A CLASSROOM COMPARISON OF BEHAVIORAL MOD1FlCATlON TECH NIQ U ES Paul A. Knipping, Ph.D. Lynne Chandler, B.S.
Paul A. Knipping, Ph.D. is with the Dept. of Health, Physical Education and Recreation, School of Education, University of Kentucky. Lynne Chandler, B.S. is wlth the School of Allled Health, Unlversity of Kentucky.
The current status of emotional health in America is in a word, deplorable. A review of the literature reveals that up to 80 percent of the adult population admit to having psychiatric symptoms and 20 percent of these normal adults experience some loss of optimum p e r f o r m a n c e . . . due to their symptoms. Approximately 40 million normal adults could benefit from improving their emotional health, but professional help is not adequately available. Experts acknowledge the fact that we are not confronted with a Drug Problem, but rather a “People Problem,” i.e. a form of social pathology involving an inability or unwillingness to cope. I n 1970, Dr. Stanley Yolles, then Director of N.I.M.H., predicted a 100-fold increase over the next decade in the number and types of psychoactive drugs being used.! However, reliance on alcohol, other drugs, etc. should diminish if individuals are helped in self-reinforcement, or personality ex pans ion tec hn iques.z Obviously, a need exists for some effective and practical way to improve emotional health on a massive scale. Previous studies,’-’ indicate that individuals can be taught to assess, analyze and improve their own emotional health with a minimum of professional help. Public schools are able to influence the behavior of most citizens because schools afford access to some of everyone’s time. However, if the classroom is used, the technique of emotional health selfimprovement must: (1) articulate with traditional school routines, (2) be teachable by lay(i.e. those untrained in mental health) teachers, (3) be easily THE JOURNAL OF SCHOOL HEALTH
monitored and graded using traditional school techniaues, and (4) be easily evaluated. “The more we make going to school a mindexpanding experience for young people, the less likely they are to turn to a chemical. Drug use is a symptom of widespread alienation, which includes great dissatisfaction; with schools which are increasingly, experienced as boring, and irrelevant by millions of our young people.” * I n a n e f f o r t t o c o r r o b o r a t e the a b o v e hypothesis, a self-improvement secondary classroom experience was offered at a private (Sayre) school in Lexington this past semester. The experience involved two separate behavioral modification techniques: (1) Rational Self Counseling (based on principles of learning theories of Skinner,99’O Rotter and Mowrer 12J3) offered a self-improvement system designed to aid the individual in becoming a full functioning self-automated person, minus any form of dependence on mood-a 1teri ng substances. Rational thinking is defined as that form of thinking or acting which (a) is based on objective facts, (b) is life-preserving, (c) helps a person achieve his goals, (d) enables him to function with a minimum of significant internal conflict, and (e) enables him to function with a minimum of significant conflict with his ~ n v i r o n m e n t The .~~ classroom experience involved: (a) analyzing audio and video tapes of successfully treated people having common emotional problems, (b) the systematic written rational self-analysis 01 common emotional problems, (c) participation in rational emotive imagery, (d) participation in group rational self-analysis. When used in combination the above techniques offer a selfimprovement system designed to aid the individual in: (a) thinking in the present, (b) remaining flexible and relatively independent, (c) remaining free of compulsive “being for others,” (d) defining their own conditions of self-worth, (e) the pursuit of life goals in the most efficient 33
personally satisfying way possible. (2) Transactional Analvsis (TA) had its beginnings in the teaching and writing of Eric Berne. Dr. Berne’s concepts swiftly intrigued others in the field (psychiatry) because they found them to be observable, concrete and usable. TA includes an understandable theory of personality, a specific but easily learned vocabulary, a method of analyzing interactions between persons and techniques by which a person can improve his relationships with himself and others. It can be used by teachers to understand themselves, to interact more effectively with children, to improve the classroom climate and to help children learn and use TA concepts as well. One particular strength of TA is the precision of its language. Only ordinary words are used and only eight basic vocabulary terms are necessary to participate i n the process.ls BACKGROUND OF THE STUDY A pool of 60 students was recruited via acceptance of equal numbers of volunteers from grades nine through 12 at Sayre School, Lexington, Kentucky. The complete pool was randomly divided into RBT Experimental Group A, (N for each group = 201, Control Group B, and TA Experimental Group C. Both experimental groups met one 50-minute period each school day for the entire semester. The control Group B had no meetings. Students heard “live” lectures, taped recordings, they completed written assignments and were given participatory training in both RBT and TA as applied to a small g r o u p setting. Experimental g r o u p s were exposed to different learning “climates,” i.e. there were competency differences between the two group coordinators, (P. A. K n i p p i n g coordinated Group A and Ms. Chandler Group C), physical differences between the classrooms occupied by each group and disciplinary differences i n that the RBT group functioned in a more permissive atmosphere. These factors introduced a degree of nonhomogeneity into the experimenta I groups. The daily attendance was purely voluntary and no grades were awarded. Student participation was sustained at a reasonably high level and this was perhaps due to their assigned roles as facilitator (discussion leader) for the day. Principle textbook materials used were: (a) For RBT Group A . . .“More Personal Happiness Through Rational Self Counseling,” by Maxie C. Maultsby, Jr., M.D. (b) For TA Group C . . “I’m 34
OK-You’re
OK,” by Thomas A. Harris, M.D.
DESCRIPTION OF ASSESSMENT INSTRUMENTS Shostrom’s Personal Orientation Inventory (POI) l6 was used to measure the values and b e h a v i o r s c o n s i d e r e d i m p o r t a n t i n the development of self-actualization. The POI is described as “unique in its emphasis on positive mental health rather than psychopathology” and i t covers two major areas in personal development and interpersonal interaction. The Support Scale assesses the degree of innerd irectedness versus other-d i rectedness, i.e. whether the individual’s primary mode of reaction is self-directed by personal values or other-directed by peer group influences. The Time Scale estimates the degree of time competence of the person. The time competent person lives primarily in the present i n terms of awareness and feeling reactivity, while the time incompetent person lives primarily in the past with guilts, regrets, resentments andlor in the future with unrealistic goals, expectations and fears. A higher score is desirable on the POI. A second instrument was Maultsby’s Common Trait (YIPTIS) Inventory. This is a list of common irrational traits that can cause unhappiness in the daily lives of normal people. I t is based on the learning theory concept of motivation, and the Grace Graham concept of an e m ~ t i o n . ~ ~ - ~ ~ Individuals who honestly lower their inventory scores, reduce their unhappiness i n living.23 However, the test is graded in the Rational Direction, so a final high score is desirable. The third instrument was the Rotter I-E Scale.24This was used to check the support scale of the POI. A lower score is desirable on the Rotter test RESULTS Tables I, I I , and I l l are based on paired t tests. Table I V is based on a one way analysis of variance with the three groups. The RBT group (refer to Table II), considered apart from the Control and TA groups, showed a significant (.OW) increase in the YlPTlS score. There was also a significant increase in the POI 10 (Self-Acceptance .034 level) and the POI 12 (Synergy .024 level) scores. This indicates that the RBT treatment significantly affected the score. Note that referring to Table I, the Control Group did not show any significant change in score on any scale from Pre- to Post-test. The TA Group (Table Ill) also exhibited a significant increase in the YlPTlS scale from PreJANUARY 1975 VOLUME X L V NO. 1
TABLE I
TABLE Ill
COMPARISON OF POST VERSUS PHE SCORES FOR C O N T R O L G R O U P O N E A C H S C A L E
COMPARISON O F POST VERSUS PRE SCORES FOR T A G R O U P O N E A C H SCALE
._
SLJle
__
YlPTlS IE POI 2 POI 4 POI 5 POI 6 POI 7
POI 8 POI 9 POI 10 POI 1 1 POI
12
POI 13 POI 14
Mean Post-Pre Score
2.35 .05 .75 .80 1 .15 -.15 -.lo -.50 .45 .55 .50 15 -.15 -1.25
t
Standard Error
1.751 ,701 .602 1.830 ,789 ,693 ,665 .560 .556 .467 ,564 .504 ,765 . .867
Statistic
1.342 .071 1.246 ,437 1.456 -.216 -.150 - ,893 ,811 1.177 .886 ,298 -.196 -1.44
Probability o f a Greater Difference b y Chance Alone
.195 .944 .228 ,667 ,161 .831 .882 .383 .427 .254 .387 .769 .847 .166
Scale
Mean Post-Pre Score
YlPTlS IE POI 2 POI 4 POI 5 POI 6 POI 7 POI 8 POI 9 POI 10 POI 1 1 POI 12 POI 13 POI 14
5.12 -1.65 .941 4.294 ,471 2.529 .235 ,059 ,529 1.647 ,706 .824 294 1.824
Scale
YlPTlS I€
POI 2 POI 4 POI 5 POI 6 poi 7 10 '1 8 POI 9 POI 10 POI 1 1 POI 12 POI 13 POI 14
9.33 -1.05 - ,048 -.190 -.714 --.190 - ,571 - ,286 - ,428 1.286 -.762 --,857 - 1.095 ,523
t
Standard Error
3.320 ,779 ,832 1.939 ,834 .776 ,827 ,548 ,660 .662 ,473 ,404 ,923 ,722
1.954 .2.281 1.447 2.61 8 ,739 3.009 .523 .1 33 .824 2.330 1.852 3.160 ,436 2.277
.722
,650 1.640 .637 .841 ,450 .441 .642 ,707 .381 .261 ,674 ,801
,068 ,037 .167 .017 ,471 ,008 ,608 ,896 .422 ,033 .083 .006 ,668 ,037
Statistic
2.81 1 - 1.344 -.057 - ,098 - .856 -.245 -.691 -.521 - .649 1.941 -1.612 -2.121 -1.187 ,725
POST-PRE D I F F E R E N C E COMPARISON O F CONTROL, RBT, A N D T A GROUPS ON E A C H S C A L E
Probability o f a Greater Difference b y Chance Alone*
.011 .194 ,955 .923 .402 .809 ,497 .608 .524 .067 ,123 ,047 .249 .477
^Two-tailed probability. I f it is expected that the Post score should be greater (or less) in magnitude than the Pre score, then divide the probability shown by two to obtain the correct mobability.
to Post-test LO34 level). The TA group had a significant decrease (.02 level) on the IE scale, and significant increases on the POI scales: 4 (inner-directedness), 6 (ex istentiality), 10 (selfacceptance), 11 (nature of man, constructive), 12 (synergy), and 14 (capacity for intimate contact). Comparison of the three groups with respect to the change in score from Pre- to Post-test shows T H E J O U R N A L OF SCHOOL H E A L T H
2.619
TABLE IV
COMPARISON OF POST VERSUS PRE SCORES FOR R B T GROUP O N E A C H S C A L E
..-
Statistic
*"See note for Table II.
TABLE I 1
Mean Post-Pre Score
t
Standard Error
Probabil ity o f a Greater Difference b y Chance Alone*
Mean Scale
YlPTlS IE POI 2 POI 4 POI 5 POI 6 POI 7 POI 8 POI 9 POI 10 POI 1 1 POI 12 POI 13 POI 14
Control
2.35 .05 .75 .80 1 .I5 - .15 - .10 - .50 .45 1.29 .50 .15 - .15 -1.25
RBT
TA
9.33 5.12 -1.05 -1.65 .94 - .05 - .19 4.29 - .71 .47 - .19 2.53 - .57 .24 - .29 .06 - .43 .53 1.65 1.14 .71 - .76 .82 - .86 -1.10 .29 .52 1.82
F
1.82 1.31 .548 1.55 1.57 3.84 34 .27 .75 .80 2.71 4.10 .76 3.58
Probability of a Greater F b y Chance Alone
,170 ,277 .586 .212 2 15 ,027t .719 .770 ,520 .5331 .074 ,021tt .524 .0336
tThe TA group differs significantly from both the Control and RBT groups. The Least Significent Difference (LSDl at the .05 level is 2.20; the LSD at the .01 level is 2.93. t t T h e TA group differs significantly from the RBTgroup. LSD 1.01) is 1.58. 1The TA group differs significantl y from the Control group on1y. The LSD at the .01 level is 3.04. Note: The LSD is the smallest difference between any two means that accounts for sianificance at the level indicated for the LSD.
that the RBT and TA groups were significantly different on the POI 6 and POI 12 scales. No other differences were noted. The TA Group exhibited 35
a greater improvement on those scales than the RBT Group. In no case d i d the RBT Group show a significant difference from the Control Group, i n spite of the fact that for the YlPTlS score, the mean of the RBT g r o u p was 6.98 greater than the Control Group. The variances for the three groups o n the YlPTlS (and other scales) scores are not equal. Since t h e a n a l y s i s of v a r i a n c e e x p e c t s homogeneity of variances, this large variance difference affected the power of the test to detect differences a m o n g the means of the three groups, even when the differences m i g h t b e large enough t o intuitively expect that the treatments d i d indeed affect the result. The nonhomogeneity c o u l d be a result of the randomization process or (as discussed earlier), due to lack of equal control over the conditions inherent in the administration of the treatments, or, indeed, any source of experimental error that was not equally controlled for a l l three groups. CONCLUSIONS
(1) G i v e n appropriate teaching materials, individuals classified as non-professionals in mental health c a n b e successful in affecting attitudinal changes among secondary students. (2) E m o t i o n a l s e l f - i m p r o v e m e n t w i t h i n a classroom environment has been demonstrated.L However, a favorable outcome is more likely, provided the academic environment remains highly structured. (3) Obviously techniques for mental-health self-improvement can b e learned by students within a classroom climate. These techniques facilitate a more favorable interaction w i t h others, the escape from feelings of inadequacy, and individuals tend to become more self-directed. The total social order can only change after persons change. ACKNOWLEDGEMENT The authors wish to acknowledge the expertise provided this research project by Maxie C. Maultsby Jr., M.D.. Dlrector of the Out-Patient Clinic, University Hospital, University of Kentucky, School of Medicine. REFERENCES 1. Ray 0s: Drug, Society and Human Behavior. Saint Louis, The CV Mosby Co., 1972, p 3. 2. Maultsby MC, Knipping PA: Teaching of RSC in the classroom. J Sch Health, October 1974. 3. Karpman 8: Objective psychotherapy. J Clin Psycho1 5 5 1 4 8 , 1949.
36
4. Kunlap K: Habits, Their Making Unmaking. New York, Liverright Publishing Corp., 1932, p 196. 5. Woipe J, Lazarus AA: Behavior Therapy Techniques. Oxford, Pergamon Press, 1966. 6. Wolpe J, Salter A, and Reyna LJ (Eds): The Conditioning Therapies. Holt, Rinehart, Winston, New York, p 11. 7. Storrow AH: Introduction to Scientific Psychlatry. Appleton-Century-Crofts, New York, 1967, pp 165167. 8. Fort J: Drug For and Against. Hart Publishing Co., New York, p 150. 9. Holland JG, and Skinner BF: The Analysis of Behavior, McGraw-Hill, New York, pp 26-34, 1961. 10. Skinner BF: Verbal Behavior, Appleton-CenturyCrofts, New York, 1957. 11. Rotter JB: S o c i a l Learning and C l i n i c a l Psychology, Prentice-Hall, Inc., New York, 1954. 12. Mowrer OH: Learning Theory and Behavior, John Wiley 8 Sons, Inc., New York, 1960. 13. Mowrer OH: Learning Theory and The Symbolic Process. John Wiley & Sons, 1963. 14. Goodman D, and Maultsby MC: Emotional WellBeing Through Rational Behavior Training. Charles C Thomas Publisher, Springfield, IL., 1974, p 15-17. 15. Johnson C, and Cramer J: The OK Classroom. Instructor, May 1973, p 33-40. 16. Shostrom EL: Manual: Personal Orientation Inventory, Educational and Industrial Testing Service, San Diego, 1962. 17. Lichtenstein EM: Techniques for Assessing Outcomes in Psychotherapy. In McRaynolds P (Ed) Advances in Psychological Assessment, Science and Behavior Books, Palo Alto, 1971, p 178-190. 18. Maultsby MC, Handbook of Rational SelfCounseling. Private Publication. 19. Grace WJ and Graham DT: Relationship of specific attitudes and emotions to certain bodily disease. Psychosom Med, 14:243-251, 1952. 20. Graham DT, Stern JA and Winokur G: Experimental investigation of the specificity of attitude hypothesis in psychosomatic disease. Psychosom Med, 24:257-266, 1962. 21. Graham DT, Kabler JD and Graham FK: Physiological response to the suggestion of attitudes specific for hives and hypertension. Psychsom Med, 24:259-260, 1962. 22. Graham DT, Lundy RM, Benjamin LS et al: Specific attitudes in initial interviews with patients having different psychosomatic disease. Psychosom Med, 24:257-266, 1962. 23. Maultsby MC and Gram JM: Long-Term Follow-Up of Patients Treated with Systematic, Written Homework in Psychotherapy, Read at Association for Advancement of Behavior Therapy, Sept 1971. 24. Rotter JB: Generalized Expectancies for Internal vs. External Control of Reinforcements. Psycho1 Monogr 80, 1966. JANUARY 1975 VOLUME XLV NO. 1
Paul A. Knipping, Ph.D. is with the Dept. of Health, Physical Education and Recreation, School of Education, University of Kentucky. Lynne Chandler, B.S. is wlth the School of Allled Health, Unlversity of Kentucky.
The current status of emotional health in America is in a word, deplorable. A review of the literature reveals that up to 80 percent of the adult population admit to having psychiatric symptoms and 20 percent of these normal adults experience some loss of optimum p e r f o r m a n c e . . . due to their symptoms. Approximately 40 million normal adults could benefit from improving their emotional health, but professional help is not adequately available. Experts acknowledge the fact that we are not confronted with a Drug Problem, but rather a “People Problem,” i.e. a form of social pathology involving an inability or unwillingness to cope. I n 1970, Dr. Stanley Yolles, then Director of N.I.M.H., predicted a 100-fold increase over the next decade in the number and types of psychoactive drugs being used.! However, reliance on alcohol, other drugs, etc. should diminish if individuals are helped in self-reinforcement, or personality ex pans ion tec hn iques.z Obviously, a need exists for some effective and practical way to improve emotional health on a massive scale. Previous studies,’-’ indicate that individuals can be taught to assess, analyze and improve their own emotional health with a minimum of professional help. Public schools are able to influence the behavior of most citizens because schools afford access to some of everyone’s time. However, if the classroom is used, the technique of emotional health selfimprovement must: (1) articulate with traditional school routines, (2) be teachable by lay(i.e. those untrained in mental health) teachers, (3) be easily THE JOURNAL OF SCHOOL HEALTH
monitored and graded using traditional school techniaues, and (4) be easily evaluated. “The more we make going to school a mindexpanding experience for young people, the less likely they are to turn to a chemical. Drug use is a symptom of widespread alienation, which includes great dissatisfaction; with schools which are increasingly, experienced as boring, and irrelevant by millions of our young people.” * I n a n e f f o r t t o c o r r o b o r a t e the a b o v e hypothesis, a self-improvement secondary classroom experience was offered at a private (Sayre) school in Lexington this past semester. The experience involved two separate behavioral modification techniques: (1) Rational Self Counseling (based on principles of learning theories of Skinner,99’O Rotter and Mowrer 12J3) offered a self-improvement system designed to aid the individual in becoming a full functioning self-automated person, minus any form of dependence on mood-a 1teri ng substances. Rational thinking is defined as that form of thinking or acting which (a) is based on objective facts, (b) is life-preserving, (c) helps a person achieve his goals, (d) enables him to function with a minimum of significant internal conflict, and (e) enables him to function with a minimum of significant conflict with his ~ n v i r o n m e n t The .~~ classroom experience involved: (a) analyzing audio and video tapes of successfully treated people having common emotional problems, (b) the systematic written rational self-analysis 01 common emotional problems, (c) participation in rational emotive imagery, (d) participation in group rational self-analysis. When used in combination the above techniques offer a selfimprovement system designed to aid the individual in: (a) thinking in the present, (b) remaining flexible and relatively independent, (c) remaining free of compulsive “being for others,” (d) defining their own conditions of self-worth, (e) the pursuit of life goals in the most efficient 33
personally satisfying way possible. (2) Transactional Analvsis (TA) had its beginnings in the teaching and writing of Eric Berne. Dr. Berne’s concepts swiftly intrigued others in the field (psychiatry) because they found them to be observable, concrete and usable. TA includes an understandable theory of personality, a specific but easily learned vocabulary, a method of analyzing interactions between persons and techniques by which a person can improve his relationships with himself and others. It can be used by teachers to understand themselves, to interact more effectively with children, to improve the classroom climate and to help children learn and use TA concepts as well. One particular strength of TA is the precision of its language. Only ordinary words are used and only eight basic vocabulary terms are necessary to participate i n the process.ls BACKGROUND OF THE STUDY A pool of 60 students was recruited via acceptance of equal numbers of volunteers from grades nine through 12 at Sayre School, Lexington, Kentucky. The complete pool was randomly divided into RBT Experimental Group A, (N for each group = 201, Control Group B, and TA Experimental Group C. Both experimental groups met one 50-minute period each school day for the entire semester. The control Group B had no meetings. Students heard “live” lectures, taped recordings, they completed written assignments and were given participatory training in both RBT and TA as applied to a small g r o u p setting. Experimental g r o u p s were exposed to different learning “climates,” i.e. there were competency differences between the two group coordinators, (P. A. K n i p p i n g coordinated Group A and Ms. Chandler Group C), physical differences between the classrooms occupied by each group and disciplinary differences i n that the RBT group functioned in a more permissive atmosphere. These factors introduced a degree of nonhomogeneity into the experimenta I groups. The daily attendance was purely voluntary and no grades were awarded. Student participation was sustained at a reasonably high level and this was perhaps due to their assigned roles as facilitator (discussion leader) for the day. Principle textbook materials used were: (a) For RBT Group A . . .“More Personal Happiness Through Rational Self Counseling,” by Maxie C. Maultsby, Jr., M.D. (b) For TA Group C . . “I’m 34
OK-You’re
OK,” by Thomas A. Harris, M.D.
DESCRIPTION OF ASSESSMENT INSTRUMENTS Shostrom’s Personal Orientation Inventory (POI) l6 was used to measure the values and b e h a v i o r s c o n s i d e r e d i m p o r t a n t i n the development of self-actualization. The POI is described as “unique in its emphasis on positive mental health rather than psychopathology” and i t covers two major areas in personal development and interpersonal interaction. The Support Scale assesses the degree of innerd irectedness versus other-d i rectedness, i.e. whether the individual’s primary mode of reaction is self-directed by personal values or other-directed by peer group influences. The Time Scale estimates the degree of time competence of the person. The time competent person lives primarily in the present i n terms of awareness and feeling reactivity, while the time incompetent person lives primarily in the past with guilts, regrets, resentments andlor in the future with unrealistic goals, expectations and fears. A higher score is desirable on the POI. A second instrument was Maultsby’s Common Trait (YIPTIS) Inventory. This is a list of common irrational traits that can cause unhappiness in the daily lives of normal people. I t is based on the learning theory concept of motivation, and the Grace Graham concept of an e m ~ t i o n . ~ ~ - ~ ~ Individuals who honestly lower their inventory scores, reduce their unhappiness i n living.23 However, the test is graded in the Rational Direction, so a final high score is desirable. The third instrument was the Rotter I-E Scale.24This was used to check the support scale of the POI. A lower score is desirable on the Rotter test RESULTS Tables I, I I , and I l l are based on paired t tests. Table I V is based on a one way analysis of variance with the three groups. The RBT group (refer to Table II), considered apart from the Control and TA groups, showed a significant (.OW) increase in the YlPTlS score. There was also a significant increase in the POI 10 (Self-Acceptance .034 level) and the POI 12 (Synergy .024 level) scores. This indicates that the RBT treatment significantly affected the score. Note that referring to Table I, the Control Group did not show any significant change in score on any scale from Pre- to Post-test. The TA Group (Table Ill) also exhibited a significant increase in the YlPTlS scale from PreJANUARY 1975 VOLUME X L V NO. 1
TABLE I
TABLE Ill
COMPARISON OF POST VERSUS PHE SCORES FOR C O N T R O L G R O U P O N E A C H S C A L E
COMPARISON O F POST VERSUS PRE SCORES FOR T A G R O U P O N E A C H SCALE
._
SLJle
__
YlPTlS IE POI 2 POI 4 POI 5 POI 6 POI 7
POI 8 POI 9 POI 10 POI 1 1 POI
12
POI 13 POI 14
Mean Post-Pre Score
2.35 .05 .75 .80 1 .15 -.15 -.lo -.50 .45 .55 .50 15 -.15 -1.25
t
Standard Error
1.751 ,701 .602 1.830 ,789 ,693 ,665 .560 .556 .467 ,564 .504 ,765 . .867
Statistic
1.342 .071 1.246 ,437 1.456 -.216 -.150 - ,893 ,811 1.177 .886 ,298 -.196 -1.44
Probability o f a Greater Difference b y Chance Alone
.195 .944 .228 ,667 ,161 .831 .882 .383 .427 .254 .387 .769 .847 .166
Scale
Mean Post-Pre Score
YlPTlS IE POI 2 POI 4 POI 5 POI 6 POI 7 POI 8 POI 9 POI 10 POI 1 1 POI 12 POI 13 POI 14
5.12 -1.65 .941 4.294 ,471 2.529 .235 ,059 ,529 1.647 ,706 .824 294 1.824
Scale
YlPTlS I€
POI 2 POI 4 POI 5 POI 6 poi 7 10 '1 8 POI 9 POI 10 POI 1 1 POI 12 POI 13 POI 14
9.33 -1.05 - ,048 -.190 -.714 --.190 - ,571 - ,286 - ,428 1.286 -.762 --,857 - 1.095 ,523
t
Standard Error
3.320 ,779 ,832 1.939 ,834 .776 ,827 ,548 ,660 .662 ,473 ,404 ,923 ,722
1.954 .2.281 1.447 2.61 8 ,739 3.009 .523 .1 33 .824 2.330 1.852 3.160 ,436 2.277
.722
,650 1.640 .637 .841 ,450 .441 .642 ,707 .381 .261 ,674 ,801
,068 ,037 .167 .017 ,471 ,008 ,608 ,896 .422 ,033 .083 .006 ,668 ,037
Statistic
2.81 1 - 1.344 -.057 - ,098 - .856 -.245 -.691 -.521 - .649 1.941 -1.612 -2.121 -1.187 ,725
POST-PRE D I F F E R E N C E COMPARISON O F CONTROL, RBT, A N D T A GROUPS ON E A C H S C A L E
Probability o f a Greater Difference b y Chance Alone*
.011 .194 ,955 .923 .402 .809 ,497 .608 .524 .067 ,123 ,047 .249 .477
^Two-tailed probability. I f it is expected that the Post score should be greater (or less) in magnitude than the Pre score, then divide the probability shown by two to obtain the correct mobability.
to Post-test LO34 level). The TA group had a significant decrease (.02 level) on the IE scale, and significant increases on the POI scales: 4 (inner-directedness), 6 (ex istentiality), 10 (selfacceptance), 11 (nature of man, constructive), 12 (synergy), and 14 (capacity for intimate contact). Comparison of the three groups with respect to the change in score from Pre- to Post-test shows T H E J O U R N A L OF SCHOOL H E A L T H
2.619
TABLE IV
COMPARISON OF POST VERSUS PRE SCORES FOR R B T GROUP O N E A C H S C A L E
..-
Statistic
*"See note for Table II.
TABLE I 1
Mean Post-Pre Score
t
Standard Error
Probabil ity o f a Greater Difference b y Chance Alone*
Mean Scale
YlPTlS IE POI 2 POI 4 POI 5 POI 6 POI 7 POI 8 POI 9 POI 10 POI 1 1 POI 12 POI 13 POI 14
Control
2.35 .05 .75 .80 1 .I5 - .15 - .10 - .50 .45 1.29 .50 .15 - .15 -1.25
RBT
TA
9.33 5.12 -1.05 -1.65 .94 - .05 - .19 4.29 - .71 .47 - .19 2.53 - .57 .24 - .29 .06 - .43 .53 1.65 1.14 .71 - .76 .82 - .86 -1.10 .29 .52 1.82
F
1.82 1.31 .548 1.55 1.57 3.84 34 .27 .75 .80 2.71 4.10 .76 3.58
Probability of a Greater F b y Chance Alone
,170 ,277 .586 .212 2 15 ,027t .719 .770 ,520 .5331 .074 ,021tt .524 .0336
tThe TA group differs significantly from both the Control and RBT groups. The Least Significent Difference (LSDl at the .05 level is 2.20; the LSD at the .01 level is 2.93. t t T h e TA group differs significantly from the RBTgroup. LSD 1.01) is 1.58. 1The TA group differs significantl y from the Control group on1y. The LSD at the .01 level is 3.04. Note: The LSD is the smallest difference between any two means that accounts for sianificance at the level indicated for the LSD.
that the RBT and TA groups were significantly different on the POI 6 and POI 12 scales. No other differences were noted. The TA Group exhibited 35
a greater improvement on those scales than the RBT Group. In no case d i d the RBT Group show a significant difference from the Control Group, i n spite of the fact that for the YlPTlS score, the mean of the RBT g r o u p was 6.98 greater than the Control Group. The variances for the three groups o n the YlPTlS (and other scales) scores are not equal. Since t h e a n a l y s i s of v a r i a n c e e x p e c t s homogeneity of variances, this large variance difference affected the power of the test to detect differences a m o n g the means of the three groups, even when the differences m i g h t b e large enough t o intuitively expect that the treatments d i d indeed affect the result. The nonhomogeneity c o u l d be a result of the randomization process or (as discussed earlier), due to lack of equal control over the conditions inherent in the administration of the treatments, or, indeed, any source of experimental error that was not equally controlled for a l l three groups. CONCLUSIONS
(1) G i v e n appropriate teaching materials, individuals classified as non-professionals in mental health c a n b e successful in affecting attitudinal changes among secondary students. (2) E m o t i o n a l s e l f - i m p r o v e m e n t w i t h i n a classroom environment has been demonstrated.L However, a favorable outcome is more likely, provided the academic environment remains highly structured. (3) Obviously techniques for mental-health self-improvement can b e learned by students within a classroom climate. These techniques facilitate a more favorable interaction w i t h others, the escape from feelings of inadequacy, and individuals tend to become more self-directed. The total social order can only change after persons change. ACKNOWLEDGEMENT The authors wish to acknowledge the expertise provided this research project by Maxie C. Maultsby Jr., M.D.. Dlrector of the Out-Patient Clinic, University Hospital, University of Kentucky, School of Medicine. REFERENCES 1. Ray 0s: Drug, Society and Human Behavior. Saint Louis, The CV Mosby Co., 1972, p 3. 2. Maultsby MC, Knipping PA: Teaching of RSC in the classroom. J Sch Health, October 1974. 3. Karpman 8: Objective psychotherapy. J Clin Psycho1 5 5 1 4 8 , 1949.
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4. Kunlap K: Habits, Their Making Unmaking. New York, Liverright Publishing Corp., 1932, p 196. 5. Woipe J, Lazarus AA: Behavior Therapy Techniques. Oxford, Pergamon Press, 1966. 6. Wolpe J, Salter A, and Reyna LJ (Eds): The Conditioning Therapies. Holt, Rinehart, Winston, New York, p 11. 7. Storrow AH: Introduction to Scientific Psychlatry. Appleton-Century-Crofts, New York, 1967, pp 165167. 8. Fort J: Drug For and Against. Hart Publishing Co., New York, p 150. 9. Holland JG, and Skinner BF: The Analysis of Behavior, McGraw-Hill, New York, pp 26-34, 1961. 10. Skinner BF: Verbal Behavior, Appleton-CenturyCrofts, New York, 1957. 11. Rotter JB: S o c i a l Learning and C l i n i c a l Psychology, Prentice-Hall, Inc., New York, 1954. 12. Mowrer OH: Learning Theory and Behavior, John Wiley 8 Sons, Inc., New York, 1960. 13. Mowrer OH: Learning Theory and The Symbolic Process. John Wiley & Sons, 1963. 14. Goodman D, and Maultsby MC: Emotional WellBeing Through Rational Behavior Training. Charles C Thomas Publisher, Springfield, IL., 1974, p 15-17. 15. Johnson C, and Cramer J: The OK Classroom. Instructor, May 1973, p 33-40. 16. Shostrom EL: Manual: Personal Orientation Inventory, Educational and Industrial Testing Service, San Diego, 1962. 17. Lichtenstein EM: Techniques for Assessing Outcomes in Psychotherapy. In McRaynolds P (Ed) Advances in Psychological Assessment, Science and Behavior Books, Palo Alto, 1971, p 178-190. 18. Maultsby MC, Handbook of Rational SelfCounseling. Private Publication. 19. Grace WJ and Graham DT: Relationship of specific attitudes and emotions to certain bodily disease. Psychosom Med, 14:243-251, 1952. 20. Graham DT, Stern JA and Winokur G: Experimental investigation of the specificity of attitude hypothesis in psychosomatic disease. Psychosom Med, 24:257-266, 1962. 21. Graham DT, Kabler JD and Graham FK: Physiological response to the suggestion of attitudes specific for hives and hypertension. Psychsom Med, 24:259-260, 1962. 22. Graham DT, Lundy RM, Benjamin LS et al: Specific attitudes in initial interviews with patients having different psychosomatic disease. Psychosom Med, 24:257-266, 1962. 23. Maultsby MC and Gram JM: Long-Term Follow-Up of Patients Treated with Systematic, Written Homework in Psychotherapy, Read at Association for Advancement of Behavior Therapy, Sept 1971. 24. Rotter JB: Generalized Expectancies for Internal vs. External Control of Reinforcements. Psycho1 Monogr 80, 1966. JANUARY 1975 VOLUME XLV NO. 1
