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The modification of interview behavior by client use of social reinforcement
BEHAVIORTHERAPY (1971) 2, 5"2--61
The Modification of Interview Behavior by Client Use of Social Reinforcement 1 JUDIT~ COHEN CONGEn-~
University of Illinois It was hypothesized that clients, through the use of social reinforcement, could alter the response classes of past or present verb forms emitted by interviewers. Two graduate students who acted the roles of "real clients" attempted this experimental manipulation in a 27-rain interview. Each "client" was interviewed by two groups of interviewers. The target response for one group was past verb forms and, for the other, present verb forms, An overall analysis indicated differences between clients and interviewers on such measures as total-talk time and number of interactions. Problems which arise in investigations of flee-operant verbal behavior and suggestions for future research are discussed. In recent years there has been a trend away from viewing the psychotherapeutic relationship as one surrounded by a special "mystery" or "'aura." Krasner (1962; p. 199) pointed out that "research in psychotherapy has increasingly focused on investigations which could be interpreted as being part of a broad psychology of behavior control." Much of the research relevant to and within psychotherapy proper tends to focus on the "behavior influencing characteristics" of the therapist, examiner, or experimenter. That is, subject or client behaviors are treated as the dependent variable. Far fewer studies have focused on the behavior influence of the client, i.e., where therapist or interviewer responses are considered as the dependent variable. Using tapes of therapy interviews, CuRer (1958) investigated countertransference and found a tendency for therapists to distort reports of patient behaviors which were need-relevant to the therapist. Bandura, Lipsher, and Miller (1960) investigated therapists' avoidance responses as related to patients' hostility. W h e n the therapist was the object of the patient's hostility, there was a tendency for all therapists to emit avoid1This paper was based on a portion of a dissertation submitted to the Department of Psychology, University of Illinois, in partial fulfillment of the requirements for the Ph.D. degree under the chairmanship of Leonard P. Ullmann. ~"Requests for reprints should be sent to: Judith Cohen Conger, c/o A. J. Conger, Psychology Department, University of North Carolina, Chapel Hill, N. C. 27514. 52
CLIENT-MODIFIED INTERVIEW BEHAVIOR
53
ance responses. However, when hostility was directed at other objects, it was found that therapists rated low in need-approval and high on direct expression of hostility made more approach responses than those rated high in need-approval and low on direct expression of hostility. Winder, Ahmad, Bandura, and Rau (1962) found that therapist's approach to dependency expression was associated with continuation of therapy and avoidance of dependency expressions was associated with termination. In a more experimental mode, Russell and Snyder (1963) used two actors to play the respective roles of a hostile and friendly client. Results indicated that hostile client behavior led to significantly greater therapist anxiety than did friendly behavior on three out of four measures. HeUer, Myers, and Kline (1963) using "stooges" to role play dominant-friendly, dominant-hostile, dependent-friendly, and dependent-hostile clients found that interviewers confronted with client friendliness responded with agreeable behavior, while interviewers confronted with hostility reacted with counter hostility. Given this background, the question arises whether "other" therapist behaviors are directly amenable to manipulation by clients. Krasner (1963; p. 603) pointed out that "behavioral control is a two-way affair and counter-controls are being asserted by the patients. Yet, part of the training of the therapist is to be able to counter the counter-controls and, to the extent that he can do so, he will be a successful therapist." Although there are few experimental investigations of this phenomenon, most contemporary views of psychotherapy assume a reciprocally contingent interaction between patient and therapist (Heller, 1963). The present study is a "pilot effort" since there has been no experimental investigation of client variables controlling therapist verbal behavior and the precise nature of the verbal classes of behavior which are controlled. The study was modeled after Russell and Snyder (1963). Unbeknown to an interviewer, a stooge, playing a client, attempted to influence his verbal behavior. It was hypothesized that interviewer verbal behavior, more specifically use of past and present verb forms, could be modified through the use of social reinforcement delivered by "clients." EXPERIMENTAL
Subiects-Interviewers The subjects were 32 students from the University of Illinois. Two subjects had to be eliminated; one because of inaudibility of the tape and the other in order that the design be balanced for statistical analysis. Thus, data from only 30 subjects were utilized. All were beyond the undergraduate level and taking courses in counseling or psychology, or were involved in social work. Subjects' participation
54
JUDITH COHEN CONGER
was solicited by the experimenter. Subjects were told that research was being conducted on short-term interviewing techniques; their aid as interviewers was being sought. They were told that they would be acting as therapists and interviewing "real clients" who had applied for aid at the University of Illinois Psychological Clinic. Further, they were told that experience was not relevant as there was evidence that inexperienced counselors or interviewers did just as well as experienced ones.
Stooges--Clients Two graduate students, one male (Cm) and one female (C~), roleplayed the "clients." The role was devised to present a person who was unhappy, mildly depressed, lacking in ambition and enthusiasm, experiencing vague anxiety feelings, and in general not gaining a great deal of sat~.sfaction from life.
Experimental Design Each of the 30 interviewers was randomly assigned to one of two "clients" (C~ or Cm) and to one of two experimental conditions (past or present target groups). Each "client" was seen by 15 interviewers, eight of whom were in the present target group (present tense verbs reinforced) and seven of whom were in the past target group (past tense verbs reinforced). The experimental session was divided into two sections; the baseline and acquisition periods, which consisted of 9 and 18 min, respectively. During baseline, clients were instructed to reinforce ever-] third interaction, since Heller, Davis, and Saunders (1964) found that complete silence depressed verbalization rates. An interaction was defined as a verbalization made by the interviewer consisting of a subject and a verb, which was preceded by an utterance or statement made by the client. Although clients were instructed to reinforce every third interaction, in order not to elevate any one class of verbs they were instructed to reinforce interactions containing the same tense only twice in succession. During the 18 minute acquisition period, clients attempted to reinforce all past or present statements depending on the response class that was the target behavior for the particular interviewer. Reinforcements consisted of eye contact, raising eyebrows, smiling, leaning toward the interviewer, increased voice volume and, in general, responding with interest and agreement with statements such as: "Yes--that's an important point," or "I've thought a lot about that."
Procedure The interviewer (subject) was asked to arrive 10 min earlier than the elient's scheduled appointment so that he could read the referral form, receive instructions and receive answers to any questions he might have had. The experimenter greeted the interviewer and took him to a small clinic room which is typieally used for psychotherapy and interviewing. To heighten the "legitimacy" of the situation the experimenter did his best to convey an air of seriousness and sobriety. The interviewer was asked to site behind the desk and was given written instructions about the orientation of the interview. In general, interviewers were asked to interview clients with a view to making some formulation about the client's problem areas (see Conger, 1988 for complete instructions), The experimenter then answered any questions the subject-interviewer might have had. The interviewer was then handed a referral form whieh consisted of a brief statement of the client's problem, and other descriptive information such as: age, place of birth, residence, etc. After
CLIENT-IV~ODIFIED INTERVIEW BEHAVIOR
55
the interviewers had been given these instructions, the experimenter left the experimental room and returned with the "client" who was introduced to the interviewer. The experimenter left and returned in 30 min. A postexperimental inquiry, as well as personality ratings, was then given to the interviewer (see Conger, 1968). A conditioning score based on the ratio, frequency of past verbs/frequency of past-~-present verbs, was calculated for each subject for both the baseline and acquisition periods. A difference between the ratio of the averages for both the operant and acquisition periods was obtained for each subject and a two-way fixed effects analysis of variance was calculated (Hays, 1963). TABLE 1 Summary of Interviewer Analyses Conditioning of past-present verbs
Talk-time
Interactions
Source
df
MS
F
MS
F
MS
F
Cf vs Cm P a v s Pr Interaction Error Total
1 1 1 26 29
429.04 572.30 373.14 175.66
2.44 3.26* 2.12
34.53 41.52 2.61 8.69
3.97* 4.78** --
2954.17 1.38 391.61 714.30
4,14" --
* p < .10.
** p < .05. The conditioning hypothesis is directional; however, comparisons based on an F test are nondirectional. Hence, significance at the a ~---.10 level with the means in the appropriate order is equivalent to doing a directional t test at the a ~ .05 level. Considering this, an overall conditioning effect was obtained at the p ~ .05 level; however, a nondirectional test would only yield a "trend" at the p ~ .10 level. Using the more conservative estimate a "trend" was obtained (p ~ .10) (see Table 1). Observation of the means for the individual groups, i.e., C~ past ~---4.5, Ct present ~ - - 4 . 0 , Cm past ~ - - 2 . 3 8 , Cm present ~---12.29, indicates that there was very little difference between the means of the past and present groups of C~; however, there was a notable difference between the means of past and present groups for C,, A t test for the difference between means for Cm was computed, using a pooled estimate of the variance. This yielded a t score of 2.19 (dr ~ 13), significant at the p < .025 level (one-tailed). Inter-rater reliability was .89 for past verbs and .97 for present verbs. In addition to the usual inter-rater reliability, an internal consistency analysis was computed on both past and present verb forms as well as the ratio scores derived from them. It can be seen that the reliability of the present tense verbs is much better than that of the past tense verbs. The reliability of the ratio used as the dependent measure is low. The lack of reliability increases the error variance which, in turn, increases the within group variance. This has the net effect of decreasing power or decreasing the probability of detecting a true difference. Thus, although a trend for conditioning was obtained, failure to achieve stronger results may be in part due to the problem of internal consistency of the response classes (Conger & Conger, 1970).
56
JUDITH COI4--EN CONGER TABLE 2 Internal Consistency Segments* Baseline 1 vs 2 and 3**
2 vs 3***
Acquisition Odd vs even segments
.64 .88 .61
.18 .86 .37
.45 .83 .17"***
Past verbs Present verbs Ratio P a / ( P a q- Pr)
* Three-rain segments. ** = 2r/(1 + r) (Spearman Brown). *** = 3r/(1 + 2r). **** Sum of odd ratios vs sum of even ratios. Total talk time was calculated for both clients and interviewers. Inter-rater reliability is .96 for interviewer talk time and .89 for client talk time. The results of the analysis for interviewer talk time are presented in Table 1. There was a significant main effect due only to condition, i.e., past vs present, b u t none to clients (although there was a trend, p < .10). The main effect was due to interviewers in the present target group talking more than those in the past target group. Also, interviewers in the present target group tended to talk most with Ct. Treatment means are C~ present ~ 13.69, Ct past --~ 10.69, Cm present -~ 10,95, C~ past ~ 9.24. Since Matarazzo (1965) had found that interviewer speech duration increased interviewee speech duration, it was thought that perhaps something of this nature had occurred, b u t with the influence being exerted in the opposite direction since it was "client" who was attempting the manipulation. TABLE 3 Analysis of Variance of Client Talk Time Source
SS
df
MS
F
C~ vs Cm Pa vs P r Interaction Error Total
171.50 4.96 13.90 77.90 266.26
1 1 1 26 29
171.50 4.96 13.90 3.0O
57.17'* 1.65 4.63*
* p < .05.
** p < .001. In contrast to the interviewer talk-time analysis, there is no difference in client talk time in the present-past target groups. To the contrary, there is a significant effect between clients regardless of the target group. Treatment means, i.e., Cf present ~ 10.29, Of past ~-~ 12,47, Cm present ~---6.22, Cm past ---~ 6.79, indicate that C~ talked significantly more than Cm who was remarkably consistent in his verbal output. Further, the significant interaction reflects the fact that C~ talked most in
CLIENT-MODIFIED INTERVIEW BEHAVIOR
57
the past condition. Both of these results are in opposition to the interviewer analysis where condition, i.e., past vs present, had an effect and interviewers "tended" to talk most in C/s present target group. The correlation between client talk time and interviewer talk time is --.17 which is consistent with the lack of relationship implied in the separate analyses of variance. An additional analysis was computed with the number of interviewer interactions. An interaction was defined as a verbalization made by the interviewer, consisting of a subject and a verb, which was preceded by an utterance or a statement made by the client. The length of the verbalization was not considered, merely the fact that the interviewer made an attempt to speak and that this unit of speech contained at least a subject and a verb. It was thought that the number of times an interviewer attempted to speak might be related to the client who was seen. This was considered simply because several of the interviewers who had interviewed Cm complained of "feeling forced" to talk. This certainly was not borne out in the talk-time analysis so that the possibility arose that, although interviewers who interviewed C,,~ did not talk more, they might have made more attempts at speech. An analysis of variance of clients by target groups yields an F - ~ 4.14 (elf 1, 26) due to clients. An F ~ 4.23 is needed for significance at the .05 levels (see Table 1 ). Thus, although not achieving significance, a trend is certainly indicated. Observation of the mean number of interactions (C, p r e s e n t : 7 4 . 2 3 , Ct past : 67.44, Cm present ~ 86.09, C,, : 95.14 ) indicates that the male client indeed "tended" to elicit more interactions than the female client. The following questions were asked after the experiment: "Did you have any suspicions prior to the interview?" and "Did you at any time question the authenticity of the client?". In response to the first question, 23 replied negatively and 7 positively. Of the seven positive responders, none verbalized suspicions, doubts, etc. which precluded their participation as subjects, i.e., no one verbalized the "real purpose" behind the experiment. In response to the second question, 24 responded negatively, 4 said the notion of a stooge had occurred at some time during the interview, but they dismissed it, and 2 said they thought it might be a stooge, but felt that it did not affect their own behavior. DISCUSSION W h i l e t h e r e has b e e n s o m e r e s e a r c h u s i n g t h e r a p i s t o r i n t e r v i e w e r b e h a v i o r as a d e p e n d e n t v a r i a b l e , t h e p r e s e n t w o r k r e p r e s e n t s a n initial a t t e m p t to e x p l o r e t h e m o d i f i a b i l i t y of i n t e r v i e w e r b e h a v i o r s v i a a v e r b a l c o n d i t i o n i n g p a r a d i g m . T h e analysis of v a r i a n c e y i e l d s a t r e n d in f a v o r of c o n d i t i o n i n g . Post h o c t tests i n d i c a t e t h a t Cm o b t a i n e d c o n d i t i o n i n g , m o s t n o t a b l y in his p a s t g r o u p . F u r t h e r analysis r e v e a l s t h a t interv i e w e r s a s s i g n e d to t h e p r e s e n t t a r g e t g r o u p t a l k e d significantly m o r e t h a n t h o s e in t h e p a s t t a r g e t g r o u p ; h o w e v e r , this d i d n o t a p p e a r to b e r e l a t e d to c l i e n t t a l k t i m e w h e r e b y Cf t a l k e d significantly m o r e t h a n Cm in b o t h t a r g e t groups. T h e r e was a t e n d e n c y for Cf to t a l k t h e m o s t w i t h t h e p a s t t a r g e t g r o u p ; h o w e v e r , this is n o t in line w i t h i n t e r v i e w e r results w h e r e b y t h e g r o u p w i t h t h e h i g h e s t m e a n t a l k t i m e was t h e p r e s e n t t a r g e t g r o u p of Cf. F u r t h e r , a l t h o u g h i n t e r v i e w e r t a l k t i m e d i d n o t a p p e a r to b e r e l a t e d to t h e c l i e n t w h o was i n t e r v i e w e d , t h e n u m b e r
58
JUDITH COHEN CONGER
of attempts made at speech by an interviewer did depend on the client seen.
Verbal conditioning, as such, is a phenomenon which has been amply demonstrated in many situations (Greenspoon, 1963; Krasner, 1958, 1961; Salzinger, 1959). Although this situation was reversed in the sense that it was the "subject" who was trying to influence the "experimenter," it still seems reasonable to expect that conditioning should occur. Moos and Clemes (1967), using a content analytic approach, found that therapists modified their verbal behavior with different patients more than patients modified their verbal behavior with different therapists. They suggest that therapists may be potentially more modifiable than patients during psychotherapy. There are several reasons for suspecting that the ambiguity of the results may stem from problems inherent in free operant methodology of verbal behavior. At first glance, the response class of past versus present verbs looks deceptively easy to discriminate; however, people tend to use rather complex verb forms in which are contained both past and present verbs. Add to this a fairly rapid speech pace and it becomes fairly difficult for the experimenter to direct reinforcement accurately to the appropriate response class. Thus, some responses would go unreinforced while some would be incorrectly reinforced. As such, one would expect the conditioning proccss to be retarded. Another problem which is raised is the choice of "reinforcers." Social behaviors, such as smiling, nodding, "mm-hmm's," have been shown to have reinforcing effects in various experimental situations (Greenspoon, 1962; Krasner, 1958, 1961; Salzinger, 1959). In a restricted experimental situation, where the subject is presented with a choice of only two responses, it would seem that "simple social reinforcement," i.e., "Mmhmm," would be effective simply because of its enhanced saliency due to a limited situation. "Simple reinforcers" have been effective in shaping various response classes in more complex situations, such as interviews (Salzinger & Pisoni, 1958). In these situations, however, it is usually the interviewer or therapist who is the reinforcing agent. Thus, it may be that, when emitted by a person who has the "dominant or authority role," these types of social behaviors function as reinforcers simply because they are indicative of approval by a high-prestige individual. If it is reasonable to assume the reinforcers may be role related, one might speculate as to the "inappropriateness" of the reinforcers used by clients in this experiment. In this situation the client, who might be conceptualized as the "nondominant" or "nonauthority member" of the dyad, was delivering reinforcers which were perhaps inconsistent with his role. In
CLIENT-MODIFIED INTERVIEW BEI-tAVIOI:I
59
other words, what functions as reinforcers for clients or subjects does not function as a reinforcer for the therapist. Thus, the client may have been emitting behaviors inconsistent with his role. The nature of the task should also be borne in mind. Interviewers were asked to interview the client with a view to making some formulation as to the nature of the client's problem. Thus, this task was structured so that it was at least a quasi-diagnostic interview. This is quite different from the Taffel or Greenspoon paradigm. Aside from the fact that it was the interviewer who was really the subject, which presents a marked departure from the traditional conditioning paradigm, the interviewer was also given a task to perform. A one- or two-session diagnostic interview is quite different from a continuous series of therapy interviews. In the former instance the task of information gathering has high priority; in the latter the establishment and maintenance of a "good relationship" probably precludes the information-gathering aspect, and as such the interviews are likely to be less structured and the pacing slower. Thus, it may be that, where there is an impending task to be completed in a relatively short period of time and the interviews are conducted in a semistructured manner, the interviewer may be less susceptible to client influence in the area of verbal behavior than in a situation where there is less immediate task orientation together with increased ambiguity with respect to structure. It would seem that, for investigators interested in studying behavioral influence within a quasi-psychotherapy situation, one interview is simply not enough. The "nature" of the interview changes over a course of 30 min. Moos and Clemes (1967) found that therapists ask more questions during the first half of an interview than during the last half. Also, the amount of verbal output by the therapist in terms of numbers of words spoken rises consistently during the last quarter of an interview. Karl and Abeles (1969) found that certain variables appeared consistently more frequently in some segments of an interview than in other segments. A better approach might be to conduct several interviews using the first two interviews for establishing a baseline. A free operant situation presents many difficulties in terms of noncontrolled external sources of variation. While verbal conditioning studies using limited response options are less troublesome methodologically, their generalizability would seem limited. Content-analytic studies, although a rich source of hypotheses, lack the experimental manipulation required to establish inferential relationships between variables. The author agrees with K.rasner (1963) that verbal conditioning studies are not "analogues" of psychotherapy in the sense that they
60
JUDITH COHEN CONGER
try to duplicate the same p h e n o m e n a as therapy, b u t rather are systematic attempts to delineate the effects of basic variables in behavioral influence situations. However, ff behavioral influence is mutual, then eventually one w o u l d expect to demonstrate this influence within the context of a p s y c h o t h e r a p e u t i c or quasi-psychotherapeutic situation with the influence being exerted b y the client. REFERENCES
BANDURA, A., Ln, saEn, D., & MmI_~a, P. Psychotherapists" approach-avoidance reactions to patients' expression of hostility. Journal of Consulting Psychology, 1960, 24, 1-8. CONCEB, J. C. The modification of therapist behavior by client use of social reinforcement. Unpublished doctoral dissertation, University of Illinois, 1968. CONCErt, J. C., & CONGER,A. Internal consistency of verbal response classes. Psychological Reports, 1970, 26, 777-778. CUTLER, R. L. Countertransference effects in psychotherapy. Journal of Consulting Psychology, 1958, 22, 349--356. GnEENSI'OON, J. Verbal conditioning and clinical psychology. In A. J. Bacbrach, (Ed.), Experimental Foundations of Clinical Psychology. New York: Basic Books, 1962, Pp. 510--553. HELLEB, K. Experimental analogues of psychotherapy: the clinical relevance of laboratory findings of social influence. The Journal of Nervous and Mental Disease, 1963, 137, 420--426. HELLEa, K., MYEaS, R. A., & KLINE, L. V. Interviewer behavior as a function of standardized client roles. Journal of Consulting Psychology, 1963, 27, 117-122. HELLEa, K., DAVXS,J., & SAUNDEaS, F. Clinical implications of laboratory studies of interpersonal style. Paper presented at the Midwestern Psychological Association, St. Louis, 1964. KAaL, J. K., & A~ELES, N. Psychotherapy Process as a function of the time segment sampled. Journal of Consulting and Clinical Psychology, 1969, 33, 207-212. KnASN~R, L. Studies of the conditioning of verbal behavior. Psychological Bulletin, 1958, 55, 148-170. KaASNEn, L. The therapist as a social reinforcement machine. Presented at the Second Conference on Research in Psychotherapy, University of North Carolina, Chapel Hill, May, 1961. KaASNER, L. Behavior control and social responsibility. American Psychologist, 1962, 17, 199-204. KRASNEa, L. Reinforcement, verbal behavior and psychotherapy. American ]ournal of Orthopsychiatry, 1963, 33, 601--613. MATAaAZZO, J. D. The interview. In B. B. Wohnan (Ed.), Handbook of Clinical Psychology. New York: McGraw-Hill, 1965, Pp. 403--450. Moos, R. H., & CLEMES, S. R. Multivariate study of the patient-therapist system. Journal of Consulting Psychology, 1967, 31, 119-130. RVSSELL, P. D., & S~DER, W. U. Counselor anxiety in relation to amount of clinical experience and quality of affect demonstrated by clients. Journal of Consulting Psychology, 1963, 27, 358-363. SALZINCEn, K. Experimental manipulation of verbal behavior: a review. ]ournal o] Genetic Psychology, 1959, 61, 65-94.
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SALZlNGEB, K., & PISONI, S. Reinforcement of affect responses of schizophrenics during clinical interview. Journal of Abnormal and Social Psychology, 1958, 57, 84-90. WILSON, W. C., & VEaPLANCK, W. S. Some observations on the reinforcement of verbal operants. American Journal of Psychology, 1956, 69, 448-451. WINDER, C. L., AHMAD, F. Z., BANDVaa, A., &RAtr, Lucy C. Dependency of patients, psychotherapists' responses, and aspects of psychotherapy. Journal o[ Consulting Psychology, 1962, 26, 129-134.
The Modification of Interview Behavior by Client Use of Social Reinforcement 1 JUDIT~ COHEN CONGEn-~
University of Illinois It was hypothesized that clients, through the use of social reinforcement, could alter the response classes of past or present verb forms emitted by interviewers. Two graduate students who acted the roles of "real clients" attempted this experimental manipulation in a 27-rain interview. Each "client" was interviewed by two groups of interviewers. The target response for one group was past verb forms and, for the other, present verb forms, An overall analysis indicated differences between clients and interviewers on such measures as total-talk time and number of interactions. Problems which arise in investigations of flee-operant verbal behavior and suggestions for future research are discussed. In recent years there has been a trend away from viewing the psychotherapeutic relationship as one surrounded by a special "mystery" or "'aura." Krasner (1962; p. 199) pointed out that "research in psychotherapy has increasingly focused on investigations which could be interpreted as being part of a broad psychology of behavior control." Much of the research relevant to and within psychotherapy proper tends to focus on the "behavior influencing characteristics" of the therapist, examiner, or experimenter. That is, subject or client behaviors are treated as the dependent variable. Far fewer studies have focused on the behavior influence of the client, i.e., where therapist or interviewer responses are considered as the dependent variable. Using tapes of therapy interviews, CuRer (1958) investigated countertransference and found a tendency for therapists to distort reports of patient behaviors which were need-relevant to the therapist. Bandura, Lipsher, and Miller (1960) investigated therapists' avoidance responses as related to patients' hostility. W h e n the therapist was the object of the patient's hostility, there was a tendency for all therapists to emit avoid1This paper was based on a portion of a dissertation submitted to the Department of Psychology, University of Illinois, in partial fulfillment of the requirements for the Ph.D. degree under the chairmanship of Leonard P. Ullmann. ~"Requests for reprints should be sent to: Judith Cohen Conger, c/o A. J. Conger, Psychology Department, University of North Carolina, Chapel Hill, N. C. 27514. 52
CLIENT-MODIFIED INTERVIEW BEHAVIOR
53
ance responses. However, when hostility was directed at other objects, it was found that therapists rated low in need-approval and high on direct expression of hostility made more approach responses than those rated high in need-approval and low on direct expression of hostility. Winder, Ahmad, Bandura, and Rau (1962) found that therapist's approach to dependency expression was associated with continuation of therapy and avoidance of dependency expressions was associated with termination. In a more experimental mode, Russell and Snyder (1963) used two actors to play the respective roles of a hostile and friendly client. Results indicated that hostile client behavior led to significantly greater therapist anxiety than did friendly behavior on three out of four measures. HeUer, Myers, and Kline (1963) using "stooges" to role play dominant-friendly, dominant-hostile, dependent-friendly, and dependent-hostile clients found that interviewers confronted with client friendliness responded with agreeable behavior, while interviewers confronted with hostility reacted with counter hostility. Given this background, the question arises whether "other" therapist behaviors are directly amenable to manipulation by clients. Krasner (1963; p. 603) pointed out that "behavioral control is a two-way affair and counter-controls are being asserted by the patients. Yet, part of the training of the therapist is to be able to counter the counter-controls and, to the extent that he can do so, he will be a successful therapist." Although there are few experimental investigations of this phenomenon, most contemporary views of psychotherapy assume a reciprocally contingent interaction between patient and therapist (Heller, 1963). The present study is a "pilot effort" since there has been no experimental investigation of client variables controlling therapist verbal behavior and the precise nature of the verbal classes of behavior which are controlled. The study was modeled after Russell and Snyder (1963). Unbeknown to an interviewer, a stooge, playing a client, attempted to influence his verbal behavior. It was hypothesized that interviewer verbal behavior, more specifically use of past and present verb forms, could be modified through the use of social reinforcement delivered by "clients." EXPERIMENTAL
Subiects-Interviewers The subjects were 32 students from the University of Illinois. Two subjects had to be eliminated; one because of inaudibility of the tape and the other in order that the design be balanced for statistical analysis. Thus, data from only 30 subjects were utilized. All were beyond the undergraduate level and taking courses in counseling or psychology, or were involved in social work. Subjects' participation
54
JUDITH COHEN CONGER
was solicited by the experimenter. Subjects were told that research was being conducted on short-term interviewing techniques; their aid as interviewers was being sought. They were told that they would be acting as therapists and interviewing "real clients" who had applied for aid at the University of Illinois Psychological Clinic. Further, they were told that experience was not relevant as there was evidence that inexperienced counselors or interviewers did just as well as experienced ones.
Stooges--Clients Two graduate students, one male (Cm) and one female (C~), roleplayed the "clients." The role was devised to present a person who was unhappy, mildly depressed, lacking in ambition and enthusiasm, experiencing vague anxiety feelings, and in general not gaining a great deal of sat~.sfaction from life.
Experimental Design Each of the 30 interviewers was randomly assigned to one of two "clients" (C~ or Cm) and to one of two experimental conditions (past or present target groups). Each "client" was seen by 15 interviewers, eight of whom were in the present target group (present tense verbs reinforced) and seven of whom were in the past target group (past tense verbs reinforced). The experimental session was divided into two sections; the baseline and acquisition periods, which consisted of 9 and 18 min, respectively. During baseline, clients were instructed to reinforce ever-] third interaction, since Heller, Davis, and Saunders (1964) found that complete silence depressed verbalization rates. An interaction was defined as a verbalization made by the interviewer consisting of a subject and a verb, which was preceded by an utterance or statement made by the client. Although clients were instructed to reinforce every third interaction, in order not to elevate any one class of verbs they were instructed to reinforce interactions containing the same tense only twice in succession. During the 18 minute acquisition period, clients attempted to reinforce all past or present statements depending on the response class that was the target behavior for the particular interviewer. Reinforcements consisted of eye contact, raising eyebrows, smiling, leaning toward the interviewer, increased voice volume and, in general, responding with interest and agreement with statements such as: "Yes--that's an important point," or "I've thought a lot about that."
Procedure The interviewer (subject) was asked to arrive 10 min earlier than the elient's scheduled appointment so that he could read the referral form, receive instructions and receive answers to any questions he might have had. The experimenter greeted the interviewer and took him to a small clinic room which is typieally used for psychotherapy and interviewing. To heighten the "legitimacy" of the situation the experimenter did his best to convey an air of seriousness and sobriety. The interviewer was asked to site behind the desk and was given written instructions about the orientation of the interview. In general, interviewers were asked to interview clients with a view to making some formulation about the client's problem areas (see Conger, 1988 for complete instructions), The experimenter then answered any questions the subject-interviewer might have had. The interviewer was then handed a referral form whieh consisted of a brief statement of the client's problem, and other descriptive information such as: age, place of birth, residence, etc. After
CLIENT-IV~ODIFIED INTERVIEW BEHAVIOR
55
the interviewers had been given these instructions, the experimenter left the experimental room and returned with the "client" who was introduced to the interviewer. The experimenter left and returned in 30 min. A postexperimental inquiry, as well as personality ratings, was then given to the interviewer (see Conger, 1968). A conditioning score based on the ratio, frequency of past verbs/frequency of past-~-present verbs, was calculated for each subject for both the baseline and acquisition periods. A difference between the ratio of the averages for both the operant and acquisition periods was obtained for each subject and a two-way fixed effects analysis of variance was calculated (Hays, 1963). TABLE 1 Summary of Interviewer Analyses Conditioning of past-present verbs
Talk-time
Interactions
Source
df
MS
F
MS
F
MS
F
Cf vs Cm P a v s Pr Interaction Error Total
1 1 1 26 29
429.04 572.30 373.14 175.66
2.44 3.26* 2.12
34.53 41.52 2.61 8.69
3.97* 4.78** --
2954.17 1.38 391.61 714.30
4,14" --
* p < .10.
** p < .05. The conditioning hypothesis is directional; however, comparisons based on an F test are nondirectional. Hence, significance at the a ~---.10 level with the means in the appropriate order is equivalent to doing a directional t test at the a ~ .05 level. Considering this, an overall conditioning effect was obtained at the p ~ .05 level; however, a nondirectional test would only yield a "trend" at the p ~ .10 level. Using the more conservative estimate a "trend" was obtained (p ~ .10) (see Table 1). Observation of the means for the individual groups, i.e., C~ past ~---4.5, Ct present ~ - - 4 . 0 , Cm past ~ - - 2 . 3 8 , Cm present ~---12.29, indicates that there was very little difference between the means of the past and present groups of C~; however, there was a notable difference between the means of past and present groups for C,, A t test for the difference between means for Cm was computed, using a pooled estimate of the variance. This yielded a t score of 2.19 (dr ~ 13), significant at the p < .025 level (one-tailed). Inter-rater reliability was .89 for past verbs and .97 for present verbs. In addition to the usual inter-rater reliability, an internal consistency analysis was computed on both past and present verb forms as well as the ratio scores derived from them. It can be seen that the reliability of the present tense verbs is much better than that of the past tense verbs. The reliability of the ratio used as the dependent measure is low. The lack of reliability increases the error variance which, in turn, increases the within group variance. This has the net effect of decreasing power or decreasing the probability of detecting a true difference. Thus, although a trend for conditioning was obtained, failure to achieve stronger results may be in part due to the problem of internal consistency of the response classes (Conger & Conger, 1970).
56
JUDITH COI4--EN CONGER TABLE 2 Internal Consistency Segments* Baseline 1 vs 2 and 3**
2 vs 3***
Acquisition Odd vs even segments
.64 .88 .61
.18 .86 .37
.45 .83 .17"***
Past verbs Present verbs Ratio P a / ( P a q- Pr)
* Three-rain segments. ** = 2r/(1 + r) (Spearman Brown). *** = 3r/(1 + 2r). **** Sum of odd ratios vs sum of even ratios. Total talk time was calculated for both clients and interviewers. Inter-rater reliability is .96 for interviewer talk time and .89 for client talk time. The results of the analysis for interviewer talk time are presented in Table 1. There was a significant main effect due only to condition, i.e., past vs present, b u t none to clients (although there was a trend, p < .10). The main effect was due to interviewers in the present target group talking more than those in the past target group. Also, interviewers in the present target group tended to talk most with Ct. Treatment means are C~ present ~ 13.69, Ct past --~ 10.69, Cm present -~ 10,95, C~ past ~ 9.24. Since Matarazzo (1965) had found that interviewer speech duration increased interviewee speech duration, it was thought that perhaps something of this nature had occurred, b u t with the influence being exerted in the opposite direction since it was "client" who was attempting the manipulation. TABLE 3 Analysis of Variance of Client Talk Time Source
SS
df
MS
F
C~ vs Cm Pa vs P r Interaction Error Total
171.50 4.96 13.90 77.90 266.26
1 1 1 26 29
171.50 4.96 13.90 3.0O
57.17'* 1.65 4.63*
* p < .05.
** p < .001. In contrast to the interviewer talk-time analysis, there is no difference in client talk time in the present-past target groups. To the contrary, there is a significant effect between clients regardless of the target group. Treatment means, i.e., Cf present ~ 10.29, Of past ~-~ 12,47, Cm present ~---6.22, Cm past ---~ 6.79, indicate that C~ talked significantly more than Cm who was remarkably consistent in his verbal output. Further, the significant interaction reflects the fact that C~ talked most in
CLIENT-MODIFIED INTERVIEW BEHAVIOR
57
the past condition. Both of these results are in opposition to the interviewer analysis where condition, i.e., past vs present, had an effect and interviewers "tended" to talk most in C/s present target group. The correlation between client talk time and interviewer talk time is --.17 which is consistent with the lack of relationship implied in the separate analyses of variance. An additional analysis was computed with the number of interviewer interactions. An interaction was defined as a verbalization made by the interviewer, consisting of a subject and a verb, which was preceded by an utterance or a statement made by the client. The length of the verbalization was not considered, merely the fact that the interviewer made an attempt to speak and that this unit of speech contained at least a subject and a verb. It was thought that the number of times an interviewer attempted to speak might be related to the client who was seen. This was considered simply because several of the interviewers who had interviewed Cm complained of "feeling forced" to talk. This certainly was not borne out in the talk-time analysis so that the possibility arose that, although interviewers who interviewed C,,~ did not talk more, they might have made more attempts at speech. An analysis of variance of clients by target groups yields an F - ~ 4.14 (elf 1, 26) due to clients. An F ~ 4.23 is needed for significance at the .05 levels (see Table 1 ). Thus, although not achieving significance, a trend is certainly indicated. Observation of the mean number of interactions (C, p r e s e n t : 7 4 . 2 3 , Ct past : 67.44, Cm present ~ 86.09, C,, : 95.14 ) indicates that the male client indeed "tended" to elicit more interactions than the female client. The following questions were asked after the experiment: "Did you have any suspicions prior to the interview?" and "Did you at any time question the authenticity of the client?". In response to the first question, 23 replied negatively and 7 positively. Of the seven positive responders, none verbalized suspicions, doubts, etc. which precluded their participation as subjects, i.e., no one verbalized the "real purpose" behind the experiment. In response to the second question, 24 responded negatively, 4 said the notion of a stooge had occurred at some time during the interview, but they dismissed it, and 2 said they thought it might be a stooge, but felt that it did not affect their own behavior. DISCUSSION W h i l e t h e r e has b e e n s o m e r e s e a r c h u s i n g t h e r a p i s t o r i n t e r v i e w e r b e h a v i o r as a d e p e n d e n t v a r i a b l e , t h e p r e s e n t w o r k r e p r e s e n t s a n initial a t t e m p t to e x p l o r e t h e m o d i f i a b i l i t y of i n t e r v i e w e r b e h a v i o r s v i a a v e r b a l c o n d i t i o n i n g p a r a d i g m . T h e analysis of v a r i a n c e y i e l d s a t r e n d in f a v o r of c o n d i t i o n i n g . Post h o c t tests i n d i c a t e t h a t Cm o b t a i n e d c o n d i t i o n i n g , m o s t n o t a b l y in his p a s t g r o u p . F u r t h e r analysis r e v e a l s t h a t interv i e w e r s a s s i g n e d to t h e p r e s e n t t a r g e t g r o u p t a l k e d significantly m o r e t h a n t h o s e in t h e p a s t t a r g e t g r o u p ; h o w e v e r , this d i d n o t a p p e a r to b e r e l a t e d to c l i e n t t a l k t i m e w h e r e b y Cf t a l k e d significantly m o r e t h a n Cm in b o t h t a r g e t groups. T h e r e was a t e n d e n c y for Cf to t a l k t h e m o s t w i t h t h e p a s t t a r g e t g r o u p ; h o w e v e r , this is n o t in line w i t h i n t e r v i e w e r results w h e r e b y t h e g r o u p w i t h t h e h i g h e s t m e a n t a l k t i m e was t h e p r e s e n t t a r g e t g r o u p of Cf. F u r t h e r , a l t h o u g h i n t e r v i e w e r t a l k t i m e d i d n o t a p p e a r to b e r e l a t e d to t h e c l i e n t w h o was i n t e r v i e w e d , t h e n u m b e r
58
JUDITH COHEN CONGER
of attempts made at speech by an interviewer did depend on the client seen.
Verbal conditioning, as such, is a phenomenon which has been amply demonstrated in many situations (Greenspoon, 1963; Krasner, 1958, 1961; Salzinger, 1959). Although this situation was reversed in the sense that it was the "subject" who was trying to influence the "experimenter," it still seems reasonable to expect that conditioning should occur. Moos and Clemes (1967), using a content analytic approach, found that therapists modified their verbal behavior with different patients more than patients modified their verbal behavior with different therapists. They suggest that therapists may be potentially more modifiable than patients during psychotherapy. There are several reasons for suspecting that the ambiguity of the results may stem from problems inherent in free operant methodology of verbal behavior. At first glance, the response class of past versus present verbs looks deceptively easy to discriminate; however, people tend to use rather complex verb forms in which are contained both past and present verbs. Add to this a fairly rapid speech pace and it becomes fairly difficult for the experimenter to direct reinforcement accurately to the appropriate response class. Thus, some responses would go unreinforced while some would be incorrectly reinforced. As such, one would expect the conditioning proccss to be retarded. Another problem which is raised is the choice of "reinforcers." Social behaviors, such as smiling, nodding, "mm-hmm's," have been shown to have reinforcing effects in various experimental situations (Greenspoon, 1962; Krasner, 1958, 1961; Salzinger, 1959). In a restricted experimental situation, where the subject is presented with a choice of only two responses, it would seem that "simple social reinforcement," i.e., "Mmhmm," would be effective simply because of its enhanced saliency due to a limited situation. "Simple reinforcers" have been effective in shaping various response classes in more complex situations, such as interviews (Salzinger & Pisoni, 1958). In these situations, however, it is usually the interviewer or therapist who is the reinforcing agent. Thus, it may be that, when emitted by a person who has the "dominant or authority role," these types of social behaviors function as reinforcers simply because they are indicative of approval by a high-prestige individual. If it is reasonable to assume the reinforcers may be role related, one might speculate as to the "inappropriateness" of the reinforcers used by clients in this experiment. In this situation the client, who might be conceptualized as the "nondominant" or "nonauthority member" of the dyad, was delivering reinforcers which were perhaps inconsistent with his role. In
CLIENT-MODIFIED INTERVIEW BEI-tAVIOI:I
59
other words, what functions as reinforcers for clients or subjects does not function as a reinforcer for the therapist. Thus, the client may have been emitting behaviors inconsistent with his role. The nature of the task should also be borne in mind. Interviewers were asked to interview the client with a view to making some formulation as to the nature of the client's problem. Thus, this task was structured so that it was at least a quasi-diagnostic interview. This is quite different from the Taffel or Greenspoon paradigm. Aside from the fact that it was the interviewer who was really the subject, which presents a marked departure from the traditional conditioning paradigm, the interviewer was also given a task to perform. A one- or two-session diagnostic interview is quite different from a continuous series of therapy interviews. In the former instance the task of information gathering has high priority; in the latter the establishment and maintenance of a "good relationship" probably precludes the information-gathering aspect, and as such the interviews are likely to be less structured and the pacing slower. Thus, it may be that, where there is an impending task to be completed in a relatively short period of time and the interviews are conducted in a semistructured manner, the interviewer may be less susceptible to client influence in the area of verbal behavior than in a situation where there is less immediate task orientation together with increased ambiguity with respect to structure. It would seem that, for investigators interested in studying behavioral influence within a quasi-psychotherapy situation, one interview is simply not enough. The "nature" of the interview changes over a course of 30 min. Moos and Clemes (1967) found that therapists ask more questions during the first half of an interview than during the last half. Also, the amount of verbal output by the therapist in terms of numbers of words spoken rises consistently during the last quarter of an interview. Karl and Abeles (1969) found that certain variables appeared consistently more frequently in some segments of an interview than in other segments. A better approach might be to conduct several interviews using the first two interviews for establishing a baseline. A free operant situation presents many difficulties in terms of noncontrolled external sources of variation. While verbal conditioning studies using limited response options are less troublesome methodologically, their generalizability would seem limited. Content-analytic studies, although a rich source of hypotheses, lack the experimental manipulation required to establish inferential relationships between variables. The author agrees with K.rasner (1963) that verbal conditioning studies are not "analogues" of psychotherapy in the sense that they
60
JUDITH COHEN CONGER
try to duplicate the same p h e n o m e n a as therapy, b u t rather are systematic attempts to delineate the effects of basic variables in behavioral influence situations. However, ff behavioral influence is mutual, then eventually one w o u l d expect to demonstrate this influence within the context of a p s y c h o t h e r a p e u t i c or quasi-psychotherapeutic situation with the influence being exerted b y the client. REFERENCES
BANDURA, A., Ln, saEn, D., & MmI_~a, P. Psychotherapists" approach-avoidance reactions to patients' expression of hostility. Journal of Consulting Psychology, 1960, 24, 1-8. CONCEB, J. C. The modification of therapist behavior by client use of social reinforcement. Unpublished doctoral dissertation, University of Illinois, 1968. CONCErt, J. C., & CONGER,A. Internal consistency of verbal response classes. Psychological Reports, 1970, 26, 777-778. CUTLER, R. L. Countertransference effects in psychotherapy. Journal of Consulting Psychology, 1958, 22, 349--356. GnEENSI'OON, J. Verbal conditioning and clinical psychology. In A. J. Bacbrach, (Ed.), Experimental Foundations of Clinical Psychology. New York: Basic Books, 1962, Pp. 510--553. HELLEB, K. Experimental analogues of psychotherapy: the clinical relevance of laboratory findings of social influence. The Journal of Nervous and Mental Disease, 1963, 137, 420--426. HELLEa, K., MYEaS, R. A., & KLINE, L. V. Interviewer behavior as a function of standardized client roles. Journal of Consulting Psychology, 1963, 27, 117-122. HELLEa, K., DAVXS,J., & SAUNDEaS, F. Clinical implications of laboratory studies of interpersonal style. Paper presented at the Midwestern Psychological Association, St. Louis, 1964. KAaL, J. K., & A~ELES, N. Psychotherapy Process as a function of the time segment sampled. Journal of Consulting and Clinical Psychology, 1969, 33, 207-212. KnASN~R, L. Studies of the conditioning of verbal behavior. Psychological Bulletin, 1958, 55, 148-170. KaASNEn, L. The therapist as a social reinforcement machine. Presented at the Second Conference on Research in Psychotherapy, University of North Carolina, Chapel Hill, May, 1961. KaASNER, L. Behavior control and social responsibility. American Psychologist, 1962, 17, 199-204. KRASNEa, L. Reinforcement, verbal behavior and psychotherapy. American ]ournal of Orthopsychiatry, 1963, 33, 601--613. MATAaAZZO, J. D. The interview. In B. B. Wohnan (Ed.), Handbook of Clinical Psychology. New York: McGraw-Hill, 1965, Pp. 403--450. Moos, R. H., & CLEMES, S. R. Multivariate study of the patient-therapist system. Journal of Consulting Psychology, 1967, 31, 119-130. RVSSELL, P. D., & S~DER, W. U. Counselor anxiety in relation to amount of clinical experience and quality of affect demonstrated by clients. Journal of Consulting Psychology, 1963, 27, 358-363. SALZINCEn, K. Experimental manipulation of verbal behavior: a review. ]ournal o] Genetic Psychology, 1959, 61, 65-94.
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SALZlNGEB, K., & PISONI, S. Reinforcement of affect responses of schizophrenics during clinical interview. Journal of Abnormal and Social Psychology, 1958, 57, 84-90. WILSON, W. C., & VEaPLANCK, W. S. Some observations on the reinforcement of verbal operants. American Journal of Psychology, 1956, 69, 448-451. WINDER, C. L., AHMAD, F. Z., BANDVaa, A., &RAtr, Lucy C. Dependency of patients, psychotherapists' responses, and aspects of psychotherapy. Journal o[ Consulting Psychology, 1962, 26, 129-134.