Examination of the effects of pre-counseling treatment strategies on prospective client self-efficacy and readiness for change in counseling

165 Pages·2002·6.3 MB·English

by  Cox, David Kent

ANEXAMINATIONOFTHEEFFECTSOFPRE-COUNSELINGTREATMENT
STRATEGIESONPROSPECTIVECLIENTSELF-EFFICACYANDREADINESS
FORCHANGEINCOUNSELING
By
DAVIDKENTCOX
ADISSERTATIONPRESENTED.TOTHEGRADUATESCHOOLOFTHE
UNIVERSITYOFFLORIDAINPARTIALFULFUILLMENTOFTHE
REQUIREMENTSFORTHEDEGREEOFDOCTOROFPHILOSOPHY
UNTVERSITYOFFLORIDA
2002
Copyright2002
by
DAVIDKENTCOX
ACKNOWLEDGMENTS
Ihonorthefollowingwithgreatappreciationandgratitude.Theirhelp,guidance,
wisdomandleadershipservedtosustainmethroughthisextremelyrewardingand
challengingdoctoralprocess.
Firstandforemost,IhonorGod;withoutthepowerofhiscreation,andhis
guidanceandwisdom,noneofanyofthiswouldhavebeenpossible.Second,Ihonorand
thankmywife,Alison.Hergreatloveandsupportthroughoutmysevenyearsofgraduate
schoolarebeyondmeasure;languagefailstocapturehowmuchhersupportmeanttome
duringthemoretryingmomentsofthisprotractedprocess.Third,Ihonormychildren,
JordynandKyle. JordynenteredthisworldthreeweeksbeforeIbeganmydoctoral
studies;herentranceintothisworldhasmademylifeexperiencessomuchmoreloving,
richandmeaningful.ToKyle,myson,whoseendlesslove,smilesandlaughterserved
andcontinuetoserveasagentleremindertoenjoythejourneywhilenotfocusingso
muchonthedestination.
SpecialthanksgotoDr.JimArcher,myadvisor,whoseexpertguidanceand
instructionhelpedmenavigatethroughtheintricaciesanddifficultiesofmydissertation.
ThanksalsogotoDr.DavidMiller,Dr.HarryDaniels,andDr.MarshallKnudson,who
allservedonmycommitteeandwereeagertohelp.IthankMarshallforhis
understandingandsupport. VeryspecialthanksgotoSaraSummerfieldforher
dedicationandworkinhelpingmeformatmydissertationandhelpingmeentermydata
ill
andtoBeverlyBuckleyforherideasandhelpregardingthegraphicdesignofmy
literaturetreatmentgroup.
SpecialthanksalsogotoDr.JamesAlgina.whosetime,patience,willingnessto
helpandclassroominstructionservedmetremendouslywiththerigorofstatisticswhile
shapingmythinkingasascientificresearcher.Specialthanksalsogotoformer
professorsDr.J.WalterWeingartatWhitmanCollege,Dr.JohnMeany,Seattle
University,andDr.SonnyCytrynbaumandDr.JohnLyonsatNorthwesternUniversity,
whowereallinstrumentalinpromotingmyearlyacademicdevelopmentregarding
improvedstudyhabits,criticalthinkingandoverall,scholasticexcellence.
Veryspecialthanksgotopersonalanddeepfriend,Dr.MarkGignac,whose
sharedloveofEasternphilosophy,Rumi,spirituality,psychology,andthespacious
questionsofthecosmoshelpedkeepmetrueandfocusedtowhatreallymatters.And
specialthanksgotofriendWilliamCorley,whoseacademicexcellenceduringmyhigh
schoolyearsinSeattleandcollegedaysatWhitmanservedtomodelgreaterscholarship
inmyself. IthankBryanRobinsonforhisgreatfriendshipovertheyearswhilediverting
meawayfrommystudies,towardtalkofhoops,theLakersandMJ.AndIthankJimand
Dianaforputtingupwithmeforninemonthswhileputtingmeupattheirresidence
whiletravelingtoChicagotofinishmymastersatNorthwestern.
Lastly,withspeciallovetomymother,whoseunconditionalloveandsupport
overtheyearshasbeenwonderful.WegowaybackMom.Andtomyfather,who
indirectlyshowedmehowimportantitisforgenerationstoimprove,howcriticalitisto
becomeagoodfatherandhusband,hownevertoquit,andhowtruethatifweimagine,
likeJohnLennon,thattheworldisone,thatintheend,allweneedislove.
IV
TABLEOFCONTENTS
ACKNOWLEDGEMENTS in
ABSTRACT
viii
CHAPTER
1 INTRODUCTION 1
StatementoftheProblem 1
NeedfortheStudy 3
PurposeoftheStudy 5
BackgroundoftheProblem 7
OrganizationoftheStudy '. 13
GeneralResearchQuestions 13
DefinitionofTerms 14
2 REVIEWOFTHELITERATURE 16
Self-Efficacy 16
Self-EfficacyResearch 16
CounselingSelf-EfficacyResearch 17
TheoreticalFrameworkofSelf-Efficacy 18
StudiestoIncreaseTheoreticalComponentsofSelf-Efficacy 19
TheRoleofSelf-EfficacyonCopingPerformance 21
Social-CognitiveTheory 23
TheLevel,Strength,andGeneralityofSelf-Efficacy 24
TheRoleofPersonalAgencyinCounseling 30
TheAssociationofSelf-EfficacywithMotivationinCounseling 32
Motivation 33
MotivationandPersonalityTheory 34
DifferentTheoriesonMotivation 35
MotivationandCognitiveDissonance 37
MotivationalInterviewing 37
MotivationandPersonalExpectations 39
MotivationandGoalSetting 39
MotivationinStages/Prochaska 40
MotivationandMeasurementStudies/Prochaska,DiClemente,Isenhart 42
GeneralTrainingStrategies 47
DateRapeAwareness 4g
Pre-testHIV/AIDSCounseling 51
ProspectiveFacultyTraining 51
RATraining 52
SpecificPre-CounselingTreatmentMethods 54
VideotapeinCounseling 54
Role-Plays 57
CounselingLiterature ... 62
Conclusion 64
3 METHODOLOGY 71
StatementofPurpose 71
Hypotheses 71
DelineationofRelevantVariables 73
DependentVariables 73
IndependentVariables 73
Population 74
SamplingProcedures 74
ExperimentalProcedures 76
DataCollectionProcedures 78
Instrumentation 78
CSEBS 78
URICA 79
DataAnalyticProcedures 82
LimitationsoftheStudy 84
4 DATAANALYSISANDRESULTS 86
SummaryandChapterOverview 86
DataCollectionandResponseRates 86
DescriptiveData 88
ReliabilityEstimatesforCSEBSandURICA 86
AnalysisProcedures 89
ResultsofHypothesesTests 100
Summary 102
5 DISCUSSION 105
Summary 105
DiscussionofResults 106
TheoreticalImplicationsoftheStudy Ill
ClinicalImplicationsoftheStudy 113
LimitationsoftheStudy 115
ResearchImplications 118
FutureRecommendationsforResearch 118
Conclusion 120
APPENDDC 121
A INFORMEDCONSENT 121
B ROLE-PLAYSCRIPT 122
C VIDEOSCRIPTOFROLE-PLAY 123
VI
D COUNSELINGLITERATURE 125
E COUNSELINGBROCHURE 128
F COUNSELINGQUIZ 131
G SURVEY 132
H IRBFORM 133
I ROLE-PLAYINSTRUCTIONS 135
J FOLLOW-UPSURVEYTOSEEKCOUNSELING 136
K URICAMEASURE 137
REFERENCES 139
vn
AbstractofDissertationPresentedtotheGraduateSchooloftheUniversityof
FloridainPartialFulfillmentoftheRequirementsfortheDegreeofDoctorofPhilosophy
ANEXAMINATIONOFTHEEFFECTSOFPRE-COUNSELINGTREATMENT
STRATEGIESONPROSPECTIVECLIENTSELF-EFFICACYANDREADINESS
FORCHANGEINCOUNSELING
By
DavidKentCox
December2002
Chairperson:JamesArcher,Jr.
MajorDepartment:CounselorEducation
Inorderthatclientsmaximizetheservicesofferedtothem,itiscrucialthat
counselorsfocusonmethodsofincreasingclientself-efficacyandmotivationearlyin
counseling.Thus,thepurposeofthisstudywastodocumenttheeffectivenessofthree
pre-counselingtreatmentsonprospectiveclientself-efficacyandmotivation,asa
functionofreadinessforcounseling.Themajorityofresearchonself-efficacyhas
emergedfromsocial-cognitivetheoryandcontextsotherthancounseling.Further,much
ofourunderstandingofmotivationandreadinessforcounselinghasitsgenesisin
substanceabuseresearch.Studiesexaminingbothself-efficacyandmotivationtogether
areoftenrestrictedtoattrition.Therefore,empiricalstudiesthatlinktreatmentson
improvingprospectiveclientself-efficacyandreadinesstocounselingappearwarranted.
Empiricalresearchfocusingonthesetwoimportantclinicalvariablescanalsobe
Vlll
improvedwithgreatersamplesizes,participantsthatarerandomlyassigned,andmore
reliableandvalidmeasures.
Approximately400studentsweresurveyedtoassesswillingnesstodiscussa
problemincounseling.Afterattrition,119studentswereselectedfromexclusionary
criteriainordertoapproximaterealclients.Participantswererandomlyassignedtoone
offourgroups:threetreatmentgroups—counselingrole-play,acounselingvideo,and
counselingliterature—orafourth,notreatmentcontrolgroup,toexaminetreatment
effectsonprospectivesubjectself-efficacyandreadinessforcounseling,asafunctionof
motivation.Also,gender,treatment,counselingself-efficacyandreadinessforchange
wereanalyzedseparatelytodeterminefollow-upinterestinseekingcounselingasadirect
resultofstudentparticipationinthisstudy.
Resultsweregeneratedfromfivemodels.Resultsfromfourdifferent2x4
ANOVAmodelsindicatednosignificanttreatmentinteractionwithgenderinpredicting
counselingreadinessandself-efficacy.Separately,femalegendersignificantlypredicted
readinessforcounseling,andself-efficacypredictedtotalreadinessscore.Inthefifth
model,treatment,self-efficacyandreadinessforcounselingseparatelypredicted
willingnesstoseekpost-testcounseling;genderwasnotsignificant.However,when
readinessforcounselingwasadded,thetreatmenteffectbecamenon-significantin
predictingfollow-up,thusdemonstratingthemediatingeffectofreadinessontreatmentin
seekingpost-testcounseling.Limitations,implicationsofthestudyanddirectionsfor
futureresearchwerealsodiscussed.
IX
CHAPTER
1
INTRODUCTION
StatementoftheProblem
Onechallengethatclinicianscurrentlyencounterisprovidingcost-effective
counselinginamanagedcareenvironment(Lyons,1997;Hoyt,1995).Asaresult,there
isaprofoundneedforcounselorstoutilizeresourcesandtreatmentplanningas
efficientlyandeffectivelyaspossible.Thus,empiricallydriventreatmentsthatincrease
prospectiveclientself-efficacyandmotivationtochange(Longo,LentandBrown,1992;
Longo,1991)earlyinthecounselingprocessappearwarranted. Additionally,empirical
researchthatinformstreatmentprovidersonhowtoincreaseclientself-efficacyand
motivation(Longoetal.,1992;Mennicke,1988)isneededinordertominimize
prematuretermination.
Theoriesonself-efficacyhavewideapplicationincounseling.Self-efficacy
(Bandura,1997,1986,1977),definedasone'sbeliefinone'scapabilitytoexecutea
specifictaskorseriesoftasks,hasbeenexaminedandappliedtocounselingoutcome
researchregardingalcoholconsumption(Tran,HaagaandChambless,1997)substance
abuse(Burke,1998;Walton,1995),stressmanagement(Wiedenfeldetal.1990),positive
self-concept(Harrisonetal,1997),motivationandclientattrition(Longo,Lentand
Brown,1992).
Themajorityofcounselingself-efficacyresearchtargetssubstanceabusetreatment
contexts(DiClementeandNorcross1992;MillerandRollnick,1991;Prochaska,