P~ychologicdReports, 1978, 43, 1003-1008. @ Psychological Reports 1978 IS THERE A PLACE FOR PROGRAMMED INSTRUCTION TRAINING I N PSYCHOTHERAPY? PAT SMITH Delgado College -. . . . Ill; : Summary.-Mastery of technical and theoretical &p.ects of systems of psychotherapy is incomplete without development of similar skills in building of relationships. Programmed instruction in interpersonal facilitative behavior seems to have potential for inclusion in training in psychotherapy.
KENNETH N. ANCHOR Geovge Peabody College for Teachers
If the skills and personal qualities requisite for s'uccessful practice of psychotherapy were known, questions ebout training desiderata would not have to be raised. At present, however, convictions about training tend to reflect theoretical predilections which, in turn, depend latgely on personal preference and one's most charismatic supervisor. Thus, analytic apprentices are taught to be aloof and incisive, aspiring humanists are amointed in self-liberating experiential encounters, and neophyte social engineers are shaped to be judicious distributors of valued reinforcements. Meanwhile the breeding of paraprofessionals with a community fervor continues apace (Roback, Abramowitz, & Strassberg, 1978). The advent of empirical arbitration of disputes over whether, how much, and which training is necessary is unlikely to bring speedy redress because the underlying issues are rooted in sensitive professional and ideological commitments. In spite of the above differences, most psychotherapists would agree that the quality of the patient-therapist relationship relates to therapeutic outcome; thus it is surprising how little formal training exists for skill in building relationships in curricula for psychotherapy. Rather the thrust of psychotherapeutic training appears oriented toward theoretical, technical, and conceptual issues. Perhaps one r w n for this is the enormous difficulty in knowing how to teach psychotherapeutic intervention skills. The current paper discusses ( a ) behaviors in building relationships, (b) programmed instruction in development of interpersonal skills, and ( c ) studies employing this module, and concludes with a few words on the potential far such an instructional program in psychotherapy.
Relationrhip-orientedBehaviors It is the authors' contention that behaviors in building relationships, such as congruence, unconditional positive regard, and empathy which have been demonstrated empirically (Truax & Carkhuff, 1967) to relate to therapeutic outcome with mildly maladjusted persons, can be taught effectively through programmed instruction.
1004
K. N. ANCHOR
&
P. SMITH
Congruence, or genuineness, refers to the accurate matching of experience and awareness. When there is an incongruence between experience and awareness, it is u s u d y spoken of as defensiveness or denial to awareness. The concept of congruence can be extended to cover a matching of experience, awareness, and communication. An example of incongruence of awareness and experiencing and communication is the bored guest who insists he is having a wonderful time. Here, the guest may be unaware of the incongruence between his real feeling of boredom and his desire to be polite. When the incongruence is between awareness and conun~inication,it may be thought of as falseness or deceit. Empathy is the ability to sense another person's inner world of private personal meanings as if it were one's own but without ever losing the "as if" quality. Empathy is the capacity to understand the inner world of another and to communicaix something of that understanding to him, while maintaining one's own identity. When one feels that his communication has been clearly perceived and understood by another, he will be likely to share more of his experiences with that person as well as to bring more of his experiences into his own awareness. In doing this, he becomes less defensive and more congment (Rogers, 1961) . Unconditional positive regard is prizing another person regardless of his particular behavior at the moment; it is a prizing in a total rather than in a conditional way. Unconditional positive regard implies unconditional acceptance of the individual as a person, and it is characterized by an ongoing positive feeling without reservations or evaluations. Unconditional positive regard is a caring which respects the other person as a separate individual with his own feelings and experiences and does not attempt to control or possess him. When one feels that another person has positive feelings toward him and is willing to let him have his own beliefs and feelings, although not always agreeing with them, then that person is likely to reveal more of himself and to come to a greater self-awareness and self-understanding (Rogers, 1961) . In psychotherapeutic relationships characterized by high levels of empathy, congruence, and unconditional positive regard, a person will begin to: ( a ) explore the various areas of his life and of himself which were previously denied to his awareness because they were threatening; ( b ) experience fully feelings which were previously denied to his awareness; and ( c ) reorganize his concept of himself to assimilate denied aspects. As a result of this reorganization process the person becomes more positive and realistic in his self-concepc and attitudes toward himself. When self-perception is altered in a direction which makes the self more highly valued, other changes also take place. The person becomes: ( a ) more self-accepting, self-confident, and self-directing; ( b ) more open to his experiencing; (c) more mature, socialized, and adaptive; ( d ) less
PROGRAMMED INSTRUCTION FOR THERAPY
1005
defensive and frustrated by stress; and ( e ) Inore accepting of others (Rogers, 1961). P.rogrrrmmed Instruction Programmed instruction was developed in response to the need for effective and efficient methods of teaching. . It is a technique whereby a finished product, such as a skill or body of knowledge, is partitioned systematically into incremental steps. The learner masters these steps piecemeal from the simple beginning up to the final, complex behavioral performance (Jourard, 1968). In addition to teaching facts and bodies of knowledge, such as physics, basic electricity, and statistics, programmed instruction also has been effective in teaching behavioral and interpersonal skills (Bullmer, 1972; Delaney, 1969; Dirnattia & Zimmer, 1972; Hart, 1973). An initial attempt to teach the basic skill of interpersonal competence was described in a paper, "The Teaching of Improved Interpersonal Relations Through Programmed Insrn~ction for Two People Working Together," presented by Berlin and Wyckoff (1963). The approach suggested by Berlin and Wyckoff focused on Rogerian concepts s ~ ~ cash congruence, empathy, and positive regard. In 10 1-hr. sessions the partners learn principles of human relationships through their own interaction. Soon after the introduction of the General Relationship Improvement Program (Berlin & Wyckoff, 1963), evaluation and validation studies were initiated. Pli~ckarnlstudied the effectiveness of the program in increasing n ~ ~ r s i nstudents' g knowledge and understanding of principles of interpersonal relationships. His results indicated that although the subjects had "a fair knowledge" of the program prior to its use, "there was a substantial but not spectacular gain in knowledge and understanding" (p. 1 7 ) . After an 11-wk. intetval retention of what had been learned was "ninety-two percent" (p. 18). Students' reactions to this program and programmed instruction as a teaching technique were "generally favorable" (p. 18). Saltzman (1966) used the program to teach human relations skills to 30 counselor-education students. The Barrett-Lennard Relationship Inventory was used to measure changes in behaviors believed to be essential to the helping process. Results indicated that ( a ) positive behavioral changes were registered by students exposed; and ( b ) the degree to which an individual initially is perceived as empathic, congruent, and unconditionally positive in his regard for others appeared to be a function of his level of dogmatism. Hurst and Jensen (1968) divided 20 "house counselors" at a residential school for boys into three groups: ( a ) the theory-methodology group, who 'M. L. Pluckham. A study of the teaching effectiveness of the General Relationship Irnprovement Program through its use with a selected group of students in nursing. Report of the New Teaching Techniques Project of the Western Council on Higher Education for Nursing, Boulder, Colorado, 1964.
1OOG
K. N.ANCHOR
&
P. SMITH
completed a program of readings in counseling theory and methods plus weekly seminars; ( b ) the personal growth group, who completed the Berlin and Wyckoff program plus weekly T-group sessions; and ( c ) the control group who received no preparation of any kind. The effects of the differential procedures mere assessed with a battery of three self-report inventories administered before and after the 11-wk. experimental session. Analysis indicated that the personal growth group was the only one to demonstrate significant increases in self-acceptance and acceptance of others. Currey, Swisher, and Kruse (1968) used the Management Improvement Program, the second programmed text developed by Berlin and Wyckoff (1963) to teach human relations skills to 40 student nurses. The second program is essentially the same as the first, with an added part for all pairs of subjects to come together for a group discussion. Thus in addition to a dyadic section at each session, participants also interact with a partner plus the group as a whole. Analysis indicated that this program had a significant impact on the human relations skills of the students participating in the program. Although there was no evidence to show increased sensitivity as measured by the Clinical Awareness Scale, final scores on the Barrett-Lemard Relationship Inventory suggested that the students viewed each other as people whose interpersonal competence had improved as a result of participation in the program. Final scores on the Group Perception Inventory suggested that the group had become more productive and more cohesive a s a result of the learning experience. The primary purpose of an unpublished study by Norod (1970) was to examine behavioral changes demonstrated by student nurses at the end of a simulated experience in interpersonal relationships. A secondary purpose was to determine whether the objectives of a learning experience designed to improve skills in human relations and to enhance awareness of the significance of interpersonal interaction could be achieved with programmed materials. Subjects in the experimental group studied a programmed text, Haman Relations in Nurriltg P r o g m (Human Development Institute, 1968), and those in the control group interacted with ambulatory male patients in a neuropsychiatric hospital. At the end of the experience subjects met in small groups to discuss a hypothetical case study relevant to nurse-patient relationships. Discussions were recorded, and students' performance was assessed by two laymen trained in interaction analysis. Results were interpreted as indicating that programmed instruction in human-relations skills is an effective way to teach skills in communication to student nurses. The effectiveness of the program in teaching the basic skills in relating successfidly to another person also has been tested with groups of college students. Martin (1966) reported results which suggest that the program combined with group meetings produced significant favorable changes in college students as indicated by the Edwards Personal Preference Schedule and Jourard's
PROGRAMMED INSTRUCTION
FOR THERAPY
1007
Self-disclosure Inventory. Brown and Campbell ( 1966) conducted an experimental evaluation using two matched samples of unmarried undergraduate female students, one of whom completed the program while the other completed a course in psychology of adjustment. Both groups were administered personality tests pre- and posttreatment. Significant changes in the direction of a more integrated, better functioning personality were reported on the MMPI for the subjects given the program. Subjects unanimously reported favorable reaction to the program supporting the conclusion that the program has some effect in producing measurable and durable personality changes which might generalize to improvements in interpersonal relationships. However, the small number of subjects and competing hypotheses suggest that the results should be interpreted with caution. Celio (1971) investigated the feasibility of using modeling and programmed materials in a dyadic situation to teach skills judged to be important in interpersonal relationships. Volunteer college students were assigned randomly to same-sex dyads and to one of fouc treatments to discover a successful means of teaching disclosing and responding to affect. Subjects in Treatment 1 were instructed to relate to each other as they had learned in the past; subjects in Treatment 2 were given the program; and subjects in Treatment 3 were exposed to an audio model demonstrating 3 facilitative relationship as well as to a portion of the program; and subjects in Treatment 4 received a variation of Treatment 3--exposure to an audio model, a short performance task in which the subject demonstrated the modeled behavior, and a portion of the program. The results of this study "in general support the efficacy of using some types of programmed interpersonal skills training in facilitating relating behavior between dyads of same-sex students" (p. 88). The studies cited in this paper suggest that programmed instruction in relationship facilitation may well have a place in training for psychotherapy, at least on an experimental basis. All supervisors of therapy regardless of discipline or orientation have been confronted with brilliant trainees whose personalities as reflected in the patient-therapist relationship have likely undermined the novice therapists' potential effectiveness. Programmed instruction may well be one means of systematically helping such persons acquire interpersonally facilitative behavior and further enhance the repertoire of social skills of already personally competent trainees. It is the current authors' contention that mastery of only the technical and theoretical aspects of psychotherapy leads to an incomplete clinician. REFERENCES BBRLM, J. I.,
&
WYCKOPP, B. L. The teaching of improved interpersonal relations
though programmed instruction for two people working together. Presented at the 71st annual convention of the American Psychological Association, 1963. BROWN, E. C., & CAMPBELL, R. L. Programmed interpersonal relationships improvement: objective benefits to college students. JorcsnaL o f Programmed In~cruction, 1966, 3, 1-6.
K. N. ANCHOR
&
P. SMITH
BULLMER,K. Improving accuracy of interpersonal perception through a direct teaching method. Jorrrnal o f Corrnseling Psychology, 1972, 19, 37-41. CELIO, D. L. A study of rhe efficacy of several types of programmed interpersonal skills training in facilitating relating behavior. Unpublished doctoral dissertation, Univer. of Maryland, 1971. CURREY,J. W., SWISHER,J. N., & KRUSB, L. C. Improving human relations skills through programmed instruction. Ntrrsing Research, 1968, 17, 455-459. DELANEY,D. J. Simulation techniques in counsclor education: proposal of a unique approach. Cownselor Education and Supervi.riolz, 1969, 8, 183-188. D I M A ~ I AD,. J., & ZIMMER, J. M. Comparison of training devices for teaching emotional discrimination. Cor~nselorEdz~ca~t'on and Superr~i~ion, 1972, 12, 17-23. HART, G. A programmed approach to increased couns:lor op-n-mindedness. Jorrrnal o f Corrnseling Psychology, 1973, 20, 569-570. HUMAN DEVELOPMENTINSTITUTE. Human relations in nursing program. Atlanta, Ga.: Author, 1968. HURST, J. C., & JENSEN, V. H. Personal grawth: an ingredient in counselor education programs? Counselor Edr~cationand Supervision, 1968, 8 , 12-17. JOURARD,S. M. Disclosing man to hi?nself. New York: Van Nostrand Reinhold, 1968. NOROD, E. F. Effects of simulated instruction in interpersonal relationships on verbal behavior of student nurses. Unpublished doctoral dissertation, Univer. of Rcchester, 1970. MARTIN, D. H. An experimental invcst~gat~on of the effects of a dyadic teaching program o n prospective teachers' atr~tudcs Unpublished doctoral dissertation, George Peabody College for Teachers, 1366. ~ ROBACK, H. B., ABRAMOWITZ, S., & SIRASSBERG,D. S. (Eds.) G T O U ~sychotherapy research: commentaries and selected readings. New York: Krieger. 1978. ROGERS, C. R. O n becoming n person. Boston: Houghton Mifflin, 1961. SALTZMAN,G. A. Programmed materials and school counselor development. Unpublished doctoral dissertation, Ohio State Univer., 1966. TRUAX, C. B., & CARKHUFF,R. R. Toward effective cortnseling and psychotherapy. Chicago: Aldine, 1967. Accepted October 3, 1978.
KENNETH N. ANCHOR Geovge Peabody College for Teachers
If the skills and personal qualities requisite for s'uccessful practice of psychotherapy were known, questions ebout training desiderata would not have to be raised. At present, however, convictions about training tend to reflect theoretical predilections which, in turn, depend latgely on personal preference and one's most charismatic supervisor. Thus, analytic apprentices are taught to be aloof and incisive, aspiring humanists are amointed in self-liberating experiential encounters, and neophyte social engineers are shaped to be judicious distributors of valued reinforcements. Meanwhile the breeding of paraprofessionals with a community fervor continues apace (Roback, Abramowitz, & Strassberg, 1978). The advent of empirical arbitration of disputes over whether, how much, and which training is necessary is unlikely to bring speedy redress because the underlying issues are rooted in sensitive professional and ideological commitments. In spite of the above differences, most psychotherapists would agree that the quality of the patient-therapist relationship relates to therapeutic outcome; thus it is surprising how little formal training exists for skill in building relationships in curricula for psychotherapy. Rather the thrust of psychotherapeutic training appears oriented toward theoretical, technical, and conceptual issues. Perhaps one r w n for this is the enormous difficulty in knowing how to teach psychotherapeutic intervention skills. The current paper discusses ( a ) behaviors in building relationships, (b) programmed instruction in development of interpersonal skills, and ( c ) studies employing this module, and concludes with a few words on the potential far such an instructional program in psychotherapy.
Relationrhip-orientedBehaviors It is the authors' contention that behaviors in building relationships, such as congruence, unconditional positive regard, and empathy which have been demonstrated empirically (Truax & Carkhuff, 1967) to relate to therapeutic outcome with mildly maladjusted persons, can be taught effectively through programmed instruction.
1004
K. N. ANCHOR
&
P. SMITH
Congruence, or genuineness, refers to the accurate matching of experience and awareness. When there is an incongruence between experience and awareness, it is u s u d y spoken of as defensiveness or denial to awareness. The concept of congruence can be extended to cover a matching of experience, awareness, and communication. An example of incongruence of awareness and experiencing and communication is the bored guest who insists he is having a wonderful time. Here, the guest may be unaware of the incongruence between his real feeling of boredom and his desire to be polite. When the incongruence is between awareness and conun~inication,it may be thought of as falseness or deceit. Empathy is the ability to sense another person's inner world of private personal meanings as if it were one's own but without ever losing the "as if" quality. Empathy is the capacity to understand the inner world of another and to communicaix something of that understanding to him, while maintaining one's own identity. When one feels that his communication has been clearly perceived and understood by another, he will be likely to share more of his experiences with that person as well as to bring more of his experiences into his own awareness. In doing this, he becomes less defensive and more congment (Rogers, 1961) . Unconditional positive regard is prizing another person regardless of his particular behavior at the moment; it is a prizing in a total rather than in a conditional way. Unconditional positive regard implies unconditional acceptance of the individual as a person, and it is characterized by an ongoing positive feeling without reservations or evaluations. Unconditional positive regard is a caring which respects the other person as a separate individual with his own feelings and experiences and does not attempt to control or possess him. When one feels that another person has positive feelings toward him and is willing to let him have his own beliefs and feelings, although not always agreeing with them, then that person is likely to reveal more of himself and to come to a greater self-awareness and self-understanding (Rogers, 1961) . In psychotherapeutic relationships characterized by high levels of empathy, congruence, and unconditional positive regard, a person will begin to: ( a ) explore the various areas of his life and of himself which were previously denied to his awareness because they were threatening; ( b ) experience fully feelings which were previously denied to his awareness; and ( c ) reorganize his concept of himself to assimilate denied aspects. As a result of this reorganization process the person becomes more positive and realistic in his self-concepc and attitudes toward himself. When self-perception is altered in a direction which makes the self more highly valued, other changes also take place. The person becomes: ( a ) more self-accepting, self-confident, and self-directing; ( b ) more open to his experiencing; (c) more mature, socialized, and adaptive; ( d ) less
PROGRAMMED INSTRUCTION FOR THERAPY
1005
defensive and frustrated by stress; and ( e ) Inore accepting of others (Rogers, 1961). P.rogrrrmmed Instruction Programmed instruction was developed in response to the need for effective and efficient methods of teaching. . It is a technique whereby a finished product, such as a skill or body of knowledge, is partitioned systematically into incremental steps. The learner masters these steps piecemeal from the simple beginning up to the final, complex behavioral performance (Jourard, 1968). In addition to teaching facts and bodies of knowledge, such as physics, basic electricity, and statistics, programmed instruction also has been effective in teaching behavioral and interpersonal skills (Bullmer, 1972; Delaney, 1969; Dirnattia & Zimmer, 1972; Hart, 1973). An initial attempt to teach the basic skill of interpersonal competence was described in a paper, "The Teaching of Improved Interpersonal Relations Through Programmed Insrn~ction for Two People Working Together," presented by Berlin and Wyckoff (1963). The approach suggested by Berlin and Wyckoff focused on Rogerian concepts s ~ ~ cash congruence, empathy, and positive regard. In 10 1-hr. sessions the partners learn principles of human relationships through their own interaction. Soon after the introduction of the General Relationship Improvement Program (Berlin & Wyckoff, 1963), evaluation and validation studies were initiated. Pli~ckarnlstudied the effectiveness of the program in increasing n ~ ~ r s i nstudents' g knowledge and understanding of principles of interpersonal relationships. His results indicated that although the subjects had "a fair knowledge" of the program prior to its use, "there was a substantial but not spectacular gain in knowledge and understanding" (p. 1 7 ) . After an 11-wk. intetval retention of what had been learned was "ninety-two percent" (p. 18). Students' reactions to this program and programmed instruction as a teaching technique were "generally favorable" (p. 18). Saltzman (1966) used the program to teach human relations skills to 30 counselor-education students. The Barrett-Lennard Relationship Inventory was used to measure changes in behaviors believed to be essential to the helping process. Results indicated that ( a ) positive behavioral changes were registered by students exposed; and ( b ) the degree to which an individual initially is perceived as empathic, congruent, and unconditionally positive in his regard for others appeared to be a function of his level of dogmatism. Hurst and Jensen (1968) divided 20 "house counselors" at a residential school for boys into three groups: ( a ) the theory-methodology group, who 'M. L. Pluckham. A study of the teaching effectiveness of the General Relationship Irnprovement Program through its use with a selected group of students in nursing. Report of the New Teaching Techniques Project of the Western Council on Higher Education for Nursing, Boulder, Colorado, 1964.
1OOG
K. N.ANCHOR
&
P. SMITH
completed a program of readings in counseling theory and methods plus weekly seminars; ( b ) the personal growth group, who completed the Berlin and Wyckoff program plus weekly T-group sessions; and ( c ) the control group who received no preparation of any kind. The effects of the differential procedures mere assessed with a battery of three self-report inventories administered before and after the 11-wk. experimental session. Analysis indicated that the personal growth group was the only one to demonstrate significant increases in self-acceptance and acceptance of others. Currey, Swisher, and Kruse (1968) used the Management Improvement Program, the second programmed text developed by Berlin and Wyckoff (1963) to teach human relations skills to 40 student nurses. The second program is essentially the same as the first, with an added part for all pairs of subjects to come together for a group discussion. Thus in addition to a dyadic section at each session, participants also interact with a partner plus the group as a whole. Analysis indicated that this program had a significant impact on the human relations skills of the students participating in the program. Although there was no evidence to show increased sensitivity as measured by the Clinical Awareness Scale, final scores on the Barrett-Lemard Relationship Inventory suggested that the students viewed each other as people whose interpersonal competence had improved as a result of participation in the program. Final scores on the Group Perception Inventory suggested that the group had become more productive and more cohesive a s a result of the learning experience. The primary purpose of an unpublished study by Norod (1970) was to examine behavioral changes demonstrated by student nurses at the end of a simulated experience in interpersonal relationships. A secondary purpose was to determine whether the objectives of a learning experience designed to improve skills in human relations and to enhance awareness of the significance of interpersonal interaction could be achieved with programmed materials. Subjects in the experimental group studied a programmed text, Haman Relations in Nurriltg P r o g m (Human Development Institute, 1968), and those in the control group interacted with ambulatory male patients in a neuropsychiatric hospital. At the end of the experience subjects met in small groups to discuss a hypothetical case study relevant to nurse-patient relationships. Discussions were recorded, and students' performance was assessed by two laymen trained in interaction analysis. Results were interpreted as indicating that programmed instruction in human-relations skills is an effective way to teach skills in communication to student nurses. The effectiveness of the program in teaching the basic skills in relating successfidly to another person also has been tested with groups of college students. Martin (1966) reported results which suggest that the program combined with group meetings produced significant favorable changes in college students as indicated by the Edwards Personal Preference Schedule and Jourard's
PROGRAMMED INSTRUCTION
FOR THERAPY
1007
Self-disclosure Inventory. Brown and Campbell ( 1966) conducted an experimental evaluation using two matched samples of unmarried undergraduate female students, one of whom completed the program while the other completed a course in psychology of adjustment. Both groups were administered personality tests pre- and posttreatment. Significant changes in the direction of a more integrated, better functioning personality were reported on the MMPI for the subjects given the program. Subjects unanimously reported favorable reaction to the program supporting the conclusion that the program has some effect in producing measurable and durable personality changes which might generalize to improvements in interpersonal relationships. However, the small number of subjects and competing hypotheses suggest that the results should be interpreted with caution. Celio (1971) investigated the feasibility of using modeling and programmed materials in a dyadic situation to teach skills judged to be important in interpersonal relationships. Volunteer college students were assigned randomly to same-sex dyads and to one of fouc treatments to discover a successful means of teaching disclosing and responding to affect. Subjects in Treatment 1 were instructed to relate to each other as they had learned in the past; subjects in Treatment 2 were given the program; and subjects in Treatment 3 were exposed to an audio model demonstrating 3 facilitative relationship as well as to a portion of the program; and subjects in Treatment 4 received a variation of Treatment 3--exposure to an audio model, a short performance task in which the subject demonstrated the modeled behavior, and a portion of the program. The results of this study "in general support the efficacy of using some types of programmed interpersonal skills training in facilitating relating behavior between dyads of same-sex students" (p. 88). The studies cited in this paper suggest that programmed instruction in relationship facilitation may well have a place in training for psychotherapy, at least on an experimental basis. All supervisors of therapy regardless of discipline or orientation have been confronted with brilliant trainees whose personalities as reflected in the patient-therapist relationship have likely undermined the novice therapists' potential effectiveness. Programmed instruction may well be one means of systematically helping such persons acquire interpersonally facilitative behavior and further enhance the repertoire of social skills of already personally competent trainees. It is the current authors' contention that mastery of only the technical and theoretical aspects of psychotherapy leads to an incomplete clinician. REFERENCES BBRLM, J. I.,
&
WYCKOPP, B. L. The teaching of improved interpersonal relations
though programmed instruction for two people working together. Presented at the 71st annual convention of the American Psychological Association, 1963. BROWN, E. C., & CAMPBELL, R. L. Programmed interpersonal relationships improvement: objective benefits to college students. JorcsnaL o f Programmed In~cruction, 1966, 3, 1-6.
K. N. ANCHOR
&
P. SMITH
BULLMER,K. Improving accuracy of interpersonal perception through a direct teaching method. Jorrrnal o f Corrnseling Psychology, 1972, 19, 37-41. CELIO, D. L. A study of rhe efficacy of several types of programmed interpersonal skills training in facilitating relating behavior. Unpublished doctoral dissertation, Univer. of Maryland, 1971. CURREY,J. W., SWISHER,J. N., & KRUSB, L. C. Improving human relations skills through programmed instruction. Ntrrsing Research, 1968, 17, 455-459. DELANEY,D. J. Simulation techniques in counsclor education: proposal of a unique approach. Cownselor Education and Supervi.riolz, 1969, 8, 183-188. D I M A ~ I AD,. J., & ZIMMER, J. M. Comparison of training devices for teaching emotional discrimination. Cor~nselorEdz~ca~t'on and Superr~i~ion, 1972, 12, 17-23. HART, G. A programmed approach to increased couns:lor op-n-mindedness. Jorrrnal o f Corrnseling Psychology, 1973, 20, 569-570. HUMAN DEVELOPMENTINSTITUTE. Human relations in nursing program. Atlanta, Ga.: Author, 1968. HURST, J. C., & JENSEN, V. H. Personal grawth: an ingredient in counselor education programs? Counselor Edr~cationand Supervision, 1968, 8 , 12-17. JOURARD,S. M. Disclosing man to hi?nself. New York: Van Nostrand Reinhold, 1968. NOROD, E. F. Effects of simulated instruction in interpersonal relationships on verbal behavior of student nurses. Unpublished doctoral dissertation, Univer. of Rcchester, 1970. MARTIN, D. H. An experimental invcst~gat~on of the effects of a dyadic teaching program o n prospective teachers' atr~tudcs Unpublished doctoral dissertation, George Peabody College for Teachers, 1366. ~ ROBACK, H. B., ABRAMOWITZ, S., & SIRASSBERG,D. S. (Eds.) G T O U ~sychotherapy research: commentaries and selected readings. New York: Krieger. 1978. ROGERS, C. R. O n becoming n person. Boston: Houghton Mifflin, 1961. SALTZMAN,G. A. Programmed materials and school counselor development. Unpublished doctoral dissertation, Ohio State Univer., 1966. TRUAX, C. B., & CARKHUFF,R. R. Toward effective cortnseling and psychotherapy. Chicago: Aldine, 1967. Accepted October 3, 1978.
