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Evaluation of counsellor training in Gestalt methods Sarkissian, Margaret Greig 1980

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EVALUATION OF COUNSELLOR TRAINING IN GESTALT METHODS MARGARET GREIG SARKISSIAN B.A., University of Br i t ish Columbia, 1974 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS THE FACULTY OF GRADUATE STUDIES (Department of Counselling Psychology) We accept this thesis as conforming to the required standard UNIVERSITY OF BRITISH COLUMBIA Apr i l , 1980 C) Margaret Greig S a r k i s s i a n , 1980, by i n In p resent ing t h i s t h e s i s i n p a r t i a l f u l f i l m e n t of the requirements f o r an advanced degree at the U n i v e r s i t y of B r i t i s h Co lumbia , I agree t h a t the L i b r a r y s h a l l make i t f r e e l y a v a i l a b l e f o r re fe rence and s tudy . I f u r t h e r agree tha t permiss ion f o r e x t e n s i v e copying of t h i s t h e s i s f o r s c h o l a r l y purposes may be granted by the Head of my Department or by h i s r e p r e s e n t a t i v e s . I t i s understood t h a t copying or p u b l i c a t i o n of t h i s t h e s i s f o r f i n a n c i a l ga in s h a l l not be a l lowed wi thout my w r i t t e n p e r m i s s i o n . Department The U n i v e r s i t y of B r i t i s h Columbia 2075 Wesbrook P lace Vancouver , Canada V6T 1W5 D E - 6 B P 75-5 I I E ( i ) ABSTRACT This study evaluated the e f f e c t i v e n e s s of a G e s t a l t t r a i n i n g group designed to t r a i n c o u n s e l l o r s i n the i n f l u e n c i n g s k i l l s of G e s t a l t therapy. The study i n v o l v e d eleven experimental group c o u n s e l l o r s , a matched c o n t r o l group and four coached c l i e n t s . A p r e - t e s t p o s t - t e s t research design was used. C o u n s e l l o r s i n both groups were t e s t e d f o r s i m i l a r i t y at pre-treatment l e v e l s . The dependent v a r i a b l e s being examined were c o u n s e l l o r response t o a s p l i t : a c t u a l use o f the i n f l u e n c i n g s k i l l s o f d i r e c t guidance, open question and non-verbal r e f e r e n t : intended use o f the i n f l u e n c i n g s k i l l s o f d i r e c t guidance, open question and non-verbal r e f e r e n t ; and degree o f personal growth goal attainment. P o s t - t e s t measures were used as an i n d i c a t i o n of the e f f e c t i v e n e s s of the treatment. In the p r e - t e s t , each c o u n s e l l o r had a c o u n s e l l i n g s e s s i o n with a c l i e n t coached to present a c o n f l i c t s p l i t . The Wilcoxon Matched-Pairs Signed Ranks t e s t of s i g n i f i c a n c e was used to analyze the c o u n s e l l o r response to a s p l i t and intended use of i n f l u e n c i n g s k i l l s . The dependent t - t e s t was used to measure a c t u a l use of i n f l u e n c i n g s k i l l s . At the end of the t r a i n i n g experience a Chi square t e s t of independence was used to compare both groups on t h e i r degree o f personal growth goal attainment. A C h i square goodness o f f i t was used to measure the experimental group on t h e i r degree o f t r a i n i n g goal attainment. R e s u l t s i n d i c a t e d t h a t the experimental group c o u n s e l l o r s responded to a s p l i t with the G e s t a l t two-chair operation s i g n i f i c a n t l y more than d i d the c o n t r o l group. The experimental group used s i g n i f i c a n t l y more of the i n f l u e n c i n g s k i l l s o f d i r e c t guidance and open question. In a d d i t i o n , they reported that they intended to use non-verbal r e f e r e n t s i g n i f i c a n t l y more than the c o n t r o l group. In the degree o f attainment of personal growth goals the two groups were not shown to be d i f f e r e n t . The experimental group was found to have achieved t h e i r t r a i n i n g goals. In summary, i t appears that t h i s G e s t a l t t r a i n i n g group was s u c c e s s f u l i n t r a i n i n g c o u n s e l l o r s i n i n f l u e n c i n g s k i l l s . ( i i ) TABLE OF CONTENTS Page List of Tables (iv) Acknowledgments ( v) I INTRODUCTION Background of the Problem: The Need for Counsellor Training Programmes Offering Advanced Influencing Sk i l l s 1 The Problem: Evaluation of the Effectiveness of a Gestalt Training Group 3 Definition of Terms 7 Gestalt Two-Chair Experiment 7 Spl i t 7 Principles of Working with a Spl i t 7 General S k i l l s of Working with a Spl i t 8 Hypotheses 10 Rationale for Hypotheses 12 Assumptions of the Study 13 Limitations of the Study ' 13 Just i f icat ion of the Study 14 II LITERATURE REVIEW Developments in Counsellor Education 15 Reactions to S k i l l Training 24 Empathy 25 Gestalt Therapy 28 ( i i i ) III METHODOLOGY Population 32 Sample 32 Raters and C l i n i c i a n s 35 Design 35 Measuring Instruments 36 Other Measures 39 Data C o l l e c t i o n 40 Data Analysis 44 IV RESULTS 46 V DISCUSSION Discussion of Results 55 Delimitations 59 Conclusions 60 Bibliography 61 Appendices 65 (iv) LIST OF TABLES TABLE PAGE I M i c r o s k i l l s of the Gestalt Two-Chair Experiment. 9 II Egan Counseling Model. 18 III Expanded Model of Counseling. 30 IV Data C o l l e c t i o n Sequence. 43 V Pre-test Scores for Counsellor Response to a S p l i t . 47 VI Pre-test Means, Standard Deviations and t-Scores for Actual Use of Influencing S k i l l s . 47 VII Pre-test Medians, Quartile Deviations and T--Scores for Intended Use of Influencing S k i l l s . 48 VIII Post-test Scores for Counsellor Response to a S p l i t . 49 IX Post-test Means, Standard Deviations and t-Scores for Actual use of Influencing S k i l l s . 50 X Post-test Medians, Quartile Deviations and T-Scores for Intended Use of Influencing S k i l l s . 52 XI Test of Independence for Attainment of Personal Growth Goals. 53 XII Goodness of F i t Test of Observed and Expected Frequencies for Attainment of Training Goals. 54 (v) ACKNOWLEnZJGMENTS I would like to express my appreciation to the many people who contributed to this thesis. Leslie Greenberg provided challenge and direction. Above a l l , I appreciate his academic excellence. Harold Ratzlaff offered thoughtful advice and assistance. Sharon Kahn helped to give this thesis a clearer focus. On a more personal note, I wish to express my gratitude to Graham Greig and Irene Barr for their generous gifts of time, effort and encouragement. - 1 -CHAPTER I  INTRODUCTION BACKGROUND OF THE PROBLEM Considerable research has been done to evaluate the effectiveness o f psychotherapy. Although researchers d i f f e r i n t h e i r d e f i n i t i o n s of desired c l i e n t change, most studies support the idea that counselling and psychotherapy are e f f e c t i v e (Smith & Glass, 1977; Bergin & Lambert, 1978). This i n t e r e s t i n evaluating counselling outcome has coincided with an increased i n t e r e s t i n the actual components of the e f f e c t i v e counselling process. In addition, researchers are concerned with developing models for counsellor t r a i n i n g which incorporate these e f f e c t i v e s k i l l s and -indicate t h e i r appropriate use within the counselling sequence (Pearson, 1978). This current trend towards the s p e c i f i c a t i o n of the e f f e c t i v e counselling process was i n i t i a t e d by Rogers (1957). I t has been further developed through the e f f o r t s of researchers such as Truax and Carkhuff (1967), Egan (1975), and Ivey and Authier (1978). Each of these researchers has contributed to the a r t i c u l a t i o n of important therapeutic conditions and techniques. Also, each has attempted to delineate a model for counsellor t r a i n i n g which incorporates the e s s e n t i a l counselling s k i l l s . Rogers work has spearheaded research i n i d e n t i f y i n g the components of good counselling. In a seminal a r t i c l e (1957), he argued that empathy, genuineness, and p o s i t i v e regard are the necessary and s u f f i c i e n t conditions for c l i e n t growth. He stressed that these three s k i l l s are more than just techniques; the counsellor must integrate these q u a l i t i e s so that they become part of his/her e s s e n t i a l a t t i t u d e toward the c l i e n t . - 2 -A number of researchers have questioned Rogers' three conditions as being s u f f i c i e n t to f a c i l i t a t e c l i e n t change. The search has continued for more act i v e s k i l l s which would not only give focus to the counselling session but would also more a c t i v e l y promote c l i e n t change. Carkhuff ss model (1969) which i s an elaboration of Rogers' early work, attempts to meet t h i s need. The responding dimensions of h i s model include empathy, respect and concreteness; the i n i t i a t i n g dimensions include s e l f -disclosure, genuineness, confrontation and immediacy. Ivey and Authier (1978) have also contributed to the trend towards s p e c i f i c a t i o n of s k i l l s . Their taxonomy of microcounselling s k i l l s also involves two categories - attending and influencing s k i l l s . . Under attending s k i l l s they include open question, closed question, minimal encourage, paraphrase, r e f l e c t i o n of f e e l i n g and summarization. Influencing s k i l l s involve d i r e c t i o n s , expression of content, expression of f e e l i n g , i n f l u e n c i n g summary, i n t e r p r e t a t i o n and direct-mutual communication. The above taxonomies represent j u s t a few of the many counsellor s k i l l models that have been proposed. One recent study has attempted to evaluate, integrate, and reduce the complexity of research r e s u l t s into one comprehensive system. H i l l (1978) factor analyzed eleven d i f f e r e n t taxonomies and found that the s k i l l s could be reduced to seventeen categories. Further analysis reduced the taxonomy to fourteen counsellor response categories. Her system includes minimal encourager, approval-reassurance, information, d i r e c t guidance, open question, closed question, restatement, r e f l e c t i o n , non verbal referent, i n t e r p r e t a t i o n , confrontation, s e l f disclosure, s i l e n c e and other. - 3 -A number of researchers have expressed concern about t h i s growing emphasis upon s k i l l t r a i n i n g i n counsellor education. Mahon and Altmann (1977) argue that while s k i l l s are important, the personal q u a l i t i e s underlying s k i l l s are even more important. They maintain that t r a i n i n g programmes must also address the values, attitudes and b e l i e f s of the trainees. They st r e s s that only by e f f e c t i n g perceptual change i n trainees can t r a i n e r s hope to e f f e c t the desired behavioural change. Other researchers echo t h i s concern. Rogers has always stressed the importance of t r a i n i n g the whole person. Although he was one of the f i r s t researchers to i d e n t i f y e f f e c t i v e counselling s k i l l s , he also maintained that the counsellor uses him/herself as an agent to f a c i l i t a t e the c l i e n t ' s growth (1957). This necessitates that the counsellor i s committed to h i s or her own personal growth and i s l i v i n g h i s or her own l i f e e f f e c t i v e l y . This reaction to the proponents of s k i l l t r a i n i n g models has generated research i n more balanced counsellor education programmes. The quest to develop e f f e c t i v e counselling s k i l l s continues, tempered with a concern for the personal i n t e g r i t y of the counsellor. I t seems important, therefore, that any new counsellor education model o f f e r an i n t e g r a t i o n of these two major themes of s k i l l development and personal growth. THE PROBLEM In a recent paper, Greenberg (1980b) has outlined a model for counsellor education which attempts to meet t h i s need for an integrated s k i l l t r a i n i n g and personal growth approach. The model i s designed to teach counsellors the advanced s k i l l s of Gestalt therapy i n a group s e t t i n g . The t r a i n i n g group i s comprised of a knowledge component, a s k i l l t r a i n i n g component and an i n t e g r a t i n g personal growth component. The major focus of the group i s to t r a i n counsellors i n the Gestalt two-chair experiment. - A -The b a s i c t r a i n i n g programme i n v o l v e d twenty - fou r group s e s s i o n s and s i x s u p e r v i s i o n s e s s i o n s . The programme was l e d by the o r i g i n a t o r o f the model (Greenberg, 1980b) . In the group s e s s i o n s the t r a i n e r presented the major t h e o r e t i c a l themes, p r i n c i p l e s and s k i l l s o f the G e s t a l t approach. A t h e o r e t i c a l l e c t u r e t t e on each theme was fo l l owed by an e x p e r i e n t i a l e x e r c i s e . A f t e r a demonstrat ion of the s p e c i f i c s k i l l r e l a t e d to each theme t r a i n e e s p r a c t i c e d the m i c r o s k i l l s i n s m a l l groups. In the s u p e r v i s i o n s e s s i o n s , the t r a i n e r eva luated v ideotaped s e s s i o n s i n which each c o u n s e l l o r used the new s k i l l s w i th a f e l l o w t r a i n e e as c l i e n t . A manual o f the themes and programme content can be found i n Appendix A. Th is study was concerned w i th e v a l u a t i n g the e f f e c t i v e n e s s o f t h i s G e s t a l t t r a i n i n g group. An e v a l u a t i o n o f the t r a i n i n g programme i n v o l v e d a s s e s s i n g the e f f e c t i v e n e s s o f both the s k i l l t r a i n i n g and persona l growth components. The f i r s t o b j e c t i v e o f t h i s s tudy , t h e r e f o r e , was to eva lua te whether the G e s t a l t t r a i n i n g group was a s u c c e s s f u l means o f t e a c h i n g c o u n s e l l o r s the advanced s k i l l s o f G e s t a l t therapy . These advanced s k i l l s have two components: p e r c e p t u a l and execut i ve s k i l l s . The p e r c e p t u a l s k i l l r e q u i r e d o f the c o u n s e l l o r i s the r e c o g n i t i o n o f d i f f e r e n t types o f c l i e n t s p l i t s . The c o n f l i c t s p l i t i s c h a r a c t e r i z e d by two p a r t s of the s e l f which are f e l t to be i n c o n f l i c t . "I want to get good grades but I c a n ' t seem to get down to any s e r i o u s s t u d y i n g . " In the s u b j e c t - o b j e c t s p l i t , the c l i e n t d e s c r i b e s h i m / h e r s e l f as s p l i t i n t o both the s u b j e c t and o b j e c t o f h i s e x p e r i e n c i n g . " I 'm c o n s t a n t l y e v a l u a t i n g m y s e l f . " The t h i r d category of s p l i t has two s u b - t y p e s : the a t t r i b u t i o n o f agency and the a t t r i b u t i o n o f c o n f l i c t . In the a t t r i b u t i o n of agency, the c l i e n t d i s c u s s e s h i s / h e r exper ience as caused by another person or event . "He made me f e e l so s t u p i d . " In the a t t r i b u t i o n o f c o n f l i c t , the c l i e n t a t t r i b u t e s the cause o f the c o n f l i c t to a source other than h i m / h e r s e l f . "I want to q u i t my job and go back to schoo l but my w i f e won't l e t me." _ 5 -The executive s k i l l s required of the trainee involve engaging the c l i e n t i n a dialogue with him/herself, increasing c l i e n t self-awareness, and encouraging c l i e n t expression of non-verbal behaviour. Each of these three executive s k i l l s has a d i s t i n c t purpose. By using d i r e c t guidance, the counsellor i n i t i a t e s the c l i e n t into the two-chair role- p l a y . The counsellor then suggests c e r t a i n experiments or a c t i v i t i e s to the c l i e n t as a means of increasing the c l i e n t ' s awareness and sense of r e s p o n s i b i l i t y for his/her own experiencing. By drawing the c l i e n t ' s attention to non-verbal behaviours, the counsellor f a c i l i t a t e s the c l i e n t ' s awareness and exploration of his/her gestures, posture, tone of voice and f a c i a l expressions. In asking open questions, the counsellor focuses on the process of the two-chair experiment and encourages c l i e n t exploration of his/her present experiencing. To evaluate the s k i l l t r a i n i n g component of the programme, t h i s study investigated whether the trainees learned to be more active and intervene at a s p l i t using the two-chair method. More s p e c i f i c a l l y , counsellors' performances were judged as to whether they responded to a c o n f l i c t by i n i t i a t i n g a dialogue between the two parts of the c l i e n t ' s s e l f . Evaluation also included determining whether the counsellors used more dir e c t i o n s , non-verbal referents and open questions over the session. As described e a r l i e r , the model for the t r a i n i n g programme includes an emphasis upon the trainees' personal growth. A number of authors (Rogers, 1957; Carkhuff & Berenson, 1974; Mahon & Altmann, 1977) have stressed the importance of ensuring that counsellor education programmes stimulate the trainee's personal growth as well as his/her s k i l l development. They argue that counsellors who have not dealt with t h e i r own personal issues may do more harm than good. - 6 -Research has suggested that one e f f e c t i v e means of f a c i l i t a t i n g the psychological development of trainees i s through p a r t i c i p a t i o n i n a Gestalt workshop. P a r t i c i p a n t s i n Gestalt workshops have been shown to make gains i n t h e i r personal growth immediately a f t e r the group and the experience seemed to stimulate further personal growth as evaluated i n a s i x month follow-up (Foulds & Hannigan, 1976). The personal growth component was integrated into the programme i n two ways. F i r s t l y , the t r a i n i n g sessions were alternated with the personal growth sessions. During the personal growth sessions, trainees were i n v i t e d to p a r t i c i p a t e as c l i e n t s i n a session with the t r a i n e r . Secondly, the personal growth component was integrated into the s k i l l t r a i n i n g sessions. Trainees practiced new s k i l l s i n t r i a d s , a l t e r n a t i n g as counsellor, c l i e n t and observer. In addition to experiencing the e f f e c t of the s k i l l s , the trainee as c l i e n t had the opportunity to work on r e a l personal issues. To evaluate t h i s personal growth component, the study investigated whether the trainees were successful i n achieving t h e i r personal growth goals. At the beginning of the programme, trainees were asked to i d e n t i f y important personal growth goals. At the end of the programme, trainees were asked to evaluate the degree to which the group experience f a c i l i t a t e d the attainment of t h e i r goals. - 7 -DEFINITION OF TERMS Gestalt two-chair experiment: This operation i s used when the c l i e n t presents a c o n f l i c t s i t u a t i o n or s p l i t . The c o n f l i c t may be between him/herself and another person, or between two p a r t i a l aspects of the c l i e n t ' s s e l f . The counsellor f i r s t separates out the two parts, helping the c l i e n t achieve a sense of i d e n t i t y for each part. The counsellor then encourages the c l i e n t to create a dialogue between the two parts, using two chai r s . While s i t t i n g i n one chair, the c l i e n t speaks for one part of the s e l f or s p l i t , then changes to the other chair to respond as the other part. S p l i t : "The s p l i t i s a verbal performance pattern manifested by one person ' c l i e n t ' i n i n t e r a c t i o n with another. The c l i e n t here i s conceptualized as being i n process and the s p l i t i s an observable process form characterized by a d i v i s i o n of s e l f process i n t o two p a r t i a l aspects of the s e l f or tendencies. These tendencies or p a r t i a l aspects of the s e l f are rela t e d to each other i n d i f f e r e n t ways and the d i f f e r e n t r e l a t i o n s h i p s between these tendencies define d i f f e r e n t types of s p l i t s . Four discriminative features of t h i s process form are to be found i n the c l i e n t ' s behaviour productions. The four features are: part one of the s p l i t ; part two of the s p l i t : a r e l a t i o n a l feature; and a q u a l i t a t i v e feature. Together, they constitute the marker of the s p l i t " (Greenberg, 1975, p 178). P r i n c i p l e s of working with a s p l i t 1. Establishment of a contact boundary: e s t a b l i s h i n g and maintaining clear separation and contact between the p a r t i a l aspects of the s e l f . 2. Responsibility: d i r e c t i n g the person to use h i s or her a b i l i t i e s to respond i n accordance with the true nature of h i s or her experience i n each part. - 8 -3. Attending: d i r e c t i n g the c l i e n t ' s attention to p a r t i c u l a r aspects of his/her experience. 4. Heightening: h i g h l i g h t i n g aspects of experience by increasing the c l i e n t ' s general l e v e l of arousal. 5. Expressing: i n s t r u c t i n g the c l i e n t to do what i s being talked about in each chair. P a r t i c u l a r i z i n g experience by moving from discussion or theory to a s p e c i f i c a c t i v i t y . (Greenberg, 1980b) General s k i l l s of working with a s p l i t Greenberg (1980b) has i d e n t i f i e d a number of general s k i l l s involved i n using the Gestalt two-chair r o l e play. These general s k i l l s are: 1. Creating "here and now" experiments. 2. Making process i n q u i r i e s . 3. Making process suggestions. 4. Making behavioural observations. 5. Giving e x p e r i e n t i a l feedback. These general s k i l l s categories have been further defined into the micro-s k i l l s outlined i n Table I. These m i c r o s k i l l s , together with the p r i n c i p l e s of two-chair work, comprise the s k i l l t r a i n i n g component of the Gestalt t r a i n i n g programme. - 9 -TABLE I MICRO-SKILLS OF THE GESTALT TWO-CHAIR EXPERIMENT SKILL CATEGORY SPECIFIC SKILL ACTUAL BEHAVIOUR Here and now Recognizing s p l i t s I t seems l i k e there are two p a r t s experiments D i r e c t i n g person to "get a sense" o f the d i f f e r e n t parts What are1 you l i k e as your s t r o n g p a r t ? I d e n t i f y i n g d i f f e r e n c e s What are your d i f f e r e n c e s ? D i r e c t i n g the person to "make con t a c t " j with the other part Say t h i s t o the other part. Process i n q u i r i e s A f f e c t i n q u i r y What are you f e e l i n g or experiencing? D e s i r e i n q u i r y What do jyou want? E x p e c t a t i o n i n q u i r y What do 'you expect or a n t i c i p a t e ? Avoidance i n q u i r y What axe you avoiding? Awareness i n q u i r y What are you aware of? Ex p r e s s i o n i n q u i r y What are you doing? or • How are you doing t h i s ? Process suggestions Language suggestion Attending suggestion Focusing suggestion Demand suggestion I d e n t i f i c a t i o n suggestion. S p e c i f i c i t y suggestion Exaggeration and r e p e t i t i o n suggestion Say " I " i n s t e a d o f " i t " Become aware of your v o i c e Go i n s i d e . What are you experiencing? T e l l the other p a r t what i t should do. Become your v o i c e your judge e t c W i l l you be more s p e c i f i c ? Say t h i s again. Exaggerate i t -Behavioural o b s e r v a t i o n Behavioural o b s e r v a t i o n I'm aware that you are speaking s o f t l y . E x p e r i e n t i a l feedback Feeding a sentence Personal awareness statement Sharing hunches W i l l y o u : t r y on, "I want to be loved" I'm aware o f f e e l i n g touched, o f l o s i n g 1 i n t e r e s t . My hunch;is you're f e e l i n g l i k e you want to hide. Does that f i t f o r you? (Greenbera, 1980b) - 10 -HYPOTHESES The following hypotheses were tested: H-^: There w i l l be no s t a t i s t i c a l l y s i g n i f i c a n t difference i n the degree to which the Gestalt group trainees and the control group respond to a s p l i t with separation and contact as revealed by the Wilcoxon Matched-Pairs Signed-Ranks non-parametric test of s i g n i f i c a n c e . H-Q: There w i l l be a s t a t i s t i c a l l y s i g n i f i c a n t difference i n the degree to which the Gestalt group trainees and the control group respond to a s p l i t with separation and contact as revealed by the Wilcoxon Matched-Pairs Signed-Ranks non-parametric t e s t of s i g n i f i c a n c e . H 2 Q: There w i l l be no s t a t i s t i c a l l y s i g n i f i c a n t difference i n the degree to which the Gestalt group trainees and the control group (a) use the i n f l u e n c i n g s k i l l of d i r e c t guidance, (b) use the influencing s k i l l of open question and (c) use the infl u e n c i n g s k i l l of non-verbal referent as revealed by dependent t - t e s t s . H 2 j : : There w i l l be a s t a t i s t i c a l l y s i g n i f i c a n t difference i n the degree to which the Gestalt group trainees and the co n t r o l group (a) use the infl u e n c i n g s k i l l of d i r e c t guidance, (b) use the in f l u e n c i n g s k i l l of open question and (c) use the i n f l u e n c i n g s k i l l of non-verbal referent as revealed by dependent t - t e s t s . - 11 -There w i l l be no s t a t i s t i c a l l y s i g n i f i c a n t difference i n the degree to which the Gestalt group trainees and the co n t r o l group report that they (a) intended to use the influencing s k i l l of d i r e c t guidance, (b) intended to use the i n f l u e n c i n g s k i l l of open question and (c) intended to use the influencing s k i l l of non-verbal referent as revealed by the Wilcoxon Matched-Pairs Signed-Ranks non-parametric test of s i g n i f i c a n c e . There w i l l be a s t a t i s t i c a l l y s i g n i f i c a n t difference i n the degree to which the Gestalt group trainees and the control group report that they (a) intended to use the infl u e n c i n g s k i l l of d i r e c t guidance, (b) intended to use the infl u e n c i n g s k i l l of open question and (c) intended to use the i n f l u e n c i n g s k i l l of non-verbal referent as revealed by the Wilcoxon Matched-Pairs Signed-Ranks non-parametric t e s t of s i g n i f i c a n c e . There w i l l be no s t a t i s t i c a l l y s i g n i f i c a n t difference i n the degree to which the Gestalt group trainees and the control group w i l l a t t a i n t h e i r personal growth goals as revealed by a Chi square t e s t of independence. There w i l l be a s t a t i s t i c a l l y s i g n i f i c a n t d i f f e r e n c e i n the degree to which the Gestalt group trainees and the control group w i l l a t t a i n t h e i r personal growth goals as revealed by a Chi square t e s t of independence. - 12 -RATIONALE FOR HYPOTHESES: A number of studies have i d e n t i f i e d the s k i l l s of Gestalt therapy as more active i n o r i e n t a t i o n than other t r a d i t i o n a l therapies. In a comparison of d i f f e r e n t therapeutic approaches, Ivey and Authier (1978) note that the Gestalt therapist frequently uses d i r e c t i o n and role-p l a y . In addition, the Gestalt therapist encourages the c l i e n t to explore his/her non-verbal as well as verbal behaviours. In a recent paper, H i l l (1979) also compares various therapeutic orientations. Her study evaluates Rogers, Perls and E l l i s i n t h e i r sessions with the same c l i e n t i n the f i l m "Three Approaches to Psychotherapy". The r e s u l t s i n d i c a t e that of the three approaches, Gestalt therapy was notable for involving more d i r e c t guidance, open questions and non-verbal referents. Recent studies have suggested that the active s k i l l s of Gestalt therapy are e f f e c t i v e i n increasing c l i e n t depth of experiencing. (Dompierre, 1979; Greenberg, 1975: and Greenberg & Clarke, 1979). In addition, research has indicated that depth of experiencing i s p o s i t i v e l y correlated with c l i e n t outcome i n therapy (Klein et a l , 1969). Therefore i f a p a r t i c u l a r intervention f a c i l i t a t e s depth of experiencing, then that intervention i s an important s k i l l i n e f f e c t i v e counselling. This finding suggests support for teaching the active s k i l l s of Gestalt therapy to counsellor trainees. Counsellor educators have also highlighted the importance of integr a t i n g s k i l l t r a i n i n g with personal growth experiences. Greenberg (1980b) has stressed that active s k i l l s implemented without s e n s i t i v i t y could be used mechanistically. - 13 -In summary, there i s research to support the effectiveness of the Gestalt two-chair experiment which incorporates the active s k i l l s described above. In addition, research supports the importance of personal growth experiences as an i n t e g r a l part of counsellor education programmes. I f t h i s study demonstrates that counsellor trainees can gain advanced s k i l l s and experience personal growth i n the Gestalt t r a i n i n g group, then the model proposed by Greenberg (1980b) represents a useful contribution to research i n counsellor education. ASSUMPTIONS It was assumed that the pre-test and post t e s t counselling sessions were representative of the counsellors' usual counselling s k i l l s . I t was assumed that the control group would have no t r a i n i n g i n Gestalt s k i l l s between the period of the pre-test and the post-test. It was assumed that the c l i e n t s ' problems represented an adequate match and sample of problems dealt with in counselling. LIMITATIONS OF THE STUDY This study was done with eleven counsellors who were involved i n a Gestalt t r a i n i n g group. A l l of the counsellor trainees had been trained at the graduate l e v e l i n an empathy-based model. While t h i s small number could r a i s e questions concerning the g e n e r a l i z a b i l i t y of the r e s u l t s , the small s i z e of the group was necessary i n order to f a c i l i t a t e the personal and s k i l l development o f each trainee. In addition, the study investigated only one group with one leader. Further research would be necessary to evaluate the effectiveness of d i f f e r e n t groups with d i f f e r e n t leaders. - 14 -JUSTIFICATION OF THE STUDY As discussed e a r l i e r , l i t e r a t u r e i n the area of counsellor education indicates the necessity of teaching counsellor trainees advanced counselling s k i l l s . Research has shown that Gestalt s k i l l s f a c i l i t a t e depth of experiencing, change i n awareness, and c o n f l i c t r e s o l u t i o n (Greenberg, 1975). These r e s u l t s suggest that counsellors trained i n the active s k i l l s of Gestalt therapy can f a c i l i t a t e c l i e n t progress i n therapy more than they can with empathy s k i l l s alone. Therefore, i f the Gestalt t r a i n i n g group being evaluated i s e f f e c t i v e i n enhancing the trainees' personal growth and developing t h e i r r e p e r t o i r e of active s k i l l s , then the model proposed by Greenberg (1980b) represents a viable counsellor education programme. - 15 -CHAPTER II  LITERATURE REVIEW A review of the l i t e r a t u r e pertinent to t h i s t hesis includes research i n the following areas: developments i n counsellor education, reactions to s k i l l t r a i n i n g , the ro l e of empathy i n therapy, and the s k i l l s of Gestalt therapy. DEVELOPMENTS IN COUNSELLOR EDUCATION As mentioned e a r l i e r , Rogers was one of the f i r s t researchers to i d e n t i f y the e s s e n t i a l s k i l l s of the therapeutic r e l a t i o n s h i p . In addition he was one of the f i r s t educators to develop a systematic counsellor t r a i n i n g programme. His t r a i n i n g workshops involved students i n : 1. l i s t e n i n g to tape-recorded interviews of experienced therapists; 2. role-playing therapist with fellow students; 3. observing a s e r i e s of l i v e demonstrations by the supervisor; 4. p a r t i c i p a t i n g i n group therapy or multiple therapy; 5. conducting i n d i v i d u a l psychotherapy and recording the interviews for discussion with a f a c i l i t a t i v e non-directive supervisor: and 6. personal therapy. (Matarazzo, 1978, p. 943) Rogers' t r a i n i n g programme was refined by Truax and Carkhuff (1967) and evaluated i n several studies which substantiated i t s effectiveness (Barrett-Lennard, 1962; Lorr 1965; and Rice, 1965). Truax and Carkhuff describe t h e i r t r a i n i n g model as: 1. A therapeutic context i n which the supervisor himself provides a high l e v e l of therapeutic conditions; 2. Highly s p e c i f i c d i d a c t i c t r a i n i n g i n the implementation of the therapeutic conditions; and 3. A quasi-group therapy experience where the trainee can explore h i s own existence, and h i s i n d i v i d u a l therapeutic s e l f can emerge. (1967, p. 242) - 16 -A current counsellor education model developed by Gerald Egan (1975) represents a further development which incorporates the contributions of both Rogers and Carkhuff. This model i s represented i n Table I I . The f i r s t stage of Egan's model involves the establishment of a f a c i l i t a t i v e c l i e n t - c o u n s e l l o r r e l a t i o n s h i p . Egan concurs with Rogers when he stresses the importance of empathy as the cornerstone of the e f f e c t i v e therapeutic a l l i a n c e . Like Rogers, he maintains that i t i s only within the safety of an empathy-based r e l a t i o n s h i p that the c l i e n t can f e e l secure enough to engage i n the necessary s e l f - e x p l o r a t i o n . The second phase of the model builds upon these c l i e n t s e l f - e x p l o r a t i o n s . Egan argues that the s o c i a l influence of the counsellor f a c i l i t a t e s the c l i e n t ' s progress from s e l f - e x p l o r a t i o n to an integrated self-understanding. In the t h i r d stage of the model, Egan stresses the action component of counselling and draws heavily on the learning theories. The counsellor's r o l e i n t h i s stage i s to help the c l i e n t move from self-understanding to the development and enactment of s p e c i f i c action programmes. Egan's model represents an attempt to move beyond the responsive dimensions and give the counsellor s p e c i f i c action s k i l l s with which to f a c i l i t a t e c l i e n t change. While the action phase includes a l l the s k i l l s of the two previous stages, i t also incorporates a s p e c i f i c methodology with which the counsellor can a s s i s t the c l i e n t i n problem-solving. - 17 -This problem-solving procedure i s an a p p l i c a t i o n of f o r c e - f i e l d analysis. In t h i s approach the counsellor works with the c l i e n t through each of the following steps: 1. Identify and c l a r i f y the problem. 2. Es t a b l i s h p r i o r i t i e s i n choosing problems for attent i o n . 3. E s t a b l i s h workable goals. 4. Take a census of the means av a i l a b l e for achieving established goals. 5. Choose the means that w i l l most e f f e c t i v e l y achieve established goals. 6. E s t a b l i s h c r i t e r i a for the effectiveness of action programmes. 7. Implementation: use chosen means to achieve established goals. 8. Review and evaluate the c l i e n t ' s progress. (Egan, 1975, p. 200) Egan's model represents a systematic approach to counsellor education. The model suggests a small group as the most e f f e c t i v e means of combining s k i l l t r a i n i n g and e x p e r i e n t i a l learning. In p a r t i c u l a r the model stresses: 1 . Extended practice i n i n d i v i d u a l s k i l l s . 2. Modeling of extended counseling sessions by high-level helpers. 3. Supervised pra c t i c e with extended sessions. (Egan, 1975, p. 53) - 18 -TABLE II EGAN COUNSELING MODEL Pre-helping phase: Helper's s k i l l s : Helper's goal: Stage I: Helper's s k i l l s : Helper's goal: Stage II: Helper's s k i l l s : Helper's goal: Stage I I I : Helper's s k i l l s : Helper's goal: Attending Physical attending, l i s t e n i n g to both verbal and non-verbal messages of the c l i e n t . To "be with" the c l i e n t both p h y s i c a l l y and psychologically. Responding Accurate empathy, respect, genuineness, concrete-ness. Responding to the c l i e n t with respect and empathy, e s t a b l i s h i n g rapport and an e f f e c t i v e working r e l a t i o n s h i p , f a c i l i t a t i n g the c l i e n t ' s s e l f - e x p l o r a t i o n . Integrative understanding A l l s k i l l s of Stage I. Advanced accurate empathy, s e l f - disclosure, immediacy, confrontation, a l t e r n a t i v e frames of reference. Integrating the information produced by the c l i e n t through his/her s e l f - e x p l o r a t i o n , helping the c l i e n t i d e n t i f y behavioural themes, teaching the c l i e n t t h i s i n t e g r a t i v e process. F a c i l i t a t i n g a ction A l l s k i l l s of Stages I and I I . Development of action programmes and support. Helping the c l i e n t develop s p e c i f i c action programmes, a s s i s t i n g the c l i e n t to act on the new self-understandings, exploring with the c l i e n t a var i e t y of means for con s t r u c t i v e l y changing behaviour, and supporting the c l i e n t i n his/her action programmes. (Egan> 1975, p.30) - 19 -The microcounselling model proposed by Ivey and Authier (1978) represents another attempt to define the important s k i l l s of the e f f e c t i v e counselling process. In t h i s model, counsellor trainees learn these s k i l l s i n d i s c r e t e units. The counselling process i s broken down into: " s p e c i f i c s k i l l s and behaviour which can be defined, seen i n operation, pr a c t i c e d and evaluated. Rather than confuse the interviewing trainee with an overwhelming amount of data, the component-skills approach breaks interviewing into workable and observable dimensions" (Ivey & Authier, 1978, p.45). The Ivey and Authier taxonomy of microtraining s k i l l s i s as follows: I. Attending S k i l l s : Closed questions: Most often begin with "do", " i s " , "are" and can be answered by the helpee with only a few words. Open questions: T y p i c a l l y begin with "what", "how", "why", or "could" and allow the helpee more room for s e l f - e x p l o r a t i o n . Minimal encourage: S e l e c t i v e attention to and r e p e t i t i o n back to the helpee of exact words or phrases. May also be represented by " T e l l me more..." or "uh-huh". Paraphrase: Gives back to the helpee the essence of past verbal statements. Selective attention to key content of helpee v e r b a l i z a t i o n s . - 20 -Reflection of f e e l i n g : Selective attention to key a f f e c t i v e or emotional aspects of helper behaviour. Summarization: Similar to paraphrase and r e f l e c t i o n of f e e l i n g but represents a longer time period and gives back to c l i e n t several strands of thinking. I I . Influencing S k i l l s : D irections: T e l l i n g the helpee or helpees what to do. Expression of content: Giving advice, sharing information, making suggestions, giving opinions. Expression of f e e l i n g : Sharing personal or other people's a f f e c t i v e state i n the interview. Influencing summary: Stating the main themes of the helpee's statements over a period of time. Interpretation: Renaming or r e - l a b e l l i n g the helpee's behaviours or v e r b a l i z a t i o n s with new words from a new frame of reference. Direct-mutual communication: Sharing personal fee l i n g s with each other and responding to these shared f e e l i n g s . (Ivey & Authier, 1978, pp 67-67) - 21 -Ivey and Authier have i d e n t i f i e d the above s k i l l s as the e s s e n t i a l components of e f f e c t i v e counselling. They indi c a t e that t h i s model i s designed to be f l e x i b l e and to adapt to the p a r t i c u l a r needs of the i n d i v i d u a l t h e r a p i s t . They st r e s s however the importance of attending behaviour as the most basic unit of microcounselling (1978). More s p e c i f i c a l l y , they define open and closed questions and minimal encouragers as valuable s k i l l s at the beginning of the interview. Paraphrase, r e f l e c t i o n of f e e l i n g , and summarization are i d e n t i f i e d as more advanced attending s k i l l s . They describe these as " s k i l l s of s e l e c t i v e attention" used to give the session d i r e c t i o n or focus (1978, p. 92). The second group of s k i l l s i n the Ivey and Authier taxonomy are those of inter-personal influence. These s k i l l s involve the counsellor more a c t i v e l y i n the session. By using self-expression, d i r e c t i o n , expression of content, expression of f e e l i n g , s e l f - d i s c l o s u r e , i n f l u e n c i n g summarization, i n t e r p r e t a t i o n , and direct-mutual communication, the counsellor attempts to influence the c l i e n t to make p o s i t i v e personal changes (1978). The model of Ivey and Authier not only represents a taxonomy of important counsellor s k i l l s , but also represents a system of categorizing counsellor s k i l l s i n t o s i n g l e teachable units. Their basic micro-counselling model involves teaching counsellor trainees each of the s k i l l s i n a s i n g l e unit, then integ r a t i n g the components into a whole. - 22 -The stages of the model are as follows: 1. Baseline interview of f i v e minutes on videotape. The trainee interviews a volunteer c l i e n t about a r e a l or r o l e played concern. Depending on the s i t u a t i o n , a s p e c i f i c issue may be agreed to by both p a r t i c i p a n t s before the session begins, or a simple, unstructured/unplanned interview may be held. 2. Training A. A written manual describing the s i n g l e s k i l l to be learned i s read by the trainee. B. Video models i l l u s t r a t i n g the s p e c i f i c s k i l l are shown to the trainee and discussed with reference to the s i n g l e s k i l l being taught. C The trainee views the o r i g i n a l baseline interview and compares his or her performance with the modeling tape. D. The supervisor/trainer maintains a warm, supportive r e l a t i o n s h i p with the trainee, s t r e s s i n g p o s i t i v e aspects of the performance while constantly focusing on the s i n g l e s k i l l being taught. 3. Re-interview The trainee videotapes another session and gives s p e c i a l emphasis to the single s k i l l being learned. This tape i s reviewed with the supervisor/trainer. (Ivey & Authier, 1978, p. 11) The authors note that t h i s microcounselling model i s based on several p r i n c i p l e s . They hi g h l i g h t the importance of: 1. focusing on s i n g l e s k i l l s . 2. s e l f observation and confrontation. 3. observing video models. 4. r e a l interviewing. - 23 -In addition they note that the f l e x i b i l i t y of t h i s model means that i t can be used to teach the counselling s k i l l s of very d i f f e r e n t t h e o r e t i c a l o r i e n t a t i o n s . A number of studies have found the microcounselling approach e f f e c t i v e i n teaching interviewing and counselling s k i l l s . In one study (Moreland. Ivey & P h i l l i p s , 1973) a group of twelve medical students was trained i n microcounselling while another group received a d i f f e r e n t but equivalent t r a i n i n g . The microcounselling group was found to make more s i g n i f i c a n t gains i n s k i l l development than the equivalent group on most of the experimental measures. Another important study (Toukmanian & Rennie, 1975) compared the effectiveness of microcounselling t r a i n i n g with human r e l a t i o n s t r a i n i n g based on the model developed by Truax and Carkhuff (1967). They note some s i g n i f i c a n t areas of difference between these two approaches. F i r s t l y , microcounselling used role-play while human r e l a t i o n s t r a i n i n g used discrimination and communication t r a i n i n g . Secondly, the microcounselling approach used video tapes while the human r e l a t i o n s approach used audio tapes. F i n a l l y , the microcounselling group obtained feedback from t h e i r supervisor and peers through an analysis of the video tapes. Human r e l a t i o n s students obtained feedback through objective ratings of t h e i r counselling responses. The r e s u l t s of t h i s study indicated that regardless of the d i f f e r e n t approaches, both groups gained s i g n i f i c a n t l y i n the use of the s k i l l "open i n v i t a t i o n to t a l k " . Both groups decreased s i g n i f i c a n t l y i n t h e i r use of "closed question" and "advice and i n t e r p r e t a t i o n " . In the use of empathy the microcounelling group gained s i g n f i c a n t l y more that the human r e l a t i o n s group. The authors speculate that t h i s unexpected r e s u l t may be due to the use of the videotape and the extra practice involved i n the microcounselling approach. - 24 -Another recent taxonomy of counselling s k i l l s i s the system developed by H i l l (1978) for the purpose of measurement of counsellor behaviour. This Counselor Verbal Response Category System represents an attempt to integrate the various components of eleven e x i s t i n g taxonomies into one comprehensive system. Twenty f i v e separate categories were reduced to a system of fourteen counsellor response categories. These include minimal encourager, approval-reassurance, information, d i r e c t guidance, closed question, open question, restatement, r e f l e c t i o n , non-verbal referent, i n t e r p r e t a t i o n , s e l f d i s c l o s e , s i l e n c e and other. The complete taxonomy i s reprinted i n Appendix B. REACTIONS TO SKILL TRAINING While the i d e n t i f i c a t i o n of counselling s k i l l s and the elaboration of s k i l l taxonomies such as those presented have gained considerable impetus, a number of researchers have expressed some concern about t h i s recent emphasis. Although Rogers was among the f i r s t to i d e n t i f y core therapeutic conditions, he cautioned against a focus on s k i l l s alone (1957). Instead he stressed the importance of growth experiences i n the t r a i n i n g of the counsellor as a whole person. Recognizing the developing popularity of s k i l l t r a i n i n g , he noted how the client-centered approach d i f f e r e d from the current trend: "Actually a client-centered philosophy does not f i t comfortably into a technologically oriented society. Even psychotherapy i s coming more and more to value ' e f f i c i e n c y ' . Proper diagnosis, reliance on immediate cause and e f f e c t theories and other l i n e a r constructs are seen as ways to ' f i n d out what i s wrong and cure i t ' , quickly. Client-centered therapy, lacking flashy methods and techniques, r e l y i n g upon the evocation of the c l i e n t ' s strengths, flowing at the c l i e n t ' s pace, seems to many, naive and i n e f f i c i e n t . I t does not f i t into a ' f i x - i t ' c u l ture." (in Burton, ed. 1974, p. 213) - 25 -Other writers (Mahon & Altmann, 1977; Carkhuff & Berenson, 1977) have also highlighted the hazards of emphasizing s k i l l s over the personal i n t e g r i t y of the counsellor. They stress the importance of supplementing s k i l l t r a i n i n g with personal growth experiences i n order to ensure that the new s k i l l s are used appropriately. The counsellor education models discussed here represent some recent attempts to i d e n t i f y and develop counselling approaches which can f a c i l i t a t e c l i e n t s e l f - d i s c o v e r y . The research i n t h i s area, however, su f f e r s from a major l i m i t a t i o n . In a recent review of the l i t e r a t u r e , Matarazzo (1978) notes that most counsellor education programmes are designed to teach beginning s k i l l s to neophyte counsellors. There i s a burgeoning need to develop counsellor education models which can o f f e r the already-trained counsellor an opportunity to develop more advanced s k i l l s . EMPATHY One of the e a r l i e r s k i l l s defined i n therapy was empathy. In h i s early work, Rogers i d e n t i f i e d empathy as one of the three conditions necessary and s u f f i c i e n t for behaviour change. "The state of empathy, or being empathic i s to perceive the i n t e r n a l frame of reference of another with accuracy and with emotional components and meanings which pertain thereto as i f one were the person, but without ever l o s i n g the 'as i f condition" (1957). In more recent years, Rogers re-defined empathy to r e f l e c t h i s changing perception of t h i s important q u a l i t y . This new d e f i n i t i o n r e f l e c t s h i s conceptualization of empathy as a process, rather than a state. - 26 -"The way of being with another person which i s termed empathic has several facets. I t means entering the private perceptual world of the other and becoming thoroughly at home i n i t . I t involves being s e n s i t i v e , moment to moment, to the changing f e l t meanings which flow i n t h i s other person, to the fear or rage or tenderness or confusion or whatever, that he/she i s experiencing. I t means temporarily l i v i n g i n his/her l i f e , moving about i n i t d e l i c a t e l y without making judgements, sensing meanings of which he/she i s scarcely aware, but not t r y i n g to uncover feel i n g s of which the person i s t o t a l l y unaware, since t h i s would be too threatening. I t includes communicating your sensings of his/her world as you look with fresh and unfrightened eyes at elements of which the i n d i v i d u a l i s f e a r f u l . I t means frequently checking with him/her as to the accuracy of your sensings, and being guided by the responses you receive. You are a confident companion to the person i n his/her inner world. By pointing to the possible meanings i n the flow of his/her experience you help the person to focus on t h i s useful type of referent, to experience the meanings more f u l l y , and to move forward i n the experiencing." (Rogers, 1975) Since Rogers f i r s t defined empathy as the c r i t i c a l element i n therapy, considerable research has been done to evaluate the effectiveness of t h i s v a r i a b l e . A number of researchers have found evidence supporting the ro l e of empathy i n f a c i l i a t i n g s e l f - e x p l o r a t i o n and process movement (Truax & Carkhuff, 1967; Carkhuff & Berenson, 1978; Kurtz & Grummon, 1972). Other research has suggested that early use of empathy i n the therapeutic r e l a t i o n s h i p predicts l a t e r success (Barrett - Lennard, 1962). One important finding suggests that therapists consider the i d e a l therapist to be empathic. Raskin (1974) found that eighty-three therapists of d i f f e r i n g orientations ranked empathy as the si n g l e most important therapeutic v a r i a b l e . Other research suggests a p o s i t i v e c o r r e l a t i o n between degree of empathy and degree of therapist experience. In one study the variable of empathy was evaluated by c l i e n t s ( F i e d l e r . 1950); i n another by q u a l i f i e d judges (Barrett - Lennard, 1962). - 27 -Th is i s not to suggest tha t a l l exper ienced t h e r a p i s t s are empath ic . Rask in (1974) d i s c o v e r e d t h a t even though t h e r a p i s t s g e n e r a l l y agreed upon the importance o f empathy, few demonstrated tha t q u a l i t y i n t h e i r own work. Some research f i n d i n g s have p a r t i c u l a r re levance fo r c o u n s e l l o r educat ion programmes. Two s t u d i e s have found t h a t the t h e r a p i s t ' s degree o f empathy i s u n r e l a t e d to h i s/her academic competence or d i a g n o s t i c e x p e r t i s e (Berg in & J a s p e r , 1969; Berg in & Solomon, 1970) . In a d d i t i o n , other s t u d i e s have suggested t h a t empathy can be l e a r n e d through t r a i n i n g . Th is l e a r n i n g i s best f a c i l i t a t e d by i n d i v i d u a l s who possess t h a t s p e c i a l q u a l i t y o f empathy themselves (Apsy, 1972; Berg in & Solomon, 1970) . These f i n d i n g s underscore the importance o f empathy i n the t h e r a p e u t i c r e l a t i o n s h i p . However, o ther s t u d i e s have quest ioned the supremacy o f t h i s s i n g l e q u a l i t y . C a r k h u f f (1969) has found t h a t too much empathy too soon i n the r e l a t i o n s h i p may a c t u a l l y impede c l i e n t p r o g r e s s . Th is suggests tha t s k i l l f u l t i m i n g o f the use o f empathy may be an important v a r i a b l e . Another research review (Lambert, De J u l i o & S t e i n , 1978) has examined the l i t e r a t u r e to eva lua te the r e l a t i o n s h i p o f psychotherapeut ic outcome to the t h e r a p i s t s k i l l s o f empathy, p o s i t i v e regard and genuineness. The r e s u l t s suggest on ly moderate support f o r these core c o n d i t i o n s o f the c l i e n t - c e n t e r e d approach. In a d d i t i o n , research o f f e r s r e l a t i v e l y l i t t l e support f o r the p o p u l a r i t y o f c o u n s e l l o r educat ion programmes based s o l e l y on these i n t e r - p e r s o n a l s k i l l s . Berg in and S u i n n ' s review o f the research i n psychotherapy (1975) has a l s o h i g h l i g h t e d the d i m i n i s h i n g p o p u l a r i t y o f empathy as the s i n g l e most important v a r i a b l e of s u c c e s s f u l therapy . In p a r t i c u l a r , they c i t e the r e s u l t s o f a study by M i t c h e l l e t a l (1973) whose f i n d i n g s demonstrated no r e l a t i o n s h i p between empathy and outcome. - 28 -In a recent overview of developments in c l i n i c a l research, Greenberg (1980a) has summarized empathy's changing status over the last decade: "Therapist communicated empathy has not fared well and has been relegated from the supreme position at the beginning of the decade as the 'core condition' of a l l therapeutic change (Truax & Mitchel l , 1971), to a mid-seventies position of being possibly an important ingredient in client-centred therapy but not a suff icient condition in other approaches (Bergin & Suinn, 1975), to a position at the end of the decade as being possibly fac i l i ta t i ve at particular, precise times in therapy" (Lamberts De Julio & Stein, 1978, Mitchel l , Bozarth & Krauft, 1977). GESTALT THERAPY In general, research has fai led to support the Rogerian hypothesis that empathy, positive regard, and genuineness are necessary and suff icient to fac i l i ta te positive therapeutic outcome. As a result , there has been a c a l l to develop more active s k i l l s in counselling that go beyond the responsive dimensions. In an effort to meet this need, Greenberg and Kahn (1979) have proposed the addition of a stimulation phase to the three-stage Egan model. This new stimulation phase i s based upon perceptual theory which argues that behaviour is determined by perceptions and therefore behavioural change must be preceded by perceptual change. Greenberg and Kahn suggest that the addition of the stimulation phase meets an important need by offering the counsellor active tools with which to stimulate change in cl ient perception. The f i r s t stage of this expanded Egan model involves building a therapeutic relationship which w i l l fac i l i ta te cl ient self -exploration. The stimulation phase builds upon this empathy-based relationship and involves a number of active techniques. The s k i l l s of this second phase include Gestalt experiments, focusing, structured exercise, body awareness and guided imagery. These s k i l l s are used to stimulate more - 29 -a c t i v e l y the c l i e n t s e l f - e x p l o r a t i o n which leads to discovery and perceptual change. Greenberg and Kahn argue that as these s k i l l s promote deeper experiencing, they are more e f f e c t i v e than r e f l e c t i v e s k i l l s alone i n f a c i l i t a t i n g c l i e n t perceptual change. In the t h i r d stage of t h i s model, the c o u n s e l l o r uses h i s / h e r i n t e r - p e r s o n a l i n f l u e n c e e s t a b l i s h e d through the r e l a t i o n s h i p to help the c l i e n t gain new s e l f - u n d e r s t a n d i n g s . In the f i n a l stage, the c o u n s e l l o r c o l l a b o r a t e s with the c l i e n t to develop s u i t a b l e a c t i o n plans and provides the necessary support and encouragement f o r the d e s i r e d behaviour change. The expanded model i s shown i n Table I I I . In a separate paper, Greenberg and Kahn summarize the r a t i o n a l e f o r the a d d i t i o n of the s t i m u l a t i o n phase: "The c o u n s e l l i n g process that f a i l s to s t i m u l a t e the c l i e n t to deeper l e v e l s of experiencing and s e l f understanding once s a f e t y and acceptance are e s t a b l i s h e d o f t e n l a c k s d i r e c t i o n . i n a d d i t i o n to c o n f r o n t a t i o n , immediacy and advanced accurate empathy, the c o u n s e l l o r can use s t i m u l a t i o n s k i l l s to add impetus and d i r e c t i o n to c l i e n t e x p l o r a t i o n . S t i m u l a t i o n of deeper experiencing and involvement by these more i n i t i a t i v e methods often moves the c l i e n t d i r e c t l y to emotional r e s o l u t i o n of the problem being explored." (1978, p.23) In recent years, research has been done to evaluate the e f f e c t i v e n e s s o f these a c t i v e s k i l l s o f G e s t a l t therapy. Greenberg found the two-chair method h e l p f u l i n promoting c l i e n t self-awareness and r e s p o n s i b i l i t y (1975) and i n r e s o l v i n g s p l i t s (1979). Greenberg and Clarke (1979) found that the two-chair r o l e play a p p l i e d at a s p l i t deepened c l i e n t experiencing. Dompierre (1979) found that the two-chair operation deepened c l i e n t experiencing and a l s o l e d to b e t t e r outcome than d i d empathy when a p p l i e d at a s p l i t . In another study Bohart (1977) found that G e s t a l t two-chair r o l e play was more e f f e c t i v e i n reducing c l i e n t anger, h o s t i l i t y and behavioural aggression than two other t h e r a p e u t i c procedures. Counselor behaviour Counselor s k i l l s C l i e n t process - 30 -TABLE I I I EXPANDED MODEL OF COUNSELING Stage I Responding Pr imary l e v e l accurate empathy Respect Genuineness Concreteness Stage 2 S t i m u l a t i n g G e s t a l t experiments Guided imagery Focus ing S t r u c t u r e d e x e r c i s e s Body awareness Evocat i ve r e f l e c t i o n S e l f e x p l o r a t i o n Trust and rappor t D i s c o v e r i n g Stage 3 I n f l u e n c i n g new understanding Advanced l e v e l accurate empathy S e l f - d i s c l o s u r e Immediacy C o n f r o n t a t i o n A l t e r n a t e frames o f re fe rence Dynamic s e l f -understanding Stage 4 F a c i l i t a t i n g a c t i o n E l a b o r a t i o n o f a c t i o n programs such as problem s o l v i n g t e c h n i q u e s , d e c i s i o n making processes behaviour m o d i f i c a t i o n programs, "homework", and t r a i n i n g i n i n t e r p e r s o n a l s k i l l s . Support A c t i n g (Greenberg and Kahn, 1979) 31 -Research has a l s o suggested that c o u n s e l l o r t r a i n e e s are i n t e r e s t e d i n l e a r n i n g a c t i v e c o u n s e l l i n g s k i l l s . In a comparison o f f i l m e d excerpts of Rogers, E l l i s , and P e r l s , c o u n s e l l o r t r a i n e e s i n d i c a t e d a preference for the a c t i v e s k i l l s o f G e s t a l t therapy, developed by P e r l s ( K e l l y & Bryne, 1977). These r e s u l t s seem to suggest that c o u n s e l l o r education programmes need to o f f e r t r a i n e e s the opportunity to develop these more advanced c o u n s e l l i n g s k i l l s . In general, the l i t e r a t u r e seems to suggest that G e s t a l t s k i l l s are potent t o o l s , u s e f u l i n promoting the c l i e n t awareness necessary f o r growth. T r a i n i n g methods i n these s k i l l s need to be developed and evaluated. Because o f the importance of using these s k i l l s a p p r o p r i a t e l y , a f t e r the establishment of a t r u s t i n g r e l a t i o n s h i p , i t seems prudent to o f f e r these s k i l l s to c o u n s e l l o r s with previous t r a i n i n g i n the responsive dimensions of c o u n s e l l i n g . I t a l s o appears important to t r a i n the "whole person" by encouraging the c o u n s e l l o r t r a i n e e ' s personal growth as w e l l as h i s / h e r s k i l l development. - 32 -CHAPTER III  METHODOLOGY This chapter w i l l identify and discuss the population, sample, design, data collection and scoring procedure used in this study. The measuring instruments used in this research w i l l also be presented with comments on their r e l i a b i l i t y . In addition, the selection and training of raters and c l in ic ians w i l l be discussed. Final ly , the s t a t i s t i c a l analyses used w i l l be identi f ied. 1. POPULATION The sample for this study was selected from a population of counsellors with a background in empathy s k i l l s . The population consists of counsellors between twenty-four and f i f t y years of age with a baccalaureate degree and at least one year of graduate level training in counselling. In addition, these counsellors have had one to five years of related professional experience. It i s assumed that the results w i l l be generalizable to similar counsellors with empathy backgrounds who desire training in the advanced s k i l l s of Gestalt therapy. 2. SAMPLE Subject Selection and Preparation: The subjects for this study consisted of eleven counsellors who participated in a Gestalt training group. A l l of the subjects in this group had experienced at least one year of training (72 hours) in empathy s k i l l s . Their experience in counselling ranged from one to five years. The trainees in this group were selected partly through their own stated interest in the training group.. In addition, the trainer evaluated each potential trainee for personal su i tab i l i t y . - 33 -Sub jec ts were t o l d tha t the study would be g e n e r a l l y focused on c o u n s e l l i n g s k i l l s . They were not informed o f the hypotheses under i n v e s t i g a t i o n . C o n t r o l Group The e leven s u b j e c t s chosen fo r the c o n t r o l group were matched w i th the exper imenta l group i n terms o f age, background t r a i n i n g and years o f exper ience . These v a r i a b l e s were judged to be o f g r e a t e s t re levance to the s t u d y . The c o n t r o l group was s e l e c t e d from a pool o f c o u n s e l l o r s who had the same empathy background as the exper imenta l group. These c o u n s e l l o r s had expressed an i n t e r e s t i n t h i s p a r t i c u l a r G e s t a l t t r a i n i n g but were unable to a t tend due to s c h e d u l i n g d i f f i c u l t i e s , other commitments e t c . A number o f the c o n t r o l group had expressed t h e i r i n t e n t i o n to p a r t i c i p a t e i n the t r a i n i n g i n the f o l l o w i n g year . C l i e n t s Four c l i e n t s , two men and two women, were used i n t h i s s t u d y . A l l c l i e n t s had had some prev ious exper ience w i th the c o u n s e l l i n g process i n c l u d i n g G e s t a l t therapy to reduce the n o v e l t y e f f e c t . P r i o r to the exper imenta l s e s s i o n , each c l i e n t was coached to present a c o n f l i c t s p l i t to each one o f h i s / h e r c o u n s e l l o r s w i t h i n the f i r s t ten minutes o f the t h i r t y - m i n u t e c o u n s e l l i n g s e s s i o n . The s p l i t was f i r s t presented i n a genera l f o r m u l a t i o n and then i n a more s p e c i f i c f o r m u l a t i o n as shown below. In t h i s example, the s p l i t was the c l i e n t ' s c o n f l i c t between f e e l i n g he should con tac t an o l d f r i e n d but not wanting to do s o . - 34 -Genera l f o r m u l a t i o n : C l i e n t : So now I f e e l k i n d o f as though the b a l l i s i n my c o u r t . I f e e l I shou ld* c a l l him and see him a g a i n . C o u n s e l l o r : Mm hmm. C l i e n t : Uh, probably because I s a i d I would . Another t h i n g . I t h i n k , I guess I f e e l g u i l t y . . . C o u n s e l l o r : Mm hmm. C l i e n t : . . . t h a t I d i d n ' t c a l l him fo r over a year and he s t i l l * c a l l e d me. C o u n s e l l o r : R i g h t . C l i e n t : So there must be something t h e r e . C o u n s e l l o r : R i g h t . C l i e n t : Yet on the other hand, I d o n ' t know i f I l i k e him t h a t much now. C o u n s e l l o r : Mm hmm. Y e a h . . . I understand i t ' s k i n d o f hard when you have been c l o s e f r i e n d s w i th him. S p e c i f i c f o r m u l a t i o n : C l i e n t : Yeah, I f e e l I should a t l e a s t c a l l him and g i ve him a chance. C o u n s e l l o r : Y e a h . . . . C l i e n t : And yet I t h i n k , why bother , why exer t the energy? * I n d i c a t e s v o i c e emphasis . - 35 -In the pre-test, each c l i e n t had sessions with counsellors i n both the experimental and control groups. In the post-test, each c l i e n t again presented a s p l i t i n each session with d i f f e r e n t experimental and control group counsellors. In order to help control for any i n t e r - a c t i o n e f f e c t between c l i e n t and counsellor, an attempt was made to ensure that each c l i e n t had sessions with an equal number of experimental and control group counsellors. Although d i f f i c u l t i e s i n scheduling prevented a completely balanced arrangement, no c l i e n t was counselled by the same counsellor i n both the pre and post t e s t s . 3. RATERS AND CLINICIANS Two ra t e r s , both graduate students i n counselling psychology were used i n t h i s study. Both of the raters were f a m i l i a r with the Gestalt two-chair experiment. Each rater was trained a t o t a l of twelve hours i n the scoring procedures. In addition two c l i n i c i a n s were used i n t h i s study. Both of these c l i n i c i a n s were f a m i l i a r with the s k i l l s of Gestalt therapy. 4. DESIGN The design for t h i s study was a v a r i a t i o n of the Pre-test Post-test Control Group Design (Campbell & Stanley, 1963). Because the subjects for t h i s study were not a random sample, the control group was matched to the experimental group as described e a r l i e r . Procedure The treatment or independent variable of t h i s research was the twenty-four session Gestalt t r a i n i n g group described e a r l i e r i n t h i s paper. The purpose of t h i s study was to evaluate the effectiveness of t h i s method of teaching counsellors Gestalt s k i l l s and of promoting t h e i r personal growth. - 36 -Pre-test measures of s k i l l and personal growth goals were obtained from both the experimental and control groups p r i o r to the onset of the t r a i n i n g programme. On completion of the t r a i n i n g experience, post-test measures on degree of s k i l l and goal attainment were obtained from both groups. MEASURING INSTRUMENTS Dependent Variables The dependent variables i n t h i s study were: 1. counsellor response to a s p l i t 2. actual use of influencing s k i l l s 3. intended use of influ e n c i n g s k i l l s 4. degree of goal attainment 1. Counsellor response to a s p l i t : (Appendix H) To determine how the counsellor responded to the c l i e n t - presented s p l i t , two trained r a t e r s l i s t e n e d to the f i r s t ten minutes of the tape session. The counsellor's response was judged according to the f i r s t p r i n c i p l e of the two-chair operation outlined by Greenberg (1979). This p r i n c i p l e of maintaining separation and contact has three components - getting a sense of the part, contacting, and defining differences. To help the c l i e n t get a sense of the part, the counsellor encourages the c l i e n t to speak as that p a r t i c u l a r part. To aid the c l i e n t to make contact with the other part, the counsellor encourages the c l i e n t to speak d i r e c t l y to him/herself i n the other chair. To help the c l i e n t define differences, the counsellor aids the c l i e n t i n c l a r i f y i n g the boundaries between the two parts of the s e l f that are i n dialogue. - 37 -I f the t w o - c h a i r o p e r a t i o n was i n i t i a t e d i n the f i r s t ten minutes o f the s e s s i o n , the f o u r - m i n u t e segment preceding the i n i t i a t i o n was s e l e c t e d to determine whether the c o u n s e l l o r began the o p e r a t i o n i n response to the c l i e n t - presented s p l i t . Th is fou r -minute segment was t r a n s c r i b e d f o r r a t i n g of the c o u n s e l l o r responses . I f the t w o - c h a i r o p e r a t i o n was not l o c a t e d i n the f i r s t ten -minute segment, the s p e c i f i c statement o f the s p l i t and the f o l l o w i n g four minutes were t r a n s c r i b e d fo r r a t i n g o f the c o u n s e l l o r responses . Each r a t e r eva luated t h r e e - f o u r t h s of the four - minute segments t o determine whether the c o u n s e l l o r responded to the s p l i t w i th the G e s t a l t t w o - c h a i r o p e r a t i o n . Th is l e f t o n e - h a l f of the tapes to p rov ide a check fo r i n t e r - r a t e r r e l i a b i l i t y . The Pearson product-moment c o r r e l a t i o n c o e f f i c i e n t was found to be r= 1 . 0 0 , i n d i c a t i n g p e r f e c t agreement. 2 . Counselor V e r b a l Response Category System: (Appendix B) ( A c t u a l use o f i n f l u e n c i n g s k i l l s ) In e v a l u a t i n g the c o u n s e l l o r s ' a c t u a l use o f i n f l u e n c i n g s k i l l s , the segment c o n t a i n i n g the c l i e n t - p r e s e n t e d s p l i t was analyzed s e p a r a t e l y from the other segments. The f i r s t fou r -minute segment was s e l e c t e d from the i n i t i a l ten minutes o f the s e s s i o n . To s e l e c t the other two segments, the remainder of each tape was d i v i d e d i n t o f o u r - m i n u t e segments. The f i n a l segment, u s u a l l y i n v o l v i n g summary and c l o s u r e , was o m i t t e d . The remain ing segments were c a t e g o r i z e d i n t o the f i r s t h a l f and second h a l f o f the s e s s i o n . Where the number o f segments was uneven, a c o i n t o s s determined the a l l o c a t i o n o f the middle segment. For the a n a l y s i s , one segment was then randomly chosen from the f i r s t h a l f of the s e s s i o n and a second segment chosen from the second h a l f . - 38 -To analyze these segments for actual use of influencing s k i l l s , the counsellor statements were divided into units according to the rules outlined by Auld and White (1956) and used by H i l l i n her development of the Counselor Verbal Response Category System (1978). Each rater evaluated three-fourths of the tape segments leaving one-half of the segments to provide a check for i n t e r - r a t e r r e l i a b i l i t y . They achieved a 91% agreement. Where differences occurred, the r a t e r s discussed the discrepancy u n t i l mutual agreement was reached. The raters then i d e n t i f i e d each u n i t i z e d counsellor response i n the tape segments under the fourteen categories of the H i l l Counselor Verbal Response Category System (1978). Recent research ( H i l l , Thames, & Rardin, 1979) suggests that t h i s system represents a r e l i a b l e taxonomy of counsellor verbal behaviour. In that study, the r e l i a b i l i t y was computed by determining the c o e f f i c i e n t s of agreement of a l l possible combinations of the three judges. The kappas were found to be .79, .78 and .81, i n d i c a t i n g high agreement among judges. In t h i s study, the i n t e r - r a t e r r e l i a b i l i t y was also determined by the use of Cohen's c o e f f i c i e n t of agreement (1960) and found to be .83. Where differences between ratings occurred, the f i n a l choice of category was determined by a coin toss. 3. Counselling Session Follow-up Questionnaire: (Appendix C) (Intended use of i n f l u e n c i n g s k i l l s ) To measure the counsellors' intended use of i n f l u e n c i n g s k i l l s , subjects were asked to complete a questionnaire immediately a f t e r the pre-test and post-test counselling sessions. The form required counsellors to i d e n t i f y the intentions of t h e i r counselling responses i n the sessions. This questionnaire i s a close adaptation of the H i l l Counselor Verbal Response Category System (1978) described e a r l i e r . The categories of " s i l e n c e " and "other" were deleted for the purpose of c l a r i t y , leaving twelve response categories. - 39 -4 . Goal Attainment Inventory (Appendices D, E, F and G) To determine behaviour change as a r e s u l t o f the t r a i n i n g e x p e r i e n c e , a m o d i f i e d Goal Atta inment Inventory was u s e d . Research has suggested t h a t use o f the Goal Atta inment Inventory to s p e c i f y observab le goa ls may represent a v i a b l e measure o f outcome (K i resuk & Sherman, 1968) . In the p r e - t e s t , exper imenta l s u b j e c t s was asked to s p e c i f y both t r a i n i n g and pe rsona l growth goa ls (Appendices D and E ) . C o n t r o l group s u b j e c t s were asked to s p e c i f y pe rsona l growth goa ls on ly (Appendix E ) . In the p o s t - t e s t , the exper imenta l group was asked to i n d i c a t e to what degree they achieved both t h e i r pe rsona l and t r a i n i n g goa ls (Appendices F and G) . The c o n t r o l group was asked to i n d i c a t e to what degree they achieved t h e i r pe rsona l goa ls (Appendix F ) . OTHER MEASURES C l i e n t E v a l u a t i o n (Appendix I ) A f t e r each o f the p o s t - t e s t s e s s i o n s o f both groups, each c l i e n t eva luated the c o u n s e l l o r ' s h e l p f u l n e s s i n working w i t h the presented i s s u e on a f i v e - p o i n t o r d i n a l s c a l e . - 40 -C l i n i c a l Evaluation (Appendix J) Two c l i n i c i a n s i n counselling psychology evaluated the post-test segments of the experimental group to obtain a measure of effectiveness and appropriateness of the counsellor interventions. Each c l i n i c i a n evaluated three-quarters of the tape segments leaving one-half of the tapes to provide a check for i n t e r - r a t e r r e l i a b i l i t y . The Spearman Rho c o r r e l a t i o n c o e f f i c i e n t was found to be .77. In the event of differences between the c l i n i c a l ratings, the f i n a l choice was determined by a coin toss. DATA COLLECTION 1. Before the f i r s t experimental session, the c l i e n t was coached to present the prepared s p l i t i n a general formulation and then i n a more s p e c i f i c format within the f i r s t ten minutes of the session. The counsellor was i n s t r u c t e d to imagine that he/she had already spent four sessions with t h i s c l i e n t b u i l d i n g a r e l a t i o n s h i p . Since Gestalt s k i l l s are best u t i l i z e d when a r e l a t i o n s h i p has been established, t h i s mental set was designed to allow the counsellor the choice of using more active s k i l l s i f he/she deemed i t appropriate. The counsellor and the c l i e n t then engaged i n a thirty-minute counselling session. The e n t i r e session was audio-taped for future r a t i n g . 2. Immediately a f t e r the session, the counsellor completed the Counselling Session Follow-up Questionnaire i n d i c a t i n g the intent of his/her responses throughout the session (Appendix C). Each counsellor then completed the appropriate form of the Goal Attainment Inventory (Appendices D and E). - 41 -3. Two trained r a t e r s evaluated the i n i t i a l ten minutes of each tape to determine i f the counsellor responded to the s p l i t with the f i r s t p r i n c i p l e of the Gestalt two-chair operation. This p r i n c i p l e of maintaining separation and contact involves helping the c l i e n t get a sense of the part, make contact with the other part and define differences (Appendix H). 4. In addition, the raters evaluated a l l of the counsellor responses on the selected tape segments according to the fourteen categories of the Counselor Verbal Response Category System (Appendix B). A l l of the above procedures were repeated at the post t e s t . Gestalt group counsellors completed Goal Attainment Follow-up forms for both personal growth and t r a i n i n g goals (Appendices F and G). Control group counsellors completed follow-up forms for personal growth goals only (Appendix F ) . The following procedures were performed at the post-test only. 5. Each c l i e n t completed a questionnaire evaluating the counsellor's helpfulness i n working with the presented s p l i t . Both groups of counsellors were evaluated (Appendix I ) . 6. Two c l i n i c i a n s i n counselling psychology evaluated the tapes segments of the experimental group to determine the effectiveness and appropriateness of the counsellors' responses (Appendix J ) . The sequence of the pre-test and post-test measures i s d e t a i l e d i n Table IV. After the thirty-minute counselling session with the confederate c l i e n t , each counsellor completed the follow-up questionnaire and goal inventory. Raters evaluated the counsellor response to the s p l i t , and intended and actual use of d i r e c t guidance, open question and non-verbal referent. - i\2 -In the p o s t - t e s t , each c o u n s e l l o r again completed the f o l l o w - u p q u e s t i o n n a i r e a f t e r the c o u n s e l l i n g s e s s i o n . C o u n s e l l o r s i n both groups then completed goa l a t ta inment forms, e v a l u a t i n g t h e i r own achievement. A measure of o v e r a l l h e l p f u l n e s s o f each c o u n s e l l o r was obta ined from the c l i e n t and a measure o f e f f e c t i v e n e s s and appropr ia teness o f the exper imenta l group c o u n s e l l o r s was determined by two c l i n i c i a n s . Raters eva luated the c o u n s e l l o r response to the s p l i t and intended and a c t u a l use o f d i r e c t gu idance, open q u e s t i o n and n o n - v e r b a l r e f e r e n t . TABLE IV DATA COLLECTION SEQUENCE PRE-TEST MEASURES POST-TEST MEASURES ( i ) C o u n s e l l i n g Sess ion F o l l o w up Q u e s t i o n n a i r e (Co) ( i i ) Goal At ta inment Inventory (Co) ( i i i ) C o u n s e l l o r Response to a S p l i t : tape r a t i n g (R) ( i v ) Counselor Ve rba l Response Category System: tape r a t i n g (R) ( i ) C o u n s e l l i n g Sess ion Fo l low -up Quest ionna i re (Co) ( i i ) Goal Attainment Fo l low-up (Co) ( i i i ) C l i e n t E v a l u a t i o n (C) ( i v ) C l i n i c a l E v a l u a t i o n (C l ) ( fo r exper imenta l group on ly ) (v) Counse l lo r Response to a S p l i t : tape r a t i n g (R) ( v i ) Counselor Ve rba l Response Category System: tape r a t i n g (R) Key Co = C o u n s e l l o r R = Rater C l = C l i n i c i a n C = C l i e n t - 44 -DATA ANALYSIS Th is s e c t i o n d e s c r i b e s the data a n a l y s i s fo r the four dependent v a r i a b l e s under i n v e s t i g a t i o n i n t h i s s t u d y . C o u n s e l l o r response to a s p l i t Two t r a i n e d r a t e r s eva luated each c o u n s e l l o r ' s response to the c l i e n t -presented s p l i t and determined the a p p r o p r i a t e category on a t h r e e - p o i n t nominal s c a l e . The data obta ined from t h i s e v a l u a t i o n were then sub jec ted to a non -paramet r i c s t a t i s t i c a l a n a l y s i s to t e s t fo r d i f f e r e n c e between groups. The Wilcoxon M a t c h e d - P a i r s S i g n e d - Ranks t e s t o f s i g n i f i c a n c e was u s e d . Th is same procedure was repeated at the post t e s t . A c t u a l use of i n f l u e n c i n g s k i l l s In the p r e - t e s t , the tape segments o f both the exper imenta l and c o n t r o l group were analyzed to determine the a c t u a l use o f i n f l u e n c i n g s k i l l s . For each c o u n s e l l o r , the segment c o n t a i n i n g the c l i e n t - p r e s e n t e d s p l i t was eva luated s e p a r a t e l y . The other two segments which had been randomly s e l e c t e d from the remain ing tape as d e s c r i b e d e a r l i e r were then eva luated and mean scores o b t a i n e d . In the a c t u a l s c o r i n g , r a t e r s f i r s t u n i t i z e d a l l o f the responses as d e s c r i b e d e a r l i e r a c c o r d i n g to the r u l e s o f Au ld and White (1956) . Each u n i t i z e d response was c l a s s i f i e d under the a p p r o p r i a t e category o f the H i l l Counselor Ve rba l Response Category System (1978) . The r a t e r s then determined the number o f responses be long ing i n each o f the c a t e g o r i e s o f d i r e c t guidance(#4) open ques t ion (#6) , and n o n - v e r b a l r e f e r e n t ( # 9 ) . These s c o r e s , i n d i c a t i n g the th ree s e l e c t e d i n f l u e n c i n g s k i l l s , were then converted to p r o p o r t i o n s , r e p r e s e n t i n g the percentage o f the t o t a l c o u n s e l l o r responses i n the fou r -minute segment which were d e f i n e d as - 45 -d i r e c t guidance, open question and non-verbal referent. These proportion scores were passed through an arc s i n transformation to render them appropriate for a n a l y s i s . Three dependent t - t e s t s were used. These procedures were repeated at the post t e s t . Intended use of i n f l u e n c i n g s k i l l s To measure intended use of inf l u e n c i n g s k i l l s , the categories of d i r e c t guidance(#4), open question(#6), and non-verbal referent(#9) were selected from the Counselling Session Follow-up Questionnaires of both the experimental and co n t r o l groups. This questionnaire was designed as an o r d i n a l scale, suggesting the use of a non-parametric s t a t i s t i c a l a n a l y s is. The scores for the experimental and control groups were compared i n each of the three selected response categories. The Wilcoxon Matched-Pairs Signed-Ranks test was used to analyze the data of each of these response categories. This same procedure was repeated at the post- t e s t . Goal attainment To measure degree of goal attainment at the post-test, two d i f f e r e n t analyses were used. In order to determine the degree to which the counsellors i n the Gestalt group achieved t h e i r t r a i n i n g goals, a Chi square goodness of f i t t e s t was used. In order to compare the degree to which both the experimental and control groups achieved t h e i r personal goals, a Chi square t e s t of independence was used. C l i e n t and c l i n i c a l evaluations In the post-test, each counsellor i n both groups was evaluated for global helpfulness by his/her c l i e n t . Counsellors i n the experimental group were evaluated for effectiveness and appropriateness by two c l i n i c i a n s . Median scores and range were obtained for each measure. - 46 -CHAPTER IV  RESULTS This chapter presents the r e s u l t s of a l l of the ratings and s t a t i s t i c a l analyses performed on the data. The pre-test measures of the experimental and control groups were compared to determine i f t h e i r i n i t i a l l e v e l s were s i g n i f i c a n t l y d i f f e r e n t . These pre-test measures included counsellor response to a s p l i t , actual use of influencing s k i l l s and intended use of i n f l u e n c i n g s k i l l s . On counsellor response to a s p l i t , the scores of both groups were found to be i d e n t i c a l . The scores are shown i n Table V. Dependent t - t e s t s were applied to compare the scores of both groups on the actual use of d i r e c t guidance(#4), open question(#6), and non -verbal referent(#9) i n the s p l i t s and the segments. The r e s u l t s yielded no s i g n i f i c a n t differences between groups on any of these s k i l l s . Means, standard deviations and t-scores appear i n Table VI. In evaluating the intended use of infl u e n c i n g s k i l l , the two groups were compared on t h e i r stated intentions to use d i r e c t guidance(#4), open question(#6) and non-verbal referent(#9). The Wilcoxon Matched-Pairs Signed-Ranks t e s t indicated no s i g n i f i c a n t difference between the groups. Medians, q u a r t i l e deviations and T-scores are shown in Table VII. - 47 -TABLE V PRE-TEST SCORES FOR COUNSELLOR RESPONSE TO A SPLIT No Unclear Yes Experimental 10 1 Control 10 - 1 TABLE VI PRE-TEST MEANS,* STANDARD DEVIATIONS* AND t-SCORES** FOR ACTUAL USE OF INFLUENCING SKILLS Group Means Standard Deviations t-scores #4 #6 #9 #4 #6 #9 . #4 #6 #9 Spl i t Experimental .03 .05 .01 .05 .08 .00 Control .01 .07 .00 .04 .08 .00 Segments Experimental .03 .01 .00 .03 .01 .00 Control .03 .04 .00 .05 .00 .00 * proportions prior to transformation ** calculated from transformed scores 1.94 .70 1.27 .30 .45 1-20 - 48 -TABLE VII PRE-TEST MEDIANS, QUARTILE DEVIATIONS AND T-SCORES FOR  INTENDED USE OF INFLUENCING SKILLS Group Medians Quartile Deviations T-scores #4 #6 #9 #4 #6 #9 #4 #6 #9 Experimental 2.13 3.63 1.42 .75 .69 1.31 23.0 16.6 21.5 Control 2.6 4.0 1.75 .78 .39 .55 The preceding analyses ind i c a t e that the two groups were matched at the pre-test l e v e l on the v a r i ables of counsellor response to a s p l i t , actual use of i n f l u e n c i n g s k i l l and intended use of i n f l u e n c i n g s k i l l . This allowed post-test scores to be compared for differences as a c r i t e r i o n of treatment effectiveness. In the post-test measures the same analyses were applied. In evaluating the two groups on counsellor response to a s p l i t , the following hypotheses were tested: H-^: There w i l l be no s t a t i s t i c a l l y s i g n i f i c a n t difference i n the degree to which the Gestalt group trainees and the control group respond to a s p l i t with separation and contact as revealed by the Wilcoxon Matched-Pairs Signed-Ranks non-parametric t e s t of s i g n i f i c a n c e . Hj^: There w i l l be a s t a t i s t i c a l l y s i g n i f i c a n t difference i n the degree to which the Gestalt group trainees and the control group respond to a s p l i t with separation and contact as revealed by the Wilcoxon Matched-Pairs Signed-Ranks non-parametric t e s t of s i g n i f i c a n c e . - 49 -The Wilcoxon Matched-Pairs Signed Ranks analysis revealed that the two groups were signif icantly different at oC = .05 level of significance. The nul l hypothesis was rejected in favour of the alternative. The scores appear in Table VIII. TABLE VIII POST-TEST SCORES FOR COUNSELLOR RESPONSE TO A SPLIT No Unclear Yes Experimental Control 1 1 10 11 - -In evaluating the two groups on the actual use of influencing s k i l l s the following hypotheses were tested: H 2 r j : There w i l l be no s ta t i s t i ca l l y significant difference in the degree to which the Gestalt group trainees and the control group (a) use the influencing s k i l l of direct guidance, (b) use the influencing s k i l l of open question and (c) use the influencing s k i l l of non-verbal referent as revealed by dependent t - tes ts . H 2^: There w i l l be a s ta t i s t i ca l l y significant difference in the degree to which the Gestalt group trainees and the control group (a) use the influencing s k i l l of direct guidance, (b) use the influencing s k i l l of open question and (c) use the influencing s k i l l of non-verbal referent as revealed by dependent t - tes ts . The four-minute segment containing the cl ient sp l i t was analyzed separately and the dependent t - test revealed that in the use of direct guidance(#4), the groups were signif icantly different at cc = .05 level of signfiicance. Part (a) of the nul l hypothesis was rejected in favour of the alternative. In the use of open question (#6) and non-verbal - 50 -referent(#9), the two groups were not found to be s i g n i f i c a n t l y d i f f e r e n t at O C = .05 l e v e l of s i g n i f i c a n c e . Parts (b) and (c) of the n u l l hypothesis were retained. Means, standard deviations and t-scores appear i n Table IX. On the two four-minute segments, the same hypotheses were tested by dependent t - t e s t s . In the use of d i r e c t guidance(#4) and open question(#6), the two groups were found to be s i g n i f i c a n t l y d i f f e r e n t at OC = .05 l e v e l of s i g n i f i c a n c e . Parts (a) and (b) of the n u l l hypothesis were therefore rejected i n favour of the a l t e r n a t i v e s . In the use of non-verbal referent (#9), the two groups were not found to be s i g n i f i c a n t l y d i f f e r e n t at O C = .05 l e v e l of s i g n i f i c a n c e . Part (c) of the n u l l hypothesis was therefore retained. Means, standard deviations and t-scores are shown i n Table IX. TABLE IX POST-TEST MEANS,* STANDARD DEVIATIONS* AND t-5C0RES** FOR ACTUAL USE OF INFLUENCING SKILLS Group Means Standard Deviations t-scores # 4 # 6 # 9 '#4 #6 #9 #4 #6 #9 S p l i t Experimental .22 .05 .02 .05 .08 .00 5.8 1.63 1.50 Control .01 .07 .00 .04 .08 .00 Segments Experimental .18 .15 .00 .10 .09 .00 5.18° 4.09° 1.00 Control .03 .03 .00 .04 .00 .00 * proportions p r i o r to transformation ** c a l c u l a t e d from transformed scores 0 s i g n i f i c a n t atcxi = .05 l e v e l . - 51 -In evaluating the two groups on their intended use of influencing s k i l l s , the following hypotheses were tested. H^g: There w i l l be no s ta t i s t i ca l l y significant difference in the degree to which the Gestalt group trainees and the control group report that they (a) intended to use the influencing s k i l l of direct guidance, (b) intended to use the influencing s k i l l of open question and (c) intended to use the influencing s k i l l of non-verbal referent as revealed by the Wilcoxon Matched-Pairs Signed-Ranks non-parametric test of significance. H^ : There w i l l be a s ta t i s t i ca l l y significant difference in the degree to which the Gestalt group trainees and the control group report that they (a) intended to use the influencing s k i l l of direct guidance, (b) intended to use the influencing s k i l l of open question and (c) intended to use the influencing s k i l l of non-verbal referent as revealed by the Wilcoxon Matched-Pairs Signed-Ranks non-parametric test of significance. The Wilcoxon Matched-Pairs Signed Ranks analysis revealed that in the intended use of direct guidance(#4) and open question(#6), the two groups were not signif icantly different at oC = .05 level of significance. Parts (a) and (b) of the nul l hypothesis were therefore retained. In their intended use of non-verbal referent(#9) the two groups were found to be signif icantly different at c< = .05 level of significance. Part (c) of the nul l hypothesis was rejected in favour of the alternative. Medians, quartile deviations and T-scores are shown in Table X. - 52 -TABLE X POST-TEST MEDIANS, QUARTILE DEVIATIONS AND T-SCORES FOR  INTENDED USE OF INFLUENCING SKILLS Group Medians Quartile Deviations T-scores #4 #6 #9 #4 #6 #9 #4 #6 #9 Experimental 2.13 4.14 2.86 1.08 .42 .44 21.0 10.5 4.0* Control 2.75 3.40 1.63 .57 .61 .63 * significant ©oC= .05 leve l . To measure the counsellors' degree of goal attainment, two different analyses were used. In a comparison of the two groups on their degree of goal attainment, the following hypotheses were tested: H ^ : There w i l l be no s ta t i s t i ca l l y signif icant difference in the degree to which the Gestalt group trainees and the control group w i l l attain their personal growth goals as revealed by a Chi square test of independence. I-L :^ There w i l l be a s ta t i s t i ca l l y signif icant difference in the degree to which the Gestalt group trainees and the control group w i l l attain their personal growth goals as revealed by a Chi square test of independence. Goal Attainment forms were completed by ten of the eleven Gestalt group counsellors. The matched control group counsellor was eliminated from the following two analyses. The Chi square test of independence revealed that the two groups were not s ignif icantly different in their attainment of personal growth goals at oC = .05 level of significance. The nul l hypothesis was retained. The frequencies are shown on Table XI. - 53 -The second analysis evaluated the degree to which the experimental group counsellors were successful in achieving their training goals. The Chi square goodness of f i t analysis revealed that at oC = .05 level of significance, the sample deviates signif icantly from the expected frequency. The observed and expected frequencies are shown on Table XII. The cl ient evaluations of counsellor helpfulness for the experimental group were found to have a median of 3.9 and a range of 3 to 5. The control group evaluations had a median of 3.2 and a range of 3 to 5. The c l i n i c a l evaluations of the post-test experimental group answered two questions. For counsellor effectiveness in promoting cl ient exploration, the median was 4.19 with a range of 3 to 5. For the appropriateness of the counsellor s k i l l s the median was found to be 4.14 with a range of 3 to 5. TABLE XI TEST OF INDEPENDENCE FOR ATTAINMENT  OF PERSONAL GROWTH GOALS Category zL zL P. il il TOTAL Group Experimental 0 0 1 6 3 10 Control 0 1 2 7 0 10 Total 0 1 3 13 3 20 X 2 = 2.21 - 54 -TABLE XII GOODNESS OF FIT TEST OF OBSERVED AND EXPECTED FREQUENCIES  FOR ATTAINMENT OF TRAINING GOALS Frequency Improved 10 X 2 = 10 Significant at oC= .05 level . 0-E (O-Er Worsened -5 Total 10 10 10 - 55 -CHAPTER V  DISCUSSION DISCUSSION OF RESULTS The results of the present study suggest that the training programme under evaluation was effective in teaching counsellors advanced influencing s k i l l s of Gestalt therapy. Counsellors demonstrated the ab i l i t y to recognize and respond to a sp l i t with the two-chair operation and their responses to the sp l i t showed signif icantly more use of direct guidance. The results also indicate that counsellors used signif icantly more direct guidance and open question once the two-chair role-play was in progress. In addition, results indicate that counsellors fe l t that through the Gestalt training experience they were successful in attaining both their personal growth and training goals. In the counsellor response to a s p l i t , ten of the eleven counsellors responded with the Gestalt two-chair role-play. The single counsellor who fai led to respond to the sp l i t within the f i r s t ten minutes did use the two-chair operation later in the session. A l l counsellors who in i t iated the two-chair operation in response to the client-presented sp l i t continued with that process unt i l the last few minutes of the session. Although i t can be argued that trainees performed the two-chair operation in response to experimental demand, the results do indicate that counsellors had learned the perceptual and executive s k i l l s required of this operation. In addition, both the c l ient and c l i n i c a l evaluations of the counsellors in the experimental group were favourable, suggesting that this particular intervention was used effectively and appropriately in the session. - 56 -Further examination of the results of this study yields a number of interesting contradictions. One major discrepancy occurs between the counsellors' intended use and actual use of influencing s k i l l s . Counsellors in the experimental group were signif icantly higher than the control group in the use of direct guidance. However, in their stated intentions to use direct guidance, the two groups were matched with relatively low scores. One possible explanation l i e s in the fact that a l l the Gestalt group counsellors had f i r s t been empathy-trained. This type of background discourages the counsellor from using direct guidance and emphasizes instead the importance of the cl ient providing direction. Therefore, although the Gestalt group counsellors used direct guidance fa i r l y consistently throughout the sessions, they may have been reluctant to recognize that s k i l l as part of their repertoire. This highlights the need for more theoretical or conceptual s k i l l s to bring the counsellors' attitudes and behaviour closer together. Although the issue of control and direction was discussed in the group, i t was done so only br ief ly and no attempt was made to challenge the trainees' beliefs about non-directiveness. Another discrepancy occurs between intended and actual use of open question. At the pre-test, the scores of both groups on intended use of open question were fa i r l y high, while in actual use the scores of both groups were relatively low. These scores for intended use suggest that empathy-trained counsellors regard open question as a valuable s k i l l and believe that they use i t more than they actually do. At the post test, the experimental group increased their actual use of open question in the segments, bringing their performance more in l ine with their stated intentions. - 57 -A third discrepancy occurs between intended and actual use of non -verbal referent. In their intended use of non-verbal referent, Gestalt group counsellors were signif icantly higher than the control group. In actual use however, the Gestalt group counsellors demonstrated very l i t t l e of this s k i l l . The scores of this group on actual use were not signif icantly different from those of the control group. One possible explanation for this discrepancy l i e s in the experimental nature of the sessions. In a real counselling situation, a counsellor would not normally use active s k i l l s unt i l the relationship had become established. For the purposes of this research, counsellors were given a mental set designed to fac i l i ta te the use of active s k i l l s within the single thirty-minute experimental session. Prior to each of the experimental sessions, each counsellor was instructed to counsel as i f he/she had previously spent four sessions with the cl ient building a therapeutic relationship. The results of this study suggest that the mental set was successful in encouraging the use of direct guidance and open question but not the use of non-verbal referent. Non-verbal referent, which i s designed to bring the c l ient 's non- verbal behaviour into his/her awareness, can be a potent too l . It may be that in spite of the mental set, counsellors regarded this s k i l l as too intrusive or confrontative for a person they were seeing for the f i r s t time and therefore avoided using i t . Another possible explanation for the discrepancy between intended and actual use of non-verbal referent l i es in the nature of the two-chair operation. Separating out the parts of the c l ient ' s sel f and in i t ia t ing a dialogue between the parts requires consistent use of direct guidance. Non-verbal referent i s typical ly used once the dialogue has begun, primarily to heighten the c l ien t ' s awareness. It i s important that this s k i l l i s used selectively in order not to distract or confuse the c l ient . In an entire session, the counsellor might use non-verbal referent only two or three times. This would suggest that the sampling procedure used in this study may not be the most appropriate method for - 58 -evaluating the use of non-verbal referent. A more meaningful measure of the actual use of this s k i l l might be obtained by examining the entire taped session. This approach could possibly yield more accurate information about the use of this s k i l l in the Gestalt two-chair role-play. Another important observation concerns the proportion scores indicating the actual use of the Gestalt influencing s k i l l s . In the post-test, the mean proportion score of the experimental group representing combined Gestalt influencing s k i l l s was .33. This score represents one-third of the total responses, leaving two-thirds of the responses designated to other categories. An examination of the data indicates that although counsellors were using Gestalt influencing s k i l l s , many of their other responses involved reflection or restatement. This indicates that the Gestalt-trained counsellors were using their new s k i l l s in conjunction with their empathy-based s k i l l s . In addition the single most commonly-used response found across a l l counsellors was minimal encourager, a s k i l l designed to indicate understanding and encourage the c l ient 's self -exploration. A mean proportion of the use of this s k i l l by the post-test experimental group was .39. When this single s k i l l i s removed from the- analysis, the mean use of direct guidance in the segments increases from .18 to .28. The use of open question increases from .15 to .23. With this adjustment, the use of the combined Gestalt influencing s k i l l s increases from .33 to .51 representing a substantial proportion of the total counsellor responses. The f ina l observations concern the counsellors' achievement of their personal growth and training goals. It was anticipated that experimental group counsellors would achieve their personal growth goals signif icantly more than would the control group. The results indicated however that both groups fe l t they had achieved their personal growth goals. Upon - 59 -consideration, these results are not surprising. As a programme and as a profession, counselling psychology emphasizes the importance of the counsellor's own personal growth. Students in the counselling programme and recent graduates are l ike ly to be interested in their own personal growth. As a result, they may see themselves moving successfully towards that goal. In their evaluation of their training goals, counsellors in the Gestalt group indicated a sense of achievement. On many of the feedback forms, counsellors noted that they saw the learning of new s k i l l s as an on-going process and hoped in time to gain more experience and confidence with their new s k i l l s . It could be argued that this group would, want to see themselves as achieving their training goals due to the considerable investment they had made in terms of time, effort and expense. In addition, the very fact that they had undertaken advanced training suggests that they represent a highly-motivated group of counsellors, desirous of achieving specific goals. However, the results of this study confirm that the counsellors were successful in learning Gestalt s k i l l s . Also, evaluations by both cl ients and c l in ic ians suggest that in using these new s k i l l s , the Gestalt counsellors were appropriate, effective and helpful. DELIMITATIONS In general, the results of this study suggest that the training programme being evaluated was effective in teaching counsellors some of the advanced s k i l l s of Gestalt therapy. What i s needed now is evidence concerning the generalizabil ity of these results. In order to apply the results of this research more generally, i t i s important to examine the effectiveness of other such groups led by other trainers. - 60 -The results of this study are subject to a further l imitat ion. One of the major confounding variables of training research i s that of experimental demand. Given that these counsellors were completing a training programme, i t would not be unexpected that they would attempt to demonstrate competence with the trained s k i l l s . It seems important therefore that a follow-up study be done to evaluate the long-term effectiveness of the training experience. Results of a follow-up study could indicate whether the counsellors had successfully integrated and retained their new s k i l l s . CONCLUSIONS To date, training of Gestalt therapists has been primarily experiential with no clearly articulated s k i l l base. Using this combined approach of s k i l l s and personal growth, i t appears possible to train counsellors in the effective use of specif ic Gestalt s k i l l s within twenty-four sessions. Assuming that the results are generalizable, the study suggests that this method of training counsellors in Gestalt s k i l l s represents an important contribution to the counsellor education l i terature. It now seems important to evaluate whether this particular approach i s more effective or more eff ic ient than the previous personal growth or experiential approaches. - 61 -BIBLIOGRAPHY Aspy, D. Toward a Technology for Humanizing Education. Champaign, I l l i n o i s : Research Press, 1972. Barrett-Lennard, G.T. Dimensions of therapist response as causal factors in therapeutic change. Psychological Monographs, 1962, 76, 43. Bergin, A. and Lambert, M. The evaluation of therapeutic outcomes. Garfield, S. and Bergin, A. (Eds.) Handbook of Psychotherapy and Behavior  Change, New York, 1978. Bergin, A.E. and Suinn, R.M. Individual psychotherapy and behaviour therapy. M.R. Rosenzweig and L.W. Porter (Eds.), Annual Review of  Psychology, Palo Alto, Cal i f : Annual Reviews, Inc., 1975, 26, 509-556. Bergin, A.E. and Jasper, L.G. Correlates of empathy in psycho therapy: A repl ication. Journal of Abnormal Psychology, 1969, 74, 477-481. Bergin, A.E. and Solomon, S. Personality and performance correlates of empathic understanding in psychotherapy. J.T. Hart and T.M. Tomlinson (Eds.) New Directions in Client-Centred Therapy, Boston: Houghton M i f f l i n , 1970, 233-236. Bohart, A.C. Role-playing and interpersonal-conflict reduction. Journal  of Counseling Psychology, 1977, 30, 311-18. Burton, A. (Ed.) Operational Theories of Personality. Brunner Mazel, New York, 1974. Campbell, D.T. and Stanley, J .C. Experimental and Quasi-Experimental  Designs for Research. Chicago: Rand McNally, 1963. Carkhuff, R.R. Helping and Human Relations (Vol 1). New York: Holt, Rinehart & Winston, 1969. Carkhuff, R.R. and Berenson, B.G. Beyond Counseling and Therapy. New York: Holt, Rinehart & Winston, 1977. Cohen, J . A coefficient of agreement for nominal scales. Educational  and Psychological Measurement, 1960, XX, 1, 483-487. Dompierre, L. Differential Effects of the Gestalt Two-Chair Dialogue and  Empathic Reflection at a Spl i t in Therapy. Unpublished master's thesis, University of Br i t ish Columbia, 1979. Egan, G. The Ski l led Helper. Monterey, Cal i f : Brooks/Cole Publishing Co., 1975. - 62 -Ferguson, G.A. S tat i s t i ca l Analysis in Psychology and Education. McGraw-Hill, New York, 1971. Fiedler, F.E. The concept of the ideal therapeutic relationship. Journal of Consulting Psychology, 1950, 14, 239-245. Foulds, M.L. and Hannigan, P.S. Gestalt marathon group: Does i t increase reported self -actualization? Psychotherapy: Theory Research and  Practice, Winter, 1976, 13, 4, 278-383. Gay, L. R. Educational Research: Competencies for Analysis and  Application. Charles E. M e r r i l l , Columbus, Ohio, 1976. Greenberg, L.S. A Task Analytic Approach to the Study of Psycho-therapy  Events. Unpublished doctoral dissertation, York University., 1975. Greenberg, L.S. Resolving s p l i t s : Use of the two chair technique. Psychotherapy: Theory Research and Practice, F a l l , 1979, 16, 3, 310-318. Greenberg, L.S. Advances in c l i n i c a l research: A decade review. Canadian Psychology, 1980a, in press. Greenberg, L.S. Training counsellors in Gestalt methods. Canadian  Counsellor, 1980b, in press. Greenberg, L.S. and Clarke, K.M. Differential effects of the two-chair experiment and empathic reflections at a confl ict marker. Journal of  Counseling Psychology, 1979 26, 1_, 1-8. Greenberg, L.S. and Kahn, S.E. Experimentation: A Gestalt approach to counselling. Canadian Counsellor, October, 1978, 13, 1_, 23-27. Greenberg, L.S. and Kahn, S.E. The stimulation phase in counseling. Counselor Education and Supervision, 1979, 19, 137-145. H i l l , C E . Development of a counselor verbal response category system. Journal of Counseling Psychology, 1978, 25, 5_, 461-468. H i l l , C.E., Thames, T.B., and Rardin, D.K. Comparison of Rogers, Per ls , and E l l i s on the H i l l counselor verbal response category system. Journal  of Counseling Psychology, 1979, 26, 3, 198-203. Ivey, A.E. and Authier, J . Microcounseling. Springfield, I l l i n o i s : Charles C. Thomas, 1978. Kiresuk, T.J . and Sherman, R.E. Goal attainment scaling: A general method for evaluating community mental health programs. Community Mental  Health Journal, 1968, 4, 443-453. - 63 -Kirk, Roger E. Experimental Design Procedures for the Behavioral  Sciences. Brooks/Cole, Belmont, C a l i f . : 1968. Klein, M., Mathieu, P . , Gendlin, E., and Keisler, D. The Experiencing  Scale. Wisconsin Psychiatric Institute, Madison, Wisconsin, 1969. Kurtz, R.R. and Grummon, D.L. Different approaches to the measurement of therapist empathy and their relationship to therapy outcomes. Journal of  Consulting and C l in ica l Psychology, 1972, 39, 106-115. Lambert, M., De Ju l io , S . , and Stein, D. Therapist interpersonal s k i l l s : Process, outcome, methodological considerations and recommendations for further research. Psychological Bul let in , 1978, 85, 467-489. Lorr, M. Client perception of therapists: A study of the therapeutic relat ion. Journal of Consulting Psychology, 1965, 29, 146-149. Mahon, B.R. and Altmann, H.A. S k i l l training: Cautions and recommendations. Counselor Education and Supervision, 1977, 17, 1, 42-50. Matarazzo, R. G. Research on the teaching and learning of psycho-therapeutic s k i l l s . Garfield, S. and Bergin, A. (Eds.) Handbook of  Psychotherapy and Behavior Change. John Wiley and Sons, New York, 1971. Mitchel l , K., Bozarth, J . , and Krauft, C , A reappraisal of the therapeutic effect of accurate empathy, non-possessive warmth and genuineness. Gurman, A. and Razin, A. (Eds.), Effective Psychotherapy:  A Handbook of Research, New York, Pergamon Press, 1977. Mitchel l , K., Bozarth, J . , Truax, C. and Krauft, C. Antecedent to  Psychotherapeutic Outcome. Arkansas Rehabilitation, Research and Training Centre, University of Arkansas, (NIMH, f ina l report, MH 12306), March, 1973. Moreland, J . R., Ivey, A .E . , and P h i l l i p s , J .S . An evaluation of microcounseling as an interviewer training too l . Journal of Consulting  and C l in i ca l Psychology, 1973, 41, 294-300. Pearson, R.E. Segmented counseling interview: A training procedure. Counselor Education and Supervision, 1978, 18, 2, 153-157. Raskin, N. Studies on psychotherapeutic orientation: Ideology in  practice. AAP Psychotherapy Research Monographs, Orlando. Florida: American Academy of Psychotherapists, 1974. Rice, L. N. Therapists' style of participation and case outcome. Journal  of Consulting Psychology, 1965, 29, 155-160. - 64 -Rogers, C R . The necessary and suff icient conditions of therapeutic personality change. Journal of Counseling Psychology, 1957, 21, 95-103. Rogers, C R . On Becoming a Person. Boston: Houghton Mi f f l in Co., 1961. Rogers, CR . Empathic: An unappreciated way of being. The Counseling  Psychologist, 1975, 5, 2. Roscoe, J.T. Fundamental Research Stat ist ics for the Behavioral  Sciences. Holt, Rinehart and Winston, New York, 1975. Smith, M. and Glass G. Meta-analysis of psychotherapeutic outcome studies. American Psychologist, 1977, 32, 752-760. Stokes, J .P . and Keys, C.B. Design and evaluation of a short-term paraprofessional training program. Counselor Education and Supervision, 1978, 17, 4, 279-285. Toukmanian, S.G. and Rennie, D.L. Microcounseling versus human relations training: Relative effectiveness with undergraduate trainees. Journal  of Counseling Psychology, 1975, 22, 345-352. Truax, C.B. and Carkhuff, R.R. Towards Effective Counseling and  Psychotherapy: Training and Practice. Chicago, Aldine, 1967. Truax, C.B. and Mitchel l , K. Research on certain therapist interpersonal s k i l l s in relation to process and outcome. Bergin, A. , and Garfield, S. (Eds.), Handbook of Psychotherapy and Behavior Change. New York, Wiley, 1971. - 65 -A P P E N D I X A THEMES AND PROGRAM CONTENT ( e x c e r p t e d from Greenberg,1980b) Awareness Lecturette and Experiential Exercises. The first training session begins with a "here and now" based awareness exercise. Each member of the group is asked to say how he or she feels "right now," in order to focus on actual present experiencing. This provides an opportunity right at the start to experience the vitality of the process of awareness. A lecturette is then provided on different aspects of awareness. A discussion of Perl's three zones of awareness (1969) and the difference between thinking and sensing is followed by another experiential awareness exercise. An exercise Is used in which people in dyads share present awareness and present imagining and explore different aspects of their own awareness (Stevens, 1970; Passons, 1975). Skill Training. Counsellor skills which are designed to aid client awareness are the first to be introduced in the s k i l l training. Client and counsellor dyads are formed and the clients are instructed to talk about recent unfinished situations. The counsellors are instructed to refrain from reflecting. In place of reflecting content or feeling, counsellors ask their clients to become aware of their present experiencing. The distinction between "talking about" and "experiencing" is thereby clarified at this early stage in the - 66 -t r a i n i n g process. The c o u n s e l l o r i n q u i r e s i n t o the c l i e n t ' s present s t a t e by s a y i n g , "What are you aware of as you say t h i s ? " , or "What are you f e e l i n g r i g h t now?" The m i c r o - s k i l l s b e i n g taught i n t h i s e x e r c i s e are awareness i n q u i r i e s and a f f e c t i n q u i r i e s . Use of these m i c r o - s k i l l s h i g h l i g h t the presence of the i n n e r process that accompanies content. In a d d i t i o n , t h i s e x e r c i s e p r o v i d e s the f i r s t experience f o r the c o u n s e l l o r i n engaging i n a d i r e c t i v e i n q u i r y s t y l e . F o l l o w i n g t h i s e x e r c i s e the r o l e s are changed and the c o u n s e l -l o r s are asked to b r i n g to awareness v i s i b l e phenomena, such as gestures or hand movements that t h e i r c l i e n t s may be making w h i l e they are t a l k i n g . This i s done by u t i l i z i n g an a t t e n d i n g sugges- t i o n , e.g., "become aware of what you are doing w i t h your hands, eyes, mouth, e t c . " . Again process i s emphasized over content and the c o u n s e l l o r has an experience i n t i m i n g a suggestion and having to i n t e r r u p t the c l i e n t v e r b a l i z a t i o n to b r i n g something to aware-ness . I n t r o j e c t i o n L e c t u r e t t e and E x p e r i e n t i a l E x e r c i s e s . F i r s t a b r i e f l e c t u r e on i n t r o j e c t i o n ( P e r l s et a l . , 1951) i s given. P e r l s ' n o t i o n of Top Dog and Underdog and the s e l f m a n i p u l a t i o n game are presented. The d i a l o g u e between the " b u l l y i n g a u t h o r i t a r i a n " p a r t of the per-s o n a l i t y and the "sabotaging a v o i d i n g " p a r t i s demonstrated i n a r o l e p l a y . The f u n c t i o n of i n t r o j e c t i o n i n the c r e a t i o n of c o n f l i c t - 67 -i s d i s c u s s e d and the importance of s e p a r a t i n g the two p a r t s of a c o n f l i c t i n t o the i n t r o j e c t e d "shoulds" and the o r g a n i s n i c "wants" i s s t r e s s e d . The b a s i c process of i n t r o j e c t i o n and the method by which i t i s r e s o l v e d i n the two c h a i r process i s e x e m p l i f i e d by an e x e r c i s e f o c u s i n g on the tyranny of "should" by which many people govern t h e i r l i v e s (Stevens, 1970). Other e x e r c i s e s i n v o l v i n g awareness of "shoulds" and Top Dog/Underdog dialogues are used i f time permits. S k i l l T r a i n i n g . The d e f i n i t i o n of a c o n f l i c t s p l i t i s provided and the f i r s t p r i n c i p l e of two c h a i r work s e p a r a t i o n and contact i s presented. B r i e f l y the t r a i n e r d i s c u s s e s the idea that c l i e n t s o f t e n present s p l i t s c h a r a c t e r i z e d by two pa r t s i n f e l t c o n f l i c t , e . g . , " I am not sure i f I want to get married and have k i d s or continue a t my s c h o o l " , " I j u s t can't seem to de c i d e " or " I should work harder but I j u s t can't get going, I don't know what to do". The fundamental s k i l l i n d e a l i n g w i t h s p l i t s i s the s e t t i n g up of the experiment by s e p a r a t i n g the two p a r t s i n t o d i f f e r e n t c h a i r s and having them make contact or begin a d i a l o g u e . The f i r s t m i c r o s k i l l emphasized In the c r e a t i o n of t h i s experiment i s the s k i l l of g e t t i n g a sense  of y o u r s e l f - g e t t i n g each s i d e to d e s c r i b e i t s e l f and what i t i s l i k e by say i n g , "get a sense of what t h i s p a r t of you i s l i k e ; t e l l me who you are as t h i s p a r t " . The second s k i l l emphasized i s the s k i l l of g e t t i n g the p a r t s to make - 68 -contact - i n s t r u c t i n g the p a r t s to t a l k to each other r a t h e r than to the c o u n s e l l o r by saying " t e l l t h i s to your other p a r t . " C l i e n t , c o u n s e l l o r and observer t r i a d s are formed to p r a c t i c e the s k i l l s . The f i r s t experience i s made as easy and e r r o r f r e e as p o s s i b l e by a s k i n g the person i n the c l i e n t r o l e to take respon-s i b i l i t y f o r s e p a r a t i n g out the p a r t s and conducting t h e i r own dialo g u e and having the c o u n s e l l o r merely occupy the r o l e of coun-s e l l o r w i t h o u t the r e s p o n s i b i l i t y f o r doing anything. C l i e n t s un-f o l d t h e i r own di a l o g u e s and the c o u n s e l l o r has only to be aware of what i t f e e l s l i k e to be i n that r o l e and make observations on c l i e n t process. The observer s i m i l a r l y observes and the exper-ience i s then d i s c u s s e d . C l i e n t s are then asked to express a c o n f l i c t s p l i t to t h e i r c o u n s e l l o r and the c o u n s e l l o r engages i n paraphrasing the f e l t s p l i t to i n s u r e that the c l i e n t f e e l s understood and that the c o u n s e l l o r understands the i s s u e . The c o u n s e l l o r must then f i n d an a p p r o p r i a t e time to c r e a t e the experiment and recognize the  s p l i t by obser v i n g t h a t , " i t seems l i k e there are two p a r t s of you" and i d e n t i f y i n g and l o c a t i n g the p a r t s i n two c h a i r s . This i s f o l -lowed by the g e t t i n g a sense of and make conta c t i n t e r v e n t i o n s . The whole group meets to d i s c u s s t h i s experience. From the d i s c u s s i o n s the importance of usin g the c l i e n t s ' d e s c r i p t i o n s of unique p a r t s to capture the essence of the c o n f l i c t i s emphasized. The c o u n s e l l o r s are encouraged to d i r e c t t h e i r c l i e n t s to make con-t a c t w i t h t h e i r imagined other p a r t s r a t h e r than to seek understanding - 69 -from the c o u n s e l l o r . Contact between p a r t s of the s e l f r a t h e r than between c o u n s e l l o r and c l i e n t i s s t r e s s e d as a v e h i c l e of change and the p o t e n t i a l medium f o r f a c i l i t a t i n g s e l f - a c c e p t a n c e which comes about by l i t e r a l l y ' l i s t e n i n g to o n e s e l f i n the two c h a i r s . In a d d i t i o n the importance to the whole experiment of g e t t i n g a t r u e f e l t sense of the o p p o s i t i o n i n the c o n f l i c t i s emphasized. The c o u n s e l l o r discourages the c l i e n t from ' t a l k i n g about' the c o n f l i c t or the p a r t s and encourages the. a c t u a l exper-i e n c i n g , here and now, of the two d i f f e r e n t tendencies or p a r t s . I d e n t i f y i n g the opposed f o r c e s c o r r e c t l y i s the major task f o r both c o u n s e l l o r and c l i e n t i n the c r e a t i o n of t h i s experiment. R e t r o f l e c t i o n L e c t u r e t t e and E x p e r i e n t i a l E x e r c i s e . P e r l s ' n o t i o n of r e t r o -f l e c t i o n , the t u r n i n g back of a c t i v i t y a g a i n s t the s e l f , i s pre-sented and the r o l e of the musculature i n the squeezing of the jaw, the neck, the t h r o a t , e t c . i s d i s c u s s e d ( P e r l s , et a l . , 1951). This t o p i c can be explored at v a r i o u s depths depending on time and i n t e r e s t but the e s s e n t i a l concept to be conveyed i s that of a c t i v -i t y a g a i n s t the s e l f . The importance of people t a k i n g r e s p o n s i b i l -i t y f o r what they do to themselves as the f i r s t step toward change i s s t r e s s e d . The f a c t t h a t people 'do th i n g s to themselves' i s explored e x p e r i e n t i a l l y by a s k i n g students to become aware o f how they i n -t e r f e r e w i t h t h e i r own i n t e g r a t e d f u n c t i o n i n g as witnessed i n - 70 -statements l i k e " I judge myself, I hold myself back, I f r i g h t e n myself, I pressure myself, I egg myself on, e t c . " The students are asked to p a i r up and one of the p a i r i s designated as "the s e l f " . The other members of the dyad then proceed to enact what they do to themselves, on t h e i r p a r t n e r . They are i n s t r u c t e d to a c t u a l l y "do" things to t h e i r p a r t n e r both v e r b a l l y and p h y s i -c a l l y and not j u s t " t a l k about" what they do to t h e i r p a r t n e r . They proceed to experience themselves as a c t i v e agents of t h e i r own d i s t r e s s by ' s i t t i n g on' t h e i r p a r t n e r s , 'dragging them' around the room, 'squeezing' t h e i r necks and 'barraging' them w i t h c r i t i c i s m , e t c . This Is u s u a l l y a h i g h l y enjoyable and i l -l u m i n a t i n g e x e r c i s e which by the embodiment i n c u l c a t e s i n the t r a i n e e s the G e s t a l t ' m e n t a l i t y of r e s p o n s i b i l i t y ' that i t i s JE who am r e s p o n s i b l e f o r much of my own experience. S k i l l T r a i n i n g . The d e f i n i t i o n of the Subject/Object s p l i t i s presented and the second p r i n c i p l e of two c h a i r work Responsi- b i l i t y i s d i s c u s s e d . B r i e f l y the t r a i n e r presents the observa-t i o n that o f t e n c l i e n t s make statements i n c o u n s e l l i n g c h a r a c t e r -i z e d by the f a c t t h a t they are s p l i t Into being both s u b j e c t and the o b j e c t of t h e i r statements, e.g., " I d i s l i k e myself", " I watch myself". I t i s pointed out that having separated the s i d e s i n t h i s and ot h e r s p l i t s i t i s important to get the person to take r e s p o n s i b i l -i t y f o r t h e i r experience i n each c h a i r , I.e., to respond i n accord-ance w i t h the true nature of t h e i r experience i n that c h a i r . The micro-skills of affect and desire inquiries and language and demand suggestions are emphasized as ones which promote the taking of re-sponsibility in each chair. A language exercise in which trainees experiment with the use of sentence beginning with ' i t 1 , 'you', 'we', 'I' respectively is used to ground this s k i l l in experience (Stevens, 1970; Passons, 1975). Triads are again formed with client, counsellor and observer. The clients are asked to express a split and the counsellor sets up the two chair experiment and focuses on the use of one of the responsibility micro-skills, like language suggestions. The ob-server is asked to be alert to possible responsibility interven-tions. The notion of the observer as a "surrogate" counsellor to whom the counsellor may turn for assistance is introduced at this point. This provides some needed support for beginners who are often overwhelmed by the complexity of the client stimulus material and their responsibility as moment by moment initiators. In the group discussion following the feedback in the triad several issues are discussed. The idea of the appropriate timing of interventions within the dialogue so as to promote experiencing rather than cause 'diffusion' of experience is discussed. Clients whose counsellors intervene too slowly or infrequently "talk about" their experience whereas those whose counsellors intervene too quickly and too often without allowing a theme to develop report feeling scattered and confused without meaning developing from their experiencing. - 72 Figure/Background L e c t u r e t t e and E x p e r i e n t i a l E x e r c i s e s . The fundamental importance of awareness as the source of e x p e r i e n c i n g i s s t r e s s e d . The f i g u r e background p r i n c i p l e of p e r c e p t u a l f u n c t i o n i n g i s d i s c u s s e d and the two p r i n c i p l e of a t t e n d i n g and heig h t e n i n g which f u n c t i o n to sharpen awareness are in t r o d u c e d . In the a t t e n d i n g s e s s i o n , awareness e x e r c i s e s , emphasizing non-verbal communication both i n body and v o i c e are used (Stevens, 1970) and Gendlin's (1969) f o c u s i n g e x e r c i s e i s given to emphasize i n n e r a t t e n d i n g . Body e x e r c i s e s (Fadiman and Frager, 1977) of h i t t i n g a p i l l o w or shouting "yes-no" or " I w i l l - you won't" are used as a he i g h t e n i n g e x e r c i s e to i n c r e a s e the gene r a l l e v e l of a r o u s a l . An exagerated r o l e p l a y e x e r c i s e i s a l s o used (Stevens, 1970) to experience heightened awareness of r o l e s . S k i l l T r a i n i n g . The awareness i n q u i r y , a t t e n d i n g suggestion, and f o c u s i n g suggestion m i c r o - s k i l l s are p r a c t i c e d and the importance of the c l i e n t ' s awareness as the medium of the whole experiment i s emphasized. I t i s s t r e s s e d that i f ever a c l i e n t or c o u n s e l l o r i s confused, a method f o r g e t t i n g back to what's important f o r t h i s c l i e n t i s to simply make an i n q u i r y such as "What are you e x p e r i e n c i n g ? " as the way to heighten awareness and e x p e r i e n c i n g . The exaggeration  and r e p e t i t i o n s k i l l i s p r a c t i c e d as a method of he i g h t e n i n g . P r o j e c t i o n L e c t u r e t t e and E x p e r i e n t i a l E x e r c i s e s . P e r l ' s ideas on p r o j e c t i o n are di s c u s s e d and the d i s t i n c t i o n i s made between - 73 -projection of standards and disapproval (you think I am not O.K.) and projection of feelings and impulses (you feel angry towards me). Projection is described in a non-analytic framework and an attribution of one's own thoughts and feelings onto the environment and as a hypersensitivity to minor manifestations of attitudes and feelings in other people (Enright, 1970). A number of experiential exercises can be used to explore the ideas of projection and attribution (Stevens, 1970). An awareness exercise in which people report their awareness and their imaginings used in the first session can be repeated in order to emphasize the importance of distinguishing between fantasy and reality. Skill Training. Two attribution splits are discussed. The first is the Attribution of conflict split in which clients report opposition from the environment, e.g., "I want to leaVe school but my father says I shouldn't and I don't know what to do". The second is the Attribution of agency split or giving up of one's power, when clients report that their experience is the result of another's actions, e.g., "she made me feel embarrassed". "I need his reasurance". The triads work on attribution splits utilizing a l l the skills learned to date. They are now able to introduce other people or parts of the world into the other chair. The process of reowning the attributed part and the tendency for this to often be accompanied by a lot of feelings is discussed. - Ik -P r o c e s s , S t r u c t u r e and Feedback L e c t u r e t t e and E x p e r i e n t i a l E x e r c i s e s . The importance of d i s c o v e r i n g the "what" and the "how", the content and the process of experience, r a t h e r than the "why", the cause of experience, i s d i s c u s s e d . E x e r c i s e s designed to show how being more s p e c i f i c and becoming aware of how one i s doing something are used. I n dyads one person i s i n s t r u c t e d to r e p e a t e d l y ask the other 'what do you want?' and to f o l l o w the o t h e r s answer w i t h a s p e c i f i c i t y q u e s t i o n "please be more s p e c i f i c " . T his h i g h l i g h t s t h a t by becoming more concrete and s p e c i f i c i n e x p r e s s i o n , experience i s deepened. The d i f f i c u l t G e s t a l t i n t u i t i o n , t hat of becoming aware of "how" one does t h i n g s , i s approached by a s k i n g people to become aware of "how" they are doing or j u s t d i d something, e.g., they are asked "how are you i n t e r a c t i n g , how d i d you get what you wanted, e t c . ? " I n d i s c u s s i n g feedback i t i s s t r e s s e d t h a t i t i s the medium i n t h i s experiment f o r c o u n s e l l o r s to maint a i n genuine contact w i t h t h e i r c l i e n t s and to share t h e i r own awareness, exper-i e n c e s , p e r c e p t i o n s and hunches that r e l a t e to the c l i e n t ' s work. S k i l l T r a i n i n g . The s k i l l s to be learned r e l a t i n g to e x p r e s s i o n are those of making an ex p r e s s i o n i n q u i r y and s p e c i f i c i t y suggestions and these are p r a c t i c e d i n t r i a d s as p a r t of a two c h a i r experiment. In a d d i t i o n the s k i l l s of feeding back to the c l i e n t b e h a v i o u r a l  o b s e r v a t i o n s and making per s o n a l awareness statements are p r a c t i c e d as part of two c h a i r work. 75 -APPENDIX B COUNSELOR VERBAL RESPONSE CATEGORY SYSTEM 1. Minimal encourager. This consists of a short phrase that indicates simple agreement, acknowledgement, or understanding. It encourages but does not request the cl ient to continue talking, i t does not imply approval or disapproval. It may be a repetition of key word(s) and does not include responses to questions (see information). 2. Approval-reassurance. This provides emotional support, approval, or reinforcement. It may imply sympathy or tend to al leviate anxiety by minimizing c l ient ' s problems. 3. Information. This supplies information in the form of data, facts resources, theory and the l i k e . It may be information specif ical ly related to the counselling process, counselor's behaviour or arrangement (time, place, fee etc.) It may answer direct questions but does not include directions for what the cl ient should do (see direct guidance). 4. Direct guidance. This consists of directions or advice that the counselor suggests for the c l ient , or for the cl ient and counselor together either within or outside the counseling session. It i s not aimed at so l i c i t ing verbal material from the cl ient (see closed or open question). 5. Closed question. This i s a data-gathering inquiry that requests a one-or-two word answer, a "yes" or "no" or a confirmation of the counselor's previous statement. The possible cl ient responses to this type of inquiry are typical ly l imited and speci f ic . If statements are phrased in the form of a closed queston but meet the c r i te r ia for another category, they should be put in the other category. 6. Open question. A problem requests a c lar i f i cat ion of feelings or an exploration of the situation without purposely l imit ing the nature of the response to a yes or no or a one or two word response. If statements are phrased in the form of an open question but meet the c r i te r ia for another category, they should be put in the other category. 7. Restatement. This i s a simple repeating or rephrasing of the c l ient ' s statement(s) (not necessarily just the immediately preceding statements. It typical ly contains fewer but similar words and i s more concrete and clear than the c l ient ' s message. It may be phrased either tentatively or as a statement. - 76 -8. Reflection. This i s a repeating or rephrasing of the c l i en t ' s statement (not necessarily just the immediately preceding statements). It must contain reference to stated or implied feelings. It may be based on previous statements, non-verbal behaviour, or knowledge of the total s i tuation. It may be phrased either tentatively or as a statement. 9. Nonverbal referent. This points out or inquires about aspects of the c l ient 's nonverbal behaviour, for example, body posture, voice tone or leve l , fac ia l expressions, gestures and so on. It may be phrased either tentatively or as a statement. 10. Interpretation. This goes beyond what the cl ient has overtly recognized. It might take one of several forms. It might establish connections between seemingly isolated statements or events; i t interprets defenses, feelings, resistance, or transference (the interpersonal relationship between counselor and c l ient ) : i t might indicate themes, patterns, or causal relationships in the c l ient ' s behaviour or personality. It usually gives alternative meanings for old behaviour or issues. If a statement also meets the c r i te r ia for a confrontation, i t should be put in confrontation. 11. Confrontation. This contains two parts: The f i r s t part may be implied rather than stated and refers to some aspect of the c l ient ' s message or behaviour; the second part usually begins with a "but" and presents a discrepancy. This contradiction or discrepancy may be between words and behaviour, between two things the cl ient has stated, between behaviour and action, between real and ideal se l f , between verbal and nonverbal behaviour, between fantasy and rea l i ty , or between the counselor's and the c l ient ' s perceptions. 12. Self -disclose: This usually begins with an "I"; the counselor shares his or her own personal experiences and feelings with the c l ient . Note that not a l l statements that begin with an "I" are self -disclosure, i t must have a quality of sharing or disclosing. 13. Silence. A pause of 5 seconds i s considered the counselor's pause i f i t occurs between a c l ien t ' s statement and a counselor's statement or within the c l ient ' s statmnt (except after a simple acceptance of the counselor's statement, e .g . , "yes," pause). 14. Other. These include statements that are unrelated to c l ient ' s problems, such as small talk or salutations, comments about the weather or events; disapproval or cr i t ic ism of the c l ient ; or statements that do not f i t into any other category or are unclassifiable due to d i f f i cu l t i es in transciption, in comprehensibility or incompleteness. - 77 -APPENDIX C (Pre and post-test experimental and control groups) COUNSELLING SESSION FOLLOW-UP QUESTIONNAIRE Below are 12 response categories which represent different counsellor interventions. Please indicate, by c i rc l ing the appropriate number, to what degree you intended to use each of the following types of responses during your counselling session: 1. Were your responses intended to indicate agreement, acknowledgement, encouragement, or understanding through the use of short phrases or single words? 1 2 3 4 5 not at a l l seldom sometimes often very often 2. Were your responses intended to provide emotional support, approval, reinforcement or reassurance, or to al leviate the c l ient ' s anxiety? 1 2 3 4 5 not at a l l seldom sometimes often very often 3. Were your responses intended to supply information in the form of data, facts, resources, theory, etc? 1 2 3 4 5 not at a l l seldom sometimes often very often 4. Were your responses intended to offer direct guidance through directions or suggestions? 1 2 3 4 ' 5 not at a l l seldom sometimes often very often 5. Were your responses intended to ask data-gathering questions which request a one or two word answer or a "yes" or "no"? 1 2 3 4 5 not at a l l seldom sometimes often very often - 78 -6. Were your responses intended to ask questions to c lar i fy feelings or explore the situation without l imit ing the nature of the response to one or two words, or a "yes" or "no"? 1 2 3 4 5 not at a l l seldom sometimes often very often 7. Were your responses intended to repeat or restate your c l ient ' s statements in similar words but more concretely or clearly? 1 2 3 4 5 not at a l l seldom sometimes often very often 8. Were your responses intended to ref lect or rephrase the implied or stated feeling in your c l ient ' s statements? 1 2 3 4 5 not at a l l seldom sometimes often very often 9. Were your responses intended to point out or inquire about aspects of your c l ient ' s non-verbal behaviour eg. posture, voice, fac ia l expression, gestures? 1 2 3 4 5 not at a l l seldom sometimes often very often 10. Were your responses intended to establish connections between seemingly isolated statements or events, indicate themes in your c l ient 's behaviour or interpret defenses, feelings, resistance or transference? 1 2 3 4 5 not at a l l seldom sometimes often very often 11. Were your responses intended to confront contradictions or discrepancies in your c l ient ' s information, feelings, perceptions or behaviour? 1 2 3 4 5 not at a l l seldom sometimes often very often 12. Were your responses intended to self -disclose i . e . share your own personal experinces and feelings with your cl ient? 1 2 3 4 5 not at a l l seldom sometimes often very often - 79 -APPENDIX D (Pre-test experimental group) GOAL ATTAINMENT INVENTORY (Form A) We are interested in determining what goals you have for yourself in the Gestalt group. Please answer the following questions as clearly and specif ical ly as you can. a) What do you hope to achieve from this training experience as a counsellor? What specific s k i l l s do you hope to acquire? 2) What do you hope to achieve from this training experience in terms of your own personal growth? In what specif ic ways would you hope to be different at the end? - 80 -APPENDIX E (Pre-test control group) GOAL ATTAINMENT INVENTORY (Form B) Counsellors in training programmes and recent graduates experience a number of changes in terms of their personal growth. We are interested in discovering what sort of personal growth goals you have set for yourself. As fu l ly as possible, please state what your goals are in the space below. In addition, please describe the specif ic ways in which you w i l l be different once you have achieved your goals. - 81 -APPENDIX F (Post-test experimental and control groups) GOAL ATTAINMENT FOLLOW-UP In the f i r s t session, you identif ied certain personal growth goals for yourself. 1. Please indicate by checking next to the appropriate answer, where you  are now in relation to where you started. -2 Much worse than before - 1 Worse than before 0 Same as before +1 Better than before +2 Much better than before - 82 -APPENDIX G (Post-test experimental group) GOAL ATTAINMENT FOLLOW-UP At the beginning of the Gestalt training group, you identif ied certain training goals for yourself. 1. Please indicate by checking next to the appropriate answer, where you  are now in relation to where you started. ~ 2 Much worse than before - 1 Worse than before 0 Same as before + 1 Better than before + 2 Much better than before - 83 -APPENDIX H (Pre and post-test experimental and control groups) COUNSELLOR RESPONSE TO A SPLIT RATER:  COUNSELLOR:  Indicate by c i rc l ing the appropriate number, i f the counsellor responded to the cl ient sp l i t by in i t ia t ing the separation and contact of the Gestalt two-chair role-play. 1 2 3 No Unclear Yes - 84 -APPENDIX I (Post-test experimental and control groups) CLIENT EVALUATION COUNSELLOR: CLIENT: Please indicate to what degree you feel your counsellor was helpful in working on your issue by c i rc l ing the appropriate number. 1 extremely unhelpful 2 unhelpful 3 somewhat helpful 4 helpful 5 extremely helpful 85 -APPENDIX J (Post-test experimental group) CLINICAL EVALUATION COUNSELLOR: CLINICIAN: Please indicate your evaluation of the appropriate number. 1. Was the counsellor effective in 1 2 not at a l l not very effective effective the counsellor's responses by c i rc l ing promoting cl ient exploration? 3 4 5 somewhat effective very effective effective 2. Were the s k i l l s that the counsellor used being used appropriately? 1 2 not at a l l not very appropriately appropriately 3 4 5 somewhat appropriately very appropriately appropriately - 86 -APPENDIX K Dear Counsellor: Thank you for your willingness to participate in this research. Your total participation as a counsellor w i l l involve two half-hour sessions and completion of four questionnaires. You w i l l be paired with a cl ient for a f i r s t session now and paired with a different cl ient for your session in March. A l l cl ients have had some previous experience with the counselling process and w i l l be coached to some extent. However, the problem that your cl ient presents w i l l be a real one. In the actual session, please assume that you have already spent some time, about four sessions, building a relationship with your c l ient . Then proceed to counsel your cl ient as you normally would in a regular session. Please be sure to tape record the entire session. Again, many thanks for your co-operation in this project. Sincerely, 

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