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Egalitarian versus traditional behavioral marital therapy: A test of preference
nEI-IAVIOgTtmRAPY 18, 279-282, 1987
BRIEF REPORT Egalitarian Versus Traditional Behavioral Marital Therapy: A Test of Preference PmLW H. BOR~ISTEn,I, DAVID STUBE, GREGORYL. WILSON, ANN M. HORSTMAN, DEEANN R. SHEETS, JONETTE R. ZULAIYF, KARIN L. BRIER, AND KENNETH A. COOSWELL University o f Montana Eighty introductory psychology students participated in a 2 × 2 x 2 × 2 experimental design viewing videotapes of two differing marital therapy treatments (egalitarian vs. traditional). In addition to the above manipulation, experimental factors also included therapist gender, order of presentation, and subject gender. A variety of dependent variables were utilized, all of which assessed either treatment acceptability or therapist characteristics. Results were highly consistent with all treatment acceptability measures generally indicating significantly higher acceptability ratings (allp's < .0001) for traditional as opposed to egalitarian behavioral marital therapy. Similarly, traditional therapists were rated as more likeable than egalitarian therapists. Results are briefly discussed with regard to treatment acceptability and the advocacy of particular values during the course of therapy.
Longitudinal research has found that, over the past 40 years, there has been a clear shift toward greater equality within marriages (Holohan, 1984). Yet, only limited experimental research has focused upon the role of egalitarian relationships in promoting marital satisfaction. Recently, two sociopolitical articles relevant to the above topic appeared in the marital therapy literature (Jacobson, 1983; Margolin, Talovic, Fernandez, & Onorato, 1983). Margolin et al. (1983) urge therapists to become more conscious of, and sensitive to, specific sex-role issues in conducting behavioral marital therapy (BMT). Jacobson (1983) also suggests that marital therapists often convey political viewpoints, values, and biases leading to the reinforcement of traditional attitudes/behavior. Overall, both papers offer a number of specific recommendations which should promote greater marital egalitarianism and sex-role equality. Portions of this research were completed while the senior author was on leave at the University of Arizona and Pima County Court Clinic, Tucson, AZ. Requests for reprints should be addressed to Philip H. Bornstein, Department of Psychology, University of Montana, Missoula, MT 59812. 279 0005-7894/87/0279-028251.00/0 Copyright 1987 by Association for Advancement of Behavior Therapy All rights of reproduction in any form reserved.
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BORNSTEIN ET tEL.
Unfortunately, no research to date clearly demonstrates the superior impact of egalitarian interventions. Moreover, serious questions exist about the acceptability of therapeutic practices that explicitly promote particular value systems (Garfield & Bergin, 1978). Hence, the present investigation sought to examine the acceptability of egalitarian versus traditional therapeutic interventions. Since both the Margolin et al. (1983) and Jacobson (1983) discussions focus on behavioral treatment methods, our study chose to compare egalitarian with traditional BMT.
METHOD Subjects and Procedures Subjects were 80 introductory psychology students, given credit for participation. A 2 x 2 x 2 x 2 (Type of Treatment x Gender of Therapist × Order of Presentation x Gender of Subject) split-plot, factorial design was used wherein each subject viewed two counterbalanced, videotaped marital treatments (egalitarian versus traditional) with an individual male or female therapist. Four separate videotapes were prepared from scripts depicting both therapists conducting an initial session of both egalitarian and traditional BMT. 1 The dialogue and theme for each therapy session closely followed the discussion and recommendations of Margolin et al. (1983) and Jacobson (1983). The same couple appeared in all four role-plays, and each videotaped segment began with a narrated case history delineating the problems which led to the couple's request for treatment. Problems were extracted from actual clinic records and case files. Dependent Measures Prior to the investigation, 11 advanced graduate clinical psychology students rated each of the videotaped therapeutic interactions on egalitarian and traditional dimensions. A 2 × 2 × 2 repeated measures ANOVA (Type of Treatment × Gender of Therapist × Dimension) revealed highly significant Treatment x Dimension interaction effects p < .0001, with each treatment receiving substantially higher ratings on the respective dimension of relevance (i.e., egalitarian treatment rated higher on egalitarian dimension, etc.). After each videotape segment was presented, subjects completed the following dependent measures: (a) Treatment Evaluation Inventory (TEI; Kazdin, 1980a, 1980b); (b) Semantic Differential (SD; Osgood, Suci, & Tannenbaum, 1957); (c) Credibility Rating Scale (CRS; Fox & Wollersheim, 1984); and (d) Interpersonal Evaluation Inventory (IEI; Anderson, 1968).2 In addition, subjects were asked to make a therapy preference rating and space was provided for openended qualitative remarks. i Videotape scripts are available from the authors u p o n request. 2 Subject characteristics were also examined via administration of the Egalitarian Scale (Beere, King, Beere, & King, 1984). Post hoc analyses were generally unremarkable and revealed little further information.
EGALITARIAN VERSUS TRADITIONAL THERAPY
281
RESULTS Significant differences in TEI and CRS mean ratings were obtained across the two treatments (TEI means: Traditional = 76.1, Egalitarian -- 63.1; F(1,72) = 27.88,p< .0001; CRS means: Traditional = 23.9; Egalitarian -- 6.3; F(1,72) = 25.72, p < .0001. Traditional approaches (-£ -- 28.2) were also rated significantly higher than egalitarian interventions (~ = 22.6) on the evaluation dimension of the SD, F(1,72) = 36.26, p < .0001. On the potency and activity dimensions, significant Order x Treatment effects were revealed; Neuman-Keuls tests showed that traditional therapy was rated as more potent when egalitarian therapy preceded traditional approaches F (1,72) = 14.20, p < .0001, but egalitarian treatment was rated as more active than traditional treatment when presented in the traditional-egalitarian order, F(1,72) = 9.75, p < .01. Interestingly, results generally indicated higher ratings for both approaches as a result of this presentation order. Separate analyses were conducted on the Likeability and Competence subscales of the IEI. Likeability analyses revealed significant differences between treatments (Traditional X = 71.66, Egalitarian X = 58.99), F (1,72) = 41.88, p < .0001, and gender of subjects (females X = 68.09, males X 62.56, F (1,72) = 5.10, p = 0.25.) In addition, a significant Order x Treatment interaction emerged F (1,72) 10.43, p < .01. Neuman-Keuls analyses showed that subjects rated traditional consistently higher than egalitarian therapists although the differences were smaller in the egalitarian-traditional order. Finally, therapy preference ratings and qualitative comments clearly confirmed the greater acceptability of traditional (n = 64) versus egalitarian approaches (n = 16), x 2 (1) = 27.62, p < .0001 in subjects' views.
DISCUSSION The results of the present investigation clearly indicate the greater popularity of traditional versus egalitarian BMT. Moreover, our findings were quite consistent across all measures. In essence,, the data indicates that an important distinction must be made between a therapist's private adoption of some particular set of values versus disclosing those values during the course of treatment. As Margolin et al. (1983) noted, good therapy involves: "knowing when not to insist upon changes that would be too intrusive or upsetting, or that reflect the values of the therapist more than those of the couple" (p. 142). Our results support their contention both regarding sex-role issues in general and BMT in particular.
REFERENCES Anderson, N. H. (1968). Likeableness ratings of 555 personality-trait words. Journal of Personality and Social Psychology, 9, 272-279. Beere, C. A., King, D. W., Beere, D. B., & King, L. A. (1984). The sex-role egalitarian scale: A measure of attitudes toward equality between the sexes. Sex Roles, 10, 563-576. Fox, S. G., & Wollersheim, J. P. (1984). Effect of treatment rationale and problem severity upon therapeutic preferences. Psychological Reports, 55, 207-214.
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BORNSTEIN ET AL.
Garfield, S. L., & Bergin, A. E., (Eds.) (1978). Handbook of psychotherapy and behavior change: An empirical analysis. New York: Wiley. Holohan, C. K. (1984). Marital attitudes over 40 years: Longitudinal and cohort analysis. Journal of Gerontology, 39, 49-57. Jacobson, N. S. (1983). Beyond empiricism: The politics of marital therapy. The American Journal of Family Therapy, 11, 11-24. Kazdin, A. E. (1980a). Acceptability of alternative treatments for deviant child behavior. Journal of Applied Behavior Analysis, 13, 259-273. Kazdin, A. E. (1980b). Acceptability of time-out from reinforcement procedures for disruptive child behavior. Behavior Therapy, 11, 329-344. Margolin, G., Talovic, S., Fernandez, V., & Onorato, R. (1983). Sex role considerations and behavioral marital therapy: equal does not mean identical. Journal of Marital and Family Therapy, 9, 131-145. Osgood, C. E., Suci, G. J., & Tannenbaum, P. H. (1957). Measurement of meaning. Urbana, IL: University of Illinois Press. RECEIVED: October 30, 1986 FINAL ACCEPTANCE: December 18, 1986
BRIEF REPORT Egalitarian Versus Traditional Behavioral Marital Therapy: A Test of Preference PmLW H. BOR~ISTEn,I, DAVID STUBE, GREGORYL. WILSON, ANN M. HORSTMAN, DEEANN R. SHEETS, JONETTE R. ZULAIYF, KARIN L. BRIER, AND KENNETH A. COOSWELL University o f Montana Eighty introductory psychology students participated in a 2 × 2 x 2 × 2 experimental design viewing videotapes of two differing marital therapy treatments (egalitarian vs. traditional). In addition to the above manipulation, experimental factors also included therapist gender, order of presentation, and subject gender. A variety of dependent variables were utilized, all of which assessed either treatment acceptability or therapist characteristics. Results were highly consistent with all treatment acceptability measures generally indicating significantly higher acceptability ratings (allp's < .0001) for traditional as opposed to egalitarian behavioral marital therapy. Similarly, traditional therapists were rated as more likeable than egalitarian therapists. Results are briefly discussed with regard to treatment acceptability and the advocacy of particular values during the course of therapy.
Longitudinal research has found that, over the past 40 years, there has been a clear shift toward greater equality within marriages (Holohan, 1984). Yet, only limited experimental research has focused upon the role of egalitarian relationships in promoting marital satisfaction. Recently, two sociopolitical articles relevant to the above topic appeared in the marital therapy literature (Jacobson, 1983; Margolin, Talovic, Fernandez, & Onorato, 1983). Margolin et al. (1983) urge therapists to become more conscious of, and sensitive to, specific sex-role issues in conducting behavioral marital therapy (BMT). Jacobson (1983) also suggests that marital therapists often convey political viewpoints, values, and biases leading to the reinforcement of traditional attitudes/behavior. Overall, both papers offer a number of specific recommendations which should promote greater marital egalitarianism and sex-role equality. Portions of this research were completed while the senior author was on leave at the University of Arizona and Pima County Court Clinic, Tucson, AZ. Requests for reprints should be addressed to Philip H. Bornstein, Department of Psychology, University of Montana, Missoula, MT 59812. 279 0005-7894/87/0279-028251.00/0 Copyright 1987 by Association for Advancement of Behavior Therapy All rights of reproduction in any form reserved.
280
BORNSTEIN ET tEL.
Unfortunately, no research to date clearly demonstrates the superior impact of egalitarian interventions. Moreover, serious questions exist about the acceptability of therapeutic practices that explicitly promote particular value systems (Garfield & Bergin, 1978). Hence, the present investigation sought to examine the acceptability of egalitarian versus traditional therapeutic interventions. Since both the Margolin et al. (1983) and Jacobson (1983) discussions focus on behavioral treatment methods, our study chose to compare egalitarian with traditional BMT.
METHOD Subjects and Procedures Subjects were 80 introductory psychology students, given credit for participation. A 2 x 2 x 2 x 2 (Type of Treatment x Gender of Therapist × Order of Presentation x Gender of Subject) split-plot, factorial design was used wherein each subject viewed two counterbalanced, videotaped marital treatments (egalitarian versus traditional) with an individual male or female therapist. Four separate videotapes were prepared from scripts depicting both therapists conducting an initial session of both egalitarian and traditional BMT. 1 The dialogue and theme for each therapy session closely followed the discussion and recommendations of Margolin et al. (1983) and Jacobson (1983). The same couple appeared in all four role-plays, and each videotaped segment began with a narrated case history delineating the problems which led to the couple's request for treatment. Problems were extracted from actual clinic records and case files. Dependent Measures Prior to the investigation, 11 advanced graduate clinical psychology students rated each of the videotaped therapeutic interactions on egalitarian and traditional dimensions. A 2 × 2 × 2 repeated measures ANOVA (Type of Treatment × Gender of Therapist × Dimension) revealed highly significant Treatment x Dimension interaction effects p < .0001, with each treatment receiving substantially higher ratings on the respective dimension of relevance (i.e., egalitarian treatment rated higher on egalitarian dimension, etc.). After each videotape segment was presented, subjects completed the following dependent measures: (a) Treatment Evaluation Inventory (TEI; Kazdin, 1980a, 1980b); (b) Semantic Differential (SD; Osgood, Suci, & Tannenbaum, 1957); (c) Credibility Rating Scale (CRS; Fox & Wollersheim, 1984); and (d) Interpersonal Evaluation Inventory (IEI; Anderson, 1968).2 In addition, subjects were asked to make a therapy preference rating and space was provided for openended qualitative remarks. i Videotape scripts are available from the authors u p o n request. 2 Subject characteristics were also examined via administration of the Egalitarian Scale (Beere, King, Beere, & King, 1984). Post hoc analyses were generally unremarkable and revealed little further information.
EGALITARIAN VERSUS TRADITIONAL THERAPY
281
RESULTS Significant differences in TEI and CRS mean ratings were obtained across the two treatments (TEI means: Traditional = 76.1, Egalitarian -- 63.1; F(1,72) = 27.88,p< .0001; CRS means: Traditional = 23.9; Egalitarian -- 6.3; F(1,72) = 25.72, p < .0001. Traditional approaches (-£ -- 28.2) were also rated significantly higher than egalitarian interventions (~ = 22.6) on the evaluation dimension of the SD, F(1,72) = 36.26, p < .0001. On the potency and activity dimensions, significant Order x Treatment effects were revealed; Neuman-Keuls tests showed that traditional therapy was rated as more potent when egalitarian therapy preceded traditional approaches F (1,72) = 14.20, p < .0001, but egalitarian treatment was rated as more active than traditional treatment when presented in the traditional-egalitarian order, F(1,72) = 9.75, p < .01. Interestingly, results generally indicated higher ratings for both approaches as a result of this presentation order. Separate analyses were conducted on the Likeability and Competence subscales of the IEI. Likeability analyses revealed significant differences between treatments (Traditional X = 71.66, Egalitarian X = 58.99), F (1,72) = 41.88, p < .0001, and gender of subjects (females X = 68.09, males X 62.56, F (1,72) = 5.10, p = 0.25.) In addition, a significant Order x Treatment interaction emerged F (1,72) 10.43, p < .01. Neuman-Keuls analyses showed that subjects rated traditional consistently higher than egalitarian therapists although the differences were smaller in the egalitarian-traditional order. Finally, therapy preference ratings and qualitative comments clearly confirmed the greater acceptability of traditional (n = 64) versus egalitarian approaches (n = 16), x 2 (1) = 27.62, p < .0001 in subjects' views.
DISCUSSION The results of the present investigation clearly indicate the greater popularity of traditional versus egalitarian BMT. Moreover, our findings were quite consistent across all measures. In essence,, the data indicates that an important distinction must be made between a therapist's private adoption of some particular set of values versus disclosing those values during the course of treatment. As Margolin et al. (1983) noted, good therapy involves: "knowing when not to insist upon changes that would be too intrusive or upsetting, or that reflect the values of the therapist more than those of the couple" (p. 142). Our results support their contention both regarding sex-role issues in general and BMT in particular.
REFERENCES Anderson, N. H. (1968). Likeableness ratings of 555 personality-trait words. Journal of Personality and Social Psychology, 9, 272-279. Beere, C. A., King, D. W., Beere, D. B., & King, L. A. (1984). The sex-role egalitarian scale: A measure of attitudes toward equality between the sexes. Sex Roles, 10, 563-576. Fox, S. G., & Wollersheim, J. P. (1984). Effect of treatment rationale and problem severity upon therapeutic preferences. Psychological Reports, 55, 207-214.
282
BORNSTEIN ET AL.
Garfield, S. L., & Bergin, A. E., (Eds.) (1978). Handbook of psychotherapy and behavior change: An empirical analysis. New York: Wiley. Holohan, C. K. (1984). Marital attitudes over 40 years: Longitudinal and cohort analysis. Journal of Gerontology, 39, 49-57. Jacobson, N. S. (1983). Beyond empiricism: The politics of marital therapy. The American Journal of Family Therapy, 11, 11-24. Kazdin, A. E. (1980a). Acceptability of alternative treatments for deviant child behavior. Journal of Applied Behavior Analysis, 13, 259-273. Kazdin, A. E. (1980b). Acceptability of time-out from reinforcement procedures for disruptive child behavior. Behavior Therapy, 11, 329-344. Margolin, G., Talovic, S., Fernandez, V., & Onorato, R. (1983). Sex role considerations and behavioral marital therapy: equal does not mean identical. Journal of Marital and Family Therapy, 9, 131-145. Osgood, C. E., Suci, G. J., & Tannenbaum, P. H. (1957). Measurement of meaning. Urbana, IL: University of Illinois Press. RECEIVED: October 30, 1986 FINAL ACCEPTANCE: December 18, 1986