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A personal construct assessment of structural family therapy training

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A personal construct assessment of structural family therapy training
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Family structure ( jstor )
Family therapy ( jstor )
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Dissertations, Academic -- Psychology -- UF
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Thesis (Ph. D.)--University of Florida, 1985.
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Includes bibliographical references (leaves 149-156).
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Also available online.
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Typescript.
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Vita.
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by Flora Zaken-Greenberg.

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A PERSONAL CONSTRUCT ASSESSMENT OF STRUCTURAL FAMILY THERAPY TRAINING






BY






FLORA ZAKEN-GREENBERG
















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


UNIVERSITY OF FLORIDA 1985


























Copyright 1985

by

Flora Zaken-Greenberg















ACKNOWLEDGMENTS



I would like to take this opportunity to acknowledge and thank those individuals who have given their encouragement and guidance throughout the completion of my dissertation. Drs. Harry Grater and Greg Neimeyer, the chairpersons of my committee, have guided and directed this work from its inception to its completion. They have both been invaluable as sounding boards, as well as being my friends. Harry and Greg's commitments to excellence and professionalism have been important models during my years as a graduate student. Their enthusiasm and flexibility in support of my basic ideas, and cooperation over the many years and miles are greatly appreciated. I would also like to thank the members of my committee, Bill Froming, Carolyn Tucker, and Robert Jester, for their effort and insightful suggestions. I have enjoyed and profited from being a student in their respective courses and seminars. It has been my pleasure to know these outstanding individuals personally and professionally.

I would also like to thank all the people who were an integral part of this dissertation. Drs. Peggy Fong, Mary Fukuyama, Max Parker, Ellen Amatea, Robert Myrick and Harry Grater allowed me to utilize their classrooms to solicit subjects. Drs. Herb Steier and Andres Nazario gave their time and energy on short notice in the aid


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of refining the stimulus materials. Florence Roess and Ces Bibby

were invaluable in coordinating subjects, experimenters, testing rooms and preparation of all dissertation stimulus materials. I would especially like to thank all the undergraduate research

assistants who gave long hours and were involved in all technical aspects of this study. Susan Lerner, April Metzler, Marc Levant, Mark Kaplan, Regina Davis, Gloria Pinzon, Joni Congdon and Jesus Llobet were invaluable aids to this project as well as good friends. Anita Moreles, Michele Majorek and Chere Ruquist also gave much of their time to this project.

I would like to give a very special acknowledgment to my husband Michael, for his constant love and support, and the many sacrifices he has made in his own career so that I may pursue mine. Throughout

his own graduate work, he has always ungrudingly found the time to give me many hours of technical and professional help on the various

aspects of this project. He has been the single greatest support in my work and in my life, and I am happy to be able to share this time with him. I would also like to thank my parents, Shirley and David Zaken, for their unconditional faith and support throughout my life

and the long years of my graduate career.













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TABLE OF CONTENTS


Page

ACKNOWLEDGMENTS ................................................. iii

ABSTRACT ........................................................ vii

CHAPTERS

ONE INTRODUCTION .......................................... 1

Commonalities and Differences in Family Therapy
Training ............................................ 3
Outcome Studies in Family Therapy Training ............ 9
The Present Study .................................... 10

TWO LITERATURE REVIEW .................................... 14

Family Therapy Training .............................. 14
Descriptive Studies ............................. 14
Empirical Studies ............................... 18
Personal Construct Theory ............................ 25
Personal Construct Psychology and Training Studies...29 The Present Study .................................... 34
Hypotheses ........................................... 35

THREE METHODOLOGY .......................................... 38

Subjects ............................................. 38
Instruments .......................................... 39
Family Experience Inventory ..................... 39
Family Repertory Grid ........................... 40
Therapist Responses to Simulated Family Tapes ... 45 Case Conceptualizations ............... 50
Procedure ............................................ 52
Design and Analyses ... o .............. o ............... 55
Structural Grid Analyses ........................ 56
Content Grid Measures .................. o ... o .... 56
Case Conceptualization Analyses ................. 57
Therapist Response Analyses ... o ........ oo- .... 57





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FOUR RESULTS .............................................. 60

Structural Grid Analyses ............................. 60
Content Grid Analyses ................................ 63
Case Conceptualization Analyses...' 63
Family Conceptualization Analyses ............... 63
Family Intervention Analyses .................... 64
Therapist Response Analyses .......................... 64
Within Category Analyses ........................ 64
Between Category Analyses ....................... 66

FIVE DISCUSSION ........................................... 68

Perceptual Skills and Cognitive Complexity ........... 70
Perceptual Skills and Level of Construct
Abstraction ........................................ 75
Conceptual Skills and Case Conceptualizations ........ 76 Executive Skills and Therapist Responses ............. 78
Executive Skills Within Category ................ 80
Executive Skills Across Category ................ 83
Summary .............................................. 84
Future Considerations ................................ 87

APPENDICES

A FAMILY THERAPY COURSE DESCRIPTION .................... 92

B FAMILY THERAPY EXPERIENCE INVENTORY .................. 96

C FAMILY REPERTORY GRID ................................ 98

D GRID CONTENT CODING INSTRUCTIONS ..................... 99

E GRID CONTENT EXAMPLES ............................... 101

F FAMILY A DYNAMICS SEEN BY ACTORS .................... 102

G FAMILY B DYNAMICS SEEN BY ACTORS .................... 107

H THERAPIST RESPONSE CODING SYSTEM .................... Ill

I THERAPIST RESPONSE ALTERNATIVES: FA14ILY A .......... 112

i THERAPIST RESPONSE ALTERNATIVES: FAMILY B .......... 119

K THERAPIST RESPONSES ANSWER SHEET .................... 126

L CASE CONCEPTUALIZATION QUESTIONS: FAMILY A ......... 135

M CASE CONCEPTUALIZATION QUESTIONS: FAMILY B ......... 139



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N INFORMED CONSENT FOR FAMILY THERAPIST'S PROJECT ..... 143

0 FAMILY A DYNAMICS SEEN BY SUBJECTS .................. 144

P FAMILY B DYNAMICS SEEN BY SUBJECTS .................. 145

Q CASE CONCEPTUALIZATION ANSWER SHEET ................. 146

R FAMILY REP TEST INSTRUCTIONS ........................ 147

REFERENCES ...................................................... 149

BIOGRAPHICAL SKETCH ............................................. 157







































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Abstract of Dissertation Presented to the Graduate School of the University of Florida in Partial Fulfillment of the
Requirements for the Degree of Doctor of Philosophy A PERSONAL CONSTRUCT ASSESSMENT OF STRUCTURAL FAMILY THERAPY TRAINING BY

FLORA ZAKEN-GREENBERG

August, 1985


Chairman: Dr. Harry Grater
Cochairman: Dr. Greg J. Neimeyer Major Department: Psychology



The investigation of the effects of training in family therapy is a new and relatively uncharted area of inquiry. There are only

two studies cited in the literature that begin to approach the experimental rigor and control necessary to explore the impact of family therapy training on therapy skills. The present investigation

attempted to control for the lack of experimental control and objective measures of family therapy skills that continue to be

reported in the literature.

Based upon the distinction among therapy skills cited in the

literature, the present study investigated perceptual, conceptual and executive skills associated with effective family therapy. Perceptual skills were measured using a modified version of the Role Repertory Grid, yielding measures of the structure and content of


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individuals' personal cognitive systems. It was predicted that the structural complexity and level of abstraction in the family construct system would increase as a function of family therapy training.

Conceptual and executive skills were measured by analyzing

trainees' multiple choice responses to simulated family therapy tapes. It was predicted that the family therapy trainees would show increases in level of systemic conceptualization and therapist response sophistication over the course of training.

Results of the 2 x 2 Analyses of Variance on the pre-post scores for both family and nonfamily therapy trainees provided equivocal support for the predictions of increased complexity in family therapy trainee skills. The analyses revealed significantly decreased levels of differentiation in perceptual skills for family therapy trainees

and significantly increased levels of differentiation for the nonfamily therapy trainees, and no significant changes between groups for conceptual or executive skills.

These results suggest that family therapy skills may be

developmentally dependent upon each other such that higher level conceptual and executive skills cannot develop until lower level

perceptual skills have been adequately developed and consolidated. The results of this study were also discussed in relation to the unique contribution of family therapy training on therapy skills, and

future directions were suggested.






ix















CHAPTER I
INTRODUCTION



The past decade has witnessed the growing demand for clinical

and counseling psychology programs, professional psychology programs,

and specialized training programs for mental health and post-doctoral professionals. Foremost among these is the demand for training in family therapy which has resulted in the growth of a variety of family therapy training programs. Despite this increasing demand, there has been a dearth of research investigating important variables in the training of family therapists (Woody & Weber, 1984).

The task of investigating the impact of training on potential

family therapists is an ambitious one. The investigator must decide

what type of program to investigate, what theoretical orientation within the family therapy field to explore, and then, how to go about isolating the critical variables involved in order that general statements about training can be made. According to Tucker and Pinsof (1984), this task is made even more difficult due to the complexity of measuring conceptual, experiential, and behavioral learning in a stimulus situation that is never duplicated. In addition to the problem of not having a standard stimulus, the family therapy field has also lacked the necessary instruments to measure conceptual and behavioral skills (Gurman & Kniskern, 1978).



1





2




The present investigation focuses on training in structural

family therapy. As in all forms of therapy, the structural family therapist relies on his powers of observation when assessing a family's functioning. The distinguishing feature of structural family therapy, however, involves the active participant observation of the therapist. The focus of intervention according to the structural model is the patterns of structural relatedness occurring within the family system (White, 1979). The therapist's task is to discover the dysfunctional structure existing within the family and to design interventions to alter that structure. Structure is examined in terms of power hierarchy, coalitions, alliances,

individual and subsystem boundary regulation, and the family's flexibility for change (Minuchin, 1974). In order to observe these patterns, the structural family therapist must find a way to get the

family to demonstrate their patterns of behavior, and this is where the techniques of the therapy are first utilized. Once the therapist

has operationalized where in the structure the system fails to carry out its functions, the goals of therapy are to solve problems through changing the underlying systemic structure of the family.

The present study will adopt a personal construct approach to the study of training in structural family therapy. Personal construct psychology is a theoretical and empirical approach to the study of personality and interpersonal relationships. The personal construct methodology can provide the needed empirical rigor, which has been lacking in prior studies of family therapy training, and can

bridge the gap between the relatively uncharted area of family





3




therapy training and more established approaches to personality, counseling and interpersonal relationships.

Researchers in the field of family therapy have recently begun

to report some descriptive studies of training, typically ending with a discussion of the need for empirical research in this area. Before discussing the findings of the current literature on family therapy training, the reader needs to be acquainted with the programs currently available, the-goals of family therapy, and how those goals are translated into training and assessment. Further, the components of family therapy training that extend across the various schools of thought will be reviewed. In addition, a brief discussion of the outcome literature will be presented, followed by a rationale for the adoption of a Personal Construct Psychology approach to the study of training in family therapy.


Commonalities and Differences in Family Therapy Training


In a national survey of training programs in family therapy, Bloch and Weiss (1981) reported a growing and varied assortment of programs. In addition to the diversity of programs available, they

also discovered that the establishment of family therapy training programs has grown exponentially between 1942 and 1980. Levant (1984) has suggested that these training programs may be divided into two major groups. The first group involves training that is offered as part of the overall training program of one of the various mental health or human-service professions. The second group involves programs that are specifically designed to train family therapists.





4




According to Kniskern and Gurman (1979), these training models differ on three major dimensions. The first dimension involves whether or not the training leads to a degree or certificate in family therapy. Second, is family therapy the only form of therapy taught

at a given training center or does the program require some experience with individual and group therapy? Third, training programs vary as to the extent of previous experience in psychotherapy that is required for admission.

In order to evaluate family therapy training, investigators must specify what type of program is under study as well as how that program defines family therapy. Kniskern and Gurman (1979) argue

that the meaning which one attaches to the term family therapy will directly affect the way in which one trains family therapists and evaluates that training. These authors suggest that a training program that views family therapy as a technique will focus primarily on the acquisition of technical skill, and as such, the acquisition of specific technical skills will be viewed as the most appropriate criterion of the success of the training program (e.g., behavioral and communications approaches). However, if family therapy is viewed

as a conceptual approach to the understanding of behavior and behavioral pathology, Kniskern and Gurman (1979) argue that the training program will view the acquisition of specific intervention

techniques as a secondary goal (e.g., existential and strategic approaches) Thus, before general statements about the effectiveness of family therapy training can be made, differences between the goals










and methods of different training programs must be taken into consideration.

Although there exists a diversity of theoretical orientations

and training programs in family therapy, several investigators (e.g., Bloch & Weiss, 1981; Woody & Weber, 1984) have suggested that there

are several important basic concepts that are inherent to all training programs irrespective of the setting, experience of the student, and theoretical preferences of the trainers. Regardless of

the theoretical orientation, family therapy focuses on the interrelationships of the family members. Each theory provides guidelines for the therapist to assess and develop treatment

interventions that are intended to create systemic changes among the family members (Woody & Weber, 1984).

Many family therapists (e.g., Okun & Rappaport, 1980; Sedgwick,

1981; Stanton & Todd, 1979; Woody & Weber, 1984) agree that students need to learn to assess the family from a developmental model that considers the progression of the family through family life stages.

Since each stage of the family life cycle requires that specific tasks be successfully accomplished before the family can progress

into the next stage, failure on the part of the family to perform the tasks can result in becoming fixated, resulting in dysfunctional behavior. Family therapy trainees need to learn to consider the family's current level of functioning in relation to their life stages.

A third major point that family therapists agree upon is the emphasis on the individuation processes of the family members as a





6




primary task for the family to accomplish. If a family is unable to foster this individuation process, an individual's symptoms and problems may be reflective of family stress, conflict, or the internalization of other family breakdowns. Further, the less effective the family, the more limited the family will be in its capacity to facilitate the individuation process. The student

requires training that focuses on learning to accurately assess and develop goals for the family that will alter the family system and promote the individuation process.

Most importantly, family therapies are problem focused. The family therapist must be skilled in assessing the function of the problem for the family and the family system's response to it (e.g., enmeshed or disengaged relations, regression, rigidity, or internalization).

Although the differing family therapy orientations agree on

these four points, the conceptual orientation of the curriculum will influence how the problem resolution will be obtained. While some theories, such as problem-solving, learning, behavioral, and communication emphasize learning problem-solving skills as a major objective, other theories, such as structural and strategic approaches, use indirect, manipulative, and metacommunicative interventions to induce change for problem resolution (Woody & Weber, 1984). How these goals of therapy are translated into training remains unclear. Empirical research that investigates the process of change as well as the outcome of training may be able to overcome the

dilemma of differing programs and theoretical orientations, and





7




answer the question of what impact training has on family therapy trainees.
.Regardless of the type of training program involved, there are certain components of family therapy training that extend across the various schools of thought. All therapy training programs, including family programs, utilize four primary methods for training: didactic, supervisory, observational, and experiential. Since the field of family therapy is relatively new, most training programs

require their trainees to read a variety of sources that reflect the diversity of family therapy. However, there are also training

programs that concentrate on the work of a single well known therapist and school of thought. Kniskern and Gurman (1979) suggest that although programs with a single, integrated approach to family therapy lessens the confusion that results from sampling readings from the various schools of thought, these programs may run the risk of producing less creative and flexible therapists. In agreement with Kniskern and Gurman's argument, the present study will

investigate the training process that occurs within a program that places a major emphasis on structural family therapy (e.g., Minuchin), while also incorporating other schools of thought such as strategic (e.g., Haley), communications (e.g., Satir), and experiential (e.g., Whitaker).

The second mode of training involves supervision of the

trainees. Most family therapy trainers agree (Kniskern & Gurman, 1979; Liddle & Haiprin, 1978) that the primary teaching of family therapy occurs in supervision. However, the techniques of





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supervision vary from a focus almost exclusively on the problems of

the family being treated to a focus almost entirely on the trainee independent of the family being treated, to the therapist's relationship with the family. Thus, the techniques utilized by the supervisor, as well as his or her style of supervision, are

influenced by both the theoretical and therapeutic orientation (Kniskern & Gurman, 1979). For example, a directive and problemoriented therapist would probably supervise in a direct, problemoriented way, while a process-oriented therapist would be more concerned with the personal growth of the trainee. Although no study

has investigated this impact of training, Kniskern and Gurman (1979) suggest that such stylistic differences in supervision will tend to result in differences in therapeutic style by the trainees. Thus, when interpreting shifts across training, it is necessary to keep the supervision style in mind. The supervision style utilized in the present study is based on a structural problem-solving approach to family therapy.

The observational component involves having the trainees view tapes of family therapists in action, viewing in vivo family therapy sessions through a one-way mirror, and viewing role-play interviews of other family therapy trainees. As with the supervision style,

what is observed is influenced by the style and theoretical orientation of the trainer.

The fourth mode of therapy training is classified as

experiential. Experiential methods may involve role-playing, participating in a simulated family, or actually working with a






9




clinical family. In the present study, trainees participate in roleplaying interview sessions with simulated families, and work with a clinical family throughout their second semester of training.

Although these training components extend across the various schools of thought, each program utilizes them in a different way.

Thus, it becomes necessary to concentrate on the processes of change involved in training rather than simply on which modes of training are effective, or which school of therapy produces more effective family therapists. Further, when attempting to generalize across the various theoretical orientations through the commonalities in

training methods, it is important to clarify and operationalize the structure and content of the program. Without this specificity, it will be impossible to account for discrepant findings, or even to integrate findings among the different schools of thought.


Outcome Studies in Family Therapy Training


Although there recently has been an emphasis placed on the need for process-outcome investigations (Gurman & Kniskern, 1981), there have been only a handful of empirical studies of family therapy training (e.g., Allred & Kersey, 1977; Breunlin, Schwartz, Krause & Selby, 1983; Byles, Bishop & Horn, 1983; Friedman, 1971; Lange, 1978; Lewis, 1977; Pinsof, 1977; Tomm, 1980; Tucker & Pinsof, 1984), or even descriptive analyses of training in family therapy (e.g., Ferber, 1972; Flint & Rioch, 1963; Flomenhaft & Carter, 1974; 1977; Nichols, 1979). In an extensive review of the literature on structural family therapy, Aponte and Van Deusen (1981) cite only





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four studies designed to address issues related to training structural family therapists. Three of these (Betof, 1977; Flomenhaft & Carter, 1974; 1977) described results of uncontrolled post-hoc evaluations of training programs. The fourth (Kaplan, Rosman, Liebman & Honig, 1977) represented a multi-method assessment of a one year training program within the context of a small sample (20 trainees and 5 controls). These studies only begin to redress a

long-standing inattention to the empirical assessment of family therapy training programs. Another major difficulty encountered in this area of research is the lack of sensitive instruments for measuring change in therapist skills (Gurman, 1983). Therefore, the dearth of process-outcome studies and lack of a methodology sensitive enough to detect changes in the skills of family therapists support Gurman and Kniskern's recent conclusion that "we must acknowledge and underline the field's collective empirical ignorance about this domain" (1981, p. 772).


The Present Study


The theory and methodology underlying the present study is

adopted from Kelly's (1955) personal construct psychology. Personal construct theory was initially developed as a conceptual approach to the study of personality, psychopathology and psychotherapy. This theory has generated a wide body of empirical research and has recently reemerged as an important contribution to the study of human behaviors (e.g., Bannister, 1981; Bannister & Fransella, 1955; R.A. Neimeyer, 1985; Neimeyer, Klein, Gurman & Griest, 1983; Neimeyer &










Neimeyer, 1981). This theory has also been applied to various training contexts, including training in social work (e.g., Lifshitz, 1974), education (e.g., Ryle & Breen, 1974) and marriage and family therapy (e.g., Lewis, 1977; G.J. Neimeyer, 1985; Neimeyer & Hudson, 1984; Procter, 1981).

According to personal construct theory, individuals operate as personal scientists" whose aim is to render experience meaningful;

to better understand, predict and control the events with which they are confronted. After repeated experience with a particular type of event, an individual abstracts salient commonalities and characteristics of these situations. The abstracted features are meaningful only in relation to their opposites. For example, after several family therapy sessions, a family therapist may come to see certain families as enmeshed, a quality meaningful insofar as it contrasts with being disengaged. This personal dimension, or construct of "enmeshed-disengaged" serves as a continuum along which events (i.e., families) can be ordered, thereby lending structure and meaning to the family therapy experience. Taken together, many such

dimensions form the construct system, a unique conceptual template for ordering and anticipating experience.

Importantly, this system of dimensions is ordered (Organization Corollary, Kelly, 1955) and undergoes characteristic shifts over the course of personal and professional development (see Crockett, 1982, for a review). In particular, following Werner (1955), it can be

assumed that construct systems develop from a stage of globality to particularity; that is, moving from simple to complex levels of





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cognitive differentiation over the course of continued experience. In general, this reasoning is consistent with Bieri's definition of complexity as "the tendency to construe social behavior in a multidimensional way such that a cognitively complex individual has available a more versatile system for perceiving the behavior of others than does a less complex person" (1955, p. 14). Following from this definition, subsequent work has noted predicted changes in cognitive complexity over the course of professional development.

For example, two studies have reported a curvilinear relationship between cognitive complexity and level of training for teachers (Runkel & Damrin, 1961) and social workers (Ryle & Breen, 1974). Training seemed to first restrict, and then to enlarge, the subjects' cognitive systems. Subsequent work has addressed the relationship between this level of cognitive complexity and therapeutic decision making among a group of social work students (Duehn & Procter, 1974). These investigators reported that the more complex students

specified a greater number of alternative therapeutic interventions, suggesting that greater complexity may be associated with greater flexibility in responding.

In addition to structural changes in cognitive complexity

associated with training, shifts in the content of the constructs are also predictable from personal construct theory. For example, Lifshitz (1974) compared the content of social work students' constructs with those of their supervisors. Results indicated that students used more concrete descriptions (e.g., age, sex, profession)





13




while their supervisors used more abstract dimensions (e.g., diligent, responsible).

Thus, the use of personal construct methodology lends itself well to the study of a variety of training methods. Extending this personal construct training literature to the training of family therapists suggests several lines of inquiry. These concern both

structural and qualitative changes in trainees' conceptual and clinical abilities as they gain exposure to, and practice with, a structural-systemic approach to family treatment.

First, based on the systems approach of structural family therapy, shifts are expected in the direction of greater use of systemic dimensions for the trainees (e.g., focusing on family interactions versus an individual focus), as well as shifts in the direction of greater overall complexity in the family construct systems of family therapy trainees (e.g., increases in the number of

constructs used and the interrelationships between those constructs) relative to a comparable control group. In addition, it is predicted that there will be similar shifts towards more complex and systemically oriented case conceptualization skills in the trainees, and more effective and systemically oriented therapist responses in trainees than in control subjects.
















CHAPTER II

LITERATURE REVIEW


Family Therapy Training


Descriptive Studies


Although there is little empirical evidence for the

effectiveness of family therapy training, there is some research concerning the specific therapist factors that influence the outcome of family therapy (e.g., Epstein, Sigal & Rakoff, 1968; Thomlinson, 1974; Tomm & Wright, 1979). Thus, the identification of those

factors that may be taught in training provide indirect support for the potential effectiveness of family therapy training programs. In an extensive review of the family therapy research literature, Gurman and Kniskern (1978) reported therapy structuring skills, experience

level, and relationship skills as the three most important factors that influence the outcome of family therapy. Obviously, experience level is not able to be taught in a training program; however, both therapy structuring skills and relationship skills may be focused on in training. Structuring skills have been investigated by several researchers (Alexander, Barton, Schiavo & Parsons, 1976; Epstein et al., 1968; Sigal, Guttman, Chagoya & Lasry, 1973). Based on thlis research, structuring skills of the therapist have been divided into

directiveness, clarity, self-confidence, information gathering, and


14










stimulating interaction. Further, Gurman and Kniskern (1978) have argued that the family therapist must generally be active and provide early structure without assaulting family defenses too soon.

In addition, the -ability of a family therapist to establish a

positive relationship with the family has received consistent support as the most important outcome-related therapist factor. Several investigators (Shapiro, 1974; Shapiro & Budman, 1973; Waxenburg,

1973) have reported that therapist empathy, warmth, and genuineness appear to be very important in keeping families in treatment beyond the first interview. In an impressive investigation of relationship

skills, Alexander et al. (1976) reported that while structuring skills discriminated between two levels of poor outcome, only relationship skills were able to discriminate between good and very good outcomes. They reported that these factors were related to positive outcome regardless of the theoretical orientation of the therapist. However, these are the same skills that have been found to be critical for the process of effective psychotherapy in general. Thus, research in family therapy training needs to identify and confirm the effectiveness of those variables specific to family therapy in order to conclude that this training is any more effective than traditional training in psychotherapy.

However, the goals of training and supervision and the skills of

the supervisor are dependent upon the theoretical orientation of the particular training program involved. The experientially oriented (Constantine, 1976; Ferber & Mendelsohn, 1969; Luthman & Kirschenbaum, 1974) and psychodynamically based programs (Ackerman,





16




1973; La Perriere, 1977) tend to emphasize the personal growth aspects of training and the affective experiences of the trainees.

For example, two studies which attempted to isolate changes in psychiatric residents undergoing psychodynamic family therapy training were based on trainee self-reports (Flint & Rioch, 1963; Schopler, Fox & Cochrane, 1967). Based on these self-reports, both

investigators concluded that the trainees gained increased awareness and appreciation for family dynamics. However, as Orlinsky and Howard (1978) point out, self-report is often unreliable due to the investment the individual has in perceiving change. In addition, since external judges were not employed and the variables being judged were often poorly defined, these results must be interpreted with caution. Self-report should not, however, be ignored, but should be reported in conjunction with more objective measures of change.

In those programs that operate more from structural (Minuchin, 1974), behavioral (Cleghorn & Levin, 1973), and strategic (Haley, 1976) therapeutic orientations, goals are more cognitively based and focus more on defining particular sets of therapist skills and ways of intervening into dysfunctional systems. The current trend in the family therapy training literature is in the direction of establishing operationally defined objectives and therapist competencies according to differing theoretical schools of thought (Garrigan & Bambrick, 1976).

Within the behavioral and structural schools, Cleghorn and Levin (1973) have been influential in proposing operational objectives for





17




the assessment of training in family therapy. According to their model, therapist skills may be classified into three groups: perceptual, conceptual, and executive. Perceptual skills refer to what the therapist observes in the therapy session, how the therapist

perceives interactions, and the meaning and effect of them on family members and the family system. Conceptual skills basically involve what the therapist thinks about in the therapy session and how those thoughts are organized. Cleghorn and Levin argue that in order to formulate a problem in terms of the family system, one must specify the implicit rules of behavior in the family that make sequences of family interactions predictable. In addition to the perceptual and conceptual skills required of the family therapist, he/she must also

develop skills that influence the family to demonstrate the way it functions. Cleghorn and Levin have labeled these skills as executive skills. Executive skills involve what the therapist says and does in the therapy session in order to influence the family's sequences of transactions and thus alter the way the family functions. The

present study will attempt to assess the process of change in these three skills delineated by Cleghorn and Levin (1973).

This descriptive model proposed by Cleghorn and Levin (1973) has yet to be empirically tested, although several articles on family therapy training have based their discussions on this model (e.g., Barton & Alexander, 1977; Woody & Weber, 1984). Although the current trend is to objectify the skills of family therapy trainees, the majority of the family therapy training literature continues to be based on an impressionistic perspective (Tomm, 1980). For example, a





18




review of the training literature revealed tnat studies either described training methods based on the clinical observations of the trainer (e.g., Aponte & Van Deusen, 1931; Beal, 1976; Ferber & Mendelsohn, 1969; Nichols, 1979), described the historical development of marital and family therapy training (e.g., Constantine, 1977; Nichols, 1979; Tucker, Hart, & Liddle, 1976), or provided a sociological comparison of supervision methods based on trainee self-reports (e.g., Tomm & Leahey, 1980). Thus, rigorous empirical investigations are required, including the addition of

appropriate control groups, adequate number of subjects, multiple objective measures, and operational ization of variables that are specific to family therapy.


Empirical Studies


A popular method of assessing trainees' knowledge of family therapy course content and theory involves paper and pencil tests such as multiple choice questions and essay questions (Friedman, 1971; Tomm, 1980). Friedman reported that mental health professionals significantly increased in factual and theoretical knowledge between pre- and posttraining tests. Similarly, Tomm

reported that first year medical students demonstrated significant increases in their knowledge of a Family Categories Scheme devised by Epstein and his associates following their training experiences (Epstein, Sigal & Rakoff, 1968). An additional method popular in the

family therapy training literature involves assessing changes in trainees' attitudes. Poelstra and Lange (1978) and Lange and





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Brinckman (1976) reported that trainees' attitudes shifted significantly towards acceptance of behavioral family therapy as a result of training in this model. In addition, Flomenhaft and Carter

(1974; 1977) reported that mental health professionals trained in family therapy reported a significant increase in the amount of time spent in family therapy over individual therapy. Although these findings suggest that training leads to an increased knowledge of

course content and an acceptance of new theoretical positions, these investigations actually offer little more than an assurance that professionals are capable of learning new concepts and are more favorably disposed to those concepts with increased familiarity.

Several studies have attempted to measure changes in the

conceptual and perceptual skills of family therapy trainees by having them respond to videotaped segments of family therapy sessions as if they were the therapists (e.g., Friedman, 1971; Lange & Brinckman, 1976; Lange & Zeegers, 1978; Tomm, 1980). In each of these studies, the trainees' responses were coded by independent judges using preselected coding schemes. The majority of these studies reported

significant increases in trainees' perceptual and conceptual skills.

A third method for evaluating the therapy skills of family therapy trainees is the family genogram measure proposed by Tom (1980). Using this method, trainees are required to determine the

level of family development and associated family developmental tasks from genograms that are provided to them. Tomm reported significant increases in both perceptual and conceptual skills based on the

Family Categories Schema (Epstein et al., 1968).





20




However, there are two major limitations of the empirical

research discussed so far. First, these research designs did not

include comparable control groups and thus any changes in the trainees may be attributable to factors other than the training program (e.g., spontaneous improvement, maturation, attention-placebo effects, Cook & Compbell, 1979). Second, the variables which have

been selected for evaluation measure whether or not trainees have assimilated the instructional material and not whether their therapeutic skills have been influenced by training. In addition, those studies that do assess therapeutic skills are not specific to family therapy, but may be generalized to any form of psychotherapy.

In a recent attempt to eliminate these two major limitations, namely, the lack of a comparable control group and the use of paper and pencil tests of increased knowledge of training, Breunlin et al. (1983) reported the development of an instrument designed to measure the perceptual, conceptual and executive skills of family therapists. This instrument consists of a videotape of an enacted family's first session and a series of multiple choice questions regarding the subjects' perceptions, conceptualizations and therapeutic recommendations about the tape. The experimental

subjects consisted of 22 psychiatric residents who were given one month of family therapy training, and the control subjects consisted

of 11 pediatric residents who were not given family therapy training or any formal training in psychotherapy. A pre-post assessment revealed a significant increase in conceptualization skills for only the family therapy trainees. However, there were no changes in





21




either perceptual or executive skills for either group. Breunlin et al. (1983) suggested that their instrument may not have been sensitive enough to detect change in skill level.

The study of Breunlin et al. (1983) represents a considerable advance over previous investigations; however, there are several flaws in their methodology that need to be addressed. First, the

simulated therapy tapes showed a therapist interacting with the family. It might be expected that viewing another therapist might influence the responses of the subjects, thus confounding the results. Further, the authors do not adequately describe how subjects' responses were coded, or along what dimension. Third, the actual construction of the tape is not adequately described. Four family therapists reviewed the tape and arrived at a consensus that it was representative of the structural -strategic model. Although this procedure may provide a high level of content validity, the reliability of this measure is open to question. Fourth, their control group was not comparable for level of therapeutic sophistication. It is logical to expect that psychiatric residents would show greater levels of conceptual skill concerning family therapy dynamics than a group of pediatric residents with no therapy training. Finally, prior to developing multiple choice responses to

the simulated tape, open-ended test responses were subjectively analyzed and determined to have substantially improved in both complexity of answers and correct application of training knowledge from pre- to posttest. Again, there was no mention of any objective coding system and thus the results may have been biased toward the





22



logical expectation that trainees' responses would become more complex after training.

More promising have been recent advances in the development of objective instruments to assess behavioral changes of family therapists. There have recently been two analysis systems developed that target therapist executive skills behavior (e.g., Allred & Kersey, 1977; Pinsof, 1977). Both of these measures have been shown

to demonstrate appropriately high levels of reliability and validity. Pinsof (1977) provided empirical evidence that the therapeutic verbal behavior of novice and advanced family therapists can be coded reliably and shown to be significantly different. At the present time, the Family Therapist Coding System (FTCS, Pinsof, 1977) is the only family therapist verbal coding instrument that has provided researchers with the ability to distinguish among trainees according to their training level (Tucker & Pinsof, 1984). However, there is a major limitation involved in the use of this measure. Due

to the complexity of the instrument, a considerable amount of practice administration is required in order to ensure reliable measurement and therefore the use of the FTCS is often prohibitive.

The second measure, the Allred Interactional Analysis for

Counsellors (AIAC, Allred & Kersey, 1977), has also been shown to differentiate among trainees' levels of training. Several studies have reported this measure of verbal behavior to be both highly reliable (Kersey, 1976; Sanders, 1974; Watson, 1975) and valid (Kersey, 1976; Sanders, 1974; Tripp, 1975; Watson, 1975). Compared





23




to the FTCS, the AIAC is much less complex and produces reliable results after a short period of coding practice.

This measure has recently been used to compare the executive skills of family therapy trainees with those of nonfamily therapy trainees. Zaken-Greenberg and Neimeyer (1934) investigated the executive skills of family therapy trainees and comparable controls in a pre-post design using a modified version of the AIAC. Subjects

were required to observe videotapes of a simulated family therapy session and instructed to assume the role of the primary therapist. At different intervals, a family member looked into the camera and asked the therapist (i.e., the subjects) a question to which the

subject was to respond to in writing. Each response was rated by two independent judges on a modified version of the AIAC. The original categories were broken down into more refined and mutually exclusive categories ordered along a dimension from obstructive responses through levels of functional family therapy responses (e.g., relationship building, structural realignment). An overall average of response level was obtained.

The results of this investigation revealed that family therapy trainees responded with significantly more structural maneuvering techniques than did the control subjects at posttest. In addition, the family therapy trainees' use of these responses increased significantly from pre- to posttest with no change indicated for the control group. Zaken-Greenberg and Neimeyer (1984) suggested that the structural training emphasis on behavioral manipulation of the





24



family influenced the way in which trainees revised their executive skills when responding to a family.

A major problem with this approach is the unreliability

contributed by the judges. This approach is also weakened by the difficulty in scoring and the lack of standardization. As Breunlin et al. (1983) point out, a multiple choice format in which subjects

choose an alternative in response to a simulated videotape constitutes a reasonable compromise in that it can reliably measure therapist skills within a standardized and easily scramble methodology. The present study will use a Breunlin et al. (1983) paradigm, combined with a modified version of the AIAC, to assess and compare the executive skills of family therapy trainees and individual therapy trainees.

After reviewing this literature, it becomes clear that the

research in family therapy training is only beginning to contribute a firm empirical grounding for the exploration and assessment of the effectiveness of family therapy training. In order to provide a

comprehensive literature capable of integrating the disparate findings, there needs to be a unified methodology that allows for comparison across the different established training programs as well as across the varying theoretical orientations. In addition, this methodology must include comparative measures of family and nonfamily therapy trainees. If there is no difference between individual therapy experience and family therapy experience in producing effective family therapists, then the skills proposed for family therapy need to be reevaluated. The present study suggests the use




25




of Kelly's (1955) personal construct approach as a basis for the empirical study of family therapy training.


Personal Construct Theory


George Kelly's (1955) personal construct psychology has been

described as a comprehensive theoretical framework for the study of human personality (Mancuso & Adams-Webber, 1982). Personal construct

theory takes the position that an individual's interpretation of the world is explained in terms of that person's organized system of personal constructs. Each person has a unique way of construing the world, and people are similar to each other to the extent that they construe events in a similar way. Thus, the personal construct is the basic unit of analysis in this system, and was originally defined as "a way in which some things are construed as alike and yet different from others" (Kelly, 1955, p. 105). Thus, the construct is a bipolar dimension upon which a decision is made between a pair of alternative acts (e.g., a family therapist may construe a family as It rigid versus permissive").

Kelly based his psychology of personal constructs on a

fundamental postulate and 11 corollaries. This fundamental postulate states that "A person's processes are psychologically channelized by the ways in which he anticipates events" (Kelly, 1955, p. 46). Any act or behavior can be viewed as hypotheses which are continuously validated or invalidated by experience. However, a validated hypothesis does not imply that an event has only one interpretation. Kelly's theory argues that a totally different





26




interpretation may have led to an equally successful prediction. This concept, labeled "constructive alternativesm" is an important reason why personal construct psychology lends itself so well to the investigation of process-outcome variables. In family therapy training, for example, each theoretical orientation perceives the process of change differently, and yet the outcome (i.e., an effective family therapist) will hopefully be the same. Even within the field of family therapy itself, the therapist may construe a family differently and through the therapeutic process bring that family to the same outcome; a change from dysfunctional behavior to

functional behavior.

Personal construct psychology has recently been extended to the area of family therapy. Although this theory was designed for individual psychotherapy and intrapsychic processes, Procter (1981)

argues that it can easily be extended to the area of multiperson relationships. There are two important corollaries that allow for this extension. The first is the sociality corollary, which states that, "To the extent that one person construes the construction process of another, he may play a role in a social process involving the other person" (Kelly, 1955, p. 95). This corollary states that a person makes choices or behaves in accordance with how he anticipates that another will respond, regardless of the accuracy of his construal. Thus, the sociality corollary allows for an understanding of the complementary aspects of dyadic relationships. In order to

look at families, Procter introduced the group corollary which states that, "To the extent that a person can construe the relationships





27



between members of a group, he may take part in a group process with them" (1981, P. 354). This new corollary is applicable to training as the trainee must learn to construe the relationships between the members of the family and himself if he is to take part in a group process with them.

The second corollary that extends to multiperson relationships involves the choice corollary, which states that, "A person chooses for himself that alternative in a dichotomized construct through which he anticipates the greater possibility for extension and definition of his (construct) system" (Kelly, 1955, P. 64). Kelly further emphasized that choices are not necessarily conscious or verbalized. An extension of this logic is Procter's family corollary, which states that "For a group of people to remain together over an extended period of time, each must make a choice, within the limitations of his system, to maintain a common construction of the relationships in the group" (p. 354). Procter (1981) argues that a negotiation of a common family reality occurs in families, which he labeled as the family construct system (FCS). This family construct system involves a hierarchically organized set of family constructs used by the family members to make choices and anticipations. The family therapy trainee must somehow learn to perceive and conceptualize the common family reality (i.e., FCS), and through his executive skills, to change that reality. According to Procter, this will lead to new understandings about what has occurred in the past,

thus allowing the family to negotiate a new construction.





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A review of the family therapy and training literatures suggests that family therapists either restrict themselves to one theoretical school, or find themselves in a confusing eclectic mixture of theories and techniques. Haley (1976) has stated that a direct synthesis of the various theoretical orientations in family therapy is not possible due to the fundamental differences in their basic postulates. However, common to both family therapy and family therapy training is the process of change. Kelly explained change as a process of reconstruction. According to this view, reconstruction involves a change in the linkages between constructs, the addition of new constructs, the elaboration of subsystems or a change in the range of convenience (i.e., inclusiveness of a particular construct dimension) which the construct system covers. Thus, family therapy training consists of giving the trainees experiences which enable them to elaborate and revise their own construct system such that they are capable of objectifying the constructions of the family and expediting the change process. It may be argued that personal construct psychology subsumes the different approaches in a theoretical framework that lies outside and at a greater level of

abstraction to the various present alternatives (Procter, 1981). Further, personal construct theory allows a synthesis of various theoretical alternatives without any compromise of theoretical rigor and precision. This provides a strong rationale for the use of personal construct psychology as a method to investigate the training of family therapists.





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Personal Construct Psychology and Training Studies


With the increased recognition of personal construct psychology

as a viable context within which to study human behavior and relationships (i.e., systems of personal constructs), there has been a burgeoning of research based on Kelly's Role Construct Repertory Grid (Rep Grid). This Rep Grid measure has been adapted to the study

of a variety of issues ranging from analyses of individuals with psychiatric disorders to the perceptions of therapists, friends, marital couples, and trainees in various fields. Many of these studies have focused on a concept labeled cognitive complexity which Bieri (1955) has defined in terms of the differentiation of (i.e.,

the number of constructs in) an individual's construct system. Basically, Bieri argued that as the construct system develops it becomes more differentiated. This notion of progressive differentiation has been investigated in many training studies based

on Kelly's (1955) organization corollary, suggesting that a construct system is hierarchically organized and undergoes shifts over the course of personal and professional development.

However, several studies investigating the training of

professionals have suggested that the relationships among the constructs undergo periods of decreased complexity during the early

phases of training, followed by a reorganization of the constructs at higher levels of complexity during advanced training stages (e.g., Baldwin, 1972; Pope, 1978; Runkel & Damrin, 1961; Ryle & Breen, 1974). These findings offer some suggestions concerning the





30




conceptual difficulties that family therapy trainees often report during the early phases of training (Gurman & Kniskern, 1978). According to personal construct psychology, a person develops new ideas through shifts in construction. This shift in construction,

known as the Creativity Cycle, starts with loosened construction and terminates with tightened and validated constructions. Constructs must be loosened in order that hypotheses may be tested, and then they must be tightened after the hypotheses have been either validated or invalidated so that they may be acted upon. Extending this logic to family therapy training, if the trainees' constructs pertaining to families become less organized during early phases of training such that the relationships among the constructs decrease,

then efforts to interpret family behavior would be based on constructs that are loosely related and lacking meaningful connections. Consequently, trainees may experience difficulty in formulating their conceptualizations of families, resulting in the temporary decline in trainee performance cited in the training literature (Duhl, 1978; Gurman & Kniskern, 1978).

Contrary to the above findings, Adams-Webber and Mirc (1976)

reported no decrease in construct relationships during the early phases of training. These findings were based on "integration" scores that provided estimates of the overall degree of intercorrelations among supplied constructs (e.g., activities of educational personnel). The results indicated that there was a

gradual increase in the level of integration (i.e., cognitive complexity) of "teacher role" subsystems as the trainees acquired





31




classroom experience. These findings may indicate that integration either increases in an irregular fashion during periods of training,

or actual experience accelerates the integration and tightening of new constructs. However, these discrepant findings may also be the result of using different measures than Pope (1978), Ryle and Breen (1974), and Runkel and Damrin (1961) to estimate cognitive complexity. The present study will use pre-post measures of

cognitive complexity based on both differentiation and integration scores as a method of investigating the cognitive complexity issue in training.

Crockett (1982) has suggested that a second major feature of a developing construct system involves the appearance of abstract constructs. One method used to assess the development of abstract constructs involves a content analysis of the construct dimensions elicited by the Rep Grid. Lifshitz (1974) investigated whether constructs became more abstract as a consequence of training. This study used factor analysis to identify the construct with the highest loading on the first factor in the grids of social work trainees and their supervisors. Each construct was then assigned to one of seven

categories and the distribution across the categories was examined. The results indicated that the trainees used more concrete

descriptive categories while their supervisors showed more abstract constructs of themselves, others, and their work. An increase of more abstract constructs in the construct subsystems of trainees during training was also revealed. However, this study provided

content information about only one construct in each trainee's





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construct system. The present study will investigate a larger sample of the constructs in the training subsystem in order to evaluate the hypothesis of increased abstraction over the course of training.

Kelly's Rep Grid methodology has only recently been applied to the area of family therapy training. Lewis (1977) conducted a study of family therapy trainee's perceptual and conceptual abilities before and after a twelve-hour structural family therapy workshop. Basically, Lewis examined how trainees structured their thoughts about families and the type of constructs that they used when thinking about families. This study examined both the structural and content changes of family therapy trainees. Lewis used a structural measure devised by Landfield (1971) called ordination. Ordination is a measure of the hierarchical organization of the trainees' system of thoughts about the elements under investigation (e.g., families). Lewis also employed a measure called the functional independence of

constructs (Landfield, 1971) that measures the degree of uniqueness between family constructs, along with Bonarius' (1970) measure of the meaningfulness of the constructs to the individual. The results showed a significant change from pre- to posttraining, indicating

that the structure of the trainees' thoughts about families had become more cognitively complex. Further, a content analysis of the

trainee's family constructs revealed that a significant number of trainees increased their use of interactional family constructs. Interactional constructs were considered to be the most abstract in the family construct subsystem as they impart more information about





33




a family and thus allow for the generation of more hypotheses about the family system.

In contrast to the findings reported by ewis (1977), ZakenGreenberg and Neimeyer's (1984) investigation of the structure and content of family therapy trainees' family construct systems revealed that training in family therapy was generally associated with lower levels of differentiation and integration. These results suggest that such training initially channelizes and rigidifies perception of the family. This interpretation is consistent with the related body of work which has shown that the construct system undergoes periods of decreased complexity during the early periods of training,

followed by a reorganization of the constructs at higher levels during advanced training stages (Baldwin, 1972; Pope, 1978; Ryle & Breen, 1974).

Zaken-Greenberg and Neimeyer also reported a concomitant

decrease in the level of abstraction of the constructs themselves. These authors suggest that this content shift toward more concrete,

descriptive construing that occurred in both groups may reflect the tendency for trainees to favor more behaviorally evident constructs (e.g., single-parent family vs. two-parent family) over more abstract ones (e.g., undifferentiated family ego mass) as they are confronted with the need to effectively understand actual clinical experience.

The effect of this gravitation towards concrete dimensions might be to reduce the structure of the system since the dichotomous nature of many concrete descriptions (e.g., dual career vs. single career family) prevents their flexible, and hence more integrated, use in





34




the system. The present study will use both structural and content analyses of family rep grids in an attempt to examine any changes in cognitive complexity or level of abstraction as a result of structural family therapy training.


The Present Study


Kniskern and Gurman (1979) suggest that the assessment of the outcome of training procedures in family therapy should be made on several dimensions. First, it is important to assess if the trainee increases his/her conceptual knowledge of family dynamics and interaction patterns. The second major area for the assessment of change involves the trainees' in therapy behavior (i.e., executive skills). Third, it is important to evaluate if the trainees' perceptions of families have changed as a function of training. The present study will address all of these points.

This study is based on a structural training foundation. The subjects have been divided into two groups: (1) an experimental group consisting of 12 graduate students in counselor education and counseling psychology undergoing a 16-week (45 hours) training program in structural family therapy, and (2) a control group consisting of 21 graduate students in counselor education and counseling psychology undergoing individual psychotherapy training.

These control subjects have not taken any graduate courses in family therapy. Participants in the present study completed (1) a family therapy experience inventory, (2) a family repertory grid, (3) a multiple choice questionnaire made up of therapist response





35




alternatives in response to a series of simulated-family therapy videotapes (with the response alternatives designed to reflect the classification system of the Allred Family Interaction Scale), and

(4) a multiple choice questionnaire designed to measure the case conceptualization of the simulated family dynamics and treatment intervention, both before and after the 16-week interval.


Hypotheses


There are four basic components that are being analyzed in this study. The first is based on the family repertory grid which consists of a clinical interview in which participants systematically

compare and contrast various families to determine dimensions representative of their evaluations of family dynamics. A structural analysis (FIC and chi square scores, see Landfield, 1971) will provide measures of cognitive complexity. Based on the training

literature reviewed, it is hypothesized that family trainees will significantly increase in cognitive complexity after training compared to the control group.

The second component of this study involves a content analysis of the repertory grid data. The content analysis is based on an adaptation of Duck's (1973) procedure. Basically, constructs are coded as either physical, role, psychological, or interactional. A

content analysis will provide measures of abstraction and it is hypothesized that there will be a significant increase in the use of

abstract (i.e., interactional) constructions in the experimental





36




group. It is expected that the control group will remain at

consistent levels at pre- and posttesting.

The third component of this study will investigate trainees' conceptual skills in three major areas. These areas include a conceptualization of the family, a conceptualization of the intervention, and a systemic dimension (e.g., focusing on an individual vs. the entire system). Subjects will be required to

answer eight multiple choice questions that reflect these three areas of interest. Based on the construction corollary, Kelly (1955)

stated that a person's anticipations are a matter of ascribing certain recurrent themess" as he successively construes events. This logic suggests that recurrent themes for family dynamics are learned in training. Further, personal construct psychology suggests that training should lead to more successful prediction of the experience of the family in treatment, as well as creating shared meanings among family therapists. Case conceptualization analyses will indicate if the family therapy trainees are capable of conceptualizing family

dynamics, predicting family behaviors, prescribing treatment, and describing these constructions of families using the shared meanings of structural family therapists. It is hypothesized that these conceptual skills will increase for the family therapy trainees, and remain stable across time for the nonfamily therapy trainees.

One of the most important skills of family therapists involves executive skills. The family therapist must be capable of translating perceptual and conceptual skills into active behavior

that will expedite change in the family rather than result in a





37




deterioration in family behavior and interactions. The present study will investigate whether structural training aids in increasing these executive skills through the use of a set of family therapy videotapes consisting of 20-minute simulations of family therapy sessions in which the viewer is oriented as the therapist. The sessions is halted periodically, and participants are asked to select a preferred response as primary therapist to the family. Measures of response effectiveness will be obtained by coding these responses

according to a modified version of the Allred Family Interaction Scale. It is hypothesized that there will be an increase in family therapy trainee executive skills as compared to the control group.

Each dependent measure will involve a 2(Group) x 2(Time) mixed factorial design. The results of these analyses will test the predictions that, compared to controls, trainees will become more complex (differentiated and integrated) and systemic in conceptualizing family dynamics, and more effective in therapeutic responding to simulated cases. Such findings would suggest that training in structural family therapy influences both the quality and

effectiveness of therapeutic interventions in a manner consistent with the objective of the training program.

In summary, this dissertation will investigate family therapy training by the personal construct methodology. There has been a dearth of empirical research in this area, with most studies being either descriptive in nature or lacking empirical rigor and sophistication. The present study provides a sounder empirical basis for investigating the training of family therapists.
















CHAPTER III
METHODOLOGY



Subjects


Thirty-three subjects were recruited voluntarily from the

counselor education and counseling psychology graduate programs at the University of Florida in Gainesville, Florida. The experimental

group consisted of 12 graduate students currently enrolled in a graduate seminar in structural family therapy given through the counseling psychology program (see Appendix A for a description of the seminar). This group consisted of four males and eight females, with a mean age of 32 (range = 23 to 41). The control group

consisted of 21 graduate students from the identical programs who had not had previous training in family therapy and who had not yet taken the graduate seminar in structural family-therapy. There were seven

males and fourteen females in the control group, with a mean age of 29 (range = 21 to 49). The experimental subjects had an average of

four semesters of graduate school and the control subjects had an average of two semesters of graduate school. Thus, both groups are comparable in their graduate training, with the experimental group receiving additional training in structural family therapy.





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39




Instruments


Family Experience Inventory


Each subject was required to complete a modified version of the Family Therapy Experience Inventory (FTEI) in order to assess any contact with family therapy prior to the current family training seminar (Connors, 1984). This modified inventory provides information on age, sex, educational level in their graduate program, and amount of prior counseling experience (see Appendix B). Connors (1984) originally developed this inventory in order to assess both

the type of prior exposure with family therapy as well as the extent of that experience. There are three major categories of prior exposure. The first involves prior training level in family therapy and is determined by the number of courses taken where there was a major focus on the "family," as well as any training sessions or workshops that focused on work with families. The amount of prior

reading in family therapy comprised the second category of reading (e.g., the number of books or articles read on family therapy). The

third category, experience, consisted of direct experiences with family therapy, and the number of these cases that were supervised. Table 1 presents the mean family therapy experience scores for experimental and control subjects. In the present investigation, there are no significant differences between the two groups for prior exposure to some form of family therapy training.





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Table 1. Mean Family Therapy Experience Scores for Experimental and
Control Subjects



Group N Courses Workshops Books Articles Family SuperTaken Attended Read Read Therapy vised
Therapy


Experimental 12 1.82 1.36 2.09 2.00 2.00 1.82
(.78)* (.67) (1.22) (.45) (.63) (.40) Control 21 1.90 1.57 1.62 2.24 1.29 1.24
(.83) (1.16) (1.20) (.89) (.40) (.44)


Numbers in parentheses are standard deviations.





Family Repertory Grid


The Family Repertory Grid (Connors, 1984) is a modified version of Kelly's Role Construct Repertory Grid (Rep Grid), originally devised as a measure of different aspects of the structure and content of individuals' personal cognitive systems. When using this

personal construct methodology, elements are selected that represent the cognitive constructs that are to be investigated. The elements chosen for the present study were family role titles adopted from Connor's (1984) Family Repertory Grid. These elements have been designed to represent various types of families that are familiar to most individuals (e.g., the family you grew up in; a happy family; a single parent family). The present study is based on the minimum

context card form in which the subjects are required to give names to ten preselected elements (i.e., family role titles), and then write




41




the names on index cards numbered from one to ten. The subjects are

then presented with three of these elements written on the index cards and asked to specify some important way in which two of the families are "alike in some way and yet different from the third family." For example, after they respond with how two of the elements are alike, they are required to specify "in what way the third family differs from the other two families." Following the

elicitation of the constructs, the subjects are required to rate each family along each construct dimension using a 7-point Likert type scale (see Appendix C).

Kelly's repertory grid procedure has been used extensively in

research on various issues related to personality theory and clinical applications. As a result of this procedure's increasing popularity,

attention has been directed toward obtaining psychometric data, with special reference to reliability and construct validation. Generally, reliability coefficients based on the consistency of

ratings across time and the consistency of constructs across time (given identical elements in the repertory grid) have been found to be relatively high. For example, Hunt (1951) elicited constructs to

fit 41 role titles by the triadic method and reported a test-retest reliability of .70 over an interval of a week. Similarly, Fjeld and

Landfield (1961) repeated Hunt's basic design and demonstrated that, given the same elements, there was a correlation of .80 between the two sets of elicited constructs over a two week interval. Validity, however, has proven much more difficult to assess. The repertory

grid is not a static assessment tool in that it may be adapted to a





42




variety of content areas (e.g., schizophrenia, depression, suicide, education and training). Consequently, validity studies have been generated in these various content areas. In general, however, Fransella and Bannister (1977) argue that the validity of this

technique has been shown to be acceptable, as the grid has been demonstrated to discriminate between different diagnostically defined groups as well as between before and after treatment groups.

The Family Repertory Grid provided data for the first two

components of this investigation (i.e., cognitive complexity and

construct content). A structural analysis of the subjects' ratings provides measures of cognitive complexity, and a content analysis of their constructs provides measures of construct abstraction.


Structural grid measures


Cognitive integration. Based on a cluster analysis designed by Landfield (1971), the family repertory grid ratings result in

ordination scores that are basically an integration measure of the hierarchical organization of the trainees' system of thoughts about the family elements. This Landfield analysis also provides chi

square scores that measure integration and level of flexibility in the use of constructs. These chi square scores measure the extent to which the personal constructs are arranged into interrelated systems of constructions. According to Landfield and Schmittdiel (1983), the

chi square score is a more reliable measure of hierarchical potential than the ordination score.





43




Cognitive differentiation. Structural analyses also provide FIC scores. The FIC scores reflect the functional independence of constructs which measure the degree of uniqueness between family constructs. Landfield (1971) originally developed the FIC score as a measure of cognitive differentiation such that an individual who is

highly differentiated has a large number of different constructs that are used in different ways. By using constructs in different ways, one is capable of viewing a situation from a number of different perspectives. Thus, FIC scores provide information on the level of differentiation (i.e., how many different ways are the constructs used). According to this system, differentiation and integration provide indices of cognitive complexity, such that higher levels of differentiation and integration imply a cognitively complex individual.


Content grid measures


The second component of this study involved a content analysis of the family repertory grid constructs elicited from the subjects.

The content analysis was based on an adaptation of Duck's (1973) procedure in which constructs are coded as either physical, role, psychological, or interactional. Based on the pilot data and feedback from both the subjects and the examiners, it was determined

that independent judges' coding of the subjects' construct content was often misleading and inconsistent. Subjects frequently provided

constructs that fit into one of the category codes (e.g., psychological), while also making comments to the examiner concerning





44




what the construct implied (e.g., discussing the interactional properties of the construct). Consequently, the manner of coding the constructs was not always consistent with the inferred meaning the constructs had for the subjects. In view of the marginal interrater reliabilities (range = .56 to .82), the present study was designed to

exclude judges, and to base the content coding on the subjects' perceptions of their own constructs (see Appendix D). In addition, the coding label "psychological" was changed to "personality" since it is believed to be less abstract in its meaning, and therefore more

familiar to the average subject.

A test-retest reliability analysis was performed using this new

procedure in order to establish a strong empirical rationale for its use. One-hundred-thirty-four undergraduate volunteers were given a repertory grid measuring their perception of various types of interpersonal relationships. These subjects were required to use Duck's (1973) coding system to code their own constructs. After an 18-day delay, subjects were again asked to code their constructs. With no training or prior exposure to this sytem, an analysis of the

data revealed a 73% agreement across time, suggesting that the selfcoding procedure is as reliable as using independent judges. A major advantage to using this procedure is that the data will be a more

accurate reflection of the subjects' perceptions of their personal constructs.

Subjects in the present investigation were provided with

instructions and examples of how to use the coding system. They were given five constructs to code using Duck's system, and were corrected





45




by the experimenter if they made an error. Any subject who made two or more coding errors was given five more constructs to practice on. No subjects made any errors on the second set of trial constructs (see Appendix E). Analyses of content provided measures of abstraction (i.e., shifts in the use of personality and interactional constructs as a function of training). Therapist Responses to Simulated Family Tapes


Subjects were required to observe videotapes of a simulated family therapy session, and instructed to assume the role of the primary therapist. At four different intervals a family member looked into the camera and asked the therapist (i.e., the subjects) a question to which the subject was to respond by selecting one of several provided multiple choice answers.

There are two 20-minute simulated-family videotapes that were used in this study. These tapes are based on the dynamics of

simulated families used by Connors (1984) to investigate family therapy training. Student volunteers from an undergraduate psychology course and research assistants in the family therapy training project made up the simulated families. Each "actor" received a written description of the family dynamics and their role in particular which served as a guide for their performance (see Appendices F and G). They were given the family dynamics the evening before taping, and were allowed one practice trial in order to feel comfortable with their role. The actors were signaled when they were





46




to speak into the camera and ask the "therapist" a question concerning the family.

The family scenarios consisted of disturbances in the family structure which required intervention by the family therapist. The first family is composed of two parents, two adolescent daughters and two young sons. The oldest daughter is presented as the identified patient by the parents, the mother as ineffective and the father as peripheral. The second family is composed of a single mother with an adolescent daughter and son. In this family, the son is presented as the identified patient, and the mother focuses on her bitter

relationship with her ex-husband and her inability to control her son's behavior. Mother and daughter are in a coalition against the

identified patient.

Connors (1984) reported that the two sets of family dynamics used in his study were equated for level of difficulty. Level of

difficulty was determined through consultation with professionals acquainted with family therapy. In addition, presentation of the

videotapes were counterbalanced at pre- and posttraining to distribute any possible order effects.

Based upon the results of the pilot investigation, several revisions were made for the improvement of this dissertation. A major difficulty with the pilot study involved the use of naive and unsophisticated judges concerning family therapy. Judges were

undergraduate students without any exposure to family therapy prior to participating in this project. In addition, the pilot data for

therapist responses revealed a paucity of information for the amount





47




of data collected. Allred's coding system did not prove to be reliably used by the judges (r = .52 at Time 1 and r = .60 at Time

2), requiring that the data be collapsed across categories for a composite score for each subject. This composite score simply

reflected what direction subjects were moving toward in terms of their level of executive skills. Thus, the present study was revised

to both eliminate the unreliability contributed by the judges, and to provide a greater array of information concerning the executive skills of the two different training groups.

The revisions for the dissertation study involved providing

subjects with alternative therapist responses to choose from at each of the four intervals. These responses represent the categories found to be meaningful in the pilot study. There were four main

categories used for coding therapist responses: Gathers Information, Supports and Reflects, Interprets and Confronts, and Structural Real ignment. In order to represent each of the main categories, four alternative therapist responses were generated within each category. These responses represent a dimension from obstructive to the most sophisticated response level within that category. For example, the category of interprets and confronts has four alternative responses ranging from obstructive +1, direct

interpretation = +2, strategic interpretation +3, and confrontive interpretation = +4 (see Appendix H for a description of the coded categories). Thus, subjects are required to answer four multiple choice questions at each of the four intervals. Except for the obstructive responses, all response alternatives were designed to be





48




appropriate responses to the dynamics of the family tape that the subjects have viewed (see Appendices I and J). Within each of the four response groups, subjects were also required to rank the confidence level they felt concerning their chosen response on a scale of 1 to 10 (very unconfident to very confident). These rankings provide a measurement of perceived confidence across time for both groups of subjects. Subjects were also required to rank their four choices from most to least preferred. The most preferred therapist response was also ranked for confidence level on a scale of 1 to 10. Thus, in addition to measuring whether subjects' confidence changes across time, it is also possible to measure if their confidence about their most preferred response changes across time (see Appendix K).

Two professional structural family therapists in the community

were solicited to evaluate these materials in order to establish empirical reliability. Both therapists were asked to rank order the

response alternative category from least to most preferred therapist response. These rankings were correlated between the two therapists, and between the therapist rankings and the rank ordering generated by the experimenter using a modified version of Allred's AIAC coding system. Therapist responses were based on the actual responses provided by the subjects in the pilot study. For a therapist response to be chosen, it had to be coded identically by the two independent judges. In addition, the actual responses were also

evaluated using the procedure just outlined (see Tables 2 and 3 for reliability coefficients).





49






Table 2. Family Expert Ratings for Therapist Response Stimuli-Family Tape I



Modified Expert 1 Expert 2
Allred
Scheme


Modified Allred Scheme .61* .45*

Expert I .65*

Expert 2


* p<.05












Table 3. Family Expert Ratings for Therapist Response Stimuli-Family Tape II



Modified Expert 1 Expert 2
Allred
Scheme


Modified Allred Scheme .58* .68*

Expert 1 .76*

Expert 2


* p<.05





50




Case Conceptual izations


The reliabilities for the case conceptualization pilot data were, at best, marginal (range = .12 to .67). Therefore, this

component of the dissertation was revised to exclude the use of judges. Based on the pilot data, it was determined that there were three major areas of information that were not being adequately tapped. These areas include a conceptualization of the family, a

conceptual ization of the intervention, and a systemic dimension (e.g., focusing on an individual versus the entire system). Rather than have subjects simply write their impressions of the family dynamics, subjects were required to answer eight multiple choice questions that reflect these three areas of interest. Each question was provided with four alternative choices ranging from individual, dyad, subgroup, and system. Four of the questions target the

conceptual ization of the family and four of the questions target the conceptualization of the intervention with the family. Each of the

response alternatives is appropriate to the dynamics of the family videotapes (see Appendices L and M for a description of the response alternatives). Again, two structural family therapists evaluated these questions and response alternatives in terms of the

appropriateness of the responses as well as whether they accurately reflect the systemic dimensions they have been constructed to reflect (see Tables 4 and 5 for reliability coefficients).





51






Table 4. Expert Ratings of Case Conceptualization Stimuli-Family Tape I



Cases Expert 1 Expert 2
Coding
Scheme


Cases Coding Scheme .38 *53*

Expert 1 563*

Expert 2


*p<.05










Table 5. Expert Ratings of Case Conceptualization Stimuli-Family Tape II



Cases Expert 1 Expert 2
Coding
Scheme


Cases Coding Scheme .33 .69*

Expert 1 569*

Expert 2


* p<.05




52




Procedure


All subjects were scheduled by phone for a testing time at their convenience. Subjects were tested in small groups ranging from two to four subjects depending on their availability. Each subject was told that he/she would be participating in a family therapy training study that would last approximately two hours at both pre- and

posttesting.

Subjects were met in an outer office by the experimenter and led into a small testing room containing a portable video monitor, a table to write on, and several chairs. Each subject was requested to sit at a table facing the video monitor. All subjects received identical instructions regardless of whether they were in the control group or the experimental group.

The first task required of the subjects was reading and signing the informed consent form (see Appendix N), followed by the completion of the Family Therapy Experience Inventory. This was followed by instructions for the first phase of the testing session which involved viewing the videotape of a simulated family therapy session. All subjects were given the following instructions:


You are about to view a simulated family in an initial family therapy session. You are to view the family as
though you were the primary therapist and were actually
involved in the session. At different points in the
session, the tape will be stopped, a family member will ask the therapist a question, and you will be provided
with four groups of therapist response alternatives.
From each group of response alternatives, you are to
select the therapist response that you feel you might use
with that family at that point in time. All of the
responses are viable alternatives and there are no right





53




or wrong answers. We are simply interested in which
responses you would choose from each group of response
alternatives.

After you have viewed the tape and selected your
therapist response alternatives, you will be requested to
answer some multiple choice questions concerning your
case conceptualization of the family as though you were
the primary therapist for the family.


Following these instructions, the subjects were provided with the written family descriptions (see Appendices 0 and P). When the

subjects indicated that they had finished reading the family notes, they were given a therapist response form to use for recording their responses to the family (see Appendix K). The examiner stopped the

videotape at four intervals and requested the subjects to write their responses on the designated pages. The booklet of four therapist response forms was then removed by the examiner and replaced with the

following written case conceptual ization instructions:


We are interested in your case conceptualization of the
family as though you were the primary therapist for this family. There are 8 multiple choice questions regarding
the dynamics that you see as important in this family.
We would like you to choose the alternatives that best reflect how you perceive this family. Again, there are
no right or wrong answers to these questions, each choice simply reflects a preferred style of viewing the dynamics
of the case.

You will have 10 minutes to answer these questions.


When the subjects indicated that they finished reading the instructions, they were given the case conceptualization questions and a form to use for recording their responses (see Appendix Q).





54




Upon completion of this task, subjects were administered the

family repertory grid. This task consists of a structured interview in which subjects systematically compare and contrast various families to determine dimensions representative of their evaluations of family dynamics (see Appendix R for a complete description of administration). The administration of this family repertory grid

involves the experimenter asking the subject to give names to role titles (e.g., the name of the family you grew up in, the name of a happy family, etc.). The subjects are then presented with three of

these elements and asked to specify "some important way in which two of the families are alike in some way and yet different from the third family." After they respond with how two of the elements are alike, they are required to "give a word or short phrase that describes how the third family is different from the other two."

Following the elicitation of the constructs, subjects are required to rate each pole of the construct as either positive or negative. The experimenter then takes these descriptions and uses them as end points on a 7-point Likert type scale (e.g., Happy +3, +2, +1, 0, -1,

-2, -3 Sad). Subjects then use these construct dimensions to rate all ten families across each of the 15 construct dimensions.

After the administration of the family repertory grid, subjects

were told that they would be contacted in approximately 10 weeks for another two-hour session. The second session involved the same procedure as the first session, with the exception that all subjects viewed a different simulated family therapy videotape. The presentation of the therapy tapes were counterbalanced to reduce





55



testing effects. Subjects were then debriefed and told tnat the study was designed to investigate the effects of family therapy training on how counselor-trainees respond to and conceptualize various family problems. They were also given a brief rationale for

undertaking this investigation, followed by a question and answer session if desired by the subject. Subjects were also given the

opportunity to sign up for feedback sessions on their participation in the investigation.


Design and Analyses


This investigation has been divided into four major

components. The first component involves the management of trainees' perceptual skills. Perceptual skills may be measured by using structural grid analyses (see Landfield, 1971) on the following dependent measures: chi square scores (measuring level of cognitive integration) and FIC scores (measuring level of cognitive differentiation). The second component involves the measurement of the level of abstraction of trainees' perceptual skills. This component involves two dependent measures: Abstractness (reflected by a Weighted Average score) and Modal Response. The third component of this investigation involves the measurement of trainees' conceptualization skills for both family dynamics and treatment for the following two dependent variables: Weighted Average and Modal Response. The fourth component of this investigation involves the measurement of trainees' executive skills. Executive skills may be

measured by analyzing trainees' therapist responses to the simulated





56




family tapes. There are two sets of dependent measures for therapist responses. The first set involves analyses within each category of

interest (e.g., gathers information, reflects and supports) for the following dependent variables: Weighted Average, Modal Response and Average Confidence Level. The second set involves analyses across the four categories of interest on the following two dependent variables: Mode for Preferred Response and Average Confidence for Preferred Response. For all four major components of this design, all dependent measures were analyzed with a 2(Group) x 2(Time) Analysis of Variance with repeated measures on the last factor. Structural Grid Analyses


Subjects' ratings from the 7-point Likert type scales were

cluster analyzed by Landfield's (1971) computerized method. This analysis provided FIC and chi square scores for each subject, thus providing the measures of cognitive complexity previously discussed (see pages 42-43). These scores comprise the dependent measures for

the structural grid data.


Content Grid Analyses


Each of the 15 constructs elicited from the subjects were selfcoded along a dimension of abstractness ranging from physical, role,

personality and interactional characteristics (i.e., physical = +1, role = +2, personality = +3, and interactional = +4). A single score

representing a subject's overall level of abstraction was obtained by averaging the weighted ratings across the 15 constructs. Each





57




subject was also assigned a score based on their modal response category.


Case Conceptualization Analyses


Therapist conceptual skills were evaluated along a systemic dimension. Subjects were required to respond to eight multiple choice questions which were provided with four alternative choices ranging from individual, dyad, subgroup and system. Four of the

questions targeted the conceptual ization of the family and four of the questions targeted the conceptual ization of the intervention with the family. This design provides for two categories (family

conceptual ization and family intervention) that are analyzed separately for the following dependent measures: Weighted Average and Modal Response. The Weighted Average is an overall average of systemic response level obtained by totaling a subjects' coded ratings and then dividing the total by the number of questions within a category. The Modal Response represents that response level used most frequently within each category. Therapist Response Analyses


Each subject responded to the videotape with multiple choice

questions at four separate intervals. For each interval, the four multiple choice questions reflected a modified classification system designed by Allred and Kersey (1977). The four categories selected were found to be the most meaningful of Allred's system based on the pilot investigation. The four categories reflected by the questions





58




were Gathers Information, Reflects and Supports, Interprets and Confronts, and Structural Realignment. Within each category there

are four possible response alternatives that represent a dimension from obstructive to the most sophisticated response level within that category (see Appendix H).


Within category analyses


All four intervals of therapist responses were combined for the following three dependent measures: Weighted Average, Modal Response and Average Confidence Level. These three measures were analyzed separately for each of the four therapist response categories. The Weighted Average is an overall average of response level obtained by

totaling a subject's coded ratings and then dividing the total by 4 (i.e., the number of intervals). The Modal Response represents that response level used most frequently within each category across the four intervals. Within each of the four therapist response categories, subjects rated how confident they felt about the response they had chosen on a scale of I to 10 (very unconfident to very confident). The Average Confidence Level was obtained by taking an average across the four intervals.


Between category analyses


In addition to investigating possible changes within each of the

four therapist response categories, two dependent measures were designed to reflect any changes in therapeutic skills or confidence across these four categories. Subjects were asked to rank the four





59



therapist responses they chose for working with the family in order of preference from the most to the least preferred. That category most frequently endorsed by the subject as their preferred response was labeled as the Mode for Preferred Response. This score provided a measure of response preference across the four different categories. The final dependent measure represents the Average Confidence for Preferred Response. Subjects were required to rank how confident they felt about their most preferred response on a scale of 1 to 10 (very unconfident to very confident). An average

score was obtained across the four intervals.
















CHAPTER IV
RESULTS



Structural Grid Analyses


A 2(Group) x 2(Time) analysis of variance for Functionally

Independent Construct (FIC) scores on family constructs revealed a significant interaction, F (1,31) = 12.63, p<~.001 (see Table 6). Followup analyses revealed a significant effect of Time for the control subjects, F (1,20) = 8.42, p<.008, such that the nonfamily therapy trainees became significantly more differentiated in their family constructs across time. Followup analyses also revealed a significant effect of Time for the experimental subjects, F (1,11)

5.25, p<.04. These results suggest that the family therapy trainees became significantly less differentiated across time (see Figure 1).

In addition to looking at levels of differentiation, analyses also revealed some significant findings based on integration scores. Landfield's chi square score is viewed as a measure of integration and flexibility. A 2(Group) x 2(Time) analysis of variance on chi square scores revealed a significant main effect of Group, F (1,31) = 6.27, p<.02, such that the control subjects were significantly less integrated in their family constructs than were the family therapy trainees. An analysis of variance also revealed a trend toward a main effect of Time, F (1,31) = 2.71, p=.10,


60





61





Table 6. Analysis of variance for FIC scores



Source Sum of Squares df Mean Square F p


Mean 6127.286 1 6127.286 145.32 .000
Group 31.953 1 31.953 0.76 .391
Error 1307.077 31 42.164

Time 0.091 1 0.091 0.01 .909
Time x Group 71.304 1 71.304 10.17 *QQ3*
Error 217.363 31 7.012


* p<.001











Table 7. Analysis of variance for chi square scores



Source Sum of Squares df Mean Square F p


Mean 141671.093 1 141671.093 483.82 .000
Group 1835.680 1 1835.680 6.27 .012*
Error 9077.315 31 292.816

Time 543.736 1 543.736 2.71 .109
Time x Group 23.829 1 23.829 0.12 .732
Error 6220.378 31 200.657


*p<.01





62









Q experimental Control

10.5

10.0 9.5 I

9.0


Mean 8.
FIC 8.0 Scores 7.


7.0 6.5

6.0 5.5 5.0

4.5

4.0



TIME TIME
1 2





Figure 1. Interaction for FIC scores





63




suggesting that both groups tended to become less integrated across time (see Table 7).


Content Grid Analyses


The 2(Group) x 2(Time) analysis of variance revealed no significant findings for Modal Response. However, these analyses did reveal a trend toward a main effect of Group, F (1,31) = 2.94, p=.09 for the Weighted Average score of abstraction such that the family therapy trainees appeared to have higher levels of abstraction in their family constructs than did the control subjects. Analyses also revealed a trend toward a main effect of Time, F (1,31) = 2.94, p=.09, such that both groups became somewhat more abstract across time.


Case Conceptualization Analyses


Family Conceptualization Analyses


Analyses of the Weighted Average score revealed no significant differences in level of systemic conceptualization of family dynamics for the two groups. However, an analysis of variance on the Modal Response scores did reveal a trend toward a main effect of Time, F(1,31) = 3.40, p=.07. The direction of the means suggests that both groups were viewing families along subgroup-systemic dimensions at Time 1 (M=3.51), while at Time 2 they were viewing families along more dyadic-subgroup dimensions (M=3.09). These results suggest that both groups had a tendency to narrow the focus of their family conceptualizations across time.





64




Family Intervention Analyses


The analysis of variance did not reveal any significant findings for either Weighted Average or Modal Response scores. The mean response levels, however, suggest that both groups focused on

subgroup relationships when conceptualizing an intervention for a family (means range from 2.87 to 3.64).


Therapist Response Analyses


Within Category Analyses


Gathers information


The analysis of variance revealed no significant findings for the Modal Response and Average Confidence scores. However, the results did reveal a trend toward a main effect of Time for the Weighted Average score, F (1,31) = 3.64, p=.06. These results suggest that both groups had a tendency to ask for information about a subsystem relationship less frequently at Time 2 (M=3.15) than at Time l(M=3.39).


Reflects and supports


The analysis of variance revealed a significant main effect of Time for the Weighted Average score, F (1,31) = 9.22, p<.004, such

that both groups had a higher frequency of supportive responses at Time 1 (M=3.15) than at Time 2 (M=2.73) which revealed a higher frequency of reflecting responses (see Table 8).




65




Table 8. Therapist Response ANOVA for Reflects and Supports Weighted
Average Scores



Source Sum of Squares df Mean Square F p


Mean 522.883 1 522.883 1191.76 .000
Group 0.156 1 0.156 0.36 .550
Error 13.601 31 0.439

Time 3.208 1 3.208 9.22 .004*
Time x Group 0.239 1 0.239 0.69 .410
Error 10.792 31 0.348


P<.001





An analysis of variance also revealed a significant main effect of Time for Modal Response (see Table 9), F (1,31) = 17.90, p<.001 such that the modal response for both groups at Time 1 was a sophisticated combination response of reflecting and supporting (M=4.00), while the modal response for both groups at Time 2 was a much less sophisticated response involving simple reflection responses (M=2.94). These results suggest that both groups became less sophisticated across time. There was no significant difference in their Average Confidence Level suggesting that they were equally confident across time.




66




Table 9. Therapist Response ANOVA for Reflects and Supports Modal
Response Scores



Source Sum of Squares df Mean Square F p


Mean 719.377 1 719.377 487.51 .000
Group 1.195 1 1.195 0.81 .375
Error 45.744 31 1.476

Time 21.001 1 21.001 17.90 .001*
Time x Group 2.576 1 2.576 2.20 .148
Error 36.363 31 1.173


* P<.001





Interprets and confronts


The 2(Group) x 2(Time) analysis of variance revealed no

significant findings for Weighted Average, Modal Response, or Average Confidence Level.


Structural realignment


The analyses of variance did not reveal any significant findings for Weighted Average, Modal Response, or Average Confidence Level. Between Category Analyses


Mode of preferred category response analyses


The analysis of variance revealed no significant findings for

the Modal Preference score. It is interesting to note, however, that





67




the preferred category for both groups was the Reflects and Supports

category of therapist responses (Control M=2.86, Experimental M=3.00).


Average confidence for preferred category response analyses


The 2(Group) x 2(Time) analyses of variance revealed a

significant main effect of Time, F (1,31) = 5.60, pcz.02, such that both groups became significantly more confident concerning their preferred responses across time (M at Time 1 = 7.45, M at Time 2

7.94). See Table 10 for the results of the ANOVA table.



Table 10. Therapist Response ANOVA for Preferred Category Response



Source Sum of Squares df Mean Square F p


Mean 3602.506 1 3602.506 1296.49 .000
Group 0.307 1 0.307 0.11 .742
Error 86.138 31 2.779

Time 5.325 1 5.325 5.60 .020*
Time x Group 2.161 1 2.161 2.27 .140
Error 29.476 31 0.951


* p<.05
















CHAPTER V
DISCUSSION



The primary purpose of the present investigation was to

determine whether or not training in structural family therapy has an impact on the perceptual, conceptual and executive skills of family therapy trainees. This division of therapy skills is based on Cleghorn and Levin's (1973) model for the assessment of training in family therapy. Perceptual skills refer to how the therapist perceives family interactions and the effects of them on family members and the family system. Conceptual skills involve what the therapist thinks about in the therapy session and how those thoughts are organized. Executive skills involve how the therapist actually intervenes in therapy in order to influence the family's

dysfunctional patterns of interactions.

A review of the literature revealed that a majority of family therapy training studies reported significant increases in trainees' perceptual and conceptual skills (e.g., Friedman, 1971; Lange & Brinckman, 1976; Lange & Zeegers, 1978; Tomm, 1980; Tucker & Pinsof, 1984). Several studies have also reported significant increases in trainees' executive skills (e.g., Allred & Kersey, 1977; Pinsof, 1977; Watson, 1975). However, one limitation of this research

concerns the absence of comparable control groups against which the



68





69




effects of family therapy training can be measured. This leaves open the question as to whether factors other than the training program were responsible for the noted changes (see Cook & Campbell, 1979). The unique contribution of the present investigation is the assessment of change in the family therapy skills of family therapy trainees compared with a comparable control group.

In general, the results of this study did not provide compelling support for the major hypotheses. For example, it was predicted that the family trainees would become more cognitively complex than the

control subjects. The results of this investigation revealed that the family therapy trainees became less cognitively complex, while the control subjects became significantly more cognitively complex across time. It was also predicted that the trainees' family construct system would become more abstract than the family construct

system of the control subjects. Although the results revealed some trends in support of this hypothesis, the data do not argue cogently in support of the expected increase in abstraction among the family therapy trainees. In addition to predicting increases in the level

of perceptual skills of the family trainees, it was hypothesized that family trainees would show an increase in conceptual skills as a function of training compared to the control group. The results revealed that both groups changed across time, becoming somewhat more narrowly focused than predicted. Lastly, it was predicted that the family trainees wo uld show more sophisticated levels of executive skills compared to control subjects as a function of structural family therapy training. Although the results revealed some





70




interesting changes in executive skills for both groups across time, there were no significant differences between the two groups. These results are contrary to the prediction of increased skill level of family trainees compared to controls as a function of structural family therapy training. The remainder of this discussion will be organized around each of the major components and hypotheses of the study.


Perceptual Skills and Cognitive Complexity


Cognitive differentiation refers to the number of different

constructs that an individual has available for viewing and interpreting a situation. According to Werner (1955), construct systems develop from simple to complex levels of cognitive differentiation over the course of continued.experience. This reasoning is consistent with Bieri's definition of complexity as "the tendency to construe social behavior in a multidimensional way such that a cognitively complex individual has available a more versatile

system for perceiving the behavior of others than does a less complex person" (1955, p. 14). The present study investigated whether family therapy trainees' construct systems would become more cognitively complex as a function of structural family therapy training.

Analyses of differentiation revealed that the family therapy trainees became significantly less complex as a function of training. Interestingly, the control subjects showed significant increases in their level of complexity across time. These results

suggest that when students in the mental health fields are exposed to





71




family therapy training, they begin to construe families in less differentiated ways. The fact that the family therapy trainees were

less differentiated than those students without that training suggests that they are more channel ized in their constructions of

families, and have not yet integrated their new experiences into a larger framework within which to anticipate and predict families in therapy.

These results are consistent with the literature which has reported that trainees' constructs undergo periods of decreased complexity during the early phases of training, often followed by a

reorganization of the constructs at higher levels of complexity during advanced training stages (e.g., Baldwin, 1972; Lipshitz, 1974; Pope, 1978; Ryle & Breen, 1974). These findings are also consistent with the conceptual difficulties that family therapy trainees often report during the early phases of training (Gurman & Kniskern, 1978). Family therapy trainees may experience more difficulty than nonfamily therapy trainees in formulating their conceptualizations of families, thereby resulting in the temporary decline in trainee performance cited in the training literature (Duhi, 1978; Gurman & Kniskern, 1978).

Further, these findings may offer support for the operation of

the Creativity Cycle in structural family therapy, such that there is a shift that starts with loosened construction and terminates with tightened and validated constructions. Constructs must be loosened in order that hypotheses may be tested, and then they must be

tightened after the hypotheses have been either validated or





72




invalidated so that they may be acted upon. If the family therapy trainees' family construct system becomes less organized during early

phases of -training such that the relationships among the constructs decrease, then efforts to interpret family behavior would be based on

constructs that are loosely related and lacking meaningful connections. To explore this hypothesis further, future research needs to measure the impact of training on therapy skills at different intervals throughout training and after training.

In addition to looking at levels of cognitive differentiation,

analyses also revealed some significant findings concerning cognitive integration. The results revealed that the nonfamily therapy

trainees were significantly less integrated in their family constructs than the family therapy trainees. Further, both groups of

trainees tended to become somewhat less integrated across time regardless of the form of therapy training engaged in.

The results of the integration measures suggest that the family therapy trainees are more flexible in their use of their family construct system than are the nonfamily therapy trainees. However, this does not appear to be a unique function of training in structural family therapy. Although the family trainees appear to have fewer constructs available for perceiving families than the nonfamily therapy trainees, it may be that they are more invested in

tightening their family construct system in an attempt to make the constructs more meaningful. Further, it is interesting that both groups of trainees had a tendency to become somewhat less integrated




73




across time, suggesting that any training in therapy initially channelizes and rigidifies trainees' clinical perceptions.

Taken as a whole, the results of the measures of cognitive differentiation and cognitive integration are mixed. On the one hand, the results suggest that family therapy trainees become less

differentiated as a function of structural family therapy training while the nonfamily therapy trainees become more differentiated across time. However, the results also revealed that the family therapy trainees are more cognitively integrated than the nonfamily therapy trainees. Both sets of results are consistent with the training literature. Those studies reporting decreases in cognitive complexity based their conclusions on the results of differentiation scores (e.g., Baldwin, 1972; Pope, 1978; Ryle & Breen,1974) while those studies reporting increases in cognitive complexity based their

conclusions on the results of integration scores (e.g., Adams-Webber & Mirc, 1976). Thus, these discrepant findings reported in the

literature, as well as those revealed in the current investigation, may be the result of using different measures of cognitive complexity. These two measures may reflect different aspects of cognitive complexity that develop at differential rates as trainees are exposed to new training and therapy experiences.

However, there is an alternative hypothesis that may explain the discrepancy between cognitive differentiation and cognitive integration. As family therapy trainees learn a coherent and systemic conceptualization of family dynamics, they may begin to see families as less different from each other. Further, the family





74




therapy trainees irkay begin to see the commonalities and similar patterns across different families. This hypothesis is consistent with the goal of structural family therapy which is to look for the structural patterns that are supporting what appear to be the differing dynamics of different families (e.g., looking for the homeostatic principles that maintain the presenting symptom). Thus, the decreased levels of differentiation for the family therapy trainees suggests that.they see families as more alike as they begin to learn to interpret family dynamics with a structural template. However, the increased levels of differentiation for the nonfamily

therapy trainees suggests that their interpretations of family dynamics may be based on several different conceptualizations that they are utilizing in their individual therapy training. Thus, the lower levels of differentiation in the family therapy trainees may

suggest that structural family therapy training does not necessarily lead to lower levels of cognitive complexity, but influences family

therapy trainees' family construct system in such a way that they are able to tighten those family construct dimensions compared to therapy trainees without that training. This interpretation is also consistent with the higher level of cognitive integration found for the family therapy trainees. The family therapy trainees appear to

be more flexible in their use of their family construct system than the nonfamily therapy trainees. Perhaps the family therapy trainees are more willing to explore the possibilities of interrelationships among their family constructs and in that sense, they show higher





75




levels of cognitive complexity in their perceptual skills than the nonfamily therapy trainees.


Perceptual Skills and Level of Construct Abstraction


According to Crockett (1982), a major feature of a developing

construct system involves the appearance of abstract constructs. One method frequently used to assess the development of abstract

constructs involves a content analysis of the construct dimensions elicited by the Rep Grid (Duck, 1973). A review of the literature

revealed that those studies using a content analysis to investigate the level of construct abstraction as a function of training reported significant increases in level of abstraction as a function of training (e.g., Lewis, 1977; Lifshitz, 1974). The present study investigated whether family therapy trainees' family constructs would become more abstract as a function of structural family therapy training.

Level of abstraction is measured with a weighted average score based on Duck's (1973) system of content analysis. Contrary to expectations, there were no significant findings on measures of abstraction. However, there was a trend toward a main effect of Group, suggesting that the family therapy trainees tended to have

relatively higher levels of abstraction in their family constructs than did the nonfamily therapy trainees. Although these results are

in the predicted direction, the data do not argue cogently for differences between the two groups of therapy trainees. Perhaps a larger sample size would provide enough power to detect any changes





76




that may be taking place. It must be kept in mind, however, that family therapy training itself may not lead to higher levels of family construct abstraction.


Conceptual Skills and Case Conceptualizations


According to Cleghorn and Levin's (1973) model of therapy

skills, conceptual skills involve what the therapist thinks about in the therapy session and how those thoughts are organized. They argue that in order to formulate a problem in terms of the family system, the family therapist must specify the implicit rules of behavior in

the family that make sequences of family interactions predictable. Although the majority of the studies reported in the literature found increases in levels of conceptual skills for family therapy trainees,

these studies have been limited by the lack of a comparable control group (e.g., Breunlin et al., 1983; Friedman, 1971; Lange & Brinckman, 1976; Lange & Zeegers, 1978; Tom, 1980; Tucker & Pinsof, 1984) and the lack of a reliable, valid and standardized assessment instrument (e.g., Breunlin et al., 1983; Friedman, 1971; Lange & Brinckman, 1976).

In the present study, conceptual skill level was measured along a systemic dimension ranging from an individual focus to a systems focus. Trainees' conceptual skill level was measured for their ability to conceptualize intervention dynamics. it was predicted that the family therapy trainees would show an increase in their level of family and intervention conceptualization skills while the nonfamily therapy trainees would remain stable across time. The





77




results of the family intervention measures revealed no significant differences between the two training groups and no significant difference across time. The mean level of responses suggests that both groups focused on subgroup relationships when conceptualizing an

intervention strategy.

The results of the family conceptualization measures revealed a trend toward a main effect of Time, suggesting that both groups of subjects had a tendency to use slightly lower levels of conceptual skills at posttesting. There are several possible explanations for these findings. First, it is possible that the nature of the task biased the subjects to focus on family dynamics. Subjects were instructed to select case conceptualization response alternatives

that best reflected how they perceived the dynamics that were important in the family. By instructing subjects to focus on family dynamics, it is not surprising that subjects did just that, regardless of their training orientation.

A second explanation may involve the instrument itself. This instrument may not be sensitive enough to detect subtle changes, in part, because asking subjects to select their conceptualization of a segment of behavioral data is only a partial evaluation of conceptual skills. Such an evaluation may not predict how a trainee would conceptualize family dynamics if actually in a similar clinical situation. Since this measure is a compromise in that it can be

reliable, valid and standardized, it is important that it be made as reliable and valid as possible. Future research needs to establish such reliability and validity in their family therapy skills





78




instruments before changes in skill level of family therapy trainees can be adequately investigated.

Third, it may also be possible that the conceptual skills of the family therapy trainees were only beginning to undergo change at the time of the second measurement. It is possible that Cleghorn and Levin's (1973) model of therapy skills may be arranged along a dimension of skill level such that perceptual skills are a prerequisite for conceptual skill development and, in turn, conceptual skills are a prerequisite for the development of executive skills. Since the family therapy trainees are only beginning to change their perceptions of families, they may not have had enough time to develop family conceptual skills. Future research needs to

take a longitudinal approach to the investigation of the development of family therapy skills as a function of training. Lastly, it must be kept in mind that the development of family conceptual skills may not be unique to training in family therapy.


Executive Skills and Therapist Responses


The structural family therapist must develop therapy skills that influence the family to demonstrate the way it functions. Cleghorn and Levin (1973) have labeled these skills as executive skills. They argue that these skills involve what the therapist says and does in the therapy session in order to influence the family's sequences of transactions and consequently alter the way the family functions. Investigating the executive skills of family therapy trainees has proven to be a very difficult task. A review of the literature





79




reveals many methodological flaws in this area of investigation.

These flaws have consisted of the lack of comparable control groups and the absence of reliable, valid, and standardized measures sensitive to changes in skill level that are unique to family therapy. Those studies reporting increases in family therapy trainees' executive skills were unable to attribute those changes to training in family therapy as they did not include a comparable control group (e.g., Allred & Kersey, 1977; Tucker & Pinsof, 1984).

In those studies that did include some type of control group, the results have typically not shown significant differences in executive skill level of the trainees (e.g., Breunlin et al., 1983). However, these studies did not use a reliable coding instrument and thus their lack of results may be due to the instruments used rather than there being no differences. The present study investigated whether the executive skills of family therapy trainees, as compared with nonfamily therapy trainees, would increase when measured by a reliable arid valid coding system.

Executive skills were measured along four categories of

therapist responses that were found to be the most meaningful of Allred and Kersey's (1977) system based on a pilot investigation. The four categories reflected by the therapist response alternatives were Gathers Information, Reflects and Supports, Interprets and Confronts, and Structural Realignment. All measures of executive skill level were analyzed separately for each of the four the rapist response categories.





80




Executive Skills Within Category


Gathers information


Contrary to expectations, there were no significant differences between the two groups for level of executive skill within this category of therapist responses. Both groups of subjects were able to ask for information about subsystem relationships regardless of

their theoretical orientation (i.e., systems versus intrapsychic). This lack of significant findings suggests that these executive skills may not be a unique function of training in family therapy. If basic therapy skills, such as information gathering, can be adapted to use with families, then it will be important for future

research to explore which therapy skills cannot make that transition without additional training in family therapy. The question that continues to concern the field revolves around what skills are unique

to family therapy.


Reflects and supports


The results of these analyses of the Weighted Average scores and the Modal Response scores were also contrary to expectations. Both groups of therapy trainees showed a significantly higher frequency of

supportive responses at Time 1, which shifted to a significantly higher frequency of less sophisticated reflective responses at Time 2. A possible interpretation of these results may be that as the family therapy trainees attempt to make sense of their new family construct system, and the nonfamily therapy trainees attempt to




81




effectively understand actual clinical experience that they are not prepared for, they revert back to their first learned style of

interacting in therapy. The fact that there were no significant differences between the two groups of therapy trainees suggests that reverting to previously learned levels of executive skills may not be a function of structural family therapy training, but a function of attempting to interact effectively in a new situation. This lack of significant differences between the two groups of trainees again raises the question concerning the unique impact of family therapy training. Although the subjects reverted to a lower level of their executive skills, it is interesting to note that there were no changes in their average confidence level concerning their choice of therapist response to the family.


Interprets and confronts


The results of these analyses revealed that there were no

significant differences in level of executive skWs between the two groups of therapy trainees. Both groups of subjects tended to use strategic and confrontive interpretations, and there were no changes across time. This lack of change in executive skill level for

interpretive responses suggests that these skills may not be unique to family therapy training. If these skills are unique to family

therapy, it is possible that the task in the present investigation was biased toward not detecting changes. Since all the subjects were required to respond to the family by selecting an interpretive response, it is not possible to determine whether the nonfamily





82



therapy trainees would have responded differently than the family therapy trainees if allowed to select an interpretive response with an individual rather than a family focus. Future research needs to adjust for this factor of response bias in a forced choice format. One possibility may be to use a crossed design similar to the present investigation with the addition of an individual therapy tape. This would allow for an assessment of whether family and individual therapy trainees differ in their level of interpretive executive skills when interacting with an individual versus interacting with a family.


Structural realignment


According to Allred and Kersey's (1977) classification scheme,

structural realignment consists of the most sophisticated levels of therapy responses that can be made to a family. It was predicted that the family therapy trainees would show an increase in their level of structural realignment responses while the nonfamily therapy trainees would remain stable across time. Contrary to these predictions, the results revealed that there were no significant differences in response level for the two groups of trainees, and there were no significant differences across time. A possible explanation for this lack of change in executive skill level may be

that these responses were too sophisticated for even beginning family therapy trainees to attempt. It would be interesting to reassess the executive skill level of these trainees after the family therapy trainees had gained more training and exposure in family therapy.





83




Executive Skills Across Category


In addition to investigating possible changes within each of the

four therapist response categories, analyses were also performed to assess any possible changes in executive skills or confidence across these four categories. An analysis of modal responses for trainees' preferred category of therapy responses revealed no significant differences between the two groups or across time. Both groups of therapy trainees preferred to use Reflecting and Supporting responses. However, the results for the Average Confidence Level for the Preferred Response revealed that both groups of therapy trainees became significantly more confident concerning their preferred responses across time.

Taken together, these results suggest that there are no changes in executive skill level for family therapy trainees as a function of structural family therapy training. Both groups of therapy trainees maintained stable levels of executive skill for interpretive and structural realignment therapist responses. Perhaps these two categories of responses were too sophisticated to reflect changes in executive skill level of beginning therapists. Consistent with this hypothesis, changes in executive skill level were revealed for the therapist response categories of Gathers Information and Reflects and Supports. The results revealed that the level of executive skill decreased across time for both groups of therapy trainees. Further, the results revealed that the preferred category of therapist responses were Reflecting and Supporting responses. One possible





84




explanation for these results is that regardless of the therapy training involved, when confronted with a new situation, therapy trainees will revert back to more familiar and comfortable lower level therapist responses. Future research in this area will need to take a longitudinal view of the executive skill level of family therapy trainees (as compared to nonfamily therapy trainees) as they gain more exposure to family therapy.


Summary


In a recent review of the family therapy training field, Kniskern and Gurman (1979) emphasized the lack of empirical, evaluative studies. The majority of the studies that have been reported have been based on self-report and uncontrolled investigations. Although these studies have reported increases in family therapy skills, it has not been possible to attribute these perceived changes to training in family therapy. Recently there has been a trend toward more empirically sound measurement of the effects of family therapy training (e.g., Breunlin et al., 1983; Tucker & Pinsof, 1984). However, even these studies have been hampered by the lack of reliable and valid measures of therapy skills and the lack of

adequate control groups. The present investigation attempted to provide both reliable measures of family therapy skills as well as a comparable control group. Although the results of this investigation did not provide compelling support for the major hypotheses, they were suggestive of several alternative hypotheses that require additional research in the future.





35



Based on Cleghorn and Levin's (1973) model of family therapy

skills, the present study investigated three major skills associated with effective family therapy (i.e., perceptual, conceptual and executive skills). Using Kelly's (1955) Role Repertory Grid measure, the results of the present investigation revealed changes in

perceptual skills that at first glance appear to be opposite of those predicted. Measures of cognitive differentiation increased for the nonfamily therapy trainees and decreased for the family therapy trainees. This would appear to suggest that training in structural family therapy has a negative impact on trainees, resulting in decreased levels of cognitive complexity. However, measures of

cognitive integration revealed that the family therapy trainees were much more integrated and flexible than the nonfamily therapy

trainees. Taken as a whole, these results suggest that as trainees begin to learn about family dynamics they form a structural template that is used as the basis for their family interpretations. It appears that the family therapy trainees are beginning to see the commonalities and patterned similarity across the different families,

while the nonfamily therapy trainees continue to view families based on several different theoretical orientations. Thus, the decrease in differentiation for the family therapy trainees may be a reflection of the tightening of the new family construct system, while the increase in integration reflects their flexibility in the use of

their new constructs. In contrast, the increase in differentiation for the nonfamily therapy trainees may simply reflect their continued use of a diversity of therapy constructs, while their lower level of





86



integration reflects their less flexible use of therapy constructs when applied to families.

Interestingly, although the family therapy trainees are

beginning to experience changes in their perceptions of families, they have not yet developed these skills to the point where they can begin to conceptualize the family differently. Regardless of the therapy training involved, all trainees were able to focus on subsystem dynamics when required to conceptualize the family. However, the family therapy trainees were not yet able to conceptualize the family in completely systemic terms. It is possible that they had simply not advanced to this point. This hypothesis is consistent with the results of the content analysis of trainees' perceptual skills. Although trainees were beginning to show perceptual changes, there were no significant increases in level

of abstraction, suggesting that the trainees' perceptual skills were still developing.

Based on the results of the measures of perceptual and

conceptual skills, it is not surprising that there were no changes in their executive skill level. This further suggests that executive skills would be the last skills to develop. Before the family therapist can act differently in therapy, he or she must perceive the family differently and conceptualize the family dynamics differently. The fact that both groups of therapy trainees reverted back to relatively basic reflection of feeling responses suggests that dealing with a family was a new and possibly confusing situation that





87



prompted subjects to respond in ways that they felt more confident wi th.

In conclusion, although the results of this study did not

support the hypotheses of increased family therapy skill levels, the results did not negate these hypotheses either. Rather than

indicating an increase in these skills, the results suggest that family therapy skills may be developmentally dependent upon each other such that higher level skills can not develop until lower level skills have been adequately developed and consolidated. Thus, as a function of training in structural family therapy, trainees may first show changes in their perceptual skills, followed by changes in conceptual and then executive skills. Future research needs to take a longitudinal approach to the investigation of the impact of training on the family therapy skills of trainees in this field.


Future Considerations


The investigation of the effects of training in family therapy is a new and relatively uncharted area of inquiry. There are only two studies cited in the literature that approach the empirical sophistication and rigor necessary to explore the impact of family therapy training on therapy skills (e.g., Breunlin et al., 1983; Tucker & Pinsof, 1984). Both of these investigations have several flaws in their methodology that need to be addressed. In the Breunlin et al. (1983) study, there was no mention of any objective coding system and, although they are beginning to develop an instrument for measuring family therapy skills, without an objective





38




measure their results may have been biased toward the logical expectation that trainees' responses would become more complex after training. Further, this study did not employ a comparable control group. In the Tucker and Pinsof (1984) investigation, the authors reported the use of a measure found to reliably discriminate between the family therapy skills of beginning and advanced family therapists. However, they did not employ any control group and, consequently, it is difficult to attribute their results to the specific effects of training in family therapy. Future research must combine these two aspects of empirical investigation, namely, the use

of a reliable measurement and experimental control.

While the present investigation attempted to control for these

two major limitations, the instruments used may not have been sensitive enough to detect subtle changes. The reliabilities for the therapist response executive skill measure ranged from .45 to .76, while the reliabilities for the conceptual skill measure only ranged from .33 to .69. These two instruments need to be revised and reliabilities increased before they can be expected to reliably measure changes in therapy skill level. A second limitation in the present investigation consisted of the small sample size (N=33), reducing the power of the analyses to detect changes that may be present. For example, analyses of power for structural measures of

cognitive integration and cognitive differentiation revealed that the power of the F tests were .11 and .72, respectively. In the present

study, adequate power (e.g., .80 to .90) would require an approximate sample size of 50 to 70 subjects. Future studies must include an





89




adequate sample size of both family therapy trainees and control subjects in order to determine if changes in therapy skills are a unique function of training in family therapy.

In addition to the above two changes in methodology, future

research may also benefit from taking a longitudinal approach to the study of family therapy training. It may be that changes in conceptual and executive skills do not begin to change until the trainees gain actual clinical experience with families. Future research will need to investigate this issue of past clinical experience more closely. Does the amount of past experience with individual therapy affect how family therapy trainees integrate their new knowledge? This could be investigated by comparing four groups of subjects: family therapy trainees with no prior therapy experience, family therapy trainees with two to five years of prior therapy experience, nonfamily therapy trainees with no prior therapy experience, and nonfamily therapy trainees with two to five years of

prior therapy experience. It would also be interesting to investigate the relationship between trainees' own family background (e.g., only child versus several siblings) and their family conceptual skills as a function of training in family therapy.

Further, future research may also benefit from taking a slightly different approach to the study of therapy skills in family therapy trainees. The present investigation may have biased trainees toward focusing on family dynamics. According to structural family

therapists (e.g., Minuchin, 1974), one can take a structural systems approach even when working with an individual. In order to control





90




for biasing subject responses simply by being in a family therapy project, future research can use a crossed design such that subjects are required to view an individual as well as a family on rape in order to measure conceptual and executive skills. It would be

expected that control subjects would not take a systems view of the individual, while the family therapy trainees may begin to conceptualize and respond to an individual along a more systemically oriented dimension.

If the field of family therapy training is going to claim that it has a unique impact on the family therapy skills of its trainees, then future research must not ignore the proven, traditional methodological approaches (Gurman, 1983). According to London and Klerman (1982), the basic principles of empirical investigation are measurability and replicibility. As the area of family therapy moves toward traditional methodological investigation, the area of training in family therapy must also make this move toward controlled comparative investigation.





























APPENDICES




Full Text
5
and methods of different training programs must be taken into
consideration.
Although there exists a diversity of theoretical orientations
and training programs in family therapy, several investigators (e.g.,
Bloch & Weiss, 1981; Woody & Weber, 1984) have suggested that there
are several important basic concepts that are inherent to all
training programs irrespective of the setting, experience of the
student, and theoretical preferences of the trainers. Regardless of
the theoretical orientation, family therapy focuses on the
interrelationships of the family members. Each theory provides
guidelines for the therapist to assess and develop treatment
interventions that are intended to create systemic changes among the
family members (Woody & Weber, 1984).
Many family therapists (e.g., Okun & Rappaport, 1980; Sedgwick,
1981; Stanton & Todd, 1979; Woody & Weber, 1984) agree that students
need to learn to assess the family from a developmental model that
considers the progression of the family through family life stages.
Since each stage of the family life cycle requires that specific
tasks be successfully accomplished before the family can progress
into the next stage, failure on the part of the family to perform the
tasks can result in becoming fixated, resulting in dysfunctional
behavior. Family therapy trainees need to learn to consider the
family's current level of functioning in relation to their life
stages.
A third major point that family therapists agree upon is the
emphasis on the individuation processes of the family members as a


33
a family and thus allow for the generation of more hypotheses about
the family system.
In contrast to the findings reported by Lewis (1977), Zaken-
Greenberg and Neimeyer's (1984) investigation of the structure and
content of family therapy trainees' family construct systems revealed
that training in family therapy was generally associated with lower
levels of differentiation and integration. These results suggest
that such training initially channelizes and rigidities perception of
the family. This interpretation is consistent with the related body
of work which has shown that the construct system undergoes periods
of decreased complexity during the early periods of training,
followed by a reorganization of the constructs at higher levels
during advanced training stages (Baldwin, 1972; Pope, 1978; Ryle &
Breen, 1974).
Zaken-Greenberg and Neimeyer also reported a concomitant
decrease in the level of abstraction of the constructs themselves.
These authors suggest that this content shift toward more concrete,
descriptive construing that occurred in both groups may reflect the
tendency for trainees to favor more behaviorally evident constructs
(e.g., single-parent family vs. two-parent family) over more abstract
ones (e.g., undifferentiated family ego mass) as they are confronted
with the need to effectively understand actual clinical experience.
The effect of this gravitation towards concrete dimensions might be
to reduce the structure of the system since the dichotomous nature of
many concrete descriptions (e.g., dual career vs. single career
family) prevents their flexible, and hence more integrated, use in


I certify that I have read this study and that in my opinion it
conforms to acceptable standards of scholarly presentation and is
fully adequate, in scope and quality, as a dissertation for the
degree of Doctor of Philosophy.
Professor of Psychology
I certify that I have read this study and that in my opinion it
conforms to acceptable standards of scholarly presentation and is
fully adequate, in scope and quality^as a dissertation for the
degree of Doctor of Philosophy.
Greg jSweimeyer, Cocha
Assistant Professor of Psychology
irmarr
I certify that I have read this study and that in my opinion it
conforms to acceptable standards of scholarly presentation and is
fully adequate, in scope and quality, as a dissertation for the
degree of Doctor of Philosophy.
I certify that I have read this study and that in my opinion it
conforms to acceptable standards of scholarly presentation and is
fully adequate, in scope and quality, as a dissertation for the
degree of Doctor of Philosophy.
William Froi;
Associate P
of Psychology


63
suggesting that both groups tended to become less integrated across
time (see Table 7).
Content Grid Analyses
The 2(Group) x 2(Time) analysis of variance revealed no signifi
cant findings for Modal Response. However, these analyses did reveal
a trend toward a main effect of Group, F (1,31) = 2.94, p=.09 for the
Weighted Average score of abstraction such that the family therapy
trainees appeared to have higher levels of abstraction in their
family constructs than did the control subjects. Analyses also re
vealed a trend toward a main effect of Time, F (1,31) = 2.94, p=.09,
such that both groups became somewhat more abstract across time.
Case Conceptualization Analyses
Family Conceptualization Analyses
Analyses of the Weighted Average score revealed no significant
differences in level of systemic conceptualization of family dynamics
for the two groups. However, an analysis of variance on the Modal
Response scores did reveal a trend toward a main effect of Time,
F(1,31) = 3.40, p=.07. The direction of the means suggests that both
groups were viewing families along suogroup-systemic dimensions at
Time 1 (M=3.51), while at Time 2 they were viewing families along
more dyadic-subgroup dimensions (M=3.09). These results suggest that
both groups had a tendency to narrow the focus of their family
conceptualizations across time.


APPENDICES


87
prompted subjects to respond in ways that they felt more confident
wi th.
In conclusion, although the results of this study did not
support the hypotheses of increased family therapy skill levels, the
results did not negate these hypotheses either. Rather than
indicating an increase in these skills, the results suggest that
family therapy skills may be developmentally dependent upon each
other such that higher level skills can not develop until lower level
skills have been adequately developed and consolidated. Thus, as a
function of training in structural family therapy, trainees may first
show changes in their perceptual skills, followed by changes in
conceptual and then executive skills. .Future research needs to take
a longitudinal approach to the investigation of the impact of
training on the family therapy skills of trainees in this field.
Future Considerations
The investigation of the effects of training in family therapy
is a new and relatively uncharted area of inquiry. There are only
two studies cited in the literature that approach the empirical
sophistication and rigor necessary to explore the impact of family
therapy training on therapy skills (e.g., Breunlin etal., 1983;
Tucker & Pinsof, 1984). Both of these investigations have several
flaws in their methodology that need to be addressed. In the
Breunlin et al. (1983) study, there was no mention of any objective
coding system and, although they are beginning to develop an
instrument for measuring family therapy skills, without an objective


9
clinical family. In the present study, trainees participate in role-
playing interview sessions with simulated families, and work with a
clinical family throughout their second semester of training.
Although these training components extend across the various
schools of thought, each program utilizes them in a different way.
Thus, it becomes necessary to concentrate on the processes of change
involved in training rather than simply on which modes of training
are effective, or which school of therapy produces more effective
family therapists. Further, when attempting to generalize across the
various theoretical orientations through the commonalities in
training methods, it is important to clarify and operationalize the
structure and content of the program. Without this specificity, it
will be impossible to account for discrepant findings, or even to
integrate findings among the different schools of thought.
Outcome Studies in Family Therapy Training
Although there recently has been an emphasis placed on the need
for process-outcome investigations (Gurman & Kniskern, 1981), there
have been only a handful of empirical studies of family therapy
training (e.g., Allred & Kersey, 1977; Breunlin, Schwartz, Krause &
Selby, 1983; Byles, Bishop & Horn, 1983; Friedman, 1971; Lange, 1978;
Lewis, 1977; Pinsof, 1977; Tomm, 1980; Tucker & Pinsof, 1984), or
even descriptive analyses of training in family therapy (e.g.,
Ferber, 1972; Flint & Rioch, 1963; Flomenhaft & Carter, 1974; 1977;
Nichols, 1979). In an extensive review of the literature on
structural family therapy, Aponte and Van Deusen (1981) cite only


125
(c) You and your family need to decide if you want to go on
from here. Do you want to change the way the family is
right now? I would like to hear from each of you.
(d) Ian, I'm wondering what it is about Mom and Dianne's
behavior that makes you feel that you are not an
appreciated member of the family?
III. Response Alternatives
(a) It seems like everyone here today feels like he is not
being understood or appreciated and you have taken a big
step by coming here today and admitting you have some
problems that need to be worked on.
(b) Mom, it must be very difficult for you to try and
understand Ian's feelings when he seems so ungrateful for
all you have done for him.
(c) What has happened in this session has been a good
beginning and now we need to look closer and deeper at
what is happening underneath in this family.
(d) It seems like everyone here today feels like he is not
being understood, or more importantly, appreciated. We
need to look closer and deeper at what is happening
underneath in this family.
IV. Response Alternatives
(a) The issues concerning Ian that have been presented here
are really just surface expressions of the conflict and
turmoil that is going on inside. We will need to take a
closer look at what conflicts Ian's behavior is
camouflaging.
(b) It sounds like everybody in this family is upset because
not only does Dad not love them anymore, Ian also seems
not to care about his family anymore.
(c) Well, there seems to be several problems here that are not
related to Ian, but are related to your family's
unwillingness to share both positive and negative feelings
toward each other in an open manner. We will need to take
a closer look at how we can change the style of
communication in your family.
(d) You seem like a family that is very loving and protective
of its members, especially of Ian right now. I wonder
what would happen if you expressed this concern for him in
a way other than through anger and accusations.


45
by the experimenter if they made an error. Any subject who made two
or more coding errors was given five more constructs to practice
on. No subjects made any errors on the second set of trial
constructs (see Appendix E). Analyses of content provided measures
of abstraction (i.e., shifts in the use of personality and
interactional constructs as a function of training).
Therapist Responses to Simulated Family Tapes
Subjects were required to observe videotapes of a simulated
family therapy session, and instructed to assume the role of the
primary therapist. At four different intervals a family member
looked into the camera and asked the therapist (i.e., the subjects) a
question to which the subject was to respond by selecting one of
several provided multiple choice answers.
There are two 20-minute simulated-family videotapes that were
used in this study. These tapes are based on the dynamics of
simulated families used by Connors (1984) to investigate family
therapy training. Student volunteers from an undergraduate
psychology course and research assistants in the family therapy
training project made up the simulated families. Each "actor"
received a written description of the family dynamics and their role
in particular which served as a guide for their performance (see
Appendices F and G). They were given the family dynamics the evening
before taping, and were allowed one practice trial in order to feel
comfortable with their role. The actors were signaled when they were


30
conceptual difficulties that family therapy trainees often report
during the early phases of training (Gurman & Kniskern, 1978).
According to personal construct psychology, a person develops new
ideas through shifts in construction. This shift in construction,
known as the Creativity Cycle, starts with loosened construction and
terminates with tightened and validated constructions. Constructs
must be loosened in order that hypotheses may be tested, and then
they must be tightened after the hypotheses have been either
validated or invalidated so that they may be acted upon. Extending
this logic to family therapy training, if the trainees' constructs
pertaining to families become less organized during early phases of
training such that the relationships among the constructs decrease,
then efforts to interpret family behavior would be based on
constructs that are loosely related and lacking meaningful
connections. Consequently, trainees may experience difficulty in
formulating their conceptualizations of families, resulting in the
temporary decline in trainee performance cited in the training
literature (Duhl, 1978; Gurman & Kniskern, 1978).
Contrary to the above findings, Adams-Webber and Mire (1976)
reported no decrease in construct relationships during the early
phases of training. These findings were based on "integration"
scores that provided estimates of the overall degree of
intercorrelations among supplied constructs (e.g., activities of
educational personnel). The results indicated that there was a
gradual increase in the level of integration (i.e., cognitive
complexity) of "teacher role" subsystems as the trainees acquired


69
effects of family therapy training can be measured. This leaves open
the question as to whether factors other than the training program
were responsible for the noted changes (see Cook & Campbell, 1979).
The unique contribution of the present investigation is the
assessment of change in the family therapy skills of family therapy
trainees compared with a comparable control group.
In general, the results of this study did not provide compelling
support for the major hypotheses. For example, it was predicted that
the family trainees would become more cognitively complex than the
control subjects. The results of this investigation revealed that
the family therapy trainees became less cognitively complex, while
the control subjects became significantly more cognitively complex
across time. It was also predicted that the trainees' family
construct system would become more abstract than the family construct
system of the control subjects. Although the results revealed some
trends in support of this hypothesis, the data do not argue cogently
in support of the expected increase in abstraction among the family
therapy trainees. In addition to predicting increases in the level
of perceptual skills of the family trainees, it was hypothesized that
family trainees would show an increase in conceptual skills as a
function of training compared to the control group. The results
revealed that both groups changed across time, becoming somewhat more
narrowly focused than predicted. Lastly, it was predicted that the
family trainees would show more sophisticated levels of executive
skills compared to control subjects as a function of structural
family therapy training. Although the results revealed some


123
II.Response Alternatives
(a) Ian, what do you usually do when you feel like your Mom is
coming down on you?
(b) I'd like to know how long this family has been fighting
like this and when each of you think these changes began
to occur. I'd like to hear from each of you separately
while the others listen.
(c) Ian, I think that if you stop finding fault with Mom that
she will "get off your back." It is up to you to
determine what will change or stay the same in your
relationship with Mom.
(d) I'd like to know how long you and Mom have been fighting
like this and when each of you think these changes began
to occur. I'd like to hear from Ian first and then Mom.
Ill.Response Alternatives
(a) Although there has been a lot of arguing going on it seems
that you are each concerned about the other members of the
family. What we need to do is work together to find a way
for you to express these concerns without having to argue.
(b) It sounds like you are all confused about what is
happening and what you can do, and this is not unusual in
families that have recently experienced divorce. What we
need to do is work together to find a way for you to
express these concerns in such a way that all of you are
sati sfied.
(c) Ian mentioned that Mom does not go out very much since the
divorce and he would like to see her go out more, and it
sounds to me as though Ian is concerned about what is
going on with Mom.
(d) Ian, it sounds like you feel really angry and resentful
that Mom is trying to force you to take your father's
place in the family.
IV.Response Alternatives
(a) First, I really agree with Ian that you, Mom, and Dianne,
are ganging up on him and not listening to him, so that I
think therapy needs to focus on teaching you fair
parenting.
(b) It seems that there are a lot of things going on here,
some that relate to Ian and some that relate to other
members of the family. But for some reason the family has
agreed that Ian should shoulder the responsibility for the
conflict experienced in the family.
(c) It seems that there is a lot of avoidance in this family,
such that no one is willing to share how they feel and


APPENDIX A
FAMILY THERAPY COURSE DESCRIPTION
PCO 6250
INTRODUCTORY FAMILY COUNSELING
Fall, 1984
OBJECTIVES FOR THIS COURSE
1. To acquaint you with the historical development of the family
therapy field.
2. To acquaint you with the essential elements of family process and
family systems theory.
3. To assist you in developing skills in observing and organizing
family data.
4. To acquaint you with the distinctive challenges families face at
different life stages (e.g., single parent families, families
with adolescents or aging members, blended families).
5. To assist you in developing basic interviewing skills necessary
in conducting a family interview.
MATERIALS NEEDED FOR THE COURSE
Books: Minuchin, S. Families and Family Therapy
Napier, A. and Whitaker, C. The Family Cruciable
Carter, E. and McGoldrick, M. The Family Life Cycle
Selected articles and chapters on reserve on the Education
Library will also be required for the course.
COURSE REQUIREMENTS
1. Dynamic Communication Analysis. You will be given a transcript
of a couple's dimensions. The purpose of this assignment is to
teach you how to track communication sequences, to observe ways
in which communication meaning is derailed, and use this
92


67
the preferred category for both groups was the Reflects and Supports
category of therapist responses (Control M=2.86, Experimental
M=3.00).
Average confidence for preferred category response analyses
The 2(Group) x 2(Time) analyses of variance revealed a
significant main effect of Time, F (1,31) = 5.60, p<.02, such that
both groups became significantly more confident concerning their
preferred responses across time (M at Time 1 = 7.45, M at Time 2 =
7.94). See Table 10 for the results of the ANOVA table.
Table 10. Therapist Response ANOVA for Preferred Category Response
Source
Sum of Squares
df
Mean Square
F
P
Mean
3602.506
1
3602.506
1296.49
.000
Group
0.307
1
0.307
0.11
.742
Error
86.138
31
2.779
Time
5.325
1
5.325
5.60
.020*
Time x Group
2.161
1
2.161
2.27
.140
Error
29.476
31
0.951

p<.05


A PERSONAL CONSTRUCT ASSESSMENT OF
STRUCTURAL FAMILY THERAPY TRAINING
BY
FLORA ZAKEN-GREENBERG
A DISSERTATION PRESENTED TO THE GRADUATE SCHOOL
OF THE UNIVERSITY OF FLORIDA IN
PARTIAL FULFILLMENT OF THE REQUIREMENTS
FOR THE DEGREE OF DOCTOR OF PHILOSOPHY
UNIVERSITY OF FLORIDA
1985


19
Brinckman (1976) reported that trainees' attitudes shifted
significantly towards acceptance of behavioral family therapy as a
result of training in this model. In addition, Flomenhaft and Carter
(1974; 1977) reported that mental health professionals trained in
family therapy reported a significant increase in the amount of time
spent in family therapy over individual therapy. Although these
findings suggest that training leads to an increased knowledge of
course content and an acceptance of new theoretical positions, these
investigations actually offer little more than an assurance that
professionals are capable of learning new concepts and are more
favorably disposed to those concepts with increased familiarity.
Several studies have attempted to measure changes in the
conceptual and perceptual skills of family therapy trainees by having
them respond to videotaped segments of family therapy sessions as if
they were the therapists (e.g., Friedman, 1971; Lange & Brinckman,
1976; Lange & Zeegers, 1978; Tomm, 1980). In each of these studies,
the trainees' responses were coded by independent judges using
preselected coding schemes. The majority of these studies reported
significant increases in trainees' perceptual and conceptual skills.
A third method for evaluating the therapy skills of family
therapy trainees is the family genogram measure proposed by Tomm
(1980). Using this method, trainees are required to determine the
level of family development and associated family developmental tasks
from genograms that are provided to them. Tomm reported significant
increases in both perceptual and conceptual skills based on the
Family Categories Schema (Epstein etal., 1968).


59
therapist responses they chose for working with the family in order
of preference from the most to the least preferred. That category
most frequently endorsed by the subject as their preferred response
was labeled as the Mode for Preferred Response. This score provided
a measure of response preference across the four different
categories. The final dependent measure represents the Average
Confidence for Preferred Response. Subjects were required to rank
how confident they felt about their most preferred response on a
scale of 1 to 10 (very unconfident to very confident). An average
score was obtained across the four intervals.


156
Tripp, R. (1975). An exploratory study of Allred1s Interaction
Analysis for Counselors: The relationship of naive counselors'
scores on the AIAC to their scores on selected scales on the
MMPI. Unpublished magistral dissertation, Brigham Young
University.
Tucker, B., Hart, G., & Liddle, H. (1976). Supervision in family
therapy: A developmental perspective. Journal of Marriage and
Family Counseling, 2_, 269-276.
Tucker, S.J., & Pinsof, W.M. (1984). The empirical evaluation of
family therapy training. Family Process, 23, 437-456.
Waldron-Skinner, S. (1976). Family therapy: The treatment of natural
systems. London: Routledge & Kegan Paul.
Watson, W. (1975). An exploratory study of Allred's Interaction
Analysis for Counselors: The relationship of selected AIAC
scores to Truax Accuracy Empathy Scale scores. Unpublished
magistral dissertation, Brigham Young University.
Waxenburg, B. (1973). Therapists' empathy, regard and genuineness as
factors in staying in or dropping out of short-term, time
limited family therapy. Unpublished doctoral dissertation, New
York University.
Werner, H. (1955). Comparative psychology of mental development. New
York: International Universities Press.
White, M. (1979). Structural and strategic approaches to
psychosomatic families. Family Process, 18, 303-314.
Woody, R.H., & Weber, G.K. (1984). Training in marriage and family
therapy. In B.B. Wolman & G. Strickler (Eds.), Handbook of
family and marital therapy. New York: Plenum Press.
Zaken-Greenberg, F., & Neimeyer, G.J. (1984). Assessing structural
family therapy training: A personal construct approach. Paper
presented at the First North American Personal Construct
Network Conference, Cincinnati, OH.


FOUR RESULTS 60
Structural Grid Analyses 60
Content Grid Analyses 63
Case Conceptualization Analyses...' 63
Family Conceptualization Analyses 63
Family Intervention Analyses 64
Therapist Response Analyses 64
Within Category Analyses 64
Between Category Analyses 66
FIVE DISCUSSION 68
Perceptual Skills and Cognitive Complexity 70
Perceptual Skills and Level of Construct
Abstraction 75
Conceptual Skills and Case Conceptualizations 76
Executive Skills and Therapist Responses 78
Executive Skills Within Category 80
Executive Skills Across Category 83
Summary 84
Future Considerations 87
APPENDICES
A FAMILY THERAPY COURSE DESCRIPTION 92
B FAMILY THERAPY EXPERIENCE INVENTORY 96
C FAMILY REPERTORY GRID 98
D GRID CONTENT CODING INSTRUCTIONS 99
E GRID CONTENT EXAMPLES 101
F FAMILY A DYNAMICS SEEN BY ACTORS 102
G FAMILY B DYNAMICS SEEN BY ACTORS 107
H THERAPIST RESPONSE CODING SYSTEM Ill
I THERAPIST RESPONSE ALTERNATIVES: FAMILY A 112
J THERAPIST RESPONSE ALTERNATIVES: FAMILY B 119
K THERAPIST RESPONSES ANSWER SHEET 126
L CASE CONCEPTUALIZATION QUESTIONS: FAMILY A 135
M CASE CONCEPTUALIZATION QUESTIONS: FAMILY B 139
VI


84
explanation for these results is that regardless of the therapy
training involved, when confronted with a new situation, therapy
trainees will revert back to more familiar and comfortable lower
level therapist responses. Future research in this area will need to
take a longitudinal view of the executive skill level of family
therapy trainees (as compared to nonfamily therapy trainees) as they
gain more exposure to family therapy.
Summary
In a recent review of the family therapy training field,
Kniskern and Gurman (1979) emphasized the lack of empirical,
evaluative studies. The majority of the studies that have been
reported have been based on self-report and uncontrolled
investigations. Although these studies have reported increases in
family therapy skills, it has not been possible to attribute these
perceived changes to training in family therapy. Recently there has
been a trend toward more empirically sound measurement of the effects
of family therapy training (e.g., Breunlin et al., 1983; Tucker &
Pinsof, 1984). However, even these studies have been hampered by the
lack of reliable and valid measures of therapy skills and the lack of
adequate control groups. The present investigation attempted to
provide both reliable measures of family therapy skills as well as a
comparable control group. Although the results of this investigation
did not provide compelling support for the major hypotheses, they
were suggestive of several alternative hypotheses that require
additional research in the future.


A PERSONAL CONSTRUCT ASSESSMENT OF
STRUCTURAL FAMILY THERAPY TRAINING
BY
FLORA ZAKEN-GREENBERG
A DISSERTATION PRESENTED TO THE GRADUATE SCHOOL
OF THE UNIVERSITY OF FLORIDA IN
PARTIAL FULFILLMENT OF THE REQUIREMENTS
FOR THE DEGREE OF DOCTOR OF PHILOSOPHY
UNIVERSITY OF FLORIDA
1985

Copyright 1985
by
Flora Zaken-Greenberg

ACKNOWLEDGMENTS
I would like to take this opportunity to acknowledge and thank
those individuals who have given their encouragement and guidance
throughout the completion of my dissertation. Drs. Harry Grater and
Greg Neimeyer, the chairpersons of my committee, have guided and
directed this work from its inception to its completion. They have
both been invaluable as sounding boards, as well as being my
friends. Harry and Greg's commitments to excellence and
professionalism have been important models during my years as a
graduate student. Their enthusiasm and flexibility in support of my
basic ideas, and cooperation over the many years and miles are
greatly appreciated. I would also like to thank the members of my
committee, Bill Fronting, Carolyn Tucker, and Robert Jester, for their
effort and insightful suggestions. I have enjoyed and profited from
being a student in their respective courses and seminars. It has
been my pleasure to know these outstanding individuals personally and
professionally.
I would also like to thank all the people who were an integral
part of this dissertation. Drs. Peggy Fong, Mary Fukuyama, Max
Parker, Ellen Amatea, Robert Myrick and Harry Grater allowed me to
utilize their classrooms to solicit subjects. Drs. Herb Steier and
Andres Nazario gave their time and energy on short notice in the aid

of refining the stimulus materials. Florence Roess and Ces Bibby
were invaluable in coordinating subjects, experimenters, testing
rooms and preparation of all dissertation stimulus materials. I
would especially like to thank all the undergraduate research
assistants who gave long hours and were involved in all technical
aspects of this study. Susan Lerner, April Metzler, Marc Levant,
Mark Kaplan, Regina Davis, Gloria Pinzn, Joni Congdon and Jesus
Llobet were invaluable aids to this project as well as good
friends. Anita Moreles, Michele Majorek and Chere Ruquist also gave
much of their time to this project.
I would like to give a very special acknowledgment to my husband
Michael, for his constant love and support, and the many sacrifices
he has made in his own career so that I may pursue mine. Throughout
his own graduate work, he has always ungrudingly found the time to
give me many hours of technical and professional help on the various
aspects of this project. He has been the single greatest support in
my work and in my life, and I am happy to be able to share this time
with him. I would also like to thank my parents, Shirley and David
Zaken, for their unconditional faith and support throughout my life
and the long years of my graduate career.
TV

TABLE OF CONTENTS
Page
ACKNOWLEDGMENTS iii
ABSTRACT vii
CHAPTERS
ONE INTRODUCTION 1
Commonalities and Differences in Family Therapy
Training 3
Outcome Studies in Family Therapy Training 9
The Present Study 10
TWO LITERATURE REVIEW 14
Family Therapy Training 14
Descriptive Studies 14
Empirical Studies 18
Personal Construct Theory 25
Personal Construct Psychology and Training Studies...29
The Present Study 34
Hypotheses 35
THREE METHODOLOGY 38
Subjects 38
Instruments 39
Family Experience Inventory 39
Family Repertory Grid 40
Therapist Responses to Simulated Family Tapes...45
Case Conceptualizations 50
Procedure 52
Design and Analyses 55
Structural Grid Analyses 56
Content Grid Measures 56
Case Conceptualization Analyses 57
Therapist Response Analyses 57
v

FOUR RESULTS 60
Structural Grid Analyses 60
Content Grid Analyses 63
Case Conceptualization Analyses...' 63
Family Conceptualization Analyses 63
Family Intervention Analyses 64
Therapist Response Analyses 64
Within Category Analyses 64
Between Category Analyses 66
FIVE DISCUSSION 68
Perceptual Skills and Cognitive Complexity 70
Perceptual Skills and Level of Construct
Abstraction 75
Conceptual Skills and Case Conceptualizations 76
Executive Skills and Therapist Responses 78
Executive Skills Within Category 80
Executive Skills Across Category 83
Summary 84
Future Considerations 87
APPENDICES
A FAMILY THERAPY COURSE DESCRIPTION 92
B FAMILY THERAPY EXPERIENCE INVENTORY 96
C FAMILY REPERTORY GRID 98
D GRID CONTENT CODING INSTRUCTIONS 99
E GRID CONTENT EXAMPLES 101
F FAMILY A DYNAMICS SEEN BY ACTORS 102
G FAMILY B DYNAMICS SEEN BY ACTORS 107
H THERAPIST RESPONSE CODING SYSTEM Ill
I THERAPIST RESPONSE ALTERNATIVES: FAMILY A 112
J THERAPIST RESPONSE ALTERNATIVES: FAMILY B 119
K THERAPIST RESPONSES ANSWER SHEET 126
L CASE CONCEPTUALIZATION QUESTIONS: FAMILY A 135
M CASE CONCEPTUALIZATION QUESTIONS: FAMILY B 139
VI

N INFORMED CONSENT FOR FAMILY THERAPIST'S PROJECT 143
0 FAMILY A DYNAMICS SEEN BY SUBJECTS 144
P FAMILY B DYNAMICS SEEN BY SUBJECTS 145
Q CASE CONCEPTUALIZATION ANSWER SHEET 146
R FAMILY REP TEST INSTRUCTIONS 147
REFERENCES 149
BIOGRAPHICAL SKETCH 157
vii

Abstract of Dissertation Presented to the Graduate School
of the University of Florida in Partial Fulfillment of the
Requirements for the Degree of Doctor of Philosophy
A PERSONAL CONSTRUCT ASSESSMENT OF
STRUCTURAL FAMILY THERAPY TRAINING
BY
FLORA ZAKEN-GREENBERG
August, 1985
Chairman: Dr. Harry Grater
Cochairman: Dr. Greg J. Neimeyer
Major Department: Psychology
The investigation of the effects of training in family therapy
is a new and relatively uncharted area of inquiry. There are only
two studies cited in the literature that begin to approach the
experimental rigor and control necessary to explore the impact of
family therapy training on therapy skills. The present investigation
attempted to control for the lack of experimental control and
objective measures of family therapy skills that continue to be
reported in the literature.
Based upon the distinction among therapy skills cited in the
literature, the present study investigated perceptual, conceptual and
executive skills associated with effective family therapy.
Perceptual skills were measured using a modified version of the Role
Repertory Grid, yielding measures of the structure and content of
vi 1 1

individuals' personal cognitive systems. It was predicted that the
structural complexity and level of abstraction in the family
construct system would increase as a function of family therapy
training.
Conceptual and executive skills were measured by analyzing
trainees' multiple choice responses to simulated family therapy
tapes. It was predicted that the family therapy trainees would show
increases in level of systemic conceptualization and therapist
response sophistication over the course of training.
Results of the 2x2 Analyses of Variance on the pre-post scores
for both family and nonfamily therapy trainees provided equivocal
support for the predictions of increased complexity in family therapy
trainee skills. The analyses revealed significantly decreased levels
of differentiation in perceptual skills for family therapy trainees
and significantly increased levels of differentiation for the
nonfamily therapy trainees, and no significant changes between groups
for conceptual or executive skills.
These results suggest that family therapy skills may be
developmentally dependent upon each other such that higher level
conceptual and executive skills cannot develop until lower level
perceptual skills have been adequately developed and consolidated.
The results of this study were also discussed in relation to the
unique contribution of family therapy training on therapy skills, and
future directions were suggested.
IX

CHAPTER I
INTRODUCTION
The past decade has witnessed the growing demand for clinical
and counseling psychology programs, professional psychology programs,
and specialized training programs for mental health and post-doctoral
professionals. Foremost among these is the demand for training in
family therapy which has resulted in the growth of a variety of
family therapy training programs. Despite this increasing demand,
there has been a dearth of research investigating important variables
in the training of family therapists (Woody & Weber, 1984).
The task of investigating the impact of training on potential
family therapists is an ambitious one. The investigator must decide
what type of program to investigate, what theoretical orientation
within the family therapy field to explore, and then, how to go about
isolating the critical variables involved in order that general
statements about training can be made. According to Tucker and
Pinsof (1984), this task is made even more difficult due to the
complexity of measuring conceptual, experiential, and behavioral
learning in a stimulus situation that is never duplicated. In
addition to the problem of not having a standard stimulus, the family
therapy field has also lacked the necessary instruments to measure
conceptual and behavioral skills (Gurman & Kniskern, 1978).
1

2
The present investigation focuses on training in structural
family therapy. As in all forms of therapy, the structural family
therapist relies on his powers of observation when assessing a
family's functioning. The distinguishing feature of structural
family therapy, however, involves the active participant observation
of the therapist. The focus of intervention according to the
structural model is the patterns of structural relatedness occurring
within the family system (White, 1979). The therapist's task is to
discover the dysfunctional structure existing within the family and
to design interventions to alter that structure. Structure is
examined in terms of power hierarchy, coalitions, alliances,
individual and subsystem boundary regulation, and the family's
flexibility for change (Minuchin, 1974). In order to observe these
patterns, the structural family therapist must find a way to get the
family to demonstrate their patterns of behavior, and this is where
the techniques of the therapy are first utilized. Once the therapist
has operationalized where in the structure the system fails to carry
out its functions, the goals of therapy are to solve problems through
changing the underlying systemic structure of the family.
The present study will adopt a personal construct approach to
the study of training in structural family therapy. Personal
construct psychology is a theoretical and empirical approach to the
study of personality and interpersonal relationships. The personal
construct methodology can provide the needed empirical rigor, which
has been lacking in prior studies of family therapy training, and can
bridge the gap between the relatively uncharted area of family

3
therapy training and more established approaches to personality,
counseling and interpersonal relationships.
Researchers in the field of family therapy have recently begun
to report some descriptive studies of training, typically ending with
a discussion of the need for empirical research in this area. Before
discussing the findings of the current literature on family therapy
training, the reader needs to be acquainted with the programs
currently available, the goals of family therapy, and how those goals
are translated into training and assessment. Further, the components
of family therapy training that extend across the various schools of
thought will be reviewed. In addition, a brief discussion of the
outcome literature will be presented, followed by a rationale for the
adoption of a Personal Construct Psychology approach to the study of
training in family therapy.
Commonalities and Differences in Family Therapy Training
In a national survey of training programs in family therapy,
Bloch and Weiss (1981) reported a growing and varied assortment of
programs. In addition to the diversity of programs available, they
also discovered that the establishment of family therapy training
programs has grown exponentially between 1942 and 1980. Levant
(1984) has suggested that these training programs may be divided into
two major groups. The first group involves training that is offered
as part of the overall training program of one of the various mental
health or human-service professions. The second group involves
programs that are specifically designed to train family therapists.

4
According to Kniskern and Gurman (1979), these training models differ
on three major dimensions. The first dimension involves whether or
not the training leads to a degree or certificate in family
therapy. Second, is family therapy the only form of therapy taught
at a given training center or does the program require some
experience with individual and group therapy? Third, training
programs vary as to the extent of previous experience in
psychotherapy that is required for admission.
In order to evaluate family therapy training, investigators must
specify what type of program is under study as well as how that
program defines family therapy. Kniskern and Gurman (1979) argue
that the meaning which one attaches to the term family therapy will
directly affect the way in which one trains family therapists and
evaluates that training. These authors suggest that a training
program that views family therapy as a technique will focus primarily
on the acquisition of technical skill, and as such, the acquisition
of specific technical skills will be viewed as the most appropriate
criterion of the success of the training program (e.g., behavioral
and communications approaches). However, if family therapy is viewed
as a conceptual approach to the understanding of behavior and
behavioral pathology, Kniskern and Gurman (1979) argue that the
training program will view the acquisition of specific intervention
techniques as a secondary goal (e.g., existential and strategic
approaches). Thus, before general statements about the effectiveness
of family therapy training can be made, differences between the goals

5
and methods of different training programs must be taken into
consideration.
Although there exists a diversity of theoretical orientations
and training programs in family therapy, several investigators (e.g.,
Bloch & Weiss, 1981; Woody & Weber, 1984) have suggested that there
are several important basic concepts that are inherent to all
training programs irrespective of the setting, experience of the
student, and theoretical preferences of the trainers. Regardless of
the theoretical orientation, family therapy focuses on the
interrelationships of the family members. Each theory provides
guidelines for the therapist to assess and develop treatment
interventions that are intended to create systemic changes among the
family members (Woody & Weber, 1984).
Many family therapists (e.g., Okun & Rappaport, 1980; Sedgwick,
1981; Stanton & Todd, 1979; Woody & Weber, 1984) agree that students
need to learn to assess the family from a developmental model that
considers the progression of the family through family life stages.
Since each stage of the family life cycle requires that specific
tasks be successfully accomplished before the family can progress
into the next stage, failure on the part of the family to perform the
tasks can result in becoming fixated, resulting in dysfunctional
behavior. Family therapy trainees need to learn to consider the
family's current level of functioning in relation to their life
stages.
A third major point that family therapists agree upon is the
emphasis on the individuation processes of the family members as a

6
primary task for the family to accomplish. If a family is unable to
foster this individuation process, an individual's symptoms and
problems may be reflective of family stress, conflict, or the
internalization of other family breakdowns. Further, the less
effective the family, the more limited the family will be in its
capacity to facilitate the individuation process. The student
requires training that focuses on learning to accurately assess and
develop goals for the family that will alter the family system and
promote the individuation process.
Most importantly, family therapies are problem focused. The
family therapist must be skilled in assessing the function of the
problem for the family and the family system's response to it (e.g.,
enmeshed or disengaged relations, regression, rigidity, or
internal iza ti on).
Although the differing family therapy orientations agree on
these four points, the conceptual orientation of the curriculum will
influence how the problem resolution will be obtained. While some
theories, such as problem-solving, learning, behavioral, and
communication emphasize learning problem-solving skills as a major
objective, other theories, such as structural and strategic
approaches, use indirect, manipulative, and metacommunicative
interventions to induce change for problem resolution (Woody & Weber,
1984). How these goals of therapy are translated into training
remains unclear. Empirical research that investigates the process of
change as well as the outcome of training may be able to overcome the
dilemna of differing programs and theoretical orientations, and

7
answer the question of what impact training has on family therapy
trainees.
Regardless of the type of training program involved, there are
certain components of family therapy training that extend across the
various schools of thought. All therapy training programs, including
family programs, utilize four primary methods for training:
didactic, supervisory, observational, and experiential. Since the
field of family therapy is relatively new, most training programs
require their trainees to read a variety of sources that reflect the
diversity of family therapy. However, there are also training
programs that concentrate on the work of a single well known
therapist and school of thought. Kniskern and Gurman (1979) suggest
that although programs with a single, integrated approach to family
therapy lessens the confusion that results from sampling readings
from the various schools of thought, these programs may run the risk
of producing less creative and flexible therapists. In agreement
with Kniskern and Gurman's argument, the present study will
investigate the training process that occurs within a program that
places a major emphasis on structural family therapy (e.g.,
Minuchin), while also incorporating other schools of thought such as
strategic (e.g., Haley), communications (e.g., Satir), and
experiential (e.g., Whitaker).
The second mode of training involves supervision of the
trainees. Most family therapy trainers agree (Kniskern & Gurman,
1979; Liddle & Halprin, 1978) that the primary teaching of family
therapy occurs in supervision. However, the techniques of

8
supervision vary from a focus almost exclusively on the problems of
the family being treated to a focus almost entirely on the trainee
independent of the family being treated, to the therapist's
relationship with the family. Thus, the techniques utilized by the
supervisor, as well as his or her style of supervision, are
influenced by both the theoretical and therapeutic orientation
(Kniskern & Gurman, 1979). For example, a directive and problem-
oriented therapist would probably supervise in a direct, problem-
oriented way, while a process-oriented therapist would be more
concerned with the personal growth of the trainee. Although no study
has investigated this impact of training, Kniskern and Gurman (1979)
suggest that such stylistic differences in supervision will tend to
result in differences in therapeutic style by the trainees. Thus,
when interpreting shifts across training, it is necessary to keep the
supervision style in mind. The supervision style utilized in the
present study is based on a structural problem-solving approach to
family therapy.
The observational component involves having the trainees view
tapes of family therapists in action, viewing in vivo family therapy
sessions through a one-way mirror, and viewing role-play interviews
of other family therapy trainees. As with the supervision style,
what is observed is influenced by the style and theoretical
orientation of the trainer.
The fourth mode of therapy training is classified as
experiential. Experiential methods may involve role-playing,
participating in a simulated family, or actually working with a

9
clinical family. In the present study, trainees participate in role-
playing interview sessions with simulated families, and work with a
clinical family throughout their second semester of training.
Although these training components extend across the various
schools of thought, each program utilizes them in a different way.
Thus, it becomes necessary to concentrate on the processes of change
involved in training rather than simply on which modes of training
are effective, or which school of therapy produces more effective
family therapists. Further, when attempting to generalize across the
various theoretical orientations through the commonalities in
training methods, it is important to clarify and operationalize the
structure and content of the program. Without this specificity, it
will be impossible to account for discrepant findings, or even to
integrate findings among the different schools of thought.
Outcome Studies in Family Therapy Training
Although there recently has been an emphasis placed on the need
for process-outcome investigations (Gurman & Kniskern, 1981), there
have been only a handful of empirical studies of family therapy
training (e.g., Allred & Kersey, 1977; Breunlin, Schwartz, Krause &
Selby, 1983; Byles, Bishop & Horn, 1983; Friedman, 1971; Lange, 1978;
Lewis, 1977; Pinsof, 1977; Tomm, 1980; Tucker & Pinsof, 1984), or
even descriptive analyses of training in family therapy (e.g.,
Ferber, 1972; Flint & Rioch, 1963; Flomenhaft & Carter, 1974; 1977;
Nichols, 1979). In an extensive review of the literature on
structural family therapy, Aponte and Van Deusen (1981) cite only

10
four studies designed to address issues related to training
structural family therapists. Three of these (Betof, 1977;
Flomenhaft & Carter, 1974; 1977) described results of uncontrolled
post-hoc evaluations of training programs. The fourth (Kaplan,
Rosman, Liebman & Honig, 1977) represented a multi-method assessment
of a one year training program within the context of a small sample
(20 trainees and 5 controls). These studies only begin to redress a
long-standing inattention to the empirical assessment of family
therapy training programs. Another major difficulty encountered in
this area of research is the lack of sensitive instruments for
measuring change in therapist skills (Gurman, 1983). Therefore, the
dearth of process-outcome studies and lack of a methodology sensitive
enough to detect changes in the skills of family therapists support
Gurman and Kniskern's recent conclusion that "we must acknowledge and
underline the field's collective empirical ignorance about this
domain" (1981, p. 772).
The Present Study
The theory and methodology underlying the present study is
adopted from Kelly's (1955) personal construct psychology. Personal
construct theory was initially developed as a conceptual approach to
the study of personality, psychopathology and psychotherapy. This
theory has generated a wide body of empirical research and has
recently reemerged as an important contribution to the study of human
behaviors (e.g., Bannister, 1981; Bannister & Fransella, 1955; R.A.
Neimeyer, 1985; Neimeyer, Klein, Gurman & Griest, 1983; Neimeyer &

11
Neimeyer, 1981). This theory has also been applied to various
training contexts, including training in social work (e.g., Lifshitz,
1974), education (e.g., Ryle & Breen, 1974) and marriage and family
therapy (e.g., Lewis, 1977; G.J. Neimeyer, 1985; Neimeyer & Hudson,
1984; Procter, 1981).
According to personal construct theory, individuals operate as
"personal scientists" whose aim is to render experience meaningful;
to better understand, predict and control the events with which they
are confronted. After repeated experience with a particular type of
event, an individual abstracts salient commonalities and
characteristics of these situations. The abstracted features are
meaningful only in relation to their opposites. For example, after
several family therapy sessions, a family therapist may come to see
certain families as enmeshed, a quality meaningful insofar as it
contrasts with being disengaged. This personal dimension, or
construct of "enmeshed-disengaged" serves as a continuum along which
events (i.e., families) can be ordered, thereby lending structure and
meaning to the family therapy experience. Taken together, many such
dimensions form the construct system, a unique conceptual template
for ordering and anticipating experience.
Importantly, this system of dimensions is ordered (Organization
Corollary, Kelly, 1955) and undergoes characteristic shifts over the
course of personal and professional development (see Crockett, 1982,
for a review). In particular, following Werner (1955), it can be
assumed that construct systems develop from a stage of globality to
particularity; that is, moving from simple to complex levels of

12
cognitive differentiation over the course of continued experience.
In general, this reasoning is consistent with Bieri's definition of
complexity as "the tendency to construe social behavior in a
multidimensional way such that a cognitively complex individual has
available a more versatile system for perceiving the behavior of
others than does a less complex person" (1955, p. 14). Following
from this definition, subsequent work has noted predicted changes in
cognitive complexity over the course of professional development.
For example, two studies have reported a curvilinear relationship
between cognitive complexity and level of training for teachers
(Runkel & Damrin, 1961) and social workers (Ryle & Breen, 1974).
Training seemed to first restrict, and then to enlarge, the subjects'
cognitive systems. Subsequent work has addressed the relationship
between this level of cognitive complexity and therapeutic decision
making among a group of social work students (Duehn & Procter,
1974). These investigators reported that the more complex students
specified a greater number of alternative therapeutic interventions,
suggesting that greater complexity may be associated with greater
flexibility in responding.
In addition to structural changes in cognitive complexity
associated with training, shifts in the content of the constructs are
also predictable from personal construct theory. For example,
Lifshitz (1974) compared the content of social work students'
constructs with those of their supervisors. Results indicated that
students used more concrete descriptions (e.g., age, sex, profession)

13
while their supervisors used more abstract dimensions (e.g.,
diligent, responsible).
Thus, the use of personal construct methodology lends itself
well to the study of a variety of training methods. Extending this
personal construct training literature to the training of family
therapists suggests several lines of inquiry. These concern both
structural and qualitative changes in trainees' conceptual and
clinical abilities as they gain exposure to, and practice with, a
structural-systemic approach to family treatment.
First, based on the systems approach of structural family
therapy, shifts are expected in the direction of greater use of
systemic dimensions for the trainees (e.g., focusing on family
interactions versus an individual focus), as well as shifts in the
direction of greater overall complexity in the family construct
systems of family therapy trainees (e.g., increases in the number of
constructs used and the interrelationships between those constructs)
relative to a comparable control group. In addition, it is predicted
that there will be similar shifts towards more complex and
systemically oriented case conceptualization skills in the trainees,
and more effective and systemically oriented therapist responses in
trainees than in control subjects.

CHAPTER II
LITERATURE REVIEW
Family Therapy Training
Descriptive Studies
Although there is little empirical evidence for the
effectiveness of family therapy training, there is some research
concerning the specific therapist factors that influence the outcome
of family therapy (e.g., Epstein, Sigal & Rakoff, 1968; Thomlinson,
1974; Tomm & Wright, 1979). Thus, the identification of those
factors that may be taught in training provide indirect support for
the potential effectiveness of family therapy training programs. In
an extensive review of the family therapy research literature, Gurman
and Kniskern (1978) reported therapy structuring skills, experience
level, and relationship skills as the three most important factors
that influence the outcome of family therapy. Obviously, experience
level is not able to be taught in a training program; however, both
therapy structuring skills and relationship skills may be focused on
in training. Structuring skills have been investigated by several
researchers (Alexander, Barton, Schiavo & Parsons, 1976; Epstein et
al., 1968; Sigal, Guttman, Chagoya & Lasry, 1973). Based on this
research, structuring skills of the therapist have been divided into
directiveness, clarity, self-confidence, information gathering, and
14

15
stimulating interaction. Further, Gurman and Kniskern (1978) have
argued that the family therapist must generally be active and provide
early structure without assaulting family defenses too soon.
In addition, the ability of a family therapist to establish a
positive relationship with the family has received consistent support
as the most important outcome-related therapist factor. Several
investigators (Shapiro, 1974; Shapiro & Budman, 1973; Waxenburg,
1973) have reported that therapist empathy, warmth, and genuineness
appear to be very important in keeping families in treatment beyond
the first interview. In an impressive investigation of relationship
skills, Alexander et al. (1976) reported that while structuring
skills discriminated between two levels of poor outcome, only
relationship skills were able to discriminate between good and very
good outcomes. They reported that these factors were related to
positive outcome regardless of the theoretical orientation of the
therapist. However, these are the same skills that have been found
to be critical for the process of effective psychotherapy in
general. Thus, research in family therapy training needs to identify
and confirm the effectiveness of those variables specific to family
therapy in order to conclude that this training is any more effective
than traditional training in psychotherapy.
However, the goals of training and supervision and the skills of
the supervisor are dependent upon the theoretical orientation of the
particular training program involved. The experientially oriented
(Constantine, 1976; Ferber & Mendelsohn, 1969; Luthman &
Kirschenbaum, 1974) and psychodynamically based programs (Ackerman,

16
1973; La Perriere, 1977) tend to emphasize the personal growth
aspects of training and the affective experiences of the trainees.
For example, two studies which attempted to isolate changes in
psychiatric residents undergoing psychodynamic family therapy
training were based on trainee self-reports (Flint & Rioch, 1963;
Schopler, Fox & Cochrane, 1967). Based on these self-reports, both
investigators concluded that the trainees gained increased awareness
and appreciation for family dynamics. However, as Orlinsky and
Howard (1978) point out, self-report is often unreliable due to the
investment the individual has in perceiving change. In addition,
since external judges were not employed and the variables being
judged were often poorly defined, these results must be interpreted
with caution. Self-report should not, however, be ignored, but
should be reported in conjunction with more objective measures of
change.
In those programs that operate more from structural (Minuchin,
1974), behavioral (Cleghorn & Levin, 1973), and strategic (Haley,
1976) therapeutic orientations, goals are more cognitively based and
focus more on defining particular sets of therapist skills and ways
of intervening into dysfunctional systems. The current trend in the
family therapy training literature is in the direction of
establishing operationally defined objectives and therapist
competencies according to differing theoretical schools of thought
(Garrigan & Bambrick, 1976).
Within the behavioral and structural schools, Cleghorn and Levin
(1973) have been influential in proposing operational objectives for

17
the assessment of training in family therapy. According to their
model, therapist skills may be classified into three groups:
perceptual, conceptual, and executive. Perceptual skills refer to
what the therapist observes in the therapy session, how the therapist
perceives interactions, and the meaning and effect of them on family
members and the family system. Conceptual skills basically involve
what the therapist thinks about in the therapy session and how those
thoughts are organized. Cleghorn and Levin argue that in order to
formulate a problem in terms of the family system, one must specify
the implicit rules of behavior in the family that make sequences of
family interactions predictable. In addition to the perceptual and
conceptual skills required of the family therapist, he/she must also
develop skills that influence the family to demonstrate the way it
functions. Cleghorn and Levin have labeled these skills as executive
skills. Executive skills involve what the therapist says and does in
the therapy session in order to influence the family's sequences of
transactions and thus alter the way the family functions. The
present study will attempt to assess the process of change in these
three skills delineated by Cleghorn and Levin (1973).
This descriptive model proposed by Cleghorn and Levin (1973) has
yet to be empirically tested, although several articles on family
therapy training have based their discussions on this model (e.g.,
Barton & Alexander, 1977; Woody & Weber, 1984). Although the current
trend is to objectify the skills of family therapy trainees, the
majority of the family therapy training literature continues to be
based on an impressionistic perspective (Tomm, 1980). For example, a

18
review of the training literature revealed tnat studies either
described training methods based on the clinical observations of the
trainer (e.g., Aponte & Van Deusen, 1931; Beal, 1976; Ferber &
Mendelsohn, 1969; Nichols, 1979), described the historical
development of marital and family therapy training (e.g.,
Constantine, 1977; Nichols, 1979; Tucker, Hart, & Liddle, 1976), or
provided a sociological comparison of supervision methods based on
trainee self-reports (e.g., Tomm & Leahey, 1980). Thus, rigorous
empirical investigations are required, including the addition of
appropriate control groups, adequate number of subjects, multiple
objective measures, and operationalization of variables that are
specific to family therapy.
Empirical Studies
A popular method of assessing trainees' knowledge of family
therapy course content and theory involves paper and pencil tests
such as multiple choice questions and essay questions (Friedman,
1971; Tomm, 1980). Friedman reported that mental health
professionals significantly increased in factual and theoretical
knowledge between pre- and posttraining tests. Similarly, Tomm
reported that first year medical students demonstrated significant
increases in their knowledge of a Family Categories Scheme devised by
Epstein and his associates following their training experiences
(Epstein, Si gal & Rakoff, 1968). An additional method popular in the
family therapy training literature involves assessing changes in
trainees' attitudes. Poelstra and Lange (1978) and Lange and

19
Brinckman (1976) reported that trainees' attitudes shifted
significantly towards acceptance of behavioral family therapy as a
result of training in this model. In addition, Flomenhaft and Carter
(1974; 1977) reported that mental health professionals trained in
family therapy reported a significant increase in the amount of time
spent in family therapy over individual therapy. Although these
findings suggest that training leads to an increased knowledge of
course content and an acceptance of new theoretical positions, these
investigations actually offer little more than an assurance that
professionals are capable of learning new concepts and are more
favorably disposed to those concepts with increased familiarity.
Several studies have attempted to measure changes in the
conceptual and perceptual skills of family therapy trainees by having
them respond to videotaped segments of family therapy sessions as if
they were the therapists (e.g., Friedman, 1971; Lange & Brinckman,
1976; Lange & Zeegers, 1978; Tomm, 1980). In each of these studies,
the trainees' responses were coded by independent judges using
preselected coding schemes. The majority of these studies reported
significant increases in trainees' perceptual and conceptual skills.
A third method for evaluating the therapy skills of family
therapy trainees is the family genogram measure proposed by Tomm
(1980). Using this method, trainees are required to determine the
level of family development and associated family developmental tasks
from genograms that are provided to them. Tomm reported significant
increases in both perceptual and conceptual skills based on the
Family Categories Schema (Epstein etal., 1968).

20
However, there are two major limitations of the empirical
research discussed so far. First, these research designs did not
include comparable control groups and thus any changes in the
trainees may be attributable to factors other than the training
program (e.g., spontaneous improvement, maturation, attention-placebo
effects, Cook & Compbell, 1979). Second, the variables which have
been selected for evaluation measure whether or not trainees have
assimilated the instructional material and not whether their
therapeutic skills have been influenced by training. In addition,
those studies that do assess therapeutic skills are not specific to
family therapy, but may be generalized to any form of psychotherapy.
In a recent attempt to eliminate these two major limitations,
namely, the lack of a comparable control group and the use of paper
and pencil tests of increased knowledge of training, Breunlin et al.
(1983) reported the development of an instrument designed to measure
the perceptual, conceptual and executive skills of family
therapists. This instrument consists of a videotape of an enacted
family's first session and a series of multiple choice questions
regarding the subjects' perceptions, conceptualizations and
therapeutic recommendations about the tape. The experimental
subjects consisted of 22 psychiatric residents who were given one
month of family therapy training, and the control subjects consisted
of 11 pediatric residents who were not given family therapy training
or any formal training in psychotherapy. A pre-post assessment
revealed a significant increase in conceptualization skills for only
the family therapy trainees. However, there were no changes in

21
either perceptual or executive skills for either group. Breunlin et
al. (1983) suggested that their instrument may not have been
sensitive enough to detect change in skill level.
The study of Breunlin et al. (1983) represents a considerable
advance over previous investigations; however, there are several
flaws in their methodology that need to be addressed. First, the
simulated therapy tapes showed a therapist interacting with the
family. It might be expected that viewing another therapist might
influence the responses of the subjects, thus confounding the
results. Further, the authors do not adequately describe how
subjects' responses were coded, or along what dimension. Third, the
actual construction of the tape is not adequately described. Four
family therapists reviewed the tape and arrived at a consensus that
it was representative of the structural-strategic model. Although
this procedure may provide a high level of content validity, the
reliability of this measure is open to question. Fourth, their
control group was not comparable for level of therapeutic
sophistication. It is logical to expect that psychiatric residents
would show greater levels of conceptual skill concerning family
therapy dynamics than a group of pediatric residents with no therapy
training. Finally, prior to developing multiple choice responses to
the simulated tape, open-ended test responses were subjectively
analyzed and determined to have substantially improved in both
complexity of answers and correct application of training knowledge
from pre- to posttest. Again, there was no mention of any objective
coding system and thus the results may have been biased toward the

22
logical expectation that trainees' responses would become more
complex after training.
More promising have been recent advances in the development of
objective instruments to assess behavioral changes of family
therapists. There have recently been two analysis systems developed
that target therapist executive skills behavior (e.g., Allred &
Kersey, 1977; Pinsof, 1977). Both of these measures have been shown
to demonstrate appropriately high levels of reliability and
validity. Pinsof (1977) provided empirical evidence that the
therapeutic verbal behavior of novice and advanced family therapists
can be coded reliably and shown to be significantly different. At
the present time, the Family Therapist Coding System (FTCS, Pinsof,
1977) is the only family therapist verbal coding instrument that has
provided researchers with the ability to distinguish among trainees
according to their training level (Tucker & Pinsof, 1984). However,
there is a major limitation involved in the use of this measure. Due
to the complexity of the instrument, a considerable amount of
practice administration is required in order to ensure reliable
measurement and therefore the use of the FTCS is often prohibitive.
The second measure, the Allred Interactional Analysis for
Counsellors (AIAC, Allred & Kersey, 1977), has also been shown to
differentiate among trainees' levels of training. Several studies
have reported this measure of verbal behavior to be both highly
reliable (Kersey, 1976; Sanders, 1974; Watson, 1975) and valid
(Kersey, 1976; Sanders, 1974; Tripp, 1975; Watson, 1975). Compared

23
to the FTCS, the AIAC is much less complex and produces reliable
results after a short period of coding practice.
This measure has recently been used to compare the executive
skills of family therapy trainees with those of nonfamily therapy
trainees. Zaken-Greenberg and Neimeyer (1984) investigated the
executive skills of family therapy trainees and comparable controls
in a pre-post design using a modified version of the AIAC. Subjects
were required to observe videotapes of a simulated family therapy
session and instructed to assume the role of the primary therapist.
At different intervals, a family member looked into the camera and
asked the therapist (i.e., the subjects) a question to which the
subject was to respond to in writing. Each response was rated by two
independent judges on a modified version of the AIAC. The original
categories were broken down into more refined and mutually exclusive
categories ordered along a dimension from obstructive responses
through levels of functional family therapy responses (e.g.,
relationship building, structural realignment). An overall average
of response level was obtained.
The results of this investigation revealed that family therapy
trainees responded with significantly more structural maneuvering
techniques than did the control subjects at posttest. In addition,
the family therapy trainees' use of these responses increased
significantly from pre- to posttest with no change indicated for the
control group. Zaken-Greenberg and Neimeyer (1984) suggested that
the structural training emphasis on behavioral manipulation of the

24
family influenced the way in which trainees revised their executive
skills when responding to a family.
A major problem with this approach is the unreliability
contributed by the judges. This approach is also weakened by the
difficulty in scoring and the lack of standardization. As Breunlin
et al. (1983) point out, a multiple choice format in which subjects
choose an alternative in response to a simulated videotape
constitutes a reasonable compromise in that it can reliably measure
therapist skills within a standardized and easily scorable
methodology. The present study will use a Breunlin et al. (1983)
paradigm, combined with a modified version of the AIAC, to assess and
compare the executive skills of family therapy trainees and
individual therapy trainees.
After reviewing this literature, it becomes clear that the
research in family therapy training is only beginning to contribute a
firm empirical grounding for the exploration and assessment of the
effectiveness of family therapy training. In order to provide a
comprehensive literature capable of integrating the disparate
findings, there needs to be a unified methodology that allows for
comparison across the different established training programs as well
as across the varying theoretical orientations. In addition, this
methodology must include comparative measures of family and nonfamily
therapy trainees. If there is no difference between individual
therapy experience and family therapy experience in producing
effective family therapists, then the skills proposed for family
therapy need to be reevaluated. The present study suggests the use

25
of Kelly's (1955) personal construct approach as a basis for the
empirical study of family therapy training.
Personal Construct Theory
George Kelly's (1955) personal construct psychology has been
described as a comprehensive theoretical framework for the study of
human personality (Mancuso & Adams-Webber, 1982). Personal construct
theory takes the position that an individual's interpretation of the
world is explained in terms of that person's organized system of
personal constructs. Each person has a unique way of construing the
world, and people are similar to each other to the extent that they
construe events in a similar way. Thus, the personal construct is
the basic unit of analysis in this system, and was originally defined
as "a way in which some things are construed as alike and yet
different from others" (Kelly, 1955, p. 105). Thus, the construct is
a bipolar dimension upon which a decision is made between a pair of
alternative acts (e.g., a family therapist may construe a family as
"rigid versus permissive").
Kelly based his psychology of personal constructs on a
fundamental postulate and 11 corollaries. This fundamental postulate
states that "A person's processes are psychologically channelized by
the ways in which he anticipates events" (Kelly, 1955, p. 46). Any
act or behavior can be viewed as hypotheses which are continuously
validated or invalidated by experience. However, a validated
hypothesis does not imply that an event has only one
interpretation. Kelly's theory argues that a totally different

26
interpretation may have led to an equally successful prediction.
This concept, labeled "constructive alternativism," is an important
reason why personal construct psychology lends itself so well to the
investigation of process-outcome variables. In family therapy
training, for example, each theoretical orientation perceives the
process of change differently, and yet the outcome (i.e., an
effective family therapist) will hopefully be the same. Even within
the field of family therapy itself, the therapist may construe a
family differently and through the therapeutic process bring that
family to the same outcome; a change from dysfunctional behavior to
functional behavior.
Personal construct psychology has recently been extended to the
area of family therapy. Although this theory was designed for
individual psychotherapy and intrapsychic processes, Procter (1981)
argues that it can easily be extended to the area of multi person
relationships. There are two important corollaries that allow for
this extension. The first is the sociality corollary, which states
that, "To the extent that one person construes the construction
process of another, he may play a role in a social process involving
the other person" (Kelly, 1955, p. 95). This corollary states that a
person makes choices or behaves in accordance with how he anticipates
that another will respond, regardless of the accuracy of his
construal. Thus, the sociality corollary allows for an understanding
of the complementary aspects of dyadic relationships. In order to
look at families, Procter introduced the group corollary which states
that, "To the extent that a person can construe the relationships

27
between members of a group, he may take part in a group process with
them" (1981, p. 354). This new corollary is applicable to training
as the trainee must learn to construe the relationships between the
members of the family and himself if he is to take part in a group
process with them.
The second corollary that extends to multiperson relationships
involves the choice corollary, which states that, "A person chooses
for himself that alternative in a dichotomized construct through
which he anticipates the greater possibility for extention and
definition of his (construct) system" (Kelly, 1955, p. 64). Kelly
further emphasized that choices are not necessarily conscious or
verbalized. An extension of this logic is Procter's family corol
lary, which states that "For a group of people to remain together
over an extended period of time, each must make a choice, within the
limitations of his system, to maintain a common construction of the
relationships in the group" (p. 354). Procter (1981) argues that a
negotiation of a common family reality occurs in families, which he
labeled as the family construct system (FCS). This family construct
system involves a hierarchically organized set of family constructs
used by the family members to make choices and anticipations. The
family therapy trainee must somehow learn to perceive and
conceptualize the common family reality (i.e., FCS), and through his
executive skills, to change that reality. According to Procter, this
will lead to new understandings about what has occurred in the past,
thus allowing the family to negotiate a new construction.

28
A review of the family therapy and training literatures suggests
that family therapists either restrict themselves to one theoretical
school, or find themselves in a confusing eclectic mixture of
theories and techniques. Haley (1976) has stated that a direct
synthesis of the various theoretical orientations in family therapy
is not possible due to the fundamental differences in their basic
postulates. However, common to both family therapy and family
therapy training is the process of change. Kelly explained change as
a process of reconstruction. According to this view, reconstruction
involves a change in the linkages between constructs, the addition of
new constructs, the elaboration of subsystems or a change in the
range of convenience (i.e., inclusiveness of a particular construct
dimension) which the construct system covers. Thus, family therapy
training consists of giving the trainees experiences which enable
them to elaborate and revise their own construct system such that
they are capable of objectifying the constructions of the family and
expediating the change process. It may be argued that personal
construct psychology subsumes the different approaches in a
theoretical framework that lies outside and at a greater level of
abstraction to the various present alternatives (Procter, 1981).
Further, personal construct theory allows a synthesis of various
theoretical alternatives without any compromise of theoretical rigor
and precision. This provides a strong rationale for the use of
personal construct psychology as a method to investigate the training
of family therapists.

29
Personal Construct Psychology and Training Studies
With the increased recognition of personal construct psychology
as a viable context within which to study human behavior and
relationships (i.e., systems of personal constructs), there has been
a burgeoning of research based on Kelly's Role Construct Repertory
Grid (Rep Grid). This Rep Grid measure has been adapted to the study
of a variety of issues ranging from analyses of individuals with
psychiatric disorders to the perceptions of therapists, friends,
marital couples, and trainees in various fields. Many of these
studies have focused on a concept labeled cognitive complexity which
Bieri (1955) has defined in terms of the differentiation of (i.e.,
the number of constructs in) an individual's construct system.
Basically, Bieri argued that as the construct system develops it
becomes more differentiated. This notion of progressive
differentiation has been investigated in many training studies based
on Kelly's (1955) organization corollary, suggesting that a construct
system is hierarchically organized and undergoes shifts over the
course of personal and professional development.
However, several studies investigating the training of
professionals have suggested that the relationships among the
constructs undergo periods of decreased complexity during the early
phases of training, followed by a reorganization of the constructs at
higher levels of complexity during advanced training stages (e.g.,
Baldwin, 1972; Pope, 1978; Runkel & Damrin, 1961; Ryle & Breen,
1974). These findings offer some suggestions concerning the

30
conceptual difficulties that family therapy trainees often report
during the early phases of training (Gurman & Kniskern, 1978).
According to personal construct psychology, a person develops new
ideas through shifts in construction. This shift in construction,
known as the Creativity Cycle, starts with loosened construction and
terminates with tightened and validated constructions. Constructs
must be loosened in order that hypotheses may be tested, and then
they must be tightened after the hypotheses have been either
validated or invalidated so that they may be acted upon. Extending
this logic to family therapy training, if the trainees' constructs
pertaining to families become less organized during early phases of
training such that the relationships among the constructs decrease,
then efforts to interpret family behavior would be based on
constructs that are loosely related and lacking meaningful
connections. Consequently, trainees may experience difficulty in
formulating their conceptualizations of families, resulting in the
temporary decline in trainee performance cited in the training
literature (Duhl, 1978; Gurman & Kniskern, 1978).
Contrary to the above findings, Adams-Webber and Mire (1976)
reported no decrease in construct relationships during the early
phases of training. These findings were based on "integration"
scores that provided estimates of the overall degree of
intercorrelations among supplied constructs (e.g., activities of
educational personnel). The results indicated that there was a
gradual increase in the level of integration (i.e., cognitive
complexity) of "teacher role" subsystems as the trainees acquired

31
classroom experience. These findings may indicate that integration
either increases in an irregular fashion during periods of training,
or actual experience accelerates the integration and tightening of
new constructs. However, these discrepant findings may also be the
result of using different measures than Pope (1978), Ryle and Breen
(1974), and Runkel and Damrin (1961) to estimate cognitive
complexity. The present study will use pre-post measures of
cognitive complexity based on both differentiation and integration
scores as a method of investigating the cognitive complexity issue in
training.
Crockett (1982) has suggested that a second major feature of a
developing construct system involves the appearance of abstract
constructs. One method used to assess the development of abstract
constructs involves a content analysis of the construct dimensions
elicited by the Rep Grid. Lifshitz (1974) investigated whether
constructs became more abstract as a consequence of training. This
study used factor analysis to identify the construct with the highest
loading on the first factor in the grids of social work trainees and
their supervisors. Each construct was then assigned to one of seven
categories and the distribution across the categories was examined.
The results indicated that the trainees used more concrete
descriptive categories while their supervisors showed more abstract
constructs of themselves, others, and their work. An increase of
more abstract constructs in the construct subsystems of trainees
during training was also revealed. However, this study provided
content information about only one construct in each trainee's

32
construct system. The present study will investigate a larger sample
of the constructs in the training subsystem in order to evaluate the
hypothesis of increased abstraction over the course of training.
Kelly's Rep Grid methodology has only recently been applied to
the area of family therapy training. Lewis (1977) conducted a study
of family therapy trainee's perceptual and conceptual abilities
before and after a twelve-hour structural family therapy workshop.
Basically, Lewis examined how trainees structured their thoughts
about families and the type of constructs that they used when
thinking about families. This study examined both the structural and
content changes of family therapy trainees. Lewis used a structural
measure devised by Landfield (1971) called ordination. Ordination is
a measure of the hierarchical organization of the trainees system of
thoughts about the elements under investigation (e.g., families).
Lewis also employed a measure called the functional independence of
constructs (Landfield, 1971) that measures the degree of uniqueness
between family constructs, along with Bonarius* (1970) measure of the
meaningfulness of the constructs to the individual. The results
showed a significant change from pre- to posttraining, indicating
that the structure of the trainees' thoughts about families had
become more cognitively complex. Further, a content analysis of the
trainee's family constructs revealed that a significant number of
trainees increased their use of interactional family constructs.
Interactional constructs were considered to be the most abstract in
the family construct subsystem as they impart more information about

33
a family and thus allow for the generation of more hypotheses about
the family system.
In contrast to the findings reported by Lewis (1977), Zaken-
Greenberg and Neimeyer's (1984) investigation of the structure and
content of family therapy trainees' family construct systems revealed
that training in family therapy was generally associated with lower
levels of differentiation and integration. These results suggest
that such training initially channelizes and rigidities perception of
the family. This interpretation is consistent with the related body
of work which has shown that the construct system undergoes periods
of decreased complexity during the early periods of training,
followed by a reorganization of the constructs at higher levels
during advanced training stages (Baldwin, 1972; Pope, 1978; Ryle &
Breen, 1974).
Zaken-Greenberg and Neimeyer also reported a concomitant
decrease in the level of abstraction of the constructs themselves.
These authors suggest that this content shift toward more concrete,
descriptive construing that occurred in both groups may reflect the
tendency for trainees to favor more behaviorally evident constructs
(e.g., single-parent family vs. two-parent family) over more abstract
ones (e.g., undifferentiated family ego mass) as they are confronted
with the need to effectively understand actual clinical experience.
The effect of this gravitation towards concrete dimensions might be
to reduce the structure of the system since the dichotomous nature of
many concrete descriptions (e.g., dual career vs. single career
family) prevents their flexible, and hence more integrated, use in

34
the system. The present study will use both structural and content
analyses of family rep grids in an attempt to examine any changes in
cognitive complexity or level of abstraction as a result of
structural family therapy training.
The Present Study
Kniskern and Gurman (1979) suggest that the assessment of the
outcome of training procedures in family therapy should be made on
several dimensions. First, it is important to assess if the trainee
increases his/her conceptual knowledge of family dynamics and
interaction patterns. The second major area for the assessment of
change involves the trainees' in therapy behavior (i.e., executive
skills). Third, it is important to evaluate if the trainees'
perceptions of families have changed as a function of training. The
present study will address all of these points.
This study is based on a structural training foundation. The
subjects have been divided into two groups: (1) an experimental
group consisting of 12 graduate students in counselor education and
counseling psychology undergoing a 16-week (45 hours) training
program in structural family therapy, and (2) a control group
consisting of 21 graduate students in counselor education and
counseling psychology undergoing individual psychotherapy training.
These control subjects have not taken any graduate courses in family
therapy. Participants in the present study completed (1) a family
therapy experience inventory, (2) a family repertory grid, (3) a
multiple choice questionnaire made up of therapist response

35
alternatives in response to a series of simulated-family therapy
videotapes (with the response alternatives designed to reflect the
classification system of the Allred Family Interaction Scale), and
(4) a multiple choice questionnaire designed to measure the case
conceptualization of the simulated family dynamics and treatment
intervention, both before and after the 16-week interval.
Hypotheses
There are four basic components that are being analyzed in this
study. The first is based on the family repertory grid which
consists of a clinical interview in which participants systematically
compare and contrast various families to determine dimensions
representative of their evaluations of family dynamics. A structural
analysis (FIC and chi square scores, see Landfield, 1971) will
provide measures of cognitive complexity. Based on the training
literature reviewed, it is hypothesized that family trainees will
significantly increase in cognitive complexity after training
compared to the control group.
The second component of this study involves a content analysis
of the repertory grid data. The content analysis is based on an
adaptation of Duck's (1973) procedure. Basically, constructs are
coded as either physical, role, psychological, or interactional. A
content analysis will provide measures of abstraction and it is
hypothesized that there will be a significant increase in the use of
abstract (i.e., interactional) constructions in the experimental

36
group. It is expected that the control group will remain at
consistent levels at pre- and posttesting.
The third component of this study will investigate trainees'
conceptual skills in three major areas. These areas include a
conceptualization of the family, a conceptualization of the
intervention, and a systemic dimension (e.g., focusing on an
individual vs. the entire system). Subjects will be required to
answer eight multiple choice questions that reflect these three areas
of interest. Based on the construction corollary, Kelly (1955)
stated that a person's anticipations are a matter of ascribing
certain recurrent "themas" as he successively construes events. This
logic suggests that recurrent themas for family dynamics are learned
in training. Further, personal construct psychology suggests that
training should lead to more successful prediction of the experience
of the family in treatment, as well as creating shared meanings among
family therapists. Case conceptualization analyses will indicate if
the family therapy trainees are capable of conceptualizing family
dynamics, predicting family behaviors, prescribing treatment, and
describing these constructions of families using the shared meanings
of structural family therapists. It is hypothesized that these
conceptual skills will increase for the family therapy trainees, and
remain stable across time for the nonfamily therapy trainees.
One of the most important skills of family therapists involves
executive skills. The family therapist must be capable of
translating perceptual and conceptual skills into active behavior
that will expedia te change in the family rather than result in a

37
deterioration in family behavior and interactions. The present study
will investigate whether structural training aids in increasing these
executive skills through the use of a set of family therapy
videotapes consisting of 20-minute simulations of family therapy
sessions in which the viewer is oriented as the therapist. The
sessions is halted periodically, and participants are asked to select
a preferred response as primary therapist to the family. Measures of
response effectiveness will be obtained by coding these responses
according to a modified version of the Allred Family Interaction
Scale. It is hypothesized that there will be an increase in family
therapy trainee executive skills as compared to the control group.
Each dependent measure will involve a 2(Group) x 2(Time) mixed
factorial design. The results of these analyses will test the
predictions that, compared to controls, trainees will become more
complex (differentiated and integrated) and systemic in
conceptualizing family dynamics, and more effective in therapeutic
responding to simulated cases. Such findings would suggest that
training in structural family therapy influences both the quality and
effectiveness of therapeutic interventions in a manner consistent
with the objective of the training program.
In summary, this dissertation will investigate family therapy
training by the personal construct methodology. There has been a
dearth of empirical research in this area, with most studies being
either descriptive in nature or lacking empirical rigor and
sophistication. The present study provides a sounder empirical basis
for investigating the training of family therapists.

CHAPTER III
METHODOLOGY
Subjects
Thirty-three subjects were recruited voluntarily from the
counselor education and counseling psychology graduate programs at
the University of Florida in Gainesville, Florida. The experimental
group consisted of 12 graduate students currently enrolled in a
graduate seminar in structural family therapy given through the
counseling psychology program (see Appendix A for a description of
the seminar). This group consisted of four males and eight females,
with a mean age of 32 (range = 23 to 41). The control group
consisted of 21 graduate students from the identical programs who had
not had previous training in family therapy and who had not yet taken
the graduate seminar in structural family therapy. There were seven
males and fourteen females in the control group, with a mean age of
29 (range = 21 to 49). The experimental subjects had an average of
four semesters of graduate school and the control subjects had an
average of two semesters of graduate school. Thus, both groups are
comparable in their graduate training, with the experimental group
receiving additional training in structural family therapy.
38

39
Instruments
Family Experience Inventory
Each subject was required to complete a modified version of the
Family Therapy Experience Inventory (FTEI) in order to assess any
contact with family therapy prior to the current family training
seminar (Connors, 1984). This modified inventory provides
information on age, sex, educational level in their graduate program,
and amount of prior counseling experience (see Appendix B). Connors
(1984) originally developed this inventory in order to assess both
the type of prior exposure with family therapy as well as the extent
of that experience. There are three major categories of prior
exposure. The first involves prior training level in family therapy
and is determined by the number of courses taken where there was a
major focus on the "family," as well as any training sessions or
workshops that focused on work with families. The amount of prior
reading in family therapy comprised the second category of reading
(e.g., the number of books or articles read on family therapy). The
third category, experience, consisted of direct experiences with
family therapy, and the number of these cases that were supervised.
Table 1 presents the mean family therapy experience scores for
experimental and control subjects. In the present investigation,
there are no significant differences between the two groups for prior
exposure to some form of family therapy training.

40
Table 1. Mean Family Therapy Experience Scores for Experimental and
Control Subjects
Group
N
Courses
Taken
Workshops
Attended
Books
Read
Articles
Read
Family
Therapy
Super-
vi sed
Therapy
Experimental
12
1.82
1.36
2.09
2.00
2.00
1.82
(.78)*
(.67)
(1.22)
(.45)
(.63)
(.40)
Control
21
1.90
1.57
1.62
2.24
1.29
1.24
(.83)
(1.16)
(1.20)
(.89)
(.40)
(.44)
* Numbers in parentheses are standard deviations.
Family Repertory Grid
The Family Repertory Grid (Connors, 1984) is a modified version
of Kelly's Role Construct Repertory Grid (Rep Grid), originally
devised as a measure of different aspects of the structure and
content of individuals' personal cognitive systems. When using this
personal construct methodology, elements are selected that represent
the cognitive constructs that are to be investigated. The elements
chosen for the present study were family role titles adopted from
Connor's (1984) Family Repertory Grid. These elements have been
designed to represent various types of families that are familiar to
most individuals (e.g., the family you grew up in; a happy family; a
single parent family). The present study is based on the minimum
context card form in which the subjects are required to give names to
ten preselected elements (i.e., family role titles), and then write

41
the names on index cards numbered from one to ten. The subjects are
then presented with three of these elements written on the index
cards and asked to specify some important way in which two of the
families are "alike in some way and yet different from the third
family." For example, after they respond with how two of the
elements are alike, they are required to specify "in what way the
third family differs from the other two families." Following the
elicitation of the constructs, the subjects are required to rate each
family along each construct dimension using a 7-point Likert type
scale (see Appendix C).
Kelly's repertory grid procedure has been used extensively in
research on various issues related to personality theory and clinical
applications. As a result of this procedure's increasing popularity,
attention has been directed toward obtaining psychometric data, with
special reference to reliability and construct validation.
Generally, reliability coefficients based on the consistency of
ratings across time and the consistency of constructs across time
(given identical elements in the repertory grid) have been found to
be relatively high. For example, Hunt (1951) elicited constructs to
fit 41 role titles by the triadic method and reported a test-re test
reliability of .70 over an interval of a week. Similarly, Fjeld and
Landfield (1961) repeated Hunt's basic design and demonstrated that,
given the same elements, there was a correlation of .80 between the
two sets of elicited constructs over a two week interval. Validity,
however, has proven much more difficult to assess. The repertory
grid is not a static assessment tool in that it may be adapted to a

42
variety of content areas (e.g., schizophrenia, depression, suicide,
education and training). Consequently, validity studies have been
generated in these various content areas. In general, however,
Fransella and Bannister (1977) argue that the validity of this
technique has been shown to be acceptable, as the grid has been
demonstrated to discriminate between different diagnostically defined
groups as well as between before and after treatment groups.
The Family Repertory Grid provided data for the first two
components of this investigation (i.e., cognitive complexity and
construct content). A structural analysis of the subjects' ratings
provides measures of cognitive complexity, and a content analysis of
their constructs provides measures of construct abstraction.
Structural grid measures
Cognitive integration. Based on a cluster analysis designed by
Landfield (1971), the family repertory grid ratings result in
ordination scores that are basically an integration measure of the
hierarchical organization of the trainees' system of thoughts about
the family elements. This Landfield analysis also provides chi
square scores that measure integration and level of flexibility in
the use of constructs. These chi square scores measure the extent to
which the personal constructs are arranged into interrelated systems
of constructions. According to Landfield and Schmittdiel (1983), the
chi square score is a more reliable measure of hierarchical potential
than the ordination score.

43
Cognitive differentiation. Structural analyses also provide FIC
scores. The FIC scores reflect the functional independence of
constructs which measure the degree of uniqueness between family
constructs. Landfield (1971) originally developed the FIC score as a
measure of cognitive differentiation such that an individual who is
highly differentiated has a large number of different constructs that
are used in different ways. By using constructs in different ways,
one is capable of viewing a situation from a number of different
perspectives. Thus, FIC scores provide information on the level of
differentiation (i.e., how many different ways are the constructs
used). According to this system, differentiation and integration
provide indices of cognitive complexity, such that higher levels of
differentiation and integration imply a cognitively complex
individual.
Content grid measures
The second component of this study involved a content analysis
of the family repertory grid constructs elicited from the subjects.
The content analysis was based on an adaptation of Duck's (1973)
procedure in which constructs are coded as either physical, role,
psychological, or interactional. Based on the pilot data and
feedback from both the subjects and the examiners, it was determined
that independent judges' codings of the subjects' construct content
was often misleading and inconsistent. Subjects frequently provided
constructs that fit into one of the category codes (e.g.,
psychological), while also making comments to the examiner concerning

44
what the construct implied (e.g., discussing the interactional
properties of the construct). Consequently, the manner of coding the
constructs was not always consistent with the inferred meaning the
constructs had for the subjects. In view of the marginal interrater
reliabilities (range = .56 to .82), the present study was designed to
exclude judges, and to base the content coding on the subjects'
perceptions of their own constructs (see Appendix D). In addition,
the coding label "psychological" was changed to "personality" since
it is believed to be less abstract in its meaning, and therefore more
familiar to the average subject.
A test-retest reliability analysis was performed using this new
procedure in order to establish a strong empirical rationale for its
use. One-hundred-thirty-four undergraduate volunteers were given a
repertory grid measuring their perception of various types of
interpersonal relationships. These subjects were required to use
Duck's (1973) coding system to code their own constructs. After an
18-day delay, subjects were again asked to code their constructs.
With no training or prior exposure to this sytem, an analysis of the
data revealed a 12% agreement across time, suggesting that the self
coding procedure is as reliable as using independent judges. A major
advantage to using this procedure is that the data will be a more
accurate reflection of the subjects' perceptions of their personal
constructs.
Subjects in the present investigation were provided with
instructions and examples of how to use the coding system. They were
given five constructs to code using Duck's system, and were corrected

45
by the experimenter if they made an error. Any subject who made two
or more coding errors was given five more constructs to practice
on. No subjects made any errors on the second set of trial
constructs (see Appendix E). Analyses of content provided measures
of abstraction (i.e., shifts in the use of personality and
interactional constructs as a function of training).
Therapist Responses to Simulated Family Tapes
Subjects were required to observe videotapes of a simulated
family therapy session, and instructed to assume the role of the
primary therapist. At four different intervals a family member
looked into the camera and asked the therapist (i.e., the subjects) a
question to which the subject was to respond by selecting one of
several provided multiple choice answers.
There are two 20-minute simulated-family videotapes that were
used in this study. These tapes are based on the dynamics of
simulated families used by Connors (1984) to investigate family
therapy training. Student volunteers from an undergraduate
psychology course and research assistants in the family therapy
training project made up the simulated families. Each "actor"
received a written description of the family dynamics and their role
in particular which served as a guide for their performance (see
Appendices F and G). They were given the family dynamics the evening
before taping, and were allowed one practice trial in order to feel
comfortable with their role. The actors were signaled when they were

46
to speak into the camera and ask the "therapist" a question
concerning the family.
The family scenarios consisted of disturbances in the family
structure which required intervention by the family therapist. The
first family is composed of two parents, two adolescent daughters and
two young sons. The oldest daughter is presented as the identified
patient by the parents, the mother as ineffective and the father as
peripheral. The second family is composed of a single mother with an
adolescent daughter and son. In this family, the son is presented as
the identified patient, and the mother focuses on her bitter
relationship with her ex-husband and her inability to control her
son's behavior. Mother and daughter are in a coalition against the
identified patient.
Connors (1984) reported that the two sets of family dynamics
used in his study were equated for level of difficulty. Level of
difficulty was determined through consultation with professionals
acquainted with family therapy. In addition, presentation of the
videotapes were counterbalanced at pre- and posttraining to
distribute any possible order effects.
Based upon the results of the pilot investigation, several
revisions were made for the improvement of this dissertation. A
major difficulty with the pilot study involved the use of naive and
unsophisticated judges concerning family therapy. Judges were
undergraduate students without any exposure to family therapy prior
to participating in this project. In addition, the pilot data for
therapist responses revealed a paucity of information for the amount

47
of data collected. Allred's coding system did not prove to be
reliably used by the judges (r = .52 at Time 1 and r = .60 at Time
2), requiring that the data be collapsed across categories for a
composite score for each subject. This composite score simply
reflected what direction subjects were moving toward in terms of
their level of executive skills. Thus, the present study was revised
to both eliminate the unreliability contributed by the judges, and to
provide a greater array of information concerning the executive
skills of the two different training groups.
The revisions for the dissertation study involved providing
subjects with alternative therapist responses to choose from at each
of the four intervals. These responses represent the categories
found to be meaningful in the pilot study. There were four main
categories used for coding therapist responses: Gathers Information,
Supports and Reflects, Interprets and Confronts, and Structural
Realignment. In order to represent each of the main categories, four
alternative therapist responses were generated within each
category. These responses represent a dimension from obstructive to
the most sophisticated response level within that category. For
example, the category of interprets and confronts has four
alternative responses ranging from obstructive = +1, direct
interpretation = +2, strategic interpretation = +3, and confrontive
interpretation = +4 (see Appendix H for a description of the coded
categories). Thus, subjects are required to answer four multiple
choice questions at each of the four intervals. Except for the
obstructive responses, all response alternatives were designed to be

48
appropriate responses to the dynamics of the family tape that the
subjects have viewed (see Appendices I and J). Within each of the
four response groups, subjects were also required to rank the
confidence level they felt concerning their chosen response on a
scale of 1 to 10 (very unconfident to very confident). These
rankings provide a measurement of perceived confidence across time
for both groups of subjects. Subjects were also required to rank
their four choices from most to least preferred. The most preferred
therapist response was also ranked for confidence level on a scale of
1 to 10. Thus, in addition to measuring whether subjects' confidence
changes across time, it is also possible to measure if their
confidence about their most preferred response changes across time
(see Appendix K).
Two professional structural family therapists in the community
were solicited to evaluate these materials in order to establish
empirical reliability. Both therapists were asked to rank order the
response alternative category from least to most preferred therapist
response. These rankings were correlated between the two therapists,
and between the therapist rankings and the rank ordering generated by
the experimenter using a modified version of Allred's AIAC coding
system. Therapist responses were based on the actual responses
provided by the subjects in the pilot study. For a therapist
response to be chosen, it had to be coded identically by the two
independent judges. In addition, the actual responses were also
evaluated using the procedure just outlined (see Tables 2 and 3 for
reliability coefficients).

Table 2. Family Expert Ratings for Therapist Response Stimuli--
Family Tape I
Modified Expert 1 Expert 2
Allred
Scheme
Modified Allred Scheme .61* .45*
Expert 1 .65*
Expert 2
* p<.05
Table 3.
Family Expert Ratings for Therapist Response Stimuli
Family Tape II
Modified Expert 1 Expert 2
Allred
Scheme
Modified Allred Scheme
.58* .68*
Expert 1
.76*

50
Case Conceptualizations
The reliabilities for the case conceptualization pilot data
were, at best, marginal (range = .12 to .67). Therefore, this
component of the dissertation was revised to exclude the use of
judges. Based on the pilot data, it was determined that there were
three major areas of information that were not being adequately
tapped. These areas include a conceptualization of the family, a
conceptualization of the intervention, and a systemic dimension
(e.g., focusing on an individual versus the entire system). Rather
than have subjects simply write their impressions of the family
dynamics, subjects were required to answer eight multiple choice
questions that reflect these three areas of interest. Each question
was provided with four alternative choices ranging from individual,
dyad, subgroup, and system. Four of the questions target the
conceptualization of the family and four of the questions target the
conceptualization of the intervention with the family. Each of the
response alternatives is appropriate to the dynamics of the family
videotapes (see Appendices L and M for a description of the response
alternatives). Again, two structural family therapists evaluated
these questions and response alternatives in terms of the
appropriateness of the responses as well as whether they accurately
reflect the systemic dimensions they have been constructed to reflect
(see Tables 4 and 5 for reliability coefficients).

51
Table 4. Expert Ratings of Case Conceptualization Stimuli
Family Tape I
Cases
Coding
Scheme
Expert 1
Expert 2
Cases Coding Scheme
-
.38
.53*
Expert 1
-
.63*
Expert 2
-
* p<.05
Table 5. Expert Ratings of Case Conceptualization Stimuli
Family Tape II
Cases
Coding
Scheme
Expert 1
Expert 2
Cases Coding Scheme
-
.33
.69*
Expert 1
-
.69*
Expert 2
-

p<.05

52
Procedure
All subjects were scheduled by phone for a testing time at their
convenience. Subjects were tested in small groups ranging from two
to four subjects depending on their availability. Each subject was
told that he/she would be participating in a family therapy training
study that would last approximately two hours at both pre- and
posttesting.
Subjects were met in an outer office by the experimenter and led
into a small testing room containing a portable video monitor, a
table to write on, and several chairs. Each subject was requested to
sit at a table facing the video monitor. All subjects received
identical instructions regardless of whether they were in the control
group or the experimental group.
The first task required of the subjects was reading and signing
the informed consent form (see Appendix N), followed by the
completion of the Family Therapy Experience Inventory. This was
followed by instructions for the first phase of the testing session
which involved viewing the videotape of a simulated family therapy
session. All subjects were given the following instructions:
You are about to view a simulated family in an initial
family therapy session. You are to view the family as
though you were the primary therapist and were actually
involved in the session. At different points in the
session, the tape will be stopped, a family member will
ask the therapist a question, and you will be provided
with four groups of therapist response alternatives.
From each group of response alternatives, you are to
select the therapist response that you feel you might use
with that family at that point in time. All of the
responses are viable alternatives and there are no right

53
or wrong answers. We are simply interested in which
responses you would choose from each group of response
al terna ti ves.
After you have viewed the tape and selected your
therapist response alternatives, you will be requested to
answer some multiple choice questions concerning your
case conceptualization of the family as though you were
the primary therapist for the family.
Following these instructions, the subjects were provided with
the written family descriptions (see Appendices 0 and P). When the
subjects indicated that they had finished reading the family notes,
they were given a therapist response form to use for recording their
responses to the family (see Appendix K). The examiner stopped the
videotape at four intervals and requested the subjects to write their
responses on the designated pages. The booklet of four therapist
response forms was then removed by the examiner and replaced with the
following written case conceptualization instructions:
We are interested in your case conceptualization of the
family as though you were the primary therapist for this
family. There are 8 multiple choice questions regarding
the dynamics that you see as important in this family.
We would like you to choose the alternatives that best
reflect how you perceive this family. Again, there are
no right or wrong answers to these questions, each choice
simply reflects a preferred style of viewing the dynamics
of the case.
You will have 10 minutes to answer these questions.
When the subjects indicated that they finished reading the
instructions, they were given the case conceptualization questions
and a form to use for recording their responses (see Appendix Q).

54
Upon completion of this task, subjects were administered the
family repertory grid. This task consists of a structured interview
in which subjects systematically compare and contrast various
families to determine dimensions representative of their evaluations
of family dynamics (see Appendix R for a complete description of
administration). The administration of this family repertory grid
involves the experimenter asking the subject to give names to role
titles (e.g., the name of the family you grew up in, the name of a
happy family, etc.). The subjects are then presented with three of
these elements and asked to specify "some important way in which two
of the families are alike in some way and yet different from the
third family." After they respond with how two of the elements are
alike, they are required to "give a word or short phrase that
describes how the third family is different from the other two."
Following the elicitation of the constructs, subjects are required to
rate each pole of the construct as either positive or negative. The
experimenter then takes these descriptions and uses them as end
points on a 7-point Likert type scale (e.g., Happy +3, +2, +1, 0, -1,
-2, -3 Sad). Subjects then use these construct dimensions to rate
all ten families across each of the 15 construct dimensions.
After the administration of the family repertory grid, subjects
were told that they would be contacted in approximately 10 weeks for
another two-hour session. The second session involved the same
procedure as the first session, with the exception that all subjects
viewed a different simulated family therapy videotape. The
presentation of the therapy tapes were counterbalanced to reduce

55
testing effects. Subjects were then debriefed and told tnat the
study was designed to investigate the effects of family therapy
training on how counselor-trainees respond to and conceptualize
various family problems. They were also given a brief rationale for
undertaking this investigation, followed by a question and answer
session if desired by the subject. Subjects were also given the
opportunity to sign up for feedback sessions on their participation
in the investigation.
Design and Analyses
This investigation has been divided into four major
components. The first component involves the management of trainees'
perceptual skills. Perceptual skills may be measured by using
structural grid analyses (see Landfield, 1971) on the following
dependent measures: chi square scores (measuring level of cognitive
integration) and FIC scores (measuring level of cognitive
differentiation). The second component involves the measurement of
the level of abstraction of trainees' perceptual skills. This
component involves two dependent measures: Abstractness (reflected
by a Weighted Average score) and Modal Response. The third component
of this investigation involves the measurement of trainees'
conceptualization skills for both family dynamics and treatment for
the following two dependent variables: Weighted Average and Modal
Response. The fourth component of this investigation involves the
measurement of trainees' executive skills. Executive skills may be
measured by analyzing trainees' therapist responses to the simulated

56
family tapes. There are two sets of dependent measures for therapist
responses. The first set involves analyses within each category of
interest (e.g., gathers information, reflects and supports) for the
following dependent variables: Weighted Average, Modal Response and
Average Confidence Level. The second set involves analyses across
the four categories of interest on the following two dependent
variables: Mode for Preferred Response and Average Confidence for
Preferred Response. For all four major components of this design,
all dependent measures were analyzed with a 2(Group) x 2(Time)
Analysis of Variance with repeated measures on the last factor.
Structural Grid Analyses
Subjects' ratings from the 7-point Likert type scales were
cluster analyzed by Landfield's (1971) computerized method. This
analysis provided FIC and chi square scores for each subject, thus
providing the measures of cognitive complexity previously discussed
(see pages 42-43). These scores comprise the dependent measures for
the structural grid data.
Content Grid Analyses
Each of the 15 constructs elicited from the subjects were self-
coded along a dimension of abstractness ranging from physical, role,
personality and interactional characteristics (i.e., physical = +1,
role = +2, personality = +3, and interactional = +4). A single score
representing a subject's overall level of abstraction was obtained by
averaging the weighted ratings across the 15 constructs. Each

57
subject was also assigned a score based on their modal response
category.
Case Conceptualization Analyses
Therapist conceptual skills were evaluated along a systemic
dimension. Subjects were required to respond to eight multiple
choice questions which were provided with four alternative choices
ranging from individual, dyad, subgroup and system. Four of the
questions targeted the conceptualization of the family and four of
the questions targeted the conceptualization of the intervention with
the family. This design provides for two categories (family
conceptualization and family intervention) that are analyzed
separately for the following dependent measures: Weighted Average
and Modal Response. The Weighted Average is an overall average of
systemic response level obtained by totaling a subjects' coded
ratings and then dividing the total by the number of questions within
a category. The Modal Response represents that response level used
most frequently within each category.
Therapist Response Analyses
Each subject responded to the videotape with multiple choice
questions at four separate intervals. For each interval, the four
multiple choice questions reflected a modified classification system
designed by Allred and Kersey (1977). The four categories selected
were found to be the most meaningful of Allred's system based on the
pilot investigation. The four categories reflected by the questions

58
were Gathers Information, Reflects and Supports, Interprets and
Confronts, and Structural Realignment. Within each category there
are four possible response alternatives that represent a dimension
from obstructive to the most sophisticated response level within that
category (see Appendix H).
Within category analyses
All four intervals of therapist responses were combined for the
following three dependent measures: Weighted Average, Modal Response
and Average Confidence Level. These three measures were analyzed
separately for each of the four therapist response categories. The
Weighted Average is an overall average of response level obtained by
totaling a subject's coded ratings and then dividing the total by 4
(i.e., the number of intervals). The Modal Response represents that
response level used most frequently within each category across the
four intervals. Within each of the four therapist response
categories, subjects rated how confident they felt about the response
they had chosen on a scale of 1 to 10 (very unconfident to very
confident). The Average Confidence Level was obtained by taking an
average across the four intervals.
Between category analyses
In addition to investigating possible changes within each of the
four therapist response categories, two dependent measures were
designed to reflect any changes in therapeutic skills or confidence
across these four categories. Subjects were asked to rank the four

59
therapist responses they chose for working with the family in order
of preference from the most to the least preferred. That category
most frequently endorsed by the subject as their preferred response
was labeled as the Mode for Preferred Response. This score provided
a measure of response preference across the four different
categories. The final dependent measure represents the Average
Confidence for Preferred Response. Subjects were required to rank
how confident they felt about their most preferred response on a
scale of 1 to 10 (very unconfident to very confident). An average
score was obtained across the four intervals.

CHAPTER IV
RESULTS
Structural Grid Analyses
A 2(Group) x 2(Time) analysis of variance for Functionally
Independent Construct (FIC) scores on family constructs revealed a
significant interaction, F (1,31) = 12.63, p<.001 (see Table 6).
Followup analyses revealed a significant effect of Time for the
control subjects, F (1,20) = 8.42, p<.008, such that the nonfamily
therapy trainees became significantly more differentiated in their
family constructs across time. Followup analyses also revealed a
significant effect of Time for the experimental subjects, F (1,11) =
5.25, p<.04. These results suggest that the family therapy trainees
became significantly less differentiated across time (see Figure 1).
In addition to looking at levels of differentiation, analyses
also revealed some significant findings based on integration
scores. Landfield's chi square score is viewed as a measure of
integration and flexibility. A 2(Group) x 2(Time) analysis of
variance on chi square scores revealed a significant main effect of
Group, F (1,31) = 6.27, p<.02, such that the control subjects were
significantly less integrated in their family constructs than were
the family therapy trainees. An analysis of variance also revealed a
trend toward a main effect of Time, F (1,31) = 2.71, p=.10,
60

61
Table 6. Analysis of variance for FIC scores
Source
Sum of Squares
df
Mean Square
F
P
Mean
6127.286
1
6127.286
145.32
.000
Group
31.953
1
31.953
0.76
.391
Error
1307.077
31
42.164
Time
0.091
1
0.091
0.01
.909
Time x Group
71.304
1
71.304
10.17
.003*
Error
217.363
31
7.012
* p<.001
Table 7. Analysis of variance for chi square scores
Source
Sum of Squares
df
Mean Square
F
P
Mean
141671.093
1
141671.093
483.82
.000
Group
1835.680
1
1835.680
6.27
.012*
Error
9077.315
31
292.816
Time
543.736
1
543.736
2.71
.109
Time x Group
23.829
1
23.829
0.12
.732
Error
6220.378
31
200.657
* pc.01

62
10.5
10.0
9.5
9.0
8.5
Mean
FIC 8.0
Scores
7.5
7.0
6.5
6.0
5.5
5.0
4.5
4.0
O

experimental
control
TIME TIME
1 2
Figure 1. Interaction for FIC scores

63
suggesting that both groups tended to become less integrated across
time (see Table 7).
Content Grid Analyses
The 2(Group) x 2(Time) analysis of variance revealed no signifi
cant findings for Modal Response. However, these analyses did reveal
a trend toward a main effect of Group, F (1,31) = 2.94, p=.09 for the
Weighted Average score of abstraction such that the family therapy
trainees appeared to have higher levels of abstraction in their
family constructs than did the control subjects. Analyses also re
vealed a trend toward a main effect of Time, F (1,31) = 2.94, p=.09,
such that both groups became somewhat more abstract across time.
Case Conceptualization Analyses
Family Conceptualization Analyses
Analyses of the Weighted Average score revealed no significant
differences in level of systemic conceptualization of family dynamics
for the two groups. However, an analysis of variance on the Modal
Response scores did reveal a trend toward a main effect of Time,
F(1,31) = 3.40, p=.07. The direction of the means suggests that both
groups were viewing families along suogroup-systemic dimensions at
Time 1 (M=3.51), while at Time 2 they were viewing families along
more dyadic-subgroup dimensions (M=3.09). These results suggest that
both groups had a tendency to narrow the focus of their family
conceptualizations across time.

64
Family intervention Analyses
The analysis of variance did not reveal any significant findings
for either Weighted Average or Modal Response scores. The mean
response levels, however, suggest that both groups focused on
subgroup relationships when conceptualizing an intervention for a
family (means range from 2.87 to 3.64).
Therapist Response Analyses
Within Category Analyses
Gathers information
The analysis of variance revealed no significant findings for
the Modal Response and Average Confidence scores. However, the
results did reveal a trend toward a main effect of Time for the
Weighted Average score, F (1,31) = 3.64, p=.06. These results
suggest that both groups had a tendency to ask for information about
a subsystem relationship less frequently at Time 2 (M=3.15) than at
Time 1(M=3.39).
Reflects and supports
The analysis of variance revealed a significant main effect of
Time for the Weighted Average score, F (1,31) = 9.22, p<.004, such
that both groups had a higher frequency of supportive responses at
Time 1 (M=3.15) than at Time 2 (M=2.73) which revealed a higher
frequency of reflecting responses (see Table 8).

65
Table 8. Therapist Response ANOVA for Reflects and Supports Weighted
Average Scores
Source
Sum of Squares
df
Mean Square
F
P
Mean
522.883
1
522.883
1191.76
.000
Group
0.156
1
0.156
0.36
.550
Error
13.601
31
0.439
Time
3.208
1
3.208
9.22
.004*
Time x Group
0.239
1
0.239
0.69
.410
Error
10.792
31
0.348
* p<.001
An analysis of variance also revealed a significant main effect
of Time for Modal Response (see Table 9), F (1,31) = 17.90, p<.001
such that the modal response for both groups at Time 1 was a
sophisticated combination response of reflecting and supporting
(M=4.00), while the modal response for both groups at Time 2 was a
much less sophisticated response involving simple reflection
responses (M=2.94). These results suggest that both groups became
less sophisticated across time. There was no significant difference
in their Average Confidence Level suggesting that they were equally
confident across time.

00
Table 9. Therapist Response ANOVA for Reflects and Supports Modal
Response Scores
Source
Sum of Squares
df
Mean Square
F
P
Mean
719.377
1
719.377
487.51
.000
Group
1.195
1
1.195
0.81
.375
Error
45.744
31
1.476
Time
21.001
1
21.001
17.90
.001*
Time x Group
2.576
1
2.576
2.20
.148
Error
36.363
31
1.173
* p<.001
Interprets and confronts
The 2(Group) x 2(Time) analysis of variance revealed no
significant findings for Weighted Average, Modal Response, or Average
Confidence Level.
Structural realignment
The analyses of variance did not reveal any significant findings
for Weighted Average, Modal Response, or Average Confidence Level.
Between Category Analyses
Mode of preferred category response analyses
The analysis of variance revealed no significant findings for
the Modal Preference score. It is interesting to note, however, that

67
the preferred category for both groups was the Reflects and Supports
category of therapist responses (Control M=2.86, Experimental
M=3.00).
Average confidence for preferred category response analyses
The 2(Group) x 2(Time) analyses of variance revealed a
significant main effect of Time, F (1,31) = 5.60, p<.02, such that
both groups became significantly more confident concerning their
preferred responses across time (M at Time 1 = 7.45, M at Time 2 =
7.94). See Table 10 for the results of the ANOVA table.
Table 10. Therapist Response ANOVA for Preferred Category Response
Source
Sum of Squares
df
Mean Square
F
P
Mean
3602.506
1
3602.506
1296.49
.000
Group
0.307
1
0.307
0.11
.742
Error
86.138
31
2.779
Time
5.325
1
5.325
5.60
.020*
Time x Group
2.161
1
2.161
2.27
.140
Error
29.476
31
0.951

p<.05

CHAPTER V
DISCUSSION
The primary purpose of the present investigation was to
determine whether or not training in structural family therapy has an
impact on the perceptual, conceptual and executive skills of family
therapy trainees. This division of therapy skills is based on
Cleghorn and Levin's (1973) model for the assessment of training in
family therapy. Perceptual skills refer to how the therapist
perceives family interactions and the effects of them on family
members and the family system. Conceptual skills involve what the
therapist thinks about in the therapy session and how those thoughts
are organized. Executive skills involve how the therapist actually
intervenes in therapy in order to influence the family's
dysfunctional patterns of interactions.
A review of the literature revealed that a majority of family
therapy training studies reported significant increases in trainees'
perceptual and conceptual skills (e.g., Friedman, 1971; Lange &
Brinckman, 1976; Lange & Zeegers, 1978; Tomm, 1980; Tucker & Pinsof,
1984). Several studies have also reported significant increases in
trainees' executive skills (e.g., Allred & Kersey, 1977; Pinsof,
1977; Watson, 1975). However, one limitation of this research
concerns the absence of comparable control groups against which the
68

69
effects of family therapy training can be measured. This leaves open
the question as to whether factors other than the training program
were responsible for the noted changes (see Cook & Campbell, 1979).
The unique contribution of the present investigation is the
assessment of change in the family therapy skills of family therapy
trainees compared with a comparable control group.
In general, the results of this study did not provide compelling
support for the major hypotheses. For example, it was predicted that
the family trainees would become more cognitively complex than the
control subjects. The results of this investigation revealed that
the family therapy trainees became less cognitively complex, while
the control subjects became significantly more cognitively complex
across time. It was also predicted that the trainees' family
construct system would become more abstract than the family construct
system of the control subjects. Although the results revealed some
trends in support of this hypothesis, the data do not argue cogently
in support of the expected increase in abstraction among the family
therapy trainees. In addition to predicting increases in the level
of perceptual skills of the family trainees, it was hypothesized that
family trainees would show an increase in conceptual skills as a
function of training compared to the control group. The results
revealed that both groups changed across time, becoming somewhat more
narrowly focused than predicted. Lastly, it was predicted that the
family trainees would show more sophisticated levels of executive
skills compared to control subjects as a function of structural
family therapy training. Although the results revealed some

70
interesting changes in executive skills for both groups across time,
there were no significant differences between the two groups. These
results are contrary to the prediction of increased skill level of
family trainees compared to controls as a function of structural
family therapy training. The remainder of this discussion will be
organized around each of the major components and hypotheses of the
study.
Perceptual Skills and Cognitive Complexity
Cognitive differentiation refers to the number of different
constructs that an individual has available for viewing and
interpreting a situation. According to Werner (1955), construct
systems develop from simple to complex levels of cognitive
differentiation over the course of continued experience. This
reasoning is consistent with Bieri's definition of complexity as "the
tendency to construe social behavior in a multidimensional way such
that a cognitively complex individual has available a more versatile
system for perceiving the behavior of others than does a less complex
person" (1955, p. 14). The present study investigated whether family
therapy trainees' construct systems would become more cognitively
complex as a function of structural family therapy training.
Analyses of differentiation revealed that the family therapy
trainees became significantly less complex as a function of
training. Interestingly, the control subjects showed significant
increases in their level of complexity across time. These results
suggest that when students in the mental health fields are exposed to

71
family therapy training, they begin to construe families in less
differentiated ways. The fact that the family therapy trainees were
less differentiated than those students without that training
suggests that they are more channelized in their constructions of
families, and have not yet integrated their new experiences into a
larger framework within which to anticipate and predict families in
therapy.
These results are consi stent wi th the literature which has
reported that trainees' constructs undergo periods of decreased
complexity during the early phases of training, often followed by a
reorganization of the constructs at higher levels of complexity
during advanced training stages (e.g., Baldwin, 1972; Lipshitz, 1974;
Pope, 1978; Ryle & Breen, 1974). These findings are also consistent
with the conceptual difficulties that family therapy trainees often
report during the early phases of training (Gurman & Kniskern,
1978). Family therapy trainees may experience more difficulty than
nonfamily therapy trainees in formulating their conceptualizations of
families, thereby resulting in the temporary decline in trainee
performance cited in the training literature (Duhl, 1978; Gurman &
Kniskern, 1978).
Further, these findings may offer support for the operation of
the Creativity Cycle in structural family therapy, such that there is
a shift that starts with loosened construction and terminates with
tightened and validated constructions. Constructs must be loosened
in order that hypotheses may be tested, and then they must be
tightened after the hypotheses have been either validated or

72
invalidated so that they may be acted upon. If the family therapy
trainees' family construct system becomes less organized during early
phases of training such that the relationships among the constructs
decrease, then efforts to interpret family behavior would be based on
constructs that are loosely related and lacking meaningful
connections. To explore this hypothesis further, future research
needs to measure the impact of training on therapy skills at
different intervals throughout training and after training.
In addition to looking at levels of cognitive differentiation,
analyses also revealed some significant findings concerning cognitive
integration. The results revealed that the nonfamily therapy
trainees were significantly less integrated in their family
constructs than the family therapy trainees. Further, both groups of
trainees tended to become somewhat less integrated across time
regardless of the form of therapy training engaged in.
The results of the integration measures suggest that the family
therapy trainees are more flexible in their use of their family
construct system than are the nonfamily therapy trainees. However,
this does not appear to be a unique function of training in
structural family therapy. Although the family trainees appear to
have fewer constructs available for perceiving families than the
nonfamily therapy trainees, it may be that they are more invested in
tightening their family construct system in an attempt to make the
constructs more meaningful. Further, it is interesting that both
groups of trainees had a tendency to become somewhat less integrated

73
across time, suggesting that any training in therapy initially
channelizes and rigidities trainees' clinical perceptions.
Taken as a whole, the results of the measures of cognitive
differentiation and cognitive integration are mixed. On the one
hand, the results suggest that family therapy trainees become less
differentiated as a function of structural family therapy training
while the nonfamily therapy trainees become more differentiated
across time. However, the results also revealed that the family
therapy trainees are more cognitively integrated than the nonfamily
therapy trainees. Both sets of results are consistent with the
training literature. Those studies reporting decreases in cognitive
complexity based their conclusions on the results of differentiation
scores (e.g., Baldwin, 1972; Pope, 1978; Ryle & Breen,1974) while
those studies reporting increases in cognitive complexity based their
conclusions on the results of integration scores (e.g., Adams-Webber
& Mire, 1976). Thus, these discrepant findings reported in the
literature, as well as those revealed in the current investigation,
may be the result of using different measures of cognitive
complexity. These two measures may reflect different aspects of
cognitive complexity that develop at differential rates as trainees
are exposed to new training and therapy experiences.
However, there is an alternative hypothesis that may explain the
discrepancy between cognitive differentiation and cognitive
integration. As family therapy trainees learn a coherent and
systemic conceptualization of family dynamics, they may begin to see
families as less different from each other. Further, the family

74
therapy trainees may begin to see the commonalities and similar
patterns across different families. This hypothesis is consistent
with the goal of structural family therapy which is to look for the
structural patterns that are supporting what appear to be the
differing dynamics of different families (e.g., looking for the
homeostatic principles that maintain the presenting symptom). Thus,
the decreased levels of differentiation for the family therapy
trainees suggests that.they see families as more alike as they begin
to learn to interpret family dynamics with a structural template.
However, the increased levels of differentiation for the nonfamily
therapy trainees suggests that their interpretations of family
dynamics may be based on several different conceptualizations that
they are utilizing in their individual therapy training. Thus, the
lower levels of differentiation in the family therapy trainees may
suggest that structural family therapy training does not necessarily
lead to lower levels of cognitive complexity, but influences family
therapy trainees' family construct system in such a way that they are
able to tighten those family construct dimensions compared to therapy
trainees without that training. This interpretation is also
consi stent with the higher level of cognitive integration found for
the family therapy trainees. The family therapy trainees appear to
be more flexible in their use of their family construct system than
the nonfamily therapy trainees. Perhaps the family therapy trainees
are more willing to explore the possibilities of interrelationships
among their family constructs and in that sense, they show higher

75
levels of cognitive complexity in their perceptual skills than the
nonfamily therapy trainees.
Perceptual Skills and Level of Construct Abstraction
According to Crockett (1982), a major feature of a developing
construct system involves the appearance of abstract constructs. One
method frequently used to assess the development of abstract
constructs involves a content analysis of the construct dimensions
elicited by the Rep Grid (Duck, 1973). A review of the literature
revealed that those studies using a content analysis to investigate
the level of construct abstraction as a function of training reported
significant increases in level of abstraction as a function of
training (e.g., Lewis, 1977; Lifshitz, 1974). The present study
investigated whether family therapy trainees' family constructs would
become more abstract as a function of structural family therapy
training.
Level of abstraction is measured with a weighted average score
based on Duck's (1973) system of content analysis. Contrary to
expectations, there were no significant findings on measures of
abstraction. However, there was a trend toward a main effect of
Group, suggesting that the family therapy trainees tended to have
relatively higher levels of abstraction in their family constructs
than did the nonfamily therapy trainees. Although these results are
in the predicted direction, the data do not argue cogently for
differences between the two groups of therapy trainees. Perhaps a
larger sample size would provide enough power to detect any changes

76
that may be taking place. It must be kept in mind, however, that
family therapy training itself may not lead to higher levels of
family construct abstraction.
Conceptual Skills and Case Conceptualizations
According to Cleghorn and Levin's (1973) model of therapy
skills, conceptual skills involve what the therapist thinks about in
the therapy session and how those thoughts are organized. They argue
that in order to formulate a problem in terms of the family system,
the family therapist must specify the implicit rules of behavior in
the family that make sequences of family interactions predictable.
Although the majority of the studies reported in the literature found
increases in levels of conceptual skills for family therapy trainees,
these studies have been limited by the lack of a comparable control
group (e.g., Breunlin etal., 1983; Friedman, 1971; Lange &
Brinckman, 1976; Lange & Zeegers, 1978; Tom, 1980; Tucker & Pinsof,
1984) and the lack of a reliable, valid and standardized assessment
instrument (e.g., Breunlin et al., 1983; Friedman, 1971; Lange &
Brinckman, 1976).
In the present study, conceptual skill level was measured along
a systemic dimension ranging from an individual focus to a systems
focus. Trainees' conceptual skill level was measured for their
ability to conceptualize intervention dynamics. It was predicted
that the family therapy trainees would show an increase in their
level of family and intervention conceptualization skills while the
nonfamily therapy trainees would remain stable across time. The

77
results of the family intervention measures revealed no significant
differences between the two training groups and no significant
difference across time. The mean level of responses suggests that
both groups focused on subgroup relationships when conceptualizing an
intervention strategy.
The results of the family conceptualization measures revealed a
trend toward a main effect of Time, suggesting that both groups of
subjects had a tendency to use slightly lower levels of conceptual
skills at posttesting. There are several possible explanations for
these findings. First, it is possible that the nature of the task
biased the subjects to focus on family dynamics. Subjects were
instructed to select case conceptualization response alternatives
that best reflected how they perceived the dynamics that were
important in the family. By instructing subjects to focus on family
dynamics, it is not surprising that subjects did just that,
regardless of their training orientation.
A second explanation may involve the instrument itself. This
instrument may not be sensitive enough to detect subtle changes, in
part, because asking subjects to select their conceptualization of a
segment of behavioral data is only a partial evaluation of conceptual
skills. Such an evaluation may not predict how a trainee would
conceptualize family dynamics if actually in a similar clinical
situation. Since this measure is a compromise in that it can be
reliable, valid and standardized, it is important that it be made as
reliable and valid as possible. Future research needs to establish
such reliability and validity in their family therapy skills

78
instruments before changes in skill level of family therapy trainees
can be adequately investigated.
Third, it may also be possible that the conceptual skills of the
family therapy trainees were only beginning to undergo change at the
time of the second measurement. It is possible that Cleghorn and
Levin's (1973) model of therapy skills may be arranged along a
dimension of skill level such that perceptual skills are a
prerequisite for conceptual skill development and, in turn,
conceptual skills are a prerequisite for the development of executive
skills. Since the family therapy trainees are only beginning to
change their perceptions of families, they may not have had enough
time to develop family conceptual skills. Future research needs to
take a longitudinal approach to the investigation of the development
of family therapy skills as a function of training. Lastly, it must
be kept in mind that the development of family conceptual skills may
not be unique to training in family therapy.
Executive Skills and Therapist Responses
The structural family therapist must develop therapy skills that
influence the family to demonstrate the way it functions. Cleghorn
and Levin (1973) have labeled these skills as executive skills. They
argue that these skills involve what the therapist says and does in
the therapy session in order to influence the family's sequences of
transactions and consequently alter the way the family functions.
Investigating the executive skills of family therapy trainees has
proven to be a very difficult task. A review of the literature

79
reveals many methodological flaws in this area of investigation.
These flaws have consisted of the lack of comparable control groups
and the absence of reliable, valid, and standardized measures
sensitive to changes in skill level that are unique to family
therapy. Those studies reporting increases in family therapy
trainees' executive skills were unable to attribute those changes to
training in family therapy as they did not include a comparable
control group (e.g., Allred & Kersey, 1977; Tucker & Pinsof, 1984).
In those studies that did include some type of control group, the
results have typically not shown significant differences in executive
skill level of the trainees (e.g., Breunlin etal., 1983). However,
these studies did not use a reliable coding instrument and thus their
lack of results may be due to the instruments used rather than there
being no differences. The present study investigated whether the
executive skills of family therapy trainees, as compared with
nonfamily therapy trainees, would increase when measured by a
reliable and valid coding system.
Executive skills were measured along four categories of
therapist responses that were found to be the most meaningful of
Allred and Kersey's (1977) system based on a pilot investigation.
The four categories reflected by the therapist response alternatives
were Gathers Information, Reflects and Supports, Interprets and
Confronts, and Structural Realignment. All measures of executive
skill level were analyzed separately for each of the four therapist
response categories.

30
Executive Skills Within Category
Gathers information
Contrary to expectations, there were no significant differences
between the two groups for level of executive skill within this
category of therapist responses. Both groups of subjects were able
to ask for information about subsystem relationships regardless of
their theoretical orientation (i.e., systems versus intrapsychic).
This lack of significant findings suggests that these executive
skills may not be a unique function of training in family therapy.
If basic therapy skills, such as information gathering, can be
adapted to use with families, then it will be important for future
research to explore which therapy skills cannot make that transition
without additional training in family therapy. The question that
continues to concern the field revolves around what skills are unique
to family therapy.
Reflects and supports
The results of these analyses of the Weighted Average scores and
the Modal Response scores were also contrary to expectations. Both
groups of therapy trainees showed a significantly higher frequency of
supportive responses at Time 1, which shifted to a significantly
higher frequency of less sophisticated reflective responses at
Time 2. A possible interpretation of these results may be that as
the family therapy trainees attempt to make sense of their new family
construct system, and the nonfamily therapy trainees attempt to

81
effectively understand actual clinical experience that they are not
prepared for, they revert back to their first learned style of
interacting in therapy. The fact that there were no significant
differences between the two groups of therapy trainees suggests that
reverting to previously learned levels of executive skills may not be
a function of structural family therapy training, but a function of
attempting to interact effectively in a new situation. This lack of
significant differences between the two groups of trainees again
raises the question concerning the unique impact of family therapy
training. Although the subjects reverted to a lower level of their
executive skills, it is interesting to note that there were no
changes in their average confidence level concerning their choice of
therapist response to the family.
Interprets and confronts
The results of these analyses revealed that there were no
significant differences in level of executive skills between the two
groups of therapy trainees. Both groups of subjects tended to use
strategic and confrontive interpretations, and there were no changes
across time. This lack of change in executive skill level for
interpretive responses suggests that these skills may not be unique
to family therapy training. If these skills are unique to family
therapy, it is possible that the task in the present investigation
was biased toward not detecting changes. Since all the subjects were
required to respond to the family by selecting an interpretive
response, it is not possible to determine whether the nonfamily

82
therapy trainees would have responded differently than the family
therapy trainees if allowed to select an interpretive response with
an individual rather than a family focus. Future research needs to
adjust for this factor of response bias in a forced choice format.
One possibility may be to use a crossed design similar to the present
investigation with the addition of an individual therapy tape. This
would allow for an assessment of whether family and individual
therapy trainees differ in their level of interpretive executive
skills when interacting with an individual versus interacting with a
family.
Structural realignment
According to Allred and Kersey's (1977) classification scheme,
structural realignment consists of the most sophisticated levels of
therapy responses that can be made to a family. It was predicted
that the family therapy trainees would show an increase in their
level of structural realignment responses while the nonfamily therapy
trainees would remain stable across time. Contrary to these
predictions, the results revealed that there were no significant
differences in response level for the two groups of trainees, and
there were no significant differences across time. A possible
explanation for this lack of change in executive skill level may be
that these responses were too sophisticated for even beginning family
therapy trainees to attempt. It would be interesting to reassess the
executive skill level of these trainees after the family therapy
trainees had gained more training and exposure in family therapy.

83
Executive Skills Across Category
In addition to investigating possible changes within each of the
four therapist response categories, analyses were also performed to
assess any possible changes in executive skills or confidence across
these four categories. An analysis of modal responses for trainees'
preferred category of therapy responses revealed no significant
differences between the two groups or across time. Both groups of
therapy trainees preferred to use Reflecting and Supporting
responses. However, the results for the Average Confidence Level for
the Preferred Response revealed that both groups of therapy trainees
became significantly more confident concerning their preferred
responses across time.
Taken together, these results suggest that there are no changes
in executive skill level for family therapy trainees as a function of
structural family therapy training. Both groups of therapy trainees
maintained stable levels of executive skill for interpretive and
structural realignment therapist responses. Perhaps these two
categories of responses were too sophisticated to reflect changes in
executive skill level of beginning therapists. Consistent with this
hypothesis, changes in executive skill level were revealed for the
therapist response categories of Gathers Information and Reflects and
Supports. The results revealed that the level of executive skill
decreased across time for both groups of therapy trainees. Further,
the results revealed that the preferred category of therapist
responses were Reflecting and Supporting responses. One possible

84
explanation for these results is that regardless of the therapy
training involved, when confronted with a new situation, therapy
trainees will revert back to more familiar and comfortable lower
level therapist responses. Future research in this area will need to
take a longitudinal view of the executive skill level of family
therapy trainees (as compared to nonfamily therapy trainees) as they
gain more exposure to family therapy.
Summary
In a recent review of the family therapy training field,
Kniskern and Gurman (1979) emphasized the lack of empirical,
evaluative studies. The majority of the studies that have been
reported have been based on self-report and uncontrolled
investigations. Although these studies have reported increases in
family therapy skills, it has not been possible to attribute these
perceived changes to training in family therapy. Recently there has
been a trend toward more empirically sound measurement of the effects
of family therapy training (e.g., Breunlin et al., 1983; Tucker &
Pinsof, 1984). However, even these studies have been hampered by the
lack of reliable and valid measures of therapy skills and the lack of
adequate control groups. The present investigation attempted to
provide both reliable measures of family therapy skills as well as a
comparable control group. Although the results of this investigation
did not provide compelling support for the major hypotheses, they
were suggestive of several alternative hypotheses that require
additional research in the future.

35
Based on Cleghorn and Levin's (1973) model of family therapy
skills, the present study investigated three major skills associated
with effective family therapy (i.e., perceptual, conceptual and
executive skills). Using Kelly's (1955) Role Repertory Grid measure,
the results of the present investigation revealed changes in
perceptual skills that at first glance appear to be opposite of those
predicted. Measures of cognitive differentiation increased for the
nonfamily therapy trainees and decreased for the family therapy
trainees. This would appear to suggest that training in structural
family therapy has a negative impact on trainees, resulting in
decreased levels of cognitive complexity. However, measures of
cognitive integration revealed that the family therapy trainees were
much more integrated and flexible than the nonfamily therapy
trainees. Taken as a whole, these results suggest that as trainees
begin to learn about family dynamics they form a structural template
that is used as the basis for their family interpretations. It
appears that the family therapy trainees are beginning to see the
commonalities and patterned similarity across the different families,
while the nonfamily therapy trainees continue to view families based
on several different theoretical orientations. Thus, the decrease in
differentiation for the family therapy trainees may be a reflection
of the tightening of the new family construct system, while the
increase in integration reflects their flexibility in the use of
their new constructs. In contrast, the increase in differentiation
for the nonfamily therapy trainees may simply reflect their continued
use of a diversity of therapy constructs, while their lower level of

86
integration reflects their less flexible use of therapy constructs
when applied to families.
Interestingly, although the family therapy trainees are
beginning to experience changes in their perceptions of families,
they have not yet developed these skills to the point where they can
begin to conceptualize the family differently. Regardless of the
therapy training involved, all trainees were able to focus on
subsystem dynamics when required to conceptualize the family.
However, the family therapy trainees were not yet able to
conceptualize the family in completely systemic terms. It is
possible that they had simply not advanced to this point. This
hypothesis is consistent with the results of the content analysis of
trainees' perceptual skills. Although trainees were beginning to
show perceptual changes, there were no significant increases in level
of abstraction, suggesting that the trainees' perceptual skills were
still developing.
Based on the results of the measures of perceptual and
conceptual skills, it is not surprising that there were no changes in
their executive skill level. This further suggests that executive
skills would be the last skills to develop. Before the family
therapist can act differently in therapy, he or she must perceive the
family differently and conceptualize the family dynamics differ
ently. The fact that both groups of therapy trainees reverted back
to relatively basic reflection of feeling responses suggests that
dealing with a family was a new and possibly confusing situation that

87
prompted subjects to respond in ways that they felt more confident
wi th.
In conclusion, although the results of this study did not
support the hypotheses of increased family therapy skill levels, the
results did not negate these hypotheses either. Rather than
indicating an increase in these skills, the results suggest that
family therapy skills may be developmentally dependent upon each
other such that higher level skills can not develop until lower level
skills have been adequately developed and consolidated. Thus, as a
function of training in structural family therapy, trainees may first
show changes in their perceptual skills, followed by changes in
conceptual and then executive skills. .Future research needs to take
a longitudinal approach to the investigation of the impact of
training on the family therapy skills of trainees in this field.
Future Considerations
The investigation of the effects of training in family therapy
is a new and relatively uncharted area of inquiry. There are only
two studies cited in the literature that approach the empirical
sophistication and rigor necessary to explore the impact of family
therapy training on therapy skills (e.g., Breunlin etal., 1983;
Tucker & Pinsof, 1984). Both of these investigations have several
flaws in their methodology that need to be addressed. In the
Breunlin et al. (1983) study, there was no mention of any objective
coding system and, although they are beginning to develop an
instrument for measuring family therapy skills, without an objective

38
measure their results may have been biased toward the logical
expectation that trainees' responses would become more complex after
training. Further, this study did not employ a comparable control
group. In the Tucker and Pinsof (1984) investigation, the authors
reported the use of a measure found to reliably discriminate between
the family therapy skills of beginning and advanced family
therapists. However, they did not employ any control group and,
consequently, it is difficult to attribute their results to the
specific effects of training in family therapy. Future research must
combine these two aspects of empirical investigation, namely, the use
of a reliable measurement and experimental control.
While the present investigation attempted to control for these
two major limitations, the instruments used may not have been
sensitive enough to detect subtle changes. The reliabilities for the
therapist response executive skill measure ranged from .45 to .76,
while the reliabilities for the conceptual skill measure only ranged
from .33 to .69. These two instruments need to be revised and
reliabilities increased before they can be expected to reliably
measure changes in therapy skill level. A second limitation in the
present investigation consisted of the small sample size (N=33),
reducing the power of the analyses to detect changes that may be
present. For example, analyses of power for structural measures of
cognitive integration and cognitive differentiation revealed that the
power of the F tests were .11 and .72, respectively. In the present
study, adequate power (e.g., .80 to .90) would require an approximate
sample size of 50 to 70 subjects. Future studies must include an

89
adequate sample size of both family therapy trainees and control
subjects in order to determine if changes in therapy skills are a
unique function of training in family therapy.
In addition to the above two changes in methodology, future
research may also benefit from taking a longitudinal approach to the
study of family therapy training. It may be that changes in
conceptual and executive skills do not begin to change until the
trainees gain actual clinical experience with families. Future
research will need to investigate this issue of past clinical
experience more closely. Does the amount of past experience with
individual therapy affect how family therapy trainees integrate their
new knowledge? This could be investigated by comparing four groups
of subjects: family therapy trainees with no prior therapy
experience, family therapy trainees with two to five years of prior
therapy epxerience, nonfamily therapy trainees with no prior therapy
experience, and nonfamily therapy trainees with two to five years of
prior therapy experience. It would also be interesting to
investigate the relationship between trainees' own family background
(e.g., only child versus several siblings) and their family
conceptual skills as a function of training in family therapy.
Further, future research may also benefit from taking a slightly
different approach to the study of therapy skills in family therapy
trainees. The present investigation may have biased trainees toward
focusing on family dynamics. According to structural family
therapists (e.g., Minuchin, 1974), one can take a structural systems
approach even when working with an individual. In order to control

90
for biasing subject responses simply by being in a family therapy
project, future research can use a crossed design such that subjects
are required to view an individual as well as a family on cape in
order to measure conceptual and executive skills. It would be
expected that control subjects would not take a systems view of the
individual, while the family therapy trainees may begin to
conceptualize and respond to an individual along a more systemically
oriented dimension.
If the field of family therapy training is going to claim that
it has a unique impact on the family therapy skills of its trainees,
then future research must not ignore the proven, traditional
methodological approaches (Gurman, 1983). According to London and
Klerman (1982), the basic principles of empirical investigation are
measurability and replicibi1ity. As the area of family therapy moves
toward traditional methodological investigation, the area of training
in family therapy must also make this move toward controlled
comparative investigation.

APPENDICES

APPENDIX A
FAMILY THERAPY COURSE DESCRIPTION
PCO 6250
INTRODUCTORY FAMILY COUNSELING
Fall, 1984
OBJECTIVES FOR THIS COURSE
1. To acquaint you with the historical development of the family
therapy field.
2. To acquaint you with the essential elements of family process and
family systems theory.
3. To assist you in developing skills in observing and organizing
family data.
4. To acquaint you with the distinctive challenges families face at
different life stages (e.g., single parent families, families
with adolescents or aging members, blended families).
5. To assist you in developing basic interviewing skills necessary
in conducting a family interview.
MATERIALS NEEDED FOR THE COURSE
Books: Minuchin, S. Families and Family Therapy
Napier, A. and Whitaker, C. The Family Cruciable
Carter, E. and McGoldrick, M. The Family Life Cycle
Selected articles and chapters on reserve on the Education
Library will also be required for the course.
COURSE REQUIREMENTS
1. Dynamic Communication Analysis. You will be given a transcript
of a couple's dimensions. The purpose of this assignment is to
teach you how to track communication sequences, to observe ways
in which communication meaning is derailed, and use this
92

93
knowledge in conferring the structure of a couple/family system
and in getting and keeping communication on track in therapeutic
interviews. Guidelines for this analysis will be provided during
the fourth week of classes. (3-5 typewritten pages.)
2. Teaching Outline and Annotated Bibliography. You are to prepare
a 5-7 page synopsis outline of a specific family stage/pattern
(e.g., single parent families, families with adolescents, dual
career families, children and divorce, etc.) describing typical
challenges which confront the family and family methods of
adaptation suggested in the literature. In addition to this
synopsis, you are to develop an annotated bibliography
summarizing the pertinent features of eight articles in the
literature. Your synopsis and bibliography will be distributed
to your classmates as a part of a teaching presentation you will
design with the instructor and two other students. Your synopsis
and bibliography will be due the week before you are scheduled to
present to the class.
3. Team Design Development of a Teaching Unit. You will be given
the joint responsibility (along with 2 other people) of planning
and implementing a class session) with the instructor on the
family stage/pattern in which you have become expert (from #2),
on the data for which it is scheduled in the syllabus.
Appropriate teaching activities and resources are to be designed
and developed for this assignment.
4. Film and Videotape Family Observation Reports. You will be
expected to submit 3 brief observation reports on the film or
videotaped families whom you observe in class. Guidelines for
this report will be discussed and distributed in class.
5. Class Skill Tryouts. You will have an opportunity to participate
in 2-3 family interview skill tryouts as a part of class
activities. You will be graded on your willingness to try these
experiences rather than the level of skill you demonstrate.
6. Family Assessment Report. You are expected to prepare an
assessment report on a family describing the family both
structurally and developmentally. You will be asked to describe
the family in terms of specific criteria outlined in The
Guidelines For The Family Assessment Report. May be developed on
a family you have seen or film, read about, or know personally.
The report is due the last week of class.
GRADING PLAN
Points are to be given for completion of each of the five course
requirements. Your final grade is based upon the total number of
points earned. Points will be allocated for each course requirement

94
according to the following arrangement:
(a)
Class Skill Tryouts (0-50)
29
30-39
40-44
45+
(b)
Communication Analysis (0-50)
29
30-39
40-44
45+
(c)
Videotaped Observation Reports
29
30-39
40-44
45+
(d) Topical Synopsis and
Bibliography (0-100)
75
76-85
86-90
91+
(e)
Class Teaching Unit (0-100)
75
76-85
86-90
91+
(f)
Family Assessment Report (0-100)
75
76-85
86-90
91+
TOTAL POINTS
179-
334-383
384-408
409+
LATE WRITTEN ASSIGNMENTS WILL RESULT IN A GRADE REDUCTION OF ONE HALF
UNLESS PREVIOUSLY CLEARED WITH THE INSTRUCTOR.
ORGANIZATION OF THE COURSE:
August 20
August 27
September 3
September 10
September 17
MONDAY
Getting Organized and "Thinking Systems" Amatea,
"Learning to Think Systems: A Beginning Course in
Family Systems Intervention.
Historical Development of the Family Therapy Field
Read: Haley "Family Therapy: A
* Haley "A Review of the Family Field"
* Barnhill "Heating Family Systems"
The Family Cruciable, Chaps. 1-4
LABOR DAYNo Classes
Analyzying Family Communication Content and
Process
Read: Napier and Whitaker's The Family
Cruciable, Chaps. 5-7
Luthman and Kirschenbaum, The Dynamic
Family, pp 1-49, 93-127, and 157-176
Patterns of Power, Patterns of Function: The
Structural Organization of the Family
Read: Minuchin, Families and Family Therapy,
Chaps. 1-3,
* Jackson, "Family Rules"

95
September 24
Power Tactics in the Family: Triangling
Read: Minuchin, Families and Family Therapy,
Chaps. 4-5
* Haley, "The Family of the
Schizophrenic: A Model System"
COMMUNICATION ANALYSIS PAPER DUE
October 1
Holding On and Letting Go: Patterns of Stability
and Change in the Family
Read: Carter and McGoldrick: The Family Life
Cycle, Chaps. 1-3
October 8
To Have and To Hold? Identity Development in
Marriage
Read: The Family Life Cycle, Chaps. 4, 5 and 8
The Family Cruciable, Chaps. 8-20
October 15
The Family with Young Children: Pitfalls of the
Ghetto and the Middle Class
Read: Minuchin Families of the Slums, Chaps. 1-2
* Barragan "The Child-Centered Family"
October 22
The Family with Adolescents and/or Young Adult
Children
Read: The Family Life Cycle, Chaps. 7-8
October 29
Chronic Illness, Death and the Family
Read: The Family Life Cycle, Chap. 10
November 5
Separation, Divorce Single Parent Families
Read: The Family Life Cycle, Chap. 11
* Leng Jaffe "The Divorce Adjustment
Process"
November 12
Conducting an Initial Family Interview: Joining
Problem Exploration Tracking
Read: Haley, Problem Solving Therapy, Chap. 1
Minuchin, F. and FT., Chaps. 6 and 7
November 19
Using Enactment in the Initial Interview:
Staging, Tracking, and Highlighting
Read: Minuchin Families and Family Therapy,
Chaps. 8, 9, 11
November 26
Mapping the Family, Identifying a Focus, and
Setting Goals in the Initial Interview
Read: Minuchin, F and FT, Chap. 12
December 3
Problem Redefinition and Reframing
Read: Amatea "Moving a Family into Therapy"

APPENDIX B
FAMILY THERAPY EXPERIENCE INVENTORY
1. NAME
AGE BIRTHATE SEX
HIGHEST DEGREE CURRENTLY HELD
DEGREE PROGRAM CURRENTLY ENROLLED IN
NUMBER OF SEMESTERS IN PROGRAM
NUMBER OF YEARS CONDUCTING COUNSELING/THERAPY
DO YOU PLAN TO TAKE ADVANCED FAMILY?
DO YOU PLAN TO TAKE MARRIAGE COUNSELING?
WHAT IS YOUR SUBSPECIALIZATION/MINOR?
2. Number of undergraduate, graduate or other ongoing courses taken
where there was a major focus on the "family" (i.e., courses
where three lecture sessions or more, and/or more required texts
were concerned with historical, anthropological, sociological, or
psychological study of the family, including a focus on marriage
as a primary aspect of the family).
0 2-3
1 4-6 7 or more
3. Training sessions or workshops focused on work with families that
you have attended.
0 2-3
1 4-6 7 or more
96

97
4. Number of family therapy books you have read.
0 2-3
1 4-6 7 or more
5. Number of family therapy articles you have read.
0 6-10
1-5 11 or more
6. Direct experience with family therapy (sessions where you and/or
others worked with more than one person in a family unit about
their mutual problems).
How many different families?
0 11-50
1-10 more than 50
7. How many of these cases were supervised?
0 11-30
1-10 31-50 more than 50
Do you wish feedback on your participation in this study?

APPENDIX C
FAMILY REPERTORY GRID
Subject #
Name
S.S. T~
Date
Ratings Scale
Very +3/-3
Somewhat +2/-2
Slightly +1/-1
NA/Equally 0
1
2
3
4
5
6
7
8
9
10
ALIKE
DIFFERENT
CONTENT
CODE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
98

APPENDIX D
GRID CONTENT CODING INSTRUMENTS
A content coding column is located next to your descriptions.
For each of the 15 descriptions, please code your descriptions in one
of the following ways:
1. Physical Characteristics
Examples:
has 4 children
lives in New York
single parent
Catholic
children are girls
divorced
black
member of family
nuclear family
middle-class
mother is deceased
2. Role Functions
Examples:
mother is a housewife
problem child
father is breadwinner
son is a college student
mother dominates
traditional roles
father is a doctor
3. Personality Characteristics
Examples:
warm
intelligent
religious
artificial
4. Interactional Patterns
values education
trusting
sensitive
Examples:
stable
supportive
independent
happy family
likes to have a good time
flexible
marital problems
do things together
outgoing
unsociable
99

100
If you find that your alike description and your different
description fall under separate categories, please make your decision
based on the alike description.
Please turn to the next page for a practice trial.

APPENDIX E
GRID CONTENT EXAMPLES
Before rating your own descriptions, we would like you to get a
feel for it by rating the following 5 descriptions using these 4
categories.
1. many children / no children
2. caring / cold and insensitive
3. father is a lawyer / father is a blue collar worker
4. sociable and friendly / rarely do things together
5. kind and giving / intelligent
Now we would like you to go back and rate your family descriptions.
In order to make sure that you fully understand how to use this
rating system, we have a few more examples that we would like you to
rate using these 4 categories:
physical; role; personality; interactional
1. critical / accepting
2. permissive parents / stern parents
3. small family / large family
4. first marriage / second marriage
5. father is spokesman for family /
mothers speaks for the family
Now we would like you to go back and rate your family descriptions.
101

APPENDIX F
FAMILY A DYNAMICS SEEN BY ACTORS
Two Parent Family
THE JEFFREYS
Upper Middle Class Family
Father
Gordon
Age
50 -
manager of small publishing company
Mother
Joan
46 -
housewife
Children
Alyson
17 -
student
Jessica
16 -
student
Cra i g
14 -
student
Matthew
10 -
student
Presenting
Problems
1. Alyson, the eldest daughter, is exhibiting unpredictable behavior
that has disrupted the family (parents have reported this).
2. She erupts in sudden violent fits, screams and yells at siblings
and sometimes has physical fights with her sister Jessica.
3. Other times, she is silent and withdrawn from the family. Her
pouting has been labelled by the parents as "silent contempt."
4. Alyson's parents do not approve of some members of her peer group
and feel that they are a bad influence on her.
5. Alyson's parents complain that she spends most of her time with
her peer group, away from the family.
Mrs. Jeffreys
Therapist knows about Mrs. Jeffreys:
1. Very involved with her children. Works very hard to maintain
communication with them and remain intimate.
102

103
2. Friendly and outgoing presentation.
3. However, she shows glimpses of her own depression when given the
opportunity.
Information to be given to therapist:
About Self:
1. Suffers from migraines, backaches and hypertension. She says
that she takes valium for her nerves.
2. Passes information, requests, etc. from the children to father.
3. She feels that she cannot control the kids. When their
squabbling gets on her nerves, she yells at them and then
withdraws in a depressed state.
4. Anger and fighting amongst children often leads to mother's
migraines.
5. Matthew also has angry outbursts and doesn't listen.
About Alyson:
6. Alyson has poor grades now; previously was a B+ student.
Teachers say she is acting out in school.
7. Alyson is not acting nice to grandparents, who think the world of
her.
8. Alyson withdrawing from family, spending most of her time with
peers.
Actions:
1. Encourages the children to confide in her about everything.
2. Constantly prods children, especially Alyson, for problems and
explanations, i.e., "Are you unhappy in our family?"
Mr. Jeffreys
Therapist knows about Mr. Jeffreys:
1. Supports wife's presentation of problems.
2. Gives appearance of being in control of family.
3. Uses sophisticated speech when he talks to children and usually
speaks in a lecture style.

14
4. Major joining with family is through playful teasing.
5. Work keeps him away from family. He works at the plant many
evenings and usually brings work home.
Information to be given therapist:
1. Admits his "bark" is worse than his "bite."
2. His orders and directives are often not backed up with
punishments, only threats.
3. Alyson refused to go to summer school.
Actions:
1. Speaks in adult metaphors.
2. Re-directs therapist's communications to specific children
(almost interrogates).
3. Sits separate from children and wife.
4. In session, he is the power. Wife tries to speak but allows him
to dominate the conversation, if questions are not directed to
her.
5. He interprets and guesses about others' thoughts and feelings.
6. He will tell long irrelevant stories if attention is taken from
him for very long.
Alyson
Therapist knows about Alyson:
1. Outspoken: confronts and questions parents about what they are
talking about or referring to, sometimes in a disrespectful
manner.
2. Very directive and assertive.
Information to be given to therapist:
1. Doesn't think family has problems.
Actions:
1. She is the dominant child and leader of the sibling group.

105
2. When given the opportunity, she speaks her mind to parents.
3. Teases siblings when they talk.
4. Disagrees openly with what siblings say and argues with them with
little or no provocation.
5. "Butts in" on all family members when they are talking.
6. When parents refuse her requests, she pouts and often says, "I
didn't want to do that anyway."
Jessica
Therapist knows about Jessica:
1. Quiet, doesn't offer thoughts.
2. "Perfect child" according to parents.
3. Apparent discomfort when asked to speak.
Actions
1. Doesn't speak much.
2. Uses great deal of non-verbal communication directed towards
Alyson.
3. Teases and goads Alyson.
4. Acts shy when questioned.
5. When questioned, says few words.
6. Answers "yes" or "no."
Cra i g
Therapist knows about Craig:
1. Quiet, withdrawn child.
2. Therapist doesn't know much about him.
3. Just 1istens.
Information to be given to therapist:
1. Handles problems by retreating to room.

106
Actions:
1. When asked something often replies "i don't know"; seems confused
and lost.
2. Or he doesn't answer.
3. Replies "yes" or "no" to questions.
4. Quiet, introspective.
Matthew
Therapist knows about Matthew:
1. Clown of family.
2. Gets everyone to laugh, fools around.
3. Obstinate: when asked to stop doing something will slowly
respond and shortly afterwards will do the same thing.
Actions:
1. Like sister Alyson.
2. Mother's boy: sits on or around her.
3. Acts shy at times.
General for children
Children bicker with and tease each other when parents are talking.
This is their form of resistance.

APPENDIX G
FAMILY B DYNAMICS SEEN BY ACTORS
Single Parent Family
THE WILLIAMS
Low Income Family
Age
Mother
Mrs. Williams (Jane)
- low paying job in
television production
Father
Children
Not in therapy (Frank)
Ian
Dianne
17 student
16 student
Mr. Williams refuses to have anything to do with his wife and
therefore refuses to participate in therapy. Mother and father
separated three years ago.
Mr. and Mrs. Williams have not been able to agree on the terms
of divorce. In addition, Mrs. Williams has taken Mr. Williams to
court on two occasions for failing to meet his support payments. In
one case, Mr. Williams was sentenced to a week in jail.
The children spend every second weekend with their father, they
generally enjoy these visits.
Presenting Problems
1. Ian loses his temper and becomes uncontrollable.
2. Ian pulled a knife on mother and sister the last time that he
lost his temper.
3. Ian orders his sister around and expects her to do things for him
(e.g., make him meals, watch his TV programs).
4. Ian physically pushes sister around when she doesn't listen to
him.
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108
Mrs. Williams
Therapist knows about Mrs. Williams:
1. Mrs. Williams believes that parents should be best friends with
their children.
2. She thinks she is good friends with her daughter but at the
moment not with her son.
3. Mrs. Williams joins in her children's parties and becomes very
friendly and open with their friends. She often consults her
son's friends about his problems.
4. Mrs. Williams complains that her children won't listen to her
when she asks them to do something. Ian is the worst in this
respect.
Information to be given to therapist:
1. Mrs. Williams is upset that the children listen to their father
but they won't obey her.
2. She doesn't want to use punishment and force them to obey. Mrs.
Williams wants the children to obey her because they love her and
care for her, not because she forces them to obey.
3. Father controls kids through fear and Mrs. Williams refuses to do
the same.
4. Ian is like his father: "He doesn't listen to me, he ignores me,
he is rude to me and he mocks me" (can expand on how much husband
angers you if asked; telephone battles).
5. Everyone takes advantage of me because I'm such a nice person.
6. Insists Ian is the problem; he needs individual therapy to solve
his problem.
Actions:
1. Monopolizes the conversation.
2. When questions are directed to children, Mrs. Williams often
responds for them.
3. Mrs. Williams is very friendly, outgoing and initially smiling.
4. She becomes sad and obviously depressed as the topic of her
children disobeying and taking advantage of her good nature is
introduced: "They don't love me or care about me; if you did you
would prove it to me by being good."

109
5. Challenges the therapist to fix her children.
6. She has very low self-esteem and is afraid that the therapist
will blame her for the family problems. Her defense is to direct
the attention to her son's problems and to blame him.
7. She attempts to avoid discussions of her problems.
Ian
Therapist knows about Ian:
1. Ian is very bright in school (mother harps on the fact that Ian
is so intelligent that he can outsmart and manipulate anyone).
2. Ian thinks that he is blamed for everything and that he is not
being treated fairly.
3. Ian thinks that his mother asks too much of him and that her
requests are unreasonable.
Information to be given to therapist:
1. Mother asked him to help with spring cleaning on Saturday when he
had made previous plans to go to a movie with friends. Then she
got angry and told him that he didn't care about her or his
si ster.
2. Feels that he has to defend his rights. His sister enters his
room without this permission and uses his stereo: she has broken
it before. Now he has set his room off-limits and when she
refuses to listen, he pushes her around. However, mother defends
sister and yells at him for getting angry.
3. Ian feels ganged-up by mother and sister (has to defend his
position of male of the house).
4. Mother always complains about father and says mean things about
him: "She always questions us about what Dad says, does, etc."
Actions:
1. At first, is quiet and unresponsive while Mrs. Williams speaks.
2. When questioned, is willing and wanting to air his complaints.
3. Questions that are directed to sister he will answer for her or
make a comment about how she is spoiled.
4. His mood is a mixture of anger and frustration over the injustice
that he thinks he is suffering.

no
5. He is very co-operative in response to the therapist's questions.
Dianne
Therapist knows about Dianne:
1. Dianne is a quiet and nervous person. She has not spoken much
during sessions.
2. She responds to questions when asked, but doesn't elaborate.
3. She will respond with anger if Ian pushes her enough.
Information to be supplied to therapist:
1. Dianne is angry with Ian because he bosses her around like a
slave, i.e., "When I'm watching TV, he will tell me to get him
something to eat and will get angry if I don't."
2. Agrees with mother that Ian is the problem.
3. Ian is like father: "I'm afraid of their anger."
Actions:
1. Doesn't say much or respond with much emotion until Ian has
described her as the villain.
2. When she does respond with anger to Ian, Ian stands back, mother
comes to Dianne's defense and Ian backs off becoming quiet, while
mother attacks Ian.
3. Ian seems to follow the discussion but from an observer role. He
seems reluctant to participate in the discussions.

APPENDIX H
THERAPIST RESPONSE CODING SYSTEM
I.STRUCTURAL REALIGNMENT
1. Obstructive
2. Educates
3. Seeks Alternatives
4. Structures the Family Members
II. GATHERS INFORMATION
1. Obstructive
2. Asks for more Information about the Individual
3. Asks for more Information about a Subsystem
Relationship
4. Asks for more Information about System Relationship
III. REFLECTS ANO SUPPORTS
1. Obstructive
2. Reflects
3. Supports
4. Reflects and Supports
IV. INTERPRETS AND CONFRONTS
1. Obstructive
2. Direct Interpretation
3. Strategic Interpretation
4. Confrontive Interpretation
111

APPENDIX I
THERAPIST RESPONSE ALTERNATIVES: FAMILY A
Interval I
1. Alyson: I don't think there's a problem. What do you think?
I. Response Alternatives
(a) Alyson, I think you are creating some very serious
problems for yourself and your family that we all need to
work on.
(b) Often times, too much pressure may create strife and
division within a family, even a family that loves each
other.
(c) Well Alyson, your parents feel there is a problem here and
they are very concerned. But it is difficult to
communicate when you are so spread out. Dad and Mom, I'd
like you to sit next to each other, and Alyson, turn your
chair so you are facing your parents.
(d) I think you and your family need to explore new ways of
communicating your needs and feelings to each other. I
would like each of you to state how you are feeling about
what is happening in this family while the others listen.
II. Response Alternatives
(a) I'd like to know if you fight like this often. I'd like
to hear from you and your sister and brothers.
(b) I think it is important that we hear from each member of
your family about how they perceive what is happening in
this family.
(c) I'd like to know if you fight like this often. Let's hear
from both you and mom and dad.
(d) If you don't think there is a problem, then tell me
Alyson, why is your family here today?
112

113
III. Response Alternatives
(a) Alyson, it sounds like you don't think there is a problem
here.
(b) It sounds like you are upset Alyson because you don't
think there is a problem. Let's work together so all of
you are happy and comfortable with each other.
(c) Alyson, it sounds like you really feel guilty inside for
causing your family grief.
(d) It's OK for you to feel upset. What we need to do is work
together and find a way for you to feel happier about each
other.
IV. Response Alternatives
(a) Yes, there does seem to be a problem here, though I don't
see it as only your problem. Mom and Dad are also
contributing to this problem.
(b) It seems like there is a lot of anger here in this family
that people are afraid to show.
(c) You seem like a very close and loving family and I wonder
what you fear would happen if you expressed that love for
each other.
(d) Alyson, it sounds as though you don't really like your
parents or your family very much.
Interval II
2. Dad: What do you think we ought to do with her?
I. Response Alternatives
(a) It is important for parents to realize that it is normal
for teenagers Alyson's age to spend a great deal of time
with their friends, and identifying with their friends.
(b) Dad, I think you and mom need to stop accusing Alyson of
misbehaving unless you have proof, and you need to be more
patient with Alyson's behavior in the home.
(c) Right now I'd like to have Alyson tell Dad how she feels,
very quietly and calmly, and have Dad repeat this back to
her satisfaction. Then I would like to have Dad, very
calmly and quietly, tell Alyson how he feels and have
Alyson repeat this back to his satisfaction.
(d) I think everyone needs to realize that though these
problems may seem to be caused by Alyson, they affect the
whole family and everyone must take an active part in
resolving family problems. I'd like you all to think

114
about what part you could play in resolving some of the
conflict you are experiencing.
II.Response Alternatives
(a) I'm wondering if both of you would tell me what it is like
to live in this family. What aspects do you find
upsetting and what do you see as positive?
(b) What I hear is that you are both antagonizing Alyson and
her friends, and putting unrealistic demands on her in
addition to telling her that she is not OK. I think it is
time you stop that and try something different.
(c) I'd like to know how often you children get frustrated and
upset with each other to the point that one of your
parents has to intervene, and what behavior on their part
you find upsetting.
(d) Dad, I'd like to know how often you and Mom get frustrated
and upset with Alyson and the other children, and what
behaviors on their part that you find upsetting. Let's
hear from both of you.
III.Response Alternatives
(a) I can see how much you love your children, and that is the
first step in helping your family in resolving your
conflicts with each other through working on compromises
that you will all be happy with.
(b) Dad, it sounds like you feel you have failed Alyson in
some way and you are feeling guilty and confused about how
that happened.
(c) It is obvious that you are feeling some pain in being in
conflict with each other and would much rather be getting
along. What we need to do is work on helping you develop
some working compromises that each of you would be happy
wi th.
(d) Dad, it sounds like you are very concerned about Alyson
and would like to do anything you could to help her.
IV.Response Alternatives
(a) Dad, I think you and your family have already done enough
things "to" Alyson and it is time you stop laying all this
guilt on Alyson and begin working on your problems.
(b) It appears that no one in this family is willing to take
any blame for family conflicts so that Alyson has been
elected and has agreed to take all the blame for the
family. I wonder what would happen if Alyson no longer
shouldered the blame for the others in this family.

115
(c) It seems that the members in this family are afraid to
share warm tender feelings for each other and so keep each
other at arm's distance by fighting with each other. I
wonder what would happen if you expressed positive
feelings toward each other?
(d) It seems that the members in this family have an invisible
wall around them so that you are focused only on your
feelings and are unable to really listen to each other.
Interval III
3. Dad: What do you advise we do?
I. Response Alternatives
(a) First, I would like to see you and mom sitting next to
each other rather than separated by your children. I
would like you to face your children and discuss together
what the two of you expect of your children. When you
have reached an agreement, I would like you to share those
expectations with your children and find out whether they
feel those expectations are agreeable.
(b) When a family such as yours is in conflict they tend to
place the blame on one family member. However, it has
been my experience that all the family members either
contribute to or maintain the problem.
(c) I think your family needs to continue on in therapy so you
may explore some positive ways of expressing your feelings
and needs to each other. I would like each of you to
state what your needs are that are not being met and how
you feel the family might help you meet these needs.
(d) I suggest that you both learn some new parenting skills as
you are obviously having a difficult time having to deal
with older children.
11. Response Alternatives
(a) Dad, I would like to know if the other children interrupt
you this often at home when you and Mom are trying to
discuss things together.
(b) I'd like to know how long this family has been fighting
like this and when each of you think these changes began
to occur. I'd like to hear from each of you separately
while the others listen.
(c) I think you should stop focusing all your attention on
Alyson, and start giving some attention to your other

116
children as they are obviously more disturbed than is
Alyson.
(d) I'd like to know how long this family has been fighting
like this and when each of you think these changes began
to occur. I'd like to hear from Mom first and then Dad.
III. Response Alternatives
(a) Although there has been a lot of arguing going on, it
seems that you are each concerned about the other members
of the family. What we need to do is work together to
find a way for you to express these concerns without
having to argue.
(b) It sounds like you are both confused about what is
happening and what you can do and this is not unusual in
families with teenagers. What we need to do is work
together to find a way for you to express these concerns
in such a way that all of you are satisfied.
(c) Alyson mentioned that Mom gets frequent headaches and
appears depressed and it sounds to me as though Alyson is
concerned about what is going on with Mom.
(d) Dad, it sounds like you feel really disappointed that
Alyson is not living up to your expectations.
IV. Response Alternatives
(a) First, I really feel that you, Dad and Mom, are ganging up
on Alyson and not listening to her so that I think therapy
needs to focus on teaching both of you fair parenting.
(b) It seems that here are a lot of things going on here, some
that relate to Alyson and some that relate to other
members of the family. But for some reason, the family
has agreed that Alyson should shoulder the responsibility
for the conflict experienced in the family.
(c) It seems that there is a lot of avoidance in this family,
such that no one is willing to share how they feel and
what their needs are, resulting in all the focus being
placed on Alyson in order to avoid dealing with the major
conflicts your family is experiencing. I wonder what
would happen if I removed Alyson from her central position
in the family.
(d) It seems that there are a lot of things going on here,
some that relate to Alyson and some that relate to other
members of the family. It appears that this family is
afraid of hurting each others' feelings through arguing,
and Alyson and the family have agreed that she should take
the responsibility for expressing conflict so that the
other members will not feel hurt.

117
Interval IV
4. Dad: Where do we go from here?
I.Response Alternatives
(a) It seems to me that right now you are stuck and cannot
reach each other even when you try. Without some therapy
your family will most likely continue on in this way to a
point where you may have to consider crisis intervention.
(b) I think it is important that each of you are clear about
what you expect from therapy. To help clarify some things
I would like Mom and Dad to move and sit next to each
other and I would like all four children to sit together
facing Mom and Dad in a circle so that each child has an
opportunity for some face-to-face contact with Mom and
Dad.
(c) Dad, I think it is important that you and Alyson both know
what it is you want from each other that you are not
getting. I would like you both to share that with each
other now.
(d) Often times, as children grow older, families have
difficulty in knowing how to deal with the new situations
that are created within a family that loves each other.
II.Response Alternatives
(a) Mom, how do you and your husband usually handle the
children when they disrupt discussions at home? Let's
hear from both of you.
(b) I think it is important for us to find out why your
marriage needs to be held together by Alyson's behavior.
(c) You as a family need to decide if you want to go on from
here. Do you want to change the way the family is right
now? I would like to hear from both of you.
(d) Alyson, I'm wondering what it is about your family that
makes you feel uncomfortable at home?
III.Response Alternatives
(a) It seems like everyone here today feels like he is not
being understood or appreciated and you have taken a big
step by coming here today and admitting you have some
problems that need to be worked on.
(b) Dad, it must be very difficult for you to try and
understand Alyson's feelings when she seems so ungrateful
for all you have done for her.

118
(c) What has happened in this session has been a good
beginning and now we need to look closer and deeper at
what is happening underneath in this family.
(d) It seems like everyone here today feels like he is not
being understood, or more importantly, appreciated. We
need to look closer and deeper at what is happening
underneath in this family.
IV. Response Alternatives
(a) The issues concerning Alyson that have been presented here
are really just surface expressions of the conflict and
turmoil that is going on inside. We will need to take a
closer look at what conflicts Alyson's behavior is
camouflaging.
(b) It sounds like everybody in this family is upset with
Alyson for not seeming to care about her family anymore.
(c) Well, there seems to be several problems here that are not
related to Alyson, but are related to your family's
unwillingness to share both positive and negative feelings
toward each other in an open manner. We will need to take
a closer look at how we can change the style of
communication in your family.
(d) You seem like a family that is very loving and protective
of its members, especially of Alyson right now. I wonder
what would happen if you expressed this concern for her in
a way other than through anger and accusations.

APPENDIX J
THERAPIST RESPONSE ALTERNATIVES: FAMILY B
Interval I
1. Mom: What do you think?
I. Response Alternatives
(a) I think the first thing you need to do is stop blaming Ian
for all your problems and realize that none of you have
resolved the conflict you feel about the divorce.
(b) Often times, the pressure and stress associated with a
divorce may bring strife and division within a family,
even a family that loves each other.
(c) Right now I'd like to hear Ian tell Mom how he feels, very
quietly and calmly, and have Mom report this back to his
satisfaction. Then I would like to have Mom, very calmly
and quietly, tell Ian how she feels and have Ian repeat
this back to her satisfaction.
(d) I think you and your family need to explore new ways of
communicating your needs and feelings to each other. I
would like each of you to state how you are feeling about
what is happening in this family while the others listen.
II. Response Alternatives
(a) I'd like to know if you fight like this often at home, and
how you settle disagreements in your family. Let's hear
from Ian and Diane as the children in the family.
(b) I think it is important that we hear from each member of
your family about how they perceive what is happening in
this family.
(c) I'd like to know if you fight like this often at home, and
how you settle disagreemnts in your family. Let's hear
from both Mom and Ian.
(d) Mom, I am anxious about what it is you fear would happen
if you stopped insisting that Ian had all the problems and
you had no problems other than Ian.
119

120
III. Response Alternatives
(a) Mom, it sounds like you feel frustrated and confused about
what is happening in your family.
(b) Mom, it sounds like you are feeling very frustrated about
what to do and you seem to be carrying a lot of
responsibility on your shoulders. I imagine that you
might feel very alone with this burden. Let's work
together so all of you are happy and comfortable with each
other.
(c) Mom, it sounds like you really feel guilty inside for
causing your children grief through the divorce.
(d) It's OK for you to feel frustrated and upset. What we
need to do is work together and find a way for you to feel
happier about each other.
IV. Response Alternatives
(a) It appears that Ian is the spokesman for this family's
anger and I'm wondering what the soft voices of Mom and
Dianne are covering up in the family.
(b) It seems like there is a lot of anger here in this family
that people are afraid to show.
(c) You seem like a very close and loving family and I wonder
what you fear would happen if you expressed that love for
each other.
(d) Mom, it sounds like you don't like your ex-husband or Ian
very much.
Interval II
2. Mom: I don't know what to do. What do you think?
I. Response Alternatives
(a) It is important for parents to realize that it is normal
for teenagers Ian's age to spend a great deal of time with
their friends and less time with their family. It does
not imply that they love their family less, but it is a
time of growth independently from the family.
(b) Mom, I think you need to stop blaming Ian for wanting his
freedom rather than spending time keeping you company so
you don't get lonely.
(c) First, I would like Mom to change seats with Dianne so
that Mom is sitting between both children and Mom and Ian
are not separated by Dianne. Then I would like Ian and
Dianne to discuss what they expect of each other and Mom

121
while Mom listens. When you have reached an agreement, I
would like you to share these expectations with Mom and
find out whether she feels these expectations are
agreeable.
(d) I think everyone needs to realize that though these
problems may seem to be caused by Ian, they effect the
whole family and everyone must take an active part in
resolving family problems. I'd like you all to think
about what part you could play in resolving some of the
conflict you are experiencing.
II. Response Alternatives
(a) I'm wondering if each of you would tell me what it is like
to live in this family. What aspects do you find
upsetting and what do you see as positive?
(b) What I hear is that you are antagonizing Ian and putting
unrealistic demands on him in addition to telling him that
he is not OK. I think it is time you stop that and try
something different.
(c) I'd like to know how often you children get frustrated and
upset with each other to the point that Mom has to
intervene, and what behaviors on her part you find
upsetting.
(d) Mom, I'd like to know how often you get frustrated and
upset with Ian and Dianne, and what do you do when Ian and
Dianne are fighting?
III. Response Alternatives
(a) I can see how much you love your children and that is the
first step in helping your family in resolving your
conflicts with each other through working on compromises
that you will be happy with.
(b) Mom, it sounds like you feel you have failed Ian in some
way and you are feeling guilty and confused about how that
happened.
(c) It is obvious that you are all feeling some pain in being
in conflict with each other and would much rather be
getting along. What we need to do is work on helping you
develop some working compromises that each of you would be
happy with.
(d) Mom, it sounds like you are very concerned about Ian and
would like to do anything you could to help him.

122
IV. Response Alternatives
(a) Mom, I think you and Dianne have done enough blaming of
Ian and it is time you stop laying all this guilt on Ian
and begin working on your problems.
(b) It appears that no one in this family is willing to take
any blame for family conflicts so that Ian has been
elected and has agreed to take all the blame for the
family. I wonder what would happen if Ian no longer
shouldered the blame for the others in this family.
(c) It seems that the members in this family are afraid to
share warm tender feelings for each other and so keep each
other at arm's distance by fighting with each other. I
wonder what would happen if you expressed positive
feelings toward each other?
(d) It seems that the members in this family have an invisible
wall around them so that you are focused on your feelings
and are unable to really listen to each other.
Interval III
3. Ian: Is there any way that you can get her to keep off my back?
I. Response Alternatives
(a) I think it is important that each of you are clear about
what you expect from therapy. To help clarify some things
I would like Ian and Dianne to sit together facing Mom in
a circle, so that each child has the opportunity for some
face-to-face contact with Mom. Then I would like you to
share what things you would like to see changed through
therapy.
(b) When a family, such as yours, is in conflict they tend to
place the blame on one family member. However, it has
been my experience that all the family members either
contribute to or maintain the problem.
(c) I think your family needs to continue on in therapy so you
may explore some positive ways of expressing your feelings
and needs to each other. I would like each of you to
state what your needs are that are not being met and how
you feel the family might help you meet those needs.
(d) Mom, I suggest that you learn some new parenting skills as
you are obviously having a difficult time knowing how to
deal with your children now that you are a divorced,
single parent.

123
II.Response Alternatives
(a) Ian, what do you usually do when you feel like your Mom is
coming down on you?
(b) I'd like to know how long this family has been fighting
like this and when each of you think these changes began
to occur. I'd like to hear from each of you separately
while the others listen.
(c) Ian, I think that if you stop finding fault with Mom that
she will "get off your back." It is up to you to
determine what will change or stay the same in your
relationship with Mom.
(d) I'd like to know how long you and Mom have been fighting
like this and when each of you think these changes began
to occur. I'd like to hear from Ian first and then Mom.
Ill.Response Alternatives
(a) Although there has been a lot of arguing going on it seems
that you are each concerned about the other members of the
family. What we need to do is work together to find a way
for you to express these concerns without having to argue.
(b) It sounds like you are all confused about what is
happening and what you can do, and this is not unusual in
families that have recently experienced divorce. What we
need to do is work together to find a way for you to
express these concerns in such a way that all of you are
sati sfied.
(c) Ian mentioned that Mom does not go out very much since the
divorce and he would like to see her go out more, and it
sounds to me as though Ian is concerned about what is
going on with Mom.
(d) Ian, it sounds like you feel really angry and resentful
that Mom is trying to force you to take your father's
place in the family.
IV.Response Alternatives
(a) First, I really agree with Ian that you, Mom, and Dianne,
are ganging up on him and not listening to him, so that I
think therapy needs to focus on teaching you fair
parenting.
(b) It seems that there are a lot of things going on here,
some that relate to Ian and some that relate to other
members of the family. But for some reason the family has
agreed that Ian should shoulder the responsibility for the
conflict experienced in the family.
(c) It seems that there is a lot of avoidance in this family,
such that no one is willing to share how they feel and

124
what their needs are, resulting in all the focus being
placed on Ian in order to avoid dealing with the major
conflicts your family is experiencing. I wonder what
would happen if I removed Ian from his central position in
the family.
(d) It seems that there are a lot of things going on here,
some that relate to Ian and some that relate to other
members of the family. It appears that this family is
afraid of hurting each others' feelings through arguing,
and Ian and the family have agreed that he should take the
responsibility for expressing conflict so that the other
members will not feel hurt.
Interval IV
4. Mom: I don't know what to do anymore. Can you please, please
suggest something?
I. Response Alternatives
(a) It seems to me that right now you are stuck and cannot
reach each other even when you try. Without some therapy,
your family will most likely continue on in this way to a
point where you may have to consider crisis intervention.
(b) Yes. I would like you to move your chairs into a close
circle so that you all see each other face-to-face. Then
I would like each of you to share two things that you
really like about the person on your left and then the
person on your right. Let's start with you, Mom.
(c) Mom, I think it is important that you and Ian both know
what it is you want from each other that you are not
getting. I would like you both to share that with us now.
(d) Often times, as children grow older, especially in a
recently divorced family, families have difficulty in
learning how to deal with the new pressures that are
created, even in a family that loves each other.
II. Response Alternatives
(a) Mom, how did you and your ex-husband usually handle the
children when they misbehaved, and how is discipline
different now that you are a single parent? I would also
like to hear from Ian and Dianne.
(b) I think it is important for us to find out why you need to
see Ian and his father in such a negative way.

125
(c) You and your family need to decide if you want to go on
from here. Do you want to change the way the family is
right now? I would like to hear from each of you.
(d) Ian, I'm wondering what it is about Mom and Dianne's
behavior that makes you feel that you are not an
appreciated member of the family?
III. Response Alternatives
(a) It seems like everyone here today feels like he is not
being understood or appreciated and you have taken a big
step by coming here today and admitting you have some
problems that need to be worked on.
(b) Mom, it must be very difficult for you to try and
understand Ian's feelings when he seems so ungrateful for
all you have done for him.
(c) What has happened in this session has been a good
beginning and now we need to look closer and deeper at
what is happening underneath in this family.
(d) It seems like everyone here today feels like he is not
being understood, or more importantly, appreciated. We
need to look closer and deeper at what is happening
underneath in this family.
IV. Response Alternatives
(a) The issues concerning Ian that have been presented here
are really just surface expressions of the conflict and
turmoil that is going on inside. We will need to take a
closer look at what conflicts Ian's behavior is
camouflaging.
(b) It sounds like everybody in this family is upset because
not only does Dad not love them anymore, Ian also seems
not to care about his family anymore.
(c) Well, there seems to be several problems here that are not
related to Ian, but are related to your family's
unwillingness to share both positive and negative feelings
toward each other in an open manner. We will need to take
a closer look at how we can change the style of
communication in your family.
(d) You seem like a family that is very loving and protective
of its members, especially of Ian right now. I wonder
what would happen if you expressed this concern for him in
a way other than through anger and accusations.

APPENDIX K
THERAPIST RESPONSES ANSWER SHEET
You will be reading 4 groups of possible therapist responses
that a therapist might choose to make to this family. Each of the
alternatives in the 4 groups of responses are viable choices and
there are no right or wrong answers. We are simply interested in
which response you feel you might make to this family at this point
in time in the initial session.
You will have two minutes for each interval of responses.
Please turn the page and fill out the information requested at
the top of the page.
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127
THERAPIST RESPONSES ANSWER SHEET
Office Use Only
Subject Name Subj # Family
SS# pre/post exp-er
Sex Age exp/control date
INTERVAL I
Which of the following therapist response alternatives would you
select for use with this family at this time in the session? Please
circle your preferred response.
I. a.
b.
c.
d.
On a scale of 1 to 10-, how
of this therapist response?
confident
Please i
do you feel about your selection
circle a number on the scale.
1
1
2
J
3 4
1 1
5 6
1 1
7
1
8
J
9 10
1 1
no
mild
some
moderate
very
II. a.
b.
c.
d.
1
1
2
1
3 4
1 1
5 6
1 1
7
1
8
1
9 10
1 1
no
mild
some
moderate
very
III. a.
b.
c.
d.
1
I
2
!
3 4
1 1
5 6
1 1
7
1
8
9 10
1 1
no
mild
some
moderate
very
PLEASE TURN TO THE NEXT PAGE

128
IV.
a.
b.
c.
d.
10
no
mild
some
moderate
very
We would like you to look at the 4 therapist response alternatives
that you have chosen for working with this family.
Please rank these 4 responses in order of preference from the most
preferred to the least preferred therapist response for working with
this family (most preferred = 1, somewhat preferred = 2, slightly
preferred = 3, least preferred = 4). This ranking should be based on
your preferences as primary therapist working with this family.
I.
II.
III.
IV.
After you have ranked your 4 therapist responses from most to least
preferred, on a scale of 1 to 10, how confident do you feel about
your most preferred response? Please circle a number on the scale.
123456789 10
J I I I I I I I I 1
no mild some moderate very
PLEASE STOP DO NOT TURN PAGE
THANK YOU

129
INTERVAL II
Which of the following therapist response alternatives would you
select for use with this family at this time in the session? Please
circle your preferred response.
I.a.
b.
c.
d.
On a scale of 1 to 10, how confident do you feel about your selection
of this therapist response? Please circle a number on the scale.
123456789 10
no mild some moderate very
II.a.
b.
c.
d.
1
1
2 3
1 1
4 5
1 1
6
1
CD
00
10
J
no
mild
some
moderate
very
III.a.
b.
c.
d.
123456789 10
J l I 1 I i i i i i
no mild some moderate very
PLEASE TURN TO THE NEXT PAGE

130
IV. a.
b.
c.
d.
1 2 3 4 5 6 7 8 9 10
no mild some moderate very
We would like you to look at the 4 therapist response alternatives
that you have chosen for working with this family.
Please rank these 4 responses in order of preference from the most
preferred to the least preferred therapist response for working with
this family (most preferred = 1, somewhat preferred = 2, slightly
preferred = 3, least preferred = 4). This ranking should be based on
your preferences as primary therapist working with this family.
I.
II.
III.
IV.
After you have ranked your 4 therapist responses from most to least
preferred, on a scale of 1 to 10, how confident do you feel about
your most preferred response? Please circle a number on the scale.
1 2 3 4 5 6 7 8 9 10
J I I I I I I I L_
no mild some moderate very
PLEASE STOP DO NOT TURN PAGE
THANK YOU

131
INTERVAL III
Which of the following therapist response alternatives would you
select for use with this family at this time in the session? Please
circle your preferred response.
I. a.
b.
c.
d.
On a scale of 1 to 10, how confident do you feel about your selection
of this therapist response? Please circle a number on the scale.
1
L
2
|
3
1
4
1
5
1
6
L
7
I
8
1
9
1
10
1
no
mild
some
moderate
very
II.
a.
b.
c.
d.
1
L
2
I
3
1
4
1
5
1
6
1
7
1
8
L
9
10
1
no
mild
some
moderate
very
Ill
. a.
b.
c.
d.
1
2
3
4
5
6
7
8
9
10
no
mild
some
moderate
very
PLEASE TURN TO THE NEXT PAGE

132
IV. a.
b.
c.
d.
123456789 10
J I I I I I I I I !_
no mild some moderate very
We would like you to look at the 4 therapist response alternatives
that you have chosen for working with this family.
Please rank these 4 responses in order of preference from the most
preferred to the least preferred therapist response for working with
this family (most preferred = 1, somewhat preferred = 2, slightly
preferred = 3, least preferred = 4). This ranking should be based on
your preferences as primary therapist working with this family.
I.
II.
III.
IV.
After you have ranked your 4 therapist responses from most to least
preferred, on a scale of 1 to 10, how confident do you feel about
your most preferred response? Please circle a number on the scale.
1 2 3 4 5 6 7 8 9 10
J I 3 I I I I l l l
no mild some moderate very
PLEASE STOP DO NOT TURN PAGE
THANK YOU

133
INTERVAL IV
Which of the following therapist response alternatives would you
select for use with this family at this time in the session? Please
circle your preferred response.
I.a.
b.
c.
d.
On a scale of 1 to 10, how confident do you feel about your selection
of this therapist response? Please circle a number on the scale.
1
no
2
1
4
|
5
1
6
1
7 8 9
10
L
mil
d
some
moderate
very
II.a.
b.
c.
d.
123456789 10
no mild some moderate very
III.a.
b.
c.
d.
1
2 3 4 5 6
no
mi
some
7 8 9 10
J I I L_
moderate very
PLEASE TURN TO THE NEXT PAGE

134
IV. a.
b.
c.
d.
123456789 10
no mild some moderate very
We would like you to look at the 4 therapist response alternatives
that you have chosen for working with this family.
Please rank these 4 responses in order of preference from the most
preferred to the least preferred therapist response for working with
this family (most preferred = 1, somewhat preferred = 2, slightly
preferred = 3, least preferred = 4). This ranking should be based on
your preferences as primary therapist working with this family.
I.
II.
III.
IV.
After you have ranked your 4 therapist responses from most to least
preferred, on a scale of 1 to 10, how confident do you feel about
your most preferred response? Please circle a number on the scale.
1 2 3 4 5 6
no
mi
some
7 8 9 10
moderate very
PLEASE STOP DO NOT TURN PAGE
THANK YOU

APPENDIX L
CASE CONCEPTUALIZATION QUESTIONS: FAMILY A
1. According to the psychosocial history presented by this family,
it appears that a major difficulty they are encountering
involves?
a. Mom's lack of control in the family, resulting in her
inability to parent the children when Dad is not around to
help throw his weight.
b. Marital conflict between Mom and Dad that has remained
unresolved through deflecting their focus onto Alyson.
c. Mom and Dad's inability to communicate openly with each
other or their children, hence their inability to teach open
communication to their children
d. The children seek attention in inappropriate ways (e.g.,
hitting, throwing things, interrupting each other), such
that there is little positive exchange between them.
2. Which of the following would be an apt description of the
underlying patterns of this family's interaction?
a. There appears to be an invisible wall between Alyson and the
other children that effectively keeps the focus on Alyson as
the scapegoat, and the focus off of them.
b. Alyson is the scapegoat (i.e., mechanism) that keeps this
family from falling apart. Without her to focus on, the
other family members would have to either select another
member to play her role or become consciously aware of their
conflictual relationships.
c. Mom and Dad have not established open communication patterns
and consequently are trying to deal with the children
individually, reducing the parental control they would have
in the family together.
d. Alyson, with her growing need for independence, is not very
apt at expressing those needs in a manner that shows she is
capable of handling more responsibility, resulting in Mom
and Dad's refusal to listen to her.
135

136
3.What function does the presenting problem(s) serve in this family
system?
a. Dad's distant and peripheral role in the family is
challenged by Mom and Alyson's conflicts which draws Dad in
closer to the family.
b. Alyson's role as the scapegoat in the family is used by her
as a shield for the other children in order to redirect
conflict away from them and on to herself as a diversion
from the marital difficulties not being dealt with in this
family.
c. Mom's headaches and other somatic complaints allow her to
vent her unresolved anger at Dad for not meeting her
intimacy needs while also allowing her to both deny that
anger and manipulate Dad to take care of her.
d. The children in this family have more power than the
parents, which they use to redirect conflict away from the
marital system to themselves in order to maintain an even
homeostasis in the family.
4.On what information would you base your immediate and long-term
goals?
a. This family's difficulty in adapting to change (i.e.,
children growing older) suggests a fairly rigid style of
communication that must be opened up for therapeutic change
to take place.
b. Mom and Dad's inability to express anger toward each other
through open communication has resulted in their focusing
their anger toward Alyson while ignoring other family
confl icts.
c. With the family's focus resting on Alyson, the other
children are suffering from a lack of attention and support,
resulting in their inappropriate (e.g., hitting each other)
and misguided attempts at gaining some individualized
parenting.
d. Alyson's anger and hostility, as evidenced by her
intermittent withdrawal from the family and her verbally and
physically abusing her sister, needs to be dealt with
immediately.
5.The major problem(s) presented by this family that you would want
to work with immediately basically revolves around:
a. Mom and Dad
b. Alyson
c. The parents and their children
d. Alyson and her siblings

137
6. In summarizing the information gathered from this family, which
of the following might a therapist consider first in planning
treatment?
a. Emotionally charged issues are diverted through the family's
focus on Alyson, thus maintaining a family rule that the
family should always be friends with each other and confide
in each other. The parents and siblings are circumventing
family sharing by focusing on Alyson's "unfriendliness" thus
getting themselves off the hook. Thus, this family needs to
be taught some fair fighting skills in order that conflict
be resolved openly.
b. Alyson appears to be caught in the middle of the conflict
between Mom and Dad, which she attempts to resolve by
subjugating her own needs in a rebellious manner that takes
the focus off Mom and Dad. Thus, Alyson needs to be
relieved of the central role in this family.
c. Mother and Jessica's withdrawn style, in combination with
Craig's and Alyson's more disruptive behavior, suggests that
this family has only two rigid modes of interaction
involving either overt aggression or silent aggression.
Thus, the children in this family need to have parental
attention shared more evenly among them so they can learn
more adaptive styles of interpersonal communication.
d. Mom and Dad have not learned how to parent older children,
resulting in their rigid adherence to old family rules that
no longer work for Alyson, such that she must rebel against
the family in order to separate from them in a normal
growing process. Thus, Mom and Dad need help in learning
how to accept the changes that occur as their children grow
older, as well as some new parenting skills.
7. What immediate goals might be described for this family?
a. Therapy should focus on helping the four children become
more accepting and supportive of each other so that Mom and
Dad will no longer have to take the roles of referee for
them.
b. Individual therapy for Alyson should focus on her feelings
of insecurity as well as her feelings of responsibility and
guilt toward her family. This would allow Alyson to
separate from the family in a normal growth process, also
setting an example for the family to follow for the other
chi 1 dren.
c. Therapy should focus on moving the attention away from
Alyson to the other children, freeing Alyson to pursue her
normal developmental tasks while also preventing her from
masking family conflicts so that all the family members have
an opportunity to learn to openly communicate their needs to
each other.

138
d. Therapy should focus on Mom and Dad's inability to openly
communicate with each other concerning their needs, which
would result in better communication between all the family
members.
8. What general long range goals might you formulate for this
family?
a. A major long range goal might involve helping Alyson
successfully individuate from the family so she would no
longer have to step in and hold the family together,
allowing family conflict to surface so that it might be
dealt with openly and resolved.
b. Marital conflict between Mom and Dad has remained unresolved
through deflecting their focus onto Alyson who has taken the
role of scapegoat in the family in order to maintain the
family's equilibrium. A long range goal for this family
might involve removing Alyson from the central position in
the family so that the family would experience and deal with
a family crisis, resulting in a shift of family member
relationships and a more adaptive family equilibrium.
c. Mom and Dad's inability to openly express affection for each
other has been learned by the children in this family.
Consequently, Alyson's aggression toward her siblings acts
as a catalyst for bringing the siblings closer together in a
united front against Alyson. A long range goal for this
family might involve teaching the chidlren how to
communicate honestly with each other, and allowing them to
teach their parents a new style of communication.
d. All the attention of the parents is focused on Alyson, thus
taking the heat off their own marital problems and
ineffectual parenting styles, allowing them to maintain
their rigid style of communication. A long range goal might
involve focusing the parents on their interpersonal
relationship, freeing all the family members from holding
that relationship together.

APPENDIX M
CASE CONCEPTUALIZATION QUESTIONS: FAMILY B
1. According to the psychosocial history presented by this family,
it appears that a major difficulty they are encountering
involves?
a. Mom's inability to control or discipline her children now
that their father has left.
b. Marital conflict between Mom and "Dad" that has remained
unresolved since the divorce, and is maintained through
Mom's deflecting her focus onto Ian.
c. The family's difficulties in forming new relationships with
each other now that Dad no longer plays the same role in the
family.
d. Mom's inability to help Ian and Dianne separate from her
emotionally is a function of her dependence on them for
emotional support.
2. Which of the following would be an apt description of the
underlying patterns of this family's interaction?
a. Mom is very involved with and protective of Dianne, giving
them enough power to effectively scapegoat Ian who has taken
Dad's place in the family as the "responsible male."
b. Ian is the scapegoat (i.e., mechanism) that keeps this
family from falling apart. Without him to focus on, the
other family members would have to either select another
member to play his role or become consciously aware of their
conflictual relationships now that Dad is absent.
c. Dianne and Ian are both dealing with their parent's divorce
in different ways. Dianne has withdrawn and is providing
some support for Mom while Ian is acting out and showing
loyalty for Dad. This has resulted in conflict between Ian
and Diane that the family is not sure how to deal with.
d. Ian, with his growing need for independence is not very apt
at expressing those needs in a manner that shows he is
capable of handling more responsibility, resulting in Mom's
refusal to listen to him.
139

140
3.What function does the presenting problem(s) serve in this family
system?
a. Mom's inability to deal effectively with Ian allows her to
maintain her role of good but misunderstood Mom in
conjunction with Dad's role of bad father.
b. Ian's difficulty in controlling his anger helps keep the
attention focused on him so the family will not have to deal
with the changes that have occurred as a result of the
divorce.
c. Mom's anger with Ian allows her to vent her unresolved anger
and hostility toward Dad while also allowing her to deny
that anger.
d. Dianne's support of Mom against Ian raises her from sibling
status to that of pseudo parent, giving her some control in
the family.
4.On what information would you base your immediate and long-term
goals?
a. The family's difficulties in forming new relationships with
each other now that Dad no longer plays the same role in the
family suggests a fairly rigid style of communication that
must be opened up for therapeutic change to take place.
b. Mom's and Ian's inability to allow him to separate from Mom
emotionally as a function of her dependence on him as a
replacement for Dad.
c. Dianne maintains the equilibrium in the family by taking the
focus off the escalating situation between Ian and Mom
through her support of Mom.
d. Ian's uncontrollable behavior, as evidenced by his pulling
out a knife to his mother and hitting his sister, needs to
be dealt with immediately.
5.The major problem(s) presented by this family that you would want
to work with immediately basically revolves around:
a. Mom and "absent" Dad
b. Ian
c. Mom and her 2 children
d. Ian and Dianne
6.In summarizing the information gathered from this family, which
of the following might a therapist consider first in planning
treatment?
a. Emotionally charged issues are cooled down through Mom's
digressions concerning Ian's behavior, thus maintaining a

141
family rule that the family should always be polite, calm,
and civilized. Mom and Dianne are circumventing family
sharing by focusing on Ian's "aggressiveness," thus getting
themselves off the hook. Thus, this family needs to be
taught some fair fighting skills in order that conflict may
be resolved openly.
b. Ian appears to be caught in the middle of the unresolved
conflict between Mom and Dad which he attempts to resolve by
subjugating his own needs in an aggressive manner that takes
the focus off the marital relationship. Thus, Ian needs to
be relieved of the central role in this family.
c. Dianne's withdrawn style, in combination with Ian's more
disruptive behavior, suggests that this family has only two
rigid modes of interaction, involving either overt
aggression or silent aggression. Thus, the children in this
family need to be removed from the parental conflict while
also having parental attention shared more evenly among them
so they can develop more adaptive styles of interpersonal
communication.
d. Father's psychological position in the family is maintained
through the interactions between Ian and Mom concerning his
"male" irresponsibility and concurrent obligation to take
care of the females in the family. Thus, Mom and Ian need
help in removing Dad from their daily interactions with each
other.
7. What immediate goals might be described for this family?
a. Therapy should focus on helping Ian and Dianne become more
accepting and supportive of each other so that Mom will no
longer have to referee for them.
b. Individual therapy for Mom should focus on her unresolved
feelings concerning the divorce, which would result in
better communication between all the family members.
c. Therapy should focus on restricting family member
relationships such that Diane no longer sides with Mom
against Ian, but plays her role as a sibling, in addition to
helping the family remove Dad from their daily interactions
with each other.
d. Therapy should focus on Mom and Ian's inability to openly
communicate with each other concerning his needs to begin
separating from the family.
8. What general long range goals might you formulate for this
family?
a. A major long range goal might involve helping Ian
successfully individuate from the family so he would no
longer have to step in and hold the family together by

142
taking Dad's role, allowing family conflict to surface so
that it might be dealt with openly and resolved.
b. Marital conflict between Mom and Dad has remained unresolved
through deflecting the focus of the family onto Ian, who has
taken the role as scapegoat in the family in order to
maintain the family's equilibrium. A long range goal for
this family might involve removing Ian from the central
position in the family so that the family would experience
and deal with a family crisis, resulting in a shift of
family member relationships and a more adaptive family
equilibrium.
c. Dianne and Mom have united and joined forces against Ian,
resulting in a split between the two siblings that maintains
the family role that males are impossible and
inconsiderate. A long range goal for this family would be
to remove Dianne from the role of parent and help her get
back into a positive sibling relationship with Ian that
would no longer maintain this stereotype and perception of
males that the family members hold onto so rigidly.
d. All the attention of Mom is focused on Ian, thus preventing
the family from adjusting to the divorce while allowing them
to maintain their rigid style of communication. A long
range goal might involve focusing on the marital
relationship, freeing all the members from holding that
"false" relationship together.

APPENDIX N
INFORMED CONSENT FOR FAMILY THERAPIST'S PROJECT
We are interested in studying the training of family therapists
and we need your help. Specifically, we would like approximately
four hours of your time: two hours at the beginning of the semester
and two hours at the end. During this time you will be asked to view
some videotapes of family interactions and to give us your
reactions. In addition, you would complete some brief questionnaires
and a structural interview concerning your experience with various
families.
Participation is scheduled at your convenience.
As you can see, the project is an ambitious one which we hope
will address several critical questions regarding the effective
training of family therapists. But we are also aware that it should
have some personal meaning or benefit to you as a participant:
Therefore we have designed tasks (especially the videotapes and
family exploration interview) which are personally and professionally
involving; which enable you to reflect on information relevant to a
family therapist. We are also willing to arrange to give you
personal feedback concerning your participation at the end of the
semester.
All information will be kept strictly confidential within the
legal limits of the law. Please free free to ask any questions that
you may have.
I understand the nature of the research as described to me above
and I agree to participate with the knowledge that I may withdraw my
participation at any time without prejudice.
signature of participant
Mora Zaken-reenberg reg J. Neimeyer, Ph.D.
Principal Investigator Supervisor
143

APPENDIX O
FAMILY A DYNAMICS SEEN BY SUBJECTS
The Jeffreys Family (A)
Upper middle class family
Father
Gordon
Age
50 -
manager of small publishing company
Mother
Joan
46 -
housewife
Children
Alyson
17 -
student
Jessica
16 -
student
Cra i g
14 -
student
Ma tthew
10 -
student
Presenting problems (reported by mother over the phone)
1. Parents report that Alyson, the eldest daughter, is exhibiting
unpredictable behavior that has disrupted the family.
2. She erupts in sudden violent fits, screams and yells at siblings
and sometimes has physical fights with her sister, Jessica.
3. Other times, she is silent and withdrawn from the family.
Parents label her pouting "silent contempt."
4. Parents do not approve of Alyson's friends and feel they are a
bad influence on her.
5. Alyson's parents complain that she spends most of her time with
her peer group, away from the family.
144

APPENDIX P
FAMILY B DYNAMICS SEEN BY SUBJECTS
The Williams Family (B)
Low income family
Mother Mrs. Jane Williams
Age
- has low paying job in
television production
Father Mr. Frank Williams
Children Ian
Dianne
- not in therapy
17 student
16 student
Information given to therapist over phone by Mrs. Williams:
Mr. Williams refuses to have anything to do with his wife and
therefore refuses to participate in therapy. Mother and father
separated 3 years ago.
Mr. and Mrs. Williams have not been able to agree to the terms of the
divorce. In addition, Mrs. Williams has taken Mr. Williams to court
on two occasions for failing to meet his support payments. In one
case, Mr. Williams was sentenced to a week in jail.
The children spend every second weekend with their father and they
generally enjoy these visits.
Presenting problems (presented by mother over phone)
1. Ian loves his father and becomes uncontrollable.
2. Ian pulled a knife on mother and sister the last time that he
lost his temper.
3. Ian orders his sister around and expects her to do things for him
(e.g., make him meals, watch his TV programs).
4. Ian physically pushes sister around when she doesn't listen to
him.
145

APPENDIX Q
CASE CONCEPTUALIZATION ANSWER SHEET
Office Use Only
Subject Name Subj # Family
SS# pre/post exp-er
Sex Age exp/control date
PLEASE CIRCLE YOUR PREFERRED RESPONSE FOR EACH QUESTION
1.
2.
3.
4.
5.
6.
7.
8.
a.
b.
c.
d.
a.
b.
c.
d.
a.
b.
c.
d.
a.
b.
c.
d.
a.
b.
c.
d.
a.
b.
c.
d.
a.
b.
c.
d.
a.
b.
c.
d.
OFFICE USE ONLY
1.
2.
3.
4.
5.
6.
7.
8.
146

APPENDIX R
FAMILY REP TEST INSTRUCTIONS
1. Number index cards from 1-10.
2. Subjects write families on cards (use each family only once)
1. Family you grew up in
2. Married sibling's family
If none:
a. Relative's family
b. New family
3. Your present family
4. Dual career family (both parents work)
5. Family your mother or father grew up in
6. Happy family
7. Unhappy family
8. Single parent family
9. Family spouse or mate (or ex-mate) grew up in
10.Friend's family
3. Check to make sure each family was used only once.
4. Construct elicitation **(make sure each construct is used only
once)**
a. Say: "Remove (see card groups) and place them in front of
you. From these three families, select the two families who
are most alike in some way and yet different from the
third. Place the two that are alike together and the third,
which is different, away from them. Tell me the word or
short phrase that describes how the two families are
alike. (Write the description under the alike column)
Tell me the word or short phrase that descirbes how the
other family is different from the first two. (Write the
description under the different column)
147

148
b.Card groups
1.
1,
3,
and
5
9.
4,
8,
and
10
2.
2,
3,
and
6
10.
3,
6,
and
10
3.
7,
8,
and
10
11.
1.
2,
and
3
4.
6,
7,
and
8
12.
1,
2,
and
8
5.
2,
6,
and
8
13.
3,
8,
and
9
6.
3,
4,
and
7
14.
3,
7,
and
9
7.
1,
7,
and
8
15.
2,
5,
and
8
8.
6,
9,
and
10
5. Value coding
a. For each of the 15 construct pairs, present each pair of
constructs and say: "Which in general is more positive to
you?"
b. Record a (+) or (-) next to the respective constructs.
6. Family construct ratings
a. Put cards in order from 1-10
b. Have subject write family names on grid
c. Ratings scale
+3
very
+2
somewhat
+1
si ightly
0
NA or equally
-1
si ightly
-2
somewhat
-3
very
d. For each of the 15 constructs ask: "How would you describe
each of these 10 families along each of these two
dimensions?"
e. The positive side of the scale corresponds to the constructs
that were value coded as more positive and the negative side
of the scale corresponds to the constructs that were value
coded as more negative.
f. Run through the first one with the subject and then if they
have the hang of it, let them do the rest themselves.
7.Grid content coding
a. Give subject instruction form to read and then have them
complete the content coding section. Do the example
first. Correct them if wrong.
**Make sure they don't see the instructions until they're
completely finished with the grid**

REFERENCES
Ackerman, N. (1973). Some considerations for training in family
therapy. In Career directions (Vol. 2). East Hanover, NJ:
D.J. Publications, Inc.
Adams-Webber, J., & Mire, E. (1976). Assessing the development of
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BIOGRAPHICAL SKETCH
Flora Jane Zaken-Greenberg was born on June 19, 1957, in
Monticello, New York, and is the youngest of five children. She is
the daughter of Shirley and David Zaken. Flora graduated from
Hollywood Hills High School in Hollywood, Florida, in 1975. Her last
year in high school was spent at Broward Community College, and she
received her A.A. degree with Honors in 1976. Flora then went on to
Florida Atlantic University where she graduated with Honors in 1977
with a B.A. in general experimental psychology. In 1978, Flora
enrolled in the graduate program in general experimental psycho
logy. She received a graduate fellowship for scholastic achievement
in 1979, and received her M.A. in 1980. Following her graduation in
1980, Flora worked at Northwestern University as a full-time research
assistant for two years. She began doctoral studies in counseling
psychology at the University of Florida in 1981 and expects to
graduate in August, 1985. Flora is currently completing her
predoctoral internship at the Veterans Administration Medical Center
in Gainesville, Florida.
In 1979, Flora married Michael S. Greenberg. Michael recently
received his Ph.D. in clinical psychology from Northwestern
University and is currently a staff psychologist at Marion-Citrus
Mental Health Center. Following Flora's graduation, Flora and
157

158
Michael plan to work in medical and psychiatric facilities,
respectively, as staff psychologists.

I certify that I have read this study and that in my opinion it
conforms to acceptable standards of scholarly presentation and is
fully adequate, in scope and quality, as a dissertation for the
degree of Doctor of Philosophy.
Professor of Psychology
I certify that I have read this study and that in my opinion it
conforms to acceptable standards of scholarly presentation and is
fully adequate, in scope and quality^as a dissertation for the
degree of Doctor of Philosophy.
Greg jSweimeyer, Cocha
Assistant Professor of Psychology
irmarr
I certify that I have read this study and that in my opinion it
conforms to acceptable standards of scholarly presentation and is
fully adequate, in scope and quality, as a dissertation for the
degree of Doctor of Philosophy.
I certify that I have read this study and that in my opinion it
conforms to acceptable standards of scholarly presentation and is
fully adequate, in scope and quality, as a dissertation for the
degree of Doctor of Philosophy.
William Froi;
Associate P
of Psychology

I certify that I have read this study and that in my opinion it
conforms to acceptable standards of scholarly presentation and is
fully adequate, in scope and quality, as a dissertation for the
degree of Doctor of Philosophy.
This dissertation was submitted to the Graduate Faculty of the
Department of Psychology in the College of Liberal Arts and Sciences
and to the Graduate School and was accepted as partial fulfillment of
the requirements for the degree of Doctor of Philosophy.
August, 1985
Dean, Graduate School



no
5. He is very co-operative in response to the therapist's questions.
Dianne
Therapist knows about Dianne:
1. Dianne is a quiet and nervous person. She has not spoken much
during sessions.
2. She responds to questions when asked, but doesn't elaborate.
3. She will respond with anger if Ian pushes her enough.
Information to be supplied to therapist:
1. Dianne is angry with Ian because he bosses her around like a
slave, i.e., "When I'm watching TV, he will tell me to get him
something to eat and will get angry if I don't."
2. Agrees with mother that Ian is the problem.
3. Ian is like father: "I'm afraid of their anger."
Actions:
1. Doesn't say much or respond with much emotion until Ian has
described her as the villain.
2. When she does respond with anger to Ian, Ian stands back, mother
comes to Dianne's defense and Ian backs off becoming quiet, while
mother attacks Ian.
3. Ian seems to follow the discussion but from an observer role. He
seems reluctant to participate in the discussions.


52
Procedure
All subjects were scheduled by phone for a testing time at their
convenience. Subjects were tested in small groups ranging from two
to four subjects depending on their availability. Each subject was
told that he/she would be participating in a family therapy training
study that would last approximately two hours at both pre- and
posttesting.
Subjects were met in an outer office by the experimenter and led
into a small testing room containing a portable video monitor, a
table to write on, and several chairs. Each subject was requested to
sit at a table facing the video monitor. All subjects received
identical instructions regardless of whether they were in the control
group or the experimental group.
The first task required of the subjects was reading and signing
the informed consent form (see Appendix N), followed by the
completion of the Family Therapy Experience Inventory. This was
followed by instructions for the first phase of the testing session
which involved viewing the videotape of a simulated family therapy
session. All subjects were given the following instructions:
You are about to view a simulated family in an initial
family therapy session. You are to view the family as
though you were the primary therapist and were actually
involved in the session. At different points in the
session, the tape will be stopped, a family member will
ask the therapist a question, and you will be provided
with four groups of therapist response alternatives.
From each group of response alternatives, you are to
select the therapist response that you feel you might use
with that family at that point in time. All of the
responses are viable alternatives and there are no right


95
September 24
Power Tactics in the Family: Triangling
Read: Minuchin, Families and Family Therapy,
Chaps. 4-5
* Haley, "The Family of the
Schizophrenic: A Model System"
COMMUNICATION ANALYSIS PAPER DUE
October 1
Holding On and Letting Go: Patterns of Stability
and Change in the Family
Read: Carter and McGoldrick: The Family Life
Cycle, Chaps. 1-3
October 8
To Have and To Hold? Identity Development in
Marriage
Read: The Family Life Cycle, Chaps. 4, 5 and 8
The Family Cruciable, Chaps. 8-20
October 15
The Family with Young Children: Pitfalls of the
Ghetto and the Middle Class
Read: Minuchin Families of the Slums, Chaps. 1-2
* Barragan "The Child-Centered Family"
October 22
The Family with Adolescents and/or Young Adult
Children
Read: The Family Life Cycle, Chaps. 7-8
October 29
Chronic Illness, Death and the Family
Read: The Family Life Cycle, Chap. 10
November 5
Separation, Divorce Single Parent Families
Read: The Family Life Cycle, Chap. 11
* Leng Jaffe "The Divorce Adjustment
Process"
November 12
Conducting an Initial Family Interview: Joining
Problem Exploration Tracking
Read: Haley, Problem Solving Therapy, Chap. 1
Minuchin, F. and FT., Chaps. 6 and 7
November 19
Using Enactment in the Initial Interview:
Staging, Tracking, and Highlighting
Read: Minuchin Families and Family Therapy,
Chaps. 8, 9, 11
November 26
Mapping the Family, Identifying a Focus, and
Setting Goals in the Initial Interview
Read: Minuchin, F and FT, Chap. 12
December 3
Problem Redefinition and Reframing
Read: Amatea "Moving a Family into Therapy"


140
3.What function does the presenting problem(s) serve in this family
system?
a. Mom's inability to deal effectively with Ian allows her to
maintain her role of good but misunderstood Mom in
conjunction with Dad's role of bad father.
b. Ian's difficulty in controlling his anger helps keep the
attention focused on him so the family will not have to deal
with the changes that have occurred as a result of the
divorce.
c. Mom's anger with Ian allows her to vent her unresolved anger
and hostility toward Dad while also allowing her to deny
that anger.
d. Dianne's support of Mom against Ian raises her from sibling
status to that of pseudo parent, giving her some control in
the family.
4.On what information would you base your immediate and long-term
goals?
a. The family's difficulties in forming new relationships with
each other now that Dad no longer plays the same role in the
family suggests a fairly rigid style of communication that
must be opened up for therapeutic change to take place.
b. Mom's and Ian's inability to allow him to separate from Mom
emotionally as a function of her dependence on him as a
replacement for Dad.
c. Dianne maintains the equilibrium in the family by taking the
focus off the escalating situation between Ian and Mom
through her support of Mom.
d. Ian's uncontrollable behavior, as evidenced by his pulling
out a knife to his mother and hitting his sister, needs to
be dealt with immediately.
5.The major problem(s) presented by this family that you would want
to work with immediately basically revolves around:
a. Mom and "absent" Dad
b. Ian
c. Mom and her 2 children
d. Ian and Dianne
6.In summarizing the information gathered from this family, which
of the following might a therapist consider first in planning
treatment?
a. Emotionally charged issues are cooled down through Mom's
digressions concerning Ian's behavior, thus maintaining a


3
therapy training and more established approaches to personality,
counseling and interpersonal relationships.
Researchers in the field of family therapy have recently begun
to report some descriptive studies of training, typically ending with
a discussion of the need for empirical research in this area. Before
discussing the findings of the current literature on family therapy
training, the reader needs to be acquainted with the programs
currently available, the goals of family therapy, and how those goals
are translated into training and assessment. Further, the components
of family therapy training that extend across the various schools of
thought will be reviewed. In addition, a brief discussion of the
outcome literature will be presented, followed by a rationale for the
adoption of a Personal Construct Psychology approach to the study of
training in family therapy.
Commonalities and Differences in Family Therapy Training
In a national survey of training programs in family therapy,
Bloch and Weiss (1981) reported a growing and varied assortment of
programs. In addition to the diversity of programs available, they
also discovered that the establishment of family therapy training
programs has grown exponentially between 1942 and 1980. Levant
(1984) has suggested that these training programs may be divided into
two major groups. The first group involves training that is offered
as part of the overall training program of one of the various mental
health or human-service professions. The second group involves
programs that are specifically designed to train family therapists.


86
integration reflects their less flexible use of therapy constructs
when applied to families.
Interestingly, although the family therapy trainees are
beginning to experience changes in their perceptions of families,
they have not yet developed these skills to the point where they can
begin to conceptualize the family differently. Regardless of the
therapy training involved, all trainees were able to focus on
subsystem dynamics when required to conceptualize the family.
However, the family therapy trainees were not yet able to
conceptualize the family in completely systemic terms. It is
possible that they had simply not advanced to this point. This
hypothesis is consistent with the results of the content analysis of
trainees' perceptual skills. Although trainees were beginning to
show perceptual changes, there were no significant increases in level
of abstraction, suggesting that the trainees' perceptual skills were
still developing.
Based on the results of the measures of perceptual and
conceptual skills, it is not surprising that there were no changes in
their executive skill level. This further suggests that executive
skills would be the last skills to develop. Before the family
therapist can act differently in therapy, he or she must perceive the
family differently and conceptualize the family dynamics differ
ently. The fact that both groups of therapy trainees reverted back
to relatively basic reflection of feeling responses suggests that
dealing with a family was a new and possibly confusing situation that


83
Executive Skills Across Category
In addition to investigating possible changes within each of the
four therapist response categories, analyses were also performed to
assess any possible changes in executive skills or confidence across
these four categories. An analysis of modal responses for trainees'
preferred category of therapy responses revealed no significant
differences between the two groups or across time. Both groups of
therapy trainees preferred to use Reflecting and Supporting
responses. However, the results for the Average Confidence Level for
the Preferred Response revealed that both groups of therapy trainees
became significantly more confident concerning their preferred
responses across time.
Taken together, these results suggest that there are no changes
in executive skill level for family therapy trainees as a function of
structural family therapy training. Both groups of therapy trainees
maintained stable levels of executive skill for interpretive and
structural realignment therapist responses. Perhaps these two
categories of responses were too sophisticated to reflect changes in
executive skill level of beginning therapists. Consistent with this
hypothesis, changes in executive skill level were revealed for the
therapist response categories of Gathers Information and Reflects and
Supports. The results revealed that the level of executive skill
decreased across time for both groups of therapy trainees. Further,
the results revealed that the preferred category of therapist
responses were Reflecting and Supporting responses. One possible


APPENDIX C
FAMILY REPERTORY GRID
Subject #
Name
S.S. T~
Date
Ratings Scale
Very +3/-3
Somewhat +2/-2
Slightly +1/-1
NA/Equally 0
1
2
3
4
5
6
7
8
9
10
ALIKE
DIFFERENT
CONTENT
CODE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
98


133
INTERVAL IV
Which of the following therapist response alternatives would you
select for use with this family at this time in the session? Please
circle your preferred response.
I.a.
b.
c.
d.
On a scale of 1 to 10, how confident do you feel about your selection
of this therapist response? Please circle a number on the scale.
1
no
2
1
4
|
5
1
6
1
7 8 9
10
L
mil
d
some
moderate
very
II.a.
b.
c.
d.
123456789 10
no mild some moderate very
III.a.
b.
c.
d.
1
2 3 4 5 6
no
mi
some
7 8 9 10
J I I L_
moderate very
PLEASE TURN TO THE NEXT PAGE


154
Neimeyer, R.A. (1985). Personal constructs in clinical practice. In
P.C. Kendall (Ed.), Advances in cognitive-behavioral research
and therapy (Vol. 4). New York: Academic Press.
Neimeyer, R.A., Klein, M.H., Gurman, A.S., & Griest, J.H. (1983).
Cognitive structure and depressive symptomatology. British
Journal of Cognitive Psychotherapy, 1_, 65-72.
Nichols, W. (1979). Education of marriage and family therapists:
Some trends and implications. Journal of Marital and Family
Therapy, 5(1), 19-28.
Okun, B.F., & Rappaport, L.J. (1980). Working with families. North
Scituate, MA: Duxbury Press.
Orlinsky, D., & Howard, K. (1978). The relation of process to outcome
in psychotherapy. In S.L. Garfield & A.E. Bergin (Eds.),
Handbook of psychotherapy and behavior change: An empirical
analysis! New York: Wiley & Sons, Inc.
Patterson, G. (1971). Behavioral intervention procedures in the
classroom and in the home. In A.E. Bergin & S. Garfield
(Eds.), Handbook of psychotherapy and behavior change: An
empirical analysiT! New York: John Wiley.
Pinsof, W. (1977). Family therapist verbal behavior: Development of
a coding systenT! Unpublished doctoral dissertation, York
Um versi ty.
Poelstra, P., & Lange, A. (1978). Gedragsveranderende gezinsen
relatietherapie. In J. Orlemans (Ed.), Handbook
Gedragstherapie. Deventer, Holland: Van Logham Slaterus.
Pope, M. (1978). Monitoring and reflecting in teacher training. In
F. Fransella (Ed.), Personal construct psychology. London:
Academic Press.
Procter, H. (1981). Family construct psychology: An approach to
understanding and treating families. In S. Walrond-Skinner
(Ed.), Developments in family therapy: Theories and
applications since 1948! London: koutledge and Kegan Paul.
Runkel, P., & Damrin, . (1961). Effects of training and anxiety upon
teachers' preferences for information about students. Journal
of Educational Psychology, _52_(5), 254-261.
Ryle, A., & Breen, D. (1974). Change in the course of social-work
training: A repertory grid study. British Journal of Medical
Psychology, 47, 139-147.


Copyright 1985
by
Flora Zaken-Greenberg


132
IV. a.
b.
c.
d.
123456789 10
J I I I I I I I I !_
no mild some moderate very
We would like you to look at the 4 therapist response alternatives
that you have chosen for working with this family.
Please rank these 4 responses in order of preference from the most
preferred to the least preferred therapist response for working with
this family (most preferred = 1, somewhat preferred = 2, slightly
preferred = 3, least preferred = 4). This ranking should be based on
your preferences as primary therapist working with this family.
I.
II.
III.
IV.
After you have ranked your 4 therapist responses from most to least
preferred, on a scale of 1 to 10, how confident do you feel about
your most preferred response? Please circle a number on the scale.
1 2 3 4 5 6 7 8 9 10
J I 3 I I I I l l l
no mild some moderate very
PLEASE STOP DO NOT TURN PAGE
THANK YOU


151
Duehn, D.W., & Procter, E.K. (1974). Study of cognitive complexity
in education for social-work practice. Journal of Education
for Social Work, 10, 20-26.
Duhl, B. (1978). Piaget, the Boston Family Institute, and metaphor:
An integrated approach to training in systems thinking.
Unpublished paper presented at the Boston Family Institute.
Epstein, N., Sigal, J., & Rakoff, V. (1968). Family categories
schema. Unpublished paper, Department of Psychiatry, Jewis
General Hospital, Montreal.
Ferber, A. (1972). Follow the paths with heart. International
Journal of Psychiatry, 10, 6-22.
Ferber, A., & Mendelsohn, M. (1969). Training for family therapy.
Family Process, 8_, 25-32.
Ferber, A., Mendelsohn, M., & Napier, A. (1972). The book of family
therapy. Boston: Houghton Mifflin Co.
Fjeld, S.P., & Landfield, A.W. (1961). Personal construct theory
consistency. Psychological Reports, 8_, 127-129.
Flint, A., & Rioch, M. (1963). An experiment in teaching family
dynamics. American Journal of Psychiatry, 119, 940-944.
Flomenhaft, K., & Carter, R. (1974). Family therapy training: A
statewide program for mental health centers. Hospital and
Community Psychiatry, 25_(12), 789-791.
Flomenhaft, K., & Carter, R. (1977). Family therapy training:
Program and outcome. Family Process, 16, 211-218.
Fransella, F., & Bannister, D. (1977). A manual for repertory grid
technique. New York: Academic Press.
Friedman, A. (1971). An evaluation of training in family therapy,
family counseling, and family systems concepts. In A. Friedman
(Ed.), Therapy with families of sexually acting-out girls. New
York: Springer.
Garrigan, J., & Bambrick, A. (1976). Family therapy for disturbed
children: Some experimental results in special education.
Journal of Family Counseling, 3_, 83-93.
Gurman, A.S. (1983). Family therapy research and the "new
epistomology." Journal of Marital and Family Therapy, 9, 227-
234.


CHAPTER V
DISCUSSION
The primary purpose of the present investigation was to
determine whether or not training in structural family therapy has an
impact on the perceptual, conceptual and executive skills of family
therapy trainees. This division of therapy skills is based on
Cleghorn and Levin's (1973) model for the assessment of training in
family therapy. Perceptual skills refer to how the therapist
perceives family interactions and the effects of them on family
members and the family system. Conceptual skills involve what the
therapist thinks about in the therapy session and how those thoughts
are organized. Executive skills involve how the therapist actually
intervenes in therapy in order to influence the family's
dysfunctional patterns of interactions.
A review of the literature revealed that a majority of family
therapy training studies reported significant increases in trainees'
perceptual and conceptual skills (e.g., Friedman, 1971; Lange &
Brinckman, 1976; Lange & Zeegers, 1978; Tomm, 1980; Tucker & Pinsof,
1984). Several studies have also reported significant increases in
trainees' executive skills (e.g., Allred & Kersey, 1977; Pinsof,
1977; Watson, 1975). However, one limitation of this research
concerns the absence of comparable control groups against which the
68


58
were Gathers Information, Reflects and Supports, Interprets and
Confronts, and Structural Realignment. Within each category there
are four possible response alternatives that represent a dimension
from obstructive to the most sophisticated response level within that
category (see Appendix H).
Within category analyses
All four intervals of therapist responses were combined for the
following three dependent measures: Weighted Average, Modal Response
and Average Confidence Level. These three measures were analyzed
separately for each of the four therapist response categories. The
Weighted Average is an overall average of response level obtained by
totaling a subject's coded ratings and then dividing the total by 4
(i.e., the number of intervals). The Modal Response represents that
response level used most frequently within each category across the
four intervals. Within each of the four therapist response
categories, subjects rated how confident they felt about the response
they had chosen on a scale of 1 to 10 (very unconfident to very
confident). The Average Confidence Level was obtained by taking an
average across the four intervals.
Between category analyses
In addition to investigating possible changes within each of the
four therapist response categories, two dependent measures were
designed to reflect any changes in therapeutic skills or confidence
across these four categories. Subjects were asked to rank the four


129
INTERVAL II
Which of the following therapist response alternatives would you
select for use with this family at this time in the session? Please
circle your preferred response.
I.a.
b.
c.
d.
On a scale of 1 to 10, how confident do you feel about your selection
of this therapist response? Please circle a number on the scale.
123456789 10
no mild some moderate very
II.a.
b.
c.
d.
1
1
2 3
1 1
4 5
1 1
6
1
CD
00
10
J
no
mild
some
moderate
very
III.a.
b.
c.
d.
123456789 10
J l I 1 I i i i i i
no mild some moderate very
PLEASE TURN TO THE NEXT PAGE


CHAPTER II
LITERATURE REVIEW
Family Therapy Training
Descriptive Studies
Although there is little empirical evidence for the
effectiveness of family therapy training, there is some research
concerning the specific therapist factors that influence the outcome
of family therapy (e.g., Epstein, Sigal & Rakoff, 1968; Thomlinson,
1974; Tomm & Wright, 1979). Thus, the identification of those
factors that may be taught in training provide indirect support for
the potential effectiveness of family therapy training programs. In
an extensive review of the family therapy research literature, Gurman
and Kniskern (1978) reported therapy structuring skills, experience
level, and relationship skills as the three most important factors
that influence the outcome of family therapy. Obviously, experience
level is not able to be taught in a training program; however, both
therapy structuring skills and relationship skills may be focused on
in training. Structuring skills have been investigated by several
researchers (Alexander, Barton, Schiavo & Parsons, 1976; Epstein et
al., 1968; Sigal, Guttman, Chagoya & Lasry, 1973). Based on this
research, structuring skills of the therapist have been divided into
directiveness, clarity, self-confidence, information gathering, and
14


of refining the stimulus materials. Florence Roess and Ces Bibby
were invaluable in coordinating subjects, experimenters, testing
rooms and preparation of all dissertation stimulus materials. I
would especially like to thank all the undergraduate research
assistants who gave long hours and were involved in all technical
aspects of this study. Susan Lerner, April Metzler, Marc Levant,
Mark Kaplan, Regina Davis, Gloria Pinzn, Joni Congdon and Jesus
Llobet were invaluable aids to this project as well as good
friends. Anita Moreles, Michele Majorek and Chere Ruquist also gave
much of their time to this project.
I would like to give a very special acknowledgment to my husband
Michael, for his constant love and support, and the many sacrifices
he has made in his own career so that I may pursue mine. Throughout
his own graduate work, he has always ungrudingly found the time to
give me many hours of technical and professional help on the various
aspects of this project. He has been the single greatest support in
my work and in my life, and I am happy to be able to share this time
with him. I would also like to thank my parents, Shirley and David
Zaken, for their unconditional faith and support throughout my life
and the long years of my graduate career.
TV


BIOGRAPHICAL SKETCH
Flora Jane Zaken-Greenberg was born on June 19, 1957, in
Monticello, New York, and is the youngest of five children. She is
the daughter of Shirley and David Zaken. Flora graduated from
Hollywood Hills High School in Hollywood, Florida, in 1975. Her last
year in high school was spent at Broward Community College, and she
received her A.A. degree with Honors in 1976. Flora then went on to
Florida Atlantic University where she graduated with Honors in 1977
with a B.A. in general experimental psychology. In 1978, Flora
enrolled in the graduate program in general experimental psycho
logy. She received a graduate fellowship for scholastic achievement
in 1979, and received her M.A. in 1980. Following her graduation in
1980, Flora worked at Northwestern University as a full-time research
assistant for two years. She began doctoral studies in counseling
psychology at the University of Florida in 1981 and expects to
graduate in August, 1985. Flora is currently completing her
predoctoral internship at the Veterans Administration Medical Center
in Gainesville, Florida.
In 1979, Flora married Michael S. Greenberg. Michael recently
received his Ph.D. in clinical psychology from Northwestern
University and is currently a staff psychologist at Marion-Citrus
Mental Health Center. Following Flora's graduation, Flora and
157


TABLE OF CONTENTS
Page
ACKNOWLEDGMENTS iii
ABSTRACT vii
CHAPTERS
ONE INTRODUCTION 1
Commonalities and Differences in Family Therapy
Training 3
Outcome Studies in Family Therapy Training 9
The Present Study 10
TWO LITERATURE REVIEW 14
Family Therapy Training 14
Descriptive Studies 14
Empirical Studies 18
Personal Construct Theory 25
Personal Construct Psychology and Training Studies...29
The Present Study 34
Hypotheses 35
THREE METHODOLOGY 38
Subjects 38
Instruments 39
Family Experience Inventory 39
Family Repertory Grid 40
Therapist Responses to Simulated Family Tapes...45
Case Conceptualizations 50
Procedure 52
Design and Analyses 55
Structural Grid Analyses 56
Content Grid Measures 56
Case Conceptualization Analyses 57
Therapist Response Analyses 57
v


148
b.Card groups
1.
1,
3,
and
5
9.
4,
8,
and
10
2.
2,
3,
and
6
10.
3,
6,
and
10
3.
7,
8,
and
10
11.
1.
2,
and
3
4.
6,
7,
and
8
12.
1,
2,
and
8
5.
2,
6,
and
8
13.
3,
8,
and
9
6.
3,
4,
and
7
14.
3,
7,
and
9
7.
1,
7,
and
8
15.
2,
5,
and
8
8.
6,
9,
and
10
5. Value coding
a. For each of the 15 construct pairs, present each pair of
constructs and say: "Which in general is more positive to
you?"
b. Record a (+) or (-) next to the respective constructs.
6. Family construct ratings
a. Put cards in order from 1-10
b. Have subject write family names on grid
c. Ratings scale
+3
very
+2
somewhat
+1
si ightly
0
NA or equally
-1
si ightly
-2
somewhat
-3
very
d. For each of the 15 constructs ask: "How would you describe
each of these 10 families along each of these two
dimensions?"
e. The positive side of the scale corresponds to the constructs
that were value coded as more positive and the negative side
of the scale corresponds to the constructs that were value
coded as more negative.
f. Run through the first one with the subject and then if they
have the hang of it, let them do the rest themselves.
7.Grid content coding
a. Give subject instruction form to read and then have them
complete the content coding section. Do the example
first. Correct them if wrong.
**Make sure they don't see the instructions until they're
completely finished with the grid**


27
between members of a group, he may take part in a group process with
them" (1981, p. 354). This new corollary is applicable to training
as the trainee must learn to construe the relationships between the
members of the family and himself if he is to take part in a group
process with them.
The second corollary that extends to multiperson relationships
involves the choice corollary, which states that, "A person chooses
for himself that alternative in a dichotomized construct through
which he anticipates the greater possibility for extention and
definition of his (construct) system" (Kelly, 1955, p. 64). Kelly
further emphasized that choices are not necessarily conscious or
verbalized. An extension of this logic is Procter's family corol
lary, which states that "For a group of people to remain together
over an extended period of time, each must make a choice, within the
limitations of his system, to maintain a common construction of the
relationships in the group" (p. 354). Procter (1981) argues that a
negotiation of a common family reality occurs in families, which he
labeled as the family construct system (FCS). This family construct
system involves a hierarchically organized set of family constructs
used by the family members to make choices and anticipations. The
family therapy trainee must somehow learn to perceive and
conceptualize the common family reality (i.e., FCS), and through his
executive skills, to change that reality. According to Procter, this
will lead to new understandings about what has occurred in the past,
thus allowing the family to negotiate a new construction.


103
2. Friendly and outgoing presentation.
3. However, she shows glimpses of her own depression when given the
opportunity.
Information to be given to therapist:
About Self:
1. Suffers from migraines, backaches and hypertension. She says
that she takes valium for her nerves.
2. Passes information, requests, etc. from the children to father.
3. She feels that she cannot control the kids. When their
squabbling gets on her nerves, she yells at them and then
withdraws in a depressed state.
4. Anger and fighting amongst children often leads to mother's
migraines.
5. Matthew also has angry outbursts and doesn't listen.
About Alyson:
6. Alyson has poor grades now; previously was a B+ student.
Teachers say she is acting out in school.
7. Alyson is not acting nice to grandparents, who think the world of
her.
8. Alyson withdrawing from family, spending most of her time with
peers.
Actions:
1. Encourages the children to confide in her about everything.
2. Constantly prods children, especially Alyson, for problems and
explanations, i.e., "Are you unhappy in our family?"
Mr. Jeffreys
Therapist knows about Mr. Jeffreys:
1. Supports wife's presentation of problems.
2. Gives appearance of being in control of family.
3. Uses sophisticated speech when he talks to children and usually
speaks in a lecture style.


26
interpretation may have led to an equally successful prediction.
This concept, labeled "constructive alternativism," is an important
reason why personal construct psychology lends itself so well to the
investigation of process-outcome variables. In family therapy
training, for example, each theoretical orientation perceives the
process of change differently, and yet the outcome (i.e., an
effective family therapist) will hopefully be the same. Even within
the field of family therapy itself, the therapist may construe a
family differently and through the therapeutic process bring that
family to the same outcome; a change from dysfunctional behavior to
functional behavior.
Personal construct psychology has recently been extended to the
area of family therapy. Although this theory was designed for
individual psychotherapy and intrapsychic processes, Procter (1981)
argues that it can easily be extended to the area of multi person
relationships. There are two important corollaries that allow for
this extension. The first is the sociality corollary, which states
that, "To the extent that one person construes the construction
process of another, he may play a role in a social process involving
the other person" (Kelly, 1955, p. 95). This corollary states that a
person makes choices or behaves in accordance with how he anticipates
that another will respond, regardless of the accuracy of his
construal. Thus, the sociality corollary allows for an understanding
of the complementary aspects of dyadic relationships. In order to
look at families, Procter introduced the group corollary which states
that, "To the extent that a person can construe the relationships


7
answer the question of what impact training has on family therapy
trainees.
Regardless of the type of training program involved, there are
certain components of family therapy training that extend across the
various schools of thought. All therapy training programs, including
family programs, utilize four primary methods for training:
didactic, supervisory, observational, and experiential. Since the
field of family therapy is relatively new, most training programs
require their trainees to read a variety of sources that reflect the
diversity of family therapy. However, there are also training
programs that concentrate on the work of a single well known
therapist and school of thought. Kniskern and Gurman (1979) suggest
that although programs with a single, integrated approach to family
therapy lessens the confusion that results from sampling readings
from the various schools of thought, these programs may run the risk
of producing less creative and flexible therapists. In agreement
with Kniskern and Gurman's argument, the present study will
investigate the training process that occurs within a program that
places a major emphasis on structural family therapy (e.g.,
Minuchin), while also incorporating other schools of thought such as
strategic (e.g., Haley), communications (e.g., Satir), and
experiential (e.g., Whitaker).
The second mode of training involves supervision of the
trainees. Most family therapy trainers agree (Kniskern & Gurman,
1979; Liddle & Halprin, 1978) that the primary teaching of family
therapy occurs in supervision. However, the techniques of


13
while their supervisors used more abstract dimensions (e.g.,
diligent, responsible).
Thus, the use of personal construct methodology lends itself
well to the study of a variety of training methods. Extending this
personal construct training literature to the training of family
therapists suggests several lines of inquiry. These concern both
structural and qualitative changes in trainees' conceptual and
clinical abilities as they gain exposure to, and practice with, a
structural-systemic approach to family treatment.
First, based on the systems approach of structural family
therapy, shifts are expected in the direction of greater use of
systemic dimensions for the trainees (e.g., focusing on family
interactions versus an individual focus), as well as shifts in the
direction of greater overall complexity in the family construct
systems of family therapy trainees (e.g., increases in the number of
constructs used and the interrelationships between those constructs)
relative to a comparable control group. In addition, it is predicted
that there will be similar shifts towards more complex and
systemically oriented case conceptualization skills in the trainees,
and more effective and systemically oriented therapist responses in
trainees than in control subjects.


131
INTERVAL III
Which of the following therapist response alternatives would you
select for use with this family at this time in the session? Please
circle your preferred response.
I. a.
b.
c.
d.
On a scale of 1 to 10, how confident do you feel about your selection
of this therapist response? Please circle a number on the scale.
1
L
2
|
3
1
4
1
5
1
6
L
7
I
8
1
9
1
10
1
no
mild
some
moderate
very
II.
a.
b.
c.
d.
1
L
2
I
3
1
4
1
5
1
6
1
7
1
8
L
9
10
1
no
mild
some
moderate
very
Ill
. a.
b.
c.
d.
1
2
3
4
5
6
7
8
9
10
no
mild
some
moderate
very
PLEASE TURN TO THE NEXT PAGE


53
or wrong answers. We are simply interested in which
responses you would choose from each group of response
al terna ti ves.
After you have viewed the tape and selected your
therapist response alternatives, you will be requested to
answer some multiple choice questions concerning your
case conceptualization of the family as though you were
the primary therapist for the family.
Following these instructions, the subjects were provided with
the written family descriptions (see Appendices 0 and P). When the
subjects indicated that they had finished reading the family notes,
they were given a therapist response form to use for recording their
responses to the family (see Appendix K). The examiner stopped the
videotape at four intervals and requested the subjects to write their
responses on the designated pages. The booklet of four therapist
response forms was then removed by the examiner and replaced with the
following written case conceptualization instructions:
We are interested in your case conceptualization of the
family as though you were the primary therapist for this
family. There are 8 multiple choice questions regarding
the dynamics that you see as important in this family.
We would like you to choose the alternatives that best
reflect how you perceive this family. Again, there are
no right or wrong answers to these questions, each choice
simply reflects a preferred style of viewing the dynamics
of the case.
You will have 10 minutes to answer these questions.
When the subjects indicated that they finished reading the
instructions, they were given the case conceptualization questions
and a form to use for recording their responses (see Appendix Q).


APPENDIX P
FAMILY B DYNAMICS SEEN BY SUBJECTS
The Williams Family (B)
Low income family
Mother Mrs. Jane Williams
Age
- has low paying job in
television production
Father Mr. Frank Williams
Children Ian
Dianne
- not in therapy
17 student
16 student
Information given to therapist over phone by Mrs. Williams:
Mr. Williams refuses to have anything to do with his wife and
therefore refuses to participate in therapy. Mother and father
separated 3 years ago.
Mr. and Mrs. Williams have not been able to agree to the terms of the
divorce. In addition, Mrs. Williams has taken Mr. Williams to court
on two occasions for failing to meet his support payments. In one
case, Mr. Williams was sentenced to a week in jail.
The children spend every second weekend with their father and they
generally enjoy these visits.
Presenting problems (presented by mother over phone)
1. Ian loves his father and becomes uncontrollable.
2. Ian pulled a knife on mother and sister the last time that he
lost his temper.
3. Ian orders his sister around and expects her to do things for him
(e.g., make him meals, watch his TV programs).
4. Ian physically pushes sister around when she doesn't listen to
him.
145


10
four studies designed to address issues related to training
structural family therapists. Three of these (Betof, 1977;
Flomenhaft & Carter, 1974; 1977) described results of uncontrolled
post-hoc evaluations of training programs. The fourth (Kaplan,
Rosman, Liebman & Honig, 1977) represented a multi-method assessment
of a one year training program within the context of a small sample
(20 trainees and 5 controls). These studies only begin to redress a
long-standing inattention to the empirical assessment of family
therapy training programs. Another major difficulty encountered in
this area of research is the lack of sensitive instruments for
measuring change in therapist skills (Gurman, 1983). Therefore, the
dearth of process-outcome studies and lack of a methodology sensitive
enough to detect changes in the skills of family therapists support
Gurman and Kniskern's recent conclusion that "we must acknowledge and
underline the field's collective empirical ignorance about this
domain" (1981, p. 772).
The Present Study
The theory and methodology underlying the present study is
adopted from Kelly's (1955) personal construct psychology. Personal
construct theory was initially developed as a conceptual approach to
the study of personality, psychopathology and psychotherapy. This
theory has generated a wide body of empirical research and has
recently reemerged as an important contribution to the study of human
behaviors (e.g., Bannister, 1981; Bannister & Fransella, 1955; R.A.
Neimeyer, 1985; Neimeyer, Klein, Gurman & Griest, 1983; Neimeyer &


79
reveals many methodological flaws in this area of investigation.
These flaws have consisted of the lack of comparable control groups
and the absence of reliable, valid, and standardized measures
sensitive to changes in skill level that are unique to family
therapy. Those studies reporting increases in family therapy
trainees' executive skills were unable to attribute those changes to
training in family therapy as they did not include a comparable
control group (e.g., Allred & Kersey, 1977; Tucker & Pinsof, 1984).
In those studies that did include some type of control group, the
results have typically not shown significant differences in executive
skill level of the trainees (e.g., Breunlin etal., 1983). However,
these studies did not use a reliable coding instrument and thus their
lack of results may be due to the instruments used rather than there
being no differences. The present study investigated whether the
executive skills of family therapy trainees, as compared with
nonfamily therapy trainees, would increase when measured by a
reliable and valid coding system.
Executive skills were measured along four categories of
therapist responses that were found to be the most meaningful of
Allred and Kersey's (1977) system based on a pilot investigation.
The four categories reflected by the therapist response alternatives
were Gathers Information, Reflects and Supports, Interprets and
Confronts, and Structural Realignment. All measures of executive
skill level were analyzed separately for each of the four therapist
response categories.


82
therapy trainees would have responded differently than the family
therapy trainees if allowed to select an interpretive response with
an individual rather than a family focus. Future research needs to
adjust for this factor of response bias in a forced choice format.
One possibility may be to use a crossed design similar to the present
investigation with the addition of an individual therapy tape. This
would allow for an assessment of whether family and individual
therapy trainees differ in their level of interpretive executive
skills when interacting with an individual versus interacting with a
family.
Structural realignment
According to Allred and Kersey's (1977) classification scheme,
structural realignment consists of the most sophisticated levels of
therapy responses that can be made to a family. It was predicted
that the family therapy trainees would show an increase in their
level of structural realignment responses while the nonfamily therapy
trainees would remain stable across time. Contrary to these
predictions, the results revealed that there were no significant
differences in response level for the two groups of trainees, and
there were no significant differences across time. A possible
explanation for this lack of change in executive skill level may be
that these responses were too sophisticated for even beginning family
therapy trainees to attempt. It would be interesting to reassess the
executive skill level of these trainees after the family therapy
trainees had gained more training and exposure in family therapy.


21
either perceptual or executive skills for either group. Breunlin et
al. (1983) suggested that their instrument may not have been
sensitive enough to detect change in skill level.
The study of Breunlin et al. (1983) represents a considerable
advance over previous investigations; however, there are several
flaws in their methodology that need to be addressed. First, the
simulated therapy tapes showed a therapist interacting with the
family. It might be expected that viewing another therapist might
influence the responses of the subjects, thus confounding the
results. Further, the authors do not adequately describe how
subjects' responses were coded, or along what dimension. Third, the
actual construction of the tape is not adequately described. Four
family therapists reviewed the tape and arrived at a consensus that
it was representative of the structural-strategic model. Although
this procedure may provide a high level of content validity, the
reliability of this measure is open to question. Fourth, their
control group was not comparable for level of therapeutic
sophistication. It is logical to expect that psychiatric residents
would show greater levels of conceptual skill concerning family
therapy dynamics than a group of pediatric residents with no therapy
training. Finally, prior to developing multiple choice responses to
the simulated tape, open-ended test responses were subjectively
analyzed and determined to have substantially improved in both
complexity of answers and correct application of training knowledge
from pre- to posttest. Again, there was no mention of any objective
coding system and thus the results may have been biased toward the


113
III. Response Alternatives
(a) Alyson, it sounds like you don't think there is a problem
here.
(b) It sounds like you are upset Alyson because you don't
think there is a problem. Let's work together so all of
you are happy and comfortable with each other.
(c) Alyson, it sounds like you really feel guilty inside for
causing your family grief.
(d) It's OK for you to feel upset. What we need to do is work
together and find a way for you to feel happier about each
other.
IV. Response Alternatives
(a) Yes, there does seem to be a problem here, though I don't
see it as only your problem. Mom and Dad are also
contributing to this problem.
(b) It seems like there is a lot of anger here in this family
that people are afraid to show.
(c) You seem like a very close and loving family and I wonder
what you fear would happen if you expressed that love for
each other.
(d) Alyson, it sounds as though you don't really like your
parents or your family very much.
Interval II
2. Dad: What do you think we ought to do with her?
I. Response Alternatives
(a) It is important for parents to realize that it is normal
for teenagers Alyson's age to spend a great deal of time
with their friends, and identifying with their friends.
(b) Dad, I think you and mom need to stop accusing Alyson of
misbehaving unless you have proof, and you need to be more
patient with Alyson's behavior in the home.
(c) Right now I'd like to have Alyson tell Dad how she feels,
very quietly and calmly, and have Dad repeat this back to
her satisfaction. Then I would like to have Dad, very
calmly and quietly, tell Alyson how he feels and have
Alyson repeat this back to his satisfaction.
(d) I think everyone needs to realize that though these
problems may seem to be caused by Alyson, they affect the
whole family and everyone must take an active part in
resolving family problems. I'd like you all to think


121
while Mom listens. When you have reached an agreement, I
would like you to share these expectations with Mom and
find out whether she feels these expectations are
agreeable.
(d) I think everyone needs to realize that though these
problems may seem to be caused by Ian, they effect the
whole family and everyone must take an active part in
resolving family problems. I'd like you all to think
about what part you could play in resolving some of the
conflict you are experiencing.
II. Response Alternatives
(a) I'm wondering if each of you would tell me what it is like
to live in this family. What aspects do you find
upsetting and what do you see as positive?
(b) What I hear is that you are antagonizing Ian and putting
unrealistic demands on him in addition to telling him that
he is not OK. I think it is time you stop that and try
something different.
(c) I'd like to know how often you children get frustrated and
upset with each other to the point that Mom has to
intervene, and what behaviors on her part you find
upsetting.
(d) Mom, I'd like to know how often you get frustrated and
upset with Ian and Dianne, and what do you do when Ian and
Dianne are fighting?
III. Response Alternatives
(a) I can see how much you love your children and that is the
first step in helping your family in resolving your
conflicts with each other through working on compromises
that you will be happy with.
(b) Mom, it sounds like you feel you have failed Ian in some
way and you are feeling guilty and confused about how that
happened.
(c) It is obvious that you are all feeling some pain in being
in conflict with each other and would much rather be
getting along. What we need to do is work on helping you
develop some working compromises that each of you would be
happy with.
(d) Mom, it sounds like you are very concerned about Ian and
would like to do anything you could to help him.


Abstract of Dissertation Presented to the Graduate School
of the University of Florida in Partial Fulfillment of the
Requirements for the Degree of Doctor of Philosophy
A PERSONAL CONSTRUCT ASSESSMENT OF
STRUCTURAL FAMILY THERAPY TRAINING
BY
FLORA ZAKEN-GREENBERG
August, 1985
Chairman: Dr. Harry Grater
Cochairman: Dr. Greg J. Neimeyer
Major Department: Psychology
The investigation of the effects of training in family therapy
is a new and relatively uncharted area of inquiry. There are only
two studies cited in the literature that begin to approach the
experimental rigor and control necessary to explore the impact of
family therapy training on therapy skills. The present investigation
attempted to control for the lack of experimental control and
objective measures of family therapy skills that continue to be
reported in the literature.
Based upon the distinction among therapy skills cited in the
literature, the present study investigated perceptual, conceptual and
executive skills associated with effective family therapy.
Perceptual skills were measured using a modified version of the Role
Repertory Grid, yielding measures of the structure and content of
vi 1 1


20
However, there are two major limitations of the empirical
research discussed so far. First, these research designs did not
include comparable control groups and thus any changes in the
trainees may be attributable to factors other than the training
program (e.g., spontaneous improvement, maturation, attention-placebo
effects, Cook & Compbell, 1979). Second, the variables which have
been selected for evaluation measure whether or not trainees have
assimilated the instructional material and not whether their
therapeutic skills have been influenced by training. In addition,
those studies that do assess therapeutic skills are not specific to
family therapy, but may be generalized to any form of psychotherapy.
In a recent attempt to eliminate these two major limitations,
namely, the lack of a comparable control group and the use of paper
and pencil tests of increased knowledge of training, Breunlin et al.
(1983) reported the development of an instrument designed to measure
the perceptual, conceptual and executive skills of family
therapists. This instrument consists of a videotape of an enacted
family's first session and a series of multiple choice questions
regarding the subjects' perceptions, conceptualizations and
therapeutic recommendations about the tape. The experimental
subjects consisted of 22 psychiatric residents who were given one
month of family therapy training, and the control subjects consisted
of 11 pediatric residents who were not given family therapy training
or any formal training in psychotherapy. A pre-post assessment
revealed a significant increase in conceptualization skills for only
the family therapy trainees. However, there were no changes in


35
alternatives in response to a series of simulated-family therapy
videotapes (with the response alternatives designed to reflect the
classification system of the Allred Family Interaction Scale), and
(4) a multiple choice questionnaire designed to measure the case
conceptualization of the simulated family dynamics and treatment
intervention, both before and after the 16-week interval.
Hypotheses
There are four basic components that are being analyzed in this
study. The first is based on the family repertory grid which
consists of a clinical interview in which participants systematically
compare and contrast various families to determine dimensions
representative of their evaluations of family dynamics. A structural
analysis (FIC and chi square scores, see Landfield, 1971) will
provide measures of cognitive complexity. Based on the training
literature reviewed, it is hypothesized that family trainees will
significantly increase in cognitive complexity after training
compared to the control group.
The second component of this study involves a content analysis
of the repertory grid data. The content analysis is based on an
adaptation of Duck's (1973) procedure. Basically, constructs are
coded as either physical, role, psychological, or interactional. A
content analysis will provide measures of abstraction and it is
hypothesized that there will be a significant increase in the use of
abstract (i.e., interactional) constructions in the experimental


94
according to the following arrangement:
(a)
Class Skill Tryouts (0-50)
29
30-39
40-44
45+
(b)
Communication Analysis (0-50)
29
30-39
40-44
45+
(c)
Videotaped Observation Reports
29
30-39
40-44
45+
(d) Topical Synopsis and
Bibliography (0-100)
75
76-85
86-90
91+
(e)
Class Teaching Unit (0-100)
75
76-85
86-90
91+
(f)
Family Assessment Report (0-100)
75
76-85
86-90
91+
TOTAL POINTS
179-
334-383
384-408
409+
LATE WRITTEN ASSIGNMENTS WILL RESULT IN A GRADE REDUCTION OF ONE HALF
UNLESS PREVIOUSLY CLEARED WITH THE INSTRUCTOR.
ORGANIZATION OF THE COURSE:
August 20
August 27
September 3
September 10
September 17
MONDAY
Getting Organized and "Thinking Systems" Amatea,
"Learning to Think Systems: A Beginning Course in
Family Systems Intervention.
Historical Development of the Family Therapy Field
Read: Haley "Family Therapy: A
* Haley "A Review of the Family Field"
* Barnhill "Heating Family Systems"
The Family Cruciable, Chaps. 1-4
LABOR DAYNo Classes
Analyzying Family Communication Content and
Process
Read: Napier and Whitaker's The Family
Cruciable, Chaps. 5-7
Luthman and Kirschenbaum, The Dynamic
Family, pp 1-49, 93-127, and 157-176
Patterns of Power, Patterns of Function: The
Structural Organization of the Family
Read: Minuchin, Families and Family Therapy,
Chaps. 1-3,
* Jackson, "Family Rules"


43
Cognitive differentiation. Structural analyses also provide FIC
scores. The FIC scores reflect the functional independence of
constructs which measure the degree of uniqueness between family
constructs. Landfield (1971) originally developed the FIC score as a
measure of cognitive differentiation such that an individual who is
highly differentiated has a large number of different constructs that
are used in different ways. By using constructs in different ways,
one is capable of viewing a situation from a number of different
perspectives. Thus, FIC scores provide information on the level of
differentiation (i.e., how many different ways are the constructs
used). According to this system, differentiation and integration
provide indices of cognitive complexity, such that higher levels of
differentiation and integration imply a cognitively complex
individual.
Content grid measures
The second component of this study involved a content analysis
of the family repertory grid constructs elicited from the subjects.
The content analysis was based on an adaptation of Duck's (1973)
procedure in which constructs are coded as either physical, role,
psychological, or interactional. Based on the pilot data and
feedback from both the subjects and the examiners, it was determined
that independent judges' codings of the subjects' construct content
was often misleading and inconsistent. Subjects frequently provided
constructs that fit into one of the category codes (e.g.,
psychological), while also making comments to the examiner concerning


APPENDIX L
CASE CONCEPTUALIZATION QUESTIONS: FAMILY A
1. According to the psychosocial history presented by this family,
it appears that a major difficulty they are encountering
involves?
a. Mom's lack of control in the family, resulting in her
inability to parent the children when Dad is not around to
help throw his weight.
b. Marital conflict between Mom and Dad that has remained
unresolved through deflecting their focus onto Alyson.
c. Mom and Dad's inability to communicate openly with each
other or their children, hence their inability to teach open
communication to their children
d. The children seek attention in inappropriate ways (e.g.,
hitting, throwing things, interrupting each other), such
that there is little positive exchange between them.
2. Which of the following would be an apt description of the
underlying patterns of this family's interaction?
a. There appears to be an invisible wall between Alyson and the
other children that effectively keeps the focus on Alyson as
the scapegoat, and the focus off of them.
b. Alyson is the scapegoat (i.e., mechanism) that keeps this
family from falling apart. Without her to focus on, the
other family members would have to either select another
member to play her role or become consciously aware of their
conflictual relationships.
c. Mom and Dad have not established open communication patterns
and consequently are trying to deal with the children
individually, reducing the parental control they would have
in the family together.
d. Alyson, with her growing need for independence, is not very
apt at expressing those needs in a manner that shows she is
capable of handling more responsibility, resulting in Mom
and Dad's refusal to listen to her.
135


130
IV. a.
b.
c.
d.
1 2 3 4 5 6 7 8 9 10
no mild some moderate very
We would like you to look at the 4 therapist response alternatives
that you have chosen for working with this family.
Please rank these 4 responses in order of preference from the most
preferred to the least preferred therapist response for working with
this family (most preferred = 1, somewhat preferred = 2, slightly
preferred = 3, least preferred = 4). This ranking should be based on
your preferences as primary therapist working with this family.
I.
II.
III.
IV.
After you have ranked your 4 therapist responses from most to least
preferred, on a scale of 1 to 10, how confident do you feel about
your most preferred response? Please circle a number on the scale.
1 2 3 4 5 6 7 8 9 10
J I I I I I I I L_
no mild some moderate very
PLEASE STOP DO NOT TURN PAGE
THANK YOU


REFERENCES
Ackerman, N. (1973). Some considerations for training in family
therapy. In Career directions (Vol. 2). East Hanover, NJ:
D.J. Publications, Inc.
Adams-Webber, J., & Mire, E. (1976). Assessing the development of
student teachers' role conceptions. British Journal of
Educational Psychology, 46, 338-340.
Alexander, J., Barton, C., Schiavo, R., & Parsons, B. (1976).
Systems-behavioral intervention with families of delinquents:
Therapist characteristics, family behavior and outcome.
Journal of Consulting and Clinical Psychology, 44, 656-664.
Allred, H., & Kersey, F. (1977). The AIAC, a design for
systematically analyzing marriage and family counseling: A
progress report. Journal of Marriage and Family Counseling, 3,
17-24.
Aponte, H.J., & Van Deusen, J.M. (1981). Structural family therapy.
In A.S. Gurman & D.P. Kniskern (Eds.), Handbook of Family
Therapy. New York: Brunner/Mazel.
Baldwin, B. (1972). Change in interpersonal cognitive complexity as a
function of a training group experience. Psychological
Reports, 30, 935-940.
Bannister, D. (1981). Personal construct theory of research method.
In R. Reason and J. Rowan (Eds.), Human inquiry. New York:
Academic Press.
Bannister, D., & Fransella, F. (1965). A repertory grid test of
schizophrenics thought disorder. British Journal of Social and
Clinical Psychology, 2_, 95-102.
Barton, C., & Alexander, J.F. (1977). Therapist's skills as
determinants of effective systems-behavioral family therapy.
International Journal of Family Counseling, jj, 11-20.
Beal, E. (1976). Current trends in the training of family therapists.
American Journal of Psychiatry, 133, 137-141.
149


118
(c) What has happened in this session has been a good
beginning and now we need to look closer and deeper at
what is happening underneath in this family.
(d) It seems like everyone here today feels like he is not
being understood, or more importantly, appreciated. We
need to look closer and deeper at what is happening
underneath in this family.
IV. Response Alternatives
(a) The issues concerning Alyson that have been presented here
are really just surface expressions of the conflict and
turmoil that is going on inside. We will need to take a
closer look at what conflicts Alyson's behavior is
camouflaging.
(b) It sounds like everybody in this family is upset with
Alyson for not seeming to care about her family anymore.
(c) Well, there seems to be several problems here that are not
related to Alyson, but are related to your family's
unwillingness to share both positive and negative feelings
toward each other in an open manner. We will need to take
a closer look at how we can change the style of
communication in your family.
(d) You seem like a family that is very loving and protective
of its members, especially of Alyson right now. I wonder
what would happen if you expressed this concern for her in
a way other than through anger and accusations.


28
A review of the family therapy and training literatures suggests
that family therapists either restrict themselves to one theoretical
school, or find themselves in a confusing eclectic mixture of
theories and techniques. Haley (1976) has stated that a direct
synthesis of the various theoretical orientations in family therapy
is not possible due to the fundamental differences in their basic
postulates. However, common to both family therapy and family
therapy training is the process of change. Kelly explained change as
a process of reconstruction. According to this view, reconstruction
involves a change in the linkages between constructs, the addition of
new constructs, the elaboration of subsystems or a change in the
range of convenience (i.e., inclusiveness of a particular construct
dimension) which the construct system covers. Thus, family therapy
training consists of giving the trainees experiences which enable
them to elaborate and revise their own construct system such that
they are capable of objectifying the constructions of the family and
expediating the change process. It may be argued that personal
construct psychology subsumes the different approaches in a
theoretical framework that lies outside and at a greater level of
abstraction to the various present alternatives (Procter, 1981).
Further, personal construct theory allows a synthesis of various
theoretical alternatives without any compromise of theoretical rigor
and precision. This provides a strong rationale for the use of
personal construct psychology as a method to investigate the training
of family therapists.


16
1973; La Perriere, 1977) tend to emphasize the personal growth
aspects of training and the affective experiences of the trainees.
For example, two studies which attempted to isolate changes in
psychiatric residents undergoing psychodynamic family therapy
training were based on trainee self-reports (Flint & Rioch, 1963;
Schopler, Fox & Cochrane, 1967). Based on these self-reports, both
investigators concluded that the trainees gained increased awareness
and appreciation for family dynamics. However, as Orlinsky and
Howard (1978) point out, self-report is often unreliable due to the
investment the individual has in perceiving change. In addition,
since external judges were not employed and the variables being
judged were often poorly defined, these results must be interpreted
with caution. Self-report should not, however, be ignored, but
should be reported in conjunction with more objective measures of
change.
In those programs that operate more from structural (Minuchin,
1974), behavioral (Cleghorn & Levin, 1973), and strategic (Haley,
1976) therapeutic orientations, goals are more cognitively based and
focus more on defining particular sets of therapist skills and ways
of intervening into dysfunctional systems. The current trend in the
family therapy training literature is in the direction of
establishing operationally defined objectives and therapist
competencies according to differing theoretical schools of thought
(Garrigan & Bambrick, 1976).
Within the behavioral and structural schools, Cleghorn and Levin
(1973) have been influential in proposing operational objectives for


15
stimulating interaction. Further, Gurman and Kniskern (1978) have
argued that the family therapist must generally be active and provide
early structure without assaulting family defenses too soon.
In addition, the ability of a family therapist to establish a
positive relationship with the family has received consistent support
as the most important outcome-related therapist factor. Several
investigators (Shapiro, 1974; Shapiro & Budman, 1973; Waxenburg,
1973) have reported that therapist empathy, warmth, and genuineness
appear to be very important in keeping families in treatment beyond
the first interview. In an impressive investigation of relationship
skills, Alexander et al. (1976) reported that while structuring
skills discriminated between two levels of poor outcome, only
relationship skills were able to discriminate between good and very
good outcomes. They reported that these factors were related to
positive outcome regardless of the theoretical orientation of the
therapist. However, these are the same skills that have been found
to be critical for the process of effective psychotherapy in
general. Thus, research in family therapy training needs to identify
and confirm the effectiveness of those variables specific to family
therapy in order to conclude that this training is any more effective
than traditional training in psychotherapy.
However, the goals of training and supervision and the skills of
the supervisor are dependent upon the theoretical orientation of the
particular training program involved. The experientially oriented
(Constantine, 1976; Ferber & Mendelsohn, 1969; Luthman &
Kirschenbaum, 1974) and psychodynamically based programs (Ackerman,


152
Gurman, A., therapy: Progress, perspective and prospect. In A. Bergin &
S. Garfield (Eds.), Handbook of psychotherapy and behavior
change (2nd Ed.). New York: John Wiley & Sons.
Gurman, A., & Kniskern, D. (1981). Family therapy outcome research:
Knowns and unknowns. In A.S. Gurman & D.P. Kniskern (Eds.),
Handbook of family therapy. New York: Brunner/Mazel.
Haley, J. (1976). Problem-solving therapy. San Francisco: Jossey-
Bass.
Hunt, D.E. (1951). Studies in role concept repertory: Conceptual
consistency. Unpublished master's thesis, Ohio State
Um versi ty.
Janzen, C., & Harris, 0. (1980). Family treatment in social work
practice. Chicago, IL: F.E. Peacock.
Kaplan, S., Rosman, B., Liebman, R., & Honig, P. (1977). The log as
a behavioral measure in a program to train pediatric residents
in child psychiatry. Special Interest Group/Health Profession
Education Bulletin.
Kelly, G.A. (1955). Psychology of personal constructs. New York:
Norton.
Kersey, F. (1976). An exploratory factorial validity study of
Allred's Interaction Analysis for Counselors. Unpublished
magistral dissertation, Brigham Young University.
Kniskern, D., & Gurman, A. (1979). Research on training in marriage
and family therapy. Journal of Marital and Family Therapy, 5,
83-94.
Landfield, A.W. (1971). Personal construct systems in
psychotherapy. Chicago: Rand McNally.
Landfield, A.W., & Schmittdiel, C.J. (1983). The interpersonal
transaction group. In J. Adams-Webber & J.C. Mancuso (Eds.),
Applications of Personal Construct Theory. New York: Academic
Press.
Lange, A. (1978). Gedragsveranderende gezinsen relatietherapie. In
J. Orlemans (Ed.), Handbook Gedragstherapie. Deventer,
Holland: Van Loghum Slaterus.
Lange, A., & Brinckman, T. (1976). Effekten van een kursus
relatietherapie op attitude, inzicht en eigen probleemoplossend
gedrag der deelnemers Gedrag. Tijdshrift voor psycholoqie, 3,
144-159. ~


78
instruments before changes in skill level of family therapy trainees
can be adequately investigated.
Third, it may also be possible that the conceptual skills of the
family therapy trainees were only beginning to undergo change at the
time of the second measurement. It is possible that Cleghorn and
Levin's (1973) model of therapy skills may be arranged along a
dimension of skill level such that perceptual skills are a
prerequisite for conceptual skill development and, in turn,
conceptual skills are a prerequisite for the development of executive
skills. Since the family therapy trainees are only beginning to
change their perceptions of families, they may not have had enough
time to develop family conceptual skills. Future research needs to
take a longitudinal approach to the investigation of the development
of family therapy skills as a function of training. Lastly, it must
be kept in mind that the development of family conceptual skills may
not be unique to training in family therapy.
Executive Skills and Therapist Responses
The structural family therapist must develop therapy skills that
influence the family to demonstrate the way it functions. Cleghorn
and Levin (1973) have labeled these skills as executive skills. They
argue that these skills involve what the therapist says and does in
the therapy session in order to influence the family's sequences of
transactions and consequently alter the way the family functions.
Investigating the executive skills of family therapy trainees has
proven to be a very difficult task. A review of the literature


14
4. Major joining with family is through playful teasing.
5. Work keeps him away from family. He works at the plant many
evenings and usually brings work home.
Information to be given therapist:
1. Admits his "bark" is worse than his "bite."
2. His orders and directives are often not backed up with
punishments, only threats.
3. Alyson refused to go to summer school.
Actions:
1. Speaks in adult metaphors.
2. Re-directs therapist's communications to specific children
(almost interrogates).
3. Sits separate from children and wife.
4. In session, he is the power. Wife tries to speak but allows him
to dominate the conversation, if questions are not directed to
her.
5. He interprets and guesses about others' thoughts and feelings.
6. He will tell long irrelevant stories if attention is taken from
him for very long.
Alyson
Therapist knows about Alyson:
1. Outspoken: confronts and questions parents about what they are
talking about or referring to, sometimes in a disrespectful
manner.
2. Very directive and assertive.
Information to be given to therapist:
1. Doesn't think family has problems.
Actions:
1. She is the dominant child and leader of the sibling group.


150
Betof, N. (1977). The effects of a forty-week family therapy training
program on the organization and trainees. Unpublished
dissertation, Temple University.
Bieri, J. (1955). Cognitive complexity-simplicity and predictive
behavior. Journal of Abnormal and Social Psychology, 51, 263-
268.
Bloch, D., & Weiss, H. (1981). Training facilities in marital and
family therapy. Family Process, 20, 133-146.
Bonarius, J.C. (1970). Personal construct psychology and extreme
response style: ~An interaction model of meaningfulness,
maladjustment, and communication-! Groni ngen: Uni ver si ty of
Groningen.
Breunlin, D., Schwartz, R., Krause, M., & Selby, L. (1983).
Evaluating family therapy training: The development of an
instrument. Journal of Marital and Family Therapy, 9_, 37-47.
Byles, J., Bishop, D., & Horn, 0. (1983). Evaluation of a family
therapy training program. Journal of Marital and Family
Therapy, _9, 299-304.
Cleghorn, J., & Levin, S. (1973). Training family therapists by
setting learning objectives. American Journal of
Orthopsychiatry, 43, 339-446.
Connors, E.A. (1984). The use of personal construct theory in an
examination of family therapists conceptual/perceptual skills
and verbal behavior at selected stages of training.
Unpublished doctoral dissertation, University of Toronto,
Toronto, Canada.
Constantine, L. (1976). Designed experience: A multiple, goal-
directed training program in family therapy. Family Process,
_15, 373-396.
Cook, T.D., & Campbell, D.T. (1979). Quasi-experimentation: Design
and analysis issues for field studies. Chicago, IL: Rand
McNally College Publishing Co.
Crockett, W.H. (1982). The organization of construct systems: The
organization corollary. In J. Mancuso & J. Adams-Webber
(Eds.), The Construing Person. New York: Praeger.
Duck, S.W. (1973). Personal relationships and personal constructs: A
study of friendship formation. London: John Wiley.


56
family tapes. There are two sets of dependent measures for therapist
responses. The first set involves analyses within each category of
interest (e.g., gathers information, reflects and supports) for the
following dependent variables: Weighted Average, Modal Response and
Average Confidence Level. The second set involves analyses across
the four categories of interest on the following two dependent
variables: Mode for Preferred Response and Average Confidence for
Preferred Response. For all four major components of this design,
all dependent measures were analyzed with a 2(Group) x 2(Time)
Analysis of Variance with repeated measures on the last factor.
Structural Grid Analyses
Subjects' ratings from the 7-point Likert type scales were
cluster analyzed by Landfield's (1971) computerized method. This
analysis provided FIC and chi square scores for each subject, thus
providing the measures of cognitive complexity previously discussed
(see pages 42-43). These scores comprise the dependent measures for
the structural grid data.
Content Grid Analyses
Each of the 15 constructs elicited from the subjects were self-
coded along a dimension of abstractness ranging from physical, role,
personality and interactional characteristics (i.e., physical = +1,
role = +2, personality = +3, and interactional = +4). A single score
representing a subject's overall level of abstraction was obtained by
averaging the weighted ratings across the 15 constructs. Each


122
IV. Response Alternatives
(a) Mom, I think you and Dianne have done enough blaming of
Ian and it is time you stop laying all this guilt on Ian
and begin working on your problems.
(b) It appears that no one in this family is willing to take
any blame for family conflicts so that Ian has been
elected and has agreed to take all the blame for the
family. I wonder what would happen if Ian no longer
shouldered the blame for the others in this family.
(c) It seems that the members in this family are afraid to
share warm tender feelings for each other and so keep each
other at arm's distance by fighting with each other. I
wonder what would happen if you expressed positive
feelings toward each other?
(d) It seems that the members in this family have an invisible
wall around them so that you are focused on your feelings
and are unable to really listen to each other.
Interval III
3. Ian: Is there any way that you can get her to keep off my back?
I. Response Alternatives
(a) I think it is important that each of you are clear about
what you expect from therapy. To help clarify some things
I would like Ian and Dianne to sit together facing Mom in
a circle, so that each child has the opportunity for some
face-to-face contact with Mom. Then I would like you to
share what things you would like to see changed through
therapy.
(b) When a family, such as yours, is in conflict they tend to
place the blame on one family member. However, it has
been my experience that all the family members either
contribute to or maintain the problem.
(c) I think your family needs to continue on in therapy so you
may explore some positive ways of expressing your feelings
and needs to each other. I would like each of you to
state what your needs are that are not being met and how
you feel the family might help you meet those needs.
(d) Mom, I suggest that you learn some new parenting skills as
you are obviously having a difficult time knowing how to
deal with your children now that you are a divorced,
single parent.


22
logical expectation that trainees' responses would become more
complex after training.
More promising have been recent advances in the development of
objective instruments to assess behavioral changes of family
therapists. There have recently been two analysis systems developed
that target therapist executive skills behavior (e.g., Allred &
Kersey, 1977; Pinsof, 1977). Both of these measures have been shown
to demonstrate appropriately high levels of reliability and
validity. Pinsof (1977) provided empirical evidence that the
therapeutic verbal behavior of novice and advanced family therapists
can be coded reliably and shown to be significantly different. At
the present time, the Family Therapist Coding System (FTCS, Pinsof,
1977) is the only family therapist verbal coding instrument that has
provided researchers with the ability to distinguish among trainees
according to their training level (Tucker & Pinsof, 1984). However,
there is a major limitation involved in the use of this measure. Due
to the complexity of the instrument, a considerable amount of
practice administration is required in order to ensure reliable
measurement and therefore the use of the FTCS is often prohibitive.
The second measure, the Allred Interactional Analysis for
Counsellors (AIAC, Allred & Kersey, 1977), has also been shown to
differentiate among trainees' levels of training. Several studies
have reported this measure of verbal behavior to be both highly
reliable (Kersey, 1976; Sanders, 1974; Watson, 1975) and valid
(Kersey, 1976; Sanders, 1974; Tripp, 1975; Watson, 1975). Compared


23
to the FTCS, the AIAC is much less complex and produces reliable
results after a short period of coding practice.
This measure has recently been used to compare the executive
skills of family therapy trainees with those of nonfamily therapy
trainees. Zaken-Greenberg and Neimeyer (1984) investigated the
executive skills of family therapy trainees and comparable controls
in a pre-post design using a modified version of the AIAC. Subjects
were required to observe videotapes of a simulated family therapy
session and instructed to assume the role of the primary therapist.
At different intervals, a family member looked into the camera and
asked the therapist (i.e., the subjects) a question to which the
subject was to respond to in writing. Each response was rated by two
independent judges on a modified version of the AIAC. The original
categories were broken down into more refined and mutually exclusive
categories ordered along a dimension from obstructive responses
through levels of functional family therapy responses (e.g.,
relationship building, structural realignment). An overall average
of response level was obtained.
The results of this investigation revealed that family therapy
trainees responded with significantly more structural maneuvering
techniques than did the control subjects at posttest. In addition,
the family therapy trainees' use of these responses increased
significantly from pre- to posttest with no change indicated for the
control group. Zaken-Greenberg and Neimeyer (1984) suggested that
the structural training emphasis on behavioral manipulation of the


155
Sanders, J.P. (1974). A study in counselor evaluation scale
validation: An exploratory examination of naive counselors'
scores on Allred's Interaction Analysis for Counselors with
selected scores on the Strong Vocation Interest Blank.
Unpublished magistral dissertation, Brigham Young University.
Schopler, E., Fox, R., & Cochrane, C. (1967). Teaching family
dynamics to medical students. American Journal of
Orthopsychiatry, 37, 906-911.
Sedgwick, R. (1981). Family mental health: Theory and practice. St.
Louis, MO: C.Y. Mosby.
Shapiro, R. (1974). Therapist attitudes and premature termination in
family and individual therapy. Journal of Nervous and Mental
Disease, 159, 101-107.
Shapiro, R., & Budman, S. (1973). Defection, termination, and
continuation of family and individual therapy. Family Process,
12, 55-67.
Sigal, J., Guttman, H., Chagoya, L., & Lasry, J. (1973).
Predictability of family therapists behavior. Canadian
Psychiatric Association Journal, 18, 199-202.
Sigal, J., Guttman, H., Chagoya, L., & Piln, R. (1977). Some stable
characteristics of family therapists' interventions in real and
simulated therapy sessions. Journal of Consulting and Clinical
Psychology, 45_(1), 23-26.
Stanton, M.D., & Todd, T. (1979). Structural family therapy with drug
addicts. In E. Kaufman & P. Kaufman (Eds.), The family therapy
of drug and alcohol abuse. New York: Gardner Press.
Thomlinson, R. (1974). A behavioral model for social work
intervention with the marital dyad. University of Toronto,
Dissertation Abstracts International, 35, 1227A.
Tomm, K. (1980). Towards a cybernetic-systems approach to family
therapy at the University of Calgary. In D.S. Freeman (Ed.),
Perspectives of family therapy. Toronto: Butterworths.
Tomm, K., & Leahey, M. (1980). Training in family assessment: A
comparison of three teaching methods. Journal of Marital and
Family Therapy, 6_, 453-458.
Tomm, K., & Wright, L. (1979). Training in family therapy:
Perceptual, conceptual, and executive skills. Family Process,
18, 227-250.


44
what the construct implied (e.g., discussing the interactional
properties of the construct). Consequently, the manner of coding the
constructs was not always consistent with the inferred meaning the
constructs had for the subjects. In view of the marginal interrater
reliabilities (range = .56 to .82), the present study was designed to
exclude judges, and to base the content coding on the subjects'
perceptions of their own constructs (see Appendix D). In addition,
the coding label "psychological" was changed to "personality" since
it is believed to be less abstract in its meaning, and therefore more
familiar to the average subject.
A test-retest reliability analysis was performed using this new
procedure in order to establish a strong empirical rationale for its
use. One-hundred-thirty-four undergraduate volunteers were given a
repertory grid measuring their perception of various types of
interpersonal relationships. These subjects were required to use
Duck's (1973) coding system to code their own constructs. After an
18-day delay, subjects were again asked to code their constructs.
With no training or prior exposure to this sytem, an analysis of the
data revealed a 12% agreement across time, suggesting that the self
coding procedure is as reliable as using independent judges. A major
advantage to using this procedure is that the data will be a more
accurate reflection of the subjects' perceptions of their personal
constructs.
Subjects in the present investigation were provided with
instructions and examples of how to use the coding system. They were
given five constructs to code using Duck's system, and were corrected


APPENDIX I
THERAPIST RESPONSE ALTERNATIVES: FAMILY A
Interval I
1. Alyson: I don't think there's a problem. What do you think?
I. Response Alternatives
(a) Alyson, I think you are creating some very serious
problems for yourself and your family that we all need to
work on.
(b) Often times, too much pressure may create strife and
division within a family, even a family that loves each
other.
(c) Well Alyson, your parents feel there is a problem here and
they are very concerned. But it is difficult to
communicate when you are so spread out. Dad and Mom, I'd
like you to sit next to each other, and Alyson, turn your
chair so you are facing your parents.
(d) I think you and your family need to explore new ways of
communicating your needs and feelings to each other. I
would like each of you to state how you are feeling about
what is happening in this family while the others listen.
II. Response Alternatives
(a) I'd like to know if you fight like this often. I'd like
to hear from you and your sister and brothers.
(b) I think it is important that we hear from each member of
your family about how they perceive what is happening in
this family.
(c) I'd like to know if you fight like this often. Let's hear
from both you and mom and dad.
(d) If you don't think there is a problem, then tell me
Alyson, why is your family here today?
112


46
to speak into the camera and ask the "therapist" a question
concerning the family.
The family scenarios consisted of disturbances in the family
structure which required intervention by the family therapist. The
first family is composed of two parents, two adolescent daughters and
two young sons. The oldest daughter is presented as the identified
patient by the parents, the mother as ineffective and the father as
peripheral. The second family is composed of a single mother with an
adolescent daughter and son. In this family, the son is presented as
the identified patient, and the mother focuses on her bitter
relationship with her ex-husband and her inability to control her
son's behavior. Mother and daughter are in a coalition against the
identified patient.
Connors (1984) reported that the two sets of family dynamics
used in his study were equated for level of difficulty. Level of
difficulty was determined through consultation with professionals
acquainted with family therapy. In addition, presentation of the
videotapes were counterbalanced at pre- and posttraining to
distribute any possible order effects.
Based upon the results of the pilot investigation, several
revisions were made for the improvement of this dissertation. A
major difficulty with the pilot study involved the use of naive and
unsophisticated judges concerning family therapy. Judges were
undergraduate students without any exposure to family therapy prior
to participating in this project. In addition, the pilot data for
therapist responses revealed a paucity of information for the amount


51
Table 4. Expert Ratings of Case Conceptualization Stimuli
Family Tape I
Cases
Coding
Scheme
Expert 1
Expert 2
Cases Coding Scheme
-
.38
.53*
Expert 1
-
.63*
Expert 2
-
* p<.05
Table 5. Expert Ratings of Case Conceptualization Stimuli
Family Tape II
Cases
Coding
Scheme
Expert 1
Expert 2
Cases Coding Scheme
-
.33
.69*
Expert 1
-
.69*
Expert 2
-

p<.05


93
knowledge in conferring the structure of a couple/family system
and in getting and keeping communication on track in therapeutic
interviews. Guidelines for this analysis will be provided during
the fourth week of classes. (3-5 typewritten pages.)
2. Teaching Outline and Annotated Bibliography. You are to prepare
a 5-7 page synopsis outline of a specific family stage/pattern
(e.g., single parent families, families with adolescents, dual
career families, children and divorce, etc.) describing typical
challenges which confront the family and family methods of
adaptation suggested in the literature. In addition to this
synopsis, you are to develop an annotated bibliography
summarizing the pertinent features of eight articles in the
literature. Your synopsis and bibliography will be distributed
to your classmates as a part of a teaching presentation you will
design with the instructor and two other students. Your synopsis
and bibliography will be due the week before you are scheduled to
present to the class.
3. Team Design Development of a Teaching Unit. You will be given
the joint responsibility (along with 2 other people) of planning
and implementing a class session) with the instructor on the
family stage/pattern in which you have become expert (from #2),
on the data for which it is scheduled in the syllabus.
Appropriate teaching activities and resources are to be designed
and developed for this assignment.
4. Film and Videotape Family Observation Reports. You will be
expected to submit 3 brief observation reports on the film or
videotaped families whom you observe in class. Guidelines for
this report will be discussed and distributed in class.
5. Class Skill Tryouts. You will have an opportunity to participate
in 2-3 family interview skill tryouts as a part of class
activities. You will be graded on your willingness to try these
experiences rather than the level of skill you demonstrate.
6. Family Assessment Report. You are expected to prepare an
assessment report on a family describing the family both
structurally and developmentally. You will be asked to describe
the family in terms of specific criteria outlined in The
Guidelines For The Family Assessment Report. May be developed on
a family you have seen or film, read about, or know personally.
The report is due the last week of class.
GRADING PLAN
Points are to be given for completion of each of the five course
requirements. Your final grade is based upon the total number of
points earned. Points will be allocated for each course requirement


CHAPTER III
METHODOLOGY
Subjects
Thirty-three subjects were recruited voluntarily from the
counselor education and counseling psychology graduate programs at
the University of Florida in Gainesville, Florida. The experimental
group consisted of 12 graduate students currently enrolled in a
graduate seminar in structural family therapy given through the
counseling psychology program (see Appendix A for a description of
the seminar). This group consisted of four males and eight females,
with a mean age of 32 (range = 23 to 41). The control group
consisted of 21 graduate students from the identical programs who had
not had previous training in family therapy and who had not yet taken
the graduate seminar in structural family therapy. There were seven
males and fourteen females in the control group, with a mean age of
29 (range = 21 to 49). The experimental subjects had an average of
four semesters of graduate school and the control subjects had an
average of two semesters of graduate school. Thus, both groups are
comparable in their graduate training, with the experimental group
receiving additional training in structural family therapy.
38


APPENDIX K
THERAPIST RESPONSES ANSWER SHEET
You will be reading 4 groups of possible therapist responses
that a therapist might choose to make to this family. Each of the
alternatives in the 4 groups of responses are viable choices and
there are no right or wrong answers. We are simply interested in
which response you feel you might make to this family at this point
in time in the initial session.
You will have two minutes for each interval of responses.
Please turn the page and fill out the information requested at
the top of the page.
126


4
According to Kniskern and Gurman (1979), these training models differ
on three major dimensions. The first dimension involves whether or
not the training leads to a degree or certificate in family
therapy. Second, is family therapy the only form of therapy taught
at a given training center or does the program require some
experience with individual and group therapy? Third, training
programs vary as to the extent of previous experience in
psychotherapy that is required for admission.
In order to evaluate family therapy training, investigators must
specify what type of program is under study as well as how that
program defines family therapy. Kniskern and Gurman (1979) argue
that the meaning which one attaches to the term family therapy will
directly affect the way in which one trains family therapists and
evaluates that training. These authors suggest that a training
program that views family therapy as a technique will focus primarily
on the acquisition of technical skill, and as such, the acquisition
of specific technical skills will be viewed as the most appropriate
criterion of the success of the training program (e.g., behavioral
and communications approaches). However, if family therapy is viewed
as a conceptual approach to the understanding of behavior and
behavioral pathology, Kniskern and Gurman (1979) argue that the
training program will view the acquisition of specific intervention
techniques as a secondary goal (e.g., existential and strategic
approaches). Thus, before general statements about the effectiveness
of family therapy training can be made, differences between the goals


70
interesting changes in executive skills for both groups across time,
there were no significant differences between the two groups. These
results are contrary to the prediction of increased skill level of
family trainees compared to controls as a function of structural
family therapy training. The remainder of this discussion will be
organized around each of the major components and hypotheses of the
study.
Perceptual Skills and Cognitive Complexity
Cognitive differentiation refers to the number of different
constructs that an individual has available for viewing and
interpreting a situation. According to Werner (1955), construct
systems develop from simple to complex levels of cognitive
differentiation over the course of continued experience. This
reasoning is consistent with Bieri's definition of complexity as "the
tendency to construe social behavior in a multidimensional way such
that a cognitively complex individual has available a more versatile
system for perceiving the behavior of others than does a less complex
person" (1955, p. 14). The present study investigated whether family
therapy trainees' construct systems would become more cognitively
complex as a function of structural family therapy training.
Analyses of differentiation revealed that the family therapy
trainees became significantly less complex as a function of
training. Interestingly, the control subjects showed significant
increases in their level of complexity across time. These results
suggest that when students in the mental health fields are exposed to


CHAPTER IV
RESULTS
Structural Grid Analyses
A 2(Group) x 2(Time) analysis of variance for Functionally
Independent Construct (FIC) scores on family constructs revealed a
significant interaction, F (1,31) = 12.63, p<.001 (see Table 6).
Followup analyses revealed a significant effect of Time for the
control subjects, F (1,20) = 8.42, p<.008, such that the nonfamily
therapy trainees became significantly more differentiated in their
family constructs across time. Followup analyses also revealed a
significant effect of Time for the experimental subjects, F (1,11) =
5.25, p<.04. These results suggest that the family therapy trainees
became significantly less differentiated across time (see Figure 1).
In addition to looking at levels of differentiation, analyses
also revealed some significant findings based on integration
scores. Landfield's chi square score is viewed as a measure of
integration and flexibility. A 2(Group) x 2(Time) analysis of
variance on chi square scores revealed a significant main effect of
Group, F (1,31) = 6.27, p<.02, such that the control subjects were
significantly less integrated in their family constructs than were
the family therapy trainees. An analysis of variance also revealed a
trend toward a main effect of Time, F (1,31) = 2.71, p=.10,
60


134
IV. a.
b.
c.
d.
123456789 10
no mild some moderate very
We would like you to look at the 4 therapist response alternatives
that you have chosen for working with this family.
Please rank these 4 responses in order of preference from the most
preferred to the least preferred therapist response for working with
this family (most preferred = 1, somewhat preferred = 2, slightly
preferred = 3, least preferred = 4). This ranking should be based on
your preferences as primary therapist working with this family.
I.
II.
III.
IV.
After you have ranked your 4 therapist responses from most to least
preferred, on a scale of 1 to 10, how confident do you feel about
your most preferred response? Please circle a number on the scale.
1 2 3 4 5 6
no
mi
some
7 8 9 10
moderate very
PLEASE STOP DO NOT TURN PAGE
THANK YOU


N INFORMED CONSENT FOR FAMILY THERAPIST'S PROJECT 143
0 FAMILY A DYNAMICS SEEN BY SUBJECTS 144
P FAMILY B DYNAMICS SEEN BY SUBJECTS 145
Q CASE CONCEPTUALIZATION ANSWER SHEET 146
R FAMILY REP TEST INSTRUCTIONS 147
REFERENCES 149
BIOGRAPHICAL SKETCH 157
vii


71
family therapy training, they begin to construe families in less
differentiated ways. The fact that the family therapy trainees were
less differentiated than those students without that training
suggests that they are more channelized in their constructions of
families, and have not yet integrated their new experiences into a
larger framework within which to anticipate and predict families in
therapy.
These results are consi stent wi th the literature which has
reported that trainees' constructs undergo periods of decreased
complexity during the early phases of training, often followed by a
reorganization of the constructs at higher levels of complexity
during advanced training stages (e.g., Baldwin, 1972; Lipshitz, 1974;
Pope, 1978; Ryle & Breen, 1974). These findings are also consistent
with the conceptual difficulties that family therapy trainees often
report during the early phases of training (Gurman & Kniskern,
1978). Family therapy trainees may experience more difficulty than
nonfamily therapy trainees in formulating their conceptualizations of
families, thereby resulting in the temporary decline in trainee
performance cited in the training literature (Duhl, 1978; Gurman &
Kniskern, 1978).
Further, these findings may offer support for the operation of
the Creativity Cycle in structural family therapy, such that there is
a shift that starts with loosened construction and terminates with
tightened and validated constructions. Constructs must be loosened
in order that hypotheses may be tested, and then they must be
tightened after the hypotheses have been either validated or


61
Table 6. Analysis of variance for FIC scores
Source
Sum of Squares
df
Mean Square
F
P
Mean
6127.286
1
6127.286
145.32
.000
Group
31.953
1
31.953
0.76
.391
Error
1307.077
31
42.164
Time
0.091
1
0.091
0.01
.909
Time x Group
71.304
1
71.304
10.17
.003*
Error
217.363
31
7.012
* p<.001
Table 7. Analysis of variance for chi square scores
Source
Sum of Squares
df
Mean Square
F
P
Mean
141671.093
1
141671.093
483.82
.000
Group
1835.680
1
1835.680
6.27
.012*
Error
9077.315
31
292.816
Time
543.736
1
543.736
2.71
.109
Time x Group
23.829
1
23.829
0.12
.732
Error
6220.378
31
200.657
* pc.01


41
the names on index cards numbered from one to ten. The subjects are
then presented with three of these elements written on the index
cards and asked to specify some important way in which two of the
families are "alike in some way and yet different from the third
family." For example, after they respond with how two of the
elements are alike, they are required to specify "in what way the
third family differs from the other two families." Following the
elicitation of the constructs, the subjects are required to rate each
family along each construct dimension using a 7-point Likert type
scale (see Appendix C).
Kelly's repertory grid procedure has been used extensively in
research on various issues related to personality theory and clinical
applications. As a result of this procedure's increasing popularity,
attention has been directed toward obtaining psychometric data, with
special reference to reliability and construct validation.
Generally, reliability coefficients based on the consistency of
ratings across time and the consistency of constructs across time
(given identical elements in the repertory grid) have been found to
be relatively high. For example, Hunt (1951) elicited constructs to
fit 41 role titles by the triadic method and reported a test-re test
reliability of .70 over an interval of a week. Similarly, Fjeld and
Landfield (1961) repeated Hunt's basic design and demonstrated that,
given the same elements, there was a correlation of .80 between the
two sets of elicited constructs over a two week interval. Validity,
however, has proven much more difficult to assess. The repertory
grid is not a static assessment tool in that it may be adapted to a


31
classroom experience. These findings may indicate that integration
either increases in an irregular fashion during periods of training,
or actual experience accelerates the integration and tightening of
new constructs. However, these discrepant findings may also be the
result of using different measures than Pope (1978), Ryle and Breen
(1974), and Runkel and Damrin (1961) to estimate cognitive
complexity. The present study will use pre-post measures of
cognitive complexity based on both differentiation and integration
scores as a method of investigating the cognitive complexity issue in
training.
Crockett (1982) has suggested that a second major feature of a
developing construct system involves the appearance of abstract
constructs. One method used to assess the development of abstract
constructs involves a content analysis of the construct dimensions
elicited by the Rep Grid. Lifshitz (1974) investigated whether
constructs became more abstract as a consequence of training. This
study used factor analysis to identify the construct with the highest
loading on the first factor in the grids of social work trainees and
their supervisors. Each construct was then assigned to one of seven
categories and the distribution across the categories was examined.
The results indicated that the trainees used more concrete
descriptive categories while their supervisors showed more abstract
constructs of themselves, others, and their work. An increase of
more abstract constructs in the construct subsystems of trainees
during training was also revealed. However, this study provided
content information about only one construct in each trainee's


55
testing effects. Subjects were then debriefed and told tnat the
study was designed to investigate the effects of family therapy
training on how counselor-trainees respond to and conceptualize
various family problems. They were also given a brief rationale for
undertaking this investigation, followed by a question and answer
session if desired by the subject. Subjects were also given the
opportunity to sign up for feedback sessions on their participation
in the investigation.
Design and Analyses
This investigation has been divided into four major
components. The first component involves the management of trainees'
perceptual skills. Perceptual skills may be measured by using
structural grid analyses (see Landfield, 1971) on the following
dependent measures: chi square scores (measuring level of cognitive
integration) and FIC scores (measuring level of cognitive
differentiation). The second component involves the measurement of
the level of abstraction of trainees' perceptual skills. This
component involves two dependent measures: Abstractness (reflected
by a Weighted Average score) and Modal Response. The third component
of this investigation involves the measurement of trainees'
conceptualization skills for both family dynamics and treatment for
the following two dependent variables: Weighted Average and Modal
Response. The fourth component of this investigation involves the
measurement of trainees' executive skills. Executive skills may be
measured by analyzing trainees' therapist responses to the simulated


153
Lange, A., & Zeegers, W. (1978). Structured training for behavioral
family therapy: Methods and evaluation. Behavioral Analysis
and Modification, 2, 211-225.
La Perriere, K. (1977). Toward the training of broad range family
therapists. Paper presented to the 85th Annual Meeting ofthe
American Psychological Association Conference, San Francisco,
CA.
Levant, R.F. (1984). Family therapy: A comprehensive overview.
Elizabeth, NJ: Prentice-Hall.
Lewis, A.C. (1977). An evaluation within personal construct
methodology of a multimedia workshop on family counselling.
Unpublished doctoral dissertation, University of Nebraska.
Liddle, H., <& Halprin, R. (1978). Family therapy training and
supervision literature: A comparative review. Journal of
Marriage and Family Counselling, 4_(4), 77-98.
Lifshitz, M. (1974). Quality professionals: Does training make a
difference?: A personal construct theory study of the issue.
British Journal of Social and Clinical Psychology, 13, 183-189.
London, P., & Klerman, G.L. (1982). Evaluating psychotherapy.
American Journal of Psychiatry, 139, 709-717.
Luthman, S., & Kirschenbaum, M. (1974). The dynamic family. Palo
Alto, CA: Science & Behavior Books, Inc.
Mancuso, J.C., & Adams-Webber, J.R. (1982). The construing person.
New York: Praeger Publishers.
Minuchin, S. (1974). Families and family therapy. Cambridge, MA:
Harvard University Press.
Neimeyer, G.J. (1985). Personal constructs in couples' counseling.
In F.R. Epting & A.W. Landfield (Eds.), Anticipating personal
construct theory. Lincoln: Nebraska Press.
Neimeyer, G.J., & Hudson, J.E. (1984). Couples' constructs: Personal
systems in marital satisfaction. In D. Bannister (Ed.),
Further perspectives in personal construct theory. London:
Academic Press.
Neimeyer, G.J., perspectives on cognitive assessment. In T.V. Merluzzi, C.R.
Glass, & M. Genest (Eds.), Cognitive assessment. New York:
Guilford.


APPENDIX B
FAMILY THERAPY EXPERIENCE INVENTORY
1. NAME
AGE BIRTHATE SEX
HIGHEST DEGREE CURRENTLY HELD
DEGREE PROGRAM CURRENTLY ENROLLED IN
NUMBER OF SEMESTERS IN PROGRAM
NUMBER OF YEARS CONDUCTING COUNSELING/THERAPY
DO YOU PLAN TO TAKE ADVANCED FAMILY?
DO YOU PLAN TO TAKE MARRIAGE COUNSELING?
WHAT IS YOUR SUBSPECIALIZATION/MINOR?
2. Number of undergraduate, graduate or other ongoing courses taken
where there was a major focus on the "family" (i.e., courses
where three lecture sessions or more, and/or more required texts
were concerned with historical, anthropological, sociological, or
psychological study of the family, including a focus on marriage
as a primary aspect of the family).
0 2-3
1 4-6 7 or more
3. Training sessions or workshops focused on work with families that
you have attended.
0 2-3
1 4-6 7 or more
96


25
of Kelly's (1955) personal construct approach as a basis for the
empirical study of family therapy training.
Personal Construct Theory
George Kelly's (1955) personal construct psychology has been
described as a comprehensive theoretical framework for the study of
human personality (Mancuso & Adams-Webber, 1982). Personal construct
theory takes the position that an individual's interpretation of the
world is explained in terms of that person's organized system of
personal constructs. Each person has a unique way of construing the
world, and people are similar to each other to the extent that they
construe events in a similar way. Thus, the personal construct is
the basic unit of analysis in this system, and was originally defined
as "a way in which some things are construed as alike and yet
different from others" (Kelly, 1955, p. 105). Thus, the construct is
a bipolar dimension upon which a decision is made between a pair of
alternative acts (e.g., a family therapist may construe a family as
"rigid versus permissive").
Kelly based his psychology of personal constructs on a
fundamental postulate and 11 corollaries. This fundamental postulate
states that "A person's processes are psychologically channelized by
the ways in which he anticipates events" (Kelly, 1955, p. 46). Any
act or behavior can be viewed as hypotheses which are continuously
validated or invalidated by experience. However, a validated
hypothesis does not imply that an event has only one
interpretation. Kelly's theory argues that a totally different


117
Interval IV
4. Dad: Where do we go from here?
I.Response Alternatives
(a) It seems to me that right now you are stuck and cannot
reach each other even when you try. Without some therapy
your family will most likely continue on in this way to a
point where you may have to consider crisis intervention.
(b) I think it is important that each of you are clear about
what you expect from therapy. To help clarify some things
I would like Mom and Dad to move and sit next to each
other and I would like all four children to sit together
facing Mom and Dad in a circle so that each child has an
opportunity for some face-to-face contact with Mom and
Dad.
(c) Dad, I think it is important that you and Alyson both know
what it is you want from each other that you are not
getting. I would like you both to share that with each
other now.
(d) Often times, as children grow older, families have
difficulty in knowing how to deal with the new situations
that are created within a family that loves each other.
II.Response Alternatives
(a) Mom, how do you and your husband usually handle the
children when they disrupt discussions at home? Let's
hear from both of you.
(b) I think it is important for us to find out why your
marriage needs to be held together by Alyson's behavior.
(c) You as a family need to decide if you want to go on from
here. Do you want to change the way the family is right
now? I would like to hear from both of you.
(d) Alyson, I'm wondering what it is about your family that
makes you feel uncomfortable at home?
III.Response Alternatives
(a) It seems like everyone here today feels like he is not
being understood or appreciated and you have taken a big
step by coming here today and admitting you have some
problems that need to be worked on.
(b) Dad, it must be very difficult for you to try and
understand Alyson's feelings when she seems so ungrateful
for all you have done for her.


42
variety of content areas (e.g., schizophrenia, depression, suicide,
education and training). Consequently, validity studies have been
generated in these various content areas. In general, however,
Fransella and Bannister (1977) argue that the validity of this
technique has been shown to be acceptable, as the grid has been
demonstrated to discriminate between different diagnostically defined
groups as well as between before and after treatment groups.
The Family Repertory Grid provided data for the first two
components of this investigation (i.e., cognitive complexity and
construct content). A structural analysis of the subjects' ratings
provides measures of cognitive complexity, and a content analysis of
their constructs provides measures of construct abstraction.
Structural grid measures
Cognitive integration. Based on a cluster analysis designed by
Landfield (1971), the family repertory grid ratings result in
ordination scores that are basically an integration measure of the
hierarchical organization of the trainees' system of thoughts about
the family elements. This Landfield analysis also provides chi
square scores that measure integration and level of flexibility in
the use of constructs. These chi square scores measure the extent to
which the personal constructs are arranged into interrelated systems
of constructions. According to Landfield and Schmittdiel (1983), the
chi square score is a more reliable measure of hierarchical potential
than the ordination score.


48
appropriate responses to the dynamics of the family tape that the
subjects have viewed (see Appendices I and J). Within each of the
four response groups, subjects were also required to rank the
confidence level they felt concerning their chosen response on a
scale of 1 to 10 (very unconfident to very confident). These
rankings provide a measurement of perceived confidence across time
for both groups of subjects. Subjects were also required to rank
their four choices from most to least preferred. The most preferred
therapist response was also ranked for confidence level on a scale of
1 to 10. Thus, in addition to measuring whether subjects' confidence
changes across time, it is also possible to measure if their
confidence about their most preferred response changes across time
(see Appendix K).
Two professional structural family therapists in the community
were solicited to evaluate these materials in order to establish
empirical reliability. Both therapists were asked to rank order the
response alternative category from least to most preferred therapist
response. These rankings were correlated between the two therapists,
and between the therapist rankings and the rank ordering generated by
the experimenter using a modified version of Allred's AIAC coding
system. Therapist responses were based on the actual responses
provided by the subjects in the pilot study. For a therapist
response to be chosen, it had to be coded identically by the two
independent judges. In addition, the actual responses were also
evaluated using the procedure just outlined (see Tables 2 and 3 for
reliability coefficients).


CHAPTER I
INTRODUCTION
The past decade has witnessed the growing demand for clinical
and counseling psychology programs, professional psychology programs,
and specialized training programs for mental health and post-doctoral
professionals. Foremost among these is the demand for training in
family therapy which has resulted in the growth of a variety of
family therapy training programs. Despite this increasing demand,
there has been a dearth of research investigating important variables
in the training of family therapists (Woody & Weber, 1984).
The task of investigating the impact of training on potential
family therapists is an ambitious one. The investigator must decide
what type of program to investigate, what theoretical orientation
within the family therapy field to explore, and then, how to go about
isolating the critical variables involved in order that general
statements about training can be made. According to Tucker and
Pinsof (1984), this task is made even more difficult due to the
complexity of measuring conceptual, experiential, and behavioral
learning in a stimulus situation that is never duplicated. In
addition to the problem of not having a standard stimulus, the family
therapy field has also lacked the necessary instruments to measure
conceptual and behavioral skills (Gurman & Kniskern, 1978).
1


24
family influenced the way in which trainees revised their executive
skills when responding to a family.
A major problem with this approach is the unreliability
contributed by the judges. This approach is also weakened by the
difficulty in scoring and the lack of standardization. As Breunlin
et al. (1983) point out, a multiple choice format in which subjects
choose an alternative in response to a simulated videotape
constitutes a reasonable compromise in that it can reliably measure
therapist skills within a standardized and easily scorable
methodology. The present study will use a Breunlin et al. (1983)
paradigm, combined with a modified version of the AIAC, to assess and
compare the executive skills of family therapy trainees and
individual therapy trainees.
After reviewing this literature, it becomes clear that the
research in family therapy training is only beginning to contribute a
firm empirical grounding for the exploration and assessment of the
effectiveness of family therapy training. In order to provide a
comprehensive literature capable of integrating the disparate
findings, there needs to be a unified methodology that allows for
comparison across the different established training programs as well
as across the varying theoretical orientations. In addition, this
methodology must include comparative measures of family and nonfamily
therapy trainees. If there is no difference between individual
therapy experience and family therapy experience in producing
effective family therapists, then the skills proposed for family
therapy need to be reevaluated. The present study suggests the use


APPENDIX D
GRID CONTENT CODING INSTRUMENTS
A content coding column is located next to your descriptions.
For each of the 15 descriptions, please code your descriptions in one
of the following ways:
1. Physical Characteristics
Examples:
has 4 children
lives in New York
single parent
Catholic
children are girls
divorced
black
member of family
nuclear family
middle-class
mother is deceased
2. Role Functions
Examples:
mother is a housewife
problem child
father is breadwinner
son is a college student
mother dominates
traditional roles
father is a doctor
3. Personality Characteristics
Examples:
warm
intelligent
religious
artificial
4. Interactional Patterns
values education
trusting
sensitive
Examples:
stable
supportive
independent
happy family
likes to have a good time
flexible
marital problems
do things together
outgoing
unsociable
99


36
group. It is expected that the control group will remain at
consistent levels at pre- and posttesting.
The third component of this study will investigate trainees'
conceptual skills in three major areas. These areas include a
conceptualization of the family, a conceptualization of the
intervention, and a systemic dimension (e.g., focusing on an
individual vs. the entire system). Subjects will be required to
answer eight multiple choice questions that reflect these three areas
of interest. Based on the construction corollary, Kelly (1955)
stated that a person's anticipations are a matter of ascribing
certain recurrent "themas" as he successively construes events. This
logic suggests that recurrent themas for family dynamics are learned
in training. Further, personal construct psychology suggests that
training should lead to more successful prediction of the experience
of the family in treatment, as well as creating shared meanings among
family therapists. Case conceptualization analyses will indicate if
the family therapy trainees are capable of conceptualizing family
dynamics, predicting family behaviors, prescribing treatment, and
describing these constructions of families using the shared meanings
of structural family therapists. It is hypothesized that these
conceptual skills will increase for the family therapy trainees, and
remain stable across time for the nonfamily therapy trainees.
One of the most important skills of family therapists involves
executive skills. The family therapist must be capable of
translating perceptual and conceptual skills into active behavior
that will expedia te change in the family rather than result in a


77
results of the family intervention measures revealed no significant
differences between the two training groups and no significant
difference across time. The mean level of responses suggests that
both groups focused on subgroup relationships when conceptualizing an
intervention strategy.
The results of the family conceptualization measures revealed a
trend toward a main effect of Time, suggesting that both groups of
subjects had a tendency to use slightly lower levels of conceptual
skills at posttesting. There are several possible explanations for
these findings. First, it is possible that the nature of the task
biased the subjects to focus on family dynamics. Subjects were
instructed to select case conceptualization response alternatives
that best reflected how they perceived the dynamics that were
important in the family. By instructing subjects to focus on family
dynamics, it is not surprising that subjects did just that,
regardless of their training orientation.
A second explanation may involve the instrument itself. This
instrument may not be sensitive enough to detect subtle changes, in
part, because asking subjects to select their conceptualization of a
segment of behavioral data is only a partial evaluation of conceptual
skills. Such an evaluation may not predict how a trainee would
conceptualize family dynamics if actually in a similar clinical
situation. Since this measure is a compromise in that it can be
reliable, valid and standardized, it is important that it be made as
reliable and valid as possible. Future research needs to establish
such reliability and validity in their family therapy skills


137
6. In summarizing the information gathered from this family, which
of the following might a therapist consider first in planning
treatment?
a. Emotionally charged issues are diverted through the family's
focus on Alyson, thus maintaining a family rule that the
family should always be friends with each other and confide
in each other. The parents and siblings are circumventing
family sharing by focusing on Alyson's "unfriendliness" thus
getting themselves off the hook. Thus, this family needs to
be taught some fair fighting skills in order that conflict
be resolved openly.
b. Alyson appears to be caught in the middle of the conflict
between Mom and Dad, which she attempts to resolve by
subjugating her own needs in a rebellious manner that takes
the focus off Mom and Dad. Thus, Alyson needs to be
relieved of the central role in this family.
c. Mother and Jessica's withdrawn style, in combination with
Craig's and Alyson's more disruptive behavior, suggests that
this family has only two rigid modes of interaction
involving either overt aggression or silent aggression.
Thus, the children in this family need to have parental
attention shared more evenly among them so they can learn
more adaptive styles of interpersonal communication.
d. Mom and Dad have not learned how to parent older children,
resulting in their rigid adherence to old family rules that
no longer work for Alyson, such that she must rebel against
the family in order to separate from them in a normal
growing process. Thus, Mom and Dad need help in learning
how to accept the changes that occur as their children grow
older, as well as some new parenting skills.
7. What immediate goals might be described for this family?
a. Therapy should focus on helping the four children become
more accepting and supportive of each other so that Mom and
Dad will no longer have to take the roles of referee for
them.
b. Individual therapy for Alyson should focus on her feelings
of insecurity as well as her feelings of responsibility and
guilt toward her family. This would allow Alyson to
separate from the family in a normal growth process, also
setting an example for the family to follow for the other
chi 1 dren.
c. Therapy should focus on moving the attention away from
Alyson to the other children, freeing Alyson to pursue her
normal developmental tasks while also preventing her from
masking family conflicts so that all the family members have
an opportunity to learn to openly communicate their needs to
each other.


54
Upon completion of this task, subjects were administered the
family repertory grid. This task consists of a structured interview
in which subjects systematically compare and contrast various
families to determine dimensions representative of their evaluations
of family dynamics (see Appendix R for a complete description of
administration). The administration of this family repertory grid
involves the experimenter asking the subject to give names to role
titles (e.g., the name of the family you grew up in, the name of a
happy family, etc.). The subjects are then presented with three of
these elements and asked to specify "some important way in which two
of the families are alike in some way and yet different from the
third family." After they respond with how two of the elements are
alike, they are required to "give a word or short phrase that
describes how the third family is different from the other two."
Following the elicitation of the constructs, subjects are required to
rate each pole of the construct as either positive or negative. The
experimenter then takes these descriptions and uses them as end
points on a 7-point Likert type scale (e.g., Happy +3, +2, +1, 0, -1,
-2, -3 Sad). Subjects then use these construct dimensions to rate
all ten families across each of the 15 construct dimensions.
After the administration of the family repertory grid, subjects
were told that they would be contacted in approximately 10 weeks for
another two-hour session. The second session involved the same
procedure as the first session, with the exception that all subjects
viewed a different simulated family therapy videotape. The
presentation of the therapy tapes were counterbalanced to reduce


108
Mrs. Williams
Therapist knows about Mrs. Williams:
1. Mrs. Williams believes that parents should be best friends with
their children.
2. She thinks she is good friends with her daughter but at the
moment not with her son.
3. Mrs. Williams joins in her children's parties and becomes very
friendly and open with their friends. She often consults her
son's friends about his problems.
4. Mrs. Williams complains that her children won't listen to her
when she asks them to do something. Ian is the worst in this
respect.
Information to be given to therapist:
1. Mrs. Williams is upset that the children listen to their father
but they won't obey her.
2. She doesn't want to use punishment and force them to obey. Mrs.
Williams wants the children to obey her because they love her and
care for her, not because she forces them to obey.
3. Father controls kids through fear and Mrs. Williams refuses to do
the same.
4. Ian is like his father: "He doesn't listen to me, he ignores me,
he is rude to me and he mocks me" (can expand on how much husband
angers you if asked; telephone battles).
5. Everyone takes advantage of me because I'm such a nice person.
6. Insists Ian is the problem; he needs individual therapy to solve
his problem.
Actions:
1. Monopolizes the conversation.
2. When questions are directed to children, Mrs. Williams often
responds for them.
3. Mrs. Williams is very friendly, outgoing and initially smiling.
4. She becomes sad and obviously depressed as the topic of her
children disobeying and taking advantage of her good nature is
introduced: "They don't love me or care about me; if you did you
would prove it to me by being good."


115
(c) It seems that the members in this family are afraid to
share warm tender feelings for each other and so keep each
other at arm's distance by fighting with each other. I
wonder what would happen if you expressed positive
feelings toward each other?
(d) It seems that the members in this family have an invisible
wall around them so that you are focused only on your
feelings and are unable to really listen to each other.
Interval III
3. Dad: What do you advise we do?
I. Response Alternatives
(a) First, I would like to see you and mom sitting next to
each other rather than separated by your children. I
would like you to face your children and discuss together
what the two of you expect of your children. When you
have reached an agreement, I would like you to share those
expectations with your children and find out whether they
feel those expectations are agreeable.
(b) When a family such as yours is in conflict they tend to
place the blame on one family member. However, it has
been my experience that all the family members either
contribute to or maintain the problem.
(c) I think your family needs to continue on in therapy so you
may explore some positive ways of expressing your feelings
and needs to each other. I would like each of you to
state what your needs are that are not being met and how
you feel the family might help you meet these needs.
(d) I suggest that you both learn some new parenting skills as
you are obviously having a difficult time having to deal
with older children.
11. Response Alternatives
(a) Dad, I would like to know if the other children interrupt
you this often at home when you and Mom are trying to
discuss things together.
(b) I'd like to know how long this family has been fighting
like this and when each of you think these changes began
to occur. I'd like to hear from each of you separately
while the others listen.
(c) I think you should stop focusing all your attention on
Alyson, and start giving some attention to your other


ACKNOWLEDGMENTS
I would like to take this opportunity to acknowledge and thank
those individuals who have given their encouragement and guidance
throughout the completion of my dissertation. Drs. Harry Grater and
Greg Neimeyer, the chairpersons of my committee, have guided and
directed this work from its inception to its completion. They have
both been invaluable as sounding boards, as well as being my
friends. Harry and Greg's commitments to excellence and
professionalism have been important models during my years as a
graduate student. Their enthusiasm and flexibility in support of my
basic ideas, and cooperation over the many years and miles are
greatly appreciated. I would also like to thank the members of my
committee, Bill Fronting, Carolyn Tucker, and Robert Jester, for their
effort and insightful suggestions. I have enjoyed and profited from
being a student in their respective courses and seminars. It has
been my pleasure to know these outstanding individuals personally and
professionally.
I would also like to thank all the people who were an integral
part of this dissertation. Drs. Peggy Fong, Mary Fukuyama, Max
Parker, Ellen Amatea, Robert Myrick and Harry Grater allowed me to
utilize their classrooms to solicit subjects. Drs. Herb Steier and
Andres Nazario gave their time and energy on short notice in the aid


158
Michael plan to work in medical and psychiatric facilities,
respectively, as staff psychologists.


89
adequate sample size of both family therapy trainees and control
subjects in order to determine if changes in therapy skills are a
unique function of training in family therapy.
In addition to the above two changes in methodology, future
research may also benefit from taking a longitudinal approach to the
study of family therapy training. It may be that changes in
conceptual and executive skills do not begin to change until the
trainees gain actual clinical experience with families. Future
research will need to investigate this issue of past clinical
experience more closely. Does the amount of past experience with
individual therapy affect how family therapy trainees integrate their
new knowledge? This could be investigated by comparing four groups
of subjects: family therapy trainees with no prior therapy
experience, family therapy trainees with two to five years of prior
therapy epxerience, nonfamily therapy trainees with no prior therapy
experience, and nonfamily therapy trainees with two to five years of
prior therapy experience. It would also be interesting to
investigate the relationship between trainees' own family background
(e.g., only child versus several siblings) and their family
conceptual skills as a function of training in family therapy.
Further, future research may also benefit from taking a slightly
different approach to the study of therapy skills in family therapy
trainees. The present investigation may have biased trainees toward
focusing on family dynamics. According to structural family
therapists (e.g., Minuchin, 1974), one can take a structural systems
approach even when working with an individual. In order to control


32
construct system. The present study will investigate a larger sample
of the constructs in the training subsystem in order to evaluate the
hypothesis of increased abstraction over the course of training.
Kelly's Rep Grid methodology has only recently been applied to
the area of family therapy training. Lewis (1977) conducted a study
of family therapy trainee's perceptual and conceptual abilities
before and after a twelve-hour structural family therapy workshop.
Basically, Lewis examined how trainees structured their thoughts
about families and the type of constructs that they used when
thinking about families. This study examined both the structural and
content changes of family therapy trainees. Lewis used a structural
measure devised by Landfield (1971) called ordination. Ordination is
a measure of the hierarchical organization of the trainees system of
thoughts about the elements under investigation (e.g., families).
Lewis also employed a measure called the functional independence of
constructs (Landfield, 1971) that measures the degree of uniqueness
between family constructs, along with Bonarius* (1970) measure of the
meaningfulness of the constructs to the individual. The results
showed a significant change from pre- to posttraining, indicating
that the structure of the trainees' thoughts about families had
become more cognitively complex. Further, a content analysis of the
trainee's family constructs revealed that a significant number of
trainees increased their use of interactional family constructs.
Interactional constructs were considered to be the most abstract in
the family construct subsystem as they impart more information about


106
Actions:
1. When asked something often replies "i don't know"; seems confused
and lost.
2. Or he doesn't answer.
3. Replies "yes" or "no" to questions.
4. Quiet, introspective.
Matthew
Therapist knows about Matthew:
1. Clown of family.
2. Gets everyone to laugh, fools around.
3. Obstinate: when asked to stop doing something will slowly
respond and shortly afterwards will do the same thing.
Actions:
1. Like sister Alyson.
2. Mother's boy: sits on or around her.
3. Acts shy at times.
General for children
Children bicker with and tease each other when parents are talking.
This is their form of resistance.


40
Table 1. Mean Family Therapy Experience Scores for Experimental and
Control Subjects
Group
N
Courses
Taken
Workshops
Attended
Books
Read
Articles
Read
Family
Therapy
Super-
vi sed
Therapy
Experimental
12
1.82
1.36
2.09
2.00
2.00
1.82
(.78)*
(.67)
(1.22)
(.45)
(.63)
(.40)
Control
21
1.90
1.57
1.62
2.24
1.29
1.24
(.83)
(1.16)
(1.20)
(.89)
(.40)
(.44)
* Numbers in parentheses are standard deviations.
Family Repertory Grid
The Family Repertory Grid (Connors, 1984) is a modified version
of Kelly's Role Construct Repertory Grid (Rep Grid), originally
devised as a measure of different aspects of the structure and
content of individuals' personal cognitive systems. When using this
personal construct methodology, elements are selected that represent
the cognitive constructs that are to be investigated. The elements
chosen for the present study were family role titles adopted from
Connor's (1984) Family Repertory Grid. These elements have been
designed to represent various types of families that are familiar to
most individuals (e.g., the family you grew up in; a happy family; a
single parent family). The present study is based on the minimum
context card form in which the subjects are required to give names to
ten preselected elements (i.e., family role titles), and then write


124
what their needs are, resulting in all the focus being
placed on Ian in order to avoid dealing with the major
conflicts your family is experiencing. I wonder what
would happen if I removed Ian from his central position in
the family.
(d) It seems that there are a lot of things going on here,
some that relate to Ian and some that relate to other
members of the family. It appears that this family is
afraid of hurting each others' feelings through arguing,
and Ian and the family have agreed that he should take the
responsibility for expressing conflict so that the other
members will not feel hurt.
Interval IV
4. Mom: I don't know what to do anymore. Can you please, please
suggest something?
I. Response Alternatives
(a) It seems to me that right now you are stuck and cannot
reach each other even when you try. Without some therapy,
your family will most likely continue on in this way to a
point where you may have to consider crisis intervention.
(b) Yes. I would like you to move your chairs into a close
circle so that you all see each other face-to-face. Then
I would like each of you to share two things that you
really like about the person on your left and then the
person on your right. Let's start with you, Mom.
(c) Mom, I think it is important that you and Ian both know
what it is you want from each other that you are not
getting. I would like you both to share that with us now.
(d) Often times, as children grow older, especially in a
recently divorced family, families have difficulty in
learning how to deal with the new pressures that are
created, even in a family that loves each other.
II. Response Alternatives
(a) Mom, how did you and your ex-husband usually handle the
children when they misbehaved, and how is discipline
different now that you are a single parent? I would also
like to hear from Ian and Dianne.
(b) I think it is important for us to find out why you need to
see Ian and his father in such a negative way.


47
of data collected. Allred's coding system did not prove to be
reliably used by the judges (r = .52 at Time 1 and r = .60 at Time
2), requiring that the data be collapsed across categories for a
composite score for each subject. This composite score simply
reflected what direction subjects were moving toward in terms of
their level of executive skills. Thus, the present study was revised
to both eliminate the unreliability contributed by the judges, and to
provide a greater array of information concerning the executive
skills of the two different training groups.
The revisions for the dissertation study involved providing
subjects with alternative therapist responses to choose from at each
of the four intervals. These responses represent the categories
found to be meaningful in the pilot study. There were four main
categories used for coding therapist responses: Gathers Information,
Supports and Reflects, Interprets and Confronts, and Structural
Realignment. In order to represent each of the main categories, four
alternative therapist responses were generated within each
category. These responses represent a dimension from obstructive to
the most sophisticated response level within that category. For
example, the category of interprets and confronts has four
alternative responses ranging from obstructive = +1, direct
interpretation = +2, strategic interpretation = +3, and confrontive
interpretation = +4 (see Appendix H for a description of the coded
categories). Thus, subjects are required to answer four multiple
choice questions at each of the four intervals. Except for the
obstructive responses, all response alternatives were designed to be


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34
the system. The present study will use both structural and content
analyses of family rep grids in an attempt to examine any changes in
cognitive complexity or level of abstraction as a result of
structural family therapy training.
The Present Study
Kniskern and Gurman (1979) suggest that the assessment of the
outcome of training procedures in family therapy should be made on
several dimensions. First, it is important to assess if the trainee
increases his/her conceptual knowledge of family dynamics and
interaction patterns. The second major area for the assessment of
change involves the trainees' in therapy behavior (i.e., executive
skills). Third, it is important to evaluate if the trainees'
perceptions of families have changed as a function of training. The
present study will address all of these points.
This study is based on a structural training foundation. The
subjects have been divided into two groups: (1) an experimental
group consisting of 12 graduate students in counselor education and
counseling psychology undergoing a 16-week (45 hours) training
program in structural family therapy, and (2) a control group
consisting of 21 graduate students in counselor education and
counseling psychology undergoing individual psychotherapy training.
These control subjects have not taken any graduate courses in family
therapy. Participants in the present study completed (1) a family
therapy experience inventory, (2) a family repertory grid, (3) a
multiple choice questionnaire made up of therapist response


APPENDIX H
THERAPIST RESPONSE CODING SYSTEM
I.STRUCTURAL REALIGNMENT
1. Obstructive
2. Educates
3. Seeks Alternatives
4. Structures the Family Members
II. GATHERS INFORMATION
1. Obstructive
2. Asks for more Information about the Individual
3. Asks for more Information about a Subsystem
Relationship
4. Asks for more Information about System Relationship
III. REFLECTS ANO SUPPORTS
1. Obstructive
2. Reflects
3. Supports
4. Reflects and Supports
IV. INTERPRETS AND CONFRONTS
1. Obstructive
2. Direct Interpretation
3. Strategic Interpretation
4. Confrontive Interpretation
111


62
10.5
10.0
9.5
9.0
8.5
Mean
FIC 8.0
Scores
7.5
7.0
6.5
6.0
5.5
5.0
4.5
4.0
O

experimental
control
TIME TIME
1 2
Figure 1. Interaction for FIC scores


APPENDIX R
FAMILY REP TEST INSTRUCTIONS
1. Number index cards from 1-10.
2. Subjects write families on cards (use each family only once)
1. Family you grew up in
2. Married sibling's family
If none:
a. Relative's family
b. New family
3. Your present family
4. Dual career family (both parents work)
5. Family your mother or father grew up in
6. Happy family
7. Unhappy family
8. Single parent family
9. Family spouse or mate (or ex-mate) grew up in
10.Friend's family
3. Check to make sure each family was used only once.
4. Construct elicitation **(make sure each construct is used only
once)**
a. Say: "Remove (see card groups) and place them in front of
you. From these three families, select the two families who
are most alike in some way and yet different from the
third. Place the two that are alike together and the third,
which is different, away from them. Tell me the word or
short phrase that describes how the two families are
alike. (Write the description under the alike column)
Tell me the word or short phrase that descirbes how the
other family is different from the first two. (Write the
description under the different column)
147


00
Table 9. Therapist Response ANOVA for Reflects and Supports Modal
Response Scores
Source
Sum of Squares
df
Mean Square
F
P
Mean
719.377
1
719.377
487.51
.000
Group
1.195
1
1.195
0.81
.375
Error
45.744
31
1.476
Time
21.001
1
21.001
17.90
.001*
Time x Group
2.576
1
2.576
2.20
.148
Error
36.363
31
1.173
* p<.001
Interprets and confronts
The 2(Group) x 2(Time) analysis of variance revealed no
significant findings for Weighted Average, Modal Response, or Average
Confidence Level.
Structural realignment
The analyses of variance did not reveal any significant findings
for Weighted Average, Modal Response, or Average Confidence Level.
Between Category Analyses
Mode of preferred category response analyses
The analysis of variance revealed no significant findings for
the Modal Preference score. It is interesting to note, however, that


6
primary task for the family to accomplish. If a family is unable to
foster this individuation process, an individual's symptoms and
problems may be reflective of family stress, conflict, or the
internalization of other family breakdowns. Further, the less
effective the family, the more limited the family will be in its
capacity to facilitate the individuation process. The student
requires training that focuses on learning to accurately assess and
develop goals for the family that will alter the family system and
promote the individuation process.
Most importantly, family therapies are problem focused. The
family therapist must be skilled in assessing the function of the
problem for the family and the family system's response to it (e.g.,
enmeshed or disengaged relations, regression, rigidity, or
internal iza ti on).
Although the differing family therapy orientations agree on
these four points, the conceptual orientation of the curriculum will
influence how the problem resolution will be obtained. While some
theories, such as problem-solving, learning, behavioral, and
communication emphasize learning problem-solving skills as a major
objective, other theories, such as structural and strategic
approaches, use indirect, manipulative, and metacommunicative
interventions to induce change for problem resolution (Woody & Weber,
1984). How these goals of therapy are translated into training
remains unclear. Empirical research that investigates the process of
change as well as the outcome of training may be able to overcome the
dilemna of differing programs and theoretical orientations, and


39
Instruments
Family Experience Inventory
Each subject was required to complete a modified version of the
Family Therapy Experience Inventory (FTEI) in order to assess any
contact with family therapy prior to the current family training
seminar (Connors, 1984). This modified inventory provides
information on age, sex, educational level in their graduate program,
and amount of prior counseling experience (see Appendix B). Connors
(1984) originally developed this inventory in order to assess both
the type of prior exposure with family therapy as well as the extent
of that experience. There are three major categories of prior
exposure. The first involves prior training level in family therapy
and is determined by the number of courses taken where there was a
major focus on the "family," as well as any training sessions or
workshops that focused on work with families. The amount of prior
reading in family therapy comprised the second category of reading
(e.g., the number of books or articles read on family therapy). The
third category, experience, consisted of direct experiences with
family therapy, and the number of these cases that were supervised.
Table 1 presents the mean family therapy experience scores for
experimental and control subjects. In the present investigation,
there are no significant differences between the two groups for prior
exposure to some form of family therapy training.


142
taking Dad's role, allowing family conflict to surface so
that it might be dealt with openly and resolved.
b. Marital conflict between Mom and Dad has remained unresolved
through deflecting the focus of the family onto Ian, who has
taken the role as scapegoat in the family in order to
maintain the family's equilibrium. A long range goal for
this family might involve removing Ian from the central
position in the family so that the family would experience
and deal with a family crisis, resulting in a shift of
family member relationships and a more adaptive family
equilibrium.
c. Dianne and Mom have united and joined forces against Ian,
resulting in a split between the two siblings that maintains
the family role that males are impossible and
inconsiderate. A long range goal for this family would be
to remove Dianne from the role of parent and help her get
back into a positive sibling relationship with Ian that
would no longer maintain this stereotype and perception of
males that the family members hold onto so rigidly.
d. All the attention of Mom is focused on Ian, thus preventing
the family from adjusting to the divorce while allowing them
to maintain their rigid style of communication. A long
range goal might involve focusing on the marital
relationship, freeing all the members from holding that
"false" relationship together.


APPENDIX M
CASE CONCEPTUALIZATION QUESTIONS: FAMILY B
1. According to the psychosocial history presented by this family,
it appears that a major difficulty they are encountering
involves?
a. Mom's inability to control or discipline her children now
that their father has left.
b. Marital conflict between Mom and "Dad" that has remained
unresolved since the divorce, and is maintained through
Mom's deflecting her focus onto Ian.
c. The family's difficulties in forming new relationships with
each other now that Dad no longer plays the same role in the
family.
d. Mom's inability to help Ian and Dianne separate from her
emotionally is a function of her dependence on them for
emotional support.
2. Which of the following would be an apt description of the
underlying patterns of this family's interaction?
a. Mom is very involved with and protective of Dianne, giving
them enough power to effectively scapegoat Ian who has taken
Dad's place in the family as the "responsible male."
b. Ian is the scapegoat (i.e., mechanism) that keeps this
family from falling apart. Without him to focus on, the
other family members would have to either select another
member to play his role or become consciously aware of their
conflictual relationships now that Dad is absent.
c. Dianne and Ian are both dealing with their parent's divorce
in different ways. Dianne has withdrawn and is providing
some support for Mom while Ian is acting out and showing
loyalty for Dad. This has resulted in conflict between Ian
and Diane that the family is not sure how to deal with.
d. Ian, with his growing need for independence is not very apt
at expressing those needs in a manner that shows he is
capable of handling more responsibility, resulting in Mom's
refusal to listen to him.
139


65
Table 8. Therapist Response ANOVA for Reflects and Supports Weighted
Average Scores
Source
Sum of Squares
df
Mean Square
F
P
Mean
522.883
1
522.883
1191.76
.000
Group
0.156
1
0.156
0.36
.550
Error
13.601
31
0.439
Time
3.208
1
3.208
9.22
.004*
Time x Group
0.239
1
0.239
0.69
.410
Error
10.792
31
0.348
* p<.001
An analysis of variance also revealed a significant main effect
of Time for Modal Response (see Table 9), F (1,31) = 17.90, p<.001
such that the modal response for both groups at Time 1 was a
sophisticated combination response of reflecting and supporting
(M=4.00), while the modal response for both groups at Time 2 was a
much less sophisticated response involving simple reflection
responses (M=2.94). These results suggest that both groups became
less sophisticated across time. There was no significant difference
in their Average Confidence Level suggesting that they were equally
confident across time.


35
Based on Cleghorn and Levin's (1973) model of family therapy
skills, the present study investigated three major skills associated
with effective family therapy (i.e., perceptual, conceptual and
executive skills). Using Kelly's (1955) Role Repertory Grid measure,
the results of the present investigation revealed changes in
perceptual skills that at first glance appear to be opposite of those
predicted. Measures of cognitive differentiation increased for the
nonfamily therapy trainees and decreased for the family therapy
trainees. This would appear to suggest that training in structural
family therapy has a negative impact on trainees, resulting in
decreased levels of cognitive complexity. However, measures of
cognitive integration revealed that the family therapy trainees were
much more integrated and flexible than the nonfamily therapy
trainees. Taken as a whole, these results suggest that as trainees
begin to learn about family dynamics they form a structural template
that is used as the basis for their family interpretations. It
appears that the family therapy trainees are beginning to see the
commonalities and patterned similarity across the different families,
while the nonfamily therapy trainees continue to view families based
on several different theoretical orientations. Thus, the decrease in
differentiation for the family therapy trainees may be a reflection
of the tightening of the new family construct system, while the
increase in integration reflects their flexibility in the use of
their new constructs. In contrast, the increase in differentiation
for the nonfamily therapy trainees may simply reflect their continued
use of a diversity of therapy constructs, while their lower level of


76
that may be taking place. It must be kept in mind, however, that
family therapy training itself may not lead to higher levels of
family construct abstraction.
Conceptual Skills and Case Conceptualizations
According to Cleghorn and Levin's (1973) model of therapy
skills, conceptual skills involve what the therapist thinks about in
the therapy session and how those thoughts are organized. They argue
that in order to formulate a problem in terms of the family system,
the family therapist must specify the implicit rules of behavior in
the family that make sequences of family interactions predictable.
Although the majority of the studies reported in the literature found
increases in levels of conceptual skills for family therapy trainees,
these studies have been limited by the lack of a comparable control
group (e.g., Breunlin etal., 1983; Friedman, 1971; Lange &
Brinckman, 1976; Lange & Zeegers, 1978; Tom, 1980; Tucker & Pinsof,
1984) and the lack of a reliable, valid and standardized assessment
instrument (e.g., Breunlin et al., 1983; Friedman, 1971; Lange &
Brinckman, 1976).
In the present study, conceptual skill level was measured along
a systemic dimension ranging from an individual focus to a systems
focus. Trainees' conceptual skill level was measured for their
ability to conceptualize intervention dynamics. It was predicted
that the family therapy trainees would show an increase in their
level of family and intervention conceptualization skills while the
nonfamily therapy trainees would remain stable across time. The


APPENDIX Q
CASE CONCEPTUALIZATION ANSWER SHEET
Office Use Only
Subject Name Subj # Family
SS# pre/post exp-er
Sex Age exp/control date
PLEASE CIRCLE YOUR PREFERRED RESPONSE FOR EACH QUESTION
1.
2.
3.
4.
5.
6.
7.
8.
a.
b.
c.
d.
a.
b.
c.
d.
a.
b.
c.
d.
a.
b.
c.
d.
a.
b.
c.
d.
a.
b.
c.
d.
a.
b.
c.
d.
a.
b.
c.
d.
OFFICE USE ONLY
1.
2.
3.
4.
5.
6.
7.
8.
146


72
invalidated so that they may be acted upon. If the family therapy
trainees' family construct system becomes less organized during early
phases of training such that the relationships among the constructs
decrease, then efforts to interpret family behavior would be based on
constructs that are loosely related and lacking meaningful
connections. To explore this hypothesis further, future research
needs to measure the impact of training on therapy skills at
different intervals throughout training and after training.
In addition to looking at levels of cognitive differentiation,
analyses also revealed some significant findings concerning cognitive
integration. The results revealed that the nonfamily therapy
trainees were significantly less integrated in their family
constructs than the family therapy trainees. Further, both groups of
trainees tended to become somewhat less integrated across time
regardless of the form of therapy training engaged in.
The results of the integration measures suggest that the family
therapy trainees are more flexible in their use of their family
construct system than are the nonfamily therapy trainees. However,
this does not appear to be a unique function of training in
structural family therapy. Although the family trainees appear to
have fewer constructs available for perceiving families than the
nonfamily therapy trainees, it may be that they are more invested in
tightening their family construct system in an attempt to make the
constructs more meaningful. Further, it is interesting that both
groups of trainees had a tendency to become somewhat less integrated


120
III. Response Alternatives
(a) Mom, it sounds like you feel frustrated and confused about
what is happening in your family.
(b) Mom, it sounds like you are feeling very frustrated about
what to do and you seem to be carrying a lot of
responsibility on your shoulders. I imagine that you
might feel very alone with this burden. Let's work
together so all of you are happy and comfortable with each
other.
(c) Mom, it sounds like you really feel guilty inside for
causing your children grief through the divorce.
(d) It's OK for you to feel frustrated and upset. What we
need to do is work together and find a way for you to feel
happier about each other.
IV. Response Alternatives
(a) It appears that Ian is the spokesman for this family's
anger and I'm wondering what the soft voices of Mom and
Dianne are covering up in the family.
(b) It seems like there is a lot of anger here in this family
that people are afraid to show.
(c) You seem like a very close and loving family and I wonder
what you fear would happen if you expressed that love for
each other.
(d) Mom, it sounds like you don't like your ex-husband or Ian
very much.
Interval II
2. Mom: I don't know what to do. What do you think?
I. Response Alternatives
(a) It is important for parents to realize that it is normal
for teenagers Ian's age to spend a great deal of time with
their friends and less time with their family. It does
not imply that they love their family less, but it is a
time of growth independently from the family.
(b) Mom, I think you need to stop blaming Ian for wanting his
freedom rather than spending time keeping you company so
you don't get lonely.
(c) First, I would like Mom to change seats with Dianne so
that Mom is sitting between both children and Mom and Ian
are not separated by Dianne. Then I would like Ian and
Dianne to discuss what they expect of each other and Mom


30
Executive Skills Within Category
Gathers information
Contrary to expectations, there were no significant differences
between the two groups for level of executive skill within this
category of therapist responses. Both groups of subjects were able
to ask for information about subsystem relationships regardless of
their theoretical orientation (i.e., systems versus intrapsychic).
This lack of significant findings suggests that these executive
skills may not be a unique function of training in family therapy.
If basic therapy skills, such as information gathering, can be
adapted to use with families, then it will be important for future
research to explore which therapy skills cannot make that transition
without additional training in family therapy. The question that
continues to concern the field revolves around what skills are unique
to family therapy.
Reflects and supports
The results of these analyses of the Weighted Average scores and
the Modal Response scores were also contrary to expectations. Both
groups of therapy trainees showed a significantly higher frequency of
supportive responses at Time 1, which shifted to a significantly
higher frequency of less sophisticated reflective responses at
Time 2. A possible interpretation of these results may be that as
the family therapy trainees attempt to make sense of their new family
construct system, and the nonfamily therapy trainees attempt to


109
5. Challenges the therapist to fix her children.
6. She has very low self-esteem and is afraid that the therapist
will blame her for the family problems. Her defense is to direct
the attention to her son's problems and to blame him.
7. She attempts to avoid discussions of her problems.
Ian
Therapist knows about Ian:
1. Ian is very bright in school (mother harps on the fact that Ian
is so intelligent that he can outsmart and manipulate anyone).
2. Ian thinks that he is blamed for everything and that he is not
being treated fairly.
3. Ian thinks that his mother asks too much of him and that her
requests are unreasonable.
Information to be given to therapist:
1. Mother asked him to help with spring cleaning on Saturday when he
had made previous plans to go to a movie with friends. Then she
got angry and told him that he didn't care about her or his
si ster.
2. Feels that he has to defend his rights. His sister enters his
room without this permission and uses his stereo: she has broken
it before. Now he has set his room off-limits and when she
refuses to listen, he pushes her around. However, mother defends
sister and yells at him for getting angry.
3. Ian feels ganged-up by mother and sister (has to defend his
position of male of the house).
4. Mother always complains about father and says mean things about
him: "She always questions us about what Dad says, does, etc."
Actions:
1. At first, is quiet and unresponsive while Mrs. Williams speaks.
2. When questioned, is willing and wanting to air his complaints.
3. Questions that are directed to sister he will answer for her or
make a comment about how she is spoiled.
4. His mood is a mixture of anger and frustration over the injustice
that he thinks he is suffering.


97
4. Number of family therapy books you have read.
0 2-3
1 4-6 7 or more
5. Number of family therapy articles you have read.
0 6-10
1-5 11 or more
6. Direct experience with family therapy (sessions where you and/or
others worked with more than one person in a family unit about
their mutual problems).
How many different families?
0 11-50
1-10 more than 50
7. How many of these cases were supervised?
0 11-30
1-10 31-50 more than 50
Do you wish feedback on your participation in this study?


APPENDIX E
GRID CONTENT EXAMPLES
Before rating your own descriptions, we would like you to get a
feel for it by rating the following 5 descriptions using these 4
categories.
1. many children / no children
2. caring / cold and insensitive
3. father is a lawyer / father is a blue collar worker
4. sociable and friendly / rarely do things together
5. kind and giving / intelligent
Now we would like you to go back and rate your family descriptions.
In order to make sure that you fully understand how to use this
rating system, we have a few more examples that we would like you to
rate using these 4 categories:
physical; role; personality; interactional
1. critical / accepting
2. permissive parents / stern parents
3. small family / large family
4. first marriage / second marriage
5. father is spokesman for family /
mothers speaks for the family
Now we would like you to go back and rate your family descriptions.
101


100
If you find that your alike description and your different
description fall under separate categories, please make your decision
based on the alike description.
Please turn to the next page for a practice trial.


136
3.What function does the presenting problem(s) serve in this family
system?
a. Dad's distant and peripheral role in the family is
challenged by Mom and Alyson's conflicts which draws Dad in
closer to the family.
b. Alyson's role as the scapegoat in the family is used by her
as a shield for the other children in order to redirect
conflict away from them and on to herself as a diversion
from the marital difficulties not being dealt with in this
family.
c. Mom's headaches and other somatic complaints allow her to
vent her unresolved anger at Dad for not meeting her
intimacy needs while also allowing her to both deny that
anger and manipulate Dad to take care of her.
d. The children in this family have more power than the
parents, which they use to redirect conflict away from the
marital system to themselves in order to maintain an even
homeostasis in the family.
4.On what information would you base your immediate and long-term
goals?
a. This family's difficulty in adapting to change (i.e.,
children growing older) suggests a fairly rigid style of
communication that must be opened up for therapeutic change
to take place.
b. Mom and Dad's inability to express anger toward each other
through open communication has resulted in their focusing
their anger toward Alyson while ignoring other family
confl icts.
c. With the family's focus resting on Alyson, the other
children are suffering from a lack of attention and support,
resulting in their inappropriate (e.g., hitting each other)
and misguided attempts at gaining some individualized
parenting.
d. Alyson's anger and hostility, as evidenced by her
intermittent withdrawal from the family and her verbally and
physically abusing her sister, needs to be dealt with
immediately.
5.The major problem(s) presented by this family that you would want
to work with immediately basically revolves around:
a. Mom and Dad
b. Alyson
c. The parents and their children
d. Alyson and her siblings


APPENDIX O
FAMILY A DYNAMICS SEEN BY SUBJECTS
The Jeffreys Family (A)
Upper middle class family
Father
Gordon
Age
50 -
manager of small publishing company
Mother
Joan
46 -
housewife
Children
Alyson
17 -
student
Jessica
16 -
student
Cra i g
14 -
student
Ma tthew
10 -
student
Presenting problems (reported by mother over the phone)
1. Parents report that Alyson, the eldest daughter, is exhibiting
unpredictable behavior that has disrupted the family.
2. She erupts in sudden violent fits, screams and yells at siblings
and sometimes has physical fights with her sister, Jessica.
3. Other times, she is silent and withdrawn from the family.
Parents label her pouting "silent contempt."
4. Parents do not approve of Alyson's friends and feel they are a
bad influence on her.
5. Alyson's parents complain that she spends most of her time with
her peer group, away from the family.
144


37
deterioration in family behavior and interactions. The present study
will investigate whether structural training aids in increasing these
executive skills through the use of a set of family therapy
videotapes consisting of 20-minute simulations of family therapy
sessions in which the viewer is oriented as the therapist. The
sessions is halted periodically, and participants are asked to select
a preferred response as primary therapist to the family. Measures of
response effectiveness will be obtained by coding these responses
according to a modified version of the Allred Family Interaction
Scale. It is hypothesized that there will be an increase in family
therapy trainee executive skills as compared to the control group.
Each dependent measure will involve a 2(Group) x 2(Time) mixed
factorial design. The results of these analyses will test the
predictions that, compared to controls, trainees will become more
complex (differentiated and integrated) and systemic in
conceptualizing family dynamics, and more effective in therapeutic
responding to simulated cases. Such findings would suggest that
training in structural family therapy influences both the quality and
effectiveness of therapeutic interventions in a manner consistent
with the objective of the training program.
In summary, this dissertation will investigate family therapy
training by the personal construct methodology. There has been a
dearth of empirical research in this area, with most studies being
either descriptive in nature or lacking empirical rigor and
sophistication. The present study provides a sounder empirical basis
for investigating the training of family therapists.


17
the assessment of training in family therapy. According to their
model, therapist skills may be classified into three groups:
perceptual, conceptual, and executive. Perceptual skills refer to
what the therapist observes in the therapy session, how the therapist
perceives interactions, and the meaning and effect of them on family
members and the family system. Conceptual skills basically involve
what the therapist thinks about in the therapy session and how those
thoughts are organized. Cleghorn and Levin argue that in order to
formulate a problem in terms of the family system, one must specify
the implicit rules of behavior in the family that make sequences of
family interactions predictable. In addition to the perceptual and
conceptual skills required of the family therapist, he/she must also
develop skills that influence the family to demonstrate the way it
functions. Cleghorn and Levin have labeled these skills as executive
skills. Executive skills involve what the therapist says and does in
the therapy session in order to influence the family's sequences of
transactions and thus alter the way the family functions. The
present study will attempt to assess the process of change in these
three skills delineated by Cleghorn and Levin (1973).
This descriptive model proposed by Cleghorn and Levin (1973) has
yet to be empirically tested, although several articles on family
therapy training have based their discussions on this model (e.g.,
Barton & Alexander, 1977; Woody & Weber, 1984). Although the current
trend is to objectify the skills of family therapy trainees, the
majority of the family therapy training literature continues to be
based on an impressionistic perspective (Tomm, 1980). For example, a


11
Neimeyer, 1981). This theory has also been applied to various
training contexts, including training in social work (e.g., Lifshitz,
1974), education (e.g., Ryle & Breen, 1974) and marriage and family
therapy (e.g., Lewis, 1977; G.J. Neimeyer, 1985; Neimeyer & Hudson,
1984; Procter, 1981).
According to personal construct theory, individuals operate as
"personal scientists" whose aim is to render experience meaningful;
to better understand, predict and control the events with which they
are confronted. After repeated experience with a particular type of
event, an individual abstracts salient commonalities and
characteristics of these situations. The abstracted features are
meaningful only in relation to their opposites. For example, after
several family therapy sessions, a family therapist may come to see
certain families as enmeshed, a quality meaningful insofar as it
contrasts with being disengaged. This personal dimension, or
construct of "enmeshed-disengaged" serves as a continuum along which
events (i.e., families) can be ordered, thereby lending structure and
meaning to the family therapy experience. Taken together, many such
dimensions form the construct system, a unique conceptual template
for ordering and anticipating experience.
Importantly, this system of dimensions is ordered (Organization
Corollary, Kelly, 1955) and undergoes characteristic shifts over the
course of personal and professional development (see Crockett, 1982,
for a review). In particular, following Werner (1955), it can be
assumed that construct systems develop from a stage of globality to
particularity; that is, moving from simple to complex levels of


128
IV.
a.
b.
c.
d.
10
no
mild
some
moderate
very
We would like you to look at the 4 therapist response alternatives
that you have chosen for working with this family.
Please rank these 4 responses in order of preference from the most
preferred to the least preferred therapist response for working with
this family (most preferred = 1, somewhat preferred = 2, slightly
preferred = 3, least preferred = 4). This ranking should be based on
your preferences as primary therapist working with this family.
I.
II.
III.
IV.
After you have ranked your 4 therapist responses from most to least
preferred, on a scale of 1 to 10, how confident do you feel about
your most preferred response? Please circle a number on the scale.
123456789 10
J I I I I I I I I 1
no mild some moderate very
PLEASE STOP DO NOT TURN PAGE
THANK YOU


8
supervision vary from a focus almost exclusively on the problems of
the family being treated to a focus almost entirely on the trainee
independent of the family being treated, to the therapist's
relationship with the family. Thus, the techniques utilized by the
supervisor, as well as his or her style of supervision, are
influenced by both the theoretical and therapeutic orientation
(Kniskern & Gurman, 1979). For example, a directive and problem-
oriented therapist would probably supervise in a direct, problem-
oriented way, while a process-oriented therapist would be more
concerned with the personal growth of the trainee. Although no study
has investigated this impact of training, Kniskern and Gurman (1979)
suggest that such stylistic differences in supervision will tend to
result in differences in therapeutic style by the trainees. Thus,
when interpreting shifts across training, it is necessary to keep the
supervision style in mind. The supervision style utilized in the
present study is based on a structural problem-solving approach to
family therapy.
The observational component involves having the trainees view
tapes of family therapists in action, viewing in vivo family therapy
sessions through a one-way mirror, and viewing role-play interviews
of other family therapy trainees. As with the supervision style,
what is observed is influenced by the style and theoretical
orientation of the trainer.
The fourth mode of therapy training is classified as
experiential. Experiential methods may involve role-playing,
participating in a simulated family, or actually working with a


I certify that I have read this study and that in my opinion it
conforms to acceptable standards of scholarly presentation and is
fully adequate, in scope and quality, as a dissertation for the
degree of Doctor of Philosophy.
This dissertation was submitted to the Graduate Faculty of the
Department of Psychology in the College of Liberal Arts and Sciences
and to the Graduate School and was accepted as partial fulfillment of
the requirements for the degree of Doctor of Philosophy.
August, 1985
Dean, Graduate School


APPENDIX N
INFORMED CONSENT FOR FAMILY THERAPIST'S PROJECT
We are interested in studying the training of family therapists
and we need your help. Specifically, we would like approximately
four hours of your time: two hours at the beginning of the semester
and two hours at the end. During this time you will be asked to view
some videotapes of family interactions and to give us your
reactions. In addition, you would complete some brief questionnaires
and a structural interview concerning your experience with various
families.
Participation is scheduled at your convenience.
As you can see, the project is an ambitious one which we hope
will address several critical questions regarding the effective
training of family therapists. But we are also aware that it should
have some personal meaning or benefit to you as a participant:
Therefore we have designed tasks (especially the videotapes and
family exploration interview) which are personally and professionally
involving; which enable you to reflect on information relevant to a
family therapist. We are also willing to arrange to give you
personal feedback concerning your participation at the end of the
semester.
All information will be kept strictly confidential within the
legal limits of the law. Please free free to ask any questions that
you may have.
I understand the nature of the research as described to me above
and I agree to participate with the knowledge that I may withdraw my
participation at any time without prejudice.
signature of participant
Mora Zaken-reenberg reg J. Neimeyer, Ph.D.
Principal Investigator Supervisor
143


116
children as they are obviously more disturbed than is
Alyson.
(d) I'd like to know how long this family has been fighting
like this and when each of you think these changes began
to occur. I'd like to hear from Mom first and then Dad.
III. Response Alternatives
(a) Although there has been a lot of arguing going on, it
seems that you are each concerned about the other members
of the family. What we need to do is work together to
find a way for you to express these concerns without
having to argue.
(b) It sounds like you are both confused about what is
happening and what you can do and this is not unusual in
families with teenagers. What we need to do is work
together to find a way for you to express these concerns
in such a way that all of you are satisfied.
(c) Alyson mentioned that Mom gets frequent headaches and
appears depressed and it sounds to me as though Alyson is
concerned about what is going on with Mom.
(d) Dad, it sounds like you feel really disappointed that
Alyson is not living up to your expectations.
IV. Response Alternatives
(a) First, I really feel that you, Dad and Mom, are ganging up
on Alyson and not listening to her so that I think therapy
needs to focus on teaching both of you fair parenting.
(b) It seems that here are a lot of things going on here, some
that relate to Alyson and some that relate to other
members of the family. But for some reason, the family
has agreed that Alyson should shoulder the responsibility
for the conflict experienced in the family.
(c) It seems that there is a lot of avoidance in this family,
such that no one is willing to share how they feel and
what their needs are, resulting in all the focus being
placed on Alyson in order to avoid dealing with the major
conflicts your family is experiencing. I wonder what
would happen if I removed Alyson from her central position
in the family.
(d) It seems that there are a lot of things going on here,
some that relate to Alyson and some that relate to other
members of the family. It appears that this family is
afraid of hurting each others' feelings through arguing,
and Alyson and the family have agreed that she should take
the responsibility for expressing conflict so that the
other members will not feel hurt.


50
Case Conceptualizations
The reliabilities for the case conceptualization pilot data
were, at best, marginal (range = .12 to .67). Therefore, this
component of the dissertation was revised to exclude the use of
judges. Based on the pilot data, it was determined that there were
three major areas of information that were not being adequately
tapped. These areas include a conceptualization of the family, a
conceptualization of the intervention, and a systemic dimension
(e.g., focusing on an individual versus the entire system). Rather
than have subjects simply write their impressions of the family
dynamics, subjects were required to answer eight multiple choice
questions that reflect these three areas of interest. Each question
was provided with four alternative choices ranging from individual,
dyad, subgroup, and system. Four of the questions target the
conceptualization of the family and four of the questions target the
conceptualization of the intervention with the family. Each of the
response alternatives is appropriate to the dynamics of the family
videotapes (see Appendices L and M for a description of the response
alternatives). Again, two structural family therapists evaluated
these questions and response alternatives in terms of the
appropriateness of the responses as well as whether they accurately
reflect the systemic dimensions they have been constructed to reflect
(see Tables 4 and 5 for reliability coefficients).


57
subject was also assigned a score based on their modal response
category.
Case Conceptualization Analyses
Therapist conceptual skills were evaluated along a systemic
dimension. Subjects were required to respond to eight multiple
choice questions which were provided with four alternative choices
ranging from individual, dyad, subgroup and system. Four of the
questions targeted the conceptualization of the family and four of
the questions targeted the conceptualization of the intervention with
the family. This design provides for two categories (family
conceptualization and family intervention) that are analyzed
separately for the following dependent measures: Weighted Average
and Modal Response. The Weighted Average is an overall average of
systemic response level obtained by totaling a subjects' coded
ratings and then dividing the total by the number of questions within
a category. The Modal Response represents that response level used
most frequently within each category.
Therapist Response Analyses
Each subject responded to the videotape with multiple choice
questions at four separate intervals. For each interval, the four
multiple choice questions reflected a modified classification system
designed by Allred and Kersey (1977). The four categories selected
were found to be the most meaningful of Allred's system based on the
pilot investigation. The four categories reflected by the questions


12
cognitive differentiation over the course of continued experience.
In general, this reasoning is consistent with Bieri's definition of
complexity as "the tendency to construe social behavior in a
multidimensional way such that a cognitively complex individual has
available a more versatile system for perceiving the behavior of
others than does a less complex person" (1955, p. 14). Following
from this definition, subsequent work has noted predicted changes in
cognitive complexity over the course of professional development.
For example, two studies have reported a curvilinear relationship
between cognitive complexity and level of training for teachers
(Runkel & Damrin, 1961) and social workers (Ryle & Breen, 1974).
Training seemed to first restrict, and then to enlarge, the subjects'
cognitive systems. Subsequent work has addressed the relationship
between this level of cognitive complexity and therapeutic decision
making among a group of social work students (Duehn & Procter,
1974). These investigators reported that the more complex students
specified a greater number of alternative therapeutic interventions,
suggesting that greater complexity may be associated with greater
flexibility in responding.
In addition to structural changes in cognitive complexity
associated with training, shifts in the content of the constructs are
also predictable from personal construct theory. For example,
Lifshitz (1974) compared the content of social work students'
constructs with those of their supervisors. Results indicated that
students used more concrete descriptions (e.g., age, sex, profession)


90
for biasing subject responses simply by being in a family therapy
project, future research can use a crossed design such that subjects
are required to view an individual as well as a family on cape in
order to measure conceptual and executive skills. It would be
expected that control subjects would not take a systems view of the
individual, while the family therapy trainees may begin to
conceptualize and respond to an individual along a more systemically
oriented dimension.
If the field of family therapy training is going to claim that
it has a unique impact on the family therapy skills of its trainees,
then future research must not ignore the proven, traditional
methodological approaches (Gurman, 1983). According to London and
Klerman (1982), the basic principles of empirical investigation are
measurability and replicibi1ity. As the area of family therapy moves
toward traditional methodological investigation, the area of training
in family therapy must also make this move toward controlled
comparative investigation.


38
measure their results may have been biased toward the logical
expectation that trainees' responses would become more complex after
training. Further, this study did not employ a comparable control
group. In the Tucker and Pinsof (1984) investigation, the authors
reported the use of a measure found to reliably discriminate between
the family therapy skills of beginning and advanced family
therapists. However, they did not employ any control group and,
consequently, it is difficult to attribute their results to the
specific effects of training in family therapy. Future research must
combine these two aspects of empirical investigation, namely, the use
of a reliable measurement and experimental control.
While the present investigation attempted to control for these
two major limitations, the instruments used may not have been
sensitive enough to detect subtle changes. The reliabilities for the
therapist response executive skill measure ranged from .45 to .76,
while the reliabilities for the conceptual skill measure only ranged
from .33 to .69. These two instruments need to be revised and
reliabilities increased before they can be expected to reliably
measure changes in therapy skill level. A second limitation in the
present investigation consisted of the small sample size (N=33),
reducing the power of the analyses to detect changes that may be
present. For example, analyses of power for structural measures of
cognitive integration and cognitive differentiation revealed that the
power of the F tests were .11 and .72, respectively. In the present
study, adequate power (e.g., .80 to .90) would require an approximate
sample size of 50 to 70 subjects. Future studies must include an


APPENDIX J
THERAPIST RESPONSE ALTERNATIVES: FAMILY B
Interval I
1. Mom: What do you think?
I. Response Alternatives
(a) I think the first thing you need to do is stop blaming Ian
for all your problems and realize that none of you have
resolved the conflict you feel about the divorce.
(b) Often times, the pressure and stress associated with a
divorce may bring strife and division within a family,
even a family that loves each other.
(c) Right now I'd like to hear Ian tell Mom how he feels, very
quietly and calmly, and have Mom report this back to his
satisfaction. Then I would like to have Mom, very calmly
and quietly, tell Ian how she feels and have Ian repeat
this back to her satisfaction.
(d) I think you and your family need to explore new ways of
communicating your needs and feelings to each other. I
would like each of you to state how you are feeling about
what is happening in this family while the others listen.
II. Response Alternatives
(a) I'd like to know if you fight like this often at home, and
how you settle disagreements in your family. Let's hear
from Ian and Diane as the children in the family.
(b) I think it is important that we hear from each member of
your family about how they perceive what is happening in
this family.
(c) I'd like to know if you fight like this often at home, and
how you settle disagreemnts in your family. Let's hear
from both Mom and Ian.
(d) Mom, I am anxious about what it is you fear would happen
if you stopped insisting that Ian had all the problems and
you had no problems other than Ian.
119


127
THERAPIST RESPONSES ANSWER SHEET
Office Use Only
Subject Name Subj # Family
SS# pre/post exp-er
Sex Age exp/control date
INTERVAL I
Which of the following therapist response alternatives would you
select for use with this family at this time in the session? Please
circle your preferred response.
I. a.
b.
c.
d.
On a scale of 1 to 10-, how
of this therapist response?
confident
Please i
do you feel about your selection
circle a number on the scale.
1
1
2
J
3 4
1 1
5 6
1 1
7
1
8
J
9 10
1 1
no
mild
some
moderate
very
II. a.
b.
c.
d.
1
1
2
1
3 4
1 1
5 6
1 1
7
1
8
1
9 10
1 1
no
mild
some
moderate
very
III. a.
b.
c.
d.
1
I
2
!
3 4
1 1
5 6
1 1
7
1
8
9 10
1 1
no
mild
some
moderate
very
PLEASE TURN TO THE NEXT PAGE


64
Family intervention Analyses
The analysis of variance did not reveal any significant findings
for either Weighted Average or Modal Response scores. The mean
response levels, however, suggest that both groups focused on
subgroup relationships when conceptualizing an intervention for a
family (means range from 2.87 to 3.64).
Therapist Response Analyses
Within Category Analyses
Gathers information
The analysis of variance revealed no significant findings for
the Modal Response and Average Confidence scores. However, the
results did reveal a trend toward a main effect of Time for the
Weighted Average score, F (1,31) = 3.64, p=.06. These results
suggest that both groups had a tendency to ask for information about
a subsystem relationship less frequently at Time 2 (M=3.15) than at
Time 1(M=3.39).
Reflects and supports
The analysis of variance revealed a significant main effect of
Time for the Weighted Average score, F (1,31) = 9.22, p<.004, such
that both groups had a higher frequency of supportive responses at
Time 1 (M=3.15) than at Time 2 (M=2.73) which revealed a higher
frequency of reflecting responses (see Table 8).


29
Personal Construct Psychology and Training Studies
With the increased recognition of personal construct psychology
as a viable context within which to study human behavior and
relationships (i.e., systems of personal constructs), there has been
a burgeoning of research based on Kelly's Role Construct Repertory
Grid (Rep Grid). This Rep Grid measure has been adapted to the study
of a variety of issues ranging from analyses of individuals with
psychiatric disorders to the perceptions of therapists, friends,
marital couples, and trainees in various fields. Many of these
studies have focused on a concept labeled cognitive complexity which
Bieri (1955) has defined in terms of the differentiation of (i.e.,
the number of constructs in) an individual's construct system.
Basically, Bieri argued that as the construct system develops it
becomes more differentiated. This notion of progressive
differentiation has been investigated in many training studies based
on Kelly's (1955) organization corollary, suggesting that a construct
system is hierarchically organized and undergoes shifts over the
course of personal and professional development.
However, several studies investigating the training of
professionals have suggested that the relationships among the
constructs undergo periods of decreased complexity during the early
phases of training, followed by a reorganization of the constructs at
higher levels of complexity during advanced training stages (e.g.,
Baldwin, 1972; Pope, 1978; Runkel & Damrin, 1961; Ryle & Breen,
1974). These findings offer some suggestions concerning the


81
effectively understand actual clinical experience that they are not
prepared for, they revert back to their first learned style of
interacting in therapy. The fact that there were no significant
differences between the two groups of therapy trainees suggests that
reverting to previously learned levels of executive skills may not be
a function of structural family therapy training, but a function of
attempting to interact effectively in a new situation. This lack of
significant differences between the two groups of trainees again
raises the question concerning the unique impact of family therapy
training. Although the subjects reverted to a lower level of their
executive skills, it is interesting to note that there were no
changes in their average confidence level concerning their choice of
therapist response to the family.
Interprets and confronts
The results of these analyses revealed that there were no
significant differences in level of executive skills between the two
groups of therapy trainees. Both groups of subjects tended to use
strategic and confrontive interpretations, and there were no changes
across time. This lack of change in executive skill level for
interpretive responses suggests that these skills may not be unique
to family therapy training. If these skills are unique to family
therapy, it is possible that the task in the present investigation
was biased toward not detecting changes. Since all the subjects were
required to respond to the family by selecting an interpretive
response, it is not possible to determine whether the nonfamily


105
2. When given the opportunity, she speaks her mind to parents.
3. Teases siblings when they talk.
4. Disagrees openly with what siblings say and argues with them with
little or no provocation.
5. "Butts in" on all family members when they are talking.
6. When parents refuse her requests, she pouts and often says, "I
didn't want to do that anyway."
Jessica
Therapist knows about Jessica:
1. Quiet, doesn't offer thoughts.
2. "Perfect child" according to parents.
3. Apparent discomfort when asked to speak.
Actions
1. Doesn't speak much.
2. Uses great deal of non-verbal communication directed towards
Alyson.
3. Teases and goads Alyson.
4. Acts shy when questioned.
5. When questioned, says few words.
6. Answers "yes" or "no."
Cra i g
Therapist knows about Craig:
1. Quiet, withdrawn child.
2. Therapist doesn't know much about him.
3. Just 1istens.
Information to be given to therapist:
1. Handles problems by retreating to room.


individuals' personal cognitive systems. It was predicted that the
structural complexity and level of abstraction in the family
construct system would increase as a function of family therapy
training.
Conceptual and executive skills were measured by analyzing
trainees' multiple choice responses to simulated family therapy
tapes. It was predicted that the family therapy trainees would show
increases in level of systemic conceptualization and therapist
response sophistication over the course of training.
Results of the 2x2 Analyses of Variance on the pre-post scores
for both family and nonfamily therapy trainees provided equivocal
support for the predictions of increased complexity in family therapy
trainee skills. The analyses revealed significantly decreased levels
of differentiation in perceptual skills for family therapy trainees
and significantly increased levels of differentiation for the
nonfamily therapy trainees, and no significant changes between groups
for conceptual or executive skills.
These results suggest that family therapy skills may be
developmentally dependent upon each other such that higher level
conceptual and executive skills cannot develop until lower level
perceptual skills have been adequately developed and consolidated.
The results of this study were also discussed in relation to the
unique contribution of family therapy training on therapy skills, and
future directions were suggested.
IX


APPENDIX F
FAMILY A DYNAMICS SEEN BY ACTORS
Two Parent Family
THE JEFFREYS
Upper Middle Class Family
Father
Gordon
Age
50 -
manager of small publishing company
Mother
Joan
46 -
housewife
Children
Alyson
17 -
student
Jessica
16 -
student
Cra i g
14 -
student
Matthew
10 -
student
Presenting
Problems
1. Alyson, the eldest daughter, is exhibiting unpredictable behavior
that has disrupted the family (parents have reported this).
2. She erupts in sudden violent fits, screams and yells at siblings
and sometimes has physical fights with her sister Jessica.
3. Other times, she is silent and withdrawn from the family. Her
pouting has been labelled by the parents as "silent contempt."
4. Alyson's parents do not approve of some members of her peer group
and feel that they are a bad influence on her.
5. Alyson's parents complain that she spends most of her time with
her peer group, away from the family.
Mrs. Jeffreys
Therapist knows about Mrs. Jeffreys:
1. Very involved with her children. Works very hard to maintain
communication with them and remain intimate.
102


141
family rule that the family should always be polite, calm,
and civilized. Mom and Dianne are circumventing family
sharing by focusing on Ian's "aggressiveness," thus getting
themselves off the hook. Thus, this family needs to be
taught some fair fighting skills in order that conflict may
be resolved openly.
b. Ian appears to be caught in the middle of the unresolved
conflict between Mom and Dad which he attempts to resolve by
subjugating his own needs in an aggressive manner that takes
the focus off the marital relationship. Thus, Ian needs to
be relieved of the central role in this family.
c. Dianne's withdrawn style, in combination with Ian's more
disruptive behavior, suggests that this family has only two
rigid modes of interaction, involving either overt
aggression or silent aggression. Thus, the children in this
family need to be removed from the parental conflict while
also having parental attention shared more evenly among them
so they can develop more adaptive styles of interpersonal
communication.
d. Father's psychological position in the family is maintained
through the interactions between Ian and Mom concerning his
"male" irresponsibility and concurrent obligation to take
care of the females in the family. Thus, Mom and Ian need
help in removing Dad from their daily interactions with each
other.
7. What immediate goals might be described for this family?
a. Therapy should focus on helping Ian and Dianne become more
accepting and supportive of each other so that Mom will no
longer have to referee for them.
b. Individual therapy for Mom should focus on her unresolved
feelings concerning the divorce, which would result in
better communication between all the family members.
c. Therapy should focus on restricting family member
relationships such that Diane no longer sides with Mom
against Ian, but plays her role as a sibling, in addition to
helping the family remove Dad from their daily interactions
with each other.
d. Therapy should focus on Mom and Ian's inability to openly
communicate with each other concerning his needs to begin
separating from the family.
8. What general long range goals might you formulate for this
family?
a. A major long range goal might involve helping Ian
successfully individuate from the family so he would no
longer have to step in and hold the family together by


114
about what part you could play in resolving some of the
conflict you are experiencing.
II.Response Alternatives
(a) I'm wondering if both of you would tell me what it is like
to live in this family. What aspects do you find
upsetting and what do you see as positive?
(b) What I hear is that you are both antagonizing Alyson and
her friends, and putting unrealistic demands on her in
addition to telling her that she is not OK. I think it is
time you stop that and try something different.
(c) I'd like to know how often you children get frustrated and
upset with each other to the point that one of your
parents has to intervene, and what behavior on their part
you find upsetting.
(d) Dad, I'd like to know how often you and Mom get frustrated
and upset with Alyson and the other children, and what
behaviors on their part that you find upsetting. Let's
hear from both of you.
III.Response Alternatives
(a) I can see how much you love your children, and that is the
first step in helping your family in resolving your
conflicts with each other through working on compromises
that you will all be happy with.
(b) Dad, it sounds like you feel you have failed Alyson in
some way and you are feeling guilty and confused about how
that happened.
(c) It is obvious that you are feeling some pain in being in
conflict with each other and would much rather be getting
along. What we need to do is work on helping you develop
some working compromises that each of you would be happy
wi th.
(d) Dad, it sounds like you are very concerned about Alyson
and would like to do anything you could to help her.
IV.Response Alternatives
(a) Dad, I think you and your family have already done enough
things "to" Alyson and it is time you stop laying all this
guilt on Alyson and begin working on your problems.
(b) It appears that no one in this family is willing to take
any blame for family conflicts so that Alyson has been
elected and has agreed to take all the blame for the
family. I wonder what would happen if Alyson no longer
shouldered the blame for the others in this family.


18
review of the training literature revealed tnat studies either
described training methods based on the clinical observations of the
trainer (e.g., Aponte & Van Deusen, 1931; Beal, 1976; Ferber &
Mendelsohn, 1969; Nichols, 1979), described the historical
development of marital and family therapy training (e.g.,
Constantine, 1977; Nichols, 1979; Tucker, Hart, & Liddle, 1976), or
provided a sociological comparison of supervision methods based on
trainee self-reports (e.g., Tomm & Leahey, 1980). Thus, rigorous
empirical investigations are required, including the addition of
appropriate control groups, adequate number of subjects, multiple
objective measures, and operationalization of variables that are
specific to family therapy.
Empirical Studies
A popular method of assessing trainees' knowledge of family
therapy course content and theory involves paper and pencil tests
such as multiple choice questions and essay questions (Friedman,
1971; Tomm, 1980). Friedman reported that mental health
professionals significantly increased in factual and theoretical
knowledge between pre- and posttraining tests. Similarly, Tomm
reported that first year medical students demonstrated significant
increases in their knowledge of a Family Categories Scheme devised by
Epstein and his associates following their training experiences
(Epstein, Si gal & Rakoff, 1968). An additional method popular in the
family therapy training literature involves assessing changes in
trainees' attitudes. Poelstra and Lange (1978) and Lange and


2
The present investigation focuses on training in structural
family therapy. As in all forms of therapy, the structural family
therapist relies on his powers of observation when assessing a
family's functioning. The distinguishing feature of structural
family therapy, however, involves the active participant observation
of the therapist. The focus of intervention according to the
structural model is the patterns of structural relatedness occurring
within the family system (White, 1979). The therapist's task is to
discover the dysfunctional structure existing within the family and
to design interventions to alter that structure. Structure is
examined in terms of power hierarchy, coalitions, alliances,
individual and subsystem boundary regulation, and the family's
flexibility for change (Minuchin, 1974). In order to observe these
patterns, the structural family therapist must find a way to get the
family to demonstrate their patterns of behavior, and this is where
the techniques of the therapy are first utilized. Once the therapist
has operationalized where in the structure the system fails to carry
out its functions, the goals of therapy are to solve problems through
changing the underlying systemic structure of the family.
The present study will adopt a personal construct approach to
the study of training in structural family therapy. Personal
construct psychology is a theoretical and empirical approach to the
study of personality and interpersonal relationships. The personal
construct methodology can provide the needed empirical rigor, which
has been lacking in prior studies of family therapy training, and can
bridge the gap between the relatively uncharted area of family


75
levels of cognitive complexity in their perceptual skills than the
nonfamily therapy trainees.
Perceptual Skills and Level of Construct Abstraction
According to Crockett (1982), a major feature of a developing
construct system involves the appearance of abstract constructs. One
method frequently used to assess the development of abstract
constructs involves a content analysis of the construct dimensions
elicited by the Rep Grid (Duck, 1973). A review of the literature
revealed that those studies using a content analysis to investigate
the level of construct abstraction as a function of training reported
significant increases in level of abstraction as a function of
training (e.g., Lewis, 1977; Lifshitz, 1974). The present study
investigated whether family therapy trainees' family constructs would
become more abstract as a function of structural family therapy
training.
Level of abstraction is measured with a weighted average score
based on Duck's (1973) system of content analysis. Contrary to
expectations, there were no significant findings on measures of
abstraction. However, there was a trend toward a main effect of
Group, suggesting that the family therapy trainees tended to have
relatively higher levels of abstraction in their family constructs
than did the nonfamily therapy trainees. Although these results are
in the predicted direction, the data do not argue cogently for
differences between the two groups of therapy trainees. Perhaps a
larger sample size would provide enough power to detect any changes


138
d. Therapy should focus on Mom and Dad's inability to openly
communicate with each other concerning their needs, which
would result in better communication between all the family
members.
8. What general long range goals might you formulate for this
family?
a. A major long range goal might involve helping Alyson
successfully individuate from the family so she would no
longer have to step in and hold the family together,
allowing family conflict to surface so that it might be
dealt with openly and resolved.
b. Marital conflict between Mom and Dad has remained unresolved
through deflecting their focus onto Alyson who has taken the
role of scapegoat in the family in order to maintain the
family's equilibrium. A long range goal for this family
might involve removing Alyson from the central position in
the family so that the family would experience and deal with
a family crisis, resulting in a shift of family member
relationships and a more adaptive family equilibrium.
c. Mom and Dad's inability to openly express affection for each
other has been learned by the children in this family.
Consequently, Alyson's aggression toward her siblings acts
as a catalyst for bringing the siblings closer together in a
united front against Alyson. A long range goal for this
family might involve teaching the chidlren how to
communicate honestly with each other, and allowing them to
teach their parents a new style of communication.
d. All the attention of the parents is focused on Alyson, thus
taking the heat off their own marital problems and
ineffectual parenting styles, allowing them to maintain
their rigid style of communication. A long range goal might
involve focusing the parents on their interpersonal
relationship, freeing all the family members from holding
that relationship together.


APPENDIX G
FAMILY B DYNAMICS SEEN BY ACTORS
Single Parent Family
THE WILLIAMS
Low Income Family
Age
Mother
Mrs. Williams (Jane)
- low paying job in
television production
Father
Children
Not in therapy (Frank)
Ian
Dianne
17 student
16 student
Mr. Williams refuses to have anything to do with his wife and
therefore refuses to participate in therapy. Mother and father
separated three years ago.
Mr. and Mrs. Williams have not been able to agree on the terms
of divorce. In addition, Mrs. Williams has taken Mr. Williams to
court on two occasions for failing to meet his support payments. In
one case, Mr. Williams was sentenced to a week in jail.
The children spend every second weekend with their father, they
generally enjoy these visits.
Presenting Problems
1. Ian loses his temper and becomes uncontrollable.
2. Ian pulled a knife on mother and sister the last time that he
lost his temper.
3. Ian orders his sister around and expects her to do things for him
(e.g., make him meals, watch his TV programs).
4. Ian physically pushes sister around when she doesn't listen to
him.
107


Table 2. Family Expert Ratings for Therapist Response Stimuli--
Family Tape I
Modified Expert 1 Expert 2
Allred
Scheme
Modified Allred Scheme .61* .45*
Expert 1 .65*
Expert 2
* p<.05
Table 3.
Family Expert Ratings for Therapist Response Stimuli
Family Tape II
Modified Expert 1 Expert 2
Allred
Scheme
Modified Allred Scheme
.58* .68*
Expert 1
.76*


73
across time, suggesting that any training in therapy initially
channelizes and rigidities trainees' clinical perceptions.
Taken as a whole, the results of the measures of cognitive
differentiation and cognitive integration are mixed. On the one
hand, the results suggest that family therapy trainees become less
differentiated as a function of structural family therapy training
while the nonfamily therapy trainees become more differentiated
across time. However, the results also revealed that the family
therapy trainees are more cognitively integrated than the nonfamily
therapy trainees. Both sets of results are consistent with the
training literature. Those studies reporting decreases in cognitive
complexity based their conclusions on the results of differentiation
scores (e.g., Baldwin, 1972; Pope, 1978; Ryle & Breen,1974) while
those studies reporting increases in cognitive complexity based their
conclusions on the results of integration scores (e.g., Adams-Webber
& Mire, 1976). Thus, these discrepant findings reported in the
literature, as well as those revealed in the current investigation,
may be the result of using different measures of cognitive
complexity. These two measures may reflect different aspects of
cognitive complexity that develop at differential rates as trainees
are exposed to new training and therapy experiences.
However, there is an alternative hypothesis that may explain the
discrepancy between cognitive differentiation and cognitive
integration. As family therapy trainees learn a coherent and
systemic conceptualization of family dynamics, they may begin to see
families as less different from each other. Further, the family


74
therapy trainees may begin to see the commonalities and similar
patterns across different families. This hypothesis is consistent
with the goal of structural family therapy which is to look for the
structural patterns that are supporting what appear to be the
differing dynamics of different families (e.g., looking for the
homeostatic principles that maintain the presenting symptom). Thus,
the decreased levels of differentiation for the family therapy
trainees suggests that.they see families as more alike as they begin
to learn to interpret family dynamics with a structural template.
However, the increased levels of differentiation for the nonfamily
therapy trainees suggests that their interpretations of family
dynamics may be based on several different conceptualizations that
they are utilizing in their individual therapy training. Thus, the
lower levels of differentiation in the family therapy trainees may
suggest that structural family therapy training does not necessarily
lead to lower levels of cognitive complexity, but influences family
therapy trainees' family construct system in such a way that they are
able to tighten those family construct dimensions compared to therapy
trainees without that training. This interpretation is also
consi stent with the higher level of cognitive integration found for
the family therapy trainees. The family therapy trainees appear to
be more flexible in their use of their family construct system than
the nonfamily therapy trainees. Perhaps the family therapy trainees
are more willing to explore the possibilities of interrelationships
among their family constructs and in that sense, they show higher