Phototherapy with disadvantaged boys

Phototherapy with disadvantaged boys

PHOTOTHERAPY SARAH A. MILFORD, WITH DISADVANTAGED MA, JERRY L. FRYREAR, The use of photography as an adjunct to psychotherapy is a new and evolvin...

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PHOTOTHERAPY

SARAH A. MILFORD,

WITH DISADVANTAGED

MA, JERRY L. FRYREAR,

The use of photography as an adjunct to psychotherapy is a new and evolving discipline known as phototherapy. Although photographs are used many different ways in therapy (Krauss & Fryrear, 1983) one strong case for the use of phototherapy is to provide a confrontation with self. Photographic self-confrontation provides the client with visual information about the self as an object. The information can be in the form of still photos, film, videotape playback, or even mirrors. The rationale is that this visual information will correct misperceptions, force reconceptualizations, or enhance the esteem in which the observing self hoids the objective self. Social, family, physical. and other attributes can be captured on film or tape and used in confrontive ways. Whether the self-confrontation is therapeutic depends on the selection of the client. the selection of attributes to confront, and the methods ‘of confrontation used. Self-confrontation is not automatically or necessarily therapeutic. Regardless of the specific technique, the provision of a visual display of one’s self virtually demands that one observe one’s self. Danet (1968), speaking of video replay, states that now patients can not only see themselves as others see them, but can react to their own behavior in a way similar to that of others with whom they have interacted. Self-reaction provides them with still more information. Family phototherapists (e.g., Kaslow, 1979; Entin. 1983) may rely on historical photographs

BOYS

PhD and PAUL SWANK,

PhD*’

from the client’s family album for confrontational purposes. The album is rich in diagnostic information relative to family self-concepts and family system dynamics. By using the historical photographs, the family album method also allows the client to observe the family self-concept and selfesteem process over possibly several years in the supportive atmosphere of the therapy room. Other family phototherapists (e.g., Ruben, 1978) prefer to photograph or videotape the family as the members interact in the therapy session. This visual information provides the client with elaborate data concerning his/her family self-concept and self-esteem, relative to the other family members. For example, a client may notice that he always looks down when father speaks to him, an indication of lowered setfesteem when in the father‘s presence. This data may contradict the client’s statements or even beliefs about his relationship to the father. and lead to a more honest assessment of the family self-esteem and then to strategies for enhancing that self-esteem. Other phototherapists (Fryrear, 1983) who have less of an orientation toward family therapy and more toward the individual are likely to use visual methods directly in the therapy sessions with individual clients or groups. There are several reasons why visuaf selfconfrontation is or can be therapeutic. One is that a client simply may not know what he/she looks like, and the visual self-confrontation pro-

Sarah Milford i\ a graduate wdent in psychofog! at Text Women’< Universir>. Denton. Texas. Jerry Fryt-ear is professor of human \cience< and codirecror of the ltwitute for P~ychosociai Applications of Video and Photography. University of HoustonClear Lahe. Paul Swrnk ix a consulting statistician and lecturer. Universtt) of Houston-Clear Lake.

MILFORD.

FRYREAR

vides this previously unknown information. For example, a teenager may think himself ugly or otherwise visually unique in the absence of “objective” evidence to the contrary. His opinion may be due to real or imagined feedback from other people, who may be biased and hostile toward him. The photographic self-portrait then gives him an additional bit of evidence that, when compared with other photographs or other opinions, may change his perception of himself. convince him that his opinion was erroneous. and thus enhance self-esteem. Logic and empirical evidence support this view. Logically, there is no reason why one would have an image of one’s self that corresponds to other People‘s. We see ourselves in mirrors. which provide a reversed and reduced image: we see ourselves in stiffly posed photographs, also greatly reduced in size: we rarely see ourselves from the rear or from the side-other people see us from these angles frequently. Empirically, there is evidence that there is a range of self-recognition abilities among people. Some of us are much better at recognizing visual displays of ourselves than others. Self-recognition deficits, compared with “normal” ability, have been documented by Cornelison and Arsenian with psychotic patients ( 1960), Pollack, Karp, Kahn, and Goldfarb with geriatric patients ( 1962) and Fryrear, Kodera and Kennedy (1981). Fryrear, Kodera and Kennedy have discovered three mentally deficient people who could not recognize photographic slides of themselves. although they could recognize slides of their friends. A related therapeutic rationale is that a person knows what he/she looks like, but not what he/she could look like under other circumstances. A client may lack grooming skills and may never have seen himselfiherself with combed hair and neat clothes. Visual feedback of a well-groomed self may be rewarding to the person and may result in higher self-esteem and enhanced appearance and hygiene. Conversely, it is probably dangerous to show a client what he/she could look like in undesirable circumst~~nces, such as in 11drunken state. Such :I confrontation method may simply provide clients with selective evidence that supports theit own self-fulfilling prophecies. As Hosford ( 198(I), writing about self-modeling notes, “(Clients) particularly observe or consciously choose to

AND

SWANK

observe those suspected discrepancies betw.een their actual and desired behavior. By, focusing primarily on their perceived mistakes they not only fail to observe and strengthen the more positive behaviors being modeled. but the) learn to associate feelings of unpleasantness wtth the self-observation process itself lp. 5 I ). We believe that Hosford’s analysis applies also to phvsical appearance. Clients may choose to attend to negatively perceived physical attributes of themselves. It does not seem wise for a therapist to accentuate that self-defeating process. “arousal” rationale for visual selfThe confrontation as therapy has support from the theory of objective self-awareness developed by Duval and Wicklund ( 1972). A state of objective self-awareness occurs whenever one is confronted with oneself as an object. such as when one views one’s own photograph. This state of objective self-awareness leads to a comparison of one‘s objective self with an internalized standard. If the comparison is such that the viewer is aware of a negative discrepancy between the standard and the objective self. a state of aversive arousal exists and the person will try to escape the state of objective self-awareness. If escape is not possible. then he/she will eventually attempt to change the objective self s behavior or appearance. Of course. the therapist would have to keep the client in ;I state of objective self-awareness during the time necessary for change to occur. The time it takes is no doubt different for different people, but Wicklund (1975) has reported behavioral changes in relatively short periods. In our opinion. this is a point in favor of group phototherapy. The mutually supportive atmosphere of a group helps insure that each client continues in therapy long enough to realize benefits. Other researchers have reported therapeutic outcomes of photo~r~~phic self-Confront~Ition. Cornelison and Arsenian ( 1960) showed schizophrenic patients photographs of themselves and discussed the viewing experiences with them. They reported positive changes in psychotic state in some patients. catharsis of some patients, and a focusing of attention upon the self. “Since self-confrontation foThey remarked. cuses perception upon an external image of self. this may bring ;I psychotic individual into better contact with the realistic self” (p. 7). Miller ( 1962) used photographic self-confron-

PHOTOTHERAPY

WITH DISADVANTAGED

tation with psychotic patients in a state hospital. He photographed them and displayed the photographs on their ward. Although no significant improvement in psychotic symptoms became apparent, the activity did result in increased socializaion among patients and between staff and patients. Spire ( 1973) used photos in a self-confrontation program with chronic schizophrenic women in a state hospital. He reported increased comenhanced interpersonal relations, munication. positive behavior change, and more positive selfevaluations. The purpose of the present study was to attempt to enhance institutionalized adolescent boys’ self-esteem. social skills and grooming using a photography program as a means to achieve visual self-confrontation. It was assumed that institutionalized adolescent boys frequently have low self-esteem and minimal social skills because they have had httle practice in social interaction and because they have had incomplete information about physical appearance and ways it could be improved. It was decided to provide the boys with positive exercises in social interactions through the cooperative activity of photographing each other, and to provide them with the photographs of themselves. It was expected that the experimental subjects using photography to achieve visual self-confrontation would show significantly more improvement in self-esteem, social skills and grooming than boys in a comparison group who engaged in the positive social interactions but not the photography. We wanted to provide a comparison group experience that would incorporate many of the features of the photography group csccpt the visual self-confrontation. For this study, the senior author (Milford) met with both groups as a counselor/activity leader. In the comparison group, the activity revolved around cutting out pictures from magazines and composing a scrapbook. As the boys worked on the scrapbooks, there was continual discussion and social interchange. The two groups were similar. then. in time spent with the group leader, time spent together, and in the fact that both allowed for and encouraged pleasant social interactions. This study is a conceptual replication and extension of three earlier studies in which photography was used to enhance physical self-esteem of juvenile delinquent boys (Fryrear. Nuell & Ridley, 1974). social self-

BOYS

213

esteem of juvenile delinquent boys (Fryrear, Nuell &. White, 1977) and children’s self-esteem (Ammerman B! Fryrear, 1975).

METHOD

Twelve boys from a group home were recommended for participation in the study by the director of the facility on the basis that they had low self-esteem and problems in relating with others. Subjects were between the ages of 12 and 16 years. All had been residents of the home a minimum of two years. They were there because the parents or guardians felt unable to control them or to meet their needs. None were adjudicated and none were severely emotionally disturbed. During the course of the six week study, there was no attrition.

All subjects used self-developing Kodak Colorburst 100 cameras. Testing instruments employed were the Piers-Harris Children’s SelfConcept Scale {Piers 8: Harris, 1969). the Jesness Behavior Checklist Observer and Self-Appraisal Forms (Jesness, 1976) and the Milford Grooming and Behavior Scale. The Piers-Harris Scale consists of 80 statements relating to the subject and the way he/she feels about himself/herself. The Jesness Behavior Checklist consists of items designed to encompass a wide range of nonintellectual, noncognitive social behaviors that describe desirable and undesirable social behavior. Each Checklist consists of 80 items measuring 14 bipolar factors which are listed in Table 2. The Milford Grooming and Behavior Staff Rating Scale was developed by the senior author for use in group homes and other residential placements. It is an observer form to be completed by the cottage supervisor, counselor, or individual who has the most contact with the child to be tested. The test consists of 26 items designed to assess the subject’s behavior and grooming during the preceding week. Each question has five possible answers: (1) very poor, (2) poor, (3) satisfactory, (4) good, and (5) outstanding.

MILFORD.

??4 __

FRYREAR

The boys were randomly assigned to two groups: experimental or comparison. One week prior to the beginning of the six week study. all subjects met for an initial practice and orientation session. The subjects were told that they had been selected to participate in six weeks of activity sessions in which some would be involved in taking pictures of each other and some would be making individual scrapbooks. They were instructed that each group would meet at the same location for 1 ‘/z hours twice weekly for six consecutive weeks. The experimenter demonstrated the use of the cameras, and each of the twelve subjects was allowed to take four practice snapshots of one other boy. All subjects were able to operate the cameras with ease by the end of the practice session. All subjects were then allowed to browse through the magazines provided by the experimenter for use in constructing the scrapbooks. Subjects were allowed to cut four pictures

AND

SWANK

from any of the sports. fishing. current events and movie magazines. Immediately following the practice and orientation introduction. all subjects were tested on the Piers-Harris and the Jesness Behavior Checklist Self-Appraisal Form. Concurrent/>. the boys’ cottage supervisors were asked to rate them on the Jesness Observer Form and the Milford Grooming and Behavior Scale. All test item% for both subjects and cottage supervisors were read aloud to control for differences in reading ability. to guard against euperiAfter pretesting. menter bias. the pretest results were collected. but not scored or viewed again until after the posttest session. In the experimental group. subjects were assigned permanent partners on a random basis. Types of poses were listed for each session: each boy took pictures of his partner in those poses. In all. subjects photographed forty prescribed poses and twenty free poses of their partner’s choo+ ing. The poses were as follow:

1. Head-full

front

I.

2. Head-?/4

right front

2. Head

Head-full

real

3/4 left rear

3. Head-314

left front

3. Head-right

4.

Head-?/4

right real

4.

Head-left

5.

Free Shot

3-

Free Shot

.sl,\.\il,lr

I.

I PO,,111 ‘Y’,,

III

Standing

2. Sitting

in chair

.)‘1’\.\1011 II’ I.

lPO\/ffW\,

Kneeling

2. Sitting on floor-

3. Lying

pi-one

3. Leaning

4.

Lying

wpine

4. Squatting

5.

Free Shot

I.

Happy

2. Sad

5. Free Shot

I.

Fearful

2. Diqxsted

i.

Angry

3. I-houghtful

4.

Pouting

4. Surprlwd

5. FI-ee Shot

I.

Happy

2. .Sd

5.

Free Shot

I.

Fearful

7.

Disgusted

3. Angry

3. Thoughtful

4. Pouting

4. Surprised

5

5

FI-ce Shot

profile profile

FI-cc Shot

PHOTOTHERAPY

WITH

DISADVANTAGED

Face

I.

2. Brushing

Teeth

7. Acting

3. Combing

Hair

3. Buttoning

I.

Washing

Acting

hot

4. Buckling

5. Free Shot

5. Free Shot

Sc.\.\irw XI

S<,.\.\iO/l XII

Five

Five

During each session, the experimental subjects spent time arranging their photographs in the albums provided, and seemed to put much thought into labeling the photos. The experimenter made no effort to implement a systematic counseling procedure with the boys during the session, but maintained an air of helpfulness and friendliness. Most subjects in the experimental group were able to express their feelings about their pictures, and often brought pictures they liked to the experimenter to talk about them. They became quite involved in discussing the pictures among themselves as well, and seemed to enjoy the project very much. Subjects in the comparison group were also given albums, but instead of photographs of themselves, they were provided with magazines from which they were to cut five pictures per session to paste and label in their scrapbooks. The experimenter maintained the same air of helpfulness and friendliness as with the experimental subjects, and tried to make the experimental and comparison sessions as comparable as possible in terms of group interaction and time. All scrapbooks and albums were kept by the experimenter between sessions and none of the subjects had access to them except during the project sessions. The director and the cottage supervisors did not see the scrapbooks or albums until the end of the project: they were also blind as to the assignment of boys into groups. The experimenter did not discuss the project with them. One week after the study’s completion, the experimenter administered the same tests as before to all subjects and their cottage supervisors in exactly the same manner as before. Neither

22s

cold

4. Putting on Shoes

Free Shots

BOYS

Shirt Belt

Free Shots

supervisors nor subjects were informed ahead of time that posttests would be included in the project. The boys were given the scrapbooks to keep at that time.

RESULTS The study constitutes a pretest-posttest control group design. To analyze the results, a two factor analysis of variance was used in which one factor, pretest versus posttest, was a repeated measures factor.

As can be seen in Table 1, the experimental group showed gains of slightly more than 5 points on the Piers-Harris Scale while the comparison group gained slightly more than 1.8 points. Although in the expected direction, the differential magnitude of the change failed to reach statistical significance. The groups’ main effect was also not significant. The pretest main effect approached significance CF=3.70, df= 1110, .OS
The experimental group increased by more than 9 points from pretest to posttest on the Milford Scale while the comparison group changed less than 2 points (Table 1). This led to a significant pre-posttest X group interaction (F=9.84, df/l/lO, Pc.025). Subsequent posttest comparisons verified that this was due to the larger increase in the experimental group over the comparison group. In addition. the overall increase by both groups from pretest to posttest was significant (F= 13.18, df= l/10, Pc.01).

MILFORD.

FRYREAR

AND

TABLE

1

MEAN SCORES FOR THE PIERS-HARRIS CONCEPT SCALE AND THE MU-FORD BEHAVIOR SCALE Experimental

Postte5t

Piers-Harris

38.33

43.50

46.00

17.83

Milford

77.17

86.77

77‘77

78.00”~”

T SCORES FOR THE SUBSCALES

Responsibility

2

OF THE JESNESS

Post

50 50 61 65

BEHAVIOR

CHECKLISTS.

~OU?l

Oh\c,r\,c,i. Fr~r,,r

Comparison

Pre

Pohttest

pre-post main effect. pre-post main effect. Groups x pre-post interaction.

Sc(f’ilppUri.\tr/

Considerateness

Group

Pretest

Experimental

Friendliness

SELF .-\ND

Comparison

Group

TABLE

Unobstrusiveness

CHILDREN’S GROOMING

Pretest

Note: a. pc. 10. b. pq.01, c. pc.025.

MEAN

SWANK

Experimental

Comparison

Pre

Post

Pre

Post

Pre

Po\t

51

39

43

53

42

43

39 55

41 58 51 46 4s 56

26 36 34 38 58 37 31

24 34 43” 38 33 43

39

4 I“

57

53

53

49

71.

62

64

49

Independence

43

53

53

50

41

Rapport

39

45

58

50

56

Enthusiasm

37

40

46

56

42

3x

Sociability

38

44

52

48”

40

Conformity

49

56

40

4’

40

47 46

Calmness

31

38

46

40

31

36

Effective

49

51

31

39”

43

43

40

40

36

31 37

3x 37

Communication

69

68

68

hi

47

37

36

Social

Control

46

47

41

JI

3x

‘4

Anger

Control

33

39

36

35

36

Z-t 26

47

Cl

‘lx

4%’

Ji

36

7x

Insight

Overall

a. h. c. d.

p’ IO. pc--.O. p’ ,035, pe .10.

Group5 * pre-post i~ter~lction; pre-post main effect. pre-po\t main effect. Group\ x pre-po4t interaction.

pre-po\t

.Ic~.ctw.~.cNclrri~~irrr t’llrrf~li.~~.~ The mean T scores for the Jesness Checklists are presented in Table 2. Si~~ific~lnt main effects or inIer~l~ti~ns televnnt to the hypotheses are ~lnll0lilt~d.

30

main e@ect

There was an interaction of the Overall Behavior Score on the Self-Appraisal Form. That is. the boys in the experimental group described themselves as more improved than did the boys in the comparison group tF=4.03. df= 1; 10. PC. IO). That ~iffej-en[i~~l description was not cor-

PHOTOTHERAPY

WITH DISADVANTAGED

roborated by the cottage supervisors on the Observer Form. The only subscales that yielded significant experimental effects were the Sociability, Effective Communication, and Responsibility subscales. On the Self-Appraisal Form, the experimental group rated themselves as having improved more in sociability than the comparison group. which actually shows a slight decline from pretest to posttest (F=4.41, df= 1110. P<. IO). Boys in both groups rated themselves as improved in communication, the comparison group more so than the photography group (F=3.85, df=l/lO. Pc.10). The cottage supervisors rated boys in both groups as improved in responsibility (F=4.52, df= 1110, P<.OS). On the Observer Form. the cottage supervisors described both groups as significantly more sociable at the posttest than at the pretest (F=7.69, df= 1110. Pc.025). DISCUSSION The present study. although not providing unequivocal results. does support the use of photography as a therapeutic activity for disadvantaged boys. Compared with the group of boys who met as a more traditional activity/discussion group. without the visual self-confrontation of the photographs. the photography group described themselves as more improved in their overall behavior and particularly as more sociable. Both groups seemed to improve in selfesteem, although these results must be viewed with caution because of the tendency of the self-esteem instrument to yield higher scores on retests. The cottage supervisors noted that the photography group. compared with the discussion/activity group, improved in sociability. corroborating the boys’ self-reports. The supervisors noted that both groups seemed to improve in responsibility and grooming, with the photography group showing significantly more improvement on the Milford Grooming and Behavior Scale. That scale asked the cottage supervisors to rate the boys on very specific items that are relevant to group living. The present study included counseling. or at least discussion, adjunctive to the visual selfconfrontation. The addition of the visual self-

BOYS

227

confrontation to the verbal discussion and counseling may enhance the therapeutic value of the latter because the visual self-image evokes strong arousal in the viewer which “primes” the viewer for therapeutic change. From a psychoanalytic point of view, anxiety aroused by viewing one’s self in a photograph may result in heightened and more adaptive ego functions, perhaps mature ego mechanisms in place of immature or narcissistic ones. Certainly, visual or auditory self-confrontation can arouse one’s anxiety (Holzman, Rousey, & Snyder, 1966). It is unlikely, however, that the increased anxiety “automatically” results in therapeutic gain. What is more likely is that the state of arousal makes the client more open to therapeutic intervention and perhaps more suggestibie. Following this assumption, photographic self-confrontation would be used by therapists as affect-arousing stimuli, adjunctive to other modes of therapy. Hung and Rosenthal (1981 f conclude that visual feedback of videotaped self has “its maximum impact when conjoined with other therapies.” Their social theory framework seems to apply to photographic feedback as well. They point out that self-efficacy and outcome expectation, steered by personal cognitions about reality influence the effects of visual ~onfrontation. They emphasize that it is important to specify the meaning (message-value) of feedback. In their words, “. . . how people are oriented to observe themselves and to discriminate message content will affect the meaning clients extract from videotaped replay” (p. 53). In other words, visual self-confrontation does not occur in a social/environmental vacuum. The phototherapists must prepare the client for the self-confrontation experience if maximum benefit (and avoidance of negative consequences) is to occur. Hall (1983) states the case for carefully prepared visual self-confron~tion succinctly. “Photographs of oneself are a potent source of feedback regarding personal appearance. Potent feedback, however, can be negative as well as positive. It seems sensible that if a therapist is to provide a client the opportunity of having photographs of himself, that it would be useful to have a degree of control over the process of generating the photographs such that the results will have the best possibility of providing positive feedback.” Hall, in his phototherapy, provides “con-

MILFORD,

228

FRYREAR

trolled self-confrontation,“ directing the client through the four phases of collecting information. photographing, processing of film. and viewing the photographs in such a way that the total experience is a positive, therapeutic one. Taken together with the photography programs cited above and the three studies which have already been carried out using a similar procedure (Fryrear, Nuell & Ridley, 1974; Ammerman Sr Fryrear, 1975; Fryrear. NueIl, & White, 1977) it seems clear that the addition of photographic self-confrontation to an ongoing activity/discussion program can significantly enhance the therapeutic potential of such a program.

REFERENCES A~t~ERMAN, M. S. Sr FRYREAR. J. L. (1975) Photographic enh~tncement of children‘s self esteem. Ps~t~lrtdt&Gi/l rhc &hwi.\, 123). 319-325. CORNELISON. F. S. & ARSENIAN, J. (19601 A study of the response of psychotic patients to photographic selfimage experienck. P.~~c~/ri~,/;?c.L),,(,rfer/l.. 34.-l-8. DANET. B. 8. i 1968) Self-confrontation.in psychotherapy revisited. A/,/cric,o,r ,/or/rrrtr/ c!/’ P\?c.lrr,clfc,.[,p~, 21, 24% 258. DUVAL. S. & WICKLUND, R. A. f 1972) i\ 7/r(,r,/;\, f{/ Ohjcc rii,c, .S~,!/-~~,‘o~c’,c~\.\. New York: Academic Press. ENTIN, A. D. (1983) The family album its icon: Photographs in family p\ychotherxpy. In 5. Krause and J. Fryrear f Edh.), ~3~~~~r~)~/~~,r~/~~~ ,,i ,~~~,~t~~~~ HP&)/~. Springfield. IL: Charles C Thomas. FRYREAR, J. L. I 1983) Photo~r~lphic self-confro~t~lti~~n as therapy. In D. Krause and J. Fryrear tEds.1, Plrr~r>i/x,/-~r,>i irt .&fr~rrrrr/I/c,c//tt~. Springfield. IL: Charles C Thomas. FRYREAR. J. L.. KODERA. T. A. & KENNEDY. M. (19x1) Self recognilion ability in mentally retarded adolescent\. 7/l<, ./r,lr/.,lo/ <(/ /J\,vc~/r~&,~,) IOX. 123-I 31.

AND SWANK FRYREAR. J. L.. NUELL. L. R. & RIDLE\r. S. D. 1197-&l Photographic . 4. 432-441. HOSFORD. R. E. I 1980t Self-as-a-model: .A cognitive \oclxi learning technique. 71~) COCOI\c~l,/~~ P\\ c~ir~~i<~:‘irr.91 I). 45-Q. HUNG. J. H. Y( ROSENTHAL. T. L. (1981) Therapeutic videotaped playback. In J. L. Fryrear & R. Fleyhman tEds.1. Vi~/~o/l~~,/.(l~>\ i/r .&/~,rrrt~/ Hccil/lr. Springfield. IL: Charles C Thomas. JESNESS. C. F. (1976 Jesness Behavior Check Lizt. Consulting Psychologists Prey<, Inc.. 577 College Avenue. Palo Alto. CA 94306.

KRAUSS, D. 61 FRYREAR. J. L. (1983) ~~~(~~~~/~~~,~~/~?~ i/l .bIc,/lrtr/ Hcc~lilr. Springfield. IL: Charles C Thomas. MILLER. M. F. I 1962) Responses of psychiatric patients to their photographed images. f)i.\ccc\c,.\ ~~f’,il<~.Xcr\,rjr/\ .Y! \/(‘!)I. 23, 196-198. PIERS, E. V. & HARRIS. 5. B. (1969) The Piers-Harris Children‘\ Self Concept Scale. Counselor Recordings and Tests. Box 6184 Acklen Station. Nashville. TN 37211. POLLACK, M.. KARP, E., KAHN, R L. & GOLDFARB. A. I. (1962) Perception of self m instituttonalized agrd subjects: 1. Response patterns to mirror reflection<. .lcst(r/iill t>f Gr~r-<~/frri/cl,~\. 17. 405-408.

SPIRE, R. H. (197j) Photographic self image confrontation. il/rrcJ?t (111.l0rtr,ttrl rg ,Lttr,\;lQ!. 7317). I x7- I1 IO. WICKLUND. R. A. (197.5) Objective \eif-awarenes\. In I_. Berkowitz (Ed.), ,A(/~.[(/I(.(,\ i/r t\~c,‘.i/,~c,rtrt,( S~~c-ici/ PITclr~do:,~.Vol. 8. New York: Academic Press.