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UBC Theses and Dissertations

Member to member learning in a therapeutic enactment group Bailey, Bruce 2009

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Member to Member Learning in a Therapeutic Enactment Group by Bruce Bailey B.A., University of Alberta M.A., University of British Columbia A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY in THE FACULTY OF GRADUATE STUDIES (Interdisciplinary Studies) THE UMVERSITY OF BRITISH COLUMBIA (Vancouver) August, 2009 © Bruce Bailey 2009 11 ABSTRACT This study examines the influence of member to member learning in a Therapeutic Enactment group. Using the lens of Bandura’s (1986) Social Cognitive Theory this study utilizes this theoretical framework to examine the extent members have influenced and do influence each other’s therapeutic change process. Using Yalom’s (1985) work on group process as a base and incorporating the elements he has identified as necessary for therapeutic change the study examines the factors as they relate to the change process. Fourteen individuals participated in a therapeutic enactment based on a model Westwood &Wilensky (2005) developed using Moreno’s (1946) initial work. This is a qualitative study utilizing content analysis and Mayring’s (2000) model as the methodological approach. 111 TABLE OF CONTENTS Abstract.ii Table of Contents iii Acknowledgements v Chapter 1: Introduction 1 The Research Problem 2 The Research Question 3 Overview 5 Chapter 2: Literature Review 7 Social Cognitive Theory 7 Symbols 9 Forethought 9 Vicarious Learning 9 Self-Efficacy 10 Self-Regulation 11 Self-Reflection 12 Agency 12 Modes of Agency 14 Beginning of Group Therapy 14 Human Relationship and Therapeutic Change 17 Psychodrama 19 Sociometry 21 Warm Up 22 Action 22 Therapeutic Enactment 23 Lieberman, Yalom and Miles 28 Member Influence in Group Process 29 Summary 30 Chapter 3: Methodology 31 Participants and the Interview 33 Content Analysis Historical Perspective 34 Manifest versus Latent Content Analysis 35 What to Count 36 Open Coding 36 Mayring’s Model 37 Procedures of Qualitative Content Analysis 39 Deductive Development 39 Deductive Category Application 39 iv Chapter 4: Findings .43 The Sub-Categories 44 Shame/Suffering/Pain 44 Support/Understanding/Acceptance 45 Renewal/Trauma/Loss 47 RedemptionlSalvation 48 Taking One’s Place/Not Good Enough 50 Belonging 52 Integrating Self-Reflection as it Relates to Other Members of the Group 54 Awareness of Change Past/Present/Future 55 Connection with Others that is Different from Belonging 56 Recognition of the Impact of Members’ Experience on Each Other 57 Summary 59 Chapter 5: Discussion 60 Introduction 60 The Sub-Categories 62 Shame and Suffering 62 Support/Understanding/Acceptance 64 Renewal/Trauma/Loss 66 Redemption/Salvation 68 Taking One’s Place/Not Good Enough 69 Belonging 70 Integrating Self-Reflection as it Relates to Other Members of the Group 72 Awareness of Change Past/Present/Future 73 Connection with Others that is Different from Belonging 74 Recognition of the Impact of Members’ Experience on Each Other 75 Social Cognitive Theory and the T.E. Model 77 Catharsis 77 Symbolism 78 Self-Regulation 81 Safety and Preparation 82 Leadership 83 Therapeutic Component of the Interview 84 Limitations 85 Implications 86 REFERENCES 90 APPENDIX 96 VACKNOWLEDGMENTS I would first like to thank my committee as a whole for the support you have provided me from the very beginning. I would like to thank Dr. Borgen for his extraordinary gift of editing that he provided for me. I would like to thank Dr. Rungta for his insight to clinical practice in group therapy. I would like to thank Dr. Westwood for his faith, support and the many times he encouraged me through a process that was both challenging and exciting. I have no words to describe his gift. I would like to thank my children, Jennifer, Katelynn and Sean for their encouragement and faith in me. Finally, to my wife Donna, for her unconditional love and support for this journey we have taken together. 1Chapter 1 Introduction Researchers have investigated the dynamics of group processes from a variety of theoretical orientations and perspectives. Groups span the continuum beginning with information groups, to psycho-education or educational groups and concluding with more complex psychotherapy or process groups (Borgen, Amundson, Westwood, and Pollard, 1989). There are a variety of settings within which groups are developed. In the corporate world several avenues have been investigated to address methods and processes to increase efficiency and productivity (Greenbaum, 1997). Groups form much of the basis for learning in our educational system. They are created for a variety of purposes and include sport groups, learning groups, and instructionally based teaching groups (Smith, 1996). Groups are developed for specific purposes depending on the need or anticipated outcomes. As groups evolve across the range of potential interventions, so does the complexity of the needs of the individual members. An example of attending to the needs of a specific population is reflected in government initiatives in respect to unemployed people. Government policy is designed to assist Canadians who experience labor market transitions by developing group based interventions (Amundson, Borgen, Westwood, Bailey, Kovacs, & Poebnell, 1992). Psycho-educational groups were developed to mediate the effects of unemployment. Amundson (1992) et al. suggested groups can be categorized by the competing needs of group members for structure and maintenance of both social and emotional factors. Hospitals and care facilities also use groups for treatment purposes, both in the physical and in the psychological domain. Medical practitioners need to organize 2themselves into effective treatment teams. Complex treatment requires teams that are able to perform at an inter-disciplinary level. Groups are an efficient intervention for bringing about change and need to be organized within therapeutic environments to maximize efficiency. Therapeutically focused groups establish both group goals, objectives and build in provisions for assessing members needs (Gladding, 2002). Psychological problems can be complex and groups can support the members through the process that leads to therapeutic change. This study is focused on an investigation of a specific kind of therapeutic group referred to as Therapeutic Enactment (T.E.). This particular type of group involves a muhimodal systems approach for helping clients resolve personal difficulties and to facilitate individual development and change (Westwood and Wilensky, 2005). Characterized by a great deal of interaction among members, it affords the opportunity to examine more closely the potential influence of members on therapeutic change. Much of the approach involves a highly facilitated interaction among participants; the process focuses on group action much more than most groups and as a result, members when observing the group action, can reflect on the process of the group. The Research Problem This study examined the impact and influence that members have on one another in T.E. groups as explained on the previous page. My specific interest was to study member to member influence within the group process and secondarily examine the link between social cognitive theory and the therapeutic enactment process. The research question endeavored to investigate the kind of influence members have on one another, both in the domains of support and therapeutic change processes. 3There is a dearth of research investigating group member to member learning in the literature. Early in the initial development of Yalom’s (1985) approach to group development, he identified the need to investigate the influence of group members but little empirical support was provided. Lieberman, Yalom & Miles (1973) examined member influence in their early studies and referred to the concept of spectatorism. Therapeutic Enactment integrates several different change systems which are incorporated into a broad theoretical framework. I have included Bandura’s (1986) social cognitive theory to extend the understanding of the learning processes being investigated within the T.E. context. Bandura’s theory has the benefit of providing an overarching construct referred to as reciprocal determinism which helps to understand how members can have an influence on one another with respect to personal learning and change. Briefly stated, reciprocal determinism provides a triadic model that allows for the interaction of the affective, cognitive and motivational processes of the individual. It was thought that this construct would assist in better understanding how individual learning occurs in the enactment group and in doing so help extend the theoretical framework of the study. The Research Question Specifically the study asked the question: What impact do members have on one another in a therapeutic enactment group and how does this influence each other’s learning and therapeutic change process? The methodological approach to answer this question was qualitative. Hill, Thompson, and Williams (1997) strongly recommend qualitative investigations that explore counselling process issues and suggest this can be accomplished by examining 4process issues in small units. My study was exploratory and descriptive in nature and the methodology chosen to investigate this question was content analysis. In the early development of content analysis, sometimes referred to as textual analysis, Hoisti (1969) suggested a core group of questions were needed, and defined the process as “any technique for making inferences by objectively and systematically identifying specific characteristics of messages”. Later Krippendorff (2000) suggested six questions for this purpose. 1. Which data are analyzed? 2. How are they defined? 3. What is the population from which they are drawn? 4. What is the context relative to which data analyzed? 5. What are the boundaries of the analysis? 6. What is the target of the inferences? Berg (1995) further enhanced the technique by introducing the constructs of latent and manifest content analysis. This method has the advantage that analysis can be subdivided into two levels. Manifest content analysis examines the surface content of the interview data using specific deductive techniques. Latent content analysis explores the same data using a deductive technique and explores the data at a deeper more complex level. (Mayring, 2000) suggests a stepped model, beginning with the research question and choosing deductive or inductive processes. Analysis of categories, sub categories and defining coding rules and collecting data in coding agenda’s are the main features of this model. This study utilized the deductive method supplied by Mayring’s (2000) which includes a theoretical formulation of definitions and examples for coding the categories and sub categories. The definitions to construct the categories was based on Bandura’s (1977) social cogitative theory and the specific constructs of reciprocal determinism which are; affective, cognitions and behavioral outcomes. 5It was anticipated that this study would begin to identify the therapeutic effects members have on each other that will further inform research theory and practice. It was hoped that the findings would help to reinforce the need for group leaders to have member to member attentiveness when they conduct groups, and have implications for their professional training. Overview of the Dissertation In Chapter 1, I have briefly reviewed the continuum of group processes and the theoretical orientation of groups (Borgen, Amundson, Westwood, Pollard, 1989, Gladding 2002, Westwood &Wilensky 2005, and Yalom, 1985). I have highlighted the T.E. group process and the relationship between group process, group action and member reflections. In addition, I have discussed the development of content analysis with the early applications examining written texts and its meaning, and described the levels of content analysis that employ both a deductive and inductive interpretative approach. The methodology used for the study was Mayring’s (2000) deductive technique of content analysis. In Chapter 2, I will review the literature related to Social Cognitive Theory (SCT) (Bandura, 1977) and include a brief review of group counselling and psychotherapy models. Finally Westwood and Wilensky’s (2005) model will triangulate with SCT. Denzin (1978) defines triangulation as “the combination of methodologies in the study of the same phenomenon” (p. 291). The purpose of triangulation has two elements to consider. It is to establish cross validation and convergent validity which in turn contributes to the establishment of construct validity. I have also reviewed the literature 6in the following areas: Social cognitive theory, Reciprocal determinism, and Therapeutic Enactment. In chapter 3, I outlined the methodology as suggested by Hill, Thompson and Williams (1997) to use when investigating the counselling process. I will also review the development of content analysis as suggested by Berg (1995) including manifest and latent content analysis as well as an explanation of Mayring’s (2000) deductive content analysis technique. Finally, I will discuss the process followed for data collection. In chapter 4, I will report on the findings of the study and in Chapter 5, I will discuss those findings. 7Chapter 2 Literature Review Therapeutic change is complex, ubiquitous and difficult to measure (Hill, 1997 et: al.). Many theoretical orientations exist that speak to the process of therapeutic change in groups but few have considered the role of member to member influence. This chapter will link the theoretical model of (SCT) with member to member influence and examine this experience within the context of members in a Therapeutic Enactment group. In this chapter, I will review the literature, including the constructs of social cognitive theory, as a foundation for understanding member to member influence in groups. In particular, the central themes of self efficacy, motivation, agency, self regulation, reflective thought, forethought and vicarious learning are presented and summarized. These constructs are foundational and I will link them to therapeutic enactment to examine the influence of member to member learning in a group. Several selected models of group counselling and psychotherapy are briefly reviewed. In addition, the theoretical group process models of Psychodrama and Therapeutic Enactment are reviewed. Social Cognitive Theory The preferred theoretical model for looking at member to member learning is provided by Bandura (1977) who has developed a complex and highly useful framework for understanding group member process. There has been extensive investigation in the literature examining social learning from a wide variety of perspectives. For the purpose of this study I will focus the discussion of member to member learning on the model of reciprocal determinism. Bandura (1986) renamed Social Learning Theory to Social 8Cognitive Theory (SCT) and stressed the triadic dimensions of personal factors (judgment and appraisal), behaviors and the environment. Those dimensions are affective, cognitive and motivational processes. In order to understand the contributing factors to this approach Bandura (1991) has supplied the following definitions: Affective Processes: processes regulating emotional states and elocution of emotional reactions. Cognitive Processes: thinking processes involved in the acquisition, organization and use of information. Motivation: activation to action. In addition to these three pillars, there are two additional elements which are self efficacy and self regulation. A subset of self-efficacy includes self concept, control and cognitive processes. Bandura (1986) suggests that the triadic factors of affect, cognitions and motivation are bi-directional. Each factor influences the next so one’s thoughts influence one’s feelings and motivation. He maintains that social or environmental influences impact behavior and these influences change the dynamic of the self. Bandura (1986) examines the nature of his triadic model and relies on all three components, cognitions, affect and motivation to explain change. The self in this triadic exchange incorporates five basic capabilities: symbolism, vicarious learning, forethought, self regulation and self reflection. Self-reflection is of special interest in this study because it is in the follow-up stage of therapeutic enactment that the group member reflects and makes meaning of their experience. 9Symbols Bandura posits that symbols play a role in the definition of self. They assist the individual to create meaning by influencing cognitions. Symbolism assists in the development of meaning and links thoughts to other thoughts. Forethought Forethought contributes to self understanding and insight by preparing the individual to consider consequences of behavior. Vicarious Learning Vicarious learning is a process for understanding and explaining how learning from others occurs and is a foundational concept in the therapeutic enactment process. Participants experience each other, watch, interact and begin the process of new learning. Vicarious learning is at the theoretical centre of examining the potential therapeutic interaction between members. As members of a T.E. group model behavior for each other, this process also allows for members to learn new behaviors or fashion new perceptions that they experience vicariously. This process appears to facilitate and expand member learning, and helps members to begin to shift away from remaining rooted in their old paradigms and attributions. Self regulation and self-reflection are both foundational to assisting the individual in the regulation and control of thoughts, feelings and motivation, These two processes individually or in concert, allow people to reflect on their lived experience, which then alters their thinking and behavior. These two constructs and their influence will also be discussed in relation to Therapeutic Enactments and the role of self efficacy. 10 Self Efficacy Betz and Hackett (1987) postulated that efficacious behavior is contiguous and linked to beliefs central to expectations of success and the setting of firm behavioral targets. Researchers across disciplines, Damrosch (1991), Gecas (1989), and Lev (1997), have operationalized the self efficacy construct, while Bandura (1991) has been the most influential with his work on this construct. Two models are suggested for learning, actual and symbolic which are linked to modeling. Bandura proposes four conditions be in place for effective modeling to occur. First, the individual needs to be alert to the behavior being modeled. Second, the individual needs to be able to remember and recall the behavior. Third, the ability to replicate the observed behavior needs to be present. Fourth, and most important, the required motivation to demonstrate the behavior needs to be present. Motivation is foundational to self efficacy theory. Earlier, White (1959) challenged the accepted theory of motivation arising from basic drives or instincts. Instead he postulated that motivation was linked to competence. Bandura shares this concept and adds level of motivation, intensity and effort, and finally efficacy expectancy. Bandura (1977) advanced understanding of the construct of self-efficacy by introducing the notion of efficacy expectancies. He suggested that the more competent individuals perceive themselves, the greater the opportunity they have to be self determined. Kear (2000) suggests two elements of control associated with self-efficacy which are locus of control and self-actualization. Rotter (1971) first suggested internal versus external locus of control. Internal control is associated with direct control over an individual’s life events and external control having little or no perceived control over 11 one’s life. Self-efficacy (Kear, 2000) incorporates internal locus of control in both the motivational and cognitive process components. The individual experiences a feeling of control as well as a causal attribution between goals and action. Bandura’s (1977) emphasis is focused on the perceived ability to alter behavior. The perception of an individual’s ability to set goals and persist in the struggle to attain their goals reflects levels of efficacy. Higher persistence and intensity of effort would reflect a higher sense of efficacy. As noted earlier, social cognitive theory is the framework in which to examine member process. Self efficacy becomes an important variable to consider in the influence members may have on each other. The more efficacious or successful the individual becomes, the greater the impact on confidence and self actualization. Motivation will be important when examining the relationship between therapeutic enactment and self efficacy. Self Regulation Bandura (1986) suggests that self regulation is important to one’s self concept and is linked to self efficacy. As already indicated, a dynamic interaction occurs between the individual, the environment and behavior. Self regulation incorporates three phases and includes self observation, judgment and self response. 1. Self regulation is the process of looking at one’s own behaviors and examining their effectiveness. 2. Judgment involves the process of comparing one’s self to a standard. The standard may be set by the individual or a standard set by others for the 12 individual. It falls to the individual’s judgment to evaluate if they have achieved the standard. 3. Self response is the reward set by the individual upon the successful attainment of the standard or goal. If one evaluates the performance positively the self reward is self satisfaction. If the standard is not achieved the self-response may be shame. Both the positive and negative reactions to the self response will influence self concept. Self Reflection Bandura (1986) hypothesized that the element which makes us the “most human” is our ability for self reflection. William James (2006) observation that “my experience is what I agree to attend to” is an important element in social cognitive theory. The ability to make sense of our experiences and to evaluate our self-beliefs leads to self evaluations. Brooks (1998) observes that constructions of our personal schema are essential to self understanding and require self reflection to be imbedded in that process. Agency In recent dialogue Bandura (2006) reflects on the matter of human agency and the influence it has on human development, adaptation and change. Bandura suggests agentic behavior is at the core of human interaction and is not restricted to the interface between the individual agent and the social influences encountered. The emphasis is on the social systems humans create and their unique response to those systems. The concept of “agency” can be found in a variety of forms, and its relevance in the literature and on practice continues to grow. Bandura (2006) suggests 13 that to be an agent “is to influence intentionally one’s functioning and life circumstances” (p. 2). He suggests four core properties of human agency: intentionality, forethought, self- reactiveness and self-reflectiveness. Intentionality is at the core of this cluster of agentic behaviors. Bandura suggests that intentionality is not the formulation of action in a vacuum. Rather, an agent is unable to complete actions entirely on his or her own; there is a collective element of agency that includes other agents. There is, as Bandura describes no absolute agency. Collective agency requires a collective agreement and support of one’s self interest. Bandura also links one’s self interest to the shared collective interest. Intentionality is an interaction within a group or collective. Bandura (2006) commenting on the efficacy of a group, observed that: “Effective group performance is guided by collective intentionality” (p. 2). From Bandura’s (2006) observation, through the process of forethought, agents construct action, make decisions, and motivate and regulate action. Agents are also seen as being self-reactive. They complete tasks by thinking and planning toward achieving their goals. Levine (1983) in his discussion of the explanatory gap observes the duality of what he describes as the mind /body conundrum. The agent needs to think and do and Bandura (2006) suggests self regulation is the link between thought and action in the explanatory gap. An example of the explanatory gap is when you have a thought (raise my hand) and you raise your hand; the moment between having the cognition to raise your hand and raising your hand is the explanatory gap. 14 The final property in this cluster of agentic components is self-reflectiveness. Agents are planners and self- regulators, driven to action, but they are also reflective. The metacognitive capacity of the agent allows for reflection on thought and action and includes the ability to correct or mediate that action when appropriate. Modes of Agency Social cognitive theory suggests three modes of agency. These include individual, proxy and collective agency. Individual agency is dependent upon the individual to apply their judgments, reflections and actions within their own surroundings. Proxy agency is the process of influencing others who have control or influence over their own environments. It is the attempt to positively influence others to act and to assist them to achieve that which they cannot do on their own. The third mode of agency is collective agency and it is, as stated previously, the process of seeking other agents to accomplish mutually achievable goals. Bandura’s relevance to my research question lies in his observations surrounding agency and self regulation. I will now review the literature involving group process and examine the models of group process, specifically the influence group members have on each other. I will include in the review, literature on group process and I will examine the following components: history of group development and the group theory of Bion, Schutz, Rogers, Corey, Moursund and Erskine, psychodrama and therapeutic enactment. Beginning of Group Therapy In order to provide a context for the T.E. model of group therapy and prior to linking it to Bandura’s (1986) work on social cognitive theory, I will provide a brief review of the relevant approaches to group therapy. 15 Trigant Burrow (1925) became dissatisfied with the efficacy of individual psychoanalysis and began to experiment with group processes. Although he did not use the term group therapy, he realized the power of a group. Burrow posited that decreasing the authoritarian position of the therapist would facilitate therapeutic change in the patient. What promoted this inquiry on his part is worth repeating. Burrow recounts the story of his desire to interpret one of his own dreams; this involved using his assistant by reversing roles with him and becoming the patient. His assistant proceeded to conduct the analysis of Burrows and as a result he became distressed with his loss of authority in the relationship. On the basis of that experience, Burrows began to formulate the important role authority has in the therapeutic alliance between patient and therapist. Burrow, in an indirect fashion, was the first to identify the issue of leader authority and the power differential between patient and therapist. This dynamic is important to remember when working with a group as the leader has a considerable imfluence in setting the tone in the group where people see the leader as facilitating more than directing. When this occurs trust levels increase along with self disclosure and great potential for interpersonal learning (Burrows, 1925). My study suggested a further step, which was to examine the therapeutic influence members have on each other. This will be discussed in greater detail in a following chapter. The development of new models describing group processes and group therapy have a long and rich history. J. H. Pratt (1946) first introduced group therapy as a way to attend to the psychological needs of T.B. patients. He found through observation that patients seemed to improve when they shared their concerns in a group. 16 Bion (1961) was influential in the development of group theory and practice. He established the Tavistock Clinic and many, such as Armstrong (1992), have compared his contributions to Freud (1971) and Klein (1948). His orientation to groups was psychoanalytic and suggested that the patient’s pain was the result of psychotic anxiety. Within his approach, individuals acted upon this anxiety in a group. He distinguished between a “work group” and a “basic assumption group”. The work group was described as being more developmental both for the individual and the group as a whole. The basic assumption group has three components which include dependency, pair bonding, and fight/flight. One of Bion’s greatest contributions has been the construct that the group can act as a container for change. As the group process unfolds, the container strengthens and supports the group in the change process. The struggle to suppress anxiety and the members’ interaction when faced with anxiety are key components of therapeutic progression and accounts, from Bion’s perspective, for therapeutic change. Trozter (1977) has contributed to the understanding of group process by developing a grid to describe it. According to Trotzer’s grid, groups fall along a continuum that range from information groups to psycho-educational groups and finally therapeutic groups. These groups are defined by the function: process, structure, information, and maintenance. Theoretical and practical approaches to group therapy are broad based and dynamic. Schutz (1958) observed that people in groups have three basic interpersonal needs; the need for inclusion, the need for control and the need for affection. Rogers (1985), in the development of T- groups, examined the interaction and observation of group members in group process. Recent group theories stress the following components: process, stages 17 or structure, dynamics and leadership (Johnson and Johnson, 1997). Tuckman and Jensen (1997) detail the need to consider the developmental stages of the group and the group leadership intervention required at each stage. Corey (2001) observes the need to establish norms, screen participants in order to form more homogenous groups and match appropriate formats to the intended intervention of the select group. Gladding (2002) illustrates the potential issues that may arise in specialized settings, such as in cross- cultural group counselling. Mackenzie (1997) provides an observation on time managed groups. Amundson, Borgen, Erleback, and Jordan (2004) explored elements that help and hinder in groups dealing with downsizing. This study found that loss, sadness and guilt were expressed by the workers. This was similar to previous studies of factors that help and hinder employment counselling groups (Amundson and Borgen 1988). Schulz (2003) addressed the issue of the advantages and disadvantages of using a group format. He suggests some of the advantages may include: high productivity, socialization of positive values, social competencies enriched and better conflict resolution. Some disadvantages may include diffusion of responsibility, collective panic and forced conformity. Human Relationships and Therapeutic Change Since the focus of this study is on member to member learning, a review of the theory of relationship, experience and influence is informative. A vigorous theoretical approach to process counselling is integrative psychotherapy proposed by Moursund and Erskine (2003). They suggest that the integration process is dependent on a number of theoretical orientations and constructs. The constructs central to this process are contact in relationship, ego states and life scripts. Useful in this approach is the distinction between the dual process of integrating personality and the 18 integration of theory. Personality focuses on assimilation of ego states and adjusting life scripts. Theory examines the integration of the affective, cognitive, behavioral, and physiological systems approach to therapy. Moursund and Erskine (2004) suggest that central to human functioning is our need for relationships. Our development is dependent upon our interaction with others in relationships. They make the observation that problems do not suddenly appear in peoples’ lives; they are based upon “the experiences and learning’s of then and there” Q,. 34). They suggest that what needs to occur in therapy is a review of our past relationships and examine what has brought us to the current problems we face. Therapy is the “must deal with the then-and-there out of which here-and-now has grown” (p. 34). Relationship begins in infancy and relationship reinforces the individual throughout the developmental stages of life. Moursund & Erskine (2004) suggest that we develop script patterns through our diverse thoughts, feelings and behaviors that shape our responses to life circumstances. Scripts are influenced by social context and by the quality of the relationship we have with others. They observe “whatever they are called, the scripts we create have largely to do with our experiences of needs and of how they are met” (p. 39). The relationship and the quality of that relationship with significant others is the process in which our needs are met. The better the quality of the relationship the better the opportunity to meet our needs is realized. Moursund &Erskine (2004) believe that at least eight basic requirements are core to relational needs and include: security, valuing, acceptance, self-definition, making an impact, mutuality, often the other initiate, and to express caring. The development of unhealthy relationships hinges on the unmet needs of childhood and the development of skewed script conclusions that limit successful contact 19 with others. If relational needs go unattended through a child’s development and the child is “constantly wrong” or “shamed” believe what they feel should not be expressed, the child may learn to first suppress their needs and then to repress their needs in relationships. This can lead to damaged script beliefs and behaviors that are isolating and unproductive. In their discussion of negative script development, Moursund & Erskine (2004) introduce the effect cumulative trauma has on script development and the ensuring behavior, thoughts and feelings it generates. Cumulative trauma is the opposite of a specific traumatizing event; it is the every day common hurts and criticism that are built up over months and years. They point out that the most common cumulative trauma is common neglect. The child never has an opportunity to express relational needs, the primary caregiver fails to shield the child or fails to respond to their needs and the child is left to build a self script that accounts for this lack of care. The trauma becomes imbedded in the individual and their scripts become isolating, inhibit spontaneity and are painftil. This leads to an inability or reduced opportunity to form lasting and secure relationships. Finally, Moursund & Erskine (2004) provide an extensive discussion on the process of healing the hurts that is based on helping the individual through a process of cognitive and emotional responses imbued in relationship with their therapist. Psychodrama Psychodrama was originally developed by Moreno (1946) and is foundational to the development of T.E. Hare and Hare (1996) defined Moreno’s Psychodrama as “it is an action based method of group psychotherapy that explores real life experiences within the group context” (p. 341). Blatner (2002) has indicated that psychodrama should be considered as complex and is imbedded in several theoretical models. It is especially 20 effective in “applied psychology”. Blatner (2002) reports that psychodrama has been used in several research domains and spans several disciplines, including: group psychotherapy, narrative therapy, child development and social psychology. Blatner (2002) goes on to suggest that Psychodrama is “a complex set of ideas and methods within the larger fields of psychotherapy” (p.8). Moreno was iconoclastic in his approach to psychodrama with broad general constructs that were not limited to what he often felt were the constraints of psychiatry. As Brooks (1998) notes, “Moreno built his theory on several foundational constructs which included creativity, spontaneity, cultural conserves, warming up, surplus reality and catharsis”. (p. 16). Original to Moreno’s approach to psychodrama is the connection between creativity and the Godhead. He postulated that an existential connection occurred between man and the Godhead and it was through creativity that this connection was established (Brooks, 1998). Moreno felt that creativity was the most important construct in the process that facilitated the healing resulting from psychodrama. As Moreno’s experience working with psychodrama increased so did his interest in spontaneity. He soon began to promote spontaneity and creativity as a foundation for the psychodrama method. Additional foundational constructs emerged and included cultural conserves which are the creative and spontaneous actions in cultural forms (Brooks, 1998). Moreno was also interested in the causal relationship that imagination played in psychodrama and labeled it as “surplus reality”. Moreno envisioned Psychodrama as a group vehicle to address a variety of psychological challenges related to physical, familial and personal development (Hare and Hare 1996). He felt that flexible roles encouraged spontaneity, creativity, and 21 imagination were the corner stone to his method. Moreno suggested several additional constructs such as Sociometry, catharsis, warm up and several stages of psychodrama. Sociometry Moreno proposed a model of human interaction that he labeled Sociometry. He postulated that at the centre of the person is the body which represents the biological core. The body is surrounded or influenced by the mind or psyche, and these structures are then interactive with society. He further suggested that central to mind and body is the core constructs of spontaneity and creativity. Moreno employed two concepts to define the relationship of the individual within society: the social and cultural atom. The cultural atom postulates that individuals relate to other persons in either a negative or positive manner. This network of negatively and positively related interactions among people constructs the individual’s social atom. The social atom is surrounded or embedded in the cultural atom. This represents the many roles each individual embraces, and defines the behavior and interactions with the members of their social atom. Moreno’s work has influenced many psychological investigations. Theories ranging from role theory (Sarbin, 1966) to social learning (Bandura, 1977) and group process (Blatner, 2002) have elements that mirror his work. Moreno organized his model of the structure of psychodrama around five core functions (Smith, 1 999).These include: 1. Director: A trained psycho dramatist who is the primary facilitator of the drama. The director has three functions which are: manage the action of the psychodrama, act as therapist, be the analyst. 2. Protagonist: the person whose life and problem is at the centre of the drama. 3. Auxiliaries: These are group members who assist the director with the drama. 4. Audience: The remainder of the group 22 who have not been assigned specific roles. Pitzeli (1992) refers to them as “the sounding board of public opinion” not unlike a Greek chorus in ancient Greek tragedy. 5. Stage: designated space for the drama to unfold. Moreno suggested, in addition to these core functions, three phases important to the psychodrama: warm up, action, sharing with the group as a whole. Warm Up Moreno’s belief was that all life activity involved warm up (Goldman and Morrison, 1984), the purpose of which was to prepare the Protagonist for action. This would include the full range of cognitive, sensory, verbal and behavioral engagement (Goldman and Morrison, 1984). Moreno used this concept to determine group climate and to focus on potential material for the action (Enactment Phase). Originally, Moreno emphasized ongoing spontaneity and focused less on safety in the group. Spontaneity was supreme and the impact the enactment had on the individual was less of a concern. His emphasis on spontaneity and creativity reflected his belief that they are essential traits in human life. In the early development of psychodrama it was acknowledged that the warm up would be unique to each person (Goldman and Morrison, 1984). Action This is the stage of the Psychodrama that reflects the convergence of the protagonist, director and the audience. Holmes and Karp (1991) suggest: “There is no script; the drama is spontaneous, created in the moment by the protagonist, auxiliary egos and the director” (p 9). Moreno’s influence has been invaluable from two perspectives and includes contributions to both theory and practice. First, he was interested in the process of the 23 drama, and the content was not accentuated. As already stated he believed that spontaneity and creativity were the important constructs to emphasize in his model. He also believed the protagonist’s emotional process was absolute and cathartic and the actual content of the drama was secondary. Second, Smith (1999) contends, “psycho dramatic work involves explorations at cognitive, behavioral, emotional sensory, linguistic, paralinguistic, spiritual and interpersonal levels” (p 3). Moreno considered process to be the fundamental dynamic of therapeutic change. The enactment concludes by allowing for both the protagonist and the audience to share their experience, enabling the ‘audience’ to debrief their experience within their context. Sharing also allows the group members who have participated in a role to debrief their experience in that role as well as to describe what they may have personally become aware of during the drama. Blatner (1985) suggests the protagonist “creates meaningful connections between events in life which otherwise may have seemed disparate or isolated” (p.135). Therapeutic Enactment Several investigators have used Moreno’s original model to expand and develop Psychodrama. Remer (1997), Blatner (2002), and Westwood & Wilensky (2005) have adapted Moreno’s model and used a variety of theoretical orientations ranging from Chaos Theory (Remer, 1997) to Object Relations Theory (Brooks, 1998) to develop the T.E. model. By adapting Moreno’s model these investigators have expanded and adapted psychodrama for a variety of therapeutic situations. Westwood and Wilensky (2005) have adapted the original work of Moreno to reflect and update both the approach and its theoretical orientation. Both approaches use 24 similar devices and procedures in tenns of the structure of the drama, but there are some significant differences. Westwood &Wilensky recognize the role of intra psychic conflicts and interpsychic conflict processes. The emphasis in this approach is on group stages such as the initial phase, the enactment and integration stages. Westwood and Wilensky place a greater emphasis on the component stages that include planning, group safety and integration as key characteristics to their model. In addition, therapeutic enactment includes: 1. Assessment& Preparation Interview, plan enactment, safety/inclusion, personal control. 2. Group Building Trust/intimacy, cohesion, selecting participants, setting up the scene, initiate enactment, risk taking. 3. Enactment Expressive experience completion de-roleing reintegration 4. Sharing reconnecting closure, Client self reflection, witness sharing, closure. 5. Integration & Transfer Follow up. The T.E. model differs from Moreno in four primary domains. First, the T.E. model has developed a precursor step prior to the beginning of the groups and that is the element of planning and preparation. Careful preparation allows for more control and clear identification of the presenting problem for the group member. With the addition of this type of personal control a greater degree of safety is brought into the process. Second, T.E. suggests that spontaneity is an end product of process. Whereas 25 Moreno felt that the “here and now” were important to the spontaneous development of the group, and conducted the group so as to create opportunities for those engaged in the psychodrama to be spontaneous, T.E. views early spontaneity as a potential threat to the group member’s need for a felt sense of personal control (Schutz, 1958). Spontaneity is seen more as a desired outcome of personal change and integration, more characteristic in the later stages of the group. This is the reverse to that of Moreno’s focus on client spontaneity through active improvisation (Blatner, 2002). Catharsis is the third and perhaps most significant of the four key processes of T.E. and is a part of the personal process essential for emotional processing and facilitating repair. T.E., with its emphasis on safety during the construction of the group, places a higher value on confronting the “shadow” or the unexpressed affect. The therapist in this circumstance must pay attention to insuring that conditions of safety are addressed so the protagonist feels safe. It is essential to the development of the container and to group process. Equally important is the link between memory, emotion and cognition. Intense emotional expression releases the client to access more awareness and often leads to reductions in anxiety, leading to less inhibition, hence greater spontaneity. This allows the individual to reach out and reconnect with a social network that includes the “self, family, colleagues and society” (Westwood, Wilensky and Keats, 2003). Fourth, the T.E. model stresses the need and value of monitoring the dynamics of group process in the course of change (Yalom, 1985, Trotzer 1977, Gladding, 2002). Groups function in developmental stages that promote the preferred conditions for member learning. A description of the developmental stages for understanding group development is offered by Borgen, Amundson, & Westwood, Pollard (1989).These 26 include initial, transition, working and termination. Trust and safety need to be present for members to initiate and engage in the process of meaningful member to member learning. Kivlighan (1991) suggests that group members benefit from interpersonal exchanges which are important to the factors that contribute to growth. In addition, Sullivan and Reno (1999) have demonstrated that members can and do assess each others task related performance. Their study is one of very few attempts to measure the influence of members on each other while the group is at work. Westwood and Wilensky (2005) describe the process of T.E. within the theoretical framework of Yalom (1985). The therapeutic enactment model incorporates the eleven therapeutic factors identified by Yalom (1985): instillation of hope, universality, imparting information, altruism, and the corrective recapitulation of the primary family group, development of socializing techniques, imitative behavior, interpersonal learning, group cohesiveness, catharsis, and existential factors. This model recognizes the influence of the witness during an enactment. Buell (1995) has suggested that this element is not only important, but plays a central role in the development and outcome of the enactment. T.E. includes the use of other senior and experienced members to assist in maintaining group safety and member support. Their purpose is to sit among the witnesses and attend to the group’s psychological and emotional needs. Similar to Moreno, the therapeutic enactment model employs four designations for the participants: 1. Leader-therapist is the individual that takes responsibility to guide the group and the various members through the enactment. The central focus is directed toward the protagonist. 2. Protagonist-client is the person for whom the enactment is designed and is the central focus of the enactment. 3. Witnesses or group participants are 27 those who are there to assist the leader and protagonist and assume the roles and alter ego’s that make up the enactment. 4. Assisting practitioners are the witnesses and attend to the group’s wellbeing. The process of enactments follows through five phases: 1. Assessment and preparation; the leader works with the protagonist in the planning and development of the enactment. 2. Group building; the group cohesion is developed and enhanced. 3. Enactment; the protagonist chooses the individuals who will participate in the enactment, assuming the roles assigned to them. 4. Group processing; the period after the enactment or after the group processing when the group shares their experience with the protagonists and others. 5. Integration and transfer of learning; the time after the enactment or after the group processing, when the protagonist reflects on their enactment and begins the process of integration of learning. Enactments include a broad range of issues and content. Westwood and Wilensky (2005) suggest appropriate interventions would include the following: “personal and group trauma, grief and loss, secondary traumatization, interpersonal conflict, family of origin issues, institutional violence, work or employment events, workplace burnout, and team building for a variety of groups experiencing barriers to personal and professional communication” (p. 4). I have discussed the development of psychodrama and therapeutic enactment and will now link that process to the early investigations into encounter groups by Lieberman, Yalom and Miles (1973). 28 Lieberman, Yalom and Miles Lieberman, Yalom and Miles (1973) in their seminal investigation into encounter groups posited several factors that impacted the direction and objectives of the current study. During their investigation the Personal Description Questionnaire and the Friendship Semantic Differential were used to generate profiles of groups and members. Their study found that those entering encounter groups were heavily influenced by significant others, either positively or negatively, and these influences were strong predictors of either a positive or negative outcome of the group. In their study they examined person-group relations by asking the members to complete a questionnaire that assessed the attractiveness of the group. The questionnaire enquired about group members and asked the groups; do you like your group? How many members of the group would you replace with ideal members? This was done in the early sessions and later sessions and the responses were compared. The results indicated that those who benefited from the group “did establish a characteristic psychosocial relationship, differing from those who did not learn” (p. 342). In this study, one significant result noted by the researchers was the sharing and the exchange of feelings between group members. They labeled this factor as Expressivity. It was ranked third out of eleven factors by group members as most important. The expression of feelings was personally important to group members and the range of emotions included positive (support) to negative (anger). Of particular interest was the finding that “over two-thirds of the events selected involved the expression of feelings by other people rather than self expression” (p. 351). Lieberman, Yalom and Miles (1973) commented that they had anticipated T groups and their members not to respond to cognitive interventions. Instead they found that members 29 did respond, and cognitive processes did influence their learning. In their findings a discussion of the concept of spectatorism is offered and is defined as “being in a situation where others are having critical and significant emotional experiences” (p. 369). This seems to reinforce early observations of Lieberman, Yalom and Miles (1973) regarding the influences members have on each other’s learning. These investigations were the only attempt to establish a causal relationship between members in a group and provide a basis for connecting member to member learning and my study. Member influence in Group Process The literature is relatively silent on the therapeutic influence and the effect of the relationships among group members. Johnson, Burlingame, Olsen, Davies and Gleave (2005) examined four group constructs: group climate, cohesion, alliance and empathy. Using a large sample, their study compared four constructs to a three factor model: member, leader and group. They found that all factors were highly correlated but the member to member influence was especially strong based on the “quality of the relationship rather then by who was involved” (p. 12). Buddeberg-Fisher, Dietz, Kiaghofer and Buddeberg (2006) examined the process Swiss medical students followed when deciding to choose or failing to choose a career in medicine. Of particular interest was the development of sub categories from the original categories in their analysis of the data. McCallum, Piper, Ogrodniczuk and Joyce (2002) examined attrition rates in short - term group process and the effect on early process issues. Additional research concerning member to member learning is sparse. This is the gap in understanding the process that members have on each other. 30 Summary This chapter has reviewed the concepts of social learning, in particular, self efficacy. The development of group therapy models related to the understanding of group dynamics and interactive processes and outcomes. Finally, I have reviewed the specific group approach found in this study, Therapeutic Enactment. It is recognized that a gap in the research has become apparent and that member to member learning has not been thoroughly investigated. The next chapter presents the methodology employed to examine the research question. 31 Chapter 3 Methodology The challenge I faced selecting an appropriate methodology for my research question included the choice of selecting a qualitative or quantitative method. Black (2003) makes the observation in a review of the literature that many methodological difficulties exist, associated with researching psychodrama. Challenges include poor definitions of constructs, low level of therapist training, and the fact that the majority of studies published are in non peer reviewed journals. Brooks (1998), in his review of the psychodrama literature, comments on quantitative studies: “Clearly such a fragmented approach to proving psychodrama effective combined with the resulting disparate finding has been unable to reveal detailed and holistic patterns that might advance a more unified theory of psychodrama, or describe enactment as a core change process” (p. 38). Hill (1997) et al. address the issue of qualitative versus quantitative approaches by suggesting it becomes a question as to the purpose of the research. They suggest that when examining the counselling process, qualitative methods are likely more satisfying in terms of outcomes. Hill (1997) et at. point to several factors that need to be considered when conducting qualitative research. They suggest that, in order for process research to have validity and reliability, the components must be broken down into a manageable and measurable size. When examining an interaction or counseling process Hill (1997) et al. suggest that an initial exploratory investigation is a logical starting point. Black (2003) points out several qualitative studies (Baum, 1994; Brooks, 1998; Devries, 1994; Keats, 2000 and Morley, 2000) have been conducted with the T.E. model because the methods 32 used in these studies capture the participant’s experiences and perceptions and contributed to the development of a rigorous qualitative approach. The challenge to select an appropriate qualitative methodology for the current study was to first focus on how to capture member to member learning and then to examine that process. The approach needed to allow for the data to be examined in a rigorous manner without allowing for the process to be compromised by potential confounds. The method also needed to allow for a stringent analysis of the interview data but not have the participants themselves become confounding, as in the Hawthorne effect. That is to say the participants needed to be unaware of what was being examined so that they did not try to give to the research what they thought I might need. An identified need of the study was to be able to collect the data so it could be collected in a small measurable size using the research question as a guide. In order to examine the interactivity of member influence on therapeutic change it became necessary to select a method that would capture the data of the actual interaction that occurred between members in order to investigate the process. In other words, a process was needed to capture member to member interactions, examine them and compare and contrast these interactions so as to measure member influence. A review of the literature suggests an array of potential qualitative methods. For the purpose of the current study, content analysis was selected since it has the distinctive feature of providing a method to study the content of a text and to examine the meaning of the text. Mayring (2000) provides a methodology to examine text and the meaning of text by employing inductive and deductive analysis. Berg (1995) suggests that “researchers examine artifacts of social communication” (p. 174). For the purpose of the 33 current study, oral communication was embedded in an interview and captured on tape. By recording the oral communication and creating a text it allowed the researcher to create a “temporal vacuum”. In a sense, a temporal vacuum freezes the therapeutic process in time or, in this case, the text. This allowed for an examination and exploration of what may be occurring within the therapeutic interaction or member to member influences. This approach focused on the meaning of the text as it was constructed. Mayring (2000) provides a staged technique employing inductive analysis to measure meaning and an unobtrusive approach. Participants and the Interviews A therapeutic enactment workshop was conducted with 14 people as participants. The participants ranged in age from twenty six to fifty one years old, old and were composed of both female and male participants. All were in the process of graduate training in counselling psychology and had participated in two psychodramas. A leader, trained in the Westwood & Wilensky TE model, led all of the enactments from warm up phase to integration. At the termination of the workshop I asked that anyone interested in being part of an investigation regarding T.E. should contact me. All fourteen group members volunteered to participate in the study. My role was that of an observer. Six were male and eight were female which I believe helped balance any potential gender issues that may act as a potential confound. All were graduate students and indicated a keen interest in the process of T.E. Although they were unaware of my research question, each participant demonstrated interest in the many different components of T.E. All participants that volunteered for the study remain for the interview and therefore there were no dropouts. 34 I conducted open ended interviews with the 14 participants. A specific open ended question was asked at the beginning of each interview. The questions were: “Is there an experience or event during the enactment that was significant and was the result of a member impacting you in some manner and would you please describe it”? Each interview ended with the participant having a final opportunity to describe their experience: is there anything else you feel the needs to added or included? The interview was guided by the participants and was based on their lived experience participating in the T.E groups. The interviews lasted approximately one hour and open ended questions, summary statements and clarifying statements were used throughout each interview. A transcription of the interviews was then completed. The accuracy of the text was verified by an independent reviewer. This text was used for the purpose of content analysis. Content Analysis Historical Perspective Historically, content analysis was used to examine speeches, informal conversations and interviews. These studies focused on frequencies of words in a text. It was time consuming and, to a large part, impractical. In thel95O’s content analysis began to evolve into a more sophisticated research method and moved away from simple counts to examining semantic relationships. This has led to two traditions in content analysis; frequencies or simple word counts or the relationships among concepts in the text. As these two traditions developed it became necessary to define the terms and processes of the method. Content analysis, as indicated by Holsti (1968), is “any technique for making inferences by systematically and objectively identifying special characteristics of messages” (p. 608). Messages can be classified as written or oral statements. Also as suggested by Mckenna and Todd (1997) “the link between 35 intervention and outcome is established through descriptive and explanatory accounts or stories generated by therapy participants” (p. 387). Content Analysis involves the examination of participant communication whether in an oral interview or an analysis of the transcript of that oral interview. The first polarity the researcher encounters in content analysis is whether it is quantitative or qualitative. It must be decided, before the data is collected if it is simple counts or relationships among concepts that are to be explored. Arguments can be made for both; however Abrahamson (1983) reports “content analysis can be fruitfully employed to examine virtually any type of communication” (p. 286). Abrahamson states that either quantitative or qualitative approaches may be utilized when using content analysis. Smith (1975) suggests a blend “because qualitative analysis deals with the forms and antecedent-consequent patterns of form, while quantitative analysis deals with duration and frequency of form” (p. 27). Manifest versus Latent Content Analysis Berg (1995) offers a model that begins to provide terms and a process for qualitative content analysis by offering the constructs Manifest and Latent analysis. Manifest analysis is comprised of that element of the text that is present and accountable. In latent analysis the emphasis is far more hermeneutical or interpretative. Berg (1995) differentiates between these two by indicating that manifest analysis is comparable to surface structural analysis, while latent analysis focuses on the deep structural meaning within the text. Additional independent corroboration is required for latent analysis (Holsti 1968). Berg (1995) outlines the process of content analysis and supplies terms for his model, which I will briefly review. 36 What to Count Content Analysis allows for a range of levels and units of analysis. These include words, phrases, sentences, paragraphs sections, chapters, books and similar elements relevant to the context (Berg, 1995). He suggests seven categories for classification of oral communication. They are: words, themes, characters, paragraphs, items, concepts, and semantics and suggests an initial sorting starting from the smallest unit and building to larger units. He also points out it is not unusual to use more than one category of analysis, until categories begin to emerge. The next step associated with context analysis is establishing the relationship across levels; sorting of the smaller units into the larger units into which maybe the emerging categories. The first step is to identify a specific content characteristic. The second is the process of organizing the data and deciding on how to record these characteristics. It is important to have these predetermined so coding can be systematized according to a theoretical framework. Open Coding Open coding is the process of reading the text and identifying the concepts and characteristics. It is a process that is conducted several times until the categories are clear and the researcher has been fully immersed in the analysis of the data. Berg (1995) suggests that “the most thorough analysis of the various concepts and categories will best be accomplished after all the material has been coded” (p.186). Strauss (1987) has four guidelines when conducting open coding. Berg (1995) has provided a model that has a 37 theoretical framework for content analysis by introducing key concepts such as manifest and latent analysis. Others have refined his model and concepts to increase validity in the process. Shenton (2004) provides four strategies for ensuring trustworthiness in qualitative research. • Credibility: well established method, credibility of researcher, voluntary participation. • Transferability: provide information about the content, people involved and procedures and design. • Dependability: planning of research, what actually happened, reflective appraisal of project. • Confirm ability: audit trail/how the data was gathered and on what bases the finding were derived. One such model is suggested by Mayring (2000). Mayring’s Model Mayring (2000) provides a model for content analysis that emphasizes inductive and deductive reasoning and a stepped approach to the data analysis. Mayring avoids potential confusion of the previous models by what Kippendorff (1980) observes; “classical quantitative content analysis has few answers as from where the categories come from, or how the system of categories is developed” (p. 103). Mayring (2000) offers an understandable model with specific steps to follow and is driven by the research question. Mayring (2000) begins with three basic ideas of content analysis and they are reproduced below: 38 Fitting the material into a model of communication: It should be determined what part of the communication inferences shall be made to the aspect of the communicator (his experiences, opinions feelings), to the situation, to the socio-cultural background, to the text itself or to the message. In my study it was determined that the inferences were to the participant’s text itself. • Rules of analysis: The material is to be analyzed step by step, following specific steps dividing the material into content analytical units. • Development of categories in the center of analysis: For a step by step review of Mayring’s deductive content analysis see the steps below: 1. Research question. 2. Theoretical based definition of the aspects of analysis, main categories and sub categories. 3. Theoretical based formulation if definitions, examples and coding rules for the categories and collect them in a coding agenda. 4. Revision of categories and coding agenda (formative check of reliability). 5. Final working through the text (summative check of reliability). 6. Interpretation of the results. Using the research question as a guide, developing the data and placing it into the categories, this can be reviewed and revised within the process of analysis. Mayring (2000) observes that this process allows for triangulation and thus more confidence in the data and results. 39 Procedures of Qualitative Content Analysis Mayring (2000) has two approaches to his model; inductive category development and deductive category development. I have chosen deductive development for the method of this study. I have done so because, as stated earlier, with little research on member to member learning it seemed a logical place to begin the process. The process is described below. Deductive Development Mayring (2000) suggests that within the framework of interpretation, the categories developed are reductive processes. Deductive category applications, according to Mayring (2000), work best with a prior formulated theoretical framework. Mayring recommends six steps; 1. research question, 2.theoretical based definition aspects of the categories, 3.theory based formulation of coding rules and collecting them in a coding agenda, 4.revision of categories and coding agenda ( formative check of reliability), 5.final working through the text (summative check of reliability), 6.interpretation of the results. A more detailed examination of the six steps and the process of how to operationalize them follow. Deductive Category Application 1. Research question. In this case the question is what impact do members have on each other in a therapeutic enactment group, and how does this contribute and influence each others learning and therapeutic change process. Mayring (2000) states that all analysis and the 40 development of the categories must start with the research question, it allows for a methodological controlled assignment of the categories. 2. Theoretical based definition of the aspects of the analysis. Mayring’s (2000) model requires a theoretical foundation and given that I have chosen to use Bandura’ s construct of reciprocal determinism and have attempted to group data according to this theoretical model. Bandura’ s model establishes predetermined categories based on the construct of reciprocal determinism. The relationship among affect, cognitions and behaviors were used as the definitions for the aspects of analysis, and main categories. In gathering the data I counted significant words that represented member to member interactions for the initial coding. I categorized them according to the three broad categories Bandura has developed. These include the triadic factors of social cognitive theory; thought (cognitive) feelings (affective) behavior (motivators). 3. Theoretical based formulation of definitions, examples and coding rules for the categories. Collect them in a coding agenda. The coding categories clustered in step 2 followed along the theoretical orientation to record, code, and analyze and collect the data in the coding agenda. Step 3 involved the establishment of the main categories. The initial coding consisted of reading through the entire transcript of the interviews of the fourteen participants and immersing myself into the text. The purpose was to become aware of the range of member to member interactions. The basics of these interactions (verbal interviews) developed the content analysis, and these ranged, from the smallest interaction such as a word, to the largest interaction being a theme such as isolation. The task then was to count all of the words or phrases in each sentence and place them in the three previously established categories 41 outlined in Bandura’s model of reciprocal determinism. They include thoughts, feelings, and behaviors. The initial examination of the data using open coding registered 26,313 words. Examples of these are betrayal, relate, support, symbolism, validating, aware, shame, thinking, angry and entanglement etc. The next step was to look for words or phrases that were used more than once and repeated across participants. The final step was to determine those words or phrases that occurred with the greatest frequency and place them into the categories predetermined using the theoretical foundation supplied by Bandura (1977) of thoughts, feelings and motivation as the foundation of his reciprocal determinism model. This was done by collecting them in a coding agenda. 4. Revision of the categories and coding agenda (At this step a formative check of reliability can occur via the research question.) It is important to consider the nature of human communication and the factors that are essential for communication to occur. Bandura contends that communication has three components which include; the message, the sender, and the audience. The message is the content of what is spoken or written. The sender is the person who initially sends the message and the audience is the receiver of the message from the sender. The current study utilized a combination of these components to establish the parameter of the investigation and allow for the collection of data centered on the nature of member’s influence. The T.E. group included all three components of what Bandura maintains is important in the process of communication; the message, the sender and the audience. The categories were based on the three categories of affect, cognition and behaviors and 42 organized into the coding agenda based on the coding rule that determined which categories it was placed into for interpretation. 5. Final working through the text. At this step the entire text and categories were reviewed by an outside reviewer for confirmation that the categories, rules and the theoretical foundation for selection of the categories were correct. 6. The final step is the interpretation of the results. The purpose is to give explicit definitions, examples and coding for each deductive category, determining exactly under what circumstances passages can be coded with a category. Those categories of definitions were put together within a coding agenda. What were produced were categories and a definition of those categories. These were reviewed by a rater to confirm the categories and the need to develop sub-categories. The categories then created ten sub categories and include; shame! suffering! pain,! supportJ understanding! acceptance, renewal! trauma! loss, redemption, !taking one’s place, belonging!, integrating self reflection, past /present/future, connection with others, recognition of the impact of members experience. These sub categories fell into one or more of the main coding categories. These sub categories are placed beneath the three main categories from the coding agenda. This will be discussed in chapter 4. 43 Chapter 4 Findings This study asked the question, what impact or influence do members of a therapeutic enactment have on each other’s therapeutic processes. As stated earlier in the method’s section, this study is exploratory and focused on the manifest content of the text. Below is Table 1 outlining the three categories that were used to code the text: Affect, Cognitions and Behaviors. Beneath the categories are the Sub-Categories which were created as a result of the coding. TABLE 1 Affect (feelings) Cognitions (thoughts) Behaviors (expectations) Shame /suffering/pain Support/understanding/acceptance Renewal! trauma /loss Renewal/trauma/loss Redemption Redemption Redemption Taking one’s place Taking one’s place Taking one’s place Belonging Belonging Integrating self reflection Self reflection Self reflection Aware of change Aware of change past/present/future past/present/future Connection with others Connection with others Connection with others Recognition of the impact of Recognition of the impact of members experience members experience 44 Ten Sub-Categories were created; definitions and explanation of the sub-categories are examined with text to support the discussion of the findings. The Sub-Categories As the coding progressed the patterns became clearer as a result of the generation of categories based on theoretical definitions supplied by Bandura (2006). Content analysis resulted in the creation of the following ten sub-categories: Shame/SufferinglPain Definition: This category can best be defined as member’s experience of circumstances that they found to be shaming where they suffered pain, humiliation and isolation. This ensued from either an inter-personal or an intra- personal incident. More concretely, the felt experience was triggered by seeing and interacting with others who experienced shame. The connection to others in the group became apparent as members experienced shame or humiliation or the felt sense of being abandoned. Words and phrases approximating the category of shame, humiliation and isolation were the largest to emerge from the coding. In this category pain and suffering also emerge. The pain and suffering is expressed in the form of the connection with others in the group. Examples from the text are the following: “That’s all I see is just suffering and grief. All the anger... like in a moment I can imagine this overwhelming kind of confusion and anger it would be easy to just “shut up” it would be easy to do that”. 45 A further example of member interaction relating to this category of shame is the following; “The other big area. . . trying to deal with our own stuff as best we can at all times and we innocently go about making a lot of things worse”. Pain and suffering were experienced vicariously sometimes in physical body pain but also in emotional pain. “Something was growing inside me.. .that was hurting... it was real pain.... What I mean except it was emotional pain”. The connection to pain and suffering was expressed in a number of ways but one of the strongest was the link between confidence and shame. In the following example the member is reflecting about how, after watching a member experience shame, he lived it vicariously. “I think I used to have a problem with confidence and shame that sort of sounds right to me because before there was this real damage way I think I looked at myself and thought that people could see and I don’t have that”. Support/Understanding/Acceptance Definition: This category is best defined as when members felt supported by other members. This had a very broad range and included something as small as a glance or smile to physical touch and contact. Also significant was the context of supporting themselves by being with the group and the group acting as a supportive container. This category was centered on the need for both emotional and physical support and a deep understanding of who the member was when they were potentially the most vulnerable. On many occasions the tolerance or acceptance was not just having a tolerant 46 attitude. It seemed more akin to unconditional regard. The understanding came from a confluence of watching the enactment unfold and how that process interacted with the members both intrapersonally and interpersonally. “Putting myself in her shoes and then of course mixing that with my own stuff. That’s sort of what I am left with”. That understanding was rooted in empathy. “Relating to where she was at in the present but then you know having what we did in the past the pieces of it were her and more empathy then my own stuff that allowed me to be there or something my empathic connecting with her”. A second example of support manifests in a different context. “Something else that came up for me was in the second one and I said also during the debrief that to see somebody just like take all the defenses that they got and let them go. That is a really hopeful thing to see because I know I have a lot of those defenses as well”. A final example of support and acceptance is the following interaction. It demonstrates how one member, unsure of their role, watches a different member, and he assumes a role so the other could watch and feel comfortable. Support and acceptance seemed to operate in different contexts and circumstances. “He is a very respectful person and so very gentle and caring and so I kind of followed his lead in some ways so lets see what he does”. 47 Renewal/Trauma/Loss Definition: This category is labeled renewal, trauma and loss because loss seems to be defined by the members in a variety of contexts and can be real or figurative and metaphorical. Trauma is identified to be the process that occurs between loss and renewal. The theme of loss and renewal was a strong and persistent category in the text. Loss is used as a metaphor in describing the member’s experience in both the enactments and in the reflection of the enactments. Loss acts as the vehicle for movement or renewal to new insight or learning. Some metaphors include the following variations: unfinished business, lack of closure, unresolved anger and the loss of innocence. Several examples follow, but in the following quote loss is linked to the search for understanding. “I think sadness was a big part of it and almost feelings of a loss a little bit I’m not sure where that came from but just like a feeling of loss maybe of knowing feeling as though I wasn’t up to par So feeling some sort of loss within whatever I didn’t have... I think so yeah yeah just knowing the piece that I’m missing I think that what I was feeling”. A second example of loss, the search for understanding and the trauma one needs to process in order to secure that understanding follows. “I just knew that I felt intense emotion and also have the feeling of wanting to shut off that emotion. So I had a real struggle to shut my self off to being something that I wasn’t even comfortable being”. Trauma is seen as a metaphor for a journey to change and is evident in the text. Members seemed to see the process of trauma as a struggle with self. 48 “That’s exactly what it was I was struggling with myself. I remember at the time thinking you know just ok yeah just you’re feeling this but you’ll deal with that later. Like you have something to do but I really had a hard time being able to do that”. Renewal is evident in a number of contexts. Part of what renewal is seems to be the attainment of awareness by reflection on self and others and the influence members have on that process. “Most helpful to see the emotion with Jane 2 actually had done the enactment and see how she responded to everybody’s comments and how it seemed to be such a positive thing that what impacted on me just seeing the positive change within her .Seeing her smile or seeing her comments to other people what they were saying to her... it brought in a piece to it that I hadn’t thought of’. Part of renewal is the connection to others in the group and the awareness that those contacts bring to the member. “What a bright man and very articulate and my reaction was his insights.., they were extremely insightful I thought and I thought that would be so valuable that kind of thinking”. Redemption/Salvation Definition; the Merriam-Webster dictionary defines redemption as” the act, process, or instance of redeeming”. In this study redemption includes the concept of recovering self and organizing it so that recovery is embedded in a variety of contexts. 49 Members seemed to self define their own moments of redemption. It seemed each member experienced their act of redemption differently, but collectively this seemed to follow a similar process. For some, redemption was an emotion. For others it was an act of atonement or reparation for an injury. Collectively, to reach this place it seemed necessary to follow a path that leads to a journey and a sense of traveling through, and to a destination. The following text reflects this sense ofjoumey and redemption. In this example it seems the journey was love. “And then calling her to come down and blah blah and she didn’t come down and she was the bad one and she and that hurts and that really impacted me personally it was just so heart breaking. Yeah she so clearly loved her dad and she wanted her dad to be normal”. In this example the sense ofjourney is a quest or a form of trial and the connection is part of a process of redemption. “I had to struggle in my own life to find my voice yeah to stay true to my voice and it’s been a struggle with my family its been a struggle with life and choices so I can relate to her I saw toward the end she found part of her voice I guess its an ongoing journey she does find.., so that was very empowering to me”. The category of redemption was powerful in the context of the text. As the additional multi layered sorts were completed meaningful examples of the pattern emerged. In this context the theme of redemption seems to have emerged as an overarching category, and is seen in much of the text and in a multitude of contexts. The connection to the group and witnessing something sacred seems to be the overarching construct and the connection between the sacred space and redemption. 50 “Yeah well for her and just the awareness that it’s possible. Because every now and then you feel- I feel so weighed down by things that there is no light at the end of the tunnel and that reminds me that there is... you know... I can go over the things that I need to let go of sometimes if 1 need to and also to be part of that is... to be in a setting where somebody is so comfortable it creates a feeling of trust and security and it is real neat to be a part of and for me that kind of stuff that makes me know... because whether I did or did nothing or whether anybody else did it or nothing just to be in a setting where she was really able to let go and there was no fear of what people might think or say or do... it feels really good to be a part of that”. Taking One’s PlacefNot Good Enough Definition: This category has two components. First is the sense that no matter what one does they are not good enough and second, it is linked to the lived experience of the members felt sense of stepping into or taking their rightful role or position in life. The first part of the category includes the intrapersonal and interpersonal experience of the member having failed to arrive or achieve “taking one’s place”. It manifested in the sense of not being good enough. “But that little voice in the back of her head that says you could get this done you could get that done and you could do better in this and you could do better on that... I real get that because that little voice is in my head too”. In this example the theme continues. 51 “I could relate quite well to her... but more around the urn how hard she was on herself and how urn she expected a lot more of herself’. In this example she relates to the protagonist as having good qualities but, “And that’s me as well I’m my own harshest critic and will constantly push myself and get mad at my self for not being more than I am and it really impacted on me listening to her story”. Context does play a role, but primarily this category deals with the intrapersonal process of arriving or achieving, a sense of competence. The text reflects the feeling component, a number of elements emerge suggesting a number of common patterns. These patterns include how members relate to each other at the feeling level. Their affect is activated and they begin to relate and feel strong emotions toward each other. Examples include family separation, conflict with parents, family conflict and resistance to authority a link to the notion that accepting one’s identity is accepting integrity in the face of authority Campbell (1 968).This category is a variation of the connection of stepping into the light of self acceptance and accepting one’s strengths and limitations. Taking one’s place seems to be about acceptance. This first example demonstrates how one member facilitates another member’s sense of acceptance; “A key to Jane 2 was she was going to try and love herself more... Having sat through the enactment and it really reinforced it for me.... you are a good person, you have accomplished things and you should be proud of that and not be so hard on yourself and give yourself a pat on the back, and give your self the opportunity to enjoy life and not worry so much about those less important things”. 52 The second example displays the efficacy of taking one’s place, and the struggles and entanglements that prevent that from occurring. A big part of the process of taking one’s place is setting boundaries so that the entanglements do not prevent the person from stepping into their place. “It’s interesting it came to me as a relief because I was hoping it sounds really silly yeah I was hoping the message would get across to her you know when you are entangled in the web like in my own family webs you know you don’t know your in it. . . it is so its hard for you to step back and see it you know and get a perspective you know its so confusing and stuff I guess I was just really hoping she could that just step back and see it”. In the following example the member speaks of the impact another member had on her sense of connection and acceptance to her father involving boundaries. “She had already lost her mom like in a sense that relationship is just so bad then she loses her dad too... so I think that was really hard to see that like how you draw boundaries around that. I know how she struggled with that so that was a big impact on me”. Belonging Definition: This category is broadly based and falls into two sub categories, which are the interpersonal dialogue the individual has with the group and the member to member interaction that they experienced, both of which contribute to a sense of belonging. These experiences occurred through a variety of sources such as acts of reciprocity and individual reparation. Acts of generosity facilitate the felt sense of belonging. 53 Reaching out to a member allowed that member themselves to feel connected to the group and increase their sense of well being. By a reflection on an act of reparation the member connected through the group to a change in relationship with the self and ultimately a change in self understanding. “That by doing one thing for somebody that made them feel like they belonged and for making them feel like they belonged, I felt like I belonged as well”. An equally strong pattern emerged from the text that is best described as “mirroring”, putting one’s self in the position of the other members and using the process to sort their feelings and reactions; “Yes that is correct it was what I felt it made me feel better after talking with other people and hearing other peoples views on it to know they were feeling similar.., similar things yes”. The next example seems to encompass the self and community, demonstrating how these elements contribute to growth and belonging. How one member helps another member to reflect and in this case maintain integrity in the group and facilitate belonging. “She said she had been in two of them and did not find them helpful. She also said a couple of years later after she watched the tapes that fairly changed... Her initial, comments about the two enactments not having a large impact on her was a bit of a break or it was a major break and pattern. Up to that point the majority of the individuals had spoken they all had very positive things to say about their own experience in observing.., that honesty I think. . . set the tone for me”. 54 This final example, in a poignant way reflects what membership in the group meant to her. “Validating in my experience because and how much the depth that mine affected me and transformed me. I mean I can’t tell you what I reclaimed but I reclaimed a lot you know”. Integrating Self-Reflection as it Relates to Other Members of the Group Defmition: This category is less well defined but I have included it to demonstrate the range of thoughts, reactions, patterns of communication and self schema and the relationship to the group and member to member interaction. A member comments on his observation of the experience, of what one member appears to be moving through, and his interpretation of that process based on his self schema. “Just that well of emotion.. I can feel it was really nice to see the mechanisms that are you know there for self preservation.... Just go away... to see that happen is very nice cause I can identifr with that feeling of letting go... it is real nice to see... that kinda stuff those self defenses’ things are really hard to lose”. On a different occasion a member was discussing a pattern or emotional script that they strongly relate to as they watched another member experience strong emotions; “Looking back at it now popping into my mind very strongly when she started crying... but she could discuss it intellectually but wasn’t accessing it at that deeper emotional level.. .to voice it out loud ... and have others witness it... I would imagine would have a big impact on her and then she started crying and that really triggered me... I have talked to other people and voiced that and I have 55 sort of burst out crying I can’t hold it in... it is almost making it real and so Ijust imagine myself standing there saying the same thing and knowing that I wouldn’t be able to hold back”. The self script can often be a negative thought about self. The sense of efficacy can falter. In this next example the member’s sense of self is influenced by other members and how that script can change as a result. “I think also what kind of painted in a different way for me is seeing somebody have similar feelings and feelings that I really identified with it made it more concrete... but I’m not sure how though”. Upon further reflection this member comes to the realization of that change. “It didn’t seem so lonely or something that somebody else also had those feelings I think ya I think validation for sure came from it”. Awareness of Change Past/Present/Future Definition: This category is fluid and can go back and forth from present to past to future in the reflection of the group member, however what this category captures is the felt sense including the interpersonal and intrapersonal self. Members have been influenced by the sense of the interpersonal and the intrapersonal self and as a result have felt changed. In this example the member reflects on the impact the enactment had on her and she relates it to her own past; “Now just taking me back to my early teen years... teen years that had some events that occurred that were impact full like I guess seeing her. . . some of how the patterns that she may have got laid down in that incident”. 56 The impact of the relationship between members and the influence of past and present seem to overlap as is the case in this example; “Yeah I do mean by activated I do mean stirred up in that area and so I felt for a while after... I mean in an area that I’m already stirred up in But for a while after I just found myself thinicing a lot about stuff that maybe about my current you know relationships but more about stuff that happened in the past when I was two”. This member speaks about change and how other members helped him with that change, and what he see as a result for the future; “Isn’t that interesting that she gave me that role... that was her motivation, part of it anyway for choosing me was to give me that experience really in hindsight it was a really good thing... if I go to a future enactment I will know what to expect... I have been in some roles so know what to expect... and so that’s good”. Connection with Others that is Different from Belonging Definition: Members had a variety of connections with other members and this category demonstrates that diversity of connection. The difference between connection and belonging is that connection is between two members and belonging is between the member and the group. This connection demonstrates that members do not have the same “scripts” or identical life events but rather use influential life themes as activators. The member will construct meaning for themselves from the connection with the other members. 57 “This is with the second enactment umm what really impacted me was that I could relate quite well to her umm concerns not the actual incidents around siblings and their impact on her but more around the urn how hard she was on herself’. This member talks about the themes and the impact upon her. “Well there is no question both had an impact on me, however, I would say it was more the themes... the first then the story very much parallels my experiences in life”. The connections between members often involved deep emotional connections such as in this example. “In having sorts yeah relating to where she was at. . . allowed me to be there or something my empathic connecting with her... with that story that kind of trauma umm yeah does that make sense”. What seems to encourage members to search for these connections to each other is the felt sense the member’s experienced in the enactment. They experienced strong emotional connections that seem almost universal in their nature. “Because I could so fully relate umm this was more then normal empathy... I could be saying the exact same thing”. Recognition of the Impact of Members’ Experience on Each Other Definition: A connection of the self and enhanced meaning making of the individual member to the group event. 58 This category captures the experience of members in the process and action of the group, what Bion (1961) described as the container. This emerged as a category in this context but also as a means for the member to reflect on the process and create meaning and learning for themselves. In this next example the member is reflecting on the process and attempting to sort through the events and how it affected him on an emotional and cognitive level. “I identified strongly with her words what she said about her self and I think crying was a byproduct of that but it was more... I don’t know which triggered me more... the crying or the actual story itself because one led to the other”. Part of the impact that a solid container can create is the safety and opportunity to reflect on what other members are experiencing and sharing, and what that process does to the member listening and reflecting. “I guess being in therapeutic enactment where that’s part of the idea of going back and healing things that happened and you know growing up parts of ourselves or reparenting or whatever probably that whole contexts also makes me think in that direction”. It seemed as if many of the participants used the process to recover memories make connections and develop further insight into their own affective and cognitive insights. “Yeah it does actually and now when you talk about it I think that’s where those feelings with me started. I felt safer because then after I felt okay to make comments or two and I did... I was watching others to see what appropriate behavior was”. 59 Summary In this chapter, I have presented the ten Sub-Categories, the definition of the Sub Categories and developed text to support the findings of these Sub-Categories. The chapter that follows discusses these findings in respect to the implications for practice, research and theory. A discussion linking Bandura’ s model of reciprocal detenninism to the findings of this study are examined. 60 Chapter 5 Discussion Introduction In this chapter the findings reported in chapter 4 will be discussed in light of relevant theories related to groups and member to member learning. Second, the relevance of the social learning theory of Bandura (1989) within each of the categories is discussed. Third, I will discuss the findings related to member to member therapeutic change within the T.E. model. The chapter ends with a review of the implications for research and practice as well as a section on the limitations of the study. The purpose of this study was to understand the influence members have on each other in the change process within the TE group. Fourteen members who had participated in a therapeutic enactment group volunteered to be interviewed for the study. An interview of approximately one hour was conducted and a transcript of the interviews was produced. It was important to identify a methodology that would suspend or freeze the member interactions so that manageable parts of the interactions could be observed. As previously observed, Hill (1997) et: a! have identified the need to examine the counselling processes in units that allow for the observation of these processes. It was important to capture data that was a small enough unit of the counselling process, so as to make it measurable and manageable. The nature of this study was exploratory, in large part because of an absence of research in the literature on the topic of member to member influence in group therapy contexts. The exploration of member change processes was explored resulting in the 61 generation of several categories that identified the type of influence members have on each others learning and therapeutic change. Following the tenets of content analysis I will provide some initial interpretation arising from the analysis as observed through the lens of Bandura’s reciprocal determinism model. This will be followed by interpretations of subtle interactions of the members and in this way provide a more detailed description of member experience. As stated earlier, this study did not intend to be generalizable. Rather it attempted an exploratory investigation, and by an examination of the text from the perspective of both social cognitive theory and therapeutic enactment, and to create a theoretical framework in which to embed this study. The role that the member’s emotional experience played in the context of the enactment seemed to emerge as being important to other members. The categories coalesced within a framework of the individual’s lived experience. All experienced shame, death, rebirth etc. across a range of different contexts within the. group process. It is also interesting to note that similar patterns emerged from the enactments and include the following; taking a journey or quest, partnership, intrapersonal experience, efficacy of place, belonging, shame, script and schema, connection to others. Death as a metaphor is seen as a route to rebirth and renewal. Social cognitive theory appears to provide a useful framework to examine the dynamic of member to member influence. The analysis of the data suggests that indeed member to member learning plays a significant role in the therapeutic enactment process. 62 The Sub-Categories Through the process of content analysis a total often Sub-categories emerged from the final coding. Sub-category 1 (Shame, Suffering, Pain) emerged as the largest of the Sub-categories. From the remaining Sub-categories from Sub-category 2 (support, understanding, acceptance) to Sub category 10 (recognition of the impact of members experience) and are presented in descending counts. These were: Shame and Suffering This finding demonstrated that members related to each other by sharing their emotional suffering, shame and pain and it seemed to connect and support the common elements of member to member influence. An important outcome of the data seems to be the emotional connection between members and occurred when members reported “I identified with them better. I felt closer more like them”. Members reported their sense of feeling “closer” and the interaction of feeling close to other members was a catalyst to their learning. The interaction between members seems to be a potential trigger for change. One participant described that emotional trigger as” Um I’m not sure I can say I thought about anything as much as I experienced feelings in myself umm”. Kline (2002) reports “significant change demands critical interpersonal concerns and insight, emotional experience, meaningful involvement with others”( p. 180). The link between members and their experience of meaningful involvement with other members was reported by every participant interviewed, and seems to be a precursor to members change, and beginning the process of member to member influence. By sharing their experiences of shame and suffering members seem to have made a connection. As Kline 63 (2002) points out, interpersonal insight and emotional experience are essential to change and these members seem to have met those conditions. Social learning theory provides a robust theoretical explanation and understanding of this process. Bandura’s model of reciprocal determinism accounts for environmental, personal, and behavioral factors but these sources of influence are not equal in nature (Bandura, 1977). In one circumstance environmental factors are more important. In a different circumstance personal factors are emphasized and visa-versa. In this example the member speaks to the environmental factor,” at least it was a place for her for those others individuals that were represented in the enactment” because they were moving and talking it became a more real and believable experience. The same member, later in the text reports “I experienced the, the bodily sensations of uh that go along with fright, and urn terror and abandonment and betrayal “. Both of these examples are dependant upon members learning vicariously. When considering vicarious learning, Bandura (1977) suggested that the mediating factors include; attention, retention, and production. This allows individuals to selectively observe behavior and learn from it without having performed the behavior themselves. Therapeutic enactment can serve as a valuable process for vicarious learning to occur. A repeat of the examples from chapter 4 allow for the reader to review them in the context of reciprocal determism and vicarious learning. The first example from the text follows; “Elements of abandonment and betrayal in there and you know I’ve had experiences of abandonment and betrayal in my life and so I could empathize with what she was re experiencing (mrnm) 64 I think because if she were just talking to me one on one (mm) I could imaging a scene in my head but the scene was being played out before me so it was like there was umm more things to perceive that made it, I don’t know kind of more real because there were more people involved there were more people that kind of actually made the scene”. What is important to remember, is that vicarious learning is dependant on retention to memory of the vicarious event. According to the theory this is done with the use of symbols. In this case the participant was induced vicariously through “a symbolic abandonment” which Bandura (1986) reports “produces valued results and expectations” (p. 136). Support! Understanding! Acceptance The need for support, understanding, and acceptance was an experience that participants spoke about often, across a range of experiences within the group. A small gesture from one member to another was seen as supportive, as were the overt demonstrations of support members reported experiencing. In this example from the text the member is reflecting on the support and acceptance they felt from the group and the strong connection they established, “How a group of people got together and loved one another.., they were there to help each other”. As reported in the previous category, emotional connection seems primary to member to member influence. Member influence seems to be associated with primary emotions such as love, and as noted earlier, this particular emotion seems akin to unconditional regard. This finding is strongly supported by Hill’s (2007) identification of the central factors in change. She reminds us that unconditional positive regard and acceptance are essential components of change. I pause 65 to point out that what individuals report feeling occurred between people who had just met and were together for a short period of time. This emotional connection of support and love was generated quickly and with a strong and lasting connection. An example is provided below in order to examine the data through the lens of reciprocal determinism and the triadic nature of this member’s observation. This example speaks to this powerful connection of support between members; “Relating to where she was at in the present, but then you know, having what we did in the past, the pieces of it were her and more empathy then my own stuff that allowed me to be there or something my empathic connecting with her”. For Bandura (1986) self reflective thought accounts for people “being most human” (p. 21). This process allows people to reflect on their experience and beliefs, and affords an opportunity for change. This study demonstrates the power of reflection, in establishing an emotional connection; “Something else that came up for me was in the second one and I said also during the debrief that to see somebody just like take all the defenses that they got and let them go ... That is a really hopeful thing to see because I know I have a lot of those defenses as well”. As discussed in the previous category vicarious learning allows the individual to select and observe behavior and learn from others without engaging in the behavior themselves. The process of reflective thought also utilizes selective behavior but the difference is temporal. In the above example the participant reflected on a past event and experienced change. That change seems to be one of acceptance, an altered perception of a member for whom she now felt hopeful, resulting in an altered belief. Acceptance 66 includes acceptance of others but also includes self acceptance, one of the most powerful change processes in personal transformation (Moursund & Erskine, 2003). In the following example Bandura would posit reflective thought influenced change after the experience because the initial emotion was too raw to process at the time, “I just knew that I felt intense emotion and also have the feeling of wanting to shut off that emotion. So I had a real struggle to shut myself off to being something that I wasn’t even comfortable being” Bandura’s sense that reflective thought is centered on our “humanism”, that which one member gives to the other was reflected upon and incorporated in their value system as a gift. In this way, reflective thought helps to provide a clearer understanding of the theoretical interaction of member learning in this category. Renewal /Traumal Loss This category is richly metaphorical and examines the sense of death as a series of journeys, symbolism, and reflective thought leading to transformation and renewal. “The protagonist and the antagonist first um I think the Uh, the cognitive awareness of the death the rebirth and that kind of stuff came upon reflection “. I have already identified in detail in previous categories the usefulness of vicarious learning and reflective thought as a theoretical framework in which to examine member to member learning. Context is also an important element in this category as the member develops insight vicariously by observing the protagonist and the antagonist as symbols of death and rebirth. Bandura (1991) would suggest that this is the result of a reflective process. Yalom (1985) supports this by his emphasis on interpersonal learning and 67 through corrective emotional experience and the need to face existential issues such as death, freedom, isolation and meaninglessness. Yalom contends the individual must have a corrective experience to repair the trauma. He indicates that eleven therapeutic factors are necessary as precursors to therapeutic change. He supports Bandura by the recognition of the concept of behavioral patterns such as imitative behavior and interpersonal learning in the social microcosm. Symbolism plays an important part in social cognitive perspectives For Bandura symbols are powerful motivators for action. They act as guides and provide meaning in the individual’s life. Evidence of this power can be found in the following example. Equally interesting is the apparent relationship linking the movement to action provided by the symbol, in this context death and rebirth and the learning between members. Once again there seems to be a triadic interaction among environment, cognitions and emotional factors. In the following example loss acts as a metaphor for reinvention, and the member is struggling about that process but clearly insight comes with loss, in this circumstance loss of the previous self-schema. “I think sadness was a big part of it and almost feelings of a loss a little bit I’m not sure where that came from but just like a feeling of loss maybe of knowing feeling as though I wasn’t up to par So feeling some sort of loss within whatever I didn’t have... I think so yeah yeah just knowing the piece that I’m missing I think that what I was feeling”. Herman (1992) observes that four factors are necessary for trauma repair; a healing relationship, safety, remembrance and mourning, and reconnection. Reviewing the above member to member interaction two of the four factors are present: remembrance & 68 mourning and reconnection. It would appear that member to member support can play a role in trauma repair. Redemption! Salvation This category had some similar elements to the previous category such as traveling and a sense ofjourney and renewal. However in this category the context seems not to be a birthing process but more “the act, process or instance of redeeming”. Member learning in this category seems to follow two processes, first individual redemption as an emotional connection, and second redemption for a previous act or wound of the psyche. This is not unlike the process Pens (1969) referred to as “letting go”. In the following example the emotional connection is primary; “most helpful to see the emotion with Jane 2 actually had done the enactment and see how she responded to everybody’s conunents and how it seemed to be such a positive thing that what impacted on me just seeing the positive change within her Seeing her smile or seeing her comments to other people, what they were saying to her... it brought in a piece to it that I hadn’t thought of’. The second process of redemption members experienced centered on identification with another persons struggle and in doing so realized there was other options and possibilities such as hope, as demonstrated in the following text; - “I had to struggle in my own life to find my voice yeah to stay true to my voice and it’s been a struggle with my family it’s been a struggle with life and choices I can relate to her, I saw toward the end she found part of her voice. I guess it’s an ongoing journey she does find.., so that was very empowering to me”. 69 This category includes many of the previously discussed constructs of vicarious learning, reflective thought, and symbolism but also includes the construct of self regulation. Bandura (1986) posits that self-regulatory mechanisms provide the opportunity for individuals to makes judgments, actions, choices and attributions. The degree individuals are able to self regulate will be the most significant factor in their potential behavior change. Self regulation also seems to play an important role in member to member learning. As demonstrated in the examples above, when the member is able to make judgments, “to stay true to my voice” this self regulation mechanism seems to account for the member’s insight and growth. In the second example redemption occurred when one member assisted the other to take action,” she found part of her voice”. As a result of the member makes an attribution and the member was able to make a judgment that it was empowering. “I guess it’s an ongoing journey she does find.., so that was very empowering to me”. Taking One’s Place/Not Good Enough Taking one’s place reflects both the intrapersonal and the interpersonal process of member interaction. In the following example one member assists the other to take action through cognitive interpersonal reframing; Bandura (1986) would describe this interaction as reflecting the fact that “behavior is largely regulated antecedently through cognitive processes” (p. 4). “But that little voice in the back of her head that says you could get this done you could get that done and you could do better in this and you could do better on that... I really get that because that little voice is in my head too”. 70 As was observed in the previous category self regulation and self reflection assist the member to make judgments and take action. In this circumstance one member influences the other member’s attribution which leads to insight and then to action. Having developed this insight through” cognitive processes” the member’s insight acts as an antecedent to behavior. Although from this text we do not see the behavioral outcome, Bandura would have predicted it to occur as a next step in the process. This members’ learning was from a direct interpersonal interaction member to member that influenced her insight. “A key was she was going to try and love herself more... Having sat through the enactment and it really reinforced it for me.... You are a good person you have accomplished things and you should be proud of that and not be so hard on yourself and give yourself a pat on the back and give yourself the opportunity to enjoy life and not worry so much about those less important things”. In this example the member describes her sense of self after the therapeutic enactment. We are able to identify from the text the antecedent cognition, as her self reflection on what the meaning in Jane 2, was for her, and what this member was motivated to do as a result. The behavior is evident in the text, from what appears to be an antecedent cognition. Similar to what Rogers (1961) introduces with the constructs of the authentic self vs. the conditional self. Belonging In this category members often referred to their felt sense of belonging to the group and what a positive influence it had on their experience. Members felt a sense of 71 belonging as a result of the experience they had with other members, and with the interaction the members had with the group as a whole. There were several means for members to access the group, including acts of reciprocity which gave them a felt sense of belonging (Shutz, 1958). Toffler (1980) noted the strong urge to belong in group members. In this example one member experiences vicariously a feeling of belonging by watching other members do tasks and make connections for each other in the group; “Yes that is correct it was what I felt, it made me feel better after talking with other people and hearing other people’s views on it to know they were feeling similar.., similar things yes”. Although all of the categories can be illuminated using social learning theory, often in different contexts, it seems that to some degree, Bandura’ s constructs are embedded in much of the text of this study. In the belonging category self reflective thought, self regulation, and symbolism are evident in the following examples; “She said she had been in two of them and did not fmd them helpful she also said a couple of years later after she watched the tapes that fairly changed... Her initial comments about the two enactments not having a large impact on her was a bit of a break or it was a major break and pattern up to that point the majority of the individuals had spoken they all had very positive things to say about their own experience in observing.., that honesty I think., set the tone for me”. Also in this second example evidence of the constructs of self regulation and symbolism is present; 72 “Validating it in my experience because and how much the depth that mine affected me and transformed me I mean I can’t tell you what I reclaimed but I reclaimed a lot you know”. The use of reflective thought and self regulation is central to this member’s sense of belonging and the modeling of breaking the pattern set the “tone”. Reflective thought contributes to “community building” or belonging and seems to lead to a clearer understanding of self. Self is identified and described by the member; stated in the second example “it transformed me”. This is also evidence of the effectiveness of self disclosure and what appears to be a contribution to member learning. This example reinforces the powerful impact members have on each other in creating a place to belong and learn and to have a potentially therapeutic impact on each other. “Yeah I agree I think the disclosures and the revelations drop a lot of the uh defenses and facades and persona (unmm) and here we are and we can relax and we can just be the way that we are”. Integrating Self-Reflection as it Relates to Other Members of the Group Bandura (2006) addresses the need for safety and preparedness in addition to self regulation and reflective thought. As seen in this example the blending of self reflection and self regulation can be seen as the building of a sense of safety. “Just that well of emotion... I can feel it was really nice to see the mechanisms t hat are you know there for self preservation.... Just go away... to see that happen is very nice cause I can identify with that feeling of letting go... it is real nice to see... that kinda stuff those self defenses’ things are really hard to lose”. 73 Although members come to the enactment with different self schemas and scripts there often is a common theme or universality to their experience. As in this case, the member felt safe, freed from self constraints, and the member’s ability to learn vicariously was a contributing factor. Moursund and Erskine (2003) comment that the relationship can act as a conduit to healing past ruptures. “I think also what kind of painted in a different way for me is seeing somebody have similar feelings and feelings that I really identified with it made it more concrete... but I’m not sure how though”. It didn’t seem so lonely or something that somebody else also had those feelings I think ya I think validation for sure came from it. Bandura posits that the cognitive, affective and behavioral outcomes are the model for change. The change patterns include these three influences and Bandura (2006) describes the relationship between the three as triadic. In this example the influence of modeling, reflective thought and affect validate this members feeling which demonstrates the construct of vicarious learning. Awareness of Change Past! Present/Future Bandura (2006) focuses on why self—referent behavioral performance is important and rejects duality between human agency and social structure. In fact, he suggests “people create social systems and these systems in turn, organize and influence people’s lives” (P. 12). Further, he indicates that there are four core components to human agency and consist of intentionality, forethought seif-reactiveness and self-reflectiveness. The discussion in the last three categories will incorporate these constructs. 74 The text has evidence of what seems to be the influence of social systems, and how these influences members’ lives’, within a temporal context of the past, present and future. Bandura (2006) reflects that fore-thought “involves the temporal extension of agency” In this example temporal fluidity is evident; “Now just taking me back to my early teen years... teen years that had some events that occurred that were impact full like I guess seeing her.. . some of how the patterns that she may have got laid down in that incident”. Forethought is more than future plans; it involves the ability for the agentic self to be engaged in the process, not simply as an observer to the process: “Yeah I do mean by activated I do mean stirred up in that area and so I felt for a while after... I mean in an area that I’m already stirred up in... but for a while after I just found my self thinking a lot about stuff that maybe about my current you know relationships but more about stuff that happened in the past when I was two”. Connection with Others that is Different from Belonging Bandura (2006) posits that people do not act as agents on their own. A connection of interactive influence is necessary. This seems to be present at both the cognitive level (self-reflectiveness) and the affective level for self-influencing behavior to occur. In this example the member reflects on the motivation of a member and how that connection has influenced past and future behavior; “Isn’t that interesting that she gave me that role... that was her motivation, part of it anyway for choosing me was to give me that experience really in hindsight it was a really good thing... if I go to a future enactment I will know what to 75 expect... I have been in some roles so I know what to expect... and so that’s good”. This member has made a causal connection and his self-reactiveness had altered his future behavior and efficacy outcomes. Moursund and Erskine (2003) suggest that contact is a bi-directional process in which individuals meet their needs. Bartholomew (1990) suggests that members have several different styles in which to establish intimacy. Bandura’s (2006) construct of self-reflectiveness and the individual’s ability to engage in metacognition is demonstrated in the following two examples: “This is with the second enactment umm what really impacted me was that I could relate quite well to her umm concerns not the actual incidents around siblings and their impact on her but more around the um how hard she was on herself’. And the final example; “Because I could so fully relate unim this was more than normal empathy... I could be saying the exact same thing”. In conclusion, these examples demonstrate the link between establishing intimacy and self-reflection. Recognition of the Impact of Members Experience on Each Other I have included this category as it captures the contiguous experience of the members and their influence on each other. Bion’s (1961) construct of container and its sense of interactivity and support for a safe group environment coupled with Bandura’s three modes of agency are complementary and theoretically robust in examining member learning and influence on each other. Bandura (2006) postulates three modes of agency: 76 individual, proxy and collective. I have examined individual agency in the previous categories. Proxy agency is the individual’s attempts to influence those that have potential resources and control over conditions that affect their efficacy expectations and outcomes. Bandura defines collective agency as the pooling of “knowledge, skills, and resources, and acts in concert to secure the outcomes they want” (p. 4). It is the shared belief in the group or collective to achieve outcomes that précis collective agency. This is not unlike a TE enactment where members come together to assist each other and work toward group goals. Lieberman, Yalom and Miles (1973) suggest that the sociometric data supports the notion that members will be influenced and with the most positive outcomes, when they are more closely aligned with group values and goals. In the following example the interaction of the collective or group agency is established; “I guess being in therapeutic enactment where that’s part of the idea of going back and healing things that happened and you know growing up parts of ourselves or reparenting or whatever probably that whole contexts also makes me think in that direction”. In this second example the group collective is also demonstrated; “I felt safer because then after I felt okay to make comments or two and I did... I was watching others to see what appropriate behavior was”. A useful reflection on the interaction and influence members have with each other is found in Bandura’s (2006) observation about human interaction and the parallel’s I see in member influence in TE groups; In interpersonal transactions, in which people are each others environments, a given exchange can be an agentic influence, a response or an environment 77 outcome depending arbitrarily on the different entry points in the on going exchange between the people involved (p. 3). Social Cognitive Theory and the T.E. Model As indicated earlier, part of the purpose of this study was to examine the T.E. model through the lens of social cognitive theory and in this way provide support to the process theory of change in T.E. I will examine Bandura’s constructs of catharsis, symbolism, reflective thought and self regulation and their theoretical relevance to T.E. Catharsis Catharsis in T.E. is approached differently than in traditional psychodrama. The cathartic experience is not viewed as an end but as a beginning (Westwood & Wilensky, 2005). Catharsis is “the beginning of reparation and healing” (p. 4). Resolution is not a single therapeutic moment but rather a renunciation of the presenting problem that was at the centre of the enactment. Black (2002) makes the observation that integration occurs at two levels; the integration of the individual and the integration of the group. This is central to the theme that members influence each other and benefit as individuals but also as group members. In this example from the text; “In having sorts yeah relating to where she was at.. .allowed me to be there or something my empathic connecting with her... with that story that kind of trauma umm yeah does that make sense”. The participant is making the observation that the member made such an empathic connection that she experienced it as cathartic. This is not the traditional view of catharsis, which is a single moment or tension brought to psychological resolution (Perls, 1969). Yalom (1985) would suggest that catharsis is only a part of the process. Instead, it 78 is the beginning of reparation, the moment where one member acts “symbolically” for the other, in this case her connection empathically. Bandura would predict that the symbol would motivate action. In this example the action is the member’s experience as cathartic. The member has used this cathartic moment to reflect on herself, make a new connection and begin the process of reframing that experience into new learning. The member to member influence was this member experiencing catharsis and having a felt sense of change. This was worthy of note from both the perspective of the T.E. model and Bandura’s model. I had not anticipated that the individual would experience cathartic feelings and this sense of connection, especially after the enactment, but when linked to her experience with a member of the group, such an event occurred. As noted earlier, in the T.E. model catharsis is not an end but a beginning and this member’s experience seems to reinforce that perspective. Symbolism For Bandura symbols are powerful motivators for action. In the examples below symbolism supports the members learning and moves the member toward insight and meaning. “I agree I think the disclosures and the revelations drop a lot of the uh defenses and facades and persona (unmm) and here we are and we can relax and we can Yeah I do mean by activated I do mean stirred up in that area and so I felt for a while after... I mean in an area that I’m already stirred up in... but for a while after I just found myself thinking a lot about stuff that maybe about my current you know relationships but more about stuff that happened in the past when I was two”. 79 What is significant is the inter-relationship between disclosure and revelation and the parallel process of catharsis and redemption in therapeutic enactment. When examining the richness of the above text, strong connections between the two theoretical orientations of therapeutic enactment and social cognitive theory begin to emerge. The symbiotic nature of the interaction demonstrates the usefulness of social cognitive theory in understanding the interaction between members. As an example of this, the participant in the quote above, is using a symbol of “stirred up” and then speaks about relationship. Bandura would suggest that this symbol is allowing for meaning making and T.E. would suggest that it would be redemptive. Her return to reflect “when I was two” also seems to act as a symbol to reflect on relationships in a more holistic way. Bandura and T.E. emphasis these processes and support the influence of members influencing member’s transformative learning. In this next example the power of symbolism as a motivator for change is apparent. The participant is referring to the act of a member who she related to and her identification with those thoughts and feelings which led to a clear understanding of self. “I think also what kind of painted in a different way for me is seeing somebody have similar feelings and feelings that I really identified with it made it more concrete”. This is useful in understanding how powerful a simple act can be in therapeutic enactment, and when symbolic meaning is linked to member insight and learning. The T.E. model views the use of symbols as essential to the creation of a “symbolic world as archetypal, containing cultural and universal myths the law, language, the spiritual and dreams” (p. 14) Westwood & Wilensky (2005). 80 Bandura contends that using symbols allows individuals to plan action, solve problems and anticipate outcomes. It is through this process that the individual can plan alternative actions with out having to experience each action themselves. This is important as it guides and motivates the person to achieve their goals. For example, in planning an enactment the individual engages in forethought which in turn helps to establish a goal for their enactment. The review process, at the conclusion of the enactment, allows both the partiapant and the group members to reflect on the outcomes of the T.E. These processes of forethought and reflective thought help make the connection to and between group members and is an example of how reflective thought is linked to forethought and ultimately to action. “Yes that is correct it was what I felt it made me feel better after talking with other people and hearing other people’s views on it to know they were feeling similar... similar things yes”. This example reinforces how important planning by both the director and the protagonist of the T.E. can meet the need for safety and ensure the protagonist is secure. Planning can also heighten and focus the goal of the enactment. It would appear that the symbolic nature of the planning of the enactment plays a role. T.E. enacts symbols at a transformative level and planning is the foundation to begin the construction of those symbols 81 Self-Regulation Bandura (1986) suggests that self regulation can be one of the most powerful components of reciprocal determinism, allowing for judgment, self reflection, making choices and for taking action. Self regulation is highlighted early in the T.E. model and focuses on movement as a regulating process. The director encourages the lead client to move around the group speaking about the process and beginning to foreshadow their upcoming enactment. T.E. describes this process as body psychotherapy or body awareness. Trauma is trapped or frozen in the body and movement facilitates a connection between body and the mind. Bandura would suggest that these processes, in his triadic model, would regulate between the person, environment and the behavior. Therapeutic enactment mirrors this process by allowing the individual to regulate the action of their enactment. The auxiliaries, director and members assist the protagonist by acting as a projective screen (Brooks, 1998).The protagonist uses their judgment and lived experience to engage in self regulating behaviors by incorporating these group members in their change process. The following text demonstrates not only the self regulatory component of T.E. but the influence of the members of the group on the participant’s regulatory process. The participant appears to have used the group as a projective screen in order to more accurately engage in self reflection. The context is altered as a result and allows for the member to member learning to occur. The container of the group plus the prior planning of the enactment seems to facilitate this process of regulation. The following example seems to support the role of self regulation and the group as a container. 82 “I felt closer to those people because umm they revealed a part of themselves to me that would not normally be revealed... doing my enactment ummm was an incredible experience You’re so in the moment that everything around you just well just disappears and that was a real neat experience for me”. Safety and Preparation I have included this as an addition observation separate and apart from the categories. It is included because it is imbued throughout the text and I have included it as a secondary finding. The Therapeutic Enactment model reports that with attention to preparation and with the focus on the lead client as well as the presenting issue “planning leads to highly controlled enactments” (p. 12) Westwood & Wilensky (2005). Although this was not a focus of the study there is support in the data that safety and planning or preparation are important features. An example of the role safety played is demonstrated in the following excerpt; “I think safety within the group. I mean, I came into that group knowing quite a few people which helped and everyone else was very, everyone else’s defenses were down pretty much”. As the T.E. model would predict, an increase in safety would lead to a compelling experience in the enactment. The group container was holding the group safely in place and the group container in turn contributed to individual safety. The observation that everyone’s defenses were down suggests this sense of container because of the high level of safety felt by the members. 83 This would lend support to the importance of the concept of control and safety as the participant speaks about the experience of self being with in the moment that all around disappears and they are left with their own sense of being. Other researchers also support the constructs of control and safety found in a T.E. group. Yalom (1985) stresses the need for therapeutic factors and the recognition of the stages of therapy. It is only after group cohesiveness is established that the essential work of the group can begin. Yalom offers the family reenactment or the corrective recapitulation as important and for him the therapy group reawakens the family of origin feelings and memories. Leadership Although not central to this research question, an ancillary finding to the issue of leadership and the function and role it plays in the T.E. model emerged as being influential. I am not linking member to member learning directly to leadership but the influence that a leader may or may not have on a member was mentioned as being important. As indicated in the methodology section all participants were asked an opened ended question to describe a significant experience that they had in the group with another member. If the participant made any reference to a leader or leadership, during the interview the opportunity arose to ask what role if any did the leader had on their experience. I wanted to give the participants an opportunity to comment on leadership as a simple method to check on participants perceptions of the leadership of the group. This was not an evaluative measure of the skill of the leader but an opportunity to examine the potential influence leaders may have in the group. 84 The following example demonstrates the role leadership had on the participant’s experience; “I think what the director did is the director kept focus, umm had a focusing role mmmm had a role in umm intensifying what was going on at times umm also had a role in assisting the players if the players were stuck umm”. The leader seems to be seen as helpful and contributing to the success of the member. It is important to understand this is from the participant’s view, and is worthy to note because the participant seems to acknowledge the role of the director as a focusing agent who assists the member. The central role of the director would certainly be found in the original psychodrama interactions, between Moreno as director and the protagonist. “I can’t believe how much I got out of it and everybody... I couldn’t have done it without the sensitivity that Jim and everybody showed me”... The above quote demonstrates a potential pattern or possible indicator of the influence of members and their focus on each other. Leadership is not the focus of this study but members see it as a potential conduit to member to member learning which has implications for the members and their individual and collective experience. Therapeutic Component of the Interview Finally, while analyzing the data, an unexpected observation occurred that may be important. The intention of the study was to examine member to member influence within an enactment. As the analysis began and proceeded through the various steps of coding it seemed to me that the entire interview with the participant had a therapeutic 85 component. As the interview unfolded and the participants recounted their observations, spoke of their feelings and shared their lived experience it appears as if they were encountering something similar to therapeutic change. They would become emotional, speak compelling about their experience and seem to at times feel catharsis. I hold this as an observation as I had no means in place to measure this event. I place this observation in a bracketed context because this was not the intention of the study. However, if one was to consider the efficacy of the interview and its implications on further uses of the interview process, it may well be worth exploring it as a part of the enactment process. Morley (2000) found individuals who participated in an enactment recall little of the final stage of debriefing and integration. In fact many report that they can not remember significant parts of the process due to emotional and cognitive fatigue. I am suggesting that further study would help to identify possible advantages to of providing for a later interview recounting the experience to enhance integration of member learning. One possible option would be to conduct a post enactment interview not from a methodology driven process but a therapy driven practice. This observation may also suggest that a combination of therapeutic interventions be employed. Limitations All methods of investigation have limitations and because this study was qualitative it is not generalizable, hopeful it will illuminate our knowledge. First, content analysis is useful as an exploratory or descriptive approach but as Berg (1995) points out the major limitation is that it cannot draw causal relationships between variables. Content analysis is unproductive in any form of experimental or causal research. 86 Second, a potential weakness in content analysis is locating unobtrusive messages. To address this weakness it is recommended that the use of verbal interviews, written, and videotaped messages would be helpful. In this study verbal interviews were conducted which were then converted to transcripts to address this issue. Third, Hill (1997) et: al speaks to the issue of the difficultly of writing up the results and discussion sections of qualitative research. Often the results and discussion sections are not clear and are repetitive. It is important that the results be clear, logical and makes sense to the outside reader. It is suggested that counselling process research consider taking short measurable pieces to avoid this potential weakness. I have attempted to collect data that is manageable and measurable in which to investigate. Implications This study set out to ask the question: What impact do members have on each other in a T.E. group, and how does this contribute to therapeutic change. Bandura’s (1986) social cognitive framework was used to examine the dynamic of member to member learning within the context of a T.E. group. By examining the content of the text of each participant interviewed and then embedding those into sub-categories, the constructs allied with reciprocal determinism from Bandura’ s theory, created the first theoretical links to support the T.E. model. I will discuss the implications of the study within this context. The findings of this study appear to inform the knowledge and theory of group work. Of significance is the impact of member’s learning and interactions that appear to contribute to therapeutic change. Yalom’s (1985) idea of Imitate Behavior and his eleven therapeutic factors for growth which include the therapist factors of installation of hope, 87 universality, altruism and imparting of information are reflected in several of the findings. These sub-categories would include; renewal/trauma/loss, redemption and integrating self reflection. Client factors identified by Yalom such as; corrective recapitulation of the primary family group, development of socialization techniques, interpersonal learning, imitative behavior, group cohesiveness, catharsis, existential factors are also evident in the experience of the group participants as reflected in the sub categories. Members influenced each other’ s learning through the experience of catharsis which had a direct impact on interpersonal learning. Taking one’s place, and redemption appear to reinforce Yalom’s (1985) notion of the instillation of hope. The sub category of shame found in this study can be linked to Bion’s (1961) group work when considering his constructs of fight! flight and pair bonding. Finally Schutz’s (1958) notion of member need for inclusion seems to mirror the sub-category of belonging. There are several implications for further research and the development of training, design and application of T.E. Originally T.E. was selected as the preferred group approach for this study because it encourages and supports member to member interactions. In addition, the T.E. model is adaptive to change and is amenable to theoretical examination. It has efficacy in promoting change and impacting individuals in the change process. This study further expands understanding of the interpersonal factors and the group process present in T.E. and reinforces what Yalom (1985) identified as curative factors in group work. Bandura’s triadic model supports the theoretical connection between T.E. and interpersonal learning. In addition, the findings add to the theory of change in group therapy by reinforcing or showing how the member variable may have more influence 88 than leadership, selection or design. In addition, consideration of an additional stage at the end of the T.E. model which would include the offer of an interview similar to the one used in this study in addition to the six week follow-up step. I found that the research interview seemed to be therapeutic and additive in nature for almost all of the participants. This therapeutic influence is based not only on the text that was developed, but on participant’s body language, engagement in the interview process and their remarks and personal reports, although these later observations are antidotal in nature. The interview was helpful as a focusing agent for their experience as well as a facilitation of participants therapeutic change process. I remain cautious in making observations or commenting on the change process as this study was not designed to examine these process issues. I mention it strictly as an observation and potential area for further investigation. It is important to examine the implication for training and practice suggested by my study. Understanding the vibrant and important role members play in the therapeutic process can be invaluable. Based on this initial investigation, it seems prudent to begin to examine the design issues associated with group processes and for the therapist, when designing and creating groups, to carefully consider ways to encourage member to member learning. These might include approaches to practice that develop observational skills and methods to increase awareness of the member to member interactions that occur in groups. It would seem useful to consider activities that increase member to member learning, and to develop additional training of directors, to incorporate approaches which would facilitate that process. A closer examination of the interaction among design, 89 group process and member to member learning would be a specific recommendation for further research. In addition, professionals working with groups may see this approach as preferable to individual therapy because of the more immediate results, efficiency and opportunity to work with great number ofparticipants. These are only a few suggestions regarding the implications for designing therapeutic enactments. A concerted effort to address how to improve design and process issues needs to be undertaken. Group leaders and therapists may, as a result, have more options available to them in approaching their clients. A further implication arising from this study relates to the training of counselling students and group directors. This study seems to link a theoretical orientation, in this case, reciprocal determination with group process T.E., and begins to establish a better understanding of how these two orientations fit and explain member learning. This may also provide practicing group therapist and directors a framework to begin to develop skill sets, techniques and applications to increase there understanding of member influence in their own group practice. Finally this study has implications as to how and where to apply the T.E approach. Although this study has restricted the investigation to an examination of member to member learning in a T.E. group, the constructs related to group process and reciprocal determinism may be effective in different groups, populations and contexts. An example would be to use the T.E. model to assist in incidents that result from events emanating from group trauma, such as school shooting, natural disasters and wars. 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Motivation reconsidered: The concept of competence, Psychological Review, 66 (5), 297-33 1. Yalom, I., D. (1985). The Theory and Practice ofGroup Psychotherapy, 3r Ed. New York: Basic Books. 96 Appendix Consent Form Project Title Member to member change in a therapeutic enactment group Principal Investigator: Dr. M Westwood Department of Educational and Counselling Psychology and Special Education, University of British Columbia, Vancouver, BC, Canada. Contact # 6O4’ Co-Investigator Bruce Bailey, M.A. Department of Interdisciplinary Studies, University of British Columbia, Vancouver. BC, Canada. This study is part of the requirement for the Degree of Doctor of Philosophy in Interdisciplinary Studies. Purpose of the Project: The purpose of the current study is to allow individuals who have participated in a Therapeutic Enactment the opportunity to tell their stories of change as it relates to their Therapeutic Enactment experience. Confidentiality: Any and all information proved by participants will be held in the strictest of confidentiality via the use of pseudonyms and coding for all names and places that might reveal the dignity of participants. Also, raw data in hard copy form will be kept in a locked cabinet, while any computer information will be keeping a password-protected file on the researcher’s hard drive. Time Requirements: The study will require the participant to engage in an in depth discussion/interview with the co-investigator to tell their personal story of their experience with Therapeutic Enactment. The interviews will involve a time commitment of 1 hour for each participant. Questions or Concerns: The principal investigator and co-investigator, as name above, will be available to answer any questions and address any concerns participants may have regarding the study procedures. If participants have any concerns regarding their rights or treatment as research participants they may contact the Director of the UBC Office of Research Services and Administration at 604-822-8598. I hereby consent to participate in this study, Signature Date

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