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