject
Test
Retest
H
1
3
14
I
2
0
-6
I
3
4
-2
D
4
14
25
E
0
c
5
-2
-3
A
M = 3.8
M = 5.6
D
L
6
-2
5
I
0
7
4
9
N
D
8
9
-5
2
5
-4
G
rT
10
-4
-3
M = -1
M 2.4
H
11
-3
-3
E
I
12
-11
1
0
13
1
-2
L
D
0
14
15
0
-2
2
9
L
r\
G
M = -3
M = 1.4
U
L
16
2
8
w
0
17
15
5
i
n
18
1
1
N
JJ
o
19
0
1
20
2
2
G
G
"Â¥ = 4 "
.
1!
a
H
21
-1
-2
I
22
7
9
C
23
-4
-4
D
24
-5
-8
0
0
25
5
6
N
G
M = .4
M .2
T
L
26
-1
1
n
0
27
1
2
0
28
2
5
T
D
29
2
6
-Li
0
30
-4
-4
G
M = 0
M 2


33
mean, and the equivalent of these differences in standard
deviation units.
Table 1
Summary of pretreatment findings on the
Rokeach Dogmatism
Scale
Leading
Following
Control
Group
Group
Group
Mean
168.2
163.6
161.0
High
Difference
4.0
.66
3.26
Dogmatism
SD
.36
.06
.34
Mean
105.4
94.2
110.6
low
Difference
2.0
9.2
7.2
Dogmatism
SD
.26
.73
.57
On the other hand, it was vital to the study that
the high and low dogmatism subjects differed significantly.
Examination of these data indicated that the mean of the
high dogmatic group was 164.3, while the mean for the low
group was 103.4. The means for the two groups were thus
separated by 60.9 points, or 3.38 standard deviations,
indicating a clear difference between them.
Further, in order to justify the use of the analysis
of variance, rather than an analysis of covariance, or some
other design, it was important to demonstrate that the high
and low dogmatic groups did not differ on their initial
scores on either the PFPS or the AACL. The high dogmatic
subjects obtained a mean score of 40.33 on the initial
administration of the PPPS, while the low dogmatic people


RESULTS
Pretreatment Findings
The reader will recall that the final subject
pool consisted of 90 college males enrolled in one of
two introductory psychology classes at the University
of Florida. These students had been selected for the
study on the basis of their scores on the Rokeach Dogma
tism Scale. The scores obtained ranged from a high of
190 to a low of 82, with the high scores indicating high
dogmatic or closed-minded orientations. This array of
scores yielded a mean of 135.98, with a standard devia
tion of 18.00, which is consistent with the data presented
by Rokeach (I960).
When the 30 subjects who participated in the study
had been selected, they were randomly assigned to one of
three groupsleading, following, and control, for a total
of 10 people in each group (five high and five low dogmatic
subjects). To insure that a random sort with such small
numbers had not produced a biased sample in one or more
of the groups, dogmatism scale scores were compared across
groups. Table 1 below presents the means of these groups,
the differences between each of these means and the grand
32


53
where individual clients are concerned, i.e., who should
see v.hon toward what end, etc. In this study, analysis of
the empirical data and examination of the subjective data
obtained combine to indicate that a favorable outcome to
therapy depends upon the client, the therapist and the com
bination of the two in a particular unit.
Most interesting in this regard were some of the
reactions and comments made by high dogmatic clients to the
three treatment conditions. One is tempted to generalize
from a few cases, and say that the high dogmatic people
were much more demanding and rigid in reacting to the exper
iment. For instance, one boy who saw a leading therapist
complained: "Upon leaving, I had the feeling that he should
have helped more by giving some suggestions toward solving
my problem. As it turned out, the help came by simple [3icl
his listening: a person, outside my family, interested."
Another boy, subjected to the experience of seeing a follow
ing therapist, was even more expressive. Because he so
adequately gives the high dogmatic reaction, he will be
quoted at length: "I had just related my problem and did
not have adequate time to discuss it. I opened up to the
councelor [sic] and there was not time to get much reaction.
I was thoroughly frustrated, and my problem seemed worse.
Discussion time or counciling [sic] time should not be
strictly regulated. If the discussion is getting repetitious,
no progress is being made and the councilor has other people


54
to see, he should tactfully make another appointment. The
councilors time should be flexible." It is rather obvious
that this subject was not happy, and,further, that he was
trying to structure the situation to meet his own needs and
preconceptions.
High dogmatic subjects also reacted strongly to the
no-therapy control group. In one case, a subject interrupted
the control group interviewer and said, "I don't know who
chose this topic (highway safety), but I find it very boring,
and Id much rather talk about my problem." Another boy
saved his discontentment until after the session, and then
quite angrily told the author that he was very frustrated
at not being asked to discuss this problem he had been think
ing about for several days. He seemed somewhat upset, and
the author promised to see him individually at the conclu
sion of the experiment, to discuss his problem and see what
might be done toward getting help for him. An appointment
was arranged at that time. After breaking that appointment
three times, the subject showed up with a rather innocuous
problem in the academic-vocational area. After an hour and
a half of pleasant conversation, he left, concluding that
everything would work out.
In general it can be said that the low dogmatic sub
jects were able to accept much more readily and agreeably
the conditions imposed by the experimental design. All of
this has convinced the author still more strongly that the


REFERENCES
Adorno, T. W., Frenkel-Brunswik, E., levinson, D. J. and
Sandord, R. N. The authoritarian personality
New York: Harper and" Row, 1950.'
Ashby, J. F., Ford, D. H., Guerney, B. G., Guerney, L. F.
and Snyder, W. U. Effects on clients of reflec
tive and a leading type of psychotherapy. Psychol.
Monogr. 1957, No. 24, 71 (whole no. 453).
Berger, E. The relation between expressed acceptance of
self and expressed acceptance of others. J. abnorm
soc. Psychol., 1952, 47, 778-782.
Bluraberg, R. W. A scale for "problems in living" research
Psychol. Reports, 1968, 22, 161-162.
Cowen, E. L. The experimental analogue: an approach to
research in nsychotherapy. Psychol. Reports, 1961,
8, 9-10.
Currier, C. G. Patient-therapist relationships and the
orocess of psychotherapy. Dissert. Abst.t 1964,
24 (12), 5539-5540.
Fiedler, F. E. A comparison of therapeutic relationships
in psychoanalytic, non-directive and Adlerian
therapv. J, consult. Psychol., 1950, 14, 436-
445 (a).
. The concept of an ideal therapeutic relation-
ship. J. consult. Psychol., 1950, 14, 239-245 (b).
. Factor analyses of psychoanalytic, non
directive and Adlerian therapeutic relationships.
J. consult. Psychol., 1951, 15, 32-38 (a).
. Quantitative studies on the role of thera-
pTsts' feelings toward their patients. In 0. H.
Kowrer (ed.) Psychotherapy: theory and research.
New York: Ronald Press, 1953, 296-35.
Ford, D. K. An experimental comparison of the relation
ship between client and therapist in a reflective
and a leading type of psychotherapy. Unpublished
doctoral dissertation, Penn. State University,
1956. Dissert. Abst. 1956, 16, 1490-1491.
80


51
measure of subjective equivalence between problems. The
very subjectivity of the measure builds in the possibility
of tremendous variance however, for what to one person may
seem reasonably problematic, may to another seem a trifle,
or a disaster! Further study, with objective ratings of
problem seriousness, would tighten control of this variable.
In addition, the post-interview comments of the sub
jects themselves sometimes tell rather convincingly their
levels of involvement. Compare the following two comments,
both made by low dogmatic scorers in the leading therapy
group: "I probably need to take more of a serious interest
in this problem in order to bring about any great change.
I am not ready to do so at this time." The other boy seems
to be writing of a different kind of experience altogether:
"I see my problem from a different standpoint, i.e., it is
not unique. I feel some confidence in tackling the problem
now, knowing that with effort and bravado, I can overcome
my intense self-awareness." It can probably be assumed
that the former boy would not have presented himself in a
real counseling settingthis type of client seems to be a
function of the analogue design employed in the present
study.
Some discussion seems necessary concerning the find
ing that the change in scores on the PPPS becomes much more
variable after one week, while at the same time the mean
change tends to increase across all subjects. It seems


45
e.
Figure 4. Plot of AACL change scores.


LIST OP TABLES
Table
Page
1
Summary of pretreatment findings on
the Rokeach Dogmatism Scale
33
2
Analysis of variance
leading responses .
for therapist
36
3
Analysis of variance
solution offering .
for client
38
4
Analysis of variance for PPPS change
scoresimmediate and delayed test . .
41
5
Post hoc analysis of
PPPS change scores .
42
6
Analysis of variance
for AACL change scores
44
iv


60
Further, all three factors studied gave rise to an inter
actiona situation always difficult to understand, and
made douhly uncertain by the high chance of a random occur
rence in this case.
Nevertheless, it is interesting to note that the
leading therapy tended to yield (at the .25 level) less
solution offering than did the following therapy. This
seems to be evolving as a fairly consistent finding. For
instance, Frank and Sweetland (1962) found that directive
therapists tend to elicit fewer statements from their clients
which reflect understanding and insight into their problems.
If this is a general finding, and given that spontaneous
verbalization of insight is valued as a therapeutic process,
then the findings tend to favor a following type of therapy,
especially with low dogmatic clients.
A word must be said regarding the failure of the
predicted interactions to appear, in both the therapist
leadership and client solution-offering data. In addition
to the above-mentioned difficulties in dealing with the
elusive nature of following behaviors, which gave rise to
observer differences, it is very probable that the instruc
tions and training given to the therapists interfered with
the normal process of therapy for them. For instance,
Rottschafer and Renzaglia (1962), who tried to select
"reflective and "leading" therapists by direct observation,


11ST O? FIGURES
0>
Figure Page
1Therapist X observer interaction for
therapist leading behaviors 37
2 Therapy X dogmatism X observer interaction
for client solution offering 40
3 Therapy X dogmatism interaction for
PPPS change scores 43
4 Plot of AACL change scores 45
v


17
the subject is undoubtedly closer to actual therapy con
ditions than could be any artificial distress induced by
the experimenter. Further, at least one of the dependent
measures has been designed to tap a specific problem area,
independent of the anxiety level of the subject. This,
together with the inclusion of an anxiety measure, should
help clarify the point Zytowski (1966) raises.
While the main focus of the present research is the
authoritarian component within the psychotherapeutic rela
tionship, there are other factors which must be considered,
and which also affect the relationship. As is customary,
some of these have been controlled for in the design of the
study, and some have been allowed to vary randomly.
Among the client variables which were controlled
are age, sex, education and intelligence. These are fre
quently controlled variables in psychological research,
and it is obvious that they might directly confound any
attempt to isolate relevant effects within the relationship.
Age and intelligence were indirectly controlled by means of
the population from which the sample was drawnan under
graduate college group. Sex has been identified as a sig
nificant component in the therapeutic relationship by Parker
(1967) and Currier (1964) as well as others. Especially in
view of the main focus of this studythe authority aspect
it was deemed imperative that sex be controlled for.


50
"be ascertained. However, there were certain post hoc checks
which could offer suggestions as to how involved the subject
was with the problem he brought in. These included the
nature of the problem itself, the initial score on the PPPS,
which provided a very subjective estimate of problem serious
ness, and, in some cases, the comments made by the subjects
at the conclusion of the experiment.
The range of problems dealt with in this study went
from the very frequent vocational or academic concerns, to
marital discord and the threat of alcoholism. In one case
the problem caused enough concern that the subject asked if
he might pursue it further at the counseling center, beyond
the extent of this study. One week later however, this
same subject felt that he had been able to look more care
fully at his difficulty during that week, and now felt that
he would be able to handle it on his own. Even with such
exceptions, the author often felt that the subjects were
considerably less concerned about their problem than actual
clients would be. This probably contributed to the variance
seen in the outcome measures to a great extent. A future
study might be enlarged to the point where uninvolved sub
jects, as judged by a panel of experienced clinicians,
could be eliminated.
As mentioned above, the initial scores on the out
come measures did not differ significantly for the high or
low dogmatic subjects. In a sense, this insures some


HYPOTHESES
e>
The following hypotheses are examined:
1) Both the clients and the therapist's behavior will
vary as a function of the particular combination of the
type of therapist the client encounters (leading or fol
lowing) and the type of client he is (high or low dogmatic).
In particular, it is hypothesized that the therapist will
tend to show more or less leadership depending upon the
client he sees, and that the client will tend to offer
more or fewer solutions to his problem (take the lead or
not take the lead) depending upon the therapist he sees.
2) The clients perception of the seriousness of his
problem will vary as a function of the particular type of
therapy he encounters (leading or following) and the type
of client he is (high or low dogmatic). That is to say,
it is predicted that in the analysis of the outcome data
there will be a significant therapist by client interac
tion.
3) Similarly, it is predicted that change in the client's
anxiety level will vary as a function of the particular
therapist and client combination.
20


thereby indirectly affect the outcome of the therapy. At
the same time (1950b) Fiedler presented data to support
the notion that theoretical orientation was not an espe
cially relevant variable, although this too might presuma
bly affect the outcome by making the therapist more or
less comfortable in the relationship.
Rogers (1957) discusses what he feels are the major
aspects of the good relationship. In terms of the inter
action per se, he emphasizes the importance of the thera
pist experiencing unconditional positive regard and empathic
understanding of the client, and also being able to commu
nicate this to him. It will be noted that Rogers focuses
on the role of the therapist, whom he sees as a constant
in the situation, and does not discuss the role of the
client in affecting the therapists behavior. Truax (1966)
has questioned the constancy of the Rogerian therapist, and
shown that Rogers himself reacts differentially to client
behaviors in therapy.
Somewhat later however, Rogers (1965) acknowledges
the client as an elicitor of behaviors in the therapist,
which is much closer to the point of view taken here.
After reviewing some of the Rogerian-oriented studies on
relationship, he concludes:
Without trying to go further into this
very complex research, I will simply say
that it indicates that the attitudinal
qualities I have described are provided


16
design, heve actually appeared within the last few years,
and have been reporxed by Cowen (1961), Gordon (1957),
Kanfer and Marston (1964), levison (1961) and others.
As Cowen (1961) discusses the analogue design, it
is a type of research in which the experimenter in some way
simulates the behavior of a therapist in the process of
giving therapy, while the subject is brought through some
means to feel distress or a symptom comparable to that which
a client might feel. It is also possible to use the anxiety
generated by normal daily problems, although this may not
have reached proportions great enough to motivate the sub
ject to seek help on his own. It is in this sense that the
adoption of a "problems in living" model relates to the
analogue designsince the major tenet of this model is the
basic similarity of problems across all persons, almost
anyone becomes eligible as a research subject. However,
Zytowski (1966), after having reviewed many of the analogue
studies, concluded that those experiments which utilized
already existing anxiety, rather than inducing it experi
mentally, less frequently obtained significant results.
This seems to suggest that while most people may have prob
lems, the anxiety generated may not be sufficient to make
a particular person amenable to therapeutic intervention.
Nevertheless, the present study will draw upon both
the "problems in living" model and the analogue design. The
examination of real problems actually being experienced by


6
of action words, the number of questions asked, and the
number of "Mm-hmms" emitted. A number of surprising find
ings came out of their data, including the fact that for
at least one of their behaviors, the effect of the client
upon the therapist was greater than the effect the thera
pist had upon the client! While potentially embarrassing,
such a finding is consistent with the interactionary model
proposed here, and points up the need for further research
to determine what reciprocal effects the therapeutic par
ticipants have upon each ether. Further, since no outcome
data are reported, it cannot be known from this study what
ultimate beneficial effects the therapists "versatility
may have had on the client.
As mentioned above, the concept of authority is an
integral and important element in the psychotherapeutic
relationship, and, as such, it plays a central role in the
present study. In keeping with the notion of relationship
already developed in the preceding pages, the concept of
authority will be examined within the context of the total
interacting unitthe client and the therapist together.
The best reflection of the therapist's reaction to his
authoritarian role is the degree to which he exerts control
or leadership in the relationship. An analogue of this for
the client is his assertiveness or submissiveness in ther
apy, as well as his general orientation to authority and
typical ways of responding to it. Several measures are


SUMMARY
The present study attempted to test the primacy of
the therapist-client relationship in determining both the
process and outcome of therapy. A factorial psychotherapy
analogue design was employed. Thirty normal college males
were selected on the basis of either very high or very low
scores on the Rokeach Dognattsm Scale. These subjects were
randomly assigned, within a fully balanced design, to three
treatment conditions: a Leading Therapy, a Following Ther
apy, or a No-Therapy control group. In each treatment con
dition, the subjects were interviewed individually for one-
half hour by a different "therapist" (a graduate student in
clinical psychology selected either for his tendency to pur
sue a leading or a following orientation in therapy). Sub
jects in the two treatment groups discussed a self-selected
personal problem that the subject was asked to bring in
with him to the session; those in the control group dis
cussed highway safety.
Outcome data collected consisted of changes in per
ception of problem seriousness as measured by the Problem
Pathological Potential Scale and change in anxiety as meas
ured by the Affect adjective Check List. Process data con
sisted of frequency counts of leading and following behaviors
67


23
Frequency counts obtained by means of direct obser
vation were the measures used for testing Hypothesis I.
The observers used were both graduate students in clinical
psychology, presumably with some skill in observation of
a therapy situation. They recorded frequency counts of
both the leading and following behaviors of the therapists
as well as the direction-seeking and solution-offering
behaviors of the clients as observed through a one-way
mirror. The criteria used for identifying leading and
following behaviors were originally described by Ashby
et al. (1957), and are presented below. The client behav
iors observed are more or less self-explanatory; any active
effort to seek advice or direction from the therapist in
achieving mastery over his problem was scored as direction
seeking. Conversely, any statement to the effect that the
client had spontaneously produced a tentative solution was
scored as solution-offering. This straightforward approach
to operationalizing behaviors observed in therapy follows
the general suggestions of Glad (1959).
An instrument developed by the author (Blumberg,
1968) was used in testing Hypothesis II. This instrument,
known as the Problem Pathological Potential Scale (PPPS)
has as its aim the assessment of the extent to which the
client sees his problem as being serious, as presenting
real difficulties in overcoming it, as having the potential
to seriously disrupt the clients daily routine, etc. (See


49
multivariate work done which has indicated an interaction
between client and therapist has demonstrated this in terms
of process data, with little mention of how either the
client or the therapist saw the ultimate purpose, or out
come, of the therapeutic encounter. Such work has been
reported in the past by Moos and Ciernes, 1967, Truax, 1966,
Van Der Veen, 1965, and others. The present finding dem
onstrates that the effects of the interaction extend beyond
the actual process measures, and can and do influence the
client's perception of the seriousness of his problem.
Further, the lack of change in the PPPS scores for the
control group solidifies the finding and attributes it
directly to the counselor's attempts at therapeutic inter
vention, eliminating the possibility that this change is
a function of social contact alone.
Several comments must be made regarding this find
ing. First, there are differences between what these sub
jects, knowingly participating in an experiment, must have
experienced, and what actual clients seeking help must
experience. This is the toll of authenticity paid by any
analogue study, or, for that matter, any laboratory study
as compared to actual field work. The entire question of
the subject's real involvement is paramount here. While
the instructions asked each subject to bring in a problem
with which he was really concerned, there was no further
control exercised over this variable. Certainly further
research is called for where the degree of involvement can


22
(30 in total) were contacted "by telephone, and given the
same information. This information is presented verbatim
in Appendix A.
The two therapists used were clinical psychology
graduate students at the University of Florida, and were
matched in experience. Approximately 20 students were
considered, and two were finally chosen on the basis of
their demonstrated propensity to be more, or to be less,
active in the conduct of therapy. Three faculty clini
cians, who had some knowledge of the students in either
a teaching or supervisory capacity, were consulted in
making the final selection. The control group interviewer
was chosen from a pool of experimental psychology students
so that his age, sex and educational level was in keeping
with the two therapists.
Measures
As stated above, the 'clients were selected by
means of the Rokeach Dogmatism Scale. This scale is
presented in full, and discussed in terms of reliability
and validity in Rokeach's Open and Closed Mind (i960).
He reports a range of reliabilities of from .68 to .93
for Form E of the scale. Among the validity studies
reported is one concurrent measure using groups of high
and low dogmatic subjects, identified as such by fellow
students, and which were differentiated at a significant
level by the scale.


8. How readily do you feel you will be able to overcome
this problem?
very readily
never


41
Tab?, e 4
Analysis of variance, lor I'-tlS cnange scores
immediate and delayed test
Source Sum of Souares
df
Mean Square
P
Between
1657.40
29
Theraoy
42.70
2
21.35

Dogmatism
2.40
1
2.40

Therapy X Dogmatism
181.30
2
90.65
1.52*
Error
1431.00
24
59.63
Within
493.00
30
Time of test
48.60
1
48.60
2.94**
Therapy X Time
7.30
2
3.65

Dogmatism X Time
.60
1
.60

Therapy X Dogmatism
X
Time
39.90
2
19.95
1.21
Error
396.60
24
16.53
* p < .25
** p < .10
As predicted, a therapy X dogmatism trend did appear,
but was not significant. Interestingly, the time of test
main effect came out at a higher level of probability with
a greater positive (diminution of problem seriousness)
change recorded one week after the treatment (see Appendix G
for complete table of change scores and means). Inspection
of the individual change scores revealed, however, that while
the mean of the retest scores was higher, the variation was
considerably greater also. Since the therapy X dogmatism
interaction had been tested across both levels of the test
factor, it was concluded that the greater variation in the
retest scores had partially masked the effect predicted in
Hypothesis II. Consequently, a post hoc analysis was con
ducted using only the change scores obtained from immediately


66
need for cross-validation of the positive findings as they
now stand. Optimally, this should he accomplished by another,
unbiased, and disinterested experimenter.


57
Concerning the proportion of leading responses by
the therapists, the reader will recall that there was a
very strong therapy effect, indicating rather clearly that
the two therapists were, on the whole, acting quite differ
ently in the experimental situation. In addition, however,
there was a significant observer effect which combined with
the therapy variable for a rather strong therapy X observer
interaction. It is this interaction which is perplexing,
for either of the two main effects is understandable, and,
in the case of the therapy effect, quite desirable. Since
the nature of the interaction is such that the observers
agreed much more closely when leading therapy was concerned
(see Figure 1), it would seem either that the definition of
terms was faulty in this experiment, or that there is some
thing intrinsically vague about following behaviors on the
part of psychotherapists. Since both observers received
the same amount of training with both types of therapy, it
does not seem plausible that training differences could
account for the different levels of agreement across therapy.
As stated above, the operationalization of the con
cepts of leading and following therapy used in this study
were taken directly from Ashby et al. (1957). These authors
have used this system rather succesfully, and have reported
their findings in a monograph cited just above. Further,
it is apparent that the concepts of leading and following
are analogous to the older and widely known dichotomy between


72
APPENDIX B
Problem Pathological Potential Scale
Name
You have been asked to bring in a personal problem
that you would be willing to discuss with a professional
person. I would like you to think of that problem now.
Imagine that you planned to seek help in a counseling center,
and that you needed to really assess your problem before you
could start solving it. Give me that assessment by placing
a check somewhere on the lines below.
1. How serious do you feel this problem is?
very not at all
2. Will this problem be good for you in the long run, e.g.,
will it educate you, or make you stronger through
experience, toughen you, etc.?
very much so not at all
3. Do you spend much time thinking about this problem?
a great deal ________ none
4. Do you thinl: many others share this problem?
many others no others
5. To what extent do you feel this problem interferes with
your daily routine?
greatly not at all
6. Would you feel comfortable discussing this problem with
a friend?
very comfortable very uncomfortable
7. Could this problem ever have disasterous consequences?
very probably no


43
Figure 3. Therapy X dogmatism interaction for
PPPS change scores.
(


6
Total
Proportion
Solution
Offering
5
4
3
2
1
LEADING
FOLLOWING
Observer 2
Observer 1
I I
Hi Dog Lo Dog
I
Hi Dog
i
Lo Dog
Figure 2. Therapy X dogmatism X observer interaction for
client solution offering.
-p-
o


48
not to weaken the assumptions made, hut rather to point
out additional complexities to be considered in subsequent
research. An example of this is the finding that fairly
sophisticated observers differ among themselves as to what
constitutes leadership, and, to an even greater degree,
differ as to what are solution-offering and direction-seek
ing responses on the part of clients. This latter finding,
for instance, raises the interesting speculation that ther
apy-wise observers may tend to be overly influenced by the
behavior of the therapist, and thereby overlook the impor
tant contributions of the client in determining the inter
action. Further, the subjective data collected indicate
that attitudes toward the encounter tended to be more proc
ess and outcome oriented for the therapists, and more liking-
disliking oriented for the clients. In a sense this only
demonstrates the well-known principle that what we are
trained or interested in looking for affects what we see.
However, it also adds relevant dimensions to the future
study of therapy relationships. In this way the present
research has broadened the perspective of the concepts
originally proposed, and demonstrated some of the difficul
ties involved in approaching them empirically.
The presence of a significant interaction between
the type of therapy and the level of client dogmatism, in
terms of change scores on the PPPS, lends considerable sup
port to the rationale of this study. Much of the


46
trends, although many of the individual comments made by
subjects were enlightening (see discussion section). It
was interesting that some 87$ of the high dogmatism sub
jects seen by the Leading therapist liked him very much,
while 60$ of the low dogmatism people liked the Following
therapist, and only 50$ of the other two groups liked the
therapist they saw. This is especially interesting in view
of the fact that the Following therapist liked 33/2 of the
high dogmatic people he saw, and only liked 17/2 of the low
dogmatic subjects. In the same vein, the Following thera
pist saw the session as not at all valuable for 87/2 of his
low dogmatic clients, and only 33$ of his high dogmatic
people. Just the reverse was true for the Leading thera
pist, who felt that the experience was not at all valuable
for 67$ of his high dogmatic subjects, and for only 17$ of
his low dogmatic interviewees.


63
they did reflect a predictable variation. On the other
hand, the interest form data did present quite a different
picture of the two therapists, again in a way that is theo
retically meaningful. Once again, additional research is
needed to identify the relevant therapist traits which
covary with leading and following orientations. Parker
(1967), for instance, has recently used a measure of thera
pist dominance, and found that dominance is positively
related to directive therapist verbalizations, and negatively
related to non-directive statements.
Another possibility is that of an observer set or
bias to see the therapist as the crucial determinant in the
therapeutic relationship, as suggested earlier in the open
ing paragraphs of this discussion. If one looks only at the
levels of probability of the findings summarized in Tables 2
and 3, regardless of the particular findings themselves, it
is clear that the internal variance, and consequently, the
error terms in the therapist measure (Table 2) are smaller.
This gives rise, in part, to higher probability levels (.01
versus .25) for the findings reported. This smaller varia
tion in the therapist data may reflect a tendency on the
part of the observers to attend primarily to the therapist,
and neglect the client and his role in determining the
course of the relationship. In this regard, the reader will
recall that the same observers were observing both therapist
and client behaviors simultaneously. The tendency to see


INTRODUCTION
The psychotherapeutic relationship, as referred to
in this paper, consists of the highly personal interaction
between two people who have been brought together specifi
cally to aid and enhance one of them. In the process of
being together and discussing very personal and meaningful
things, they may come to affect each other's behavior
they become for each other significant stimuli, eliciting
from each other behaviors that hopefully will become pre
dictable and controllable. The primary focus of therapy
is the behavioral changes demonstrated by the person seek
ing help, but since these changes derive from occurrences
within the context of the relationship, they cannot be
understood or controlled without due regard for the behav
ior of the other member of the therapeutic encounter.
Consequently, a recent trend in psychotherapy research has
been to avoid the isolated study of techniques, diagnostic
categories and particular problems, and to move toward
multifactor experiments which can simultaneously examine
various combinations within the context of the relation
ship.
This general conception of the therapeutic encounter
is analogous to the statistical notion of interaction
1


10
therapist-technique unit, in order to see to which unit
various subjects would best respond. This is consistent
with suggestions made by Ford (1956), Snyder (1957) and
others, who feel that the therapist and his method must be
viewed as a single unit.
In addition, the Ashby et al. study failed to take
into account the reciprocal effects of the various clients
on the therapists and their styles. By including an analogue
of therapist leadership for the clientnamely the clients
level of general authoritarianismthe present study has
remained truer to the interactional model described above.
As already mentioned, client dogmatism is seen as a
reflection of the clients typical ways of responding to
authority. It is in this sense that it has been used in
the present study as an analogue to therapist leadership.
By so doing, it was hoped that opposite sides of the same
central issue would be tapped, and thus give free expression
to whatever reciprocal effects might exist.
The use of the authoritarian dimension also has its
precedents in the field of therapy research. When this con
cept was originally popularized in 1950 by Adorno et al. it
first caught the attention of those doing research in social
psychology and personality development. More recently, those
working in the clinical aspects of psychology have begun to
use this dimension. For instance, Jones (1962) found that


52
likely that this finding is best explained in terms of the
discussion above concerning the level of involvement. When
the subject first learned that he would have to bring in a
problem, it is likely that he gave considerable thought to
such a problem. Such atypical focusing may well have
increased his awareness and concern. At the conclusion of
the treatment session, with its feeling of closure, the
problem was probably restored to its former level of aware
ness. In the ensuing week, many events, both positive and
negative, may be assumed to have beset the subject. When
he was again asked to rate this problem, one week later,
it is not surprising that he tended, with considerable
variation across subjects (possibly due to differing degrees
of involvement), to see his problem as less serious.
Such considerations aside, it is interesting to
consider the import of the finding as it stands. As already
mentioned, it supports rather well the model proposed for
the therapeutic relationship. In addition, it extends the
data on the client-therapist system from process measures
to outcome measures in a consistent way. Thirdly, it spells
out the nature of this relationship in two fairly broad
dimensions, and indicates what combination of dimensions
will probably lead to the most favorable results, in terms
of client perceptions or purely subjective ratings. This
would seem to be an important finding vis vis the train
ing of therapists and also, the selection of therapists


38
The second analysis performed in testing Hypothe
sis I was on the proportion of observed solution offering
responses by the subjects. The format of this analysis was
identical to the precedingonly the content of the obser
vations differed. Table 3 presents a summary of this anal
ysis.
Table 3
Analysis of variance for client solution offering
Source Sum of
Squares
df
Mean Square
F
Between
4.16
23
Therapy
.50
1
.50
2.78*
Dogmatism
.04
1
.04

Therapy X Dogmatism
.05
1
.05

Error
3.57
20
.18
Within
1.33
24
Observers
.03
1
.03

Therapy X Observers
.11
1
.11
2.20*
Dogmatism X Observers
Therapy X Dogmatism X
.02
1
.02
2.80*
Observers
.14
1
.14
Error
1.03
20
.05
* p < .25
Here too, the predicted therapy X dogmatism inter
action failed to appear. It must be noted also, that those
findings which appeared were not significant. Once again
there is a therapy effect with the leading therapy condition
associated with the lowest proportion of solution offering
on the part of the clients. (See Appendix P for complete
table of total proportions of solution offering by clients.)


31
to how valuable the session had been, immediately after
seeing each subject.


64
the therapist as more "pote: v" is probably fostered by
training programs in clinical psychology, in which both
these observers were enrolled. Future research might use
much more experienced observers, or totally naive ones,
in order to achieve enough distance from the observed ther
apists, and ensure greater objectivity in the observations.
A number of interesting, albeit very tentative
trends emerged from an examination of the subjective data
collected from the subjects and therapists. The reader
will recall that there was some tendency for high dogmatic
subjects to like the leading therapist more than other
groups liked their respective therapist. This was also true
of the following therapist and the low dogmatic group. It
would seem that the personality characteristics associated
with either high or low dogmatism scores in part determined
the subject's reaction to his counselor. Ironically, the
following therapist showed a slight preference for the high
dogmatic group. However, this may well be a function of the
experimental restrictions placed upon him, for it will be
recalled that this therapist was most stressed by the exper
imental situation when he was called upon to be a follower
with a reticent, low dogmatic client. Not so easily explain
able is the tendency for both leading and following thera
pists to see as not at all valuable sessions with high and
low dogmatic clients, respectivelythe very groups that
reported in higher percentages a liking for their therapists.


14
at both the theoretical and practical levels, the applica
bility of the design.
A most important contribution to the field of psycho
therapy within the last decade has been Thomas Szasz' sug
gestion of a "problems in living" approach to psychotherapy.
Szasz tells us (I960, 1961) that the old notion of mental
illness has outlived whatever usefulness it may have had.
It is time to recognize that maladjustment is defined in
social, legal and statistical terms, and the treatment of
it by medical means alone is misleading and ineffective.
The logical solution, according to Szasz point of view,
is to re-orient our thinking in terms of a "problems in
living" paradigm, and abandon the outdated myth of mental
illness. This view is consistent with the present author's,
and is intrinsic to the design of this research.
An excellent paper by Guemey and Stollak (1965)
concerns itself with the application of a "problems in liv
ing" approach to psychotherapy research. They begin by
summarizing the rationale of the approach:
All individuals have intra- and interpersonal
problems. . Such problems are dynamic and
changing rather than structurally fixed and
static. . All of us are continually
engaged in the process of solving intra- and
interpersonal problems. . There is no hard
and fast line separating neurotic from normal.
Rather, there are patterns of more or less
success in solving these problems. . The
person usually regarded as neurotic may be
viewed as someone who habitually solves a great
many such problems somewhat less well than will


DISCUSSION
This research explored, in several different ways,
what Moos and Ciernes (1967) have called the "patient-
therapist system." Hypotheses concerning both process and
outcome measures were generated from a point of view about
psychotherapy and counseling which might well be labeled
interactionary. This view, which is more fully developed
in the introduction to this paper, has as its major assump
tions the following: Both the process and ultimate outcome
of therapy are dependent upon the therapist, the client and
the emergent behaviors induced by the interaction between
these two; Client and therapist behaviors, in the process
of therapy, and their attitudes toward the outcome of ther
apy, will vary as a function of particular therapist-client
combinations; Therapist leadership, and its analogue, the
client's typical ways of relating to authority, are crucial
components of the therapeutic relationship because of the
conditions under which clients typically seek such an
encounter, i.e., when they are in distress and need "expert"
advice and help.
The results of this study confirm certain of the
hypotheses derived from these assumptions and fail to con
firm others. The non-confirmingdata tend, at this point,
47


28
approximately equal experienceone was working at the
internship level in counseling psychology; the other was
at the practicum level, but with one year's professional
experience in a counselling position.
In the leading treatment (LT) group, the therapist
discussed the client's problem with him as if he (the
therapist) were an expert and authority on such problem
solving. He offered suggestions, gave advice, reassured,
admonished, gave praise when he felt the client deserving
of it, etc. The techniques he used may well be described
as "directive." This situation has been described by Ashby
et al. (1957) as:
. . [being] composed of directive leads,
interpretations, directive structuring,
approval, encouragement, suggestion, advice,
information giving, and persuasion. . .
The therapist attempts to create a warm,
accepting, understanding non-critical psycho
logical atmosphere; to contrast the client's
report of his situation and difficulties with
an objective reality as the therapist deduces
it....
On the other hand, no such representation as authority was
offered in the following treatment (FT) groupthe thera
pist was friendly, supportive, neutral, accepting of what
ever suggestions or behavior was given by the client, etc.
The techniques relied upon here for conducting the inter-

view would be aptly described as "non-directive" or "reflec
tive." The above authors describe this situation as fol
lows:


26
attitudes were .897 for self acceptance, and .727 for
acceptance of others. The scale is also discussed by-
Shaw and Wright (1967), who laud its rather thorough
standardization.
Proceduhe
After the potential subjects had been selected by-
means of the Dogmatism Scale, they were contacted by
telephone, and asked if they would like to participate
in the study. Each was told that he would be required
to come into the counseling center with a personal prob
lem that he might be asked to discuss with a professional
person, that he would be asked to evaluate this problem
on some questionnaires, and that the total procedure would
require two sessions. (See Appendix A for complete instruc
tions to the subjects.) When the subjects arrived at the
counseling center, they were met individually by the author
and given the PPPS and the AACL to fill out. They were
then brought in to see one of the two therapists or the
control group interviewer, according to the group to which
they had been previously assigned. An equal number (five)
of both high and low dogmatic subjects had been randomly
assigned to the three experimental groups (leading, fol
lowing and no-therapy control) before this first session.
Immediately following the one-half hour-interview, the
subjects were again given the PPPS and AACL by the author.