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Videotape focused feedback techniques in marathon group therapy: Effects on self-actualization and psychopathology

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Videotape focused feedback techniques in marathon group therapy: Effects on self-actualization and psychopathology

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Content VIDEOTAPE FOCUSED FEEDBACK TECHNIQUES IN
MARATHON GROUP THERAPY: EFFECTS ON
SELF-ACTUALIZATION AND PSYCHOPATHOLOGY
by
Frank Merritt Tansey
A Dissertation Presented to the
FACULTY OF THE GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF PHILOSOPHY
(Education)
January 19 79
UMI Number: DP24680
All rights reserved
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a note will indicate the deletion.
Published by ProQuest LLC (2014). Copyright in the Dissertation held by the Author.
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This dissertation, w ritten by
Frank Merritt Tansey
under the direction of h .X p i...... Dissertation
Committee, and approved by all its members, has
been presented to and accepted by the Dean of The
Graduate School, in partial fu lfillm e n t of the re
quirements fo r the degree of
D O C TO R OF P H ILO SO PH Y
........
Dean
Date ,ifg lv u t
^ ^ E R T A T Ig N jC O M M IT T E E
v - j / /i/s'i Chairm an
/
O jb
TABLE OF CONTENTS
Page
LIST OF T A B L E S ........................................ iv
Chapter
I INTRODUCTION .......................... . 1
Research Hypotheses and Corollary
Objectives .............................. 8
Definitions .............................. 9
Conceptual Assumptions .................... 11
Scope of the S t u d y ....................... 12
Limitations .............................. 12
Summary..................................... 13
II SELECTED REVIEW OF LITERATURE ............. 15
Introduction . 15
Historical Perspectives ................. 16
Theoretical Framework .................... 21
Results of Marathon Research ............. 25
Videotape Historical Perspectives . . . 35
Theoretical Framework .................... 38
Results of Videotape Research .... 40
Summary . 49
III METHODOLOGY . 51
Research Purpose ........................... 51
Research Design .......................... 51
Participants in the S t u d y ................ 54
P r o c e d u r e ................................. 57
Instrumentation ........................... 63
Operational Hypotheses .................... 76
Summary.................................... 7 6
IV RESULTS .................................... 7 9
General Format of Analysis . . . . . 79
Multivariate Analysis of Post-Measures . . 80
Effects of Pre-Measures and Treatment
on Post-Measures....................... 80
Effects of Treatment on Post-Measures
with Pre-Measures Used as Co-Variates . 84
Within Subjects’ Comparisons ............. 86
Summary of R e s u l t s ....................... 88
ii
Chapter Page
V SUMMARY, CONCLUSIONS AND DISCUSSION . . . 91
Summary ................................. 91
Conclusions.............................. 93
Discussion .............................. 93
Recommendations ........................... 98
REFERENCES................ 100
iii
LIST OF TABLES
Table Page
1 Significant Effects of Treatment .............. 82
2 Pre-Measured Data for All Subjects
by Group Means and Standard Deviation . . 83
3 Post-Measure Data for All Subjects
by Group Mean and Standard Deviation . . . 85
4 Significant Effect of Treatment
with Pre-Measures as Co-Variates ............. 87
5 Changes in Dependent Variables
Calculated from Mean Pre-Tests and
Mean Post-Tests..................................89
iv
: CHAPTER I
i |
INTRODUCTION '
I
t
Two separate but related developments have resulted j
in the creation of the marathon group. While similar in j
i
nature, the concepts of group psychotherapy and sensitivity;
training were not combined until the creation of marathon !
■therapy (Ruitenbeck, 1970). Group psychotherapy’s roots ]
\
can be traced back to Joseph Pratt’s work with consumption j
i
•patients in 1905. Burrows, Wender, Schilder and Moreno :
I
1 i
.were also significant contributors to the formulation of j
;the group psychotherapy technique (Shaffer £ Galinsky, '
1974) . The significant development in the field of group !
psychotherapy, which will be discussed in the next chapter,
i
are also reviewed by Gazda (1968) and Hill (1967).
i
The National Training Laboratories are credited s
I
with the formulation of the sensitivity training princi- ^
pies. Their work which began in 1946 borrowed many of the j
t ^ »
principles from the group psychotherapy, group dynamics ;
i
and social psychology movements. Through the utilization j
i
of extended day workshops, the sensitivity training move- ,
ment attempted to promote increased awareness while
i
developing skill that would enable the participant to be
more effective in their daily lives. Benne (1964) reviews 1
{the complete development of the sensitivity movement as |
* i
'developed at the National Training Laboratories. In con- j
1 i
trast to group psychotherapy, sensitivity training has i
i
sought to facilitate a more specialized learning. These ;
training sessions were generally focused upon increasing ,
the individual’s ability to function with a group situation!
i
which would then be transferred to the course of normal |
|
:living (Stock, 1964). |
j
According to one of its major proponents, Rogers j
(1970) , in less than 30 years the grout) movement had grown I
to such an extreme that it had permeated the entire country;
to the extent that it was found in nearly all types of |
organizations. j
By combining the principles of group psychotherapy ;
and sensitivity training, Fredrick Stoller, a clinical j
I
psychologist and group psychotherapist, is credited with ;
i
creating the concept of the marathon group.
i
i
As a result of attendance at a four-day sensitivity
session for professionals in 1963 at the University of i
i
California at Los Angeles, Stoller began to formulate the j
i
principles of what he then called "accelerated inter- '
!
action." Stoller was impressed by the effects of the i
I
three-hour sessions followed by short breaks which he had
encountered at the U.C.L.A. session. He felt the experi- !
ence to be of tremendous personal value. While the ;
extended time factor was felt to be of prime importance, i
jthe face-to-face encounters with the ensuing intimacy were
considered equally important (Dinges § Weigel, 1971).
! i
Following experimentation at Camarillo State Hospital, I
\
Stoller, along with other psychotherapists, principally
i
■Bach, developed the accelerated interaction concept into j
' I
'the marathon group. |
As was the case of marathon group therapy, the use |
of videotape focused feedback was necessarily a result of 1
i
earlier development in the Twentieth Century. With Thomas j
t
'Edison’s invention of the gramaphone and then the motion j
t I
picture projector in the beginning of this century, man j
began to fulfill his long-time dream of seeing himself as
others see him. While still photographs and phonograph j
,records were being used by practitioners as early as the !
1940s (Berger, 1970), it was not until 1947 when recording I
i
»
tape was released on a commercial basis that audiovisual j
j
devices were actively utilized in the therapeutic endeavor.j
Mead (1934) speculated that individuals rehearsed what was :
, i
to be said in order to anticipate reactions. Berger (1970)
found videotape appropriate to exploit the difference
i
between the internal rehearsal and the external communica- 1
i
tion through videotape. While film was initially used as i
i
a visual medium to treat patients successfully, its main
I
use was more often found in the training of psychothera- |
f
i
,pists.
It was not until the technological advances of the i
! 1950s and 1960s that videotape gained the acceptance it now|
iholds. Early studies by Wittson and Dutton (1956), Tucker j
! (1957) and Geertsma (1969) attest to the effectiveness of !
videotape over other audiovisual devices. j
It is interesting to note that Stoller, the primary ;
rcreater of the marathon group, is also recognized as a I
i
imajor innovator in the application of videotape to the j
I
therapeutic endeavor. While Stoller’s (1967) research in
'the field of the utilization of videotape is significant,
it is his theoretical statements on the utilization of j
f
this technique that are most valuable. Stoller (1968e) j
proposed methods for the utilization of videotape in con-
i
ventional groups as well as marathon groups.^ " I
i
The purpose of this study is directed toward the ;
inclusion and evaluation of videotape focused feedback I
techniques in the marathon group process as part of the ■'
treatment regimen at a community health clinic. To assist ,
the clients of a community mental health clinic, a variety '
of treatment modalities have been utilized. Experimental ,
i
j
evidence supports the fact that groups and particularly !
marathon groups are important ingredients in this process. 1
i
Is there reason to believe that the inclusion of videotape i
to the marathon process will have major effects on the :
theory or practice of marathons with a population of this
type? Advocates of videotape contend that the inclusion ofj
videotape in the therapeutic endeavor provides externally I
i
motivated forms of self-cognition which is a potentially \
ipowerful psychotherapeutic technique (Geertsma, 1969). |
^Researchers such as Alger and Hogan (1969) have already
I
I
pointed out that videotape enhances the effects of individ-
i
ual therapy. i
i
At the same time many marathon practitioners contendj
i
that the marathon in and of itself is a major breakthrough
in the field of psychotherapy which allows the practice of
:psychotherapy to be greatly accelerated. While this con- !
' I
j
tention is subject to some challenge, the results of i
I
:initial studies indicate it to be an exciting breakthrough !
i
with potentially significant effects on the treatment j
■modality of the future (Rachman, 1970). ;
The scope of the current investigation is threefold:!
((1) to determine if the inclusion of videotape focused j
‘ feedback techniques in the marathon situation is effective j
in promoting greater changes in self-actualization; (2) to 1
i
determine if the inclusion of videotape focused feedback j
I
■ techniques in the marathon situation is effective in pro- !
moting positive changes in evidence of psychopathology; and;
i
.(3) to determine the "mortality" rate of those individuals j
■with and without the experience. In short, the purpose |
j
, is to study the outcome as it occurred in a videotaped j
i
marathon with clients of a community mental health clinic, j
The measurement of outcome or the achievement of
■ goals has been accomplished using a variety of instruments ,
I
i
and measures. Among the measures utilized have been j
; self-reports, objective instruments, observations of group I
; i
; f
.process, follow-up observation of post - group behaviors, j
■and nonreactive measurements such as grade point averages. !
r
The instruments selected for this investigation, the MMPI ■
_and the POI, have been selected for their ability to dis- j
I
criminate changes in psychopathology and self - actuali zation.j
Speer (1970) used the MMPI to assess changes in
psychopathology in the parents of child guidance clinic |
i
patients. Utilizing pre- and post-test MMPI changes, it
is concluded that this instrument was capable of yielding j
I
clinically useful and meaningful objective data for the I
evaluation of marathon groups. I
I
A frequently stated goal of marathon groups is to !
i
achieve a greater sense of self-actualization, a concept '
i
popularized by Maslow (1954, 1959). Self-actualization is
i
proposed as a basic force which motivates much of the !
I
behavior of man (Guiman § Foulds, 1970). This concept is (
not a direct measure of the individual but rather a measurej
!
of the act of placing the human potential in motion. A j
basic concept to the humanistic psychology movements, the |
i
: . I
;assessment of the tendencies toward ’’full humanness” |
(Maslow, 1968), will be measured in this investigation by
. the POI. |
i
A variety of approaches has been employed in asses- j
i
'sing the effects of psychotherapy. Studies utilizing |
■objective instruments have frequently selected one 1
arbitrarily selected instrument to evaluate the full range
iof effects on the intrapsychic functioning. Other re-
I
i
searchers have sought a multiplicity of instruments to
I
attempt to measure any and all psychic results. In more ;
recent years the employment of behavioral measurements has !
been utilized to measure treatment successes in therapy J
(Krumboltz, 1968). The solution in this investigation was i
to identify the specific factors to be measured and then |
i
i
select the instruments with the greatest capability to j
I
•measure these factors. Utilizing a multivariate approach j
j
criterion measures of ’’sickness” (MMPI) and ’’ health" (POI) j
were therefore employed. j
The treatment modality described in this study, j
i
that is the inclusion of focused feedback videotape ;
i
1 techniques in the marathon group process , may be thought |
of as the logical progression of the development of the J
I
i
marathon process and the technological advances in the |
l
field of audiovisual devices. Stoller (1967, 1968a, j
19684) and Bach (1966, 1968) were main pioneers of the I
I
marathon treatment, and it is from their works that the j
marathon evolved. j
I
Similarly, Stoller’s (1968e) work with videotape is >
cited as the formulative work in the utilization of video
tape along with the work of Geertsma (1969) and Wilmer
(1968). Research on the inclusion of videotape in the ;
treatment modality indicates that the therapeutic process I
is accelerated. A further benefit of its inclusion in the
therapeutic regime is that treatment mortality is reduced.
Because of the relatively undefined nature of the
outcome of the inclusion of videotape focused feedback in
the marathon process and because of the potential impact
of the inclusion of this technique in marathons with out
patient, community health clinic clients, the present
analysis and description of the outcome was instigated.
Research Hypotheses and Corollary Objectives
From the theoretical framework and questions identi
fied above, the following research hypotheses were
formalized:
Research Hypothesis
If the inclusion of focused feedback videotape
techniques is the independent variable in the inclusion of
marathon group treatment with clients of a community mental
health clinic, then changes in the scores of positive -
mental health as self-actualization (POI) , psychopathology
(MMPI) , and treatment mortality will, differ as a result of
participation in this enriched experience.
Corollary Research Questions
Further questions relating to the major research
hypothesis are treated in a descriptive manner,
1. Do POI score changes reflect a higher level of
self-actualization after the enriched marathon treatment
and if so which scales are altered?
2. Do MMPI score changes reflect a lowering of the
degrees of psychopathology after the enriched marathon
experience and if so which scales are so altered?
3. Is the mortality rate affected by participation
in the enriched marathon experience?
4. Will the results of this investigation offer
significant evidence regarding the inclusion of a focused
feedback videotape marathon in the treatment regime of
therapeutic activities of a community mental health clinic?
Definitions
In order to clarify the specific terminology employed
in this investigation the following definitions are
advanced:
Focused Feedback Videotape Techniques
Focused feedback videotape techniques are a form of
self-cognition characterized by directed selection of
viewed segments (Geertsma, 1969). These techniques in
volve the selection of segments of videotapes for play
backs generally limited to ten minutes (Berger, 1970).
The videotape unit is placed in the room such that it is
considered an integral part of the group (Wilmer, 1968;
Stoller, 1968e),
9
Marathon
A practicum of authentic communication characterized
by continuous interaction of a minimum of 24 hours (Bach,
1966). Characteristics include intensity, the discovery of
"what” after risking, exhausting of customary roles and
the discovery of new roles, an emphasis on interaction, a
shift from being helped to helping, and an experience of
a '
intimacy (Stoller, 1972b). Further characteristics include
elimination of social fears (Bach, 1966).
Personal Change y. T <
Personal changes are characterized by measurable . y"
differences in feelings, attitudes or behaviors. Changes
of this nature are operationally defined according to the
following procedures:
1. Emotional upset--changes based upon change
scores, pre to post on scales of the MMPI.
2. Self-actualization--changes based on gain scores,
pre to post on scales of the POI.
3. Treatment mortality--simply defined as those
subjects who drop out of the treatment program.
Minnesota Multiphasic Personality Inventory (MMPI)~*C^‘
The MMPI is recognized to be the most commonly
chosen instrument for the routine assessment of the degree
and nature of psychological upset in adults over the age (
of 16. In addition to its widely accepted clinical
10
application, it is the most cited instrument for screening
of assessing emotional upset in research populations. The
instrument created in 1943 by Hathaway and McKinney con
tains 550 items divided into 14 different scales. The
instrument assesses subject matter ranging from physical
condition to the social attitudes of the individual
queried.
Personality Orientation Inventory (POI)
Developed by Shostrom (1966), this inventory contains
150 paired items-, each defining an opposing statement
response. The subject is requested to give the one
response to each question which best represents himself.
Scores are plotted in 12 scales which assess the degree of
self-actualization which are commonly associated with
mental health.
Conceptional Assumptions
In the execution of this investigation certain
assumptions must necessarily be made:
1. Self-actualization can be measured by utilizing
the Personality Orientation Inventory.
2. Self-actualization is an indicator of mental
health.
3. Emotional upset, "psychopathology" if you
choose, can be measured by utilizing the Minnesota Multi-
phasic Personality Inventory.
11
4. Emotional upset is an indication of various
levels of psychopathology.
Scope of the Study
The results of this study are exploratory in nature
and therefore generalizability is limited to those indivi
uals who exhibit the characteristics of clients of a
community mental health clinic. A large body of research
in the area of psychology and education supports the con
tention that positive results occur with the application
of the proposed treatment (Berger, 1970; Stoller, 1968e;
Wilmer, 1968).
Limitations
While an outcome study of the effects of the inclu
sions of videotape focused feedback techniques in the
marathon format is within the capacity of this study,
controlling the number of variables which also contribute
to differential outcomes is extremely difficult. A dis
cussion of the procedures implemented to control inter
fering variables are discussed in Chapter III.
There are, however, variables which are virtually
impossible to control. Among those factors which must be
mentioned are limitations presented from the effect of
therapists. Frank (1968) elaborates on this issue by
asking whether it is the characteristics of the treatment
which affect the outcome or that of the therapist. It is
commonly recognized that leaders of similar orientations
may produce different results (Lieberman et al., 1971).
The only way to control this factor would be to select a
large number of leaders randomly from a population of all
therapists. This, however, is an impractical solution in
this study.
A second limitation is the inability to evaluate
the process of the treatment. Practical solutions enable
researchers to obtain direct data without infringing on
the actual process itself. The nature of marathons is
such that measures currently available would not meet the
needs of this study.
A final but certainly not the least important limita
tion is patient related. It is possible that the charac
teristic of the treatment population had a significant
effect on the success of the study. Furthermore, no one
can demonstrate equivalence between Southwest community
mentah health clinic clients and community mental health
clinic clients in general.
Summary
Following a brief historical account of the develop
ment of videotape as a treatment and the development of
the marathon treatment modality, the importance of this
technique for promoting positive mental health was
13
reviewed. A review of the above facts reveals a plethora
of testimonial as to the efficacy of marathons in general.
This investigation seeks to examine changes in emotional
upset or psychopathology, self-actualization and treatment
terminations attributable to the inclusion of focused
feedback videotape techniques in a marathon involving
clients of a community mental health clinic. The basic
research hypothesis was presented and the limitations and
scope of the study outlined to enable the reader to under
stand the general implications of the study.
The following chapter will review the literature
with special emphasis on the videotape and marathon
utilizations in group therapy. The third chapter will
review the methodologies involved in this study concen
trating on the specific operational and statistical
hypothesis to be investigated. The fourth chapter will
present the findings of the investigation. The final
chapter will discuss the implications and conclusions of
this study.
14
CHAPTER II
A REVIEW OF MARATHON/VIDEOTAPE RESEARCH
Introduction
A review of the literature on group counseling and
specifically marathon groups is rich and rewarding and at
the same time often limited by the quasi-experimental,
empirical nature of the study of group counseling. At the
same time, the relevant literature concerning the utiliza
tion of videotape is more rigorous but more limited.
The studies mentioned in this chapter have necessarily
been limited to those which significantly contribute to
and have a direct bearing on the specific research of
the current study.
This chapter will be organized into four areas which
will hopefully focus on the major areas of interest
surrounding this study. These areas include:
1. establishing an historical perspective of
marathon groups by examining and critiquing the literature
2. presenting and assessing the theoretical liter
ature concerning the concepts and definitions of marathon
groups;
3. examining the research regarding the use of
audiovisual devices in group therapy and particularly the
use of videotape in marathon groups; and
4. presenting the rational for the design of the
current study based upon the literature review.
Historical Perspectives
The historical development of group counseling and
group psychotherapy may be traced back to Joseph Pratt’s
work with consumption patients as early as 1905 (Ruiten-
beck, 1970; Shaffer § Galinsky, 1974). Pratt’s work was
organized as a means for providing therapy to groups of
poor patients who were unable to afford in-patient treat
ment. Pratt soon appreciated the importance of mutual
support created by the "common bond in a common disease"
(Spotnitz, 1961). This factor has continued as a dominant
tennet which all forms of psychotherapy emphasize as
therapeutic (Shaffer § Galinsky, 1974).
Jacob Moreno’s experiments with group treatment as
early as 1910 in Austria can be identified with the
development of many of the concepts of group therapy today.
While often ignored as one of group therapy creators,
Moreno’s greatest impact was the creation of the role
playing technique (Shaffer § Galinsky, 1974) as well as
the concept of the use of techniques, encounter and
involvement.
The work of Trigant Burrows, Louis Wender and Paul
Schilder integrated the budding group process into the
16
conceptual framework of psychoanalysis (Shaffer § Galinsky,
1974). Burrows, in his work, sought to offer social
relatedness for working through behavior disorders
(Ruitenbeck, 1970). The basic framework of Burrows,
Wender and Schilder remained within the psychoanalytic
model.
Alexander Wolf had become interested in the group
process in the early 1930s. His readings of the works
of Burrows, Wender and Schilder led him to experiment with
a psychotherapy group in 1938. His success resulted in his
running seminars in psychoanalytic group therapy in 1947
at the New York Medical College. By 1954, Wolf's work,
along with that of Emanuel Schwartz, had led to a certifi
cation program at the Post Graduate Center for Mental
Health (Shaffer § Galinsky, 1974).
It was not until the 1940s that group counseling
began the development of the acceptance and popularity it
now holds (Anderson, 1966). Depending upon the source,
one can find a variety of factors to which the growth of
the group counseling movement may be attributed. One
significant factor was the ability of group counseling to
provide benefits which were not provided by individual
treatments (Ruitenbeck, 1970; Mintz, 1971a). The ability
to treat a wider clientele less expensively is also cited
(Ruitenbeck, 1970). Finally, the exposure of young psycho
therapists during World War II to group processes played
17
a large role in the rapid training of group psychothera
pists (Shaffer § Galinsky, 1974).
The development of the use of groups for human
growth and development was also particularly significant
in the evolution of the group process. The work of Lewin,
Lippit, Benne and Bradford in the creation of the National
Training Laboratory (NTL) and the work of Carl Rogers and
his associates at the University of Chicago Counseling
Center are often cited as the precursors of the modern
group movement (Benne, 1964; Rogers, 1970; Ruitenbeck,
1970). These approaches utilized small group processes
on their participants (Benne, 1964).
By the 1960s the group psychotherapy movement had
found its place in society due to its constant experimenta
tion to meet the needs of the population it served
(Ruitenbeck, 1970). One reviewer (Anderson, 1966) found
240 articles on group counseling within the educational
literature for the years 1965 through 1968. Several
authors (Benne, 1964; Bradford, 1967; Ruitenbeck, 1970)
have offered thorough reviews of the development of group
counseling.
As indicated, the history of group counseling is
somewhat imprecise as many practitioners are credited with
the first complete application of the technique. The
history of the marathon experience is similarly imprecise.
The concensus of most authors is that the National Training
18
Laboratories can be credited with the first application
of the intensive weekend workshop (Eddy § Lubin, 1971).
Within the framework of this experience, Fredrick Stoller
combined the dimensions of the basic encounter group,
sensitivity training and group psychotherapy with the then
unique element of an extension of time found in marathon
groups (Bach, 1970).
In the summer of 1963 Stoller participated in a
lengthy sensitivity training by Professor George F. Lenher
at the University of California at Los Angeles. As a
result of this extended, relatively continuous session,
Stoller wrote:
Continuous involvement without interruption was
felt to be of prime importance leading to conse
quences different from intermittent routinized
sessions (Stoller, 1968a),
Shortly after this experience Stoller, in association
with Dr. George Bach, began further explorations into the
application of the time - extended formula for group
activities. These two men are credited with most of the
major innovations in marathon group techniques. Stoller
and Bach, along with their colleagues, are credited with
conducting the first private marathon in Palm Springs,
California in 1963 (Bach, 1970). By the year 1968, Bach
and Stoller had each conducted over 100 marathons
(Stoller, 1968d).
These formulative years between 1963 and 1968
resulted in dynamic changes, great modifications and
19
experimentation with the format. While the duration of
the marathon remained on a range equaling or exceeding
24 hours, one may easily notice striking differences
between the description of the first marathon (Bach, 1966),
and the 100th marathon (Bach, 1970).
In addition to the relatively stable
factor mentioned above, the concept of the
cooker" effect (Stoller, 196M) was universa
Stoller explained the pressure cooker effec
increase the effectiveness of the interacti
accomplished by the constant and growing na
marathon. In contrast to the traditional g
great efforts were expended to forestall or
avoid a "cooling off" period. The cooling
generally described as that period which no
pired between regularly scheduled group mee
1968(f)’.
While research as to the effectivenes
success of marathons was inconclusive, part
actions were cited as being overwhelmingly positive (Dinges
§ Weigel, 1971). Outcome studies as cited by practition
ers (Bach, 1966; Speer, 1966) have also reported success
ful outcomes.
Within a relatively short period of time (1966 to
1970) the clinical application of the marathon group
increased such that a review of the literature during this
time duration
"pressure
lly recognized
t as a means t
on. This was
ture of the
roup setting,
, in fact,
off period was
rmally trans-
tings (Stoller
s of the
icipant re
period reveals its application in colleges, growth centers,
penal institutions, alcohol treatment centers and private
practices (Mintz, 1971ar ). Marathons have been cited as the
most significant of all new approaches to therapy (Ruiten-
back, 1970; Rogers, 1968).
Theoretical Framework
Goals
As stated by its creators and major practitioners,
the overall goals of marathon groups are personal growth
and change (Stoller, 1970a). Within a framework demanding
"action and behavioral change," acceptance, understanding,
support or discussions of the future are at best seen as
secondary (Bach, 1966; Stoller, 1972) IMintz' (1971a)
sought to create an atmosphere where the expression of
immediate feelings would promote genuine self-expression
while eliminating social pretenses. The overwhelming
emphasis on immediate action to demand changes in behavior
without the more traditional concepts of insight differ
entiate marathons from traditional therapies (Ruitenbeck,
1970).
Group Composition and Selection
According to Stoller (1972) , in the absence of
special goals, random selection of participants is ade
quate. With the exception of the desire to avoid cliques,
that is members who had previous outside group experience
21
together, membership was open. In order to preserve the
"freshness" of the group, Stoller proposed no prelabeling
or prescreening to take place.
Bach (1966), on the other hand, sought individuals
who were "healthy and growing" with a need for more
authentic interactions. He did, however, prefer individ
uals who had been examined, had been given some individual
work and who had participated in a weekly group prior to
the marathon.
Mintz ,(1971a) sought to exclude individuals with
problems related to reality testing to the extent that they
were unable to distinguish between reality and fantasy.
Others, such as Ruitenbeck (1970), preferred to use
only their own patients.
Size
Yolom (1970) contended that the size of the group was
a function of the time duration. The longer the group the
greater the number of individuals. Although conventional
groups have an average size of eight, the report optimum
size for marathon groups range from ten to 16 participants
(Bach, 1967; Hill, 1974 ; Mintz, -1971a; Stoller, 1972). If
a group is too small the effect was that of a fragmented
arena rather than the desired microcosm of society (Mintz,
19 7fa).
Leaders
According to Bach (1967b) , the leader should be
22
well trained, skilled and knowledgeable in the field of
group psychotherapy. The leader should be able to facili
tate the development and maintenance of a group atmosphere
which is conducive to learning and sharing.
Ruitenback (1970) contends that a leader should have
had personal analysis and be well trained in group tech
niques. The leader should possess creativity and have
control of his own life and be free of interpersonal
problems. All major authors agree that conducting mara
thons is more difficult than docuting conventional groups
and requires a leader who is more active and self-
revealing.
Leadership has been identified as an important
component of the marathon experience. Lakin (1970) pro
vided guidelines for the training of marathon leaders which
included: (1) membership in two groups; (2) observation
of five groups including ongoing discussions with the group
leaders; (3) serving as a co-leader of five groups with an
experienced leader; (4) leading five groups under super
vision; and (5) personal psychotherapy.
Physical Setting
Stoller (1968a) contended that it was preferable
to spend the hours ”comfortably undisturbed by external
interference.” Bach (1966) suggested a retreat as being
appropriate. While Stoller has run marathons in locations
ranging from prisons (Krusche £ Stoller, 1967) to resorts
23
(Stoller, 1968a), the selection of a home with its atmos
phere of normal living is most often preferred. Regardless
of the location, it is desirable to provide comfortable
chairs and pillows for sitting and lying around. Food is
usually catered or pot-luck style (Mintz, 19714}*
Developmental Stages
As outlined in the most comprehensive model of the
developmental phases, Stoller (1972) identified three
major phases during the marathon process. The first phase
was characterized by marked discomfort, awkwardness, stiff
ness and stylish encounters. The basic function of this
stage is the development of relationships, cohesion and
the establishing of trust.
The second phase is represented by individuals be
ginning to share themselves rather than relating stories.
Self-disclosure in the second phase is of a more genuine
nature. The marathon at this point is on the verge of
becoming a group. Contrary to the basic principles of the
marathon, frustrations continue to seek external solutions.
The third phase emerges toward the finale of the
marathon. It is identified by swift movement and an almost
complete lack of defensiveness. It is also characterized
by spontaneity, and a feeling of intimacy.
Mintz (1971a) describes the sequence of these three
phases as (1) the recognizing of social pretenses; (2)
their gradual relinquishment; and (3) a deepened acceptance
24
of self and others.
Both of the previous statements conform to Carl
Rogers1 (1970) description of the stages of group develop
ment .
For a more detailed explanation of the patterns
within the three phases, see Marathon Groups: Towards a
Conceptual Model (Stoller, 1972, pp. 181-186).
Results of Marathon Research
The nature of the marathon is such that, by its very
structure, it presents little more than a limited theoreti
cal framework. This fact is largely due to the nature
of the personalization on its structure by its practition
ers. The theoretical presentations for the most part have
been limited to descriptive annotations of the experiences
themselves (Bach, 1968; Mintz, 19 71a).
In keeping with this weak theoretical framework, the
marathon research has not met the expectations of tradi
tional experimental methods. The 45 studies cited as of
1970 were of an outcome nature, employing minimum research
standards which include at least the use of one objective
measure and control group (Bednar, 1970).
While more recent studies indicate a desire to
perform more rigorous research methods, the available
research must still be characterized as inadequate. These
studies generally lacked formulated principles, postulates
25
and hypotheses related to product and process. This
presentation of research results will be presented accord
ing to the nature of their reporting: individual testi
monials, anecdotal records, process studies and outcome
studies.
Individual Testimonials
Individual testimonies have provided positive state
ments on the effects of marathons. The responses
characterized below have the common bond of the rekindling
of a feeling of humanness. Allen (1968) cited mixed
feelings of interest, conflict, eagerness, and curiosity
about the participation which, when coupled with dis
appointment and deflation, lead to an experience that was
positive and fruitful. A feeling of being more honest with
self and others, being more accepting of individuals in
general, and becoming a better listener was cited by
another source (Vance, 1968). Hall (1969) indicated a
sense of becoming much more sensitive toward oneself and
with others, as well as experiencing new parts of oneself
which had not been felt in a long time. These new feelings
resulted in a feeling of gratefulness for having the
opportunity to reexperience such feelings.
Other testimonials are available in this vein.
Because of their very nature, it is pointless to cite
additional references in the same tone. One would be
remiss, however, not to cite some of the negative
26
references available in the literature even though they
constitute by far the majority of the personal testimonies
on this subject. Coulson (1970) and Fenner (1968) each
cite negative reactions from a group of elementary and
secondary educators respectively. Criticisms cited inclu
ded a feeling of superficiality, issue avoidance coupled
with a deep sense of disappointment. These references cite
these feelings as being those of both the clients and
therapists.
As is the case with other occurrences other than the
marathon, positive statements tend to be stressed rather
than negative statements. As for individual testimonies,
it must be clearly stated that positive statements greatly
outnumber negative statements.
Anecdotal Records
Anecdotal records appear to provide a significant
body of the available research on marathons. For the most
part, studies of this type were initially performed as a
response to criticisms of a lack of experimental data on
marathons. As in the case of the individual testimonial,
much of the information gathered was done so by the group
leader. Data for such reports was often incompletely
collected due to the voluntary nature of the requested
responses.
Bach, in a 1964 study, found that 801 of those sur
veyed thought the marathon to be a meaningful and helpful
27
experience. Twenty percent of this sample identified the
experience as doubting the value of the experience. By
1967 Bach reported that, in a sample of 400 marathon
participants, 94% o f those queried found the marathon
experience to be one of the most significant and meaning
ful events of their lives. The remainder of the sample
reported a sense of being ’’let down.” Bach further cited
the fact that there were no instances of individuals
citing any real emotional or social damage to oneself.
McCeery (1966) also reported positive responses from
a sample of marathon participants. Ninety percent reported
more positive behavior with peers, with 70% reporting
greater openness with others while also reporting a will
ingness to take risks with others. Fifty percent of the
sample stated a willingness to experience new or different
situations and 40% were cited as being freer to express
negative feelings while feeling greater inner confidence
and security.
As was the case with individual testimonies,
anecdotal reports are not without their detractors. How
ever, in the case of anecdotal reports, much of the
criticism stems not from the leader but rather from indi
viduals criticizing the nature of the report itself. A
case in point would be Yolom’s (1970) attack from the
standpoint of social pressure and its effect on attitude.
Given the very nature of the marathon experience, it is
28
highly unlikely that groups’ members experiencing negative
feeling would be able to state opinions apparently con
trary to the mood of the group. In the face of this peer
pressure, the dissenting individual would be more likely
to maintain the stance of the group as a means of reducing
cognitive dissonance. Thus, the longer and greater the
involvement in the marathon, the more likely to seek the
equilibrium of the group stance.
While clearly in the research traditions espoused
by Carl Rogers, it is clear that studies of this nature
have little experimental value.
Process Studies
Process studies of marathons have provided more
scientifically acceptable analysis of the marathon pro
cess. The goal of such studies is to determine the effect
of factors within the marathon process rather than mea
suring outcome effects after the completion of the mara
thon. Process studies have sought to determine the
effects of such factors as group stages and group cohesive
ness as evidenced by Stoller’s phenomenon of greater
activity in the ’’ here and now” and interpersonal inter
action and the effects of group leadership.
Parks and Antennen (1970) using the HIM-G to analyze
the group process were unable to discern any definite or
sequential stages in group development.
As previously mentioned, Stoller has stated that
29
marathon groups have as a basis tenet the focusing on the
here and now and a goal of greater interpersonal inter
action. Dies and Hess (1970), in a study with hospitalized
post-narcotic users, found that there was less evidence of
a concentration on the here and now. At the same time,
they found greater evidence of interpersonal interactions
than in their control group. An additional finding of
this study was a preference for participation in the mara
thon group over the control group's participation in more
traditional groups.
In a later study, Dies and Hess (1971) sought to
measure the amount of group cohesiveness in a marathon
group as opposed to a conventional group acting as a con
trol. The researchers found greater cohesiveness in the
marathon group and additionally found that the cohesive
ness demonstrated a progressive increase as a function of
the time in therapy.
Several studies have attempted to ascertain the
effects of leadership on the group process. Gurman
(1968), in an immense study, compared the leaders of 42
different marathons. Utilizing questionnaires and reaction
sheets, Gurman found that highly skilled, directive leaders
facilitated a greater number of "peak experiences” of a
more personal nature.
Crowther arid Pantleo (1969) found no outcome differ
ences between different groups with different leaders.
30
Vernallis et al. (1968) attempted to discern any causal
relationship between members’ and leaders’ interactional
styles. While leaders reported the marathon experience
to be unique, they were unable to make any precise differ
entiations .
Perhaps the most definitive study on the effects of
leadership is that of Lieberman et al. (1971). While not
specifically focusing on the leadership of marathon groups,
their study of 18 -different leaders leading a variety of
groups did include a marathon group. Their study was both
of a process and outcome nature. While approximately ten
percent of their sample was evaluated as having suffered
substantial psychological damage as a result of the study
for all leader orientations, the preponderance of casual
ties were as a result of the more charismatic, aggressive
and highly stimulating leader. Leadership qualities of
this type are often found in marathons. It is significant
and frightening to note that group members were demonstra
ted to have a greater ability to recognize casualties than
were the leaders.
The lack of standardization, as well as the insensi
tivity of instruments in studies not cited, casts doubts
as to the results of process studies. This factor, com
bined with methodological flaws evident in other studies,
must also eliminate process studies as a desirable means
to evaluate the treatment proposed in the study at hand.
31
Outcome Studies
The final type of study to be examined is the outcome
study. The use of objective instruments as well as the
more frequent employment of control and/or contrast groups
makes the outcome studies more germaine to the purposes of
this research. While studies employing control measures
are more desirable for purposes of this inquiry, studies
employing controls and studies not employing controls will
be examined.
In keeping with the less rigorous tradition of
research of the marathon process, many of the studies cited
below are treatment group studies. An example of this
methodology was Stoller's (1968a) study to evaluate mara
thon outcomes. A series of questionnaires were administer
ed to marathon participants to assess self-images and the
difficulties in perceiving these images. Pre- and post
tests were administered with post-test results indicating
an increased quality in the perception of self-image.
Additional results revealed an improved ability to perceive
difficulties within oneself.
A study of child guidance clinic parents who were
involved in a marathon group as part of the treatment
regime was completed by Speer (1970). The MMPI was used
in a series of pre- and post-tests. The results indicated
that the inclusion of a marathon in the treatment regime
reduced depression, impulsive acting-out type behavior and
32
schizoid behavior. The subjects also displayed desirable
increases in assertiveness. A drawback of the study was
the small size of the sample.
Hurst and Fenner (1969) utilized trainees in a
counseling practicum as subjects. After a 16-hour marathon
co-leaders and participants ranked all group members as to
perceived counseling effectiveness. These rankings were
compared to rankings performed by the subjects’ supervisors
at the end of the practicum ten weeks later. The results
of a comparison of the ratings was such that the research
ers stated that post-marathon ratings may provide a
valuable predictive information in conjunction with addi
tional objective material in the selection of graduate
students.
Yolom cited the work of Navidzadeh (1968) whose study
with outpatients indicated that a 36-hour marathon produced
results similar to those patients experiencing several
years of traditional therapy.
Weigel (1968) performed a study involving two mara
thon groups and one traditional group. Using the MMPI,
Jourard Self-Disclosure Instrument and the McKinney Sen
tence Completion Test, Weigel found that the marathon was
capable of providing an environment conducive to positive
changes in mental health. An additional aspect was the
inclusion of a process evaluation in the conducting of the
groups utilizing the HIM-G.
33
In a study involving a pre-test/post-test study with
two 16-member groups of high school students, Alperson
et al. (1971) utilized the POI and the McKinney Sentence
Completion Test. Results indicated significant positive
changes in 11 of 12 scales on the POI. The control group
only demonstrated a positive change on one scale. Post
test data indicated a retention of these changes over a
five- to eight-week period.
Foulds et al. (1970) utilized two groups of 16
college students in a treatment, no treatment design.
Instruments were used to assess perceptions of self and
others as affected by a 24-hour marathon. The treatment
group revealed significant positive changes in the mean
ratings, while the control group did not reveal such
changes.
Summary of Marathon Research
Given the rudimentary nature of much of the marathon
research, there seems to be evidence that marathons do in
fact provide genuine behavior changes which generally
emerge toward the end of the marathon experience. They
also exhibit greater intensity of feelings, and a greater
evidence of the expression of negative feelings. A limit
ing factor in addition to the empirical of many of the
studies is the selection of college and high school
students in many of the studies. It must be said that
these samples are not necessarily able to provide transfer
34
to less psychologically "normal” populations. Nonetheless,
the phenomenon of marathons does deserve additional
examination. In the case of this project, the utilization
of the outcome study seems most appropriate.
Videotape Historical Perspectives
Early studies in the utilization of videotape focused
feedback techniques are in effect and necessarily studies
in self-confrontation. According to Purkey (1970),
George Mead was significant in that he made the concept of
self a major portion of his theoretical writings. At that
time, Mead appeared to offer the best conceptual framework
to be used in understanding the impact and importance of
self-image confrontation. His most important proposition
was that an individual's perception of himself is largely
dependent upon how others perceive him.
During the 1930s Wolff (1943) studied individuals'
recognition and impressions of their own voices, hands,
handwriting, gaits and profiles. He found that judgments
of self-productions were more intense than the judgments
of others. Freed (1948) reported that the playback of an
audiotape to a patient resulted in greater self-objectivi-
ty. In another study he related a fear that the replay of
an audiotape resulted in too great an anxiety for that
patient. In 1955 Epstein reported the result of the judg
ment of normal and schizophrenic subjects in responding to
35
audio recordings. His results indicated that judgments of
their own recordings were more favorable than judgments of
others regardless of psychological nature of the group.
Cornelison and Arsenian reported the positive response of
psychotic to the viewing of Polaroid pictures of them
selves. While expressing greater interest in these pic
tures than others around them, these patients demonstrated
dramatic improvement in their psychotic disorders.
The first true systematic attempts to evaluate the
effects of videotape playback in the therapeutic setting
were performed in the second half of the 1960s. Geertsma
and Reivich performed a series of studies (Geertsma, 1969;
Geertsma § Reivich, 1965, 1969; Reivich £ Geertsma, 1968)
which indicated that different techniques will produce
different results. The populations selected for these
studies included schizophrenics, neurotics and character
disordered patients. Each group presented a different
response to the tapings. Sanborn el al. (1975) indicated
that Geertsma and Reivich suggested that more self
relevant information was received from the audio portion
rather than the video portion. Geertsma (1969) meanwhile
concluded that externally motivated self-cognition is a
potentially powerful psychotherapeutic technique.
The utilization of videotape had spread to a myriad
of other areas in the 1960s and 1970s, as its positive
effects became recognized. The reduction in size of the
36
equipment resulted in increased experimentation into
techniques surrounding the application of the videotape
instrument. Consequently, the research of the late 1960s
and early 1970s is most important to this study when dis
cussing the different techniques of videotape confronta
tion.
Simultaneous to Stoller’s development work on mara
thon group therapy, we find Stoller performing equally
significant work regarding the utilization of videotape
both within and outside of the marathon arena. Stoller
(1968e) felt the marathon was so powerful that it did not
lend itself to post - examination. Stoller further contended
that, for this reason, the use of videotaped replays should
be confined to the actual marathon experience.
Outside of the confines of the application of video
tape within the marathon, Stoller (1967 , 1968b,, 1968e,
1969) was particularly influential in developing the
generally accepted techniques applied to videotape focused
feedback techniques. Additional contributions were found
in his early application of videotape in regular group
therapy sessions at Camarillo State Hospital in California.
It is interesting to note that, in the evolution of two
divergent areas, marathon group therapy and videotape
focused feedback techniques, Stoller is a key researcher
and practitioner of both techniques. His work then becomes
a critical linking pin in this review of literature.
37
Theoretical Framework
Goals
The primary goal of videotape focused feedback
techniques is to allow the individual to experience the
objective benefits of self-confrontation. Sanborn et al.
(1975) found the preponderance of the research to be
efficacious. Gergen (1969) suggested the experience of
viewing oneself in comparison to others in the same situa
tion would be beneficial. The primary goal in utilizing
any therapeutic aid is whether or not the inclusion of
that aid enhances the probability that the patient would
improve. Moore et al. (1965) advocated the use of video
tape suggesting that videotape does alter the course of the
patient and does have an effect on patient improvement.
Goldfield and Levy (1971) concluded that the message trans
mitted from the television monitor registered more clearly
and more forcefully than the one from the therapist. Thus,
a primary goal of videotape has become the interjection
of the objective clarifying tool to foster self
observation.
Length of Replay
Once again the researchers are in agreement as to
the length of the replay. Moore et al. (1965), Goldfield
and Levy (1968), Alger (1969) , Alger and Hogan (1969) and
Resnikoff et al. (1970) all agree that replays of a
38
relatively short duration are sufficient. Wilmer (1967t>)
felt that the replay of short vignettes was appropriate.
r -
Stoller (1968b) stated that it was easy to flood the
patient with too much video. In line with Sullivan (1953),
he felt that there was a natural tendency for the patient
to utilize a frame of selective attention. Thus, it was
critical to keep the replay short. Berger (1970) felt it
advisable to use no more than ten to 20 minutes of replay
due to the decreased emotional involvement of the patient.
Placement of Videotape Equipment
One of the primary concerns surrounding the applica
tion of the videotape technique is whether or not the
videotape equipment should be visible within the confines
of the therapeutic situation or whether it should remain
hidden. Stoller (1969), Wilmer (1967a), Alger and Hogan
(1969) and Alger (1969) all emphatically state that the
equipment should be placed in clear view of the patients.
Even those who concealed the camera (Moore, et al, 1965)
did not hide the fact that the camera was, in fact, con
cealed behind a two-way mirror. Stoller (1969) contended
that the presence of the videotape was less of a threat to
the participants if it was placed in plain view. Wilmer
(1967a) supported this view with the exception that, if
the camera was moved too close, it became an intrusion.
Otherwise, Wilmer felt the participants became so absorbed
that they did not notice the presence of the videotape.
39
Timing of Replays
With regard to the timing of the replay, Berger
(1971) found the instant videotape heightened the cohesive
ness and intimacy of the group. Several key researchers
(Alger, 1969; Goldfield § Levy, 1968; Resnikoff et al.,
1970; Stoller, 1969) overwhelmingly testify that immediate
replay is the key factor in patient motivation. In line
with Berger’s findings, Stoller (19681)) stated the
immediate feedback provided by the videotape heightens
the sense of immediacy he considered so important to the
group process. Stoller (1968b) further stated that the
late introduction of videotape to therapeutic groups inter
feres with the group function. It does not capture the
’’ more abstract high level data which we label ’problems’."
Results of Videotape Research
Unlike much of the marathon research, videotape
research finds a significantly higher percentage of its
research falling in the more rigorous category. Because
of the diversity of the applications of videotape, one
finds clinical studies which provide adequate controls to
assess their significance. At the same time, one finds
that, while more rigorous, there are a more limited number
of relevant studies and, in fact, there is a tremendous
overlap in terms of researchers. For purposes of conven
ience, this section is divided into those sections
40
encompassing clinical research, a section encompassing the
empirical findings related to the use of videotape and
finally a summary of research relating to the application
of videotape focused feedback techniques with the marathon
group therapy structure.
Clinical Reports of Videotape Feedback
Cornelison and Arsenian (1960) studied the response
of psychiatric patients who were immediately confronted
upon admission with still photographs of themselves. They
found that, upon confrontation, the reactions varied from
emotional outbursts to impassivity. They concluded that
patients so confronted were more receptive to therapy.
Although they did not employ videotape in this study, they
suggested that it be employed in place of still photo
graphs .
Cornelison and Tausig (1964) utilized videotape
playback within group therapy sessions at the Delaware
State Hospital. Their experiment attempted to facilitate
the reflective recalling of the disordered behavior as a
means of self-understanding for the patient.
Kagan, Krathwohl and Miller (1963) developed a
technique called "Interpersonal Process Recall" (IPR).
Primarily used as a training tool in counselor education,
the technique involved the videotaping of a psychotherapy
session. The videotape was then played back immediately
for both the client and the therapist who were in separate
41
rooms. In an early study, no significant difference was
found in comparing individuals experiencing IPR as opposed
to audiotape replay or a control group with no replay.
Kagan et al. (1963, 1967) presented six case studies in
vestigating client progress acceleration. No statistically
significant results were presented to substantiate the
effectiveness of IPR.
Armstrong (1964) used self-image confrontation with
a group of hospitalized male alcoholics. The patients were
shown images of themselves when they were intoxicated.
The experience resulted in a significant reduction of their
alcohol intake and made the men less dependent upon the
therapist while increasing the importance of their contri
butions to the group therapy. Verwodrdt, Nowlin and
Agnello (1965) utilized videotape replays with a group of
cardiac patients. It was found that the patient’s pulse
rate increased during playback. Several of the patients
testified to the fact that they were forced to make adjust
ments due to their health condition. These admissions were
significant in light of the propensity of these patients to
use denial as a typical means of behavior.
Alger and Hogan (1967) utilized videotape in
conjoint marital therapy. They utilized a process where
the first ten minutes of a session was videotaped. During
this taping the videotape equipment was in full view of
all parties. After the ten minutes had expired a video
42
monitor was introduced and the couple was informed that
either of them or the therapist may ask at any instant to
have a playback interrupted to discuss anyone’s behavior or
any noted discrepancy between subjective recalled feelings
as opposed to those projected on the screen. According to
Alger and Hogan, the videotape playback technique allowed
the development of greater awareness more rapidly. Hogan
and Alger (1969) utilized videotape in long-term outpatient
group psychotherapy. They noted that videotape enhanced
the effects of individual therapy as well as the fact that
patients often gained an awareness of behavior which had
previously eluded them through many months of verbal
interpretations. Their research supported the hypothesis
that the use of videotape increased the rate of change.
Rogers (1968) suggested that videotape be viewed by
group members with the sound off. He found that the
sharing of reactions to this nonverbal communication was
very effective in helping the group members see themselves
more realistically and less defensively. Czajkoski (1968)
investigated the operation and positioning of the camera.
He concluded that a 15-minute playback immediately after a
group session was more effective than reviewing a playback
from a previous session. Viewing from a previous session
was found to be stifling and resulted in unnecessary dis
cussion on retroactive or historical material.
Geertsma and Reivich (1965, 1968, 1969) have done a
43
significant amount of research on the effects of videotape.
Their experiences have suggested that the use of videotape
confrontation in the treatment of patients with character
disorders was especially promising. These researchers
contended that patients with character disorded possess
one salient characteristic in that they are limited in
their powers of self-observation. Since they are limited
in the ability to see themselves objectively and in under
standing the implications of their own behavior, Geertsma
and Reivich (1969) suggested that the use of videotape
would be especially helpful to this group of patients.
Geertsma (1969) further states that externally motivated
self-cognition is-a potential powerful psychotherapeutic
technique. In another study', Geertsma and Reivich (1969)
studied a patient.who had been in individual study for a
number of years. After videotape was utilized a strong
effect change and major changes in self-perception were
noted. There was greater congruency between the patient's
self-observation and the observation of the hospital staff.
Reivich and Geertsma (1968) found, while videotape con
frontation was anxiety producing, there was no prolonged
negative effect from videotape confrontation of self-
image. While 77% of the group studied experienced
anxiety, 68% responded favorably to fill in the question
"What myself was . . ."
In a study of three hospitalized psychiatric women
44
patients, Paredes, Gottheil, Tausig and Cornelison (1969)
videotaped the first group and played back the information
in biweekly sessions. A second group saw audiovisual
recording of another individual while a third group was
not exposed to any audiovisual material. The first group
showed greater clinical improvement with increased feelings
of self-acceptance. Among this group there was also a
greater tendency to enter into a closer relationship with
the viewer. The psychiatrist who conducted the videotaping
and viewing sessions observed the reactions of those
patients in the first group. These individuals appeared
to be more aware of negative feelings about themselves,
seemed to experience a decrease in these feelings while
becoming more self-accepting and finally disclosed personal
items more readily while entering into closer personal
relationships with the interviewer.
Braucht (1970) tested the hypothesis that video
self-confrontation .increases the level of anxiety in
group psychotherapy. This study involving 73 male
psychiatric inpatients failed to support the stated
hypothesis.
Empirical Findings Concerning Videotape Feedback
One of the earliest experimental studies utilizing
a control group with videotape confrontation was conducted
by Moore, Chernell and West (1965). The sample employed
in this study consisted to 80 consecutive admissions to
45
a private psychiatric hospital. There was no consideration
as to the potential diagnosis of these 80 patients. Within
24 hours of admission, all 80 of these patients were video
taped. The 80 individuals were then formed into two
groups; one control and one experimental. Until the time
of discharge, the experimental group was shown the initial
videotape along with a videotape of their most recent
session with the psychiatrist. The replays lasted about
ten minutes and provided the experimental group with a
contrast of their initial condition as compared to their
most recent condition. The results of this study reveal a
significantly higher degree of improvement on the part of
the experimental group as opposed to the group which did
not view replays of their condition.
Stoller (1967) studied the effects of videotaping
group therapy sessions with chronically hospitalized
individuals. Initially, a group of ten women were involved
in the group. Through attrition, the group gradually
became heterogeneous as male members were added to replace
the females who had dropped out. At the time of the
initiation of this experiment, the sessions were not played
back to the participants. Rather, the sessions were tele
vised to members of the ward. Even so, Stoller found the
participants to be more spontaneous and exhibited signifi
cant interaction.
When Stoller initiated a second group, he added the
46
concept of replaying the session to those participants who
were interested. This replay was done without comment or
selection of the material to be replayed. The participants
even without comment of the therapist were able to make
significant observations of their performance. Stoller
(1967) concluded that the tendency of the group without
the participation of the therapist is to view physical
aspects rather than the aspects of the manner of inter
acting .
Berger (1970) reported that videotape playback con
frontations can serve as a critical portion of the in
patient therapeutic process. His findings from a study at
a community mental health center found a significant
increase in the propensity of the patients to accept
observations when viewing videotape replays. This con
trasted with a resistance to accept these observations
when tendered by group members or therapists. Once this
acceptance process has taken place, the subject was then
more likely to receive validation from his group.
In private practice, Berger (1970) found the initial
viewing of the videotape to primarily concentrate on
physical characteristics. However, subsequent viewings
tended to be more concerned with pathological interactions
as well ais;styles of relating.
Robinson (1970) investigated the effects of videotape
focused feedback as opposed to the effects of verbal
47
ifeedback within the group setting. Using independent
raters to review tapes of the group therapy sessions, it
was concluded that focused feedback did in fact facilitate
the development of health interpersonal interaction within
j
i
ithe group. It was interesting to note that the observers
noticed change at a faster rate than was reported by the
i
:group members as a result of test measurements. The results
I
I
|of this study verified the commonly-held supposition that
I
[individuals maintain their old self-image rather than giving
!
|it up for a riskier new self-image. Stoller postulated
jthat, had the focused feedback duration been extended, the
results of the study may have exhibited less discrepancy
:between the observations of the raters and the results of
I
F
: the tests. j
j !
I Danet (1969) investigated the effects of videotape !
I
ifeedback on the self-concept of individuals and on the
!effect of the process of the group. Ten minutes of a 50-
i
minute group therapy session were extracted and played
i
back at the beginning of the following session. Results
;of this study indicated that the videotape playbacks had
i
'a disruptive effect upon the group process and that the
|experimental group subjects were more anxious and had more
negative views of themselves after the session as opposed
1 to before. It was felt that the rigid structure of the
>playback accounted for its disruptive result. Danet con-
I eluded that Stoller’s notion of the need for immediate
replay coupled with the therapist's comments and analysis
was correct.
Miller (1970) investigated whether or not videotape
feedback is an effective means of reducing the inconsisten
cies between self-concept and ideal self-concept as opposed
to audio playback or no audiovisual playback. In this
!
:study, the videotape replay was found to be significantly
1
|more effective. However, in contrast to the Danet study
i
and the research of Stoller and Berger, there was no
significant difference in the results regardless of the
i
[placement of the replay.
i
A study by Truss (1972) examined the effect of video-
itape focused feedback with regard to changes in self-
I
|concept and ideal self-concept. Truss hypothesized that
!the inclusion of the technique in a group therapy situation
i
;would produce greater ideal-real congruence as opposed to
I a group without videotape replay. While his results did
not statistically support this hypothesis, the directional
ity of the results did support the hypothesis.
Summary
Marathon groups and videotape focused feedback both
represent two of the more promising therapeutic innovations
of the past few years. The review of the literature
| speaks of both concepts in glowing terms. Ruitenbeck
: (1970) cites marathons as the most promising of all the new
I
I 49
therapies. Berger (1970) cites the use of videotape as a
means of renewing our sense of humility.
While both concepts are spoken of in glowing terms,
;the review of the literature suggests a state of confusion
I
jas to the effectiveness of both methodologies. It is
i
interesting to note that both are spoken of in glowing
(
'terms by patients, therapists and researchers alike. Yet
|one finds that the claims are often not substantiated by
;the research.
j A study investigating the effects of videotape
j focused feedback techniques in marathon group therapy and
its effects on self-concept and self-actualization is
clearly justified.
j
l 50
CHAPTER III
METHODOLOGY
Research Purpose
I
j For purposes of this study, the term research has
i
'been defined broadly in order to investigate the full
|panorama of evidence accumulated pertaining to the effects
i
:of the introduction and utilization of videotape focused
feedback techniques in a marathon experience with clients
of a community mental health clinic. Major headings to be
discussed include: (1) the research design; (2) partici-
i ;
|pants in this study; (3) procedures followed; (4) the j
Iindenendent variable; (5) the dependent variables; |
I
' (6) variables selected for further analysis; (7) operation-j
;al hypothesis; and (8) chapter summary. i
Research Design
| While it is more difficult to implement, the Solomon
.Four Group experimental design (Solomon, 1949) provides an
I
'extremely powerful design for research on marathon group
'treatment. The Solomon design provides contrast and
control groups within the same study. The resulting data
:provides relative comparisons as to the efficacy of
|different treatments in comparison to control subjects
! ’ 51
|drawn from the same pool. Of those studies reviewed, only I
i
i
Lewis (1967), Weigel and Straumfjord (1968), Crowther and
Partleo (1969) and Jacobson and Smith (1970) have utilized
j
this design.
In their review of relevant research on marathon
I
groups, Dinges and Weigel (1971) reported that, in spite
t
1 of the need for randomness in the proper assignment of
|subjects to treatment, control and contrast groups, little
■ concern for procedure has been demonstrated in current re
search. Optimally, control and contrast groups should be
|randomly assigned from a pool of participants who share a
*
j little amount of motivation (e.g., the members of our treat-
i i
Iment population).
j A major irregularity recognized by the above authors i
; I
!was that, when control and contrast groups are compared |
i j
;to treatment group, the comparison must also be made between
'groups in the amount of pre-post change. The statistical
j outcome of this irregularity often finds statistically
i
i
'significant results within the treatment group, while over
looking the statistical insignificance in pre-post results
i
iwithin the control group or contrast group. These results
I
|often lead to the conclusion that subjects who received the
i treatment changed, while control subjects did not. The
same factors which contribute to treatment group change
! also often act upon the control group. For this reason, it
; is imperative that tests be performed to determine the
I
i
i
I 52
Idiffe rences in changes between the groups in order to de-
i
]termine the true effects of the treatment.
I
i
While other designs are more often used, the Solomon
Four Group design with its patent controls is a stronger,
|more aesthetically pleasing design. Campbell and Stanley
I
(1963) say that this design has become the new ideal for
I
social scientists. The recognition of an explicit con-
!sideration of external validity factors makes the Solomon
i
]the most desirable of designs. The design is as follows:
! R 0, X 0,
j R °3 °4
j R- * o5
' R 06
Such that: R is the initial randomization, CL and O^j
I
;are pretreatment observations (pre-tests), X is the appli- ,
! cation of the treatment and , 0^, 0,- and 0^ are a final
observation (post-tests).
i
| The desired comparison is met with the first two
i
lines and the second two lines. Randomization assures
jstatistical equivalence of the groups, while history and
!maturation are controlled with the first two lines of the
i
i design. Possible interaction effects due to possible pre-
i
:test subject sensitization are controlled by the first
.three lines (Kerlinger, 1965). Paralleling other experi
mental elements (0-^ through 0^) with the experimental and
control groups lacking the pre-test allows the main effects
: 53
of testing and the interaction of the testing to be deter
mined. Generalizability is thereby increased along with
the effect of treatment being replicated in four different
manners: 0 ^ > 0^ 5 > ^4’ ^5 > ^6’ an<^ ^5 > ^3* Thus,
in effect there are two experiments with a consistency of
results providing strong evidence of the validity of our
research hypothesis.
For all of the above reasons, this design was
selected since the greater rigor it requires and the
greater controls it possesses result in a more complete
s tudy.
Participants in the Study
Leaders
Two factors were important in the selection of
leaders for this study. They must necessarily be familiar
with the application of videotape techniques as applied
to the therapeutic endeavor and they must be thoroughly
familiar with the marathon experience. Group leaders were
selected based upon the recommendations of Dinges and
Weigel (1971) in their review of the literature and upon
the familiarity of the techniques outlined by Stoller
(1968a). All the leaders selected are licensed by the
State of California to practice psychotherapy and counsel
ing. They had also had extensive experience with the use
of videotape. All therapists selected described themselves
54
|as being from humanistically oriented schools of psychology]
l
I
| The three leaders selected had a combined experience
in leading marathons that was in excess of 100 of this
type group. All three regularly used videotape in the
|course of their normal marathon group experiences. One of
the leaders had studied under Stoller during the formula-
;tion of the now-accepted techniques for the utilization of
videotape in a marathon situation,
j It was coincidental that the training proposed by
Lakin (1970) had been completed by all leaders. That is,
'they all had (1) membership in two groups; (2) observed at
I
least five groups with ongoing discussions with the group
(leaders; (3) served as co-leaders of at least five groups j
! j
iwith experienced leaders; (4) led five groups under super- i
i
‘vision; and (5) had partaken in personal psychotherapy. 1
r '
!This training was in line with that outlined by Stoller whoj
; !
iconsidered the leader particularly important since there is j
;little or no opportunity within a marathon to ’'consult" j
I i
!when a problem arises. Stoller's attitudes were echoed j
iby Bach (1967b) who was concerned that leaders be well
i
trained and professional.
i
j All three leaders were committed to and in fact
I performed in a manner which placed them in the role of
i subjects rather than objective observers. As outlined by
Beymer (1970) , the leaders felt no more and certainly no
less responsibility than the therapist working with the
t
55
individual client. All leaders were successful in shedding
their professional role and participated in the immediate
group experience as recommended by such leaders as Bugen-
thal and Haight (1965) , Bernard (1968) , and Alexander
(1969).
All three leaders were Caucasian, their average age
was 32, one was female, the other two male.
Population and Sample
The community mental health clinic, which contains
the population for which this study was selected, is an
outpatient facility with a population of 325. The clinic
is located in an urban population center in the southwest
portion of the United States. Most of the clients of the
clinic enter on a walk-in basis with a limited number having!
been referred by other treatment centers, private physi
cians in the general area, or probation officials.
The clinic includes on its staff psychiatrists, psy
chologists, marriage, family and child counselors, psycho
motorists and educational and vocational counselors. The
clinic is run on an outpatient basis with the treatment
period being open-ended. The clinic offers treatment to
those problems found in a normal cross section of the
population in which it .operates. Among the typical problems
encountered at this facility are problems relating to drugs,
alcohol, marital and family relations, sexual, delinquency
56
and traditional psychological-type problems.
Depending upon the nature of the problem, the treat
ment regime might include participation in any of the
following: psychodrama, drama lab, self-awareness groups,
body language groups, crafts classes, educational tutoring,
and limited vocational training. These activities supple
ment the normal individual and/or group counseling provided
all clients. All clients are given complete psychological
testing and an interview prior to the assignment to any of
the above treatment activities. There is no attempt to
segregate clients dependent upon the nature of the problem
for which they are receiving treatment.
The basic characteristics of the population are as
follows: (1) the average age was 35; (2) 55% were male,
45% were female; (3) the educational level was an average
of 15.5 years; (4) 50% were divorced or separated, 27.5%
were married and 22.5% were never married. The ethnic
breakdown was 95% Caucasian, 2.5% were Hispanic, and 2.5%
were Black.
Procedure
The present research was primarily instigated as a
means of quantifying the effects, if any, of the inclusion
of this treatment technique in the normal course of
marathons performed at this community mental health clinic.
The analysis and description of the process and outcome of
57
the inclusion of this treatment technique in the course of
a marathon was viewed by this researcher as a necessary
step in the investigation of this promising technique.
Utilizing the Solomon Four Group design, patients who
had begun (less than three weeks) the program at the commun
ity mental health clinic were randomly assigned to four
treatment groups. The investigator had the acceptance,
trust and cooperation of the staff and clients. A pre
condition was that the results of the study would be shared
with both staff and clients. The total sample consisted
of 40 clients of whom only one had had previous marathon
experience.
Two marathons were scheduled for successive weekends,
and those clients assigned to each treatment, control or
contrast group were in attendance at the prescribed mara
thon. Assignment was such that each marathon had a popula-
A
tion which was randomly preassigned to receive the videotape:
focused?/, feedback treatment.
Testing Procedures (MMPI and POI)
The pre-tests were administered during the week
preceding the particular marathon to which the client was
assigned. Tests were administered by a trained psycho-
metrist using standardized instructions. The post-tests
were administered ten days following the marathon experi
ence .
58
Leader Training
Two orientation sessions were held prior to the first
marathon. It was agreed that one leader would be assigned
the primary responsibility for the operation of the video
tape equipment. Each of the leaders had participated in a
marathon which they had led during the previous three
months. This was in line with Mintz’s (1971a) recommenda
tion that leaders have prior marathon experience. All
leaders agreed to follow the guidelines outlined by Bach
(1966) known as the ’’ Ten Commandments for Marathon Groups.”
Additionally, Schultz's (1971) ’’Rules of Open Encounter"
were agreed upon to be followed. With the exception of a
warm-up exercise, structured exercises were not prearranged,
but were acceptable if their use did not restrict the
natural flow of the marathon experience. It was further
agreed that as many members as possible would be videotaped,
but only those members of the treatment group would be sub
jected to videotape focussed feedback.
The warm-up exercise was such that it, in reality,
fit into Stoller’s (1969) operational notes. That is,
they were of an open, honest and unstructured nature. The
following "ground rules" were clearly stated to include
all in attendance:
1. Stress upon honesty and spontaneity rather than
being "right."
2. Focus upon being reacted to rather than being
________________________________________59
unders tood.
3. Concentration on the here and now.
4. The giving of feedback was expected.
5. Members were expected to learn to accept and use
feedback.
6. The ability to differentiate what feedback to
accept and resist.
7. Learning when nonverbal responses are more
expressive than words of one's feelings.
The leaders involved, while committed to these
principles, were not aggressive. Rather, they could be
described as Coulson's (1970) "gentle risk takers" or
Corsini's (1970) leader as a passionate person who gives
his all.
Videotape Usage
Group members were not informed prior to arriving at
the marathon that videotape was to be a part of the mara
thon process. As recommended by Stoller (1968e) , Wilmer
(1968) and Berger (1970), the videotape was placed in plain
sight as part of the group. In response to expressed
feelings of anxiety about its presence, its presence was
explained to be that of a participant observer (Wilmer,
1968). Various individuals were videotaped during the
course of the marathon. As was agreed, only those treatment
group members were shown on videotape replays. For both
treatment, control and contrast group portions of the
60
marathon were videotaped but not replayed during the
course of the marathon. Portions of the videotape were
replayed when appropriate to the occurrences of the mara
thon. The leaders involved were not informed as to the
nature of the study.
Videotape Equipment
The equipment selected for this study was Sony one-
half inch equipment. The equipment included a Sony CV 3600
one-half inch tape machine, Sony camera with a 19 to 40 mm
zoom lens, a dynamic microphone and a Sony monitor.
Nature of the Replay
As recommended by Berger (1970) and Stoller (1968b) ,
the method of videotape replay was the focused feedback
method. Segments to be replayed were generally limited to
less than 20 minutes. The majority of replays were in the
ten-minute range. Berger (1970) further recommended replays
without sound, multiple replays and frozen frame replays.
All of these techniques were employed. Additional replays
occurred alternately with and without the video portion in
one instance.
In most cases, as suggested by the literature (Berger,
1970), leader and group feedback was encouraged in those
cases where heightened effect was necessary. Stoller
(1968b) pointed out that it was easy to flood the client
with too much videotape. Great efforts were taken to avoid
61
this flooding effect.
Data Processing and Analysis
All data from POI pre-tests and post-tests were
scored at California State University, Northridge, using
standard scoring procedures. All subjects completed the
pre- and post-tests.
The commonly accepted strength of the MMPI is its
empirical derivation and norming. Because the MMPI is an
extremely complex instrument, the MMPI was scored by a
clinician with extensive MMPI experience. This enabled the
researcher to utilize its actuarial power. The MMPI in the
hands of an expert can provide considerable valid and
clinically useful information regarding the emotional
status of a cooperative subject (Rodgers, 1972). All
subjects completed the pre- and post-tests.
While not a factor in the administration of the post
test, it should be reported that two subjects terminated
participation in the clinic program. Both subjects were
in the group, no treatment, no pre-test.
While it is generally conceded that the Solomon Four
Group design only explicitly recommends only two of three
analyses (Campbell £ Stanley, 1963), the data in this exper
iment was subjected to three different analyses. The
third analysis is more conservative than the recommended
analyses which thereby reduces the possibility of Type I
error prevalent in those experiments which utilize multiple
62
dependent measures. For further information, the reader
may refer to Chapter IV.
Instrumentation
The general outcome objectives of the utilization of
focused feedback techniques in a marathon group required
objective instruments for evaluating the effects of the
treatment chosen. Attempts were necessarily made to
control the humanistic bias of the researcher. Therefore,
the instruments chosen are ones which are appropriate for
measuring positive agents of mental health and psychologi
cal dimensions of mental health.
The Minnesota Multiphasic Personality Inventory
Developed by Hathaway and McKinley (revised 1967) ,
the Minnesota Multiphasic Personality Inventory was
selected to provide an objective assessment of some of the
major personality characteristics which affect personal and
social adjustment. At the present time, the MMPI is
recognized to be the psychological instrument of choice for
the routine assessment of the nature and degree of emotion
al upset in adults over the age of 16. Since Hathaway and
McKinley’s first studies in 1940, the MMPI has grown to
become one of the most important tools in the clinical and
counseling fields. First published by the University of
Minnesota Press in 1943, the MMPI was most recently revised
in 1967.
_______________63
One purpose of this study was to contrast the MMPI
and POI scores to determine treatment effect. It has been
hypothesized that marathon groups have a beneficial effect
in improving mental health. Of particular interest is the
implication that the inclusion of videotape feedback in
the marathon group experience will serve as a more effective
antidote against the hazards to mental health. Positive
results would indicate that such an experience would be of
benefit to the general population wishing to move toward
increased positive mental health and decreased emotional
upset. The present investigation seeks to test this
hypothesis.
The MMPI was created and continues without any
significant theoretical basis. The single founding
principle was that actuarial observation of contingency
in association with past and present events will indicate
such sequences for future events (Hathaway, 1971).
Hathaway and McKinley (1967) point out the importance
of looking at personality variables to understand pathology.
The point of view determining the importance of a trait
and the use by a clinician who wishes to assay these
traits that are commonly ascribed to those possessing
characteristics of a disabling psychological abnormality.
The MMPI Scales
The MMPI and its scales were developed in an empirical
manner. The 550 test items were administered to carefully
64
studied clinical cases and to groups of individuals con
sidered to be normally adjusted. In those cases where
responses from the clinical group differed from the control
group, they were then assigned to be part of a scale. The
original standardization consisted of nine scales. It has
become apparent that it is highly undesirable, practical
nor useful to identify an individual as a member of a
diagnostic group on the basis of a single scale elevation.
The present focus in the clinical utilization of the MMPI
is analysis of the configural relationships among the
scales. Further utilization is the use of the test data
for personality description.
At the present time, the most prevalent use of the
MMPI involves the four validity scales, and the ten clini
cal scales which are described below. A vast number of
additional scales are available for special applications.
These ’’special scales” are less known, less used and
will neither be discussed nor utilized in this study.
The brief discussion of the scales which follows
are presented in the hope that the reader will be better
acquainted with the general structure of the instrument.
Validity Scales
One of the features of the MMPI which differentiates
the MMPI from other paper and pencil personality tests is
the validity scale. These scales allow the clinician to
65
assess whether or not the test taker has a tendency to
exaggerate or minimize symptoms and to identify factors
which would interefere with the proper interpretation of
the test results. Examples of the latter include the
inability to read or understand the question or a failure
to answer an adequate number of items. Validity scales
also have additional clinical implications.
7 Scale. The ? or "cannot say” score is an indica
tion of the number of questions left unanswered. Standar
dized instructions request the test taker to answer all
questions and the test administrator is asked to return
the test to the test taker for completion if more than 30
questions have been unanswered. With the exception of those
test takers with reading problems, HIGH scores may indicate
(1) a resistive, uncooperative client, and (2) obsessional-
ism, intellectualization and indecision.
L Scale. The L Scale consists of 15 items which
describe minor faults which most individuals would readily
admit. Therefore, a HIGH score on this scale suggests
that the subject, in attempting to appear socially
acceptable, has concealed or misrepresented something about
himself on the test. High L scores may indicate individuals;
who may be tense, stereotyped, and lacking insight. They
tend to be rigid, naively defensive, and uncompromising.
Low scores tend to be independent, socially responsive
individuals who are capable of admitting faults.
66
F Scale. The F Scale consists of 64 items which are
rarely answered in the scored direction. HIGH F scores
(over 80) are an indication that the test has been invali
dated for one of the following reasons:
(1) The subject was unable to read or understand
the test questions or made errors in filling out the
response sheet.
(2) The subject was seriously disorganized, confused,
or delusional.
(3) The subject attempted to make himself appear
extremely disturbed for some reason.
(4) The subject did not cooperate, by purposefully
responding in a random or irrelevant manner.
Low F scores generally indicate that the test items
were understood and the test was taken according to
instructions. Individuals with low scores are often
described as calm, conventional and dependable, and as
having narrow interests. F scores tend to be reduced after
therapy.
K Scale. While the above scales were intended to
present evidence of invalid test results, the K Scale was
intended to act as a suppressor variable. This score
provides a measure of test taking attitude as a function
of both the F and L Scales. The K Scale is more subtle than
either the F or L Scales. A HIGH score may indicate de
fensiveness or a deliberate attempt to fake a "good"
67
result. A low score may represent excessive honest and
self-criticism or a deliberate attempt to fake a "bad"
result. The K Scale score is employed to act as a
correction factor when added to the scores on some of the
clinical scales to obtain adjusted totals.
Clinical Scales
Scale 1 (Hs). Scale 1 was based on patients expres
sing somatic concern or as an index of the importance of
bodily functions and symptoms of the particular person.
High Scale 1 scores tend to indicate undue concern about
health. They frequently complain about pains and disorders
which are difficult to identify and which have no organic
basis. Low Scale 1 scores are rather ambiguous to interpret
and it is possible that they are obtained by two quite
different groups of people: people with little or no
concern about physical symptoms and persons with consider
able concern but unwilling to admit the concern to them
selves or others. The former situation is more likely with
adolescents, particularly those with problems of social
adjustment, or with adults who strive to be very self-
sufficient and independent.
Scale 2 (D). Scale 2 is related to various depres
sion syndrones. The basic derivation of this scale were
patients diagnosed as having either reactive depression or
manic depressive depression. High Scale 2 scores suggest
68
poor morale, feelings of uselessness, depression, dejection,
discouragement, subjective distress, self-dissatisfaction,
and self-criticism. People who tend to respond to stress
with depression are characterized by a tendency to worry,
narrowness of interests, introversion, and pessimism. Low
Scale 3 scores occur very rarely in medical and psychiatric
groups. They tend to appear only in certain selected
groups such as student nurses. In general, a low Scale 2
probably signifies a lack of depressive affect and a
tendency to be cheerful and enthusiastic.
Scale 5 (Hy). Scale 3 basis was the responses from a
group of patients suffering from conversion hysteria. HIGH
Scale 3 scores tend to indicate immaturity, repression,
emotional liability and a susceptibility to suggestion.
Under stress, physical symptoms may be utilized as a means
of solving conflicts or avoiding responsibilities. LOW
scores on Scale 3 indicate a constricted, guarded and
socially nonparticipating personality. They may also occur
in emotionally well-adjusted and intellectually above
average individuals.
Scale 4 (Pd). Scale 4 was based upon patients who hac.
exhibited a disregard for social values, an inability to
profit from experience and a difficulty in maintaining
satisfactory personal relationships. HIGH Scale 4 scores
may indicate an individual who is impulsive, resentful and
lacking in deep emotional responses. Moderate elevations
____________________________________________________________ 69_
may be characteristics of normal individuals who are
adventurous, social and verbal. LOW Scale 4 scores suggest
a conforming, unassuming individual who is overly accepting
of authority. They may also indicate a person lacking
heterosexual interests.
Scale 5 (Mf). Scale 5 scores measure a tendency
toward the attitudes and interests of the opposite sex.
HIGH Scale 5 scores indicate in males sensitivity and
femininity of interests, and in females a masculine, active,
aggressive orientation. However, culturally oriented,
educated males tend to have elevated scores. LOW Scale 5
scores suggest, in males, an adventurous individual who
prefers action to contemplation. In females, low scores
suggest a strong feminine interest pattern, passivity,
and, in the extreme, a masochistic willingness to accept
burdens.
Scale 6 (Pa). Scale 6 was based upon patients who
had demonstrated suspiciousness, feelings of persecution
and other paranoid symptoms. HIGH Scale 6 scores suggest
a suspicious, overly sensitive individual who utilizes
projection-type defenses. High scores tend to be self-
centered and do not feel discriminated against. LOW Scale
6 scores are often associated with traits similiar to high
Scale 6 scores. The suspiciousness is likely to be
accompanied by a lack of concern with social contact and
by stubbornness and evasiveness.
70
Scale 7 (Pt). Scale 7 was based upon a group of
patients who indicated phobias, obsessions and compulsions.
HIGH Scale 7 scores generally indicate anxiety, rigidity,
tensions, fears and excessive doubts. LOW Scale 7 scores
suggest a well-organized, persistent and realistic individ
ual who is able to mobilize his resources easily and
effectively.
Scale 8 (Sc). Scale 8 scores were derived from a
group of patients who demonstrated bizarre and unusual
thoughts and behaviors typical of schizophrenia. HIGH
Scale 8 scores indicate tendencies toward social withdrawal,
unusual thought processes and nonconformity, although not
necessarily a schizophrenic condition. LOW Scale 8 scores
suggest a conventional, controlled and somewhat compliant
individual likely to seem by others as friendly and adapt
able .
Scale 9 (Ma). Scale 9 was developed from a group of
patients who showed hypomania, emotional excitement, flight
of ideas and overactivity. HIGH Scale 9 scores suggest
high energy levels, restlessness, enthusiasm, impatience
and hyperactivity. LOW Scale 9 scores indicate low energy
levels, noncompetitiveness, and a lack of self-confidence.
Scale 0 (Si). Scale 0 was developed to measure
social participation. HIGH Scale 0 scores generally indi
cate a shy, sensitive individual who is hesitant to become
involved in social situations. LOW Scale 0 scores indicate
71
a sociable individual who is outgoing and assertive in his
relationships with others.
MMPI and Marathon Research
Prior marathon research has indicated that the MMPI
yields clinically usable and meaningful objective data
(Bernard, 1968; Speer, 1970). Rodgers (1972) indicated
that the test's greatest utility is its aid in the assess
ment of the patient. The MMPI has proved to be one of the
most powerful instruments available.
Personality Orientation Inventory
In order to assess self-actualization, the Personality
Orientation Inventory (POI), developed by Everett Shostrom
(1964, 1966), was determined to be the most desirable
instrument in this study. The POI was designed to assess
attitudes, behavior characteristics and values of Maslow's
concept of a self-actualized individual. Maslow defines
self-actualization as the:
. . . ongoing actualization of potentials, capacities,
and talents . . . as a fuller knowledge of, and
acceptance of, the person’s own intrinsic nature,
as an unceasing trend toward unity . . . [Maslow,
1962, p. 25].
Self-actualized individuals generally demonstrate the
following clinical characteristics:
Superior perception of reality . . . increased
acceptance of self, of others and of nature . . .
increased spontaneity . . . increased autonomy
. . . [Maslow, 1962, p. 26].
72
The Personality Orientation Inventory (POI) attempts
to identify the more fully functioning self-actualized
individual. The POI contains 150 double statement items,
clearly delineated, enabling the subject to choose between
paired-opposite statements of value and behavior judgments.
The subject is asked to identify the one of two paired-
opposites which most consistently describes himself. The
POI consists of two major scales. One, consisting of 127
items, measures inner-directed support. The second is a
measure of time competence. Ten additional scales are
derived to measure important elements of a conceptual nature
important to self-actualization. These additional scales
are primarily obtained from the inner-directed support
scale. These scales include: self-actualizing value,
existentiality, feeling reactivity, self-regard, spontane
ity, self-acceptance, nature of man, synergy, capacity for
intimate contact and acceptance of aggression.
Reliability and Validity
The test-retest reliability for this instrument
ranges from .55 (moderate) to .85 (strong). The two main
scales are reported to have reliability coefficients of .71
for the Time Competence and .84 for Inner Direction
(Shostrom, 1966) .
The content validity has been described as "good"
(Bloxom, 1972). A validity test of the instrument
73
(Shostrom, 1964) revealed that the inventory was able to
discriminate between clinically judged self-actualized
groups and non-self-actualized groups on 11 of 12 sub
scales. Concurrent validity was demonstrated by the
ability of the instrument to discern between two groups of
outpatients, one in the beginnings of the therapeutic pro
cess and the other in the advanced stages of the thera
peutic process (Shostrom § Knapp, 1966). This instrument
was also able to discriminate between hospitalized psychi
atric patients, a nominated self-actualized sample, and a
normal adult sample (Fox, 1965).
Further evidence of concurrent validity is evidenced
in the correlations with scales of other instruments.
Obtained correlations with the MMPI Si Scale tends to
support the notion that the POI is able to measure attri
butes which are considered important in developing
harmonious interpersonal relationships among "normal"
populations (Shostrom, 1966). Further correlations have
been demonstrated with the Guilford-Zimmerman Temperament
Survey (Shostrom, 1966), and the Eysenck Personality Inven
tory (Eysenck § Eysenck, 1963). Also included in the
manual is evidence of concurrent validity with other
personality measures such as the Allport Vernon Study of
Values, The Dogmatism Scale, The Sixteen Personality
Factor Questionnaire, The Minnesota Teacher Attitude
Inventory, and the California F-Scale.
74
The POI has generally demonstrated itself to be a
reasonably reliable and valid instrument for measuring
changes in self-actualization (Braun, 1966; Fox, Knapp §
Michael, 1968) .
Intercorrelation and Item Overlap
The POI contains extensive item overlap which may
suggest some limitations as to the desirability of the
instrument. However, the major scale items for both Time
Competence and Inner Direction do not overlap (Bloxom,
1972). Contained within the major scales are all items of
the minor scales which are revealed as considerable overlap
of content despite different conceptual labels.
An intercorrelation matrix derived from a sample of
138 subjects revealed that the Inner Directed Scale corre
lated between .37 and .71 with all ten subscales (Shostrom,
1966). The Inner Directed Scale contains 127 of the 150
items on the instrument.
POI and Marathon Research
Recent research has demonstrated that the POI is
capable of revealing significant treatment effects between
marathon subjects and control subjects (Foulds, 1971;
Guinan § Foulds, 1970; Jeffers, 1971). A more recent
study cited the POI as the single most representative
measure of self-actualization (Kimball § Gelso, 1974).
75
Operational Hypotheses
The following hypotheses are stated in an operational
form to assess the effects of the treatment. For the sake
of avoiding needless replication in the statement of
hypotheses, "experimental group" refers to those partici
pants receiving focused feedback videotape treatment during
the marathon, and "control group" refers to those partici
pants who did not receive such a treatment.
Hypothesis 1. There are no significant differences
on change scores among the experimental group and the
control group on the scales of the POI.
Hypothesis 2. There are no significant differences
on change scores among the experimental group and control
group on the scales of the MMPI .
Hypothes is 3. There are no significant differences
on treatment mortality among the experimental group and
the control group.
Summary
This study was performed to investigate the effects
of inclusion of videotape focused feedback techniques in a
marathon situation upon indices of self-actualization,
emotional upset and treatment mortality. The conservative
Solomon Four Group design was employed (Campbell § Stanley,
1966). While other designs are more frequently utilized,
76
this design represents an explicit consideration of externa!,
validity factors. Campbell and Stanley (1963) have
recommended the Solomon as the new ideal for social
scientists.
The participants in this study were all outpatients
of a community health clinic with a wide range of psycho
logical problems. Randomization was employed. Demographics
reveal that the sample was: 55% male, 45% female; 95%
Caucasian, 2.5% Hispanic and 2.5% Black; and the average
age was 35.
Three leaders were employed, one specifically for the
videotape. All were licensed therapists with a minimum of
four years of marathon work and three years of videotape
work in marathons. All three were of a humanistic orienta
tion .
Pre- and post-tests were administered to all subjects
in keeping with the guidelines of the Solomon design within
a 20-day period. All subjects completed the MMPI and the
POI.
The basic problem addressed in this study is to
ascertain the effect of the inclusion of focused feedback
videotape techniques in a marathon group as part of the
ongoing treatment regime of a community mental health
clinic. In order to examine this question, the more
rigorous Solomon design and the utilization of instruments
designed to measure changes in self-actualization and
77
emotional upset were employed.
The dependent variables selected included the MMPI
(Hathaway § McKinley, revised 1967) and the POI (Shostrom,
1966) .
It was hoped that the utilization of a strict
experimental design and clearly measurable dependent
variables would provide a more precise analysis of clinical
treatment than is customary in. psychotherapy research.
78
CHAPTER IV
RESULTS
General Format of Analysis
Three different type of analyses were selected for
the data in this experiment. While with the Solomon Four-
Way design, Campbell and Stanley (1963) recommend only
explicitly two of the three analyses, the third analysis
was performed because of its conservative nature. The
third analysis acts to reduce the probability of a Type 1
error that is inherent in an experiment utilizing multiple
dependent measures.
First a multivariate analysis of variance was under
taken in the design format of a one by four; that is, the
variance attributed to distinct factors was collapsed for
the purposes of the initial analysis. Subsequently, the
variance in the post-measure data was partialed into two
orthogonal factors, a treatment and a pre-measure. This
particularity of variance allowed for the examination of
the effects of treatment, the effects of pre-measure
sensitization, and, finally, the potential interaction of
those two factors. Lastly, pre-measure data was analyzed
by introducing pre-measures as co-variates in the analysis
of variance which addressed only the two groups which
79
received both pre-measures and post-measures. To insure
strict control over pre-treatment differences in groups,
all variables that were pre-measures were utilized as
simultaneous co-variates for each separate post-measure.
Multivariate Analysis of Post-Measures
A multivariate analysis of variance testing signifi
cance by Wilks Lambda criterion indicates that the four
treatment groups are not significant different (p=.256).
Univariate tests indicate that 18 of the 24 dependent
variables were significantly different between groups
(p<.05). Those variables included the following scales:
MMPI Hs, MMPI D, MMPI Hy, MMPI Pd, MMPI Pa, MMPI Pt,
MMPI Sc, MMPI Si, POI Tc, POI I, POI Sav, POI Ex, POI Fr,
POI S, POI Sr, POI Sa, POI A, POI C.
The nature and direction of these differences will be
discussed in terms of the two-by-two analysis of variance
which follows.
Effects of Pre-Measures and
Treatment on Post-Measures
A test of the effects of the pre-measure on the post
measures indicates no significant pre-test effects. A
multivariate analysis of pre-measures on post-test yielded
nonsignificant results (F=.346, df=24/13, p<.998). Like
wise, a multivariate analysis of the interaction of the
80
treatment and pre-testing on the post-test yielded non
significant effects (F=.190, df=24/13, p<.999). It may
therefore be safely concluded that the corpus of signifi
cant findings reported earlier can only be attributed to
treatment effects. In fact, the multivariate analysis of
variance yielded a clearly significant main effect for
treatment (F=8.11, df=24/13, p<.001).
Further examination of the effects of treatment
indicate that treatment had a significant effect on the
following scales: MMPI Hs, MMPI D, MMPI Hy, MMPI Pd,
MMPI Pa, MMPI Pt, MMPI Sc, MMPI Si, POI Tc, POI I, POI Sav,
POI Ex, POI Fr, POI S, POI Sr, POI Sa, POI A, POI C.
Results of this analysis may be found in Table 1. Exact
means for these significant findings may be found in
Table 2.
The results of these findings were such that subjects
in the treatment group, as compared to subjects in the non
treatment group, tended to be significantly less apt
to exhibit signs of hysteria, signs of depression, signs
of hypochondriasis, psychopathic deviancy, paranoia,
psychasthenia, schizophrenic symptomology, and more social
extroversion. In terms of self-actualizing traits, subjects
in the treatment group were significantly more likely to
produce inner directed support, be more time competent,
tended to hold more self-actualizing values, hold more
existential values, tended to be more flexible in the
81
Table 1
Significant Effects of Treatment
Variate F df P
MMPI
Hs 18.43 1/36 <.001
D 24.94 1/36 <.001
Hy 22.10 1/36 <.001
Pd 11.29 1/36 <.002
Pa 12.98 1/36 <.001
Pt 21. 37 1/36 < . 001
Sc 15.34 1/36 < . 001
SI 9.65 1/36 <.004
POI
TC 12.31 1/36 < . 002
I 9. 33 1/36 <.005
Sav 21.67 1/36 < . 001
Ex 11 .83 1/36 < . 002
Fr 28.77 1/36 <.001
S 28. 58 1/36 <.001
Sr 13. 65 1/36 <.001
Sa 11. 26 1/36 <.002
A 17. 93 1/36 <.001
C 33.21 1/36 <.001
82
Table 2
Pre-Measured Data
by Group Means and
for All Subjects
Standard Deviation
Scale
Treatment
x SD
Control
x SD
MMPI
F 62 . 4 9.65 60.5 8. 22
K 58. 7 7 .83 56.1 5.13
Hs 72.1 7 .82 71.9 9 .97
D 76 . 5 8 .51 75.2 7.39
Hy 72.6 4.38 73.0 7.16
Pd 76.4 5.98 78. 9 9.61
Mf 66.1 6.45 63.2 8. 70
Pa 62.7 5.40 67.3 10. 66
Pt 69.4 11. 72 74.9 8.89
Sc 73.6 10 . 04 72 . 5 8.13
Ma 68.8 9.27 71.1 9.05
Si 42.6 9.07 43.6 8.00
POI
TC 40.6 11 . 01 39. 9 10. 2
I 39. 9 6.37 39.9 4.91
Sav 40. 8 6.86 37.8 9 .78
Ex 41.1 10.57 42.1 8 .95
Fr 46. 7 7 . 21 43. 7 6.98
S 39. 7 6.62 39. 7 9.45
Sr 40.3 8. 25 41.6 12 .16
Sa 36 . 8 8 .23 38. 2 12. 09
Nc 41.1 10.91 40.1 9 .24
Sy 35. 0 8.65 42.7 7.30
A 40. 2 5. 84 38 . 7 16 .72
C 41. 6 9 . 06 40.1 10. 22
83
application of their values, tended to express spontaneous
ly their feelings behaviorally, tended to have higher self-
worth, tended to accept themselves more despite their
weaknesses, tended to accept their own feelings of anger or
aggression, and, finally, tended to have a greater capacity
for intimate contact.
An examination of cell means (Table 3) indicated
that the subjects' global tendency to become more self-
actualized did, in fact, represent a trend from nonself-
actualizing tendencies toward more normal values rather
than movement completely into the domain of the self
actualized individual. This trend is also substantiated by
the means for the MMPI post-measure. In general, these
means indicated the existence of some psychopathology,
even after treatment. However, the functioning of the
treatment did show a movement toward a "healthy personal
ity ."
Globally, these results might be interpreted as
evidence for the treatment potential of videotape focused
feedback techniques within the confines of marathon group
therapy.
Effects of Treatment on Post-Measures with
Pre-Measures Used as Co-Variates
At the outset, it should be noted that the following
tests are extremely conservative. As opposed to previous
84
Table 3
Post-Measure Data for All Subjects
by Group Mean and Standard Deviation
Scale
Pre-Test
Treatment
Pre-Test
No Treatment
No Pre-Test
Treatment
No Pre-Test
No Treatment
X SD X SD X SD X SD
MMPI
F 54.7 11. 35 63.0 7.08 55.1 8. 30 63.4 > 11. 04
K 51.6 6.64 53.6 4 . 84 53.5 ' 6.96 50.8 10.52
Hs 64.1 5.63 72.5 8.45 63.1 5. 26 72.6 6.57
D 62.9 7.65 75.3 5 .60 64.0 7.27 74. 3 7.99
Hy
63.2 4.96 72.2 5.09 64 .1 7.50 71.8 4.39
Pd 71.1 4.95 77.7 7.70 69.9 6.15 76. 5 5.70
Mf 64.3 5.83 63.4 8. 21 64.7 8.06 63.9 8.69
Pa 59.1 4. 79 67.3 10.62 60.6 4.79 68.0 5.35
Pt 61.0 10.15 72.8 6.05 60.0 6.43 69.8 6.11
Sc 63. 2 7.55 73.1 7.01 64.2 5 .07 70 . 2 5.73
Ma 68.7 8.60 73.3 7.10 69.8 7.08 72.0 5.94
Si 48.0 3.49 44.0 8.27 51.6 6.69 43.7 4.62
POI
Tc 51. 8 8.93 41.6 10.52 51.0 8.42 42.0 6.18
I 47.6 6.80 39. 8 4. 00 45.8 9.11 40.4 6.00
Sav 51. 0 5.58 36.9 8.49 49.1 11.79 39. 7 3.56
Ex 48. 2 7.32 40.3 8.42 46.3 5.89 39.7 4.32
Fr 52.2 6.86 43.2 6. 70 51. 3 5 . 31 40.3 4.35
S 51. 3 6.46 39.0 8.30 49.7 6 . 36 40.0 4 .27
Sr 50.1 7.42 40.7 12. 35 50.3 6.13 40.4 5.27
Sa 47.2 9.72 39. 3 11.91 48. 5 7.44 37.5 5. 06
Nc 43. 0 9. 08 40.3 7.79 44.8 8.01 40.2 5.05
Sy 47.1 6.26 43.1 8.50 44.2 8.53 40.7 7.48
A 53.5 8.54 39.6 14. 59 50.7 7.64 39.4 3.13
C 56.0 7.93 40.3 9.62 54. 2 7.39 41.9 5.09
85
analyses, only the 20 subjects who have both pre-measures
and post-measures as allowed by the Solomon Four Group
Design can be analyzed. Moreover, this analysis utilized
multiple co-variates in the analysis. Specifically, in
addition to pre-measure•co-variates, related pre-measure
co-variates were simultaneously utilized. All of the above
results resulted in a considerable loss of degrees of
freedom. These limiting features notwithstanding, 16 of
the 18 univariate tests remained significant in the multi
variate analysis of co-variance.
Tests of significance using the Wilks-Lambda
criterion indicate the following scales with significant
results: MMPI F, MMPI K, MMPI Hs, MMPI D, MMPI Hy, MMPI Pd,
MMPI Pt, MMPI Sc, MMPI Ma, POI Tc, POI I, POI Sav, POI Ex,
POI Fr, POI S, POI Sr, POI Sy, POI A, POI C. Results of
this analysis may be found in Table 4.
Within Subjects1 Comparisons
As recommended by Campbell and Stanley (1963) , in
addition to the above analyses, a final within-group
subjects1 comparison may be used to verify the statistical
trends in group differences. They state that, not only
should be treated group look healthier than the nontreat
ment group, but in addition they should look healthier when
pre- and post-results are compared. An examination of cell
means verifies that, in each case of a between-group
86
Table 4
Significant Effect of
Pre-Measures as
Treatment with
Co-Variates
Variate ,F df P
MMPI
F 26.35 1/12 < .001
K 5. 84 1/12 <.004
Hs 20.14 1/12 <.001
D 33. 32 1/12 <.001
Hy 20.90 1/12 <.001
Pd 11. 23 1/12 <.006
Pt 10.12 1/12 <.008
Sc 23.67 1/12 <.001
Ma 11.98 1/12 <.005
POI
Tc 7.61 1/12 <.002
I 18. 83 1/12 <.001
Sav 45.69 1/12 <.001
Ex 29.66 1/12 <.001
Fr 15.26 1/12 <.003
S 23.17 1/12 <.001
Sr 22. 59 1/12 <.001
A 30. 34 1/12 <.001
C 26.41 1/12 <.001
87
differences, one finds a similar direction for within-group
differences. A conservative estimate of the probability
of this occurrence in any particular instance is .5. From
this, the probability for this event (Binominal probability)
is .5^. Thus, the consistent conformity of the data
astronomically opposes a chance event (see Table 5 for
verification of this directional trend).
In this study no subjects were "lost" prior to or
during the administration of the post-test. As a result
of this, there were no effects upon the degrees of freedom
caused by changes in randomization. Therefore, the
assumption of homogeneity was not violated. After the
administration of the post-test, two subjects were lost.
Because cell frequencies for lost subjects is less than
five for all cells and zero for three cells, no chi-square
analysis (even with Yates correction) could be performed.
The implication of this descriptive finding will be dis
cussed later.
Summary of Results
The data in this study constantly indicates the
validity of the hypothesis that the inclusion of videotape
focused feedback techniques within a marathon experience
significantly enhances the potency of the treatment by
reducing gross potency, increasing the participants’ valuing
of self-actualization ideals, and, finally, significantly
Changes
from Me
Table 5
in Dependent Variables Calculated
an Pre-Tests and Mean Post-Tests
Scale Treatment Control
MMPI
F 7.7 -2.6
K 7.1 2.5
Hs 8.0 - .6
D 13.6 .1
Hy 8.6 .8
Pd 5.3 1.2
Mf 1.8 - . 2
Pa 3.6 0
Pt 8.4 2.1
Sc 10.4 - . 6
Ma . 1 -2.2
Si - 5.4 - .4
POI
Tc -11. 2 -1.7
I - 7.7 . 1
Sav -10.2 . 9
Ex - 7.1 1.8
Fr - 5.5 . 5
S -11.6 . 7
Sr - 9.4 .9
Sa - 6.9 -1.1
Nc - 1.9 - . 2
Sy -12.1 - .4
A -13.3 - .9
C -14.4 - .2
Note : For the MMPI positive numbers are equivalent to
pos itive changes. For the POI negative numbers
represent positive changes.
89
lowers the rate of treatment mortality. The directionality
and constancy coupled with the preponderance of highly
significant results directly to the strength of the treat
ment. Indeed, the impression among the clinical community
regarding this experience is verified.
90
CHAPTER V
SUMMARY, CONCLUSIONS AND DISCUSSION
The final chapter will serve as a summary of the
investigation, suggest conclusions which may be drawn
from the acquired results and offer the possible implica
tions for further practice and research concerning the
utilization of videotape focused feedback techniques in
marathon group therapy.
Summary
Man has long sought "0 wad some power the giftie gie
us; To see oursels as ithers see us!" Robert Burns, in
this brief two lines, has succinctly summed up the great
power of videotape. From Edison’s invention of the grama-
phone and motion picture projector in the early twentieth
century, the utilization of audiovisual devices in the
therapeutic process has increased dramatically.
Historically, man has sought to project to the world
his image of his mind. The ancient cave paintings and the
art of the earlier civilizations of the Middle East were
stylized representations of man and his civilizations of
the time. Then, as now, man created the image to be
91
perceived by others. These others, be they enemies,
friends or viewers from another civilization, must be
struck by the stylized nature of the images.
A major tenet of the humanistic existential psychol
ogy movement is man's confrontation with himself. The
ultimate outcome of this confrontation is his dealing with
his place in the world. Acceptance of this fact results
at the same time with one’s life becoming both easier and
more difficult. Easier, because one no longer need make
excuses for his decisions and actions. More difficult,
because one must now contend with the consequences of one’s
own decisions and actions.
As a consequence of this movement, a common belief
is that a person with a healthy self-structure will
demonstrate a high degree of self-acceptence. This degree
of self-acceptance can be defined in terms of a high degree
of congruence between the perceived and real self.
Two recent developments have arisen in the last few
years which have contributed significantly to the promotion
of a more self-actualized individual. The utilization of
videotape, and especially videotape focused feedback
techniques, has been demonstrated to be a highly beneficial
treatment modality in a variety of settings. Cornelison
and Arsenian (1960), Alger and Hogan (1967), Geertsma and
Reivich (1965, 1969) and Stoller (1967, 1968b) have all
reported the effectiveness of cideotape in a variety of
___________________ 92
settings. Similarly, marathons have been reported as
providing the necessary atmosphere of urgency, excitement
and intimacy which are ideal for promoting change (Bach,
1966; Stoller, 1972d). With the increasing utilization
of the marathon, Ruitenbeck (1970) has called the marathon
the "most significant" of all approaches to group therapy.
Thus, the combination of two modern treatment techniques
resulted in this investigation of the effectiveness of
videotape focused feedback techniques in marathon group
therapy.
Conclusions
Three conclusions may be drawn from this study:
1. The utilization of videotape focused feedback
techniques in marathon group therapy does significantly
reduce the level of emotional upsets as measured by the
MMPI .
2. The utilization of videotape focused feedback
techniques in marathon group therapy does increase the
participant’s valuing of self-actualization ideals.
3. The utilization of videotape focused feedback
techniques in marathon group therapy does have a positive
effect on reducing treatment mortality.
Discussion
The positive results of this study notwithstanding,
93
several questions arise which bear further examination.
Even though all subjects participated in a marathon, there
was little difference in pre-test and post-test results of
those participants who did not receive the treatment,
namely, focused feedback. This researcher was, in fact,
astounded at the nonsignificant differences between groups.
A great deal of additional effort has gone into attempting
to explain the apparent lack of effect of the marathon
experience without videotape focused feedback. From
#■
individual testimonies, the subjects have related what
they considered the great positive impact of the experi
ence. This testimony is in line with other testimony out
lined in Chapter II. Similarly, the subjects’ other
therapeutic involvements have been reported by their
therapists as having accelerated while taking on a more
positive tone. The only accounting which has been dis
covered is the apparent negative effect the participation
had on two subjects in the pre-test, no treatment group
who felt that they had experienced a setback as a result
of not receiving the videotape feedback they had vocally
requested during the marathon.
The question then arises as to whether or not the
process of involving both treatment and nontreatment
subjects in the same group resulted in an adverse effect
on the therapeutic process due to therapist biasing. Both
this reseacher and the therapists involved believe not.
94
Since the therapists were not aware of the nature of the
study, they all felt that they proceeded with the session
in what they called a normal manner. The utilization of
the videotape was felt to be normal and only used when
appropriate. No effort was felt on the part of the
therapist to, in a sense, show off with the videotape. The
conclusion of this research then results in a contradiction
of the results. Mainly, perhaps it was the videotape that
was the treatment effect irrespective of the framework
surrounding its employment.
In line with the above concern, this researcher is
concerned with the inconsistency between the perceived
positive effects by the subjects, the therapists involved
in the study and the subjects' regular therapists. Clearly,
something of value is occurring within the marathon process
which produces a positive perceived effect on the part of
the subject and others, but could not be measured by the
instruments utilized in this design. One then has to
wonder whether or not this positive effect is an illusion
or a feeling which cannot be measured by the instruments
available. For a treatment modality which receives such
positive comments in the literature and in the folklore
of the therapeutic community, one would think more rigorous
studies would have been performed which would attest to
this fact.
Where then does that leave us? The above concerns do
_____________________95
not limit the significance of the study. While the mara
thon as a sole entity did not appear to result in signifi
cant change in psychopathology or perception of self-
actualization, it did, in fact, provide a positive medium
for the utilization of videotape focused feedback
techniques. It appears that the instruments utilized were
well suited to measuring those traits which were affected
by the focused feedback techniques.
In this age of television, the results of this study
indicate an overwhelming positive reaction to this medium
when it is included in the therapeutic endeavor. Thus,
as McLuhan (1964) stated, "the medium is the message.’ 1
Rather than viewing the network’s perception of the world
and, thus, their perception of society and its individuals,
the videotape in the marathon allows the participant to see
himself as others see him. The advantage of experiencing
this view has an impact far greater than being told what
one does. We have perhaps reached an age where irrespec
tive of what we know, what we see is what we believe.
Videotape gives us the opportunity to know and believe
how we present ourselves to the world.
Even with the questions raised by this study, the
significance of the results was enhanced by the use of the
Solomon Four Group Design. Campbell and Stanley (1963)
called it the most powerful of all group designs in that it
provides at the same time a treatment, control and contrast
96
group and, in fact, this design provided the only means
of identifying the disturbing question identified above.
Furthermore, the data in this study exceeded the two
recommended analyses by introducing a third even more
conservative analysis. (See Chapter IV for a further
review of statistics and procedures.)
In spite of the results of the analysis, this
researcher was pleased to see the positive change revealed
to the treatment groups as well as the apparent, though
not statistically significant, benefits accrued to the non
treatment group.
With regard to the issue of reducing treatment
mortality, the inference that treatment mortality was
borne out by the fact that only two subjects dropped out
of the therapeutic program which harbored this program.
Two factors lead to this conclusion; the obvious fact that
the only subjects lost after post-testing were in the no
pre-test, no treatment group. Secondly, and perhaps more
importantly, tracking of all participants in this study
found no further drop-out from the treatment program
provided at the community mental health clinic which
hosted this study. This extremely low drop-out rate
contrasted with a normal 30% turnover of the population
remaining during this same time span.
The final positive result in this researcher’s mind
was the ability to utilize a noncollege population in this
97
study. The population utilized, while clearly more psycho
pathic than the general population, represented one that
might be more normally found in a therapeutic setting.
Because of this, the marathon setting was used as a
therapeutic tool rather than a growth tool as found in the
human potential movement. In light of this application,
the reductions in psychopathology were especially gratify
ing.
The implications of this study are widespread if the
utilization of videotape can be applied elsewhere as
effectively as in the marathon studied here. As the price
and capabilities of videotape units become more attractive,
it is hoped that its utilization will increase. Clearly
the studies cited in Chapter II point out a wide range of
applications for this device. The newness of the technology
and application will allow for a significant growth in the
application of this medium.
Recommendations
In light of the results of this experiment, several
other experiments are identified as possibilities. The
obvious experiments include a replication of this study
within the framework of a different treatment modality.
Because of the disturbing lack of differences in non
treatment post-testing results, the entire study might be
replicated to identify more clearly the mysterious lack of
98
improvement in the nontreatment groups. Another
possibility is the replication of this study with different
instruments which might better measure the effects of the
marathon involvement as well as the videotape effect.
Finally, replicate this study with an entirely different
type of population.
99
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Core Title Videotape focused feedback techniques in marathon group therapy: Effects on self-actualization and psychopathology

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