Client Introversion and Counseling Session Impact

Jotollal of Counseling Psychology 1986, Vol. 33, No. 3,235-241

Copyright 1986 by the American Psychological Association, Inc. 0022-0167/86/$00.75

Client Introversion and Counseling Session Impact Andrew Nocita and William B. Stiles Miami University The impact of counseling sessions cannot be assumed to be uniform across clients but may vary systematically with clients' personality characteristics. Insofar as personal counseling is a social encounter, introverted clients may be expected to experience greater distress in sessions than extraverted clients. This expectation was confirmed in two samples of clients in a university clinic, who completed the Minnesota Multiphasic Personality Inventory during their treatment and completed the Session Evaluation Questionnaire immediately after their sessions. With differences among counselors statistically controlled, relatively introverted (higher Social Introversion) clients rated their sessions as relatively uncomfortable, unpleasant, tense, rough, and difficult and rated their postsession mood as relatively unfriendly, uncertain, sad, angry, and afraid. Conversely, relatively gregarious, overactive, extraverted (higher Hypomania) clients rated their sessions as relatively comfortable, pleasant, relaxed, smooth, and easy.

A corollary of the "patient uniformity assumption," one of Kiesler's (1966) "myths" of counseling and psychotherapy research, is that in-session procedures are experienced similarly by all clients. That both the assumption and its corollary are false seems evident when they are stated explicitly. Nevertheless, there is little systematic knowledge of which client characteristics predict how counseling will be experienced. Such knowledge could help theorists account for variability in clients' response to treatments. In this study, we addressed the general hypothesis that counseling session impact--the session's immediate effect (Stiles, 1980)----is predictable to some extent from clients' personality characteristics. Following Orlinsky and Howard's (1975) question, "What kinds of experience do different kinds of people have in therapy?" (p. 4), we asked more specifically how clients' introversion or extraversion predicts their evaluation of their sessions and their postsession mood. Orlinsky and Howard's (1975) impact research focused on clients' demographic characteristics, such as age, sex, marital and parental status, education, and number of siblings. For example, clients who had experienced a family breakup during childhood or who had gone through a divorce seemed more ready to accept the therapist's helpfulness, according to clients' session ratings. Female clients between 20 and 26 years old who had some college education, were single with no children, and came from a disrupted family background tended to experience "collaborative progress" in therapy. Neither Odinsky and Howard (1967, 1975, 1977) nor others who have studied session impact

(e.g., Barak & LaCrosse, 1975; Hoyt, 1980; LaCrosse, 1977, 1980; Mintz, Auerbach, Luborsky, & Johnson, 1973; Mintz, Luborsky, & Auerbach, 1971; Stiles, 1984; Stiles & Snow, 1984a, 1984b) have systematically assessed the relation of client personality variables to session impact. Introversion-extraversion is a venerable and pervasive constituent of personality theories (Eysenck, 1970, 1971, 1972, 1973; Jung, 1923; Shapiro & Alexander, 1975) and of theoretically based personality tests, such as the MyersBriggs Type Indicator of Jungian types (Myers, 1962) and the Eysenck Personality Inventory (Eysenck & Eysenck, 1963). The concept has overflowed the theories and has found a place in common parlance; in general psychology; and in empirically based, general-purpose personality tests such as the Minnesota Multiphasic Personality Inventory (MMPI) and the Sixteen Personality Factor Questionnaire (16 PF; Carrigan, 1960; Richardson, 1982; Shapiro & Alexander, 1975). Its conceptual and psychometric importance make it a logical place to begin systematic research on how the client's personality influences session impact. Alternative measures of introversion tend to be moderately to highly correlated with each other, providing convergent validity (Carrigan; Karson & Pool, 1957; Nelson & Shea, 1956). Construct validity has been shown for a variety of people and situations (recent examples include Gormly, 1983; Keller & Tetlow, 1980; Lobstein, Mosbacher, & Ismail, 1983; Montgomery, 1983; Quattrochi-Tubin & Jason, 1983; Snyder & Gangestad, 1982; and Suda & Fouts, 1980), though not, to our knowledge, for clients in counseling or psychotherapy (cf. Luborsky, Chandler, Auerbach, Cohen, & Bachrach, 1971). Although different theories propose different underlying mechanisms, theoretical and empirical descriptions converge in depicting introverts as pensive, calculating, private, and socially uncomfortable and extraverts as impulsive, spontaneous, and socially at ease. Introverts are sometimes seen as maladjusted or neurotic because of their sensitivity and shyness. Theoretically and psychometrically, however, introversion is better considered as independent of adjustment, as illustrated by the statistical independence of

A report of this study was presented at the meeting of the Society for Psychotherapy Research, Lake Louise, Alberta, Canada, July 1984. We thank David A. Shapiro for his comments on drafts of this article. Correspondence concerning this article should be addressed to Andrew Nocita or William B. Stiles, Depart.ment of Psychology, Miami University, Oxford, Ohio 45056. 235

236

ANDREW NOCITA AND WILLIAM B. STILES

Eysenck's Neuroticism dimension from Extraversion. Thus, introversion may be seen as a moderating variable in couns e l i n g - a n influence on how treatment is experienced but not necessarily an object of treatment. Insofar as personal counseling is a social encounter, the theories imply that introverts would tend to find it uncomfortable and unpleasant, whereas extraverts would tend to find it absorbing, relaxing, and refreshing. Counseling is an atypical social encounter, however, and other features might override its social aspect. For example, it might be argued on intuitive grounds that counseling's inward focus on self would be more congenial to introverts than extraverts, making the experience easier and more comfortable for the former than for the latter. Thus, empirical assessment of the relation of clients' introversion--extraversion to counseling experience is needed. In the present study, we tested the hypothesis that counseling sessions are experienced more negatively by relatively introverted clients than by relatively extraverted clients. If introverts tend to feel less comfortable in sessions, find sessions less valuable, or leave sessions in a less positive mood, then counselors should know it because such negative session impacts could interfere with the process of change or could lead clients to terminate prematurely. Knowing of such a relation, counselors could design treatments that compensate or allow for each client's degree of introversion. This study's focus on client introversion is not meant to imply that client personality is the primary or only influence on session impact. Different counselors and theoretical approaches undoubtedly have different impacts. Events in the client's life; the memory of previous sessions; and, of course, variation in the process of the sessions themselves must powerfully affect clients' experience. Indeed, a large proportion of impact variation is from session to session, within dyads (Howard, Orlinsky, & Perilstein, 1976; Mintz et al., 1971; Stiles & Snow, 1984a). Our specific goal in the present study was to detect effects of stable client differences. Accordingly, we used statistical techniques to control these other sources of variance--averaging across sessions to obtain estimates of clients' usual or typical experience and using residual correlations to adjust for systematic differences among counselors. Once the independent influences of client personality on impact are known, then future resez-'ch and theory can take them into account.

Method Two samples of counseling sessions, involving different clients and counselors, were studied in a university clinic. These were regular clinic clients, and procedures were designed to minimize intrusion into clinic routines. All clients completed the MMPI, which included the Social Introversion (Si) scale. They also completed the Session Evaluation Questionaire (SEQ), a measure of impact, immediately after each session. The first sample was collected in the course of an earlier study (Stiles & Snow, 1984a, 1984b). The second sample, which was collected at a later time, incorporated several refinements intended to reduce extraneous variance.

Subjects and Procedure Clients were 83 adults seen in individual counseling at the Miami University Psychology Department Clinic. They were self-referred or referred by other agencies for psychological dysfunction. All individual adult clients seen in the clinic during the study period were eligible, and (except for a few cases of counselor oversight or nonparticipation) were asked to participate. Of those asked, more than 80% agreed and gave written consent. Most (88%) of the participating clients were university students (66 undergraduates and 7 graduate students), though some (10 clients) were community residents. Their ages ranged from 17 to 39 years, but most (77%) were between 18 and 23; 60% were female; 94% were white. Their most common presenting problems included depression, anxiety, low self-esteem and insecurity, relationship problems (including problems with parents), and study problems and school adjustment. MMPI results documented the clients' level of disturbance: 90% had one or more clinical scales at or above a T score of 70 (the level usually interpreted as dysfunctional); 73% had two or more clinical scales at or above 70; and 55% had three or more at or above 70. The most common high-point codes (one or two highest clinical scales other than 5 or 0, in either order, with T scores at or above 70; cf. Greene, 1980; see Table 1 for scale names) were 2-7 (10 clients), 7-8 (7 clients), Spike 4 (6 clients), 4--8 (6 clients), and 4-7 (5 clients). Clients were not charged for counseling except that nonstudents in Sample 2 (a small proportion of clients) paid $5 per session, a new clinic policy. The 24 counselors (ages 22 through 46 years and 58% female) were clinical psychology graduate students in their second to fourth year of training and with 0 to 3 years of experience. Their supervisors' theoretical orientations varied (client centered, family systems, interpersonal/Sullivanian, psychoanalytic, personal constructs, rational--emotive); each counselor usually practiced his or her supervisor's approach in treating these clients. Typical supervisory Table 1 Clients' Mean MMP1 Scale T Scores and SEQ Index Scores

Scale or index 1. 2. 3. 4. 5. 6. 7. 8. 9. 0.

Sample 1

Sample 2

M

SD

M

SD

10.0 13.6 10.2 10.5 16.2 9.1 • 12.8 12.7 10.5 10.8

63.1 73.3 66.1 70.8 58.3 66.5 73.8 75.4 65.9 59.9

12.6 18.4 12.6 12.8 19.2 12.1 14.5 15.6 11.2 10.8

MMPI scale Hypochondriasis (Hs) 56.4 Depression (D) 66.0 Hysteria (Hy) 63.4 Psychopathic Deviate (Pd) 69.5 Masculinity and Femininity (Mf) 53.2 Paranoia (Pa) 65.0 Psychasthenia (lOt) 68.0 Schizophrenia (Sc) 67.0 Hypomania (Ma) 62.7 Social Introversion (Si) 56.9 SEQ index

Session evaluation Depth Smoothness Postsession mood Positivity Arousal

5.13 4.33

.65 4.91 .82 4.28

.63 .95

4.60 4.22

.85 4.38 .66 4.18

.79 .69

Note. For Sample 1, N = 47. For Sample 2, N = 36. MMPI = Minnesota Multiphasic Personality Inventory; SEQ = Session Evaluation Questionnaire. Higher scores indicate more of the named characteristic.

INTROVERSION AND SESSION IMPACT procedures included regular tape recording and review of sessions, to help ensure that treatment quality was maintained. (Tapes were normally erased and not used for research.) For inclusion in this study, counselors had to have seen at least two clients, to permit independent estimates of counselor effects. Each counselor saw two to seven of the clients (Mdn = 3). Counselors were not aware of this study's hypothesis. Sample 1 included 47 clients and 13 counselors. Sample 2 included 36 clients and 14 counselors. (Three counselors were in both samples.) Distributions of client and counselor demographic characteristics were similar in the two samples.

Introversion Measured by the MMPI Client introversion was measured by the MMPI Si scale (Scale 0). As Greene (1980) noted, unlike other MMPI clinical scales, "Scale 0 was not based on a psychiatric syndrome; rather it was developed by using a psychological test [an earlier introversion scale]" (p. 110). Two other clinical scales share substantial variance with this personality dimension, while also measuring specific psychopathology--the Hypomania (Ma) scale (Scale 9), as an index of extraversion, and the Depression (D) scale (Scale 2), as a measure of introversion. Factor analytic studies of the MMPI have demonstrated strong loadings of these scales on introversionextraversion factors, Ma with the opposite polarity from Si and D with the same polarity as Si (Karson & Pool, 1957; Kassebaum, Couch, & Slater, 1959; Nelson & Shea, 1956). For inclusion in Sample 1, clients had to have completed the MMPI anytime during their counseling. As a refinement in Sample 2, clients were required to have completed the MMPI before their fourth counseling session, so that scores reflected their level of distress at the beginning of counseling. Taking the MMPI was part of normal procedure at the clinic, so this aspect of the study involved little intrusiveness. Mean T scores, given in Table 1, show that samples were similar, although Sample 2's scores averaged slightly higher, possibly reflecting greater distress earlier in counseling. Standard deviations indicated a full range of variation on each scale.

Session Evaluation Questionnaire Clients completed the SEQ immediately following each session and deposited it in a box in the clinic waiting room. They were assured that their counselor would not see their responses, to prevent the SEQ from becoming a channel of client--counselor communication. Clients in Sample 1 used SEQ Form 3 (fully described elsewhere; Stiles & Snow, 1984a, 1984b), which includes 24 bipolar adjective scales presented in 7-point semantic differential format. The stem "'This session w a s : " precedes the first 12 adjective pairs, and the stem "Right now I feel:" precedes the second 12. Factor analyses of the first section (session evaluation) have shown two independent factors, Depth, which reflects the session's felt power and value, and Smoothness, which reflects the session's comfort and pleasantness, Factor analyses of the second section (postsession mood) have shown two factors, called Positivity and Arousal, consistent with Russell's (1978, 1979) two-factor model of affective space. ("Pleasure and arousal are essential to the meaning of emotional terms," Russell, 1978, p. 1166.) Conducted on residual correlation matrices, the analyses confirmed these factors both at the session level, that is, for session ratings adjusted for mean differences among clients, and at the client level, that is, for clients' mean ratings adjusted for mean differences among counselors (Stiles & Snow, 1984b). Clients in Sample 2 used SEQ Form 4, which was the same as Form 3 except

237

that some adjective scales in the second section were changed to strengthen the Arousal factor. Indexes of the four SEQ factors were constr~cted by using the scales that had the highest and most consistent factor loadings. Each scale was scored from 1 to 7, with higher scores indicating greater Depth, Smoothness, Positivity, and Arousal. The Depth index was the mean rating on deep-shallow, valuable-worthless, full--empty, powerful-weak, and special--ordinary. The Smoothness index was the mean rating on smooth-rough, comfortableuncomfortable, easy--difficult, pleasant-unpleasant, and relaxedtense. The Positivity index was the mean rating on happy-sad, confident-afraid, definite-uncertain, pleased-angry, and friendlyunfriendly. The Arousal index for Sample 1 (SEQ Form 3) was the mean of aroused-quiet, fast-slow, excited--calm, and activestill. For Sample 2 (SEQ Form 4), active-still was omitted, and moving-still and energetic-peaceful were substituted. The high internal-consistency reliability of these session indexes (see Stiles & Snow, 1984a, Table 1) indicates that within each index, constituent scales measure the same dimension. Clients' session indexes were averaged across sessions to obtain measures of typical or average impact for comparison with clients' personality characteristics. Averaging tends to attenuate the effects of unusual sessions, external events, oscillation of good and bad sessions, and other sources of impact variability. Although clients used the full 1-to-7 range on each adjective scale, the variation of the mean indexes was more moderate (see standard deviations, Table 1) because the ratings were averaged--first across scales to obtain each index and then across sessions for each client. For inclusion in either sample, clients had to have completed at least six SEQs; thus very short-term clients were excluded. Previous SEQ research showed that six-session averages yield adequately stable estimates of clients' characteristic levels on the four SEQ indexes (test-retest reliabilities of .80 or greater, estimated by the Spearman-Brown prophecy formula; see Stiles & Snow, 1984a, p. 10, Footnote 1). Clients' scores on each index were averaged across all sessions for Sample l and across all sessions up to the 12th for Sample 2. (This refinement was meant to reduce possible distortions due to long-term treatment or sessions conducted long after the MMPI was completed. In Sample 1, clients took the MMPI at different times, so the restriction to the first 12 sessions was not appropriate.) Thus, for sample 1, indexes were averaged over from 6 to 49 sessions (Mdn = 11, total sessions used = 685). For Sample 2, indexes were averaged over from 6 to 12 sessions (Mdn = 12, total sessions used = 364). Mean SEQ indexes, shown in Table l, were similar in the two samples.

Analysis MMPI clinical scale T scores were correlated, across clients, with the SEQ indexes. The correlations with the Si scale and, secondarily, with the Ma and D scales tested the hypothesized association of introversion with session impact; correlations with other scales assessed the association of specific types of psychological distress with impact. To assess whether a scale's place in the client's MMPI profile predicted session impact, the ten clinical scales were ranked from 1 (lowest scale) to 10 (highest scale) within each client's profile, and the ranks were correlated, across clients, with SEQ indexes. The ranks provided a way to examine MMPI scales configurally, that is, in terms of relative elevations rather than absolute elevations. For comparing SEQ indexes with MMP! T scores and scale ranks, we used residual correlations after extracting variance due to counselors rather than zero-order correlations. This corrected

238

ANDREW NOCITA AND WILLIAM B. STILES

for possibly confounding influences of stable counselor characteristics, such as sex, age, appearance, personality, and theoretical approach to counseling. To illustrate, because of such characteristics, certain counselors may have tended to conduct smooth sessions with all clients. Introverted clients of "smooth" counselors might have had higher Smoothness raw scores than extraverted clients of "rough" counselors. Nevertheless, each counselor's extraverted clients could still have had smoother sessions than his or her introverted clients. Using the residuals adjusts for mean differences among counselors; in effect, we used clients' deviations from the mean of their counselor's clients rather than deviations from the grand mean of all clients. To put it another way, the residual correlations reflect "within-counselor" relationships, pooled across counselors.

Table 3

Residual Correlations of Clients' SEQ Indexes With MMPI Hypomania (Ma) Scale, With Counselor Differences Controlled Sample 1 SEQ index

Ma Tscore

Session evaluation Depth Smoothness Postsession mood Positivity Arousal

Sample 2

Ma rank

Ma Tscore

Ma rank

.05 .49**

.09 .46**

.49* .38

.58** .47*

.37" .17

.47"* .13

.33 .43*

.37 .42*

Note. For Sample 1, N = 47, df = 33 after controlling for counselor differences. For Sample 2, N = 36, df = 21 after controlling for counselor differences. SEQ = Session Evaluation Questionnaire; MMPI = Minnesota Multiphasic Personality Inventory. *p < .05. **p < .01.

Results As Table 2 shows, the MMPI Si scale was negatively correlated with SEQ Smoothness and with SEQ postsession Positivity in both samples. All correlations were significant except for two that were m a r g i n a l - - S i T scores with Smoothness in Sample 1 ( - .33, p < .06) and Si ranks with Positivity in Sample 2 ( - . 3 9 , p < .07). That is, as hypothesized, relatively introverted (higher Si) clients des c r i b e d t h e i r s e s s i o n s as r e l a t i v e l y r o u g h , d i f f i c u l t , uncomfortable, unpleasant, and tense. Following their sessions, relatively introverted clients reported feeling relatively unfriendly, sad, afraid, angry, and uncertain. Finding the same pattern of correlations for Si ranks as for Si T scores implied that the hypothesized associations held both for Si's actual elevation and for Si's prominence in the profile. Si T scores were significantly negatively correlated with SEQ Depth in Sample 2 but not in Sample 1, and Si ranks were significantly negatively correlated with SEQ Arousal in Sample 2 but not in Sample 1. Table 3 shows that the MMPI Ma scale T scores and ranks were positively correlated with SEQ Smoothness in both samples--all significantly except for Ma T scores in Sample 2, which were marginal (.38, p < .08). Thus, consistent with the hypothesis, relatively extraverted (higher Table 2

Residual Correlations of Clients" SEQ Indexes With MMPI Social Introversion (Si) Scale, With Counselor Differences Controlled Sample 1 SEQ index

Si T score

Session evaluation Depth Smoothness Postsession mood Postivity Arousal

Sample 2

Si rank

Si T score

Si rank

- .24 - .33

- .31 - .39*

- .54** - .60**

- .35 - .51"

- .42* - . 14

- .35* - .36*

- .43* - .37

- .39 - .08

Ma) clients tended to describe their sessions as relatively smooth, easy, comfortable, pleasant, and relaxed. In populations of university students, high Ma usually reflects, rather than manic psychosis, an outward orientation, high and perhaps unrealistic aspiration, and overactivity. Also consistent with the hypothesis, Ma T scores and ranks were significantly correlated with SEQ postsession Positivity in Sample 1; these correlations were positive but did not reach significance in Sample 2 (.33, p < .14, and .37, p < .08, respectively). Ma T scores and ranks were significantly positively correlated with Depth and Arousal in Sample 2 but not in Sample 1. The MMP1 D scale was negatively correlated with SEQ postsession Positivity ( - .40, p < .02, for T scores; - .32, p < .06, for ranks) in Sample 1, consistent with the hypothesis insofar as the D scale has been linked with introversion. Scale D was not, however, significantly correlated with Positivity in Sample 2 or with any other SEQ indexes in either sample. Among all the other residual correlations of the 10 MMPI scales' T scores and ranks with the four SEQ scores, the only significant ones were for MMPI T scores on Scale 7, Psychasthenia (Pt), in Sample 2 only. These correlations were - .46 with Depth, - .47 with Smoothness, - .46 with Positivity, and - . 4 3 with Arousal (all ps < .05). Taken alone, these would suggest that relatively anxious, obsessive clients tended to have worse sessions overall. Because the correlations did not hold for ranks and failed to replicate across samples, interpretation is difficult.

Discussion

Note. For Sample 1, N = 47, df = 33 after controlling for counselor differences. For Sample 2, N = 36, df = 21 after controlling for counselor differences. SEQ = Session Evaluation Quest'annaire; MMPI = Minnesota Multiphasic Personality Inventory. *p < .05. **p < .01.

As hypothesized, and contrary to the patient uniformity assumption, clients' evaluations of their counseling sessions and their postsession mood were correlated with their degree of introversion--extraversion. Relatively introverted, socially fearful (higher Si) clients rated their postsession mood as relatively negative, as compared with their counselor's less introverted clients. Relatively extraverted, gregarious, overactive (higher Ma) clients rated their sessions

INTROVERSION AND SESSION IMPACT as smoother and easier and rated their postsession mood as relatively positive. The correlations with the Si and Ma scales' ranks in the clients' MMPI profiles--a configural approach showed essentially the same pattern as the correlations with the scales' absolute elevations. Insofar as counseling is, among other things, a social encounter, these results are consistent with theoretical expectations that social contact tends to be difficult and unpleasant for introverts but relaxing and pleasant for extraverts.

Strengths and Limitations of the Study The replication across two independent samples makes it very unlikely that these correlations were due to chance, even though some were only marginally significant in one sample or the other by a two-tailed criterion. (Of the 16 correlations of the Si and Ma T scores and ranks with the SEQ Smoothness and Positivity indexes in both samples, all but one were significant, however, at p < .05 by a onetailed criterion.) Clients' introversion-extraversion varied substantially (i.e., standard deviations of Si and Ma were as large as in the general population; see Table 1). The demographically narrow range of the clients, however, makes replication in other populations essential to check, for example, that the effect is not restricted to university students. The use of residual correlations statistically corrected for any nonuniformity of counselors (cf. Kiesler, 1966), thus highlighting the nonuniformity of clients, which was of primary interest in this study. The more introverted clients' greater discomfort should be interpreted in relation to other clients of the same counselor rather than absolutely. It is possible that some counselors systematically conduct more comfortable sessions than do others. The present samples of counselors were too small and too restricted (graduate students in one program) to conduct analyses or draw conclusions regarding the influences of counselor characteristics on session impact. Other significant MMPI-SEQ correlations were not replicated across the two samples. Most of these correlations were broadly consistent with the hypothesis that relatively introverted clients tend to experience sessions more negat i v e l y - t h e Si scale (negatively) with Arousal in Sample 1 and Depth in Sample 2, the D scale (negatively) with Positivity in Sample 1, and the Ma scale (positively) with Depth and Arousal in Sample 2. The discrepancies might simply be random sample variation, or they might reflect procedural differences, such as Sample 2's restrictions to data from the early phases of counseling. (Recall that to reduce extraneous variance in Sample 2, MMPIs were administered before the fourth session, and SEQs were collected from the first 12 sessions.) As a further sample difference, the MMPI Pt scale was negatively correlated with all four SEQ indexes in Sample 2 but not in Sample 1. Any interpretations based on sample differences would be extremely speculative, however. Discriminant validity was indicated by the lack of significant correlations of other MMPI scales (except Pt in Sample 2) with the SEQ impact measures. If session evaluations depended on clients' overall level of disturbance or

239

on their specific form of psychopathology, then one would expect consistently higher correlations with other MMPI scales. Instead, the association with SEQ-measured impact appears specific to introversion-extraversion. In an indirect way, this confirms the theoretical and psychometric emphasis others have given to this personality dimension. Of course, other, untested aspects of client personality may also predict session impact. We did not, in this study, address whether introverts' negative session evaluations reflected observable differences in session, process or only different subjective experience. Perhaps introverted clients behave in ways that make sessions objectively rough and difficult (e.g., by being withdrawn or unresponsive), or perhaps counselors respond differently to their more introverted clients. If so, it should be possible to detect differences by coding the interaction. Alternatively, the anticipation of enforced social contact may interpose different evaluative filters, through which relatively introverted clients perceive session events more negatively. Introverted clients did not report greater postsession Arousal. (On the contrary, Arousal was significantly correlated negatively with Si ranks in Sample 1 and positively with Ma T scores and ranks in Sample 2.) In conjunction with theory and research suggesting greater chronic arousal levels ("cortical excitation") among introverts (Eysenck, 1970, 1971, 1972, 1973), this failure indirectly suggests that SEQ postsession-mood scales measure transient, "state" characteristics of respondents, as opposed to stable, "trait" ones.

Implications for Practice and Research In hindsight, it may seem unsurprising that people who report being socially ill at ease generally (via the MMPI) tend to find counseling sessions uncomfortable. The finding is no less important, however, for being plausible. Judging from the larger correlations in Tables 2 and 3, introversion may account for as much as one fourth to one third of the variance in within-session discomfort among a counselor's clients. Although the unaccounted-for variance leaves room for other influences on session impact, the finding suggests that client introversion deserves to be incorporated explicitly into counseling theories and to be measured as a possible mediating variable in process and outcome research. The association between introversion and in-session distress has implications for how clients should be dealt with. Knowing that certain clients are likely to find counseling relatively unpleasant, counselors might pay special attention to subtle cues that signal distress and tailor treatment plans accordingly. If introverts find counseling less comfortable, they might be less inclined to seek it or more inclined to terminate prematurely. Because the MMPI is widely used, clients' Si and Ma scores are already available to many counselors, for use in planning treatment. The greater discomfort experienced by more introverted clients need not necessarily lead to poorer outcomes. Some counselors might argue that a moderate level of discomfort is appropriate and useful. Success may depend on proper

240

ANDREW NOCITA AND WILLIAM B. STILES

matching of treatment to clients' degree of introversion, across different presenting problems or diagnoses. Some support for treating introverts differently from extraverts comes from DiLoreto's (1971) finding of differential effectiveness of alternative approaches in a sample that was demographically similar to, though clinically less disturbed, than ours. A m o n g u n d e r g r a d u a t e s who responded to an offer of group counseling for interpersonal anxiety, introverts improved more in rational-emotive groups, whereas extraverts improved more in client-centered groups. Process measures suggested that the rational--emotive leaders' greater directiveness stimulated self-exploration for introverts, whereas the client-centered leaders' permissiveness stimulated self-exploration for extraverts. Perhaps these effects were mediated by the introverts' discomfort with the social contact (i.e., they experienced sessions as rough), which made them unresponsive in an unstructured (clientcentered) group. It now appears worthwhile to try to replicate DiLoreto's findings in a clinically more dysfunctional sample.

References Barak, A., & LaCrosse, M. B. (1975). Multidimensional perception of counselor behavior. Journal of Counseling Psychology, 22, 471-476. Carrigan, P. A. (1960). Extraversion-introversion as a dimension of personality: A reappraisal. Psychological Bulletin, 57, 329360. DiLoreto, A. O. (1971). Comparative psychotherapy: An experimental analysis. New York: Aldine-Atherton. Eysenck, H. J. (1970). Readings in extraversion-introversion. Vol 1: Theoretical and methodological issues. London: Staples Press. Eysenck, H. J. (1971). Readings in extraversion-introversion. Vol. 2: Fields of application. London: Staples Press. Eysenck, H. J. (1972). Readings in extraversion-introversion. Vol. 3: Bearings on basic psychological processes. London: Staples Press. Eysenck, H. J. (1973). Eysenck on extraversion. New York: Wiley. Eysenck, H. J., & Eysenck, S. G. (1963). The Eysenck Personality Inventory. San Diego, CA: Education and Industrial Service. Gormly, J. (1983). Predicting behavior from personality trait scores. Personality and Social Psychology Bulletin, 9, 267-270. Greene, R. L. (1980). The MMPI: An interpretive manual. New York: Grune & Stratton. Howard, K. I., Orlinsky, D. E., & Perilstein, 5. (1976). Contribution of therapists to patients" experiences in psychotherapy: A components of variance model for analyzing process data. Journal of Consulting and Clinical Psychology, 44, 520-526. Hoyt, M. F. (1980). Therapist and patient actions in 'good' psychotherapy sessions. Archives of General Psychiatry, 37, 159161. Jung, C. G. (1923). Psychological types. In H. G. Baynes (Trans.), New York: Harcourt, Brace. Karson, S., & Pool, K. B. (1957). The construct validity of the Sixteen Personality Factors test. Journal of Clinical Psychology, 13, 245-252. Kassebaum, G., Couch, A. S., & Slater, P. E. (1959). Factorial dimensions of the MMPI. Journal of Consulting Psychology, 23, 226-236. Keller, H. T., & Tetlow, E. W. (1980). Participation in corn-

munity theatre and types of personality. Psychological Reports,

47, 711-714. Kiesler, D. J. (1966). Some myths of psychotherapy research and the search for a paradigm. Psychological Bulletin, 65, 110-136. LaCrosse, M. B. (1977). Comparative perceptions of counselor behavior: A replication and extension. Journal of Counseling

Psychology, 24,464--471. LaCrosse, M. B. (1980). Perceived counselor social influence and counseling outcomes: Validity of the counselor rating form. Journal of Counseling Psychology, 27, 320-327. Lobstein, D. D., Mosbacher, B. J., & lsmail, A. H. (1983). Depression as a powerful discriminator between physically active and sedentary middle-aged men. Journal of Psychosomatic Research, 27, 69-76. Luborsky, L., Chandler, M., Auerbach, A., Cohen, J., & Bachrach, H. M. (1971). Factors influencing the outcome of psychotherapy: A review of quantitative research. Psychological Bulletin, 75, 145-185. Mintz, J., Auerbach, A. H., Luborsky, L., & Johnson, M. (1973). Patients', therapists', and observers' views of psychotherapy: A 'Rashomon' experience or a reasonable consensus? British Journal of Medical Psychology, 46, 83-89. Mintz, J., Luborsky, L., & Auerbach, A. H. (1971). Dimensions of psychotherapy: A factor analytic study of ratings of psychotherapy sessions. Journal of Consulting and Clinical Psychology, 36, 106-120. Montgomery, G. K. (1983). Uncommon tiredness among college undergraduates. Journal of Consulting and Clinical Psychology, 51, 517-525. Myers, I. B. (1962). The Myers-Briggs Type Indicator: Manual. Princeton, NJ: Educational Testing Service. Nelson, M. O., & Shea, S. (1956). MMPI correlates of the inventory of factors STDCR. Psychological Reports, 2,433--436. Orlinsky, D. E., & Howard, K. I. (1967). The good therapy hour: Experiential correlates of patients' and therapists' evaluations of therapy sessions. Archives of General Psychiatry, 16, 621632. Orlinsky, D. E., & Howard, K. I. (1975). Varieties of psycho-

therapeutic experience: Multivariate analyses of patients' and therapists" reports. New York: Teachers College Press. Orlinsky, D. E., & Howard, K. I. (1977). The therapist's experience of psychotherapy. In A. S. Gurman & A. M. Razin (Eds.), Effective psychotherapy: A handbook of research (pp. 566-590). Oxford: Pergamon Press. Quattrochi-Tubin, S., & Jason, L. A. (1983). The influence of introversion-extraversion on activity choice and satisfaction among the elderly. Personality and Individual Differences, 4, 17-22. Richardson, J. T. (1982). Introversion-extraversion and experimenter effects in memory tasks. Personality and Individual Differences, 3, 327-338. Russell, J. A. (1978). Evidence of convergent validity on dimensions of affect. Journal of Personality and Social Psychology, 36, 1152-1168. Russell, J. A. (1979). Affective space is bipolar. Journal of Personality and Social Psychology, 37, 345-356. Shapiro, K. J., & Alexander, I. E. (1975). The experience of

introversion: An integration of phenomenological, empirical, andJungian approaches. Durham, NC: Duke University Press. Snyder, M., & Gangestad, S. (1982). Choosing social situations: Two investigations of self-monitoring processes. Journal of Personality and Social Psychology, 43, 123-135. Stiles, W. B. (1980). Measurement of the impact of psychotherapy sessions. Journal of Consulting and Clinical Psychology, 48, 176-185.

I N T R O V E R S I O N A N D SESSION I M P A C T Stiles, W. B. (1984). Client disclosure and psychotherapy session evaluations. British Journal of Clinical Psychology, 23, 3 1 1 312. Stiles, W . B., & Snow, J. S. (1984a). Counseling session impact as viewed by novice counselors and their clients. Journal of Counseling Psychology, 31, 3-12. Stiles, W. B., & Snow, J. S. (1984b). Dimensions o f psychotherapy session impact across sessions and across clients. British Journal of Clinical Psychology, 23, 59-63.

241

Suda, W . , & Fouts, G. (1980). Effects o f peer pressure on introverted and extraverted children. Child Development, 51, 12721275.

R e c e i v e d S e p t e m b e r 9, 1985 R e v i s i o n r e c e i v e d N o v e m b e r 11, 1985 •

I n s t r u c t i o n s to A u t h o r s Articles submitted to the Journal of Counseling Psychology should be concisely written in simple, unambiguous language. They should present material in logical order, starting with a statement of purpose and progressing through an analysis of evidence to conclusions and implications, with the conclusions clearly related to the evidence presented. Authors should prepare manuscripts according to the Publication Manual of the American Psychological Association (3rd ed.). All manuscripts must include an abstract of 100--150 words typed on a separate sheet of paper. Typing instructions (all copy must be double-spaced) and instructions on preparing tables, figures, references, metrics, and abstracts appear in the Manual. Also, all manuscripts are subject to editing for sexist language. APA policy prohibits an author from submitting the same manuscript for concurrent consideration by two or more journals. APA policy also prohibits duplicate publication, that is, publication of a manuscript that has already been published in whole or in substantial part in another publication. Authors of manuscripts submitted to APA journals are expected to have available their raw data throughout the editorial review process and for at least 5 years after the date of publication. Authors will be required to state in their initial submission letter or sign a statement that they have complied with APA ethical standards in the treatment of their sample, human or animal. (A copy of the APA Ethical Principles may be obtained from the APA Ethics Office, 1200 17th Street, N.W., Washington, DC 20036.) This journal publishes brief reports, which also must include an abstract and be submitted in triplicate. To ensure that a brief report does not exceed four printed pages, follow these typing instructions; (a) Set the typewriter to a 48-space line and type the text. (b) Count all lines except the abstract, title, and by-line; be sure to count the lines for acknowledgments, headings, footnotes, tables, and references. If you have exceeded 400 lines, shorten the material. Because reviewers have agreed to participate in an anonymous reviewing system, authors submitting manuscripts are requested to include with each copy of the manuscript a cover sheet, which shows the title of the manuscript, the authors' names and institutional affiliations, and the date the manuscript is submitted. The first page of text should omit the authors' names and affiliations but should include the title of the manuscript and the date it is submitted. Footnotes containing information pertaining to the authors identity or affiliations should be on separate pages. Every effort should be made to see that the manuscript itself contains no clues to the authors' identity. Manuscripts should be submitted in triplicate. All copies should be clear, readable, and on paper of good quality. A dot matrix or unusual typeface is acceptable only if it is clear and legible. Authors should keep a copy of the manuscript to guard against loss. Mail manuscripts to the Editor, Charles J. Gelso, Department of Psychology, University of Maryland, College Park, Maryland 20742.