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An Empirical Study On The Differential Influence Of Self- Concept On The Professional Behavior Of Marriage Counselors

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An Empirical Study On The Differential Influence Of Self- Concept On The Professional Behavior Of Marriage Counselors

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Content This dissertation has been microfilmed exactly as received 6 8 -1 2 ,0 2 3 ALEXANDER, F rancesca, 1926- AN EMPIRICAL STUDY ON THE DIFFERENTIAL INFLUENCE OF SELF-CONCEPT ON THE PROFESSIONAL BEHAVIOR OF MARRIAGE COUNSELORS. U niversity of Southern California, Ph.D., 1968 Social Psychology University Microfilms, Inc., Ann Arbor, Michigan AN EMPIRICAL STUDY ON THE DIFFERENTIAL INFLUENCE OF SELF-CONCEPT ON THE PROFESSIONAL BEHAVIOR OF MARRIAGE COUNSELORS by Francesca Alexander 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 (Sociology) January 1968 UNIVERSITY O F S O U T H E R N C A L IF O R N IA T H E G R AD U A T E S C H O O L U N IV E R SIT Y PARK LOS A N G E L E S. C A L IF O R N IA 9 0 0 0 7 This dissertation, written by .......... J’ xjauac£jsx;J a— ≤&an.der.............. under the direction of Dissertation Com mittee, and approved by all its members, has been presented to and accepted by the Graduate School, in partial fulfillment of requirements for the degree of D O C T O R O F P H I L O S O P H Y Dean D ate............j anua-r-y-j ■ - - -1 -9 6& DIS SE R T A T IO COM M ITTEE 1 » Chairman ■/ .... C ' PBEFACB This research has been undertaken to examine the professional behavior of people with varied self- concepts who share a professional identification. Support for the study was provided by Ur. William E. Henry, of the University of Chicago, who is currently engaged in a critical examination of careers in mental health funded by the National Institute of Mental Health. Data for certain portions of this study are directly related to the work of Ur. Henry. Several individuals must be singled out who have been instrumental with their advice and encour agement. Special thanks are due to Ur. James A. Peterson, Chairman of the Uissertation Committee, Uirector of the Marriage Counseling Training Program at the University of Southern California, and current President of the American Association of Marriage Counselors; and to Ur. Edward C. McDonagh, Professor of Sociology at the University of Southern California. Ur. Uonald G. McTavish provided consultation and assistance in planning the data analysis; and Ur. Hedda Bolgar stimulated much of the thought on identity • Finally, I am most indebted to my father, Ur. Franz Alexander, who stimulated my interests in research, and to my husband, Jack Levine, who pro vided help and encouragement at every stage of the study. — Francesca Alexander ii TABLE OF CONTENTS Page PREFACE............ ....................... ii LIST OF TABLES.................. Vi LIST OF FIGURES................................. x Chapter I. THE RESEARCH PROBLEM....................... 1 Focus of the Research Organization of the Remainder of the Dissertation II. REVIEW OF RELEVANT LITERATURE........... 7 Introduction The Importance of Work Definition of a Profession Model of a Professional Axes along Which Professions May Vary Characteristics of Emerging Professions Professions and Identity Marriage Counseling What Is Marriage Counseling? History of Marriage Counseling Who Is a Marriage Counselor? Professional Background of Marriage Counselors Professional Identification III. METHODOLOGY.................. ¥+ Introduction Hypotheses Hypothesis I; Social Characteristics Hypothesis II: Preparation for Marriage Counseling iii Chapter Hypothesis III: Professional Career of Marriage Counselors Hypothesis IV: Perception of Marriage Counselors Hypothesis V: Therapeutic Orientation Sample Design Data Collection Adequacy of the Sample The Instrument Summary IV. THE FINDINGS......................... Introduction Sample Description Hypothesis I; Social Characteristics of Marriage Counselors and Profes sional Self-Designation Hypothesis II: Preparation for Profes sional Career and Professional Self- Concept Hypothesis III; Careers in Marriage Counseling and Professional Self- Concept 1. Structure and Amount of Practice 2. Independence or Dependence of Marriage Counseling 3. Type of Therapy and Professional Self-Designation *+ . Social Characteristics of Patients and Professional Designation 5* Income and Professional Designation Hypothesis IV: Perception of Marriage Counselors 1. Reference Groups and Professional Self-Designation 2. Membership Group Perception and Professional Self-Concept iv Page Chapter Page 3. Status Perception and Professional Self-De signation k-. Role Perception and Professional Self-Designation Hypothesis V; Therapeutic Orientation of Marriage Counselors Summary V. CONCLUSIONS AND DISCUSSION OP PINDINGS .... 230 Introduction General Summary General Conclusions Limitations of the Study Discussion APPENDIXES...................................... 262 Appendix A. letter and Postcard Sent to Each Respondent................ 26^ Appendix B. Questionnaire ..............267 Appendix C. Analysis of Therapeutic Orienta tion Scale hy Professional Self- Concept ..................... 280 BIBLIOGRAPHY.................................. 286 v 86 92 95 99 103 105 118 120 12*+ 133 135 138 1M-7 LIST OP TABLES Identifying Bata for Sample of Members of the American Association of Marriage Counselors • Family Background for Sample of Members of the American Association of Marriage Counselors . Social Characteristics by Central Professional Besignation ••• ........................ Analysis of Social Characteristics and Profes sional Self-Besignation .................. Parental Family by Central Professional Besignation of Respondent ................ Analysis of Social Characteristics of Parental Family ......................... Preparation for Professional Career by Professional Self-Besignation ............. Analysis of Preparation for Professional Career by Professional Self-Besignation • • • Analysis of Continued. Education by Profes sional Self-Designation, Controlling for Age, Sex, and Level of Education........ Structure and Amount of Practice by Central Professional Besignation.......... Analysis of Structure and Amount of Practice by Central Professional Besignation • . . . « Office Location and Liability Insurance by Professional Self-Concept, Controlling for Selected Variables.......... • . Independence and Dependence of the Profes sion by Central Professional Designation. . . vi Table Page l*fo Independence and Dependence of the Profession by Professional Designation, Controlling for Private Practice.......... l*+9 15. Treatment Approach by Central Professional Designation. ....................... 157 16. Treatment Approach by Professional Designation, Controlling for Private Practice, and Frequency of Patient Contact .............. 158 17. Title Ascribed to Clients (or Patients), by Professional Designation, Controlling for Educational Attainment of Respondent, and Experience with Therapy. ................ 161 18. Social Characteristics of Patients Seen in Private Practice by Central Professional Designation. ............................ 167 19. Data Analysis of Social Characteristics of Patients Seen in Private Practice............169 20. Social Characteristics of Patients Seen in Agency Practice by Central Professional Designation.......... 173 21. Data Analysis of Social Characteristics of Patients Seen in Agency Practice.......... 175 22. Average Pees for Clinical Services by Professional Designation ...... ....... 183 23. Standard Scores for Clinical Services by Professional Designation................... I8^f 2*+. Annual Income from Counseling Activities by Professional Self-Designation................186 25. Komogorov-Smirnov Test on Annual Income from Counseling Activities.......................187 26. Total Annual Income by Professional Designation. 189 27. Respondents* Reference Croups by Professional Self—Designation ............... 193 vii Table Page 28. Analysis of Reference Group and Professional Self-Resignation......... 19** 29* Ristribution of Respondents Who Stated They Pelt That Member of Given Occupation Is a Colleague................................. 197 30. Perception of Colleagues by Professional Self-Resignation 199 31. Ristribution of Respondents Who Stated That Members of Given Occupations Are Accorded Higher Status in the Community Than Marriage Counselors ...................... 203 32. Analysis of Status Perception by Central Professional Self-Resignation............ 20*+ 33. Role Perception by Professional Resignation. • • 208 3*f. Analysis of Role Perception by Professional Resignation. ............................. 210 35- Criteria Used for Categorizing Professionals by Professional Resignation..................214 36. Analysis of Criteria Used for Categorizing Professionals by Professional Self- Resignation. .......... 215 37. Summary Table, Hypothesis Is Social Charac teristics of Marriage Counselors and Professional Self-Resignation. • ......... • 222 38. Summary Table, Hypothesis II: Preparation for Professional Career and Professional Self-Concept ....................... 223 39. Summary Table, Hypothesis III: Careers in Marriage Counseling and Professional Self-Concept ............................. 224 40. Summary Table, Hypothesis IV: Perception of Marriage Counselors and Professional Self-Resignation........... 227 viii Table Page *+1. Summary Table, Hypothesis Vi Therapeutic Orientation of Marriage Counselors ..... 228 ix LIST OF FIGURES Figure Page 1. Geographical Subdivisions of the United States .................. ••••• 73 CHAPTER I THE RESEARCH PROBLEM The problem of professionalization and the impli cations of a professional identity Have long been recog nized,1 Sociologists have become increasingly aware of this area and have undertaken the study of various pro fessional groupings attempting to examine them in terms of the influence that professions have on the interaction of 2 individuals, and their relation to the social structure. It has been pointed out that professional identifi cation is an extremely important variable in determining how individuals orient their behavior to each other in our society, and to the division of labor within a given community. Gross argued that ", . . a hundred years ago, in rural America, when two strangers met, the first ques tion was likely to be: * Where are you from?*" Today one tries to identify the stranger by asking: •^Abraham Plexner, "Is Social Work a Profession?" Proceedings of the National Conference of Charities and Correction, V 576. ^The Professions in America, ed. Kenneth S. Lynn and the editors of Daedalus CBoston: Beacon Press, 1965). Also see Harold G, Hubbard and Edward C. McJDonagh, "The Business Executive as a Career Type," Sociology and Social Research. XLVII (January 1963), 1M+-155« 1 2 'What do you do?1---and the other will understand the 'what' refers to the other's occupation • • • and the questioner can in turn make a judgment as to how he should behave toward the respondent— whether to accord him respect, indifference, or contempt, whether to seek his help, or offer him help, whether he wants him as a friend.3 Professional identity in a work-centered culture can not help but form an integral part of one's total self concept or identity. Identity is the secure knowledge of oneself as a consistent self, with permanent values which are shared and accepted by others. A strong feeling of identity results in a clear image of one's role in life and provides a reliable feeling of adequacy and strength in coping with the expectations imposed from within as well as from without.^ Work and identity are the central concepts of this study. This research traces the relationship of profes sional identify and professional behavior. In order to do this a new profession, or professional segment, within the complex of the mental health field is examined. ffoous of the Research Central to the study of professions is the question whether it is recognised membership in a profession, or professional identity which influences the behavior of an ^Edward Gross, "The Occupational Variable as a Research Category," American Sociological Review. XXIV (October, 1959), &0-659. L Hedda Bolgar, "Psychology and Psychiatry: A Prob lem of Identity," Psychology. Psychiatry. and the Public Interest, ed. by M. H. ifrouV(Minneapolis: University of Minnesota Press, 1956), pp. l*f-19. individual. There are many sociological studies which con centrate their attention on a single profession and examine the behavior of members of that profession. In doing this the relation of professional Identity to behavior is by passed. Others have studied the development of an identity with a profession, but they have not concentrated on the relation of identity to behavior. Research on marriage counselors provides an ideal opportunity to examine at least one aspect of this ques tion. Marriage counselors, who are members of their own professional association, represent a single profession. On the other hand, they do not all share an identity with each other as marriage counselors. For some, marriage counseling is an ancillary technique used in conjunction with other specialties, for others it is a skill nearly unrelated to their central professional career, and for others, still, it is a central occupational commitment. This study focuses on two facets of a group with a common membership, but not a common identification. One, examines the membership of the American Association of Marriage Counselors using the same sociological variables that have ' ’ For example, see Anselm L. Strauss and Lee Rainwater, The Professional Scientist: A Study of American Chemists (Chicago: Aldine Publishing Company, 19b2). ^Howard S. Becker and James W. Carper, "The Devel opment of Identification with an Occupation," American Journal of Sociology. LXI (January, 1956), 289~ 1+ been used in studies of other professions and which are currently being used in a major research study on careers 7 in mental health. The other, and major, purpose of this study is to determine which if any behavior can be ascribed to professional self-concept rather than to actual member ship within a profession. The behaviors that will be examined in relation to professional self-concept include the following: the training an individual undertakes in order to become a marriage counselor; the professional career of a marriage counselor which includes such things as the kind of posi tion a marriage counselor holds, the way he obtains referrals, the type of services he chooses to provide for his patients out of a choice of many, the kindB of patients he serves, the fees he charges; the perceptions that a marriage counselor has with reference to choice of role models, identification of colleagues, evaluation of others* status, and job satisfaction; and, finally, the theoretical psychotherapeutic orientation that he holds. The major research question in this study is whether professional identification influences behavior, that is, do these individuals who share a professional identifica tion behave in ways different from those who have another Careers in Mental Health," a five-year study financed by NIMH, and conducted by William E. Henry, Professor, Committee on Human Development, University of Chicago• professional identity, but share a common, membership. Related to this proposition based on the assumption that marriage counseling is ". • .an advanced speciality in o the broader field of counseling and psychotherapy,'1 is another which stipulates that some professionals' identi ties are more closely aligned with each other than are others. In other words, those whose identity is that of a marriage counselor may behave in ways which are more simi lar to the traditional psychiatric professions than those whose identity belongs to other professions. At some later date, data comparable to data in this study will be available on four professional member- 9 ship groupings within the mental health field.' At that time, this study may be continued to examine the other side of this question on professional identity as opposed to professional membership. It will then be possible to determine whether marriage counselors' behavior regardless of professional identification shows a greater tendency to uniformity with each other than it does with psychiatrists, psychoanalysts, psychologists, and social workers. Q °American Association of Marriage Counselors, Inc., 1965 Directory of Members, p. 6. 9j)ata on psychoanalysts, psychiatrists, psycholo gists, and social workers will be available from the Henry study on "Careers in Mental Health." Organization of the Remainder o£ the Dissertation In the following chapter a review of the general literature on professions and marriage counseling will he found. Chapter III begins with a discussion of the five hypotheses to be examined, which are based on a brief examination of the literature directly related to these specific propositions. In addition, the chapter contains a discussion of the sample design, an analysis of the representativeness of the sample, and a description of the research instrument. Chapter IV presents the data, and the results of the statistical analyses performed to test the hypotheses. The final chapter contains a discussion of the material, and the implications that this study has for marriage counseling, as well as for future research. CHAPTER II REVIEW OF RELEVANT LITERATURE Intro duo tion This chapter contains a review of the literature focused, on two main areas: professionalization, and marriage counseling as a profession» The first part of the chapter covers some of the literature on what a pro fession is, dimensions along which professions may vary, emerging professions, and professions and identity» The second part of the chapter discusses what marriage coun seling is, its history, who does marriage counseling, and the professional identification of marriage counselors. The Importance of Work In a society long dominated hy the protestant ethic, the place that man's work has for him in determin ing his life's chances, his identification, and his rela tion to others is recognized. It can be categorically stated that work can be viewed as one of the most impor tant ties that any individual has to his society, and that it serves as a major factor in providing an individual 1 with an identity. Hughes points out that occupation serves as the critical element in defining a man’s life- 2 cycle. In this society the course of a man’s life from birth to death can be marked off in terms of the position he holds in relation to preschool} school} work, and retirement. Hughes also argues that an individual's personal ity is intimately related to his place in the division of labor. The term personality in this case does not mean a built-in disposition to behave in a given fashion, rather it is used to refer . • « to what the human being becomes when he gains status, not merely by being assigned to some of the major differentiating categories of the society in which he lives, but by acquiring a place in a series of subgroups with variant versions and refinements of the attitudes and values of the prevailing culture ... a man's work to the extent that it provides him a sub culture and an identity, becomes an aspect of his personality.3 Within the framework of symbolic interaction theory, Hughes continues by noting that when an individual enters an occupation a personality change occurs since the individual is provided with a new language and with new ■^Hanford Kuhn and Thomas S. McPartland, "An Empiri cal Investigation of Self Attitudes," American Sociological Review, XIX (February, 195*0, 68-76. Everett G. Hughes, Men and Their Work ( Glencoes The Free Press, 1958), Chapter i• 3Ibid.. p. 23. definitions for Ms world. Rot only is work important to the individual, hut it also serves as a standard by wMch others can organize their own interpersonal behavior. In other words, a man’s occupation is a defining device not only for Mmself, but 5 also for the perception of others. In this sense, an occupation may be perceived as a form of role identifica tion* Hole, in turn, may be defined as the behavioral expectations that are associated with a given position, or status. Goode writes that ... a role relationship seems to be implicitly defined as follows: a set of mutual (but not necessarily harmonious) expectations of behavior between two or more actors, with reference to a particular type of situation. These expectations are backed by normatively based sanctions applied by ego, alter, and others. Thus, both ego and alter know, or believe they know what the others will, in fact, do in the situation.0 TMs statement is of extreme importance when attention is cast on the development of a new profession where role expectations have not yet been clearly defined. Definition of a Profession In order to systematize the relationship of work ) | Ibid.. p. 32. Also see Tamotsu Shibutani, Society and Personality (Englewood Cliffs: Prentice-Hall, Inc., 1961), pp. 127-129. ^Hughes, op. cit.« Chapter 3* ^William J. Goode, ”Rorm Commitment and Conformity to Role-Status Obligations,” American Journal of Sociology. LXVI (Hovember, I960), 2^6-25#• 10 to behavior, it is conventional to categorize various ways of making a living since each category can be related to given styles of life. The usual classification includes distinctions between professions, enterprises, arts and 7 crafts, and jobs. There seems to be a general consensus about the attributes of a profession. Using a model of the indepen dent fee-taking professions, Caplow states that profes sions are characterized by their manner of recruiting new members and maintaining control over them from "the initial choice of candidates for training to the bestowal of honors 8 at retirement." The fee-taking professions also guard their right to practice. They seek governmental sanctions for the monopoly of their particular functions. That is, they seek to be licensed to carry out a given function by a governmental board which represents the profession; and which makes "the violation of the occupational monopoly 9 punishable as a crime." The independent professions demand life-long involvement of those who wish to become members of that profession. The activities carried on in the profession ^Hughes, op. cit.. Chapter 2. Also see Theodore Caplow, The Sociology of Work (Minneapolis: University of Minnesota tress, 19pm-;, chapfer 7. ^Caplow, ibid.. p. 102. 9Ibid. 11 do not constitute just another job, rather these activi ties are a man's career. Recognition for meritorious work in the indepen dent professions is awarded by the profession itself, not by the recipient of the professional service. This recog nition frequently takes the form of prestige tokens bestowed by the professional association. A profession controls the occupational behavior of its members. A profession has formalized a code of ethics or standards to which all its members must adhere • This code usually has two functions: to protect those who may be recipients of professional services from incompetence and exploitation, and to protect the members of the pro fession from outside criticism and censure. Greenwood also delineated a profession by listing five features which characterize all professions. The degree to which any profession may be said to have these attributes, to that degree may one say that occupation has achieved professional status. These attributes include: 1) a systematic body of theory, and a tech nique or methodology based on that theory; 2) an authority or monopoly of function (e.g., the functions of the physician are con trolled by law so that impersonating a physician is punishable as crime); 3) the community's acceptance of the profes sional group's monopoly, which includes the right of privileged communication, and the right of the profession to control its own recruiting and training; 12 *+) a code of ethics designed to avoid the abuse of monopoly, which specifies such demands as the need for emotional neu trality in dealing with one’s clients, cooperative and supportive behavior in dealing with one’s colleagues, uniformly high caliber service to all clients, and the rendering of service to a client despite personal inconvenience to the practitioner; and 5) a professional culture developed through formal and informal organisations such as those evolved to give service to the public, the operation of clinics, and the conducting of educational training cen ters* This professional culture will include symbols and values, and will develop specified ways of meeting every professional contingency.10 In summing up these criteria of a profession, one might make reference to Goode’s conceptualization of a profession as a community without a physical location.^ A community, nonetheless, with a consciousness of communal identity, shared values, consensual role definitions defining behavior between members and between members and nonmembers, a shared language, and a method of socializing youthful aspirants to the community. Model of a Professional Prom this discussion one may begin to formulate a model of the professional man. Clinical psychologists in 10Ernest Greenwood, "Attributes of a Profession," Social Work, II (July, 1957). ^William J. Goode, "Community within a Community: The Professions," American Sociological Beview. XXII (April, 1957), 19V-2&0. 13 their long fight for reoognition as an independent profes sion, not subservient to the medical profession, have con structed such a model. The Los Angeles Society of Clinical Psychologists* Ad Hoc Committee on the National Training Conference suggested eleven characteristics as delineating the "true'1 professional. These characteristics are: 1) the professional renders a service or services; 2) the professional takes sole responsibil ity for his services; he is not ancillary to nor yields that responsibility to any other professional person; 3) the professional adheres to a code of ethics; b) the professional possesses at least mini mum standards of competence for the ser vices he renders based upon specific attainments in the areas of knowledge, skills, and values; 5) the professional has a firm sense of identity as a member of his profession; 6) the professional receives sanctions and rewards from society for the services he renders, and those services in return meet important needs of society; 7) the professional is an emerging, growing person in the pursuit of his professional functions; 8) the professional is open to the scrutiny of his peers; 9) the professional is committed to the advancement of the basic scientific sub strata of his profession; 10) the professional is concerned with train ing— with the professional preparation of the younger members of the calling who will succeed him; and 11) the professional is concerned with and participates in the organizations which Ik 12 order the existence of his profession. Axes along Which Professions May Vary Other sociologists have further refined the charac teristics of a profession* Priedson distinguishes between a dependent profession and an independent profession basing his distinction on the referral system used by the profes- 13 sional. He argues that there are essentially two refer ral systems operating: the lay system and the professional system. In the lay system, the client or patient first seeks lay help in the solution of his problem turning from home remedies to the advice of friends and neighbors who may have suffered similar problems. If the symptom does not disappear, he may finally seek professional help. On the other hand, the professional referral system differs in that there is a lack of intervening lay referrals before the client seeks professional advice• The implica tions then of these two referral systems point to the independence or dependence of the profession. If the pre dominant part of a professional’s clients are obtained 12Ad Hoc Committee on the National Training Confer ence , Los Angeles Society for Clinical Psychologists, "Paradigm for the Realization of a National Conference on the Professional Preparation of Clinical Psychologists," September, 1961 *, mimeographed paper. ^Eliot Priedson, "Client Control and Medical Practice," American Journal of Sociology, LXV (January, I960), 37»fr-3BS:------ ---------- 15 through the lay referral system, one can stipulate that to some extent at least the layman controls professional practice o The practitioner may even he controlled by the client's evaluation of him. This is not the case, however, in the professional referral system. If one professional refers a case to another, professional behavior becomes subject to the evaluation of the consultant. The professional whose practice is primarily made up of the referrals from other professionals is almost completely subject to the evalua tion and control of his colleagues. On the other side of the continuum is the independent professional whose exis tence can be quite free of colleague control. In order to do this, the "independent practice" must offer services which those in the lay referral system feel are needed* Obviously, the independent practitioner may well be less sensitive to professional standards and controls than the professional who is dependent on his colleagues' evalua tion of him. lh Gusfield in hie empirical study of occupational roles isolated another dimension along which professions may vary. He argues that as occupations become more specialised, members determine their area of competence ^Joseph E. Gusfield, "Occupational Roles and Forms of Enterprise." American Journal of Sociology, LXVI (May, 1961), 571-580. 16 clearly, and then the specificity of both the activity to be undertaken by the professional and the appropriate training for the professional is increased. This deter minate occupation then involves "a relatively fixed range of expected task behavior; indeterminate occupations involve diffuse expectations in methods of training and in expected tasks." In correlating determinate and indeter minate occupations, Gusfield found that those with deter minate jobs had the most stable work history in terms of both place of work and in the immediate establishment of career. This statement must be qualified, however, since "even among the professions, which show the most frequent instances of early and stable commitment to an occupation, only 50 per cent had work histories with only one occupa tion in them."^ Characteristics of Emerging Professions There has been much recent discussion about the general increase in the professionalization of all occupa tions. Hughes argues that in this common practice one may see a tendency toward collective mobility in an attempt to - | i upgrade an occupation. Correlated with this is a move to eliminate those members of a profession who are not mobile ^Ibid., p. 578. ^Hughes, op. cit.. Chapter 3. enough to go along, Wilensky, however, in his attempt to isolate the sequence of events which are correlated with the develop ment of a profession, states that "while there may he a general tendency for occupations to seek professional status, remarkably few of the thousands of occupations in modern society attain it. Perhaps no more than thirty or 17 forty occupations are fully professionalized." ' He sug gests that "the ultimate application of theory* transfer ability of skill, stability of employment or attachment to firm, and the existence of work rules do not help in defin ing a profession." However, it is on these criteria that sociologists have seen a trend toward increasing profes sionalization on the part of morticians, realtors, and taxi drivers, instead, Wilensky argues that there are two cri teria for determining the professional: (1) the work activity of the professional is technical and based on systematic knowledge which is obtained through long years of preparation, and (2) that the professional adheres to professional norms. Wilensky in agreement with Hughes traces the typi cal process by which professions have arisen. 17 Harold L. Wilensky, "The Professionalization of Everyone?" American Journal of Sociology, LXX (September, 196*+), 137-15BT 18 Men begin doing the work full-time and stake out a jurisdiction; the early masters of the technique or adherents of the movement become con cerned about the standards of training and practice and set up a training school, which, if not lodged in universities at the outset, makes academic con nection within two or three decades; the teachers and activists then achieve success in promoting more effective organization, first local, then national— through either the transformation of an existing occupational association or the creation of a new one. Toward the end, legal protection of the monopoly of skill appears; at the end, a formal code of ethics is adopted.1® Hughes also traces the development of a profession. His description agrees with Wilensky, but he includes some 19 other items, * Hughes notes that at first, people recruited for the new professions are brought in from other areas with diverse backgrounds and training. As the pro cess goes on prerequisites for professional training are increased so that career decisions must be made earlier, and thereby greater commitments go with the decision. In conjunction with this, there is also a period when clear definitions are made of exactly what part of one’s work is professional, and what part can be safely delegated to someone else. At the same time, proper behavior between the professional and his clients, and proper behavior between him and his colleagues is spelled out. Bucher and Strauss in their examination of emer gent professions warn the investigator not to overlook the Ibid •, pp. I1 *5-lJ +6, ^Hughes, op. cit.. Chapter 10 19 conflicts of interest within a profession and thereby miss an important variable which may account for change and 20 development in a profession. They claim that if one views a profession as a relatively homogeneous community then one may overlook emerging groupings within the profession. These groupings may have different values than the major body, they may begin with a sense of mission, and crystallize in the form of new specializations-. This concept is important if one wishes to examine marriage counselors as forming a new specialization in the professional area of mental health, which is currently made up of psychoanalysts, psychiatrists, clinical psychologists, and social workers. Bucher and Strauss delineate the development of a segment in the following manner. They [the segment] issue a statement of the con tribution that the.speciality, and it alone, can make in a total scheme of values, and frequently, with it an argument to shew why it is peculiarly- fitted for this task. ... Insofar as they claim an area for themselves, they aim to exclude others from it. It is theirs alone. This is accompanied by pointing out that the task activity of the new speciality uses a different methodology and technique than that of the parent professional body. Note that "methodological differences can cut across speciality— 20fiue Bucher and Anselm Strauss, "Professions in Process." American Journal of Sociology. LXVT (January, 1961) , iz'FTW. 20 and even professional— lines with specialists sharing tech niques with members of other specialities which they do not share with their fellows."2^ - One way of approaching this concept of segments within a profession is to determine who one considers one’s colleagues to be since colleagueship will be linked with both professional roles, goals, and attitudes toward pro fessional problems. This idea is similar to Shibutani's use of reference groups. Shibutani refers to the refer ence group as "that group, real or imaginary, whose stand point is being used as a frame of reference by the 22 actor.'* He further points out that a man may have as many reference groups as he has communication channels available to him. In their discussion of segments in a profession, Bucher and Strauss clearly point out that new segments may conflict with older ones in the profession, and that some newly emerging segments have more clearly established their identities than others. Professions and Identity The import of clearly established professional identities is underscored by Strauss in his discussion of 21Ibid.. pp. 326-327. 22Shibutani, op. oit.. p. 257 21 the way individuals maintain and change their identities. Insofar as careers can he visualized and imple mented because of the relative stabilities of those social structures within which one has membership, the continuity and maintenance of identity is safeguarded and maximized, and methods of maintenance and restoration are more readily utilized and evolved.23 In fact, Strauss points out that there are difficulties in maintaining a professional identity even in a well- established profession such as medicine, because it also undergoes change in what the "correct" definition of a Q l f physician is. At this point, Strauss is referring to the development of segments within the profession. Hughes also points to the problem of identity when a status is not clearly defined.2- * Hostility is expressed toward those entering a profession who for some reason do not carry the correct stigmata of that profession, or who deviate in some way from type. The advent of colleague-competitors of some new and peculiar type, or by some new route is likely to arouse anxieties. For one thing, one cannot be quite sure how *new people'-mew in kind— will act in the various contingencies which arise to test the solidarity of the group. . • • The person who is the first of his kind to attain a certain status is often not drawn into the informal brotherhood in which 23Anselm 1. Strauss, Mirrors and Masks; The Search for Identity (Glencoe: The Free £ress, 19^9P* 87. 2^lbid., p. 163. 2-*Hughes, op. cit., Chapter 8 • 22 experiences are exchanged, competence built up, and the formal code elaborated and enforced. He thus remains forever a marginal man.^o Strauss speaking to the same point indicates that if claims to a given role are not acknowledged, or not acknowledged on the basis one wishes, confusion and change may result. He argues that when there is no firm basis of shared understanding about who is to do what to whom, then the individual's expectations may be viewed as a claim. If these claims are not met by others— that is, they do not accept the claim as legitimate— then confusion and identity change may result. This kind of confusion can also result when one is learning a new role. Sometimes others insist that an individual plays a new role before he feels completely identified with it, or comfortable with his confidence in the ability to engage in the role behavior. When this occurs the individual may over-identify with the role, and the behavior resulting from this over-identification may not be accepted by others. "These and other possible posi tions between roles make of an individual what is called a marginal man; either he or other people or both do not quite know to what role (identity, reference group) to refer him."^7 26Ibid.« p. 108. 27Ibid.« p. 120. 23 Becker and Carper in their study describing the development of a professional identity found that the taking over of an occupational personality is closely related to the taking over of an image of oneself as being an integral part of a given position in the division of 28 labor* One of the important stages they isolated in this development of a new self-concept is commitment to the new profession* In studying the development of a professional identity on the part of physiology students, they found that as the student develops new skills and techniques, and as his investment of time and energy increase in the period of study coupled with the realization that the original occupational choice of medicine is unobtainable, the individual increasingly identifies with this new field* During the second year of graduate training, the student becomes aware that if he shifted his program now, he would lose a lot of time— in other words, he has an investment in the new field. "He feels not only that physiology has something to offer him but that it would be a terrible waste of time to 'start over,' to give up 29 what he has learned and begin again in a new field." 7 2®Howard S. Becker and James W. Carper, "The Development of Identification with an Occupation," American Journal of Sociology. LXI (January, 1956), 289**298. 29lbid., p. 29a* 24 This way of examining commitment is further developed, by Becker when he discusses commitment in terms of making "side bets.1 ' That i3, the "committed person has acted in such a way as to involve other interests of his, originally extraneous to the action he is engaged in, directly in that action."^ The side bets or other involvements may be deliberately made by the individual such as making a public announcement of his intentions and then having to live up to them; or "side bets" can be made by use of impersonal bureaucratic arrangements. Commitment to a profession and to a professional ideology then may be thought of as an important step in the development of a professional identity* It is through this process, however, which takes place throughout a long training period where the neophyte is in interaction with role models, and where through interaction he assimilates a set of professional attitudes that a professional conscience, solidarity and personality are built. It is in this way, that the "profession aims • 3 1 and claims to become a moral unit."'-' Marriage Counseling Before beginning a discussion of whether or not ^Howard s. Becker, "Notes on the Concept of Com mitment," American Journal of Sociology, LXVI (July, i960), 32-40. 3-^Hughes, op. cit.» Chapter 2. 25 marriage counseling is a profession, a few questions must be answered. First, what is marriage counseling, who does marriage counseling, what are the qualifications of a marriage counselor, or how is he to he identified? Then, one may ask, if this is an emerging profession how far along has it gone, and how homogeneous is the ideology or therapeutic framework of marriage counselors. A brief review of the literature indicates that marriage counselors are aware of these questions, although there is not a great deal of consensus in the answers. This alone would lead one to believe that marriage counsel ing has not yet arrived as a fully developed profession. On the other hand, the fact that these questions are topics of interest to marriage counselors also might indicate that the self-consciousness necessary to become a profession is present. In other words, one can argue that this is a group on the way to professionalization, or one might view it as a segment of an already established profession— the mental health profession. What Is Marriage Counseling? Marriage counseling is not a new field of endeavor. It is possible that in one form or another marriage coun seling is as old as marriage itself. This statement, or its equivalent, is found in much of the literature, however, it does little to delineate the modem conception of 26 32 marriage counseling. Instead, one could with equal jus tification say that psychotherapy is as old as man giving advice to his fellows in their times of need. Marriage counseling needs to be defined as the services provided by an "expert1 ' individual to a couple who perceive the need for some kind of aid. The American Association of Marriage Counselors defines marriage counseling "as an advanced specialty in the broader field of counseling and psycho therapy."^^ Mace, executive director of the American Associa tion of Marriage Counselors, outlines the task of marriage counseling in relation to four different kinds of thera- peutic services offered to people seeking help. The four services he presents are; (1) help in relieving tensions in the individual, and between individuals which are pri marily related to the pressures of the environment, such as poor housing, employment needs, and so on; (2) medical 3%jjniiy h . Madd, The Practice of Marriage Counsel ing (New Yorks Association Press, 1^51). David S. Mace, "What Is a Marriage Counselor?" Readings in Marriage Counseling, ed. by Clark E. Vincent (.New York; Thomas Y• Crowell Company, 1957)> pp. 29-35. Dean Johnson, Marriage Counseling; Theory and Prac tice (Englewood Cliffs'; Prentice-Hall, Inc., I90I) • John P. Cuber, Marriage Counseling Practice (New York; Apple ton-Century-Crofts, Inc 19M-6 ). 33American Association of Marriage Counselors, Inc., op. cit., p. 6. ^Mace, op. cit.. p. 32. services designed to help the individual attain or maintain the best possible functioning of his physiological organ ism; (3) psychological services focused on resolving uncon scious conflicts which reduce the effective functioning of the individual; and (4) therapeutic services designed to help the individual at the "conscious level, to achieve better understanding of himself and of his destiny. This broad category includes all functionally directed educa tion, ... It also includes all counseling in the gener- 35 ally understood meaning of the word." Mace argues that social and medical problems are not the principal concerns of the marriage counselor. The offering of psychological help is closer to the task of the marriage counselor since he will have to diagnose the prob lem which may well lead him from the arena of conscious behavior to that of the unconscious. However, counseling services offered on the conscious level designed to aid the individual to understand himself is the primary task of the marriage counselor. It seems plain, therefore, that marriage counseling cannot properly be described as a specialized branch of any existing profession. It is rather a specialized branch of counseling; which is not a profession, but a technique,more and more widely used by all the professions.3” 35Ibid., p. 32. 36lbid., p. 33. 28 A social worker describing the place of marriage counseling in a family agency, defined marriage counseling in the following ways In marriage counseling, therefore, we must look beyond the immediate problems and take into account ways of building sound family relation ships; the aim is not to help the partners meet specific difficulties but rather to help them develop the capacity to adapt themselves to new situations— that is, to be able to determine basic values^and to meet stress and anxiety con structively.^' Another definition of marriage counseling is "the giving of help in restoring or establishing a satisfactory balance in the marriage or in helping the individuals con- cemed to accept that this is not possible." A psychiatrist, Laidlaw, finds that ... marriage counseling is a form of short-term psychotherapy dealing with interpersonal rela tionships ... it is an approach carried out mostly on the conscious level— if unconscious factors are uncovered it is no longer a marriage counseling case. ... Psychiatry is now con cerned with all types of emotional problems • . . properly, then all marriage counseling falls within the domain of psychiatry .39 3?Jeanette Hanford, "fhe Place of the Pamily Agency in Marital Counseling," Social Casework. XXXIV (June, 1953), 249. ^Eleanor A. Moore, "Casework Skills in Marriage Counseling," Social Casework. XXXIV (June, 1953), 253* 39&obert Laidlaw, "Ihe Psychiatrist as Marriage Counselor," Readings in Marriage Counseling, ed. by Clark E. Vincent (Kew 'York; tmomas Y• Crowe 11 Company, 1957), p- 53. 29 However, Laidlaw feels that since "simple techniques" are used in marriage counseling a well-trained marriage counse lor can be useful. And a psychologist, Karpf, states that marriage counseling is not the same as psychiatry, psychoanalysis or psychology in that the marriage counselor deals mostly with normal people, who on the whole, manage their affairs quite adequately hut occasionally find themselves confronted by a set of circumstances or a constellation of problems which are too much for them, either because of their own emo tional involvement or because they do not possess the necessary information to handle the situation, or both. 0 Other descriptions of marriage counseling could be introduced, but the one thing that they all have in common is a focus on the marriage relationship as the central tar get of therapeutic services rather than a focus on the intrapsychic difficulties of one or both partners in the marriage• Another way of examining what marriage counseling is, is to ask what kinds of problems do the people have that seek help from the marriage counselor. Mudd, in describing the clients of marriage counseling centers, states that the range of problems for which clients seek help varies between those simply needing information to I lO Maurice J. Karpf, "Marriage Counseling and Psychotherapy," Readings in Marriage Counseling, ed. by Clark E. Vincent (New York: Thomas Y. Crowell Company, 1957), p. 23**. 30 those concerned, with emotional immaturity and emotional maladjustment • Sexual difficulties of all kinds were listed in the unmarried and engaged as well as the married group, These included fears, misinformation, various degrees of inadequacy in performance to impotence and frigidity, homosexuality, and many variations. There were many situations connected with weaning from parental possessiveness, parental disapproval, choice of mate, infidelity, separation, alcoholism, reconciliation, infertil ity, adoption, health, and interreligious or inter-national marriages. Cuber presents a three-and-a-half page listing of problems that his clients cited when they sought his help while he was in the role of a teacher-counselor in a 1+2 college course in marriage education. Again, the range of problems he mentions is so broad, covering all areas of interaction and intrapsychic phenomena, that little infor mation is cast on the unique services that a marriage coun selor offers. Michaelson in her study categorized the types of problems focused on in three marriage counseling centers 1 +a over a span of twenty years: 19*+0 to I960. She states: ... to define marriage counseling as focusing on interpersonal relationships or interaction ^Mudd, op . cit.. p. 67. ^Cuber, op. cit.. pp. 50-53. ^Euth B. Michaelson, "An Analysis of the Changing Focus of Marriage Counseling" (unpublished Ph. D. disserta tion, University of Southern California, 1963). 31 between husband and wife is limiting. According to the data in this study, this type of emphasis is only a part of the focus used in marriage counseling. Prom this research we find that at all periods investigated (19^0, 1950, I960), situational problems, psychological problems, and interactional problems were always ranked in this order, with the percentages for the three years showings situational, **5 per cent; psychological, 31 per cent; and interactional, 23 per cent.4^ Included under the heading of situational problems, Michaelson categorized behavior and attitudes; psychologi cal. problems included neurotic, psychotic, immature and sociopathic behavior; and interactional problems included sexual, social and emotional interaction. On the basis of the foregoing, it is clear that the presenting problems of individuals do not indicate why an individual should choose to go to a marriage counselor, rather than a psychiatrist, psychologist, or social worker. Furthermore, the list of presenting complaints would lead one to believe that there will be no clear demarcation between those cases undertaken by marriage counselors and those taken by other members of the mental health profes sion. It is of course possible that there may be marked differences in how the cases are treated and what goals are set for treatment. That is, the emphasis that the thera pist places on interaction rather than on intrapsychio processes may vary between therapists with different ^Ibid., p • l8*f o backgrounds • However, in the actual treatment process, there seems to be agreement that the usual methods of doing family therapy or marriage counseling are either concomi tant therapy, where the therapist treats both members of the marriage but sees them separately; or conjoint therapy where both members of the family are represented in all or nearly all of the therapeutic sessions. History of Marriage Counseling Before moving on to a discussion of who does marriage counseling, it might be helpful to review briefly the history of marriage counseling. Excellent historical h - i accounts can be found in the work of Mudd, and Michaelson. Interestingly enough, the same countries that gave birth to psychoanalysis fostered the infancy of formal marriage counseling. In Berlin the first official agency related to marriage counseling was established in 1919$ only three years before the first Institute for Psycho analysis was established in the same city. In 1922, the marriage counseling movement was officially recognized in Vienna where a public Center for Sexual Advice was opened. ^Irving Alexander, "Family Therapy," Marriage and Family Living, XXV (May, 1963)* 11 +6~151 +. . Also see ituby Neuh.aus, "Family Treatment in Focus," Marriage and Family Living, XXIV (February, 1962), 62-67. ^See Mudd, loo, cit., and Michaelson, loc. cit. 33 In the period between the two world wars, the marriage movement spread throughout Europe. For our purposes, however, it is sufficient to note that marriage counseling was an ongoing procedure in this country long before any official recognition or designation was made of marriage counselors per se. First, marriage counseling was a by-product of the practice of various professionally trained individuals such as physicians, lawyers, ministers, and social workers. In time, marriage counseling became an additional service of some community agencies, and finally marriage counseling was established as an independent service in agencies staffed by people specializing in this area. With respect to the concept of professionalization, one can arbitrarily state that marriage counseling became a nascent profession in the United States in 19^-2 with the founding of the American Association of Marriage Counselors, the professional association of this clinical group. The Association was started by professionals of varied back grounds; and this Association, like other professional associations, holds national and regional meetings, formu lates basic concepts on the treatment of marital dishar mony, endorses a code of ethics, outlines minimum training requirements, and approves training centers. Who Is a Marriage Counselor? Perhaps one way of determining who is a marriage counselor is simply to ask the individual in question if he is one, Bu.t, this would he a cumbersome procedure at best if it were the only means of identification, and it may well be one of the major problems in the professionali zation of the marriage counselor, Rutledge notes that a problem is posed for the practice of marriage counseling by the fact that many untrained nonprofessionals set them- 1*7 selves up in practice as marriage counselors. Nor, is this issue clarified by the fact that there are many qualified people who look upon marriage counseling as a technique or skill which can be used in an adjunctive capacity, rather than seeing it as a profession in which ohly qualified marriage counselors may participate One of the functions of a professional association is to set minimum standards for its professionals, thus anyone who is a member of that association is by defini tion a qualified professional. The requirements for mem bership in the American Association of Marriage Counselors are rigid. To be eligible for membership, the candidate must generally possess a Ph, D. in psychology, sociology or education (or a closely related field, presumably one h.n rAaron L, Rutledge, "The Future of Marriage Coun seling," The Merrill-Palmer Quarterly (Summer, 1955)* ^Michaelson, op, oit,« p. M+, 35 of the behavioral sciences); or hold an M.S.W., B.D., or LL.B. degree. In addition, the candidate must have prac ticed in his original profession for a period of at least three years, and have received additional training in psychotherapy and counseling including at least one year of a supervised clinical internship. Despite the fact that these requirements have been carefully spelled out, there are many today who are prac ticing marriage counseling who do not meet these qualifi- cations. The total membership of the Association listed in the 1965 Directory includes only **96 members, and this figure represents all categories of membership. Undoubt edly there axe many qualified and unqualified individuals— using membership requirements as criteria of qualifica tion— who practice marriage counseling and who are not 50 members of this Association. Another defining criteria for the marriage counse lor is the 1961 * licensing act of the State of California for those who offer the servioes of marriage, family or child counseling. Everyone who offers these services in California must be licensed by the Department of ^American Association of Marriage Counselors, Inc«, "Memorandum on the Membership Categories in the Association," May, 196N-. (Mimeographed paper.) 5°David R. Mace, What la Marriage Counseling? (New York: Public Affairs Pamphlets, 195'/)> pp. 11- 13. 36 Professional and Vocational Standards unless lie fits into a category of personnel who are exempt. The exemption applies to any priest, rahbi, or minister of the gospel of any religious denomi nation, any person licensed to practice medicine or admitted to practice law in this State, and the personnel of any organization which is hoth a nonprofit and charitable organization. Although not stipulated by Powers, Director of the Department of Professional and Vocational Standards, an additional exemption from this licensing requirement would include certified clinical psychologists who do conjoint therapy with husband and wife, but who do not label them selves marriage counselors. The qualifications to obtain this California license are much less rigorous than those of the American Association of Marriage Counselors, The qualifications necessary for such a license are set forth as follows: (a) At least a master*s degree in marriage counseling, in social work, or in one of the behavioral sciences, including, but not limited to, sociology or psychology, obtained from a college or university accredited by the Western College Association, the Northwestern Associa tion of Secondaiy and Higher Schools, or an essen tially equivalent accrediting agency as deter mined by the Department, (b) At least two years* experience, of a character approved by the Direc tor, under the direction of a person, who holds the degree specified in subdivision (a) or at least two years* experience of a type which in the discretion of the director is equivalent to •^Harold J. Powers, California Department of Pro fessional and Vocational Standards. 37 that obtained under the direction of such a person,52 There are nearly 1,000 licensed marriage counselors in the State of California and there are only some 67 mem bers of the American Association of Marriage Counselors in this state. However, even a cursory examination of this licensing list indicates that many of the people holding this license are not primarily engaged in marriage counsel ing, and are clearly identified with the professions of social work and/or psychology* Professional Background of Marriage Counselors Mudd identified the professional background of active members of the American Association of Marriage Counselors in 1950. She found the following! The list of active members (not including asso ciate and foreign corresponding members) at the end of 1950 showed the following distribution! 27 per cent are gynecologists, 17 per cent psychiatrists, 12 1/2 per cent social workers, 12 1/2 per cent sociologists, 10 per cent educa tors, 8 1/2 per cent psychologists, 8 1/2 per cent ministers, 2 per cent general medicine, 2 per cent urologists. Of this membership only 21 per cent gave full time, with no private practice as staff members of (agencies). ... A few members, 6 per cent, are known to have become so interested in marriage counseling that they have given up other aspects of their private practice and concentrate entirely in this speciality. However, the majority of the group of active members, per cent, carry on their marriage counseling as part of their day-by-day 52lbid. 38 53 professional practice. Michaelson found in her longitudinal study of marriage counseling in three marriage counseling centers the following professional backgrounds for counselors. Six marriage counselors were psychiatrists; ten had doctoral degrees in anthropology, sociology or social work; fourteen had a master's degree in social work; three had an LL.D.; six had a and eleven had only a B.A. with either a 5 * + liberal arts or a social work major. Professional Identification The varied academic and professional background of marriage counselors may pose a problem in the professional ization process, that is difficulty may be encountered in the building up of a shared community of language, values, and goals. Johnson points out that obviously if a marriage counselors* training and experience have been largely in the field of social work, his definition of marriage counsel ing will not be the same as that of the person whose training and experience took place in the field of psychiatry. . . • Considerable differ ence in the actual practice of counseling exists. For example, the marriage counselor who is also a psychiatrist would be more inclined to make interpretations to the client concerning his reactions and his underlying motivations, whereas interpretations probably would be used much more sparingly and perhaps more indirectly by the ^Mudd, op. cit.. pp. 70-71. ^Michaelson, op. cit.. p. 138 39 social worker engaged in the practice of marriage c ounse ling • 5 5 Cockerill makes a significant point when she dis cusses the professionalization of social work. She agrees with Hughes that one of the early tasks of a profession is to define its activities, and she criticizes social work for not having made this identity clear. This failure undoubtedly influences the secur ity with which social work is able to partici pate in the interdisciplinary endeavor and also limits its ability to proceed with some of the further steps for its professional growth. Differentiation should aid professional inter change; its purpose is not merely to distinguish one profession from others, which might result in habits of non-cooperation and lead to separa tion and divorce. In fact, one of the primary purposes of definition is to facilitate communi cation between the professions.-*® Bolgar also advances the idea that professional identification is necessary in order to work with colleagues in closely related fields. Having observed that the professional identification of both clinical psychologists and psychiatrists is precarious in that both types of professionals have to some extent deviated from their original model (that of psychologist and that of physician), she found that only in settings where both psychiatric residents and clinical-psychological interns 55johnson, op. cit.. p. 8. ^^Eleanor Cockerill, "The Independence of the Pro fessions in Helping People," Social Casework. ZXXIV (November, 1953), 371-378. bQ were trained together in psychoanalytic theory and therapy were relations cordial and mutually stimulating. In such a setting undefensive evaluation of the strengths and weaknesses of each profession's trainings and skills can and does take place and each group evolves its own identity not by severing all past identifications but by smoothly adding new ones.77 Kuhn also cites the necessity for a clear profes- (TQ sional identification in working with a client. He finds that in an interview situation designed to have the client reassess his or her behavior, the professional must have a clear self-definition which involves a reasonable congru ence between a role ideal and role activity. Kerckhoff, in an empirical study on views of different professional groups concerning marriage counsel ing, noted that objections to marriage counseling were related to ignorance about the field and the "looseness" 59 of the definition of marriage counseling. When the 57 -"Bedda Bolgar, "Psychology and Psychiatry: A Problem of Identity," Psychology. Psychiatry, and the Pub lic Interest, ed. M. H. Krout ^Minneapolis: University of Minnesota Press, 1956), pp. 18-19. ^Maaford Kuhn, "The Interview and the Professional Relationship," Human Behavior and Social Processes, ed. by Arnold Rose (Boston: Houghton Mifflin Company, 1^62), pp. 193-206. ^Richard K. Kerckhoff, "The Profession of Marriage Counseling as Viewed by Members of Four Allied Professions: A Study in the Sociology of Occupations," Readings in Marriage Counseling, ed. by Clark E. Vincent (New York: ThomasY• Crowell Company, 1957), pp• ^68-^73 * 4-1 respondents were asked which professional group they thought was best equipped to do marriage counseling each group chose its own profession. The respondents repre sented the clergy, physicians, social workers and attorneys. All four professional groupings stated that "full-time marriage counselors" would be the next best choice after their own professional group. This identification in terms of a professional and theoretical orientation may be of importance. For example, no significant differences were found in a research study conducted to determine whether or not therapists trained in different conceptualizations of psychotherapy would relate to their patients in different ways, or in the way 60 they would define the ideal therapeutic relationship• Rather the differences, according to Fiedler, were not traceable to therapeutic identification, but to experience. Perhaps this could be explained on the basis that these therapists whether from a Freudian, Adlerian, or Rogerian orientation really shared the same professional identifica tion— that of psychotherapists. On the other hand, it is possible that the measures used where so broad that they could not discriminate between these differing orienta tions. Certainly, social-psychological theory indicates ^^Fred Fiedler, "The Concept of an Ideal Therapeu tic Relationship," Journal of Consulting Psychology. XIV (1950), 239-24-5. 42 that one*a professional self-concept should influence behavior. Sundland and Barker, using the Therapist Orienta tion Questionnaire, found that their results contradicted 61 those of Fiedler. Although the study was limited to a sample of clinical psychologists with differing therapeutic orientations— Freudian, Hogerian, and Sullivanian— they found that the Freudians stressed the use of interpreta tions, the use of unconscious motivation, and the impor tance of conceptualizing the case• "The Freudian group believes that the therapist should be more impersonal than do the Rogerians, and that the therapist should plan his therapy, have definite goals, and should inhibit his spon taneity." This discussion raises more questions than answers. How do marriage counselors see themselves: as a profes sion, or as a professional employing an ancillary form of psychotherapy? Is there a difference between those who are primarily marriage counselors and those who most clearly identify themselves with some other professional group? What influence does identification with some other profes sional group or with marriage counseling as a professional group have on their therapeutic orientation? How do they ^Donald M. Sundland and Edwin N. Barker, "The Orientation of Psychotherapists," Journal of Consulting Psychology. XXVI (1962), 201-212. *>3 envision their own training, their degree of professional autonomy, their relationship with others in the mental health profession? What kind of a profession is marriage counseling, an independent or dependent profession? These are some of the questions raised on the basis of the pre vious discussion and they combine to form the focus of this investigation. Wardwell has pointed outs • • • nearly all the types of research that have been done on the medical profession could be carried out on limited, marginal, and quasi- practitioners with great theoretical and prac tical benefit. In addition, comparative research on several of these types of profes sionals representing different degrees on scales of professionalization, prestige, or role mar ginal}, ty could ascertain the correlates of differential recruitment ... professional self-image, choice of therapist by patients, and therapist-patient relationship The present study attempts to follow the dictates of Wardwell and examine the self-concept of an emerging pro fession. ^2Walter I* Wardwell, "Limited, Marginal, and Quasi-Practitioners," Handbook of Medical Sociology, ed. by Howard E. Ereeman, Sol Levine. Leo Gr. Seeder (Englewood Cliffs: Prentice-Hall, Inc., 19o3), P* 23^. CHAPTER III METHODOLOGY Intro due tion This chapter describes the research methods used in this study of marriage counselors and their self- concepts, A discussion of the hypotheses is followed by a description of the sample design and a report on the adequacy of the sample. The instrument and the operational definitions used to test the hypotheses are discussed next. Finally, the techniques used in the data analysis are examined. The study has essentially two purposes. The first goal is to describe marriage counselors in terms of socio logical variables that have been used in studies of other professions, and are currently being used in a major research study on different careers in the mental health field.^ The second purpose of the study, and the one on which this report focuses, is to determine whether or not the central professional identification or self-concept of ^This study is part of a larger study on Careers in Mental Health, conducted by Dr. William E. Henry, of the University of Chicago. ) i h I T i+$ marriage counselors is associated with social characteris tics of either the respondents or their families of origin, their preparation for a professional career in marriage counseling, their pursuit of a career in this field, their perception of their professional role and their evaluation of their enactment of that role, and finally, their thera peutic orientation. Hypotheses Members of the American Association of Marriage Counselors represent a homogeneous population inasmuch as they are all identified with marriage counseling* How ever, they present a heterogeneous grouping in terms of professional identification. The primary professional designation of the members of the American Association of Marriage Counselors falls into three categories: (1) those identified principally as Marriage Counselors; (2) those identified as Orthodox Mental Health profes sionals including social workers, psychologists, psychia trists, and psychoanalysts; and (3) Other professionals comprising sociologists, physicians other than psychia trists and psychoanalysts, ministers, lawyers, writers, and academicians. This primary self-designation is inter preted as part of the individual's phenomenological self- concept. According to Hogers, this self-concept acts to **6 guide or regulate behavior, and to explain some uniformi ties of personality between people who share similar self- concepts, Therefore, specific aspects of professional behavior included in this study may be expected to be associated with the individual's professional identifica- 2 tion. Based on the assumption that marriage counselors constitute a new group who are self-consciously entering 3 the field of professional mental health practitioners, the overall hypothesis is that those members of the American Association of Marriage Counselors who perceive themselves primarily as Marriage Counselors will share many characteristics with those whose primary identification is that of the Orthodox Mental Health professions, and will show significant discrepancies from those whose primary professional designation is that of Other professionals. In other words, the independent variable is central profes sional designation and the dependent variables are socio logical background characteristics, preparation for a 2Ruth C. Wylie, The Self Concept (Lincoln, Nebraska: University of Nebraska Press, 1961), p • 6. Also see Nelson Foote, "Identification as a Basis for a Theory of Motivation," American Sociological Review, XVI (February, 1951), 1^-21, ^Gerald I, Manus, "Marriage Counseling: A Technique in Search of a Theory," Journal of Marriage and the Family (November, 1966), 449-4537 Also see Bichard X, Kerckhoff "Interest Group Reactions to the Profession of Marriage Counseling," Sociology and Social Research, XXXIX (February, 1955), 179-18J7--- ---- ----------- 47 career in marriage counseling, the professional career itself and the perception of professional roles. Hypothesis I: Social Characteristics Five major hypotheses will he considered. The first concentrates on sociological background variables and their relationship to the respondents* perception of their professional designation. The hypothesis is that there will he no difference in sociological variables such as age, sex, marital status, size of family, race, religion, political orientation, geographical location, metropolitan background, nativity, and level of achieved education between the three identity groups. Ho significant differ ences are expected to emerge from this analysis since one can anticipate that the membership of the American Associa tion of Marriage Counselors will be homogeneous. The sociological characteristics of the respondent's family will be examined with reference to parental educa tion, religion, political orientation, nativity, and socio economic position. Again, it is anticipated that no sig nificant differences will be found between the three classifications of the sample and these family character istics. The first major hypothesis can be stated in terms of the null hypothesis, that is, this sample is homogeneous with respect to sociological variables, and these variables b 8 are not associated with, central professional identifica tion. Hypothesis II: Preparation for Marriage Counseling The second major hypothesis focuses on the respondents' preparation to practice marriage counseling. Preparation is defined in terms of three variables: edu cational specialization, emphasis on continued training, and personal experience in psychotherapy. It is hypothe sized that there will be definite associations between individual self-concepts and the preparation undertaken by the respondent to follow this career. These associations may be related to the fact that requirements for member ship in the American Association of Marriage Counselors provide more latitude regarding acceptable professional preparation than do the other more traditional disciplines engaged in the practice of psychotherapy. Por instance, to be a psychiatrist requires a medical degree and a psychiatric residency; to become a psychoanalyst the can didate must meet the requirements of a psychiatrist, and acquire three to five years of approved post-residency psychoanalytic institute training; and to act as a clini cal psychologist the individual must have earned a Ph.D. in an approved university which provided him with an acceptable psychological internship. Requirements for *+9 social workers are no less specific. Therefore, it is unlikely that a social worker would call himself a psychiatrist or that a psychiatrist would lahel himself a social worker. It is hypothesized that educational specialization will he associated with professional self-designation, since it is through formal professional training that an individual acquires a professional identity. Therefore, those identified as Marriage Counselors will probably have a greater proportion of respondents who state that they have received their training in courses of study devoted to marriage counseling; whereas those identified as Orthodox Mental Health professionals will have a greater proportion of respondents who received their training in the traditional clinical behavioral sciences; and those identified as other professionals will hold degrees in the academic behavioral sciences, or in other practice-oriented fields such as the ministry or some branch of medicine exclusive of psychiatry. Continued emphasis on education is also expected to be associated with an individual^ professional self- concept. Since professionals are involved in fields where the knowledge base is constantly expanding and where there toward S. Becker and James Carper, "The Elements of Identification with an Occupation," American Sociologi cal Review. XXI (June, 1956), S^l-31 */. 50 is a high value placed on a professionals maintaining an adequate grasp of this knowledge and the associated skills, it is hypothesized that this value will he more frequently acted towards by those who identify with the older, estab lished professions, and less frequently by those identified with a newer discipline where less traditional emphasis may have been placed on the importance of continued training. In other words, the hypothesis is that Orthodox profes sionals will engage in a continuous education more fre quently than those identified as Marriage Counselors or other professionals. It is also expected that there will be an associa tion between professional identification and personal experience with psychotherapy. The orthodox mental health professions all, to a greater or lesser degree, encourage the neophyte to enter therapy. During his residency period, the young psychiatrist is frequently encouraged to engage in a personal analysis. For the aspiring psycho analyst, a didactic analysis is mandatory as part of the post-doctoral psychoanalytical institute training program. The clinical psychologist is strictly encouraged to enter 5 therapy if he is going to practice independently; and the ^Committee on Private Practice of the Division of Clinical and Abnormal Psychology, ‘ 'Recommendations of Standards for the Unsupervised Practice of Clinical Psychol ogy," American Psychologist, VIII (1953), * * - 9 * * —*+95* social worker, who may not he subjected to direct pressure to engage in therapy, frequently works so closely with others who have had therapy that there is an indirect pres sure to acquire this training. On this basis one may expect that many of those identified with the orthodox mental health professions will frequently have had some psychotherapy. Those identified as Marriage Counselors are also expected to have had some psychotherapy since the practice of marriage counseling is defined as a clinical practice, and therefore, one may anticipate that the same pressures will be brought to bear on the Marriage Counselor to engage in therapy as in the traditional mental health fields. In fact, the American Association of Marriage Counselors stipulates in its requirements for membership that the candidate must have received general training in counseling or psychotherapy. This training frequently has two goals: that of teaching the student the methods of counseling; and, secondly, making him aware of his own con flicts which might prevent him from seeing his client objectively and thus lessen his therapeutic effectiveness. However, it is anticipated that those identified with the other professions will not have engaged in therapy as fre quently. The occupations with which these individuals are identified do not make a claim that psychotherapy per se is beneficial for the pursuit of that occupation. That is, 52 unless one has personal problems it is not expected that one will be a better minister, sociologist, physician, or lawyer because one has been in therapy. It is hypothesized then that contact with psychotherapy will be associated with professional self-concept, and specifically, that Orthodox professionals will show the greatest frequency of such contact, followed by Marriage Counselors, and then by Other professionals. Hypothesis III: Professional Career of Marriage Counselors' The third hypothesis concentrates on the profes sional career of marriage counselors. The specific areas that will be examined are subsumed under the following five headings: (1) structure and amount of practice; (2) the independence of the profession; (3) type of therapy practiced; (H-) social characteristics of patients; and (5) income earned from the practice of marriage counseling. The general hypothesis is that professional careers will be associated with professional identification, and that those identified as Marriage Counselors will resemble the Orthodox Mental Health professionals more closely than those identified as Other professionals. The first subhypothesis— structure and amount of practice— refers to the respondents' primary professional role. Information concerning this role includes the type of position the respondent holds, location of the office used for private practice if the respondent is involved in private practice, liability insurance, and the proportion of time spent in the practice of marriage counseling. It is expected that both Orthodox Mental Health professionals and Marriage Counselors will more often hold jobs where they act as therapists than will Other professionals, who may perceive the practice of marriage counseling as an ancillary activity which they occasionally practice. The same logic leads one to anticipate that the amount of time spent in the practice of marriage counseling will be asso ciated with professional self-concept. It is expected that those identified as Marriage Counselors will spend propor tionately more of their professional time in the practice of marriage counseling than either of the other two groups who do not identify themselves as Marriage Counselors. One may also anticipate that those identified with a clinical profession will more frequently spend some of their time engaged in private practice than those identified with some other profession. Focusing on just those respondents who have a pri vate practice, it is anticipated that office location will be influenced by professional designation. It is expected that there will be no differences between Marriage Counse lors and Orthodox professionals in the location of the 5 4 - office used for private practice, which will probably be an office outside of an agency setting, but it is expected that Other professionals will more frequently use the same office facilities which they normally use to carry out the occupation with which they are predominantly identified. It is also hypothesized that carrying liability insurance will differentiate those with differing professional self- concepts. Liability insurance is used as a measure of identification with a clinical profession since its func tion is to protect the therapist from charges of malprac tice in those situations where he carries the primary, if not sole, responsibility for the welfare of the patient. Since the orthodox clinical professions inform the neophyte about the importance of having malpractice insurance, it is anticipated that there will be a decreasing number of respondents carrying liability insurance moving from Ortho dox professionals to Marriage Counselors to Other profes sionals . The second subhypothesis— independence of the pro fession— refers to the profession's relation to clients and to other professionals. Relationship to clients will be identified by the practitioners' referral system, and rela tionship with other professions by the respondent's inter action with other mental health personnel. Friedson sug gests that professions vary along a continuum where on one extreme they are completely dependent on the judgment of their colleagues, and on the other dependent on the judg- ment of their clients. He suggests that professionals obtain their clients by way of one of two referral systems: the professional referral system, or the lay referral sys tem. A profession is independent of colleague control if referrals are usually obtained from nonprofessional sources; and dependent or colleague controlled if referrals are obtained from colleagues. Traditional professionals will usually refer patients only to other reputable colleagues, and since professional marriage counseling is a new field which many of the traditional mental health professions view with caution,^ it is hypothesized that those identi fied as Marriage Counselors or Other professionals will more frequently use the lay referral system than the Ortho dox Mental Health practitioner. Interaction with colleagues in other mental health professions is expected to follow the same pattern as the referral system. Those identified as Orthodox Mental Health personnel will be expected to have more interaction with other mental health personnel than those identified as Marriage Counselors or Other professionals. ^Eliot Preidson, "Client Control and Medical Prac tice," American Journal of Sociology, LXV (January, i960), 37^-382. ^Kerckhoff, loc. clt. 56 The third subhypothesis— type of therapy practiced— refers to the respondent’s usual treatment approach, how often he sees his patients, and the way he addresses them— either as patients, clients, or counselees, The tradi tional psychotherapeutic technique uses a one-to-one rela tionship between therapist and patient to help the patient solve his own intrapersonal problems. Other therapeutic methods have evolved including therapy focused on inter actional problems of the marital situation rather than on the total character structure of the individual, that is, marriage counseling, and conjoint therapy where one thera pist sees both marital partners simultaneously with or without their children present. It is hypothesized that all forms of therapy will be used by all members of the Association, but that those identified as Marriage Counse lors and Other professionals will more frequently engage in a form of treatment designated as marriage counseling and/or conjoint therapy. Orthodox professionals, it is anticipated, will engage in more individual therapy, using marriage counseling as an ancillary technique. The same relationship is expected to hold for frequency of seeing the patient. It is probable that the Orthodox professional will engage in more intensive therapy with his patients— that is, see them more frequently— than either one of the other two identity groups. Individual therapy is traditionally identified with, more intensive treatment hav ing its origins in classical psychoanalysis. Although marriage counseling and conjoint therapy may be based on psychoanalytic theory, these methods are distinguished from the older form by their novel treatment approaches which include a less intensive relationship, and therefore do not require as frequent contact with the therapist. Finally, it is expected that both Marriage Counselors and Other pro fessionals will not call those who seek their services patients as often as the Orthodox professionals who have traditionally patterned themselves after the medical, heal ing model. The fourth subhypothesis refers to patients* social characteristics including sex, age, race, religion, income, education, and general diagnostic assessment. Focusing first on those who are being seen in private practice, it is expected that there will be no association between the social characteristics of patients and professional self- concept with the possible exception of income and educa tion. It is hypothesized that the better educated and wealthier patients, those who have a higher socioeconomic status, may seek the services of an Orthodox professional rather than the services of a Marriage Counselor or a mem ber of an unrelated profession. The better educated and wealthier patients are more likely to believe that it is 58 more appropriate to go to a member of the Orthodox Mental Health professions to obtain help for some emotional prob lem, and they may be less aware of the services of the newer professions. However, the less educated and less wealthy patients may not have the information needed to make this discrimination, or may not have as ready access to an Orthodox professional. It is probable that the lower the patient is on the socioeconomic scale, the more he will be inclined to make use of a person he recognizes as having professional status, but one whose profession is not neces sarily identified in the field of mental health. Therefore it is expected that the Other professionals will see the lower socioeconomic patients in their private practice, and Orthodox professionals will see the higher. Although there is little evidence to indicate that the specific diagnoses of functional disorders are pri marily related to some objective criteria, there are data which suggest that diagnosis may be associated with the way the therapist judges the patient*s attitude toward psycho therapy, his socioeconomic class, and other nonclinical Q variables. Therefore diagnosis may be considered, at ^August B. Hollingshead and Frederick C. Redlich, Social Class and Mental Illness. A Community Study (New York: John Wiley & Sons, Inc., 1958) > pp* ^37“2*+0• Also see Norman Q. Brill and Hugh H. Storrow, "Social Class and Psychiatric Treatment," Mental Health of the Poor, ed. by F. Riessman, J. Cohen, and A. Pearl (Glencoe: The Free Press, 196*0, pp. 68-75. 59 least in part, an opinion or attitude on the part of the therapist towards his patient, and opinions and attitudes may be importantly shaped by that individuals self-concept. It is anticipated that diagnoses and self-designation will be related. Specifically it is hypothesized that those identified as Marriage Counselors and Other professionals will stipulate that they have a greater number of rela tively healthy patients, and that Orthodox Mental Health professionals will state they have a greater number of neurotics, character disorders and psychotics. Ho signifi cant differences are anticipated to emerge between Marriage Counselors and Other professionals, but Orthodox Mental Health professionals are expected to differ from both. These distinctions in socioeconomic class and diagnoses are not expected to emerge for patients seen in an agency, since both private and public agencies usually have means for controlling the socioeconomic status, and degree of illness of their patient populations. The fifth subhypothesis— income earned from the practice of marriage counseling— is closely aligned to the previous one, and is expected to follow the same pattern. It is anticipated that Orthodox professionals will charge higher fees for the same services than the other two groups; and it is expected that Marriage Counselors will charge more than Other professionals. Therefore, it is hypothesized that the rank order descending from Orthodox to Marriage Counselors to Other professionals will he observed with respect to income earned from counseling activities, and counseling fees* However, it is not expected that total annual income will follow this pattern, since this income will depend on sources other than the principal occupation of the respondent* It is hypothesized that both counseling fees and income derived from counsel ing will be associated with professional self-concept, but that total annual income will not be associated with pro fessional self-concept. Hypothesis IV; Perception of Marriage Counselors The fourth hypothesis to be tested refers to the perception of marriage counselors: perception of their reference groups, membership groups, status and role models• Reference groups, defined as the real or imaginary groups which serve as a frame of reference for the actor 9 to evaluate his own behavior, or guide his conduct, are expected to agree with the respondent's self-concept* It ^Tamotsu Shibutani, Society and Personality: An Interactionist Approach to Social Psychology (Englewood Cliffs, New Jersey: Prentice-Hall, Inc., 3^61), p. 257* Also see T* Shibutani, "Reference Groups and Social Con trol," in Human Behavior and Social Processes* ed. by Arnold M. Rose (Boston: Houghton Mifflin Company, 1962), pp. 128-1^7. 61 is hypothesized that each group’s self-designation will he in agreement with its own reference group, since a choice in self-designation is available to the individual. That is, an individual who may have been trained as a social worker, but perceives himself as a Marriage Counselor is likely to use marriage counselors as a reference group rather than social workers. This proposition is based on the empirical work of Festinger and Merton who both observed that an individual adopts the norms and ideas of 10 groups which he finds the most attractive. The same general relationship is expected to hold for the respondent's perception of membership in different groups. A membership group is defined as one in which the individual perceives he is a member, and identifies others in the group as colleagues. A clinical member of the American Association of Marriage Counselors may see himself as a member of a group of marriage counselors, or as a member of the mental health fraternity, or, in some cases, as a member of some other profession. It is hypothesized that the individual will identify himself as a member of that group which is most attractive to him, and whose title he has assumed for his primazy professional designation. ■^Leon Festinger, et_al., "The Influence Process in the Presence of Extreme Deviates," Human, Relations, V (1952), 327-3^6. Also see Robert K. Merton, Social Theory and Social Structure (Glencoe: The Free Press, 1957), pp. '28a-2$2.-------- ’ 62 Specifically, those identified as Marriage Counselors are expected to designate other marriage counselors as col leagues, and also some individuals from occupations in the orthodox mental health professions. Those identified as Orthodox professionals will name other orthodox profes sionals, and some marriage counselors as colleagues. Those identified as Other professionals will probably identify some of their own kind as colleagues, and will include marriage counselors, but will not include many kinds of Orthodox professionals as colleagues. Status perception in this study examines the respondent’s perception of the status of allied occupa tional groupings. Most people rate their own occupation as having higher status than people who are in a different occupation.11 Within the professions where status rankings are not extremely rigid, it is probable that individuals in some occupations may display more of this overestimation than others. In explaining this phenomenon, Rettlg argues that ”... self-perception of high status will tend to reduce overestimation of status ... members of a profes sion who believe that their profession has reached a high status, do not need greatly to exaggerate status- ^Salomon S. Hettig, etal., “Status Overestimation Objective Status, and Job Satisfaction among Professions,” American Sociological Review. XXIII (February, 1958), 75~ 81. Also see Harold A. Nelson and Edward C. MoDonagh, "Perception of Statuses and Images of Selected Professions,” 63 12 position," Members of a new profession may share to some degree at least the same difficulties that the lay public has in knowing what is the appropriate role of the new pro fessional, and they may also find it difficult to believe 13 that their profession has reached a high status. There fore , those identified as Marriage Counselors may over estimate their status more than either the Orthodox or Other professionals who frequently identify with long- established professional occupations. In other words, it is hypothesized that Marriage Counselors will perceive very few occupations a3 having higher status than their own. Role perception is operationally defined on the basis of two items: respondent's perception of the profes sional role as being similar or dissimilar to that of medi cine; and the evaluation of the respondent's satisfaction with his role. In terms of role model, those identified as Sociology and Social Research, XLVI (October, 1961), 3-16. Edward C. McDonagh, Sven Wermlund, and John i1 . Crowther, "Relative Professional Status as Perceived by American and Swedish University Students," Social Forces. XXXVIII (October, 1959)» *+6-56. l^Ibid., p. 75. 13s. Rettig and B. Pasamanick, "Status, Work Satis faction and Variables of Work Satisfaction of Psychiatric Social Workers," Mental Hygiene. XLIV (I960), *+8-$+• Also see Leonard S. Cottrell, Jr. and Eleanor B. Shelton, "Relationship Expectations," in Professionalization. ed. by H. M. Vollmer and Donald L. Mills (Englewood Cliffs, New Jersey: Prentice-Hall, Inc., 1966), pp. 232-236. 6*+ Marriage Counselors and as Other professionals are expected to show greater similarity with each other than they do with those identified as Orthodox professionals. The Orthodox professionals, although not principally made up of medical men, have often identified with them in terms of role expectations, and have frequently worked with them in li+ similar settings. Therefore, it is expected that the Orthodox practitioner will perceive his role as "being more closely aligned with medicine than either of the other two groupings. In relation to role satisfaction, those identified a3 Marriage Counselors and those identified as Orthodox are expected to manifest greater role satisfaction than Other professionals. This hypothesis is based on the assumption that one is more pleased if one can play a role that is central to one's self-perception, and less pleased if one must play this role only as an extracurricular 15 involvement. Hypothesis V; Therapeutic Orientation The fifth, and final, hypothesis to be examined ^Alvin Zander, Arthur Cohen. E. Stotland, "Average Attitudes of One Professional Group Toward Another," in Role Relations in the Mental Health Professions (Ann Arbor, Michigan: University of Michigan Press, 1957)» PP* 133“ 1* 4- 1. ■^Nelson N. Foote, "Identification as a Basis for a Theory of Motivation," American Sociological Review, XVI (February, 1951)» 1 * 4 —21 • refers to the theoretical therapeutic orientation of the respondent in conjunction with professional self designation. Therapeutic orientation in terms of a theo retical frame of reference, and the criteria used to cate gorize the work of other professionals serve as the two variables used in the analysis of this hypothesis. Based on the expectation that those identified as Marriage Coun selors are acting as another professional group entering the field of mental health practitioners, it is hypothe sized that Marriage Counselors will be similar to those identified as Orthodox professionals with respect to both of these variables. However, Other professionals are expected to differ from both Marriage Counselors and Ortho dox professionals on these two dependent variables. In summary then five major hypotheses will be examined. The independent variable— professional self- concept— remains constant. The five dependent variables refer toi (1) the social characteristics of the respon dents and their parental families; (2) preparation to do marriage counseling; (3) professional career of marriage counselors; (4-) perception of marriage counselors; and (5) theoretical therapeutic orientation. The five major hypotheses to which these variables refer can be broadly stated in the following way. The first hypothesis is that the social characteristics of the sample and their parents will be the game for all three identity groups. The second hypothesis is that preparation for a career in marriage counseling will differentiate the three identity groups. The third hypothesis is that careers in marriage counseling will differ between the three identity groups, and that Orthodox professionals will pursue significantly different careers from those of Marriage Counselors and Other profes sionals. The fourth hypothesis is that the role perceptions of the sample will differ according to professional self- concept. The fifth hypothesis is that the therapeutic orientation of the sample will differ according to profes sional self-concept. Sample Design Marriage counselors represent, to some degree at least, a hidden profession. Marriage counselors are not easily identified or selected out from the other clinical psychotherapeutic professions inasmuch as these professions make up a conglomerate of academic backgrounds and they are not associated with any completely circumscribed profes sional undertaking. In other words, many individuals may call themselves marriage counselors who are members of clinical psychotherapeutic professions, or who are not members of any recognized professions, but in any case are not recognized by the professional association identified with this field— the American Association of Marriage Coun selors. Because of this a state roster such as 67 California’s, Marriage, Family, and Child Counselors could not he relied on to provide a representative list of marriage counselors. Support for this view may he found in the State of California where the 1964 licensing act excludes hoth physicians and ministers who may engage in the practice of marriage counseling. These individuals may he members of the American Association of Marriage Counse lors, hut need not he licensed in California. Xn fact, only 75 per cent of the members of the American Association of Marriage Counselors who live in California had obtained the California license for Marriage, Family, and Child Counselors by June of 1965* Taking these factors into con sideration, members of the American Association of Marriage Counselors listed in the 1965 Directory of Members consti- tuted the population for this study. Although this ■l /I i0Another consideration in rejecting the California roster of licensed marriage counselors is that the study being conducted by William Henry on Careers in Mental Health would overlap with this one. This would create a competitive situation for obtaining interviews which are, to a great degree, similar and the data for which will be available. In January, 1965, Henry carried out intensive interviews with ninety-three psychiatrists, psychologists, and social workers in the Los Angeles area; and in October, 1965> he conducted a survey of the remaining members of these professions using the professional directories for his sample • The overlap between those who were his respon dents and those who have taken but a California license is high. In the intensive phase of his study 26 per cent of the Henry sample held the California license. Thus, using the roster of licensed Counselors could not have facili tated a representative sample of those engaged in marriage counseling and would have created difficulties with the other study. 68 population may not be completely congruent with, all those who practice marriage counseling, it represents those who are aware of and committed to the practice of marriage counseling. The population listed in the 1965 Directory is small (it includes some **80 members, 39 of whom are non- clinical members), and incorporates the *f8 contiguous United States as well as Canada. Rather than attempting to sample this small and dispersed a universe, the entire clinical population of the Association is included in the study. In jthis way two advantages are gained: first, one aspect of sampling error is avoided; and second, there is a guarantee that the respondents constitute a group aware of marriage counseling either as a practice or a profession. The latter is extremely important since this study focuses on professional identification and professionalization of marriage counselors. Rata Collection The data for this study were collected by a mailed questionnaire. The population of the American Association of Marriage Counselors extends from California through the New England states and into Canada, therefore, a mailed questionnaire was the only possible way of contacting the membership* 69 The usual objections to a mailed questionnaire did not apply in this situation. The hypotheses lent them selves to the use of close-ended questions which avoids one of the major factors in respondents1 hesitation or refusal to reply. Another frequent objection is that respondents will not answer a questionnaire if they are not interested in the subject, or if they are relatively illiterate. Neither of these factors could be assumed to be true of the membership of the American Association of Marriage Counse lors. There is supportive evidence that mailed question naires frequently produce results comparable with other data-collecting methods. Nor example, Ehrlich compared data he obtained in a study on role conflict resolution by the use of an interview schedule, a group-answered ques- 17 tionnaire, and a mailed questionnaire. He found the results to be generally comparable. On July 15, 1965, a questionnaire was mailed to each member of the American Association of Marriage Coun selors with the exception of those members who were classi fied in the Directory as nonclinical members or affiliate ■^Howard j# Ehrlich, "The Study of Hole Conflict; Explorations in Methodology," Soclometry. XXV (1962), 85“ 97. Also see Edward C. McDonagh and A. Leon Rosenblum, "A Comparison of Mailed Questionnaires and Subsequent Structured Interviews," The Public Opinion Quarterly. XXIX (Spring, 1965), 131-136. 70 members. The questionnaire was accompanied by a letter, a postcard, and a self-addressed, stamped envelope. The letter explained the project and indicated that this was part of a larger comprehensive research effort invest!- 18 gating careers in mental health. The postcard allowed the respondent to check a blank if he had returned the questionnaire, or to indicate when he planned to return it. It also provided him with an opportunity to state if he desired a summary statement of the findings to be mailed to him when they would be available„ The postcard device served two purposes: (1) it allowed for a check to be made on whether or not a subject had responded while insur ing his anonymity; and (2) it presented the subject with an invitation to commit himself to answering the question naire by asking when he intended to return it. Out of the questionnaires mailed on July 15, 1965, some 222 had been returned by August 27. Recogniz ing that August is the traditional summer holiday month for many professionals, it was felt that another question naire accompanied by the postcard, self-addressed, stamped envelope , and a new note asking the respondent to reply by September 27 should be mailed to increase the sample size. On August 27, 1965, 200 additional questionnaires were ■^See Appendix I for a copy of the letter and the accompanying postcard. 71 mailed to respondents who had not returned the postcard stating that they had already mailed the questionnaire. An additional 70 questionnaires were returned; a total of 292 individuals had responded. Some 150 members of the Association did not return a completed questionnaire; out of these 27, or 18 per cent, sent a note stating why they could not answer. Among the reasons given were death, illness, previous incorporation in Henry’s sample, and a lack of desire to fill out such a long and detailed form. Adequacy of the Sample The fact that two-thirds of the population replied can be interpreted as an indication that the data repre sent the population of the American Association of Marriage Counselors. In addition, it was possible to run a goodness of fit test against three population parameters to deter mine the representativeness of the sample.^ variables against which the sample could be compared with the popu lation included sex of the respondent, geographical loca tion, and status composition of the Association. Sex of the respondent was identified by checking the first name of each individual in the Directory. Seventy-two per cent of the population were judged to be p. Guilford, .Fundamental Statistics in Psychology and Education (4-th ed.; New York: McGraw-Hill Book Company > 19b5 ) , pp • 2*+3“2J+7* 72 male, and 75 per cent of the sample was male* Chi-square yielded a .72 with one degree of freedom, which indicated that there was no significant difference between the sample and the population in relation to sex. The geographical distribution of the sample was compared with that of the population. The respondents geographical location could be identified by one of two means: postcard which the respondent had returned, and/or the postmark on the envelope in which the questionnaire had been returned. Geographical territory was subdivided into five areas: west, north central, north east, south, and Canada. Figure 1 outlines the states included in each subdivision. A chi-square was conducted comparing the sample and the population in terms of geographical regions; chi-square was 2.81. A chi-square of at least 9*^9 is necessary to be significant with four degrees of freedom. The sample represented the population in terms of geographical location. Organizational status was defined by the individ ual^ membership category in the American Association of 20 Marriage Counselors, The by-laws of the Association indicate that a fellow is one who has been invited to accept that status after he has been a member of the 20 American Association of Marriage Counselors, Inc., 1965 Directory of Members, pp. 68-69. 73 C artocraft D esk O utline M ap, U nited S tates N o. 7001 (E xcluding A laska and H aw aii) Scale of Miles 90 ' P r i n t e d in U . S . A . Published by D E N O Y E R -G E P P E R T CO., Chicago A lb e rs P r o je c tio n C o p y r ig h t' Fig. 1.— Geographical subdivisions of the United States 71 * Association for a minimum of five years; a member is defined as one who has achieved professional training for marriage counseling and has had at least five years of experience in the field; an associate member is one who has achieved recognized professional training and two years of experience; and an associate-in-training is a person who is currently receiving his training in marriage counseling. A comparison of the membership status of the sample and the population yielded an insignificant chi- square of 2.61 with three degrees of freedom. This analy sis suggests that the 66 J+ per cent sample is representa tive of the 1965 clinical population of the Association at least with respect to sex ratio, geographical location, and organizational status. The Instrument The questionnaire was a highly-structured instru ment which required an average of forty minutes to com plete . It was designed to obtain data relevant to this study, and at the same time to maintain a high degree of comparability with the data obtained by the University of Chicago study on Careers in Mental Health. The questionnaire was constructed to obtain infor mation in six specific areas: (1) the respondents pro fessional self-designation and data concerning sociological background variables such as age, race, marital status, 75 sex, religious and political orientations, education, father*s occupation, and membership category in the American Association of Marriage Counselors; (2) prepara tion for the practice of marriage counseling, and an esti mate of the amount of time devoted to this practice; (3) data on the respondent's professional career din marriage counseling which includes structure and location of practice, as well as the respondent's referral sources, reference groups, itemization of the types of therapy employed, and perceptions of reference groups, colleagues, status, and role models; C1 * - ) information on the respon dent's theoretical therapeutic frame of reference; (5) description of the respondent's clients or patients in terms of socioeconomic background variables and information concerning the fees charged by the counselor for his ser vices; and (6) the respondent's professional affiliations. (See Appendix B for a copy of the entire questionnaire.) The independent variable— professional self designation— was determined by the subject's answer to a question in which he was asked to check from a list of nine possible designations those which applied to him. He was then asked to indicate which one was central or primaiy for his own professional identification. This latter response served to categorize the individual's primary designation. Those who stipulated that they were primar ily marriage counselors were grouped together under that 76 label; those who indicated that they perceived themselves primarily as a psychotherapist, psychiatrist, psychologist, or social worker, were classified as having a traditional Orthodox Mental Health professional designation; and those who indicated that they were a physician, sociologist, minister, or an attorney were grouped as Other profes sionals engaged in the practice of marriage counseling. This classification system enabled one to determine what variations, if any, exist between those who are members of the same clinical professional organization but who have different professional identifications. The first hypothesis referred to social character istics of the respondents and included such variables as age, sex, race, education, marital status, religious, and political orientations. Respondent's religious affiliation was determined by answers to an item asking the individual to check which of the following religions he adhered to. The religions included: Protestant, Catholic, Jewish, Agnostic, Atheist, and Other. A similar question was asked to identify the respondent's political orientation. The respondent was asked to check if he perceived himself to be a politically strong liberal, moderate liberal, moderate conservative, or strong conservative. In both instances he was asked to complete the same questions for his spouse and his parents. The respondent's geographical location was 77 determined by one of two methods* The postmark of the envelope in which the questionnaire was returned was examined and this information was coded in two ways: size of area, and regional location. The other method was to examine the address on the postcard which the respondent returned and match that postcard with the respondent's questionnaire. In this way it was possible to classify 28^ out of the 292 respondents in terms of geographical location. Information regarding the respondent's family structure was obtained by questions relating to his marital status, number of children he has produced by one or more wives, and the number of years he has been married. Socio economic status of the respondent's family of origin was determined by the father's occupation. These occupations were then classified according to Duncan's Socioeconomic T , 21 Index. The respondent's status in the American Associa tion of Marriage Counselors was defined by the categories provided by that Association, Respondents checked whether they were Pellows, Members, Associate Members, or Asso ciate s-in-Training. pi Otis D. Duncan, "A Socioeconomic Index for All Occupations," in Occupations and Social Status, by Albert J. Reiss, Jr. (Glencoe: The Free Press, Inc., 1961), pp. 109-161, and 263-275. 78 The second hypothesis— preparation for marriage counseling— included three variables: educational special ization, continued education; and personal contact with psychotherapy. Educational specialization refers to the academic area in which the respondent received his highest degree. The areas were defined as those specifically designed for marriage counseling such as courses in Marriage Counseling and Family Life Education; traditional psychotherapeutic programs including psychiatry, psychology, and social work; and training for other professions such as the ministry, medicine other than psychiatry, sociology, and the law* Continued education was operationally defined by the respondent's answer to a question asking him if he was currently receiving any instruction or training which was relevant to his professional practice, but which was not a part of his official duties. Lata on contact with therapy were determined by the subject's answer to a ques tion regarding whether or not he had had therapy. He was then asked if this therapy was over or under 300 hours' duration. Three hundred hours were specified since the American Psychoanalytic Association has defined 300 hours as the minimum requirement for candidates at Psychoanalytic Institutes. The American Psychoanalytic Association's requirements were used since this is the only psychothera peutic professional group which demands that its candidates ■undergo psychoanalysis. The third hypothesis— professional career--incor porates five subhypotheses. The first of these is the structure of practice. The structure of the subject's practice was determined by asking the respondent to iden tify what his most important position was. The choices which the respondent was offered included private practice, public agency, private agency, training, teaching, consul tation, and administration. In addition, the respondent was asked to describe his present primary position. This information, obtained by an open-ended item, was coded under the following headings: an agency employed thera pist; private practice which included anyone who engaged in private practice or who was a member of a private group practice; academician, including those who identified their position as that of professor, lecturer, visiting professor, clinical or field work teacher; researcher; administrator, including titles such as director or super visor; minister, including anyone engaged in the ministry whose primary job was not that of counseling; and trainees, including all internes and students. The second subhypothesis refers to the indepen dence or dependence of marriage counseling as a profession. Professional independence was determined by the respon dent's most frequent referral sources. Referral sources 80 were categorized into three groupings: (1) professional referral system including referrals from psychiatrists, psychologists, social workers, clinics, and other marriage counselors; (2) lay referral system including referrals from friends, former patients, and current patients; and (3) other professional referral system including referrals from ministers, physicians who were not psychotherapists, attorney and courts. The fourth hypothesis deals with marriage counse lors’ perceptions of their reference groups, membership groups, status, and role. A reference group was defined as that group whose judgment and acclamation the respon dent would value the most in terms of his professional competence. A membership group was defined as those whom the respondent identified as being his close professional colleagues. Status perception was determined by asking the respondent to indicate which occupations, from a list of nine, he felt were accorded higher status in his com munity than that of marriage counselor. The assumption was that the respondent would not have any definitive information regarding the public’s status perception and thus would have to rely on his own judgment to answer the question. The role model of the marriage counselor was obtained by his response to a question asking him whether he felt that his current role was modeled after the image of a physician. His satisfaction with that role was determined by his response to a question asking him whether he was highly satisfied, more or less satisfied, somewhat dissatisfied, or quite dissatisfied with that role. The fifth hypothesis was tested by two variables both of which dealt with the respondents therapeutic orientation. Therapeutic orientation in terms of the individual's theoretical frame of reference was determined by the respondent's score on a Therapeutic Orientation 22 Scale. This instrument is a Likert Scale consisting of some forty-five items. The scale has been factor analyzed and the general factor which this analysis provides indi cates that it distinguishes individuals along a continuum moving from the Freudian analytic pole to the experimental pole. The analytic pole emphasizes unconscious processes, careful planning of the therapeutic program, training of the therapist, and a restriction of therapist's spon taneity. The experiential pole stresses "• • • the per sonality of the therapist, an unplanned approach to therapy, deemphasizes unconscious processes and accepts therapist spontaneity."^ The second criteria used to examine 22ponald M. Sundland and Edwin N. Barker, "The Orientations of Psychotherapists," Journal of Consulting Psychology, XXVI (1962), 201-222. ^Edwin N. Barker, "Research Strategy in Studying the Training of Psychotherapists," International Mental Health Research Newsletter. IV (Pall-Winter 1902), 9”1>* 82 theoretical therapeutic orientation was to ask the respon dent to check which of several criteria he used to differ entiate or categorize professionals in the mental health field. The criteria included the individuals professional designation or membership, his functions and activities, his therapeutic orientation, the setting of his practice, or the amount of experience he has had. Prior to completing the design of the question naire, the instrument underwent two pretests. A total of eighteen subjects, who practice marriage counseling but who are not members of the American Association of Marriage Counselors completed the schedule and were subsequently interviewed. These interviews provided information con- cerning ambiguous wording of items, and an estimate of the approximate length of time it takes for a respondent to complete the schedule. The schedule was revised several times to reduce ambiguity and to shorten respondent time. Despite these precautions, a major deficiency in the schedule was observed after some sixty respondents had returned them. Eesponses to two questions referring to size of the community in which the respondent lived, and size of community in which he was brought up contained typographical errors. The largest community listed was: Large city (over 25,000 population). This item should have read: Large city (over 1,000,000 population). Answers to these questions could not be used, and therefore size of community had to be determined by the postmark on the envelope containing the questionnaire. Summary In this chapter the methodology used in this study' has been discussed, The hypotheses have been described, the sample design and means of data collection have been outlined, and finally the instrument used to obtain the relevant data has been examined. The techniques used for data analysis will be considered in the next chapter in conjunction with the findings. CHAPTER IV THE PIHPIHGS Introduction la this chapter, the findings of this study of professional marriage counselors will be discussed* Pirst, the sample will be described providing an overall picture of the membership of the American Association of Marriage Counselors; and then results of statistical tests which were used to examine the hypotheses discussed in Chap ter III will be presented* A discussion of these findings and their implications will be presented in the following chapter- Sample Description The original assumption has been made that members of the American Association of Marriage Counselors would present us with a picture of professional therapists who have varied self-concepts and a wide and diversified back ground. Tabulation of the data on this sample of 292 marriage counselors supports this assumption. Respondents to the questionnaire were asked to indicate which of nine specific occupational designations 8b 85 they felt applied to them, and were then asked to indicate which one was central or primaiy for their own professional identification* These data, presented in Table 1, indicate that the modal choice for professional self-designation is that of marriage counselor, but the data also show that only one-fourth of the sample use this description as the one most important to them* The traditional mental health professional titles of social worker and psychologist account for another third of the sample, and the other professional designation that is heavily represented (accounting for I1 * per cent of the total) is that of minis ter. In other words, some 78 per cent of the entire sample chose one of four occupational titles which include that of marriage counselor, social worker, psychologist, or minister. The data on central professional designation also include twenty-one respondents, or 7«2 per cent of the sample, who select the designation of "other." Of these twenty-one individuals, sixteen specified what they meant by their answer. The responses are: six who claim the title of psychotherapist; six select the title of academi cian; two who call themselves pastoral counselors, and one who choses the title administrator, and another that of writer. Table 1 also indicates that the typical marriage r \ C M O N 0 1 S 3 ( D H s a i d f > 0 1 ON 0 1 S 3 r \ 01 ON 0 1 S 3 • _ / ■ A I D r H A id • r l S S > r O O N O N l N ^ O O I t N r o O J - 0 1 H O o ') O n vQ 01 H H O I O I O I H IA 0 | UN 00 O IN + OOOCMIAIACMC'- • •• • • i « i i < i i i • vOOOON J-rl HOlj-OOC^aO^Ol IAH H rlrlfOrl H i d 3 m • H P AM Na r H 0 0 A O S 0 0 h HHOfl'H OPH-HP HhK^OlOOIll ij rl O'H'H'H Q a o s > » ' MP4 P t .. .. . 0 ) o t j a za 0 ©© ©Pf MSA AO! 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Nearly 90 per cent of all marriage counselors in this sample were married at the time the data were collected and some 97 per cent had been married at some time in their lives. Although Table 1 does not pro vide this information, it should be pointed out that marriage counselors who are married live with their spouses, and that no marriage counselor has married a person of another race. With reference to age and size of family, marriage counselors seem to be older than the general population of the United States but to be similar to the United States population in terms of family size. The mean age of marriage counselors is 48.1 years with a standard deviation of 10.1 years, whereas the median age of the United States white population as of July 1, 1965 was approximately 28.1 yearsSome 258 marriage counselors, or 88.4 per cent of the sample, have children, and the average number of chil dren per counselor is 2.5, with a standard deviation of 1.5. In June of 1964 according to the sample survey of the U. S. Census Bureau, the average number of children ever kj. S. Bureau of the Census, Population Estimates; Estimates of the Population of the United States, by Age, Color, and Sexi July 1, 1966. Series B-25» No'. 352 (Washington, D. C.s U. S. Government Printing Office, November 18, 1966), p. 14. 88 bom to married noninstitutionalized women between the 2 ages of fifteen to forty-four was 2*5. Although these figures indicate that marriage counselors have the same size family as the rest of the population, it is interest ing to note that marriage counselors produce more children per couple than other white married couples in the United States. In 1965* the U* S. Census Bureau*s sample indi cated that 34-.8 per cent of white families with heads of the household under sixty-five had no children, whereas only 5*2 per cent of the marriage counselors who were 3 married never had children. On the whole, marriage counselors are a mature group with a mean age of forty-eight years whose experience in marriage counseling per se is not necessarily of long duration. Duration in this instance is measured in terms ^Bureau of the Census, Current Population Be ports. Series P-20, No. 14-7, U. S. Department of Commerce, January 5, 1966. These data are comparable to the data on marriage counselors since the census figures were based on response to the question: "*How many babies has she ever had, not counting stillbirths* • • . The enumerator was instructed to include children bom to the woman before her present marriage, children no longer living, and children away from home as well as children bom to the woman who were still living in the home." (p. 6 ) Data on marriage counselors were obtained by asking the respondent: "Do you have any children," which was followed by a request to list the children bom to the respondent in chronological order, including all children of present and former marriages." ^U. s. Department of Commerce, Bureau of the Census, Americana at Mid-Decade. Series P-23, No. 16 (Washington, D. C.: U. S. Government Printing Office, Januaiy, 1966), p. 24*. 89 of membership categories in the Association* Gne-third of the marriage counselors are classified as Associate Members or Associates-in-Training. The rules of the Association stipulate that Associate Members are those who have achieved recognized training and between two and five years of experience in marriage counseling, and Associate-in- Training members are those who are currently receiving i f . their training or have just completed it. With respect to religion and politics, marriage counselors are most often Protestants, and consider them selves to be political liberals. However, the data on religion indicate that thirty-eight, or 13 per cent of the respondents, felt that the choices of religion included in the questionnaire did not fit their individual cases. The majority of these individuals said that they were Mormons, others stipulated that they were Unitarians or Pree- Thinkers. In coding these data no attempt was made to force these individual responses into a religious category which the subject had rejected despite the fact that there are reasonable arguments to suggest that a Unitarian could fit under the general heading of Protestant without doing violence to the concept. Education and income have been frequently linked ^American Association of Marriage Counselors, Directory of Members. 1965. p. 69* 90 together as important indices of socioeconomic class. It is interesting to note that the median annual income from counseling activities for marriage counselors is $7,500.00 with an inter-quartile range of $10,540. The total median annual income is $14,450, with an inter-quartile range of $9,645. Although the dispersion in income is great it is apparent from an examination of Table 1 that there is not as great a variation in terms of educational achievement. Nearly three-fifths of the sample holds a doctorate degree, and another third has earned a master’s degree. Only twelve out of the total sample of 292 holds less than a master’s degree, and two of these do not have a bachelor’s degree• When educational specialization is examined it is apparent that there is no single subject matter which is clearly associated with current marriage counselors. Approximately one-fifth of the sample majored in an educa tional speciality designed specifically for marriage coun selors, one-fifth majored in psychology, and one-fifth in social work. The other 40 per cent of the sample represent diverse academic training in such fields as the ministry, sociology, and medicine. These data do suggest that there is an emphasis of training in the behavioral sciences, but at the same time they indicate a lack of a real homogene ity? and thus offer support for the assumption that marriage counselors represent a heterogenous background. 91 The data show that marriage counselors are at least second generation, native bom, upwardly mobile Americans, who are better educated and more liberal politically than their parents. Table 2 provides information on the family back ground of Association members. It is readily apparent that the educational attainment of the parents of marriage counselors is lower than that of their children. Over half of the marriage counselors had earned a doctorate degree, but only seven per cent of their fathers had achieved a doctorate. In fact, the modal education of the fathers of marriage counselors is less than a high school education and for the mothers it is a high school diploma. Differences in education between parents and today's professional marriage counselors is related to the upward mobility of this group. Based on decile figures of Duncan's socioeconomic index, parents of marriage counse lors have a mean score of *f.6 with a standard deviation of 2M. This same index, with occupational scores ranging from zero through nine, provides marriage counselors with £ an estimated score of 6 .5, which is approximately two scale steps above that of their parents. 5Albert J. Reiss, Jr., Occupations and Social Status (Glencoe: The Free Press, 1961), pp. 263-275. ^Ibid., using Duncan's classification; professional, technical and kindred workers not elsewhere classified. TABLE 2 FAMILY BACKGROUND FOR SAMPLE OF MEMBERS OF THE AMERICAN ASSOCIATION OF MARRIAGE COUNSELORS Variable (N=292) Variable < £ , (N=292) Education of Fattier Religion of Father Doe "torate 6.9 Pro te s tant 58.3 Other Prof. Degrees 3.1 Jewish 23.3 M.A. 2.7 Roman Catholic 5.1 B.A. 10.6 Other 7.2 High School 29-1 None 1.0 Less -than High School 40 .4 NR 4.8 NR 7.2 Religion of Mother Education of Mother Protestant 61.0 Doc torate .3 Jewish 23.6 Other Prof. Degrees .3 Roman Catholic 5.5 M.A. 1.0 Other 5.1 B.A. 11.6 None .7 High School 41.8 NR 4.1 Less than High School 36.7 NR 8.3 Political Orientation of Father SEI Index of Father's Strong Liberal 9.3 Oecnpation Moderate Liberal 26.4 1-3 32.6 Moderate Conservative 32.2 4-6 44.2 Strong Conservative 17.1 7-9 21 .2 Other .3 NR 2.0 None 2.4 NR 11.3 Nativity of Father American Bom 59.3 Political Orientation Foreign Bom 36.6 of Mother NR 4.1 Strong Liberal 5.8 Moderate Liberal 27.0 tivit.v of Mother Moderate Conservative 38 .4 ueriean Bora 66.8 Strong Conservative 15.1 Foreign Bora 29.1 Other —— NR 4.1 None 3.4 NR 10.3 vO r o 93 Marriage counselors are on the whole native-born Americans (see Table 1), but this does not mean that they represent "old-American" families* Table 2 shows that some 37 per cent of the respondents' fathers were foreign-born, and nearly 30 per cent of the mothers were foreign-born. It is also apparent that the parents of the respondents do not differ greatly from their children with respect to religious identification; the modal religion of both mothers and fathers is Protestant. However, when one com pares children with their parents it is clear that the parental families show a stronger tendency towards conser vative political orientations; or at least the children see their parents as being more conservatively oriented. Only 36 per cent of the fathers and 33 per cent of the mothers were politically liberal as opposed to 82 per cent of the 7 marriage counselors. Hypothesis I: Social Characteristics of Marriage Counselors and Professional Self-Designation The first hypothesis focuses on the respondent's professional self-designation and social characteristics. It is hypothesized that there is no relationship between self-designation, which is used as an index of self-concept ?It will be possible to compare all of these data with other mental health professionals as soon as the University of Chicago "Careers in Mental Health" data have been tabulated and made available • 9^ throughout the entire analysis, and such variables as age, sex, race, marital status, size of family of procreation, religious and political orientations, geographical loca tion, nativity, and level of education. Data are cross-classified by the respondents* cen tral professional designation and the dependent variable. Professional designation is grouped into three classes: Marriage Counselors, Orthodox Mental Health professionals, and Other professionals. Bespondents who stated that the title Marriage Counselor was the one which was primary for their professional identification are grouped in the cate gory Marriage Counselor. Subjects who identified them selves primarily as social workers, psychologists, psychia trists or psychoanalysts are grouped into the category Orthodox Mental Health professionals. The remaining sub jects who identified themselves as sociologists, physi cians, ministers, lawyers, writers, academicians, and administrators are classified as Other Professionals. To determine if the sample is homogeneous with respect to social characteristics, chi square and Z tests are used. Table 3 provides the distribution of the respondents classified by self-designation and the social variables. Age distributions classified against self-concept are shown in Table 3. The mean age of Marriage Counselors 55 * a 0 H H 1 0 H C O C f l 0 H & 0 3 3 a o d mo O flrl 30 d0& d . . 0 So d A ( 0 t a 0 0 H rovo C M !N Q Q I • • I • I O ld N O h O d d 1 rliO Irl v A lAdtMOtiN ( J \ • I » * « I I I O l r o i A N c O r O a H J * ( M A i r \ O N U M f \ c O ^ £ ) I N p] • « t < i • rl NOr^ONd | dJ-OI % A \0 j-aO(NH tv. I * • • • I I I O J v O c O N a o i m o i H V A (MOO O N * « OllAIA jr c v - c v i a A PIOO O N * • C M 0 O C J 110 a A O lO O IdN O n • • » . OlONlAmOl |0O a A O I n O I A O n c O I S O n < t « i > oidiAiNOd i H if l a f l s O l W O O ^ N v O f O C O t t t « i • * N C v o o j - f n i i f t I I (A 0 1 a A N0,tOlrOd IN * ♦ • * 010*0 Old lltflA d a V A OIHOHCO C O * • • * OllANQNCO II P)OI r id a A (O N A d IN o o * • * • OlcOOoOOl II (A 01 H a V A Q N O lo O o o • * OlOOrl I I0 0 H a A OINONrOd O N » • • • OIOIONOUA II1A OJrl a V A lA j'vO 0 \ • • J N O I aooH A IA O N H Q \ • • IlN O I B O N A ttYO ddO l (j\ i » • • I I 0 1 0 1 0 1 ro ao\ N P A ( A f O l A o O r O H Q \ • » » « • || lAONlAINOl a im rOONOiOimHOIH Q \ « t • t « I 0 J I Q W M - r l f O H a^O r| A O N v O C J n J-H C O . . . « drool old aoKod A 0 1 A > C O C O A* On • * * • I I ro<M O IO arooioioi A OvOdNN O N • • • » Jl (AdlO'D aiAOl H A A +IAIA lAlAOlHOI ON « • O' ' * * ' JldcO JIQN'AdJ- Bo n a * o io i O C M o O 0 1 • • «8 a A 0 0 0 0 1 • * d O O O l I I O N a v A OOlOlmrO 0 1 • • i • H O N tfO m 1 1 0 0 a A OOOIAONOCO 0 1 «... • dlAOIlAIA a N J U N 0*00)0 rOd IN f j I . . . 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M M I+CMCMH aoiN O H /■ s fO N oO H J- [ V . » * * • II O N C O U N v O arOOldd A n O O lO O O NH [ n . i * • « I I fO U M N rO au3d H v A N O O l o o N * • dj-lA aood v r> S^IA H O O [VMM H O v O O lO a (A oioi 1 * 1 r> P J P > rj O N O N O n O N O N O N do!U ,11(111 o l o o o o o o C t f j O l r O c t U V O l N o i jm 0 11 II ad O V A C N . 0 d d 0 Pd P 0 f|PU dP ora f l p c a d 0 d ID ID d d 6(P 3d 0 0 0 0 M I W (B ^ p ib ^ a o a fd > dO P> 3d ' + > 823 O d 0 0 aaod H 0 d o o o fp 33 d o d p 3 0 0 ,,P00P otusato a h p r t o o 3 0 8$pW - ■ ^ I , did Odd "’o 0 o 0 asoia 0 0 0 "0 0 0 0 0 000 + 0 "d "0 OdiAd 01 010 001 "000 b o o o 0 "00 00 " " dA O O dOllAlA n I O ffl f l pd do Pd 3 0 aa 1 ( 0 0 OS d •0 • d id d d o o o d d dPdO %pi d d «Uo od p 0 • * 00^*3 4 f l o p d A 3 ROSS d o e s x i o ~ f c . i n c l u d e 96 Is 4-8.1 years with, a standard deviation of 10.2 years, for Orthodox: Mental Health professionals it is 4-8.2 years with a standard deviation of 10.2 years, and for Other profes sionals it is 4-8.1 years with a standard deviation of 9*9 years. Although the maximum difference in ages is only a tenth of a year, a Z test for differences between means was conducted. Each professional designation was compared with every other. The null hypothesis was not rejected; there is no difference in the ages of marriage counselors with different occupational self-designations. It was also hypothesised that there would he no relation between sex and professional self-designation. Sex of respondent and professional self-concept are cross classified. Table 3 indicates that Marriage Counselors have a larger percentage of females than the rest of the sample and Other professionals have the smallest propor tion of females. Analysis of these data (see Table 4-) yields a chi square of 15.8 with two degrees of freedom. The null hypothesis of no association between sex and pro fessional self-concept is rejected. To establish which of the three groups differ from each other, analyses are made taking two groups at a time. That is, Marriage Counselors are compared with Orthodox Mental Health professionals, and with Other professionals; and Orthodox Mental Health professionals are examined in relation to Other professionals. This analysis reveals a significant difference between Marriage Counselors and Other professionals, but shows no significant difference in sex between Marriage Counselors and Orthodox profes- sionals. Other professionals have a larger percentage of males than either of the other two identity groups. Since 14 per cent of the entire sample, and 43 per cent of those designated as Other professionals are ministers, another analysis was made holding the occupation of minister con stant. This analysis yielded a nonsignificant chi square of 5.49 with two degrees of freedom indicating that the ministers included in the category of Other professionals contributed to the association of sex and professional self-de signation • When data on race and professional self-concept are examined, no tests of significance can be made due to the extremely small number of non-Caucasians. Table 3 shows that the percentage distribution of race and self-concept does not vaxy between the three identity groupings. Out of the entire sample of 292 respondents there are only four non-Caucasians; they include three Negroes and one Oriental. Data on marital status and size of family of pro creation are also examined. In neither case is the null hypothesis rejected. There is no association between 98 either marital status or the number of children bora and professional self-concept* Table 4 provides the results of data analysis for the relation between marital status and identity. In conducting this analysis, the data had to be dichotomized between those currently married and all others. This may have distorted the picture on marital status, since Table 3 suggests that Marriage Counselors have a higher proportion of widowed respondents than either of the other two groupings. The age of all the respondents is similar, therefore widowhood can not be accounted for on the simple premise that Marriage Counselors are older. A one-sample test is used to determine if there is a statistically significant difference in the number of 8 widowed Marriage Counselors. Chi square equalled 3,6 with two degrees of freedom thus failing to reject the null hypothesis regarding widowhood. With respect to family size, the average number of children produced by those identified as Marriage Counse lors is 2.4; for Orthodox Mental Health professionals it is 2.2; and for Other professionals it is 2.6. The standard deviations range from 1 to 1*6 children with Marriage Counselors showing the greatest variance. Data on religious and political orientation are O Allen Edwards, Statistical Analysis for Students in Psychology and Education (Mew loric: Rinehart and Com pany , Inc. ,1^*6), pp• 241-244• d o ■ H P 0 ■ r l 0) § 0 1 < 0 0 H P 0 ) IV P 0 8 R at 4 o H a! 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H-P.S 8 r KS o o RP . 4 ®0 ft P 4 H RP4 I I ) 00 d co® 8 a 8 4 4 3 •ft d g op <H a) 8 84 at op P P Rt/300 RM ft SSO r l r l f t P rl rl ft® q X Ofdtf, 0 R ^ *5! o 4 0 0 RP 1 4 ®0 f t f 4 H RP4 OOOd t o 3 4 4 ft $ 84 0 P fisso 0 ® ®P f t 0 OH , H H H HPP o Hrl f t Pftrl ftO 0 H ®ftft o R dKH q 0 , 4 OOllP 1 4 ®0 ftP4 rl R ft 4 8 0 0 d r a 3 4 4 49S| ROOM ftSSQ 4 4 3 0 0 f t 3 3 8 ft ft 8 8 R HdR . . 0 1 0 d O PH 0 0 ftdD® ® 8 0 l> 0 r | 0 8 0 1 04 333 8 ftO C O 8 0 H R H 8 R f t 8 0 d d d o 4 H d O - r, .« R4 0 4 0 M 0® 8 ®P 8 ROOftOPlRO f t 2J S 0 8 rlHft « 00 0 •rl 03 f t f t 8 00H H 8 8 0 3 P « H f t HH H 8 0 3 0 3 . 0 0 1 ft rl R R R 8 8 8 ■ 44 i 3 dd 0 0 ■ r l H P P R R 0 0 ft ftft 0 0 0 R R R f t f t f t R R R 8 8 8 d O 3 33 8 8 ® * t>> 44 R R 8 8 %% 00 4 P 0 ® a) ® 0 0 0 0 808® HSHIn OlHHH 4HH H iOlOIOI vO fO rO fO 8 rO i*l r* ) vQm rO ro CMHHH ilAOO H ^ O l O i v O • • I • 01 H R H H® 0 RP 4,0 4 . . RP4 ® bjOO 0 3 f t H 44 Oft PH f t sso - SBS •U -P -P f t 44H 8 ££ 0 R d HH® o 4 0 0 RP 1 4 ®0 ft ft 4 H S R P 4 OftOO d 0 3 H 8 f>44 ftp i ^4 0 8 ft RSOO R f t S£0 0010101 rl $ $ i ’Spl § p d 8 0 0 H d d dft 4 0 0 8 H 8 84 p33h ft4 4 H 8HH, o , R d H H 8 o , 4 0 0 RP 1 4 80 ftP4 H RP4 800 0 3 4 4 f t ® Si 0 P R l O Q f t ftsao s 0 6 8 3 0 4 8 8 R f t f t 0 8 8 R d O 8 4 d I 4 8 8 d d o H P 0 8 I I 0 0 8 8 P 100 also presented in Table 3* The overwhelming proportion of the sample in each category of the independent variable is Protestant and politically liberal. Although the null hypothesis, based on chi square analysis, is not rejected for either religious or political orientation, it is apparent that those respondents who designated themselves as Orthodox Mental Health professionals are characterized by having proportionately less Protestants and more Jews, and as being politically more liberal than their colleagues. Ecological variables of regional location, size of area, and nativity do not reveal any relationship with pro fessional self-designation. The greatest single concen tration of the membership of the American Association of Marriage Counselors lives in the Northeastern section of the United States followed by the Western part of the country; and over half of all marriage counselors live in major metropolitan areas, classified as having a population of 1,000,000 or more. Although respondents who identified themselves as primarily Marriage Counselors are character ized by a slightly greater proportion of foreign-born sub jects, no significant differences are found. The hypothesis concerning the social homogeneity of respondents with different self-concepts is not supported by the data on the highest level of attained education. Table 4 shows that those who defined themselves as Other profeaaionals have a smaller number of subjects who are on the lowest educational rung, an M.A. degree or less, and have a greater number of subjects who hold higher degrees such as the doctorate or an advanced degree in such areas as theology and the law. Table 4 shows that the test for independence between the three different self-perceptions and education yields a chi square of 6*f.l5 with ten degrees of freedom, significant at the .001 level. When the same data are re-examined talcing two categories of professional designation at a time, chi square indicates no differences in educational level between Marriage Counselors and Orthodox Mental Health professions, but reveals a signifi cant difference between Marriage Counselors and Other pro fessionals, and between Orthodox Mental Health profes sionals and Others. In other words, those members of the American Association of Marriage Counselors who felt that their primary professional identification is best expressed in terms of such professions as medicine, the law, the ministry, or by such positions as academician, and admin istrator differ in their educational attainments from other marriage counselors. They differ by having achieved a comparatively higher proportion of higher degrees. Social Characteristics of Family of Orientation and Professional Self-Designation The first major hypothesis of this study stipulated 102 that not only would marriage counselors present a great deal of social homogeneity despite their different self- conceptions, but it also stated that marriage counselors would be homogeneous with reference to their own family backgrounds* That is, it was anticipated that there would be no relationship between self-concepts and parental edu cation, socioeconomic index, nativity, religious affilia tion, political orientation, and illness. Data on the level of education attained by the fathers of the respondents are presented in Table 5. The majority of the fathers (^3.5 per cent) have not completed a high-achool education. This is not surprising in light of the fact that the fathers, judging by the age of the respondents, must have completed their formal education sometime during or shortly after World War I. Pressures to increase educational attainments are of a relatively recent origin, at least if measured by actual behavior. Even today, a college education is not a modal education. In I960 only 8.1 per cent of the White population twenty- five years old and over has completed four years of college, and in 19^0 only M -.9 per cent had completed this Q much education. As recently as 19*+0 only 15.1 per cent of the White population twenty-five years old and over has ^U. S. Bureau of the Census, Statistical Abstract of the United States: 1966 (87th ed.; Washington, D. C.: Government Printing Office, 1966), p. 113 • b o f t to 0 H E H la b d j H to in & o a H a ® w to E H a f t 0 i H 4 H h 2 4 & p o h mo © )H © « H d& h . C l So A H M n 4 i n 4 C V | • • • • IK4HH(4 B4(4HH 'j A v O ' T n - t C O ^ O C O • • ' ' I I 0 '0 '0 l 4 B ( 4 0 1 rl H A 1 4 HOOtfj- H * • • • I I < 0 H 0 C M B4<4HH V A C M J - tN H O O [ \ i • f l o j i + j T i t n BjrOH to in ©4 ( U to " 0 0 4 o to a C O 4 0 'i n N 0 ' O J i • t • I I ( M T iC M r l B(44H v a C A C M O S M O m OO • • • • MmOOl B44H A m 4000(40' rl • • • ' iiow xo B(44H A O'OfOrOOO [> . I I I I llo O iiW Br44H S J 11)104 * 4 fl) tod ' 4 j q-“j- 3®H 'h 44MWB f t 3h 0 0 r, ,4 old o Ptfl A 4 401 rlN 0 1 • • • iifo m n iaroi oi 4 0 4 4 ( S • • • 1 1 (4 (4 (4 d m i o i A N H C O J -O O rl • • ' 11444 B(44H A rnooo © v * « « A 0 , 00 00 0 1 0 1 * * llrlC O B4<4 A o m 0\ • • 1 1 4 (4 tom v A in HfON H • ' I I C O rl B «V t w A tnc4N i\ 11 llr lC O POdOv Hill fjH4N Jll A 0 444 01 • • I I O\0 B4(4 v A O O O O I O ' • ' IlNOI feNOI A in H C M 0 0 H * • IK\4 B4(4 A iniNrf) N * * 1 1 4 (4 avoro 4 •P 0 a 0.. f t 0 < H 0 BO O h 0 0 .. 'H 'rl >(H0 A C O NOI440I4HN f\| 1 t 1 i 1 1 1 ^ I H i n | j f O r O H A O I 0 0 4 4 W H H 0\ •••••« | I I (\Iin(SC M H rl 1 BN H A H M '0(4 H O W ) IIHOlHM) H Bin ro v A OIHN440O4 » * » 1 1 • | IIH 0'(4H 0 1 H B4 0 1 v ©h I S 0 H H 0 P4 ■P PD 0 H 4P ©rah ri HO©©© \ m A 0 a ) 0 1 MS HQ\NN c M *•*••• • jroiniHtO B4 0 1 V A 010 4(4HHH Q \ * I l|in 4 N H H H BN H A in HOIOIroNOO'N p ) 1 1 1 1 1 • 1 HOIinHHN H Bn ro A rO O O O IrO N ^ t 1 • | 1 1 1 1 incoco 0 1 Bo o f 0 rl rl 0 P © P dlPO H w‘ 4 ) 1 , ..HO®©® " h q ©f f ipo P A A C O H inlnin\04M 4inr4 'nQ' 4 0 1 * • • • • • 0 1 • • • • • 1 I I O O 'N O 'O l 1140014(4 BHOIrOH B (44H v ^ A OIOIN04N 0 0 • • • • • I IIOlOO\4i4 B H O IfO O l A O ' 044H4N I I I r o i n o j j r n BH(4<4H A NO'400' 4 4 • • ' * 1 • 1 1 oioino h B O I 401 h 3 p © f t S > HO P|> © H H ip ' H © H h4d © ■ ©HO© BHD© H 0 4 © ©D PP H fi H fl h 0 © © 0 © © .POOPOP o o i J J J l t o B O A O JO 'N roO H C O • • • • • I 11404014 B 0 1 4 0 1 A N ^ ooinin c n o ic o 0 1 • • O ' * • ! 4in |in4 B(44 BHtO A A 40\H 0(4N O ' • • ro • • M O O 1 1 (4 4 B(44 B H C O 103 A A 0 (0 ■n H00I444 H44 N44 I H • * (4 • • 11044(4(4 J IH O Q M O O BH(4(4H B(44 BOlN \ j v A 0'0'ONO4 © 1 1 • • t | I|OIO'04H B ojinn v in014 0144 N • • r4 1 • I I CMtS IKK) B4>n B O' 5 © a n 0 © 0 H P f t i> H ® P f ©H ' P h©^ ...©OH Hhflri® ©HO© BHD© H 0 4 © © D PP .. h t f h 0 © © 0 © © F c d B h f lB .POOPOP otflBStoBO H B © 00 HH P ' 0 I 0 p 0 © 104 10 completed high school. Since 31-4 per cent of the fathers had a high school education, one might conclude that the fathers of marriage counselors can not he con sidered under-educated for their time. Chi square analyses were computed (see Table 6) to determine if there is a relationship between parental edu cation and respondents* professional self-designation. Neither fathers* nor mothers' education was related to respondents' self-concept; that is both chi squares failed to achieve the .05 level of significance. Socioeconomic status is closely related to educa tion. Therefore, it is not surprising to find that data on occupation scored according to Duncan's SEI index is congruent with the findings on education. Mean differences of fathers' SEI scores are computed for each identity cate gory. The mean score of fathers of Marriage Counselors and Orthodox Mental Health professionals is 4.4, and for Other professionals it is 4.6. The two-tenths difference is not large enough to reject the null hypothesis when the data are analyzed using a Z test for differences between means. On the whole, as can be seen in Table 3, marriage counselors are native-born Americans, but'more than one- third of them have foreign-born parents. Data on the 1QIbid. TABLE 6 ANALYSIS OR SOCIAL CHARACTERISTICS OR PARENTAL RAMILY Social Characteristics X2 DR Sig . Direction Prof. Self-Concept x fathers’ Education 3.55 6 No MC and Ortho x Fathers * Education -15 2 No MC and. Other x Fathers' Education 2.22 2 No Ortho and. Other x Ra“ tiler's ’ Education 1.83 2 No Prof. Self-Concept x Mothers1 Education .58 * 4 - No MC and Ortho x Mothers * Education .30 2 No MC and Other x Mothers* Education .53 2 No Ortho and O“ tineor x Mo“ tliei*s * Education .08 2 No Prof. Self-Concept x Rathers* Nativity 1.52 2 No MC and Ortho x Ra“ tiler's * Nativity .18 1 No MC and Other x Ra“ tiler's' Nativity .30 1 No Or- “ tiro and Other x Ra “ tiler's * Nativity 1-51 1 No Prof. Self-Concept x Mo“ tlier's • Nativity *+.20 2 No MC and Ortho x Mo“ tlier's • Nativity .0*4- 1 No MC and 0“ thLer* x Mo “ tlier's * Nativity 2.02 1 No Ox-“ tlio and O “ tire 2 ? x Mo “ tlier's * Nativity 3 -82 1 No Prof. Self—Concept; x Fathers * Religion 9.91 * 4 - Yes Ortho Rl gher proportion Jews MC and Oi-ttio x Railier's* Religion 5.58 2 No MC and Other x Railier's * Religion 1.80 2 No Ortho and Oilier' x Railier's * Religion 6.50 2 Yes Ortho higher proportion Jews Prof. Sell- —Concepi x Mothers* Religion 8.22 * 4 - No MC and Ortho x Mothers' Religion 3.23 2 No MC and Oilier' x Moilier*s * Religion 1.51 2 No Ortho and Other x Mothers * Religion 6.61 2 Yes Ortho Higher proportion Jews Prof. Self—Concepi x Pathers' Politics 12.66 6 Yes Ortho more liberal MC and Ortho x Raihers* Politics 8.17 3 Yes Ortho more liberal MC and Oilier' x Fathers * Politics 5.71 3 No Or'tlio and Oilier* x Railier's * Politics 6.58 3 No Prof. Self—Concept x Mothers' Politics 13.17 6 Yes Ortho more liberal MC and Ortho x Mothers• Politics 6.83 3 No MC and Oilier x Mothers • Politics 2.1*4- 3 No Ortho and Oilier x Mothers* Politics 9.71 3 Yes Ortho more liberal Prof. Self-Concept x Parental Illness 2.99 2 No MC and Ortho x Parental Illness 2.57 1 No MC and Other x Parental Illness 1.65 1 No Ortho and Other x Parental Illness .01 1 No ■ j f - Yates* correction oised. wiien degrees of freedom equal one • o V J T . 106 nativity of both, parents are available for 98 per cent of the sample. These data, cross-classified by subjects1 self-concept, indicate that slightly more of the respon dents classified as Other professionals have foreign-born parents, but a chi square analysis indicates that there is no association between the nativity of parents and the self-concept of the respondents. In comparing religious affiliation of the father with that of the respondent (Tables 5 and 3)* it is clear that more of the respondents place themselves in categories titled agnostic, atheist, or none than do their fathers. However, the fathers like the respondents are predominantly Protestant and Jewish. To examine whether or not a rela tionship exists between fathers» religion and respondents1 professional self-concept only the three major religious categories of Protestant, Catholic, and Jew are included in the analysis. This eliminates some 9 Pe^ cent of the sample, or twenty-four individuals. Out of these twenty- four subjects, fourteen of the respondents had not provided information on theix* fathers1 religion. The remaining ten subjects whose fathers are not included in the analysis said that their fathers were either atheists, agnostics or had no religious identification. The null hypothesis for religion of fathers is rejected at the .09 level of sig nificance. To further examine this relationship each type 107 of marriage counselor is compared with each other type* This analysis (see Table 6) indicates that there is no difference between those who designate themselves Marriage Counselors and those who designate themselves Orthodox Mental Health professionals, or between Marriage Counselors and Other professionals; the difference is between Orthodox and Other professionals. The percentage distribution, shown in Table 5, reveals that those with the self designation of Orthodox Mental Health professional have Jewish fathers more frequently than Other professionals (31 per cent compared with 17•*+ per cent) and have fewer Protestant fathers (51.7 per cent compared with 72*8 per cent). Data regarding the mothers* religious affiliation are also examined. This time, however, the null hypothesis is not rejected when all three groups are examined. Upon re-examination taking two of the professional identifica tions at a time, a significant difference is found between Orthodox and Other professionals. The relative distribu tion of the religion of the maternal parents shows the same pattern as the religious affiliation of the paternal parents. There is a higher proportion of Jews in the Orthodox category, and a correspondingly smaller proportion of Protestants. Although the respondents themselves are relatively 108 homogeneous with, respect to political orientation (see Table 3)j with the exceptions that Orthodox Mental Health professionals are slightly more liberal than their colleagues, parents of the respondents display no such homogeneity. Information regarding fathers* political orientation is available for 258 respondents, or 88,4 per cent of the sample. A chi square of 12.66 with six degrees of freedom yielded a significant result at the .05 level of significance when all three of the professional identifications are examined. Each professional designa tion is once again compared with each other. This analysis reveals that Orthodox professionals * fathers are more liberal than the fathers of Marriage Counselors, and simi lar to fathers of Other professionals. The distribution on political orientation of fathers also indicates that Marriage Counselors felt that their fathers were more often on the conservative end of the political spectrum than did the other two groups. A similar analysis is conducted for mothers of the respondents, and although a significant difference is observed between political orientation of the mother and the self-concepts of the marriage counselors, the specific differences between the three groupings does not follow the same pattern as fathers* political orientation. In this case, no differences are found between Marriage 109 Counselors and those with an Orthodox self-concept, nor is one found between Marriage Counselors and Others, Table 5 shows that the fathers of Marriage Counselors are the most conservative of the three groups, but the mothers of the Other professionals are the most conservative. Only those with an Orthodox Mental Health self-designation consis tently remain in the same rank order with the least con servative parents. Data were also obtained about illness within the parental family during the period when the subject lived at home. Based on the idea that professional identity may have been influenced by experience with parental illness, it is hypothesized that those with the self-designations of Orthodox Mental Health professionals and Marriage Coun selors may have experienced more parental illness than Other professionals. The data on the presence of parental illness are cross-classified with central professional designation. The percentage distribution of illness and occupational title provides partial support for the hypothesis (see Table 5). Marriage Counselors report 10 per cent more illness in their parental families than the other two self-designations, but a chi square analysis fails to substantiate the hypothesis (see Table 6). To determine if the kind of illness might be of greater importance than the presence of illness, the data 110 are re-examined. Illness is now classified as either organic or functional. Cross-classification of these data with professional self-designation suggests that the Ortho dox Mental Health professionals report a larger incidence of functional illnesses than do the other two professional self-concepts. A one-sample test is used to test the null hypothesis which stipulates that there is no difference in the frequency of reported mental illness.'1 ' ' * ' Data on paren tal illness— presence and kind of illness— do not support the hypothesis that illness differentiates between the three identity groupings. Summary of Findings, Hypothesis I In summary, the null hypothesis has been postulated for the sample with respect to social characteristics and professional self-concept. Focusing on the respondents themselves, the null hypothesis was rejected in two areas. One, there was an association between professional identi fication and sex; those identified as Marriage Counselors included a higher proportion of women than did the Other professionals. Two, there was an association between level of education and professional identification; those identified as Other professionals had a larger proportion of higher degrees than did the other two groups. The ^Edwards , loc . cit. Ill other nine social variables— age, race, marital status, size of family of procreation, religious affiliation, political orientation, geographical location, metropolitan size, and nativity— supported the original hypothesis that self-concept would not he associated with social charac teristics . Ihe social characteristics of the respondents * parents showed greater heterogeneity. Although the respon dents themselves showed no significant differences for either religious affiliation or political orientation, this was not true for either the fathers or mothers of the respondents. Data analysis showed that both fathers' and mothers * religious affiliation was associated with the respondents1 professional identification. Jews were under represented for those in the Other professional category. Although no significant differences were found between those identified as Marriage Counselors and Orthodox pro fessionals, or between Marriage Counselors and Other pro fessionals, a significant difference was observed between Orthodox Mental Health professionals and Others, Political orientation of the parents showed an association with respondents* professional identification. Fathers of Marriage Counselors were more frequently con servative politically than those identified as Orthodox Mental Health professionals; there was no association 112 between political orientation and those identified as Other professionals. The data on political orientation of the mothers also showed an association between conservative mothers and Other professionals. Data used to measure the other social variables— level of parental education, socioeconomic status of father, nativity, and illness within the household— supported the major hypothesis of social homogeneity. Hypothesis II: Preparation for Professional Career and Professional Self-Concept The second major hypothesis refers to differential preparation for the practice of marriage counseling. It is hypothesized that preparation for the practice of marriage counseling will vary according to professional self-designation. To test this hypothesis data on three variables, directly related to preparation for profes sional practice, are used: the first refers to educational specialization; the second to continued training; and the third to personal contact with psychotherapy either for didactic or personal reasons. It is anticipated that differences will exist in educational specialization according to professional self designation. One may expect that there should be an agree ment with the content area of the respondent's training and his self-concept. Therefore, those who identify 113 themselves as Marriage Counselors more frequently will have majored in marriage counseling, and those who identify themselves as Orthodox Mental Health professionals will have received traditional clinical training in psychiatry, psychology, or social work. The respondents who identify themselves as Other professionals will, Toy and large, have had training in academic areas such as theology, sociology, medicine, and in other areas exclusive of psychiatry and psychology. It is further hypothesized that Other professionals will display the greatest amount of heterogeneity in educa tional specialization since they are made up of a group of individuals who use at least five different labels with which to identify themselves; and it is conjectured that Marriage Counselors will rank second in training variation since they represent a new field in which individuals trained for some other career could enter with relatively little further preparation. At the time this study was implemented, the American Association of Marriage Counselors did not spell out specific educational requirements for its membership. It stipulated that "... the applicant shall be required to hold whatever graduate degree is necessary for the practice of the recognized profession for which he has 114 been trained. The only other requirement was that he will have completed a one-year supervised clinical intern ship in marriage counseling.^ Even this last requirement was flexible as late as September 1965 since the Associa tion maintained a grandfather clause which allowed a per son to claim an adequate internship based on his experience 1J+ instead of having to have supervised experience• On this basis it would be possible for a minister who has a profes sional degree to add onto his already established role that of marriage counselor complete with membership in the recognized professional association. This would not necessitate a change in the manfs professional self-concept unless he wanted to think of himself in terms of this newer therapeutic profession that of marriage counselor. Obviously, it vrould require more and different training for him to change his role to that of psychiatrist, psychologist, or social worker. Using the same reasoning, it is hypothesized that those whose self-concept is classified as Orthodox will show the least variation in training, since their training • ^Directory of Members, op. cit.« p. 68. ■^Requirements have been changed. Currently a Ph.D. degree is generally mandatory. An M.A. will be con sidered adequate academic training only in those cases where outstanding clinical competence can be demonstrated. - * • Directory of Members, loc. cit. 115 provides them with a professional label that may include the practice of marriage counseling. This is, they may feel that they have little to gain if they forsake the title associated with their traditional training for one that is not as easily understood today. The foregoing hypothesis is predicted on the assumption that the formal professional training one receives reinforces or even provides the individual with an important part of his self-concept. Specialized aca demic training is a process in which the student learns not only the knowledge and skills associated with a field of study, but also acquires the norms and values of the profession. Through this process the individual learns to identify himself v/ith others as colleagues. Colleague- ship is attained when one recognizes that one is accepted by other members of a group as a member, or one may see 16 colleagueship as a form of role validation. Another attribute of preparation for a career is an emphasis on continued training. It is hypothesized that this professional value on constant training will be followed more frequently in the older, established •^Ernest Greenwood, "Attributes of a Profession," Social Work, II (July, 1957), ^ “55. ■^Xai Erickson, "Patient Role and Social Uncer tainty: A Dilemma of the Mentally 111," Behavior Disorders ed. Ohmer Milton (New York: J. P. Lippincott Company, 1965), pp. 273-289. 116 professions, and followed less frequently toy memtoers of the newer professions who may not have internalized these values to the same degree. Therefore, one may anticipate that Orthodox professionals may more frequently engage in some form of continuing education than Marriage Counselors or Other professionals. Personal contact with psychotherapy is frequently seen as a necessary part of the training for a professional therapist. It is hypothesized that those respondents who choose to identify with the Orthodox Mental Health profes sions will have had more contact with psychotherapy than those who identify themselves as Marriage Counselors, who in turn, will have had more contact with psychotherapy than those who consider themselves to toelong to Other profes sions, which are not immediately associated with clinical practice• It is further hypothesized that more of the Orthodox Mental Health professionals will have had more contact with intensive psychotherapy, defined as over 300 hours, than the other respondents; and more frequently will have entered therapy for didactic reasons rather than for purely personal reasons. The foregoing is toased on the fact that the ortho dox mental health professions and the profession of marriage counseling are characterized toy more or less overtly requiring the neophyte to engage in some personal 117 psychotherapy. However, those who think of themselves as Other professionals have not had this requirement thrust upon them. The occupations included in the category of Other professions do not claim that an individual will he a more competent member of his professional group if he has received therapy. To examine the relationship between the respon dent's educational specialization and his professional self-identification the data are cross-classified in Table 7* Taking all 292 respondents into account, three major areas of concentration predominate. The fields of family life and marriage counseling, social work, and psychology account for the educational specialization of two-thirds of the respondents, and these three areas are relatively evenly divided among the respondents. However, 50 per cent of those identifying themselves as Marriage Counselors have been engaged in a curriculum specifically designed for this purpose as opposed to 10 per cent of the Orthodox Mental Health professionals, and lb per cent of the Other professionals. The Orthodox Mental Health pro fessionals have most often pursued academic careers in the clinically oriented fields of social work and psychology, and the Other professionals most frequently hold degrees in theology and sociology. The distribution of academic programs and self- concept supports the hypothesis that those identifying 118 A P 0 X 0 B 0 i h 0 * h ® 0 A 3 0 H U N d ® IS H 0 ^ J l hd B hd d o 230 H A d H h C O v O C \IC \IN C M (J \C \l c o *.... 0 1 O lO lH O N j-rnvO I I 0 1 0 1 0 1 rl B V icooi co • • OlQNO I I HW) B O IO J C O O n • ' O lC O H B v O r O B V A ONtSrO O n • • HOON jlj-UN B A 400 O n • • HISm IIn O c O B A OJUNUNO 0 \ • • • HNv O v O IlfO O JrO B v A HOUVO ■ X I • • ' .39* B O O l j T O f O O I v O I • I I 1 I t \ Q m O * H U N l S O N H 01 i f ) A O K J m H 0 \ « • J l O O v B 5 J - I A v A i T v O i C O ( J \ • ' JliU\ B'OrO A H O O \ 0 * ' I I H O N B i i f t A O n U N U N l f \ I * JIO n O B t f r o A HHOIN ^ 0 • * • I I ^ P I S B r o O I r O H N N f t I S ® N • • t 9 t « I O O M O O IH v O Hmm A \O O O O I H ' ' H O ! IS I I m P B A 000 0 1 • « HOO JlO'fO B A iUNU\ co • • Q 0 \ ^/ A rOj’v O DO • • H c O I I p m B V A © N O W [C i i « O N P m II m 0 1 m B A U N A P A i A 0 1 A m A 0 1 n ■ r l ' r l 0 3$ C O h B H B 0 w {> > il) 0 ) H O * H d > > H IH OH* P 'n H d dd o h ® o 3 H 0 H 0 H H o o bop dtJ o o in o ph ® ft 0 3 P 4 to o a 2 3 'B fjdd T (H tllti B d® ® h S h o d > H 30 E H MP Id 0 ® 0 ! h B a ® o f j H B qjB op B 0 00 rOO m $®h Hg f t 0 ■ r l P 0 d B f f l S fl * H 0 H 0 m 6 d o Q HOh a t rf ® d P f t d?« hBP ®H 0 ft A Id H o d O H ® d P f t 00 A IAJ-1AHNH0I C Q I I • * 0 I HOl0\HOlHr0 i i m m oi B '-Z A U nOOO oj I • I 01 ro A ISPHHUN i n • < • • i I I HUNHm B m m o i A iOlpOl ( V ) • • • HO00 i i i o i m B A O N O lO O c O m S i « * • I iHOlH ii m i oi B V ♦ •••••• I I • I | | • • | | I • I I * # J l * 1 * I V OCQOPPUNH B O N O B H O O B O O N BmP BjftPN B o n h unhh '- ' i ir' '- 'i 1 ^ vinoi ^moim ^ io im A O N iP P iH H O I I «•*»«• BOOooiiOl. ^ m i H d o H P d o ■ r l M H P d ® B H hBP f t ' A H H C ^ O N m \0 * • • « HNCOiON I I U N HH B \y A O N O N H I m H C O in i A vQNONiH i • • < • IIIAOIN vO BiHHO! V A H v O i V U N IA • < 0 1 IS U N i A M s u \ i i \ Q i » • • OnN)nO I I U N HH B V A » IB C O 0 1 I I i ift U N i c o i x , i ^ ^ ) m i ^ u n i n o i i • • • • n • • BicOOvO B i u n ^uo h h ^ J u n I t) H 0 k 0 H ® P hd BPP®3 K h h Uo dhuoo dp os® SUh S oh OHd BBBdHh 0 o OH h® .Sf^oSS W B P H 0 3 S O d 0 H P d p d 1 ) H h 0 0 H P . 3d o h P d h 3 & H HH PP ® ® HH dd do oo wHHH HP PP Bddo 3h h ® j)t>l>H H . . 0 # ®iHidP | d ®h<hH pod® H H 3 M b , o 0 ..PhPh dhoh® dP dP dwSwi >>o so ftp ftP Sd H 0 A * S J H H P ® 0 ® d u r* M H ® 0 8 S H P * * themselves as Marriage Counselors will have their academic training specifically in this field; that Orthodox Mental Health professionals will have had their training in tradi tional clinical areas; and that Other professionals will have been educated primarily in other fields. Half of those who identify themselves as Marriage Counselors majored in marriage counseling. However, it is important to note that 16 per cent of those who identify themselves as Other professionals, and 10 per cent who identify them selves as Orthodox also have their academic training in marriage counseling. Chi square analysis, Bhown in Table 8, rejects the null hypothesis at less than the .01 level of a significance. Educational specialization and profes sional self-designation are related variables. To avoid expected cell frequencies of less than five, computation of chi square required the combination of educational specializations into three categories. The following areas were grouped together: Psychology and social work were combined to provide a category of traditional psychothera peutic training; medicine, sociology, the ministry, law, education, and the humanities were grouped to provide a categoiy of Other training; and marriage counseling and family life education provided the third educational cate gory. To examine this relationship more carefully, the § H E H a H t o H t o hi s 0 H to !Q I P i C O I 4 E H I I 1 I n f t f t f t H rl rl rl ® ® ® Id A 4 d P ft ft P H 'H 'H 3 3 3 |p P P f t d d d . . n 5 n u t •H.................. f l o o o o o o o o 0 ft 0 f t 0 f t 0 ft P P P P d did t p d 0 0 d‘H flft d'H r H I D ft ® ft ( ! ) dddddddd o E H . E H E H E H S ( D O ) 5 0 ) 0 1)0 0 0000 u u u U U U . V U U V V U U y u v u u HH H H S MS S SSSS S S S S SSSS SSS S SSS SSSSSSSSSSSSS o o o o oooo ooo o o o o o o .o o ,o ,o o o o o o o o H (MHrlrl 0 1 rl H rl OIHHH 4 " C M O J 0 1 40101 olvf lrorOf O^fOfOroOIHHH 0\ Olrl 0 0 'OOrlN i 0 0 H 0v44^ W O O rl O m C M r O C M 4 HO vO tA 0 1 0 0 0 rH40dl 4(00 m u>40 (\l v O ro < 0 0 4 C O 4 H 4 0 4 H , . . * ' ifS H H HO 0 0 Old 0 H d d 4 r o H d d 0 1 0 1 rl 0 1 0 1 rltS v O IS O O H N C O • i « • 00 IS 0 1 C 0 1 A 4 0 rl rl & f t HH ftp) 1)0 0 0 d d d dd ftfto X 'd'dlj 1) ® f t d g gp 5 3 3 8 P COPPO d d d d .. ] o o X 00 d • H f t 0 d 0 2! 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Odd dddd f f l ddd 'dddo*4)dftdftoi)‘ dddQ ift o < S itfdft W Pi I P i < j M , d ft d x x®p XX® dd . d OdP d 1)0 - Pd ftdftd dftdmd dftd 1 )0 0 ' o dd * m o dd^ • ® oog ft (1 ftfto o s p • ' X oft ft fto o dftd d odft ft < r | XX® P®X, X d dd p d f t o f t ft p ft g ft ® P d g h i d p d ® f t d o f t p u I I fl) -H + > u u 33 ddd oo® d f t o . ° S ft®® ft ( H i dftft . p d g ® h p ooft X ®®ft ft ft o o ® ® ®®X f t E H r l E H X EHdd P P d P i 0 0 dPft ft d dft P , - ®ftg g H H ft dPi® ® ..JV 0 EH ( 0 Pi Pi ®dEH d dd d dd Pi X®d d EHoX p d®p®p . s HiogEHdtcdoXEHg f t ft 8 EH ft EH ft 0 EH bOHft Ptftdftft u ®dP0XdXd®0P X Pddd d dd ^aidfflbSa'dftiiftOdlod^doSl. ftd ftd dftftP P idft e h ft ft p e h d b ftf td f mddPdddOddPdd Qftd P ftft® ^, SSS0 0 33Srt0 8° S s 3 ° S ° S 3 3 5 f S ” S i s ftdftPd^ d^^oft'rjdodo^ftftidddddd' X ® d u S ® o d p d o F ?oo g fl?SoS ?0® P d o g " ?Sod ft ftfn o S 'ft ftjdo? d d?d s t,s § s s s s 3 § V s E,i i s s ris s S e,s a sSSa s “ s o§ ° n oi T s o S',s E,i a s 0 120 Y a t e s * c o r r e c t i o n u s e d w iie n d e g r e e s of f r e e d o m nonparametric correlation coefficient tau is adapted to 17 these data. The proportion of each professional groupte educational specialization is determined; these proportions are then ranked and N is set at seven, since seven educa tional areas are used. The association between Marriage Counselors and Orthodox Mental Health professionals yields a tau of .52; the association between Marriage Counselors and Others provides a tau of -.24-; and the association between Orthodox Mental Health professionals and Other pro fessionals is a -.52. None of these correlations is of sufficient magnitude to reject the null hypothesis, how ever this may be attributed to the fact that in using tau in this context it is necessary to convert the responses of 292 subjects into seven categories, thus reducing N to seven. Since chi square proved to be significant, the corresponding correlation coefficients are considered sig nificant as well. Clearly, educational specialization and profes sional self-concept are associated. The direction of these associations also provides support for the hypothesis that Marriage Counselors and Orthodox professionals have approximately the same type of relationship to Other pro fessionals with respect to educational specialization. ■^Sidney Siegel, Nonparametric Statistics for the Behavioral Sciences (New York: McGraw-Hill Book Company, Inc., 1956), pp. 213-233• 122 Positive associations are found between Marriage Counselors and Orthodox Mental Health professionals, and negative associations between Marriage Counselors and Other profes sionals, and between Orthodox and Other professionals. To test the hypothesis concerning continued train ing and professional self-concept data are cross-classified and presented in Table 7. The data do not support the original hypothesis that those identified as Orthodox Mental Health professionals will have the greatest number of participants in continued training. In fact, the data suggest just the opposite relationship that Orthodox Mental Health professionals have the least number of people engaged in continued education, followed by Other profes sionals. In opposition to the original hypothesis, Marriage Counselors have the greatest number involved in continuing training. Chi square analyses, shown in Table 8 indicate that the null hypothesis is rejected when examin ing all three groups at the same time; however, taking two groups at a time the relationship between Marriage Counse lors and Orthodox proves significant. To explain this relationship between continued training and professional self-designation, the variables of age, sex, and level of education are controlled. When a control variable is introduced, and chi square is sig nificant for one contingency table but not for the other, 123 the result is interpreted aa indicating that there is interaction between the control variable and the original 18 association. Table 9 indicates that when age is con trolled, the relationship between self-concept and con tinuing education holds for only the older Marriage Counse lors, but not for the younger. When sex and educational level are controlled, the original relationship between these two variables vanishes. One may conclude that engag ing in continuing education is not explained by profes sional self-designation alone, but may be better explained by the interaction of these variables and age of respon dent. The third major variable referring to preparation for marriage counseling focuses on personal experience with psychotherapy. Each respondent was asked if he had had any psychotherapy; if he had had therapy he was asked if this therapy included 300 or more hours. The respondent was also asked what the principal reason was for his entering therapy. The choice of reasons included: for didactic purposes; for personal reasons; or for both personal and didactic reasons. Data relevant to psychotherapy are tabulated and presented in Table 7» On the basis of 291 responses it is -^S. T. Mayo, "Interactions among Categorioal Variables," Education and Psychological Measurement, XXI, 839-858. ------------------- TABLE 9 ANALYSIS O F CONTINUED EDUCATION BY .PROFESSIONAL SELP-DESIGNATJON, CONTROLLING FOR AGE, SEX, AND LEVEL OF EDUCATION Control Variables x2 DP* Sig. Direction Age 20-39 Prof. Designation x Cont. Ed. l.!+7 2 No MC and Ortho x Cont. Ed. 0.00 1 No MC and Other x Cont. Ed. 0.^-1 1 No Ortho and Other x Cont. Ed. .55 1 No Age *4-0—89 Prof. Desig. x Cont. Ed. 6 .61 2 Yes MC engage in cont. education f i MC and Ortho x Cont. Ed. 5.70 1 Yes MC engage in c ont. education MC and Other x Cont. Ed. 2.17 1 No Ortho and Other x Cont. Ed. .62 1 No Sex Female Prof. Desig. x Cont. Ed. 5.36 2 No MC and Ortho x Cont. Ed. .82 1 No MC and Other x Cont. Ed. 1.13 1 No Ortho and Other x Cont. Ed. 3-70 1 No Sex Male Prof. Desig. x Cont. Ed. 3-11 2 No MC and Ortho x Cont. Ed. 21+7 1 No MC and Other x Cont. Ed. .68 1 No Ortho and Other x Cont. Ed. .^3 1 No Education Prof. Desig. x Cont. Ed. ifr.91 * 2 No Doctorate MC and Ortho x Cont. Ed. 2.82 1 No MC and Other x Cont. Ed. 2.92 1 No Ortho and Other x Cont • Ed. 0.00 1 No Education Less Than rrof. Desig. x Cont. Ed. .70 2 No Doctorate MC and Ortho x Cont. Ed. -31 * 1 No MC and Other x Cont. Ed. .05 1 No Ortho and Other x Cont. Ed. .06 1 No Yates’ correction used when degrees of freedom equal one. 125 apparent that two-thirds of the sample, or 19^ respondents, have had some experience with therapy; of these two-thirds have had less than 300 hours of therapy. Only 33 per cent of those who engaged in therapy can " be said to have under gone intensive or psychoanalytic therapy. Slightly over one-third of those who have had therapy said that therapy was sought primarily for personal problems, and one-quarter of the respondents who have had therapy state that therapy was primarily for didactic reasons. For those respondents who have had two experiences with therapy (4-1 per cent of all those who have had therapy) a slightly greater per centage state that their second therapeutic experience was for personal reasons. One hundred and eighty-five of the respondents who have had therapy indicated what the professional designa tion of their therapist was. Seventy per cent of these had gone to either a psychoanalyst or a psychiatrist for ther apy, another 21 per cent had sought the services of a psychologist, and only 1 per cent had received therapy from a marriage counselor. Respondents also indicated what the therapeutic orientation of their therapist was. Data on therapeutic orientation of the respondents* first therapist are classi fied according to a system based on historical departures from the basic teaching of Freud, which was developed by 126 19 Harper* Therapeutic orientations are classified as follows: Freudian; Deviationists I including Jungians, Adlerian, Reichians, and Rankians; Deviationists XI includ ing followers of Homey, Sullivan, Rogers, and existential therapists* In this study, an additional category of eclectic therapists is also included since many of the respondents described their therapist in these terms. The time of entering therapy in relation to the time the respondent decided to enter the field of marriage counseling is also examined. Slightly more than half of the respondents who have had therapy initiated therapy prior to their making a decision to enter this professional field. In other words, for 51 per cent of those who have had therapy the therapeutic experience itself might have been a factor in making the decision to enter the field of marri age c ounseling, Data on psychotherapy are analyzed with reference to professional self-concept. It has been hypothesized that more of the Orthodox Mental Health professionals will have had personal contact with psychotherapy than respondents with different self-concepts. This hypothesis is not sup ported by the data shown in Table 7. No statistically significant relationship is found. The distribution ^Robert A. Harper, Psychoanalysis and Psycho therapy : 36 Systems (Englewood Cliffs, f l f e w Jersey: Preniice-Hall, Inc., 1959). 127 indicates that for both those identified as Marriage Coun selors and Orthodox professionals approximately 70 per cent have sought therapy, and the proportion is slightly less than this for Other professionals. It was also hypothesized that out of those who had sought therapy that more Orthodox Mental Health profes sionals will have engaged in intensive or psychoanalytic therapy. The distribution of cases supports this conten tion with Orthodox Mental Health professionals having the highest percentage of respondents who have had therapy for 300 hours or more, and Marriage Counselors have the small est percentage who have been in intensive psychotherapy• However, chi square analysis fails to reject the null hypothesis; therefore, the data only indicate a trend, and do not provide support for the hypothesis. It was also hypothesized that Orthodox Mental Health professionals may have engaged in therapy more fre quently for didactic purposes than for personal reasons. No significant differences are found for either the first or second therapeutic experiences. The distribution of cases (see Table 7) also fails to suggest that there is a tendency for this kind of a distribution to occur. Combining the two categories of didactic, and didactic and personal therapy, Table 7 also shows that regardless of professional identification the overwhelming 128 percentage of respondents entered therapy for didactic or partially didactic reasons. Only 38 per cent of all the respondents said they entered therapy because of personal problems. The reliability of these data is somewhat ques tionable if one takes into account the fact that 51 per cent of the respondents initiated therapy prior to decid ing to enter the field of marriage counseling. On this basis, it is logical to presume that therapy was not sought for didactic purposes and suggests that the respondents may have felt that entering therapy for didactic reasons is a preferable answer than desiring therapy for personal reasons. Table 8 shows that no associations are found with reference to the therapists * identification and the respon dents * professional self-concept; nor with the therapeutic orientation of the therapist and professional self-concept. In summary, the hypothesis concerning differential preparation for marriage counseling according to profes sional self-concept was supported by data on educational specialization, and in part by the data on continued training. In the latter case only those identified as Marriage Counselors who were over forty years of age showed a marked tendency to obtain further training. How ever, the data did not support the hypothesis concerning professional identification and personal experience in psychotherapy • 129 Hypothesis III; Careers in Marriage Counseling and Professional Self-C'onc epli The third major hypothesis examines the careers of marriage counselors with reference to five major areas: structure and amount of practice; the independence or dependence of the profession; type of therapy offered; the social characteristics of the patients; and income earned by the marriage counselor. Each hypothesis will be con sidered in detail in this section, however, the general hypothesis is that the pattern of professional careers in marriage counseling will differ according to professional self-concept. Based on the assumption that marriage coun seling is a new profession, it is anticipated that for most of the variables under consideration those calling themselves Marriage Counselors will display greater simi larity to those identifying themselves as Orthodox Mental Health professionals, and will be less like those identify ing themselves as Other professionals. 1. Structure and Amount of Practice The first subhypothesis, structure and amount of practice, focuses on the primary professional position of the respondent, the conduct of private practice, and the amount of time spent in practicing marriage counseling. Bata on the respondents' primary professional posi tion are based on answers to two questions. The first asks 130 which of several positions that the respondent might hold simultaneously he feels is the most important. The posi tions included in the questionnaire are: working in a public agency, private agency, private practice, or working in administration, training, teaching, or consultation. The respondent is also asked to describe this position. Answers to this second descriptive question are open-ended; responses are coded using six categories. These categories are: agency employed therapist; academician; administra tor; minister; private practice; research scientist, intern, trainee, and student; and miscellaneous. To examine the structural arrangements of practice more closely information concerning private practice is also examined. Data on private practice focuses on loca tion of the office, amount of time devoted to the practice of marriage counseling, and whether or not the respondent carries professional liability insurance. It is hypothesized that those whose self designation is that of Marriage Counselor will resemble Orthodox Mental Health professionals more closely than Other professionals in relation to the structure of their practice. This difference is expected to be the most apparent in the area of private practice. That is, it is anticipated that those who designate themselves as Other professionals will not have the same proportion of respon dents who identify private practice as their primary 131 occupational role, since these individuals do not identify themselves as being primarily professional therapists. Information on location of private practice office is also expected to show the same trend. That is no differences are anticipated on location of office between Marriage Counselors and Orthodox professionals, but Other professionals are expected to use different kinds of facilities to carry out their private practice. It is expected that Other professionals will use the facilities they have for conducting the professional occupation with which they are identified. Liability insurance is used as a measure of identi fication with a clinical profession, since liability insur ance is designed to protect the therapist from charges of malpractice in situations where he is responsible for the welfare of the patient. It is hypothesized that of those engaged in private practice in the Orthodox Mental Health professionals will have the greatest number of respondents who carry liability insurance, next will come the Marriage Counselors, followed by the Other professionals. This hypothesis is based on the idea that the Orthodox profes sionals will have been told— both formally by their pro fessional associations and informally by their colleagues— that it is imperative to have malpractice insurance if one has a private practice; and that some, but not as many 132 Marriage Counselors will have undergone the same kind of socialization process. Other professionals may well be the ones who do not perceive a private practice as a sig nificant part of their professional career and who there fore may not see themselves as needing this kind of pro tection. Time spent in the practice of marriage counseling is expected to be related to professional self-designation. It is expected that those who perceive themselves as Marriage Counselors will devote more of their professional time to this activity than will the other respondents. This is based on the contention that self-concept is closely related to one's daily activities. It is probable that those identifying themselves as Marriage Counselors will spend the greatest amount of time engaged in the prac tice of marriage counseling, and that those identifying themselves as Orthodox Mental Health professionals or as Other professionals will spend less of their time in this activity, since marriage counseling may be perceived by them as an ancillary technique. Data on the respondents most important position are cross-classified with professional self-concept and presented in Table 10. These data show that the sample is heterogeneous in occupational roles, and that there is no significant trend with respect to private practice. The s o rO C O M N H fO O IU N U N O N (\j I I O O lO N lN O V O rO rO 2i (OHHH sz ro OPHJ-OOHrQlN Q \ 99999999 I I ONCOUNOHHJ-ON A 01 pH O J rf C O H OPj-mlNMON p | 99999999 I I H C O O Y O O N O Ij- A rOHHH ps I N I N k V - / U N H ro U N O IaO rO rO i i i i i t i • O lO vO O N U N lN H H ro O IH 0 • H > s d pwg o OOrt 'H c l 3» p fi ® 5) i l l P h W o J d d 0 rl P < 1 l i D P & 0 H ) ) ® | ' P OP’i r i - H c t f x ) d d d h t> H !> 0 H H 6 ® HPHHlJtlS dP h d d®# hop P i P i ft E H *1 E H 0 0 P S rO P 0 1 v » / 4 pj n 0 d ' 0 • H P P H h 0 0 1 . , ® ftft PHOOlHO I I t I I I \ O U N J - O I O N r O 01 01 01 rl INOIQ n O I o n rl ••••]• I I rl OnU) On 01 A (OH 01 r l 0 1 IN I I A U O v O O I N 0 1 • > 0 • | » oounqn j r rorooi P S -t o i k r l r l U N v O ' O i i i i i ONr|lA\A OlOIOlHH P S /s O N U N H J- \{)UYQ IN J- P 01 9 9 9 9 01 9 9 Jl 00 O p j - I I 0 On A f0 C M C M H A 4- U N sz ps IN O lU JU N N 'U JrO r\ U N mcOHNOI r \ IN co O N C O J - P S 0 1 U N U N C O 9 9 9 9 9 9 O N 9 9 9 9 9 U D 9 9 9 9 O N 9 9 I I ^^ONU^^01 I I ^UNHrOrO I I 0 1 HHrO I I H 0 0 s w H 01H 0 1 A '-Z C M ro C M H A ro Hj-H A • w » rO v O P to P ® 'H C Q 0 P •H rl d P | PfH ® < 0 0 0 r l d d dP 0 ® CO M IS CO dHftK, „ E H 0 P fH ^ d • r l ® f f l ® 0 o ® d d to d ttihi < ? ^ p { « ! ; £ ! $ r\ n O 3 k V - / gj H U )O O N rO 1 9 9 9 1 + M T N O IO OlOIOlHH ps IN IN i (D&&&0 h^ 8 h U OIIIO i k U N v O O n HO • 9 9 9 9 \£UVO 01 On H H 01 ro JOUNOUN 0 HHOIifttN 0 H P S 0 U N n OOOn H O N H 9 9 9 9 H • 9 H P M - I I 0 O N * 01H H A U N J 1 p n C O UN k ps n h u n n 9 9 9 |S . OJ-UN l | UN C M C M H A ro S Z * 0 i J 1 d o ■ r l U ) O ' D dri ® O t i ® > H tlO H 0 0 0 h W F 4 t O d 3 ' hh r l' o niT j ® H i f n H o o P ® r l H H hdd'H'd “ W P h • I ® H AS < d srj rl J>>® rl H 0 p f c d n j c d to • h o h hi d P 0 to o d ® dH • H u ®>j h ®p a ) o h OR 1 3 3 0 A « H P td E H d.oe 3 no't xnclnde 13^ modal occupation role for all three groups is private prac tice • The second most popular role for tooth Marriage Coun selors and Other professionals is working in a public agency. To implement the analysis of these data the occu pational roles of putolic and private agencies are combined into one categoiy, teaching and training are grouped together, and administration, consultation and other are combined. Table 11 shows that the chi square test proves significant at the .05 level. To test the specific hypothesis that Orthodox Mental Health professionals and Marriage Counselors will have similar roles, and Other professionals will differ, the test is repeated taking two groups at a time. Table 11 shows that the hypothesis is supported: analysis of Marriage Counselors and Other pro fessionals yields a significant chi square, and no signifi cant differences are found between Orthodox and Others. Data on the description of the primary position of the respondent provide more support for the original hypothesis. These data indicate that Marriage Counselors most frequently work as agency employed therapists or as academicians; that Orthodox Mental Health professionals are most frequently engaged in a clinical practice either work ing for an agency or in private practice; and that Other professionals most often pursue a career focused on the ministry or academics. Data analysis shows that signifi cant differences are found between Marriage Counselors and TABLE 11 ANALYSIS OS' STRUCTURE AND AMOUNT OP PRACTICE BY CENTRAL PROPESSIONAL RESIGNATION Professional Practice X2 DP* Sig. Direction Prof. Desig. x Most Important Position 12.35 6 Yes OriLo work in public agency MC and Ortho x Most; Important Position 5.28 3 No MC and Oilier x Most Important Position 9.69 3 Yes Other in administration Ortho and Other x Most Important Position 7.20 3 No Prof. Desig. x Present; Primary Position 64-.52 10 Yes Others work as ministers MC and Ortho x Present; Primary Position *+.96 *+ No MC and Oilier x Preseni Primary Posiiion 2*+. 78 5 Yes Others work as ministers Ortho and Oilier x Preseni Primary Posiiion *+1.82 5 Yes Others work as ministers Prof. Desig. x Time Speni in Marr. Couns . 58.88 8 Yes MC spend more time doing marr . c cuns . MC and OriLo x Time Speni in Marr. Conns. 32.50 i+ Yes MC spend more time doing marr. c ouna . MC and Oilier x Time Speni in Marr. Conns. Ortho and Oilier x Time Spend in Marr. *+6.59 *+ Yes MC spend more time doing marr. c ouns. Conns . 5.39 *+ No Prof. Desig. x Locaiion of Private Office 1*4-.22 6 Yes Ortho use home & general prof. bldg. MC and Orilio x Locaiion of Private Office 1 .*4-7 3 No MC and Oilier x Locaiion of Private Office Orilio and Oilier x Locaiion of Private *+.87 3 No Office 13.71 3 Yes Ortho use general prof. bldg. Prof. Desig. x Liabiliiy Insurance 8.75 2 Yes Ortho carry insurance MC and OriLo x Liabiliiy Insurance 3.55 1 No MC and Other x Liabiliiy Insurance .15 1 No OriLo and Other x Liabiliiy Insurance 6.95 1 Yes Ortho carry insurance *Yates' correction "used when degrees of freedom equal one. 136 Other professionals, and between Orthodox and Other pro fessionals, tout no differences are found between Marriage Counselors and Orthodox Mental Health professionals. In general, there is support for the hypothesis that Marriage Counselors and Orthodox Mental Health professionals have greater similarity with each other in terms of their present position than they do with Other professionals. The degree of involvement in the practice of marriage counseling proves to be associated with profes sional identification. Table 10 indicates that 39 per cent of those identified as Marriage Counselors spend three- quarters or more of their professional efforts in marriage counseling, whereas only 10 per cent of the Orthodox and 3 per cent of the Others concentrate as much of their time in the practice of marriage counseling. The hypothesis that those identified as Marriage Counselors will spend the greatest amount of time doing marriage counseling is sup ported toy the chi square test as shown in Table 11. No differences are observed between Orthodox and Other pro fessionals. For those who have a private practice, data on office location (Table 10) provide support for the hypothe sis that Marriage Counselors and Orthodox professionals tend to make similar arrangements for office location, tout the data do not support the view that Other professionals make different kinds of arrangements. The data indicate that it is much more common for those identified as Other professionals to use the office in which they do their regular professional work for seeing their private patients. Although only 26 per cent of the entire sample use their regular offices for purposes of seeing private patients, nearly **2 per cent of the Other professionals follow this practice. Data analysis (Table 11) indicates that there is a relationship between professional identification and office arrangements; Marriage Counselors and Orthodox tend to make similar office arrangements; but Marriage Counselors and Others also tend to make similar arrange ments. The only statistical relationship between office location and professional identification is between Ortho dox and Other professionals, In order to determine whether characteristics of the area in which the respondent works might influence the relationship between professional identification and office location, two control variables are introduced. The two control variables are size of population, and geographical location (see Table 12). Controlling for population size, chi square fails to achieve significance except for those areas which have a population of 250,000 or less. In the more heavily populated areas, profes sional identification and office location show no te l o 4 d b H P a d O K K H H 4 4 g <Io <I4 4 dP P P 0 b b cf P d P d H < j 0 P P P P ® * P b £ d-po o Ob P P HOHOHP P H d H)4 Ha O b b b d b b HO® P 0 PO O *? 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O < 4 4 c f P P p 0 bbcfPcfPcfH < ; 0 f f i p f f i p f f i . p b b c t p o o o b f f i P HOHOH® bHef H)4 Hffi 0 b b b c f b b HO0 f f i 0 bO(H Hctffi 4 f f i 0 f f i . bb Offi X X X b b H b 4 ( ! ) 4 b b b 0 0 0 0 0 0 p p p c f c f c f p . F ' b 0 0 0 P P P 0 0 0 H H H 0 H b b H 4 4 4 p . H b I I I ■b o cf a • • • • U1 0 CF CF + 0 C J 1 VO f t ) 4 0 H f f i f f l f f i b § P H b 4 P o c f b 0 f f i HHHM HHHIU H H Hw H HHIP HHHIU H HHID H HHI\1 W C o U f f i § K B KK ( I ) o f f i f f i ( Q f f i 1 1 1 0 0 0 S3 83S3 Ob 0 bo b f f i 0 ( I I 0 ( I I 0 0 0 0 p p p 4 4 4 4 4 4 B BBB o ooo K B KK f f i o f f i f f i f f i f f i f f i 0 0 0 4 P 4 P 4 . c f P e t P c f Ob 0 bO b f f i 0 f f i 0 f f i 0 0 0 0 P P P 4 4 4 4 4 4 b b P P f f i f f i P P 4 4 B BBB 0 0 0 0 K BBB ( I ) ooo f f i 0 P 4 Pet Ob f f i 0 BBB K BBK 0 0 0 f f i 0 0 f f i f f i f f i 0 0 P4 p 4 P c f P e t ob Ob ( I I 0 f f i 0 • 4 0 0 p p 4 3 4 4 b > H * p p < * ! f f i P p 4 4 B B B B 0 0 0 0 CD b 91 '* b b 3 0 et b 0 P 6ft iko relationship with each other. However, in the smaller areas a relationship does occur for those identified as Orthodox Mental Health professionals and Other profes sionals and office location. Controlling for geographical area of the country, the relationship between professional identification and office location disappears except for those who work in the Northeastern section of the United States. On the basis of this analysis, one may conclude that there is an interaction effect between the areal variables and the association between professional self-concept and the pri vate practice office location. Data on liability insurance is used as a measure of identification with a clinical profession. Data pre sented in Table 10 show that 40 per cent of the entire sample carries liability insurance, however, 51 per cent of the Orthodox Mental Health professionals carry liability insurance, and 36 per cent of the Marriage Counselors, and only 32 per cent of the Other professionals are covered by malpractice insurance. The association between central professional designation and insurance coverage proves significant. Analyzing liability insurance data taking two groups at a time points to the fact that there is an association between Orthodox professionals and Other pro fessionals; and that there is no association between those Ibl identified as Marriage Counselors and either of the other groups. To examine this relationship more closely, four control variables are introduced. The purchase of liabil ity insurance may be directly influenced by the kind of practice one engages in, therefore private practice, and the amount of time spent in the practice of marriage coun seling are controlled. Also those holding a degree in medicine are removed from the analysis since one could argue that physicians traditionally carry malpractice insurance; Finally, the title that the respondent ascribes to his patient, or client are controlled. Table 12 indicates that private practice influences the relationship between liability insurance and profes sional self-designation. Those respondents who identify themselves as Orthodox Mental Health professionals carry insurance more frequently than do either of the other groups; however, if the respondents do not engage in pri vate practice there is no relationship between professional identification and liability insurance. Controlling for the amount of professional time spent in the practice of marriage counseling also influ- ences the relationship between self-concept and liability insurance • For those who spend 50 per cent or more of their time in the practice of marriage counseling, there is V+2 no association between liability insurance and professional identification. For those who spend less than 50 per cent of their time doing marriage counseling, the relationship between professional identification and liability insurance persists for those identified as Orthodox Mental Health professionals and Other professionals. Nor does the removal of the eighteen physicians indicated in the sample change the relationship between self-concept and liability insurance. When the title ascribed to the person seeking the marriage counselor's services is controlled, the relation ship persists only for those who use the title client or counselee • For those who use the title patient there is no relationship between self-concept and liability insur ance . The overall analysis of the relationship between professional identification and liability insurance sup ports the original hypothesis that those identified as Orthodox Mental Health professionals will more frequently carry liability insurance than the other two groups. Furthermore, Marriage Counselors follow the Orthodox in carrying insurance, who, in turn, are followed by the Other professionals. The introduction of control variables does not change this basic relationship, but does show that the relationship does not hold for those who do not have a 1^3 private practice, nor for those who use the title patient. In summary, using four variables (primary profes sional position, location of private office, proportion of respondents' time devoted to the practice of marriage coun seling, and liability insurance) as indicators of the structure of marriage counselors' careers, support is found for the general hypothesis that there is a relationship between professional identification and the structure of professional work. Specific comparisons reveal that those identified as Marriage Counselors and Orthodox Mental Health profes sionals differ only with respect to the amount of time devoted to the practice of marriage counseling, and show no significant differences for the other three variables. Comparing Marriage Counselors with Other professionals reveal that the two groups differ with respect to the respondents' present primary position, and the amount of time devoted to the practice of marriage counseling. Orthodox Mental Health professionals and Other profes sionals show the greatest disparity in the structure of their careers. Significant differences are observed for three out of the four variables. These included present primary position, location of private office, and liabil ity insurance. The only variable which distinguishes those identified as Marriage Counselors from both other l¥* groups is the amount of time spent in the practice of marriage counseling, with Marriage Counselors spending more time in this pursuit than the others. 2. Independence or Dependence of Marriage Counseling Professions have "been described as being made up of autonomous individuals who provide a client with the services that the professional decides the client needs, and that the professional or his colleagues are the only 20 judges of the outcome of that treatment. However, Priedson argues that this picture of professions may be an 21 oversimplification. Professions vary in their means of obtaining clients. Essentially there are two referral systems by which a professional obtains clients. One is the professional referral system where one professional refers a client to the other and the client may be given services which he neither requests nor wants, but which are deemed appropriate by the professional. On the other hand, there is the lay referral system where the client seeks the advice of other, more or less, authoritative laymen who direct him until he reaches the professional. 2 < ^Everett C. HugheB. Men and Their Work (Glencoe, Illinois: Pree Press, 1958;, pp. 78-8'7. ^■Eliot Preidson, "Client Control and Medical Prac tice," American Journal of Sociology, LXV (January, I960), 37^-382. In tiie latter case, the professional's clients are referred to him toy nonprofessionals, and he (the professional) can act more or less independently of his colleagues* judgments tout not of his clients' judgments. Data on the independence or dependence of marriage counselors are obtained toy asking the respondents atoout their referral systems, and by asking them to indicate the amount of contact they have with other mental health per sonnel. It is hypothesized that those identified as Marriage Counselors and Other professionals will toe charac terized as toeing in a more independent profession than Orthodox Mental Health practitioners. Many people involved in professional work today view marriage counseling not as a new profession, tout rather as a new technique in the 22 repertoire of other psychotherapeutic techniques. It seems probable that individuals identified with the Ortho dox Mental Health professionals will toe the ones who would receive their referrals from traditional professional sources, tout that individuals identifying with a new pro fession, one not yet recognized toy all, will receive many of their clients from the lay referral system. 22Gerald I. Manus, "Marriage Counseling: A Tech nique in Search of a Theoiy," Journal of Marriage and the Family (November, 1966), M+9-V55^ Also see Richard X. Kerckhoff, "Interest Group Reactions to the Profession of Marriage Counseling," Sociology and Social Research, XXXDC (February, 1955), --- ----------- li+6 On the same basis, one can anticipate that those identified as Orthodox Mental Health personnel will have more interaction with other mental health personnel since their referral system and interests should bring them together more often than those identified as Marriage Counselors or Other professionals. Respondents are asked to indicate what their pri mary and secondary referral sources are. These data are grouped into three categories: (1) professional referral system, which includes referrals from psychiatrists, psychologists, social workers, mental health clinics, and marriage counselors; (2) lay referral system, which incor porates referrals from friends, former patients, and cur rent patients; and (3) other authoritative referrals covers referrals from ministers, physicians who are not psychia trists, attorneys and courts. Table 13 indicates that the modal primary referral system for all the respondents is the other authoritative professional referral system, and that the least common referral system is the professional referral system. Rata on the secondary referral system present the same general pattern except that there is an even distribution between the other professional referral system and the lay referral system. It has been hypothesized that those identified as Orthodox Mental Health professionals will use a T-AJBIjE 13 XHXEEXEHXiBHGE AMD EKTEHX1EHCE OX1 THE PROSES8IOJJ BY CEiHCfiAL EB.OEESSXOHAi TEE 3XG-HA.T X ON* Variable Central Professional Designation Marriage Counselon % On-feHo d ox % Othen % Total % Eirst Eeferral System (1T=68 3 (N=92) (H=8*4- ) CN=2*+*+ 3 Erofessional Referral System 20 .6 25 .0 15.5 20 .5 XiS-y Referral System 33 -8 26 .1 * 4-1 .7 33 -6 Olden Professional Eeferral System *4-5-6 * 4 - 8 .9 * 4- 2 .8 *+5 .9 Second Referral System (N=663 (H=100) (H=803 (H=21 +6 3 Professional Eeferral Sys"tem 22.7 2 * 4 - . 0 22.5 23 .2 Lay Referral System 31 .8 * 4 - 1 .0 *4-0 .0 38 .2 Olden Professional Referral System *4-5-5 35-0 37.5 38 .6 Inte rac - f c X on wi It) Psychoanalysts ( N = 6 o 3 CN=1033 (N=8 2) (H=21 +5 3 Seldom oar Heve n * 4 - 3 -3 3 5 .9 * 4- 1 . 5 39-6 Oc0asionally 35.0 *4-5-6 * 4 - 1 .5 *+1 .6 Of “ ten 21 .7 18.5 17.1 18 .8 In-fee rac ti on with. Psychiatrists C N = 73 3 (H=ll1 + 3 (H=92) (N=2793 Seldom on Haven 5.5 2.6 6.5 * + .7 Occasionally * 4-1 .1 * 4 - 1 .2 *4-5-7 *+2 . 7 Of-ten 53 - * 4- 56 .1 *+7.8 52.7 Intenaction witli Marriage C omnse lo ns (H=72) CN=1133 ( H = 8 83 Ch=273 3 Seldom on Neven 5.6 8 .0 13 .6 9.2 Occasionally 26 - * 4 - »+3 -1 + 1 4-0.9 38 .1 O f-ten 68 .1 * 4-8 .7 *+5-5 52.8 Intenaction with Social Workers (H=65) (H=UO 3 CH=863 (H=26l 3 Seldom on Neven 12-3 7.3 2 i+ . 1 4 - I 1 *- . 2 Occasionally 36 .9 39.1 h e 5 - * + * + 0 . 6 Of "ten 50 .8 53 -6 30 .2 *+5-2 Inte na 01 i on wi th. Psychologists CN=65D CH=112) CH=85) C N= 26 2 3 Seldom on Heven 9-2 8.9 21 . 2 13 -O Occasionally *4 -0.0 37.5 37.7 38 . 2 Of-ten 50.8 53 .6 *+1 . 2 * 4 - 8 .9 Tatle does 1101; include HE. I*t8 professional referral system more frequently than the other respondents, and that Other professionals will use the lay referral system most frequently. The data do not support this hypothesis. Private practice is introduced as a con trol variable, hut (as shown in Table 1*+) this control does not influence the relationship. There is no associa tion between primary or secondaiy referral systems and pro fessional self-concept. Data on the respondents' interaction with other mental health professionals are also examined. Table 13 shows that out of the professionals mentioned in the ques tionnaire , psychoanalysts are the ones with whom the least interaction takes place (60 per cent of the respondents have some interaction with psychoanalysts), and psychia trists are the ones with whom there is the greatest amount of contact (95 per cent of the respondents report some interaction). Interaction with the remaining professionals proceeds in the following order: marriage counselors (90 per cent), psychologists (87 per cent), and social workers (86 per cent). The original hypothesis stipulates that Orthodox Mental Health professionals will have the greatest amount of interaction with other mental health personnel, and that Marriage Counselors and Other professionals will follow in that order. 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a ) a ) P 'H rl f H f H f| a a a m° 3 5 5 o o o o o o o 0 0 0 1 ) 0 ooo a ! ©OOP © © © 30 30 30 fi lo 30 to a ) a ) a l fn a t © © P P p © P P P f H f H f H S f H f H f H f H f H f H f H fl f H © © © a a a s a dddS p p p p p p • © i i f H f H f H C J © ff i ffiH P P P • • • W 0 0 0 0 0 0 W to© d p p 5 d p p d d p p p p S £ d p p 5 f H f H f H © © © P P 3 3 3 s 533s 3 3 3 d d < h a i d 0 P fio o fH t> 0 pp f H P P i 0 © 0 f H APi f n f H M M M © H m © H M M M • 0 fi A h P . r M • 0 fl P • 0 fi 30 A © 0 30d © 0 30 d © P ¥ p P d p p d f f i f H P d © fHPd © fl p a 0 0 i s 0 0 a 0 0 n d d C D H W d d d d 0 p 3 a 0 Ap i i d 1 H p 3 s 0 P 0 P 0 f H 0 0 fi flOO f H fi 0 0 Pi a a 0 pnaao P h 3 a f H f f i © P d © © f f i fi ffi 0 ! > 0 0 p p •rl p ©p P P 0 t»o P © fi 'rl © © © flfl 0 f H si P h P h id P H p a f H f H ft © © 0 P P P d H aa 0 d p f n o < H 0 f H 0 0 p h a s d f n 0 0 fl © S I I i H 5 0 to d p p i • • i 0 0 0 0 0 0 to ww d p ■ r l * P d H •H * H s s • i fH fH © © P P 33 P 3 M M M » d • 0 fl P © id © o J S 3 « 8 00 d d M M M © , & • o ft p to d © o P f d © ftp d © 00 d d d < h si o f H 0 0 P h SS © © o p p ©p f>© p © f H f H P P h P o © f H © P P 3 5 a 0 d © f d f n p o © 0 0 00 ooo© diN H d c o n N i (MiQ\d H H O d t i i i i i i i r0 Olrl C O J-d P P P P 30 a Hi; 0 • • *0 3 0 0 0 o o od COWWP •H d d d * p p p rl rl rl 1 I I 1+3 f n f n fi q © © ©H P P P 333s fl M M H © d • 0 fHP w © fPd 8 0 0 3 dd < H i i| fl 0 0 f H PhSSO rl rl rl r| 3 0 3 1 )3 1 )0 o o od HHH 0 OOOh ddd© 0 0 0 P 4 S S r1 } © P ©ffl > 0 p p flp P h 0 © 0 fl APi P hP hP hP •rl rl rl * u r n © • 1 14} f H f H fl d f f i f f i ( D H PPP aaa* M M M ffi • o h f $ 2 ° © fnPd « 0 0 5 d d p S i d 0 P fnoo fi P h2!20 d 8 0 p P © 0 © © f H © © p p P P d © d© •H 0 p 0 a a 0 0 d © d © f d P d ftp fHP 0 0 © © .® 0 0© H S dM OOOO J- C M C M C M J- C M C M C M O d N H 0 OOlH HHINd H rO lN O I • • I I • I I I d OllA 0 J -C O H P © P P P P 30 f f i © © 0 P P rl H 0 0 od 0 H H H 0 H 0 0 0 >) 0 ddd© d 00o P h 0 l ^ s I 3 ) S P ) © r a ©d © PhP hP hP Pi d d d s d p p p p rl p rl • rl SSJfi * © l i p I ■ r l PP 30 © © 0 rl rl H 30 30 0 ood HH 0 2 2 ^ dd© 0 oH SS © rad P h P h p p dd * pp P 'rl ' m © 1 If) ■ P ff -p f«p 333s 3 33s XXK* X . 0 fiP t bod © 0 3 0 r l P d rl © fiP d © 800S 8 d d p i id p 0 p 0 fnoo f n fi MM© * * 0 fHP d ©0 fiPd 00 P hS S O P h d d ' ( 3 P oofl a a o © 0 pp ©p > g ■ r l © flfl P h P h © P © © l> 0 'rl p flP P i 0 © 0 f H APi 150 Yate s * o orrec tion -used w l i e n . degrees o Y freedom equal one 151 psychoanalysts the distribution of the data supports the hypothesis, but chi square analyses fail to reject the null hypothesis. The inclusion of private practice as a control variable does not affect the relationship. The same data analysis focused on psychiatrists produces similar results; that is, there is no association between professional self-designation and interaction with psychiatrists, nor is this lack of relationship influenced by the control variable of private practice• Interaction with marriage counselors does not follow this pattern of no relationship. Some 9*+ per cent of those identified as Marriage Counselors interact with other marriage counselors as opposed to 92 per cent of the Orthodox Mental Health professionals, and 86 per cent of the Other professionals. As shown in Table l^f, chi square analysis supports the hypothesis of a relationship between self-concept and interaction, and suggests that those identifying as Marriage Counselors interact with other marriage counselors more frequently than those who have other professional identities. However, with the intro duction of private practice as a control variable the association changes. The relationship between professional self-concept and interaction with other marriage counselors is true only for those who do not have a private practice. For those without a private practice there is an 152 association between the self-designation of Marriage Coun selor and interaction with other marriage counselors; tout for those who do not have a private practice there is no relationship. Apparently, those identified as Marriage Counselors, who do not have a private practice, may work in a setting where they interact with others who have simi lar professional identifications. Interaction with social workers supports the origi nal hypothesis; 93 per cent of the Orthodox Mental Health professionals interact with social workers compared to 88 per cent of the Marriage Counselors, and 76 per cent of the Other professionals. Chi square is significant for all three professional self-designations. Introducing private practice as a control variable produces results diametri cally opposed to those found in the analysis of interaction with other marriage counselors. The relationship between self-concept and interaction holds for those respondents who have a private practice, but not for the others. For those who have a private practice there is a significant difference in interaction for Marriage Counselors and Other professionals, and for Orthodox and Other profes sionals, but not for Marriage Counselors and Orthodox pro fessionals . Analysis of the data on interaction with psycholo gists supports the original hypothesis in a limited 153 fashion; 91 Pe* * cent of the Marriage Counselors and Ortho dox Mental Health professionals interact with psychologists as compared to 87 per cent of the Other professionals. Zero order chi square analysis fails to reject the null hypothesis except for the relationship between Orthodox and Other professionals. When private practice is introduced as a control variable, a relationship between professional self-concept and interaction is found for those who do not have a private practice. The overall findings suggest that interaction with other mental health professionals and professional iden tification are related for nonmedical mental health per sonnel, but not for medical personnel. Also where this relationship is found, it is also found to be influenced by the variable of private practice. In two cases, inter action with marriage counselors and interaction with psychologists, the relationship holds only for those who do not have a private practice, and in one instance, inter action with social workers, the relationship holds only for those with a private practice. In summary, data on the independence of the profes sion suggest that members of the American Association of Marriage Counselors are relatively free of evaluation by other members of the mental health professions, however, they are not isolated from them. 15^ Professional self-concept is associated with inter action with others in the field. The direction of this association supports the individual's self-concept; that is, those identified as Marriage Counselors interact more frequently with other marriage counselors than do the rest of the respondents; and those identified as Orthodox Mental Health professionals interact more frequently with other orthodox professionals. Furthermore, there is a greater distinction in interaction when Other professionals are examined than there is between Marriage Counselors and Orthodox professionals. No data are available to see if identification with the self-de3ignation of Other profes sional is supported by similar kinds of interaction patterns. 3• Type of Therapy and Profes sional Self-Designation It is hypothesized that professional identity may be associated with the way the professional approaches the individual who seeks his services. In other words, the kinds of treatment offered, or at least the way it is defined, may be related to professional self-concept. Data on three aspects of the professional's behavior in relation to the individual who seeks that professional's services are examined. These data include: (1) the respondents' primary treatment approach; (2) the frequency 155 of therapeutic sessions; and (3) the title ascribed to the individual— patient, client, or counselee• The first part of the hypothesis is that those whose professional self-concept is either that of Marriage Counselor or Other professional will more frequently call their therapeutic interventions marriage counseling or conjoint therapy than will those identified as Orthodox Mental Health professionals. The second part of the hypothesis— similar to the first— is that both Marriage Counselors and Other professionals will see their patients less frequently than Orthodox Mental Health professionals. The third part of the hypothesis anticipates that Marriage Counselors and Other professionals will use titles of client and/or counselee in addressing those who seek their services more frequently than will Orthodox professionals. With reference to type of therapy practiced, it is anticipated that those identified as Marriage Counselors and Other professionals will be similar, and that these two groups will differ significantly from Orthodox Mental Health practitioners. The null hypothesis stipulates that there will be no differences between the three groups in primary treatment approach, frequency of seeing patients, and in title ascribed to the patient. It is anticipated that the null hypothesis will be rejected for all three variables. 156 Table 15 presents the frequency distribution for the three variables under discussion cross-classified by professional self-concept. Marriage Counselors and Other professionals label their therapeutic intervention as marriage counseling or conjoint therapy 85 and 73 per cent respectively, whereas Orthodox professionals identify this as their primary treatment approach 53 per cent of the time. Turning to frequency of patient contacts, 91 per cent of the Marriage Counselors and 89 per cent of the Other pro fessionals see their patients no more than once a week. Although the group identified as Orthodox professionals also have a tendency to see their patients once a week, some 16 per cent engage in more intensive therapy seeing their patients two or more times per week. The modal title ascribed to those who seek their services for all three groups is client. The Marriage Counselors use this title most frequently, 66 per cent, and the Other professionals use this title the least frequently, *+6 per cent. The title counselee is favored by the Other professionals and is used infrequently by Marriage Counselors (7 per cent), and Orthodox professionals ( H - per cent). Data analysis (Table 16) supports the hypothesis on treatment approach. When data on professional designa tion and primary treatment approach are analyzed, chi square is significant. Taking two groups at a time the TABLE 15 TREATMENT APPROACH BY CENTRAL PROFESSIONAL RESIGNATION* Variable Central Professional Designation Marriage Counselor % Orthodox $ Other % Total i Treatment Approach (®»75) (ffslHO (N=93) (N=282) Individual Therapy 10.7 ^6.5 19 J* 28.0 Marriage Counseling 62.7 29.8 55.9 1*7.2 Conjoint and Family Therapy 22.7 22.8 17.2 20.9 Other b.Q .9 7.5 3.9 Title Ascribed to Patients (N*76) (Nxlll) (N*92) (N=279) Patients 27.6 38.7 23.9 30.8 Clients 65.8 56.8 ^5.7 55.6 Counselee 6.6 ^.5 30 & 13.6 Freauency of Patient Contact (N=65) (N=*112) ( n«75) (N=252) Two or more times per week 9.2 16.0 10.7 13.1 Once per week 89.2 82.1 88.0 85.7 Less than once per week 1.5 .9 1.3 1.2 *Table does not include NR. I TABLE 16 TREATMENT APPROACH BY PROFESSIONAL RESIGNATION, CONTROLLING FOR PRIVATE PRACTICE, AND FREQUENCY OF PATIENT CONTACT 003111101 Professional Practice X2 LF* Sig. Direction Zero Prof. Lesig. x Treatment; Approach *+3 .76 6 Yes MC choose marr. Order counseling MC and Ortho x Treatment Approach 31.^6 3 Yes MC choose marr. counseling MC and Other x Treatment Approach 3.81* 3 No Ortho and Other x Treatment Approach 26 .0^- 3 Yes Other choose marr. counsel. Private Prof. Lesig. x Treatment Approach 39.13 6 Yes MC choose marr. Practice c ounse ling MC and Ortho x Treatment Approach 29.3*+ 3 Yes MC choose marr. c ounseling MC and Other x Treatment Approach i*.00 3 No Ortho and Other x Treatment Approach 22.61* 3 Yes Other choose marr • o ounse 1. No Private Prof. Lesig. x Treatment Approach 23.17 6 Yes MC choose marr. Practice counseling MC and Ortho x Treatment Approach 17.61 3 Yes MC choose marr. counseling MC and Other x Treatment Approach 6.i*5 3 No Ortho and Other x Treatment Approach 9-31 3 Yes Other choose marr. counsel. Zero Prof. Lesig. x Frequency of Patient Order Contact 2.71 2 No MC and Ortho x Frequency of Patient Contact 2.05 1 No MC and Other x Frequency of Patient Contact .07 1 No Ortho and Other x Frequency of Patient Contact 1.1*1 1 No *Yates1 correction used wiien degrees of freedom equal one. 159 data continue to support the hypothesis. Data on Marriage Counselors and Other professionals do not reject the null hypothesis, but data for Marriage Counselors and Orthodox yield a significant chi square as do data for Other profes sionals and Orthodox. To examine this relationship more closely, a con trol variable is introduced. Assuming that the respondent may be influenced by the dictates of an agency in which he might work rather than the promptings of his self-concept, private practice is controlled. If the relationship between self-concept and primary treatment approach varies when private practice is controlled, one can argue that self-concept is not the critical variable in this relation ship. However, Table 16 indicates that private practice in no way influences the original relationship. Data on frequency of patient contact fail to reject the null hypothesis: professional self-concept and inten siveness of therapeutic intervention, as measured by fre quency of therapeutic contact, are not associated variables. Data on the title ascribed to those who seek pro fessional services and professional self-concept provide partial support for the hypothesis (Table 16). The zero order analysis indicates that there is a relationship between professional self-concept and title used for patients; however, the detailed analysis between groups 160 does not follow the original formulation* Instead of find- ing that Marriage Counselors and Other professionals use similar titles and that Orthodox use a different title, the data indicate that Orthodox and Marriage Counselors use similar forms of address, and that hoth of these groups differ significantly from Other professionals. Other pro- fessionals make significantly less use of the title patient or client, and more use of the lahel counselee* To examine this relationship more carefully, three control variables are introduced. Two measures of educa tion are used as controls. They are: (1) the amount of education attained by the respondent; and (2) the area of educational specialization. In addition, personal experi ence with therapy is controlled. (See Table 17.) Data on educational attainment are dichotomized between those holding a doctorate and those holding a lesser degree. The relationship between title used for patients and professional self-designation is uninfluenced for those holding a doctorate, but disappears for those with less than a doctorate with one exception, A signifi cant difference remains between Orthodox and Other profes sionals. There is an interaction effect between level of education and title used for patients. When educational specialization is controlled, the relationship between title ascribed to the patient and 3 H ® . ® . ® y ® H S o H© ho p H© « ii 0 d OH OH OH 0 0 P 0 » I f + » ® © + * ■ P oo < H ooo ©o ofl Vio oo ofl ho do op hS Hd fl® osi hfl fl0 ofl , ,, 4 * 3 r p * H + > p w d< 8 OP HO HO flH OP HO flH OP 0 H fl PO PO 00 H fl P o 00 Hfl T-„ n u n -i p P P|Q 0 4k ® o -d ® ^fl® ^ PP 0 Pfl H 0©$j 0$ PH® H ffl©$ PH® H 0 0°ij H "B H On/ 0 © p M g g o o h f h j o o h p h i p p m o . « 0 0 H 0 0 <H ff l OH H OH 0 0 p 0 o g H n H o 0 0 H fl Ofl Ofl HP P fl fl Pfl H 0 0 0 O P H 0 h p®flp flp ® Poflp o p o o p p p o flp ph S d 2 , d fl 'Oo® w « d p © © odo d od ©fl® d o good© do dHd g©dfl© dHfl ooddo oo ooddo u l JM j ! d j d o H opfl flHdoH dn flHfl©H •HO HOflr1 -1 « ^ 1 * S 0 H S 0 0 S' «• Hb/IH Ari ■HO 'hSah 55 Hoin h h52h O O H g O o P O P O O P O O O O P O O P O O O O P O o o O O O P O 0 00 00 0 0 0 0 0 0 0 0 . o 2 1® P 525.® . ® 5.® , ® ® oo o ooo o oooooooooooo fH SH |H SSfflfH fH flSH fH fH afH fH fH fcfp H AAAA AAAA ssaizi j- aicvi oi j-oicoco v f l * lA rO 0 H P H E l d o 0 4 to H 0 H 0 H rt<0 ron a < coca H 0 0 HH PP H H E H El PP 0 0 P P H H dd o o 0 0 H H P g pp dp o o p p o o a s v O fO i lA 01 0 H P H E l P 0 P H H 0 d o 3 0 0 3 d 0 C O j-v O H aaa& i i i i OvCOCON 0 H P H HH E l PPP H H H P E l El E l 0 P PPPH o o o d PPP 0 I H H O 0 0 0 0 0 0 M <!<!<!'' 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It is only within a homogeneous educational area that the relationship fails to he main tained. Controlling for those who have had a personal experience with therapy, the original relationship between professional designation and title ascribed to the patient remains the same. There is no interaction between therapy and the relationship between title ascribed and self designation. In summaiy, general support for the hypothesis that type of therapy practiced and ways of approaching the patient are related to self-concept was supported. Those identified as Marriage Counselors and Other professionals more often use a treatment approach which they call marriage counseling and/or conjoint therapy, whereas Orthodox professionals have a greater proportion of respon dents who use individually oriented therapy, Intensiveness of therapy, operationalised by frequency of seeing patients, failed to reveal any relationship with profes sional self-designation. Most members of the American Association of Marriage Counselors see their patients on a once-a-week basis. With respect to titles used to describe their patients, a relationship was found, although not the one that had heen anticipated. Other professionals differ significantly from their colleagues identified as Marriage Counselors and Orthodox Mental Health professionals. Both Marriage Counselors and Orthodox professionals have a penchant for calling those who seek their services clients, although Orthodox professionals also use the title patient. Other professionals are the only group which show a tendency to use the title counselees. This relationship was found to be influenced by the amount of education and the educational specialization of the respondent, but was not influenced by the individual's personal contact with psychotherapy, 1 +. Social Characteristics of Patients and Professional Designation It is hypothesized that the respondents' patients will be socially differentiated according to the therapists professional self-designation, Bata on the patient's age, sex, race, religion, income, education, and the diagnostic assessment made by the respondent were obtained for both the subject's private practice, and agency practice* These data were gathered by asking the respondent to indicate how many patients he sees each week in private practice, and how many he sees each week as part of his work in an agency or institution. Each respondent was then asked to describe l6*i the social characteristics of these patients by indicating how many were male, how many were Caucasian, Protestant, and so on. (See Appendix B, p. 277.) Some 27 per cent of the respondents who answered these questions did so by suggesting the proportion of patients they had which belonged within a given categoxy instead of giving the actual number; for example, a respon dent might write that approximately half of the patients he saw in private practice were male. In order to code these data, the proportional answers were converted into real numbers based on the total number of patients seen by the respondent. This practice was made difficult and possibly inaccurate when situations like the following arose. The respondent reported having a total of five private patients, half of whom were male. Cases like this were treated by stating that every other one of these ambiguous responses would be coded as having two male patients and three female patients, and the alternate ambiguous response was coded in the opposite fashion. How ever, there were enough of these ambiguous cases to make one examine all of these data on patient population with extreme caution. The greatest variation in the social characteris tics of patients is expected to be found in the respon dent’s private practice where the choice of therapist and patient is not controlled by institutional regulations. It is hypothesized that the better educated and wealthier patients will seek the services of an Orthodox professional rather than the services of a Marriage Counselor or Other professional. On the other hand, those who are less edu cated and have a lower income are expected to make up the bulk of the private practice of the less traditionally identified mental health personnel. It is also hypothe sized that the diagnostic assessment of the patients will vary according to professional self-concept. Those who label themselves as Orthodox Mental Health professionals are expected to include more patients in their practices who could be labelled seriously disturbed— i.e., the organic and functional psychoses, and character disorders. Both those designated as Marriage Counselors and Other professionals are expected to have a higher proportion of patients labelled relatively healthy and psychoneurotic. The other social variables— including age, sex, race, and religion— are not expected to show a relationship with professional self-concept. Although one may expect to find the same pattern will hold with patients seen in an agency, the relationship will probably not be as apparent since the agency in which the respondent works determines its own criteria for accepting clients. Therefore, it is not expected that 166 the associations found in private practice will he absent in the agency, hut it is likely they will he of lesser magnitude. Data on the respondents private practice are based on the responses of 197 subjects. Of these 51 were labelled Marriage Counselors, 97 were Orthodox Mental Health professions, and **9 were Other professionals. The Marriage Counselors saw an average of 12.^ patients per week, the Orthodox Mental Health professionals saw 13.2 patients per week, and the Other professionals 12.0 patients per week. Based on this information, it is apparent that no single self-identified group is more heavily engaged in private practice than any other. Table 18 presents a cross-classification of the social characteristics of the patients seen in private practice and the respondents* self-concept. Examining the entire sample of members of the American Association of Marriage Counselors it appears that the modal patient seen is a young adult (twenty-one to thirty-nine years of age) Caucasian woman, who is a protestant with an income of five to tea thousand a year, who holds a college degree and has been diagnosed as a psychoneurotic. Within this pic ture, however, there is a great deal of variation. Although the patients are overwhelmingly Caucasian (91 pe^ cent), there are many who are classified as mature adults 167 t o rl P a a i 8 H 0 u t o & P a ® o p 0 B u s p 0 H 0 T j 0 a •p U 0 u ® o s u n ( d ® rl ray?. p so ® rl 5 ■ r l as A y r \ Os sO sO 00 v O O C O 00 N r o sO 0 0 -to ( ( • to • • in 1 * 01 i n m o 01 rOto 01 H O S Jl H l A f O 1 J| Os to to to Sj’ >»/ A y A s A A y A y CO H OO 01 0 H rOrOJ- 01 r o N 0 toj- H m o s o o 0 ( ( I to ( i to i • m ( ( i to 1 s O O l H 1 roto 1 O s O J l H O N I to H i n n to Jr*\ to O O H to to 01H to v -/ y - < y ~ / A y A y A y A y r \ A y 01 O N r O fO 0 4* J* (0 OS Os O S H 00 inin CO I N O r O o c O i A J - f O O Os ro ( i ( r O ( ( r O ( • (0 • • « (0 t ( 1 ( « ro H INrOOs H rO to H H O O H inolol H i n i n o i i n H H J| Hirs 01 Jl J l Os Jl 1 f O j ' H to to to to to to ■ w > y_/ Ay ITS in 0 1 i OlOsOs I I I N O r l l A O i a l A y Os 0 1 in 0 1 I o o i i n j - o s I I • I I O s o o N j - r O r O H COlfs IN 0 1 CO « • < • • J - N J - O J h j -oih A y OS IN t o I Ollnro 0 1 0 M A y 0 1 A y C O A y O s A, in N to j- 0 1 HOs r o Hto (0 O J to « « to » • to ( i i to J l r O t o jl Hao Ji HOOI n to V to O s to inoioi to y_/ HOj-toOs i i i i i o r n o s j - HrOrOH ® H I n M o ■ H t j - q o s d 0 < o 8 I * r | W ® S3** S-d? w ® WP t J 06 } H < 5 0 • H rl 0 a 0 - H « ■ n rl J 8 t o P O a t o ® d w p 3 h oa * too o totob t o 0 ] t o 0 1 i 00 000 ® 0000 t o 0 0 * * 0 ® ' ■ o o a H O O I l n H & # t o to# I I I 000 00000 00000 00 • " O O O i n i n r i o n n 3 to t o rOj-j-OOH • • • i t H N t o O J - H O l O J r o As 0 1 0 0 in s l OJHHtoO i • ( i ( H H M n i n H r o o i o i N j-N H H • ( ( ( I HoOlnOj- rlOIOIrO A y rl in t o I t o rl 0 0 t o o w 3 h 5 0 0 O H ® to o o ® <d P O O dOto ® 0 W t o W H P o doan o ® h o o o HW caoto r\ J- ro t o O J & s> J-OrOOlH ( # « 0 ( 001 IN IN « \ HOIOIrO osoii-soinsooo I I I I I I I s O O C O O s H 0 1 0 1 J - H A y in 01 t o t o H O s t o t o j - O j - ( • ( ( ( • ( m i N r o c O H H O l r o r O H r \ H In ro H S3 rOj'lrscO O s N j - ( • • ( ( ( < O l O H O s H ( 0 0 1 J - 0 1 A y CO ro t o t o ( N O r O r O C Q O I l N ((((•( o C O O I t o O H 0 1 J- H H 0 s t o w t o ® 0 0 P t o t o ® H to o w Woo SQ ®h m o w to M P H t o t o 0 CAP S S t o OHO ® ® ® o a l > f l p n o t i ■ rl 0 0 0 H rl ptoaJtoPdh i d o t o o o 3 ® H S i d S q 5 ) t o ® wto w 3 top M t o o t o t o O O 168 (forty years old and over), with incomes greater than ten thousand a year* and many who have less than a college edu cation and a diagnosis different than that of psychoneu rotic • As stated earlier, the hypothesis is that there will be little if any variation of patients in terms of age, sex, race, and religion in relation to the therapists' professional self-concept; that is, the prediction is that the null hypothesis will not be rejected. Table 19 pro vides the results of the statistical analyses of these data. The hypothesis which focuses on age is not supported by the data; those respondents who think of themselves primarily as Marriage Counselors see fewer patients who are below the age of twenty-one than do those who classify themselves Orthodox Mental Health professionals. Although the difference in age of patients between Marriage Counse lors and Other professionals is not sufficient to reject the null hypothesis it is in the same direction. There is no relationship between patients’ age and the groups iden tified as Orthodox and Other professionals. The original expectations do hold with respect to both sex and race. No association is found for these variables and professional self-concept. The hypothesis with respect to religion, like age, is not supported. Although the overall chi square does not reach the .05 Tates’ correction used when degree o£ freedom equals one 69! o 44 I# d ef 1 3 “ H'O (D P d d 0 I < D 4 K £ o o b p . p 0 H ) £ I ■r 1 0 O ' p. d 0 d F a 4 ? d F 0 k k s & 0) p 0 0 H ) H 4) 4) d H * ® P d H Lh d d 0 P d U > O J vn H H O ' O' io 4) 0 £ £ 4 4 434 0 a 4 0 P f t 0 H d F B b H > 1 do P p * r o d d y P P b ro dP 0 0 ro to d 4 4 ro d d d d o n 0 F F 0 1 * ft 0 0 « k r o U k k k H n IS IS t e l d H & B4 & P p P P IS 0 0 0 P & p p p 0 p d d d C D 0 d d d d P 0 s 0 C O d P p P d 0 0 0 0 0 H P H H H 4 0 4 4 4 P H P P P d d d d d d d d ® a ro ro P P P P d d d d v t 1 0 H 10 C D V J t V J l O ' SI • < • i • H 0 S J 1 0 \D O ' * 0 Oo VJI SI H k| H n j r o r o r o r o i n a a a u o ro ro o o S 4 ®5 S ro a ro m ro to Pro p b d ro p ro 4® p o 4 ro 4 ro 0 d4 o o d d ® d H d H d « 4) d « d ro o * m o o s ; o *; r o v ) t f r o r o > 0 4 0 PW 443 4 P tr4 p p ^ dp* 0< d F d F d ro ro d ro d ro rop oHffi p rop PH B d P H P d d d P ffld d d d B F d I ffl FID F ^ d H *5 0 £ £ £ (JO^OFO 0 £ £ 4 4 0 0 4 d 0 ? B 6 J * d d . 00® d d 4 C O F d d 0 ® F O n d 4 0 . fflk k k 0 00 HO 0 0 f i l l 0 p o o o ro h HH 0 43414) HP P P d d d 4) d d d ..P S K b H o n 3 s r e e r * r o dd S S o o S f 1 d d 4 to F d d oro Fon g 4o . 4 o g £ 4 4 004 d 0 s i s ? dd 0 0 ® dd4 B Fdd o r o t r o t ) g i o . » hnh 4 ppjpj Wddd N P . , ooo r o r o r o H d d d do o o OOPPP d 0 0 0 0 P HHH 0 0 0 0 ro HHH 0 4)4)4) d d d 4 3 d d d dPPP d d d d r o P d \£ )L « J H O o H\0H\0 Mil ■ T O S I V O ro+'-oO' p 434)43 p r o ro r o HPpp dPPP d d d d d d d d d d ro ro ro ro p PPP d d d d o £ £ 4 og g 4 4 004 40 0 4 ft 0 d 0 I S E F I f e H • dd ft H d ft d §0 0 8 d d 4 C D dd 4 0 F dd F d d o® F« 0® F on rtHO. 6H 0 • • KKK 8 " k k C O coco H ro ® ® !> o n £ KkH ro ro ro K ► r o o o o o n o 0 0 H HHH ro h H H 0 4 4 4 0 4 4 4 Hp p p HP P P d d d d d d 4 d d d 4 d d d p ro ro ro p ro ro ro dP P P dP P P d d d d dd d d ro ro P P d d " 0 W ^ • I I I 1 0 O'UN ro rovooo H H • * « « SNOSI O V J I V O - O ■ F \0 \0 M i l I I « • o o o o co\j\ to O' vj\HHvj( \0O 0 O F F F oo FFFOo | 0 |OIOF HHHto HHHIO |o 1 0 1 0 -T 0 S ? t f %%% %%%% o ro ro ro rorororo ro o o o oooo oooo 0 9 t a o o ---- F®F® F® to m 0 1 dW dW dW P P P ro d® d® d P d ftd a d P (t> p p 0 o p o p o p P dp dp d d 1 0 d O J c + 0 9 d d d o £ o £ o £ PdPdpd ft ft ft F F F ^ o g o o W 4 04 4 P d d d dFCDFF d« d o ro o o 4 r o r o h P c d ro ro ro ( D d r o £ ® r o £ ® SS S ? S ? oo r o r o C D p £ £ o p o «H££ B ro d®ro cho p Fp p ro 4 HdHH £ r o d S ' d d ® f c W & row o 4PWW d dp p ro d d d tD ® d d d dm dffl ro » oooo F F d H d H H® H« d£ d£ 4 ® 4 ro r o 4 r o 4 P P P ' d o H m b ■ d d d C D [ D t o d 0 H r o r o to C D o o r o r o P P d d 170 level of significance, the analysis of each group against each other reveals a relationship between the patient*s religion and the respondents professional self-concept as an Orthodox Mental Health professional or as an Other pro fessional. Orthodox professionals see a larger proportion of Jewish patients than do Other professionals (23 per cent as compared to 18 per cent) and a smaller proportion of protestants. Data analysis (provided in Table 19) supports the hypotheses concerning the other three variables— income, education and diagnosis— in which relationships between patient characteristics and self-concept are anticipated. Orthodox Mental Health professionals manifest a tendency to see more of the wealthier patients and fewer with low incomes than do Marriage Counselors or Other professionals. In fact, within every income category this trend prevails with Orthodox having the richest patients, followed by the Marriage Counselors, who are in turn followed by Other pro fessionals. Data on patients' education support the origi nal idea that there will be a relationship between educa tion and professional self-concept, but it does not support the original direction of this association. It has been suggested that the more educated individual will be the patient of the Orthodox professional, and the patients of the Marriage Counselor and Other professional will have the 171 least education* The reverse is true# Those who label themselves Marriage Counselors have the greatest number of patients who have had at least some college education (67 per cent of their patients), followed by Orthodox pro fessionals (60 per cent of their patients have had some college), who are followed by Other professionals (58 per cent of their patients have had some college). Table 19 shows that the association between patients' education and identification as a Marriage Counselor is significant, but there is no relationship between education and the desig nation of Orthodox and Other professionals, Diagnostic assessment and professional identification are related variables. It had been hypothesised that Orthodox profes sionals will treat a greater number of severely disturbed patients— those diagnosed as psychotio— and that the other two identity groupings will restrict their practice to patients seen as relatively healthy or psychoneurotic, The data reveal that the Orthodox professionals do treat the least number of those defined as relatively healthy or psychoneurotic, and that the Other professionals treat the greatest number of these patients, Marriage Counselors treat the greatest number of psychoneurotics, However, all groups have some patients in each diagnostic category and the rank order of diagnoses is the same for all groups. Despite this, a statistical relationship does exist for 172 each professional group and the diagnoses they ascribe to their patients. Marriage Counselors and Other profes- sionals see the greatest number of patients diagnosed as healthy, and see proportionately fewer patients diagnosed as character disorders and psychotic. It has been stated that the same hypotheses are expected to hold for patients seen in an agency practice. Data on the respondents* agency or institutional practices are based on 166 replies. Porty-eight of these replies are from subjects who think: of themselves as Marriage Counse lors , 65 are from those who identify themselves as Orthodox professionals, and 53 are from those who label themselves as members of Other professions. The average number of patients seen by the Marriage Counselors is 13*0, for the Orthodox it is 13*3? and for the Other professionals it is 13.0. Table 20 provides data on patients* social charac teristics cross-classified by professional self-concept. Examining the patients of the total sample, the modal patient appears to be very similar to that seen in private practice. Once again, the typical patient seen in an agency is a young adult (twenty-one to thirty-nine years of age), Caucasian woman, who is a Protestant with an income of five to ten thousand dollars a year, who holds a high-school diploma and has been diagnosed psychoneurotic. H 0 P 0 ei 0 0 • r l P 0 3 fi 5 o ■ r l 4 w. 0 P a 0 H 0 0 0 r l 0 0 0 H <0 0 0 4 F l 0 A | * H * n 0 0 0 f l P 0 0 0 fl 0 0 M H 0 0 S3 0 0 S j o ® H 4 0 • r l f l 0 S ) 01 0 1 & roots • • • s fls O lN O IU N H o o o IN & a r \ UN sO 00 S 5 s * » < ~ s 0 UN s Q I /> J 1 S I 0 1 I I a 4-vOO • • • s Q U N o O HUNCM 0 ^ 4 - • • • o o o n 0 1 U N 0 1 rONO • • • OrOsO OlsQH r \ r \ C j M 0 ) ® fi fi h (d o ti« g 5 \ i jdos 5 Oro w I H ® 0olfj V(fl n p h P H 000 0 <1'-' ® l H < 0 ! H < ! 0 0 3 J - s O t I CO r ) j-U N /N 0 O J UN 4 - sO 4 ; H • • r l 0 1 O O H 01 II O O H I I a a CO 00 sO 0 00 OO 4-sO OO ts • • s£) • • sO I I oo 01 I I ONO 1 a 4-'*' a O O H a r\ r* \ sO ro 0\ SO U N U N s Q 44- 0 CO • • 00 • • 00 I I H O O Jl sflro I I a ^4- a c O H a K J SS 0 r \ ON sO CO 01 ON ON 01 4 • • UN • • II 4 - UN II ONO a 3- UN a O O H h a IS J-M J t I < rooij- sO O I h UNINoO • • • 4-4-0 N H H O lU N rO • • • H H I N sQ 01 r l r\ N i s 5 OlrlN M 3 c 0 •rl % •rl H r \ UN N S i & 0 *rl r l 35 P O 0 0 ® ri ® ® p 3 -h a pas o JH3 • 2 f4#4 £ 01 C O OOtNUN I I I I I H O I 0 ) 4 - r l 004-H r\ N 00 sO k OOsQrOsON • • 9 • • O N H H v O 0 1 4 - 0 1 r \ 4- 4 00 s5 \J 0 0 4 -SO 01 • III I 00 01v£> O J 004-H ft s £ > I I 0 1 rO0\sOC04 • ••it a 0 1 H N H 0 1 I 00 0 0 0 © 0)000 fl oio * *o a ) *qo a H O 01 UN H ® & 4 4# § a 1 o o o o o o o o ooooo 00 " " " * " 0 0 0 UNUNrl OIUN j j 0 14- o O O s O • • • • • r j O H r O f O O lrOOJOl r\ ( S CO s O & O s s O s O O I N • • • • • 0001 root HroOlrQ r \ H sO C O & S I sO I I a O N O O N 0 0 4 - • • • • • U N H r o O l s O H r q 0 1 0 1 H 0 0 a 0 m • H 0 W H U O o © 0 OH (!) 4A H P 4 o o ® 0 PWOltfH ® 0 0 4 ©HP 0 tw g H 0 0 rl 0 0 0 AWflOfl ir\ CO 0 01 i m o o s o o r o • • • • • r O O N O N U N O ! r o O I H H O O H O s N O \ 4" • •••••• NO HsONHUN O lrO O l r \ sO 4- sO I U N U N N 4-00 s O U N • •••««• 0NO4-N4- 0 1 r o r O H S i 0 3 I S * / OnOnN onO O nIN • •••••• COOsQsQ r | 01 sO H O I 01 r l 00 H v £ ) I I a O D '0 4 , rOOlONCO • •••m i 4 - r o O s O s O H s D OlrOOl I 0 ) ( 0 0 ® fl 4 4 ) H Fl 0 0 0 0 0 >,0 ® H 0) 0 ID 4 WPHHF4 0 OAP h S M I ! , 0 0 0 0 0 p 0P 0 0 0 • r l 0 0 Orl-rl 0 0 0 0 0 H M >>0 M4 0 0)4 « 3 0 p tfAOftfcQO 17*t The only patient characteristic which is not completely identical with that of the private patient is education. The modal private patient has a college degree; the modal agency patient a high-school diploma. The first part of the hypothesis is that profes sional identification will not he related to characteris tics of the patient in terms of age, sex, race, and religion; that is, it is anticipated that the null hypothe sis will not be rejected. Table 21 gives the results of statistical analyses computed on patients* social charac teristics. These data do not support the hypothesis with respect to age, sex, or religion. In fact, in only one area is the null hypothesis not rejected and that is with reference to race. First, focussing on the age of the patient, it is clear that those identified as Marriage Counselors see different aged patients than their colleagues in the American Association of Marriage Counselors. Although there is no relationship between age of patient and iden tification as an Orthodox or Other professional, there is a significant difference between these two groups and Marriage Counselors. Table 20 shows that Marriage Counse lors see proportionately more patients who are classified as young adults (twenty-one to thirty-nine years of age) and fewer mature adults (forty years old and over) than E H M f c a * 0 9 3 9393 HE) pa -4 E H a<< -aft 4 E H i f l d o H A 0 * § 0 H f l 0 ) 0) ( I ) d d 0 0 a 3 0 a d d o o H rl 0 0 a D i 3 5 0 0 0 0 flrl flj H H S U S H an 2! a a a h . O F ) O f ) o f ) a® a® ao 3 5 3 ® ® a a a a an aH an fl A A a a o S3 S3 S3 SS 0 0 0 f l 0 HO HO HO ftA OO OO 00 fl OH OH OH 0 0 dH dH dH f)0 poaooodooo s s i s s O T i a a a 8 doas aoflooflooflao to ato a to oo p e l adoadoado. h a a h a a h a a fi o d io dao daoaa doddoddQdAa ' flftdftftflH ooo oooo a a a a H H H 0 0 pood n h aoaoao AAAflAfld d d dp poo A A A dddd a a a H H H f l f l f l a a a h ft ft ft A iododfl oh o o o OH fl H H 3 A A f) A 0 dfldfldflo OflOflOflH h an an a a fta ft a fto oooo d o d a d a o odoooofl HAHdHPfl a a aA a A a H • i? fl fl o fl rl rl Orl a o d a Aaaaoaaa , 8, dHd, d dadaaoda a a o o ooo p a • h H & S SfcS S M 0 0 0 f l 0 0 0 0 0 0 ooooooa a '5 a h a 3 a fl to, to, to, Ad a d a d a d a HOHOHOdH d3d3d3afl dododOAA jHjHAHA f t a o 0 I d 3 d a 0 a o a o a ft m s | OH [Ofl H H H J h I h fH |H S h 0 1 H H H OlHH H J- 0 1 0 1 0 1 cO-tJ- i O i i i 3fl3fldH3fl a a a a 3a a a H ftftftO < H P i Od aoao aao OH OH Ofl OH o f l o f l t a o o f l o o a a o ododHdOd AdAdMAd fl afl a dAfl a dd dd |°dd a a a a | h H H | h oi H m oi n 0 s0 01 co $oic « N v O f l f l d d a a H H f l f l a a f t f t H H 0 0 H H a a 0] 93 H H t i i i H H jrO O S s O N rO 0\ sO 0 O s O s N O s I T S C s 0 1 rO 0 H O S 03 0 Ifs IT S • g i g « i i g g g g 0 1 rO IS A 0 rO o o sO sO 0 i? N H V O (0 0 0 0 0 1 ro 0 0 IS H H s O O s (0 s. o O 0 1 O s O S c o IS i g g g I O s i IS s O 0 rO ro 0 1 Jt 0 1 H H H f l d a H f l an f t o n k o a 03 9 3 . f l f l f l ddd HHH f l f l f l ftftfto n n n a oooo n o n 0 A 3 0 0 H f l 0 0 0 f l H • n o d f t o A f l d 0 , A ao A f l A °3« A a OH Afl n a a o HXXa • 0 dfl t o ^ a o a dflA 5° 3S aa ® - ' O H r I S " i l l l S " H H s f t X d Ifl Ofl Aa • h dfl n fl afl o a a dft o ft ft a n 0 d o •rl to h rl d 0 H tl) H H n n n 0 0 0 a a a a d a 0 0 0 0 0 , 0 d 5 a Ofl ^d A a H f l a i " A f l Ofl A 0 H f l a Oft I n do 0 a a a X H X d n 0 n n n d n n n 00 00 0 0 0 rl d d d fl a a a 0 0 0 a H H H H H H 0 a a a fl fl a d 0 0 0 0 - 0 - d d d A A A H W A X X X A p A H A a H f t a « 0 to A , H f l A « d A , w °fl°,dfl 0 A f l d A f l Ofl d a a X H X 4 !0 S ° S W 0 A f l d Ofl d A a • HAH OH OH HflAfl AflAfl oa a afla dftoftoft dft ft a a o •HdHDHOft ha3a3aa oa a afln dftoftoftfio ft a a o pflOAOfldH ftd d dafl oa aA a a •HdHDHOft HAOAaAA oa a ann dftoftoftdo ft a a o 175 Yates' correction used Mben degrees o£ freedom equal one 176 the others* Turning next to the sex of the patient it is again apparent that sex is associated with professional self- concept. Although there is no significant difference between Marriage Counselors and Other professionals (both seeing more women than men), there is a significant chi square between Marriage Counselors and Orthodox profes sionals. The percentage breakdown (presented in Table 20) shows that Marriage Counselors see proportionately more females in their agency practice than do Orthodox profes sionals . The data on race support the original hypothesis that there will be no association between race and profes sional identification, but the data on religion once again run counter to the original suppositions. Data analysis (reported in Table 21) indicates that patients’ religion and professional self-concept are related variables. Although the entire group of therapists see predominately Protestant patients there are definite variations between the therapist’s self-identification and the number of Roman Catholics and Jews that he treats. Those identified as Marriage Counselors see proportionately more non- Protestants than either of the other two professional groups, and see more Roman Catholics (31 per cent of their practice) than their colleagues. The Orthodox 177 professionals see more Jews (17 per cent of their practice) than the other two groups and are second to the Marriage Counselors in treating Roman Catholics* The Other profes sionals see more Protestants than their colleagues (7^ per cent of their practice) and treat proportionately fewer Catholics and Jews. The second part of the hypothesis concerning patient characteristics states that there will t o e an association between the patients* income, education, and diagnostic assessment and the professional self-concept of the therapist. It is anticipated that the Orthodox pro fessionals will have a greater number of the wealthier and better educated patients; and that the Orthodox will see patients who are labeled more seriously disturbed. On the whole, the hypothesis is supported by the data although the anticipated direction of the association was not cor rectly predicted. Focussing on patients* income, Table 20 shows that for every type of professional identification the greatest single income group is that between five and ten thousand dollars. Rata analysis (see Table 21) indicates that despite this similarity in patient income, there are definite variations. Those identified as Marriage Counse lors see more wealthy patients than their colleagues; 33 per cent of their agency practice is made up of patients 178 with incomes of $10,000 per year or more compared to 19 per cent of the Orthodox professionals* patients, and 28 per cent of the Other professionals' patients. Marriage Counselors have proportionately more higher income patients than do Other professionals, who, in turn have propor tionately more higher income patients than Orthodox pro fessionals . Turning to patient education a similar pattern is seen to hold. The modal education for all patients is a high-school diploma, yet here as with income there is a significant variation between patients' education and therapists' professional designation. Once again, the Orthodox professionals see proportionately more patients with less education, and those designated as Marriage Counselors see more patients who hold a college degree• About 29 per cent of the agency patients of Marriage Coun selors hold a college or advanced degree compared to 27 per cent of the Other professionals, and 17 per cent of the Orthodox professionals. As a corollary to this, one-third of the Orthodox professionals' agency patients have not completed high school compared to 16 per cent of the Marriage Counselors and 11 per cent of the Other profes sionals • Data on diagnostic assessment and professional self-concept shown in Table 21, support the hypothesis that 179 the Orthodox will see a greater number of severely dis turbed patients than the other two professional groups. However, the data also indicate that there is an unantici pated relationship between the professional identifications of Marriage Counselor and Other professionals and diagno sis. Marriage Counselors see proportionately more severely disturbed patients than do Other professionals. Table 20 shows that the modal agency patient of all the therapists is classified as neurotic, but further examination shows that 69 per cent of the patients of Other professionals are labelled as either relatively healthy or neurotic com pared to 58 per cent of the Marriage Counselors and ^6 per cent of the Orthodox professionals. About 1^ per cent of the Orthodox professionals* agency practice is devoted to those listed as psychotic, compared to 8 per cent of the Marriage Counselors* practice, and 5 per cent of the Other professionals. In comparing agency practice and private practice it appears that social characteristics of patients and pro fessional designation are similar but more marked in the agency. For example, there is little or no relationship between private patients' sex and religion and professional self-concept, but there is a definite relationship between these variables and patients seen through an agency. Throughout the analysis the proportional differences 180 between given social characteristics and professional self- concept are greater for agency patients than for patients seen in private practice • In only one area is there a difference in the social characteristics of patients seen in private practice or through an agency. The Orthodox professionals see more women in their private practice, and see relatively more men in their agency practice• In summary, the data show that professional self- concept is related to the kind of patient that will be treated by a given therapist. Although there is some dis crepancy between patients seen in private practice and those seen in an agency, the difference is one of degree and not kind. Marriage Counselors are more apt to see more young adult women than either of the other two groups. They are also more likely to see more Roman Catholics than either of the other two groups, and Other professionals have a higher probability of seeing more Erotestants. Marriage Counselors are seen to have more patients that come from the upper socioeconomic strata than do either Other professionals or Orthodox professionals, but Other professionals' patients rank higher on both education and income than do those who see themselves as Orthodox pro fessionals. On the whole, Orthodox professionals see more severely disturbed patients than do Marriage Counselors or Other professionals, but Marriage Counselors see more I8i disturbed patients than do Other professionals* 5• Income and Professional Designation It is hypothesized that professional self designation may be associated with the fees charged for professional services, and therefore with that part of the respondents’ income which is directly derived from his clinical professional services. Data on fees charged for various clinical activities, annual income obtained from counseling, and total annual income are used as indices to examine the hypothesis that Orthodox Mental Health profes sionals will charge higher fees for similar services than the other two professional groupings. This is based on the idea that Orthodox Mental Health professionals are more likely to attract the wealthier patient who is accustomed to seeking the services of the elite, traditional special ist. It is also anticipated that Marriage Counselors will charge more than Other professionals since the Other pro fessionals may perceive their counseling services as a secondary interest and as a supplemental instead of a primary source of income. However, it is not anticipated that this rank order— going from Orthodox to Marriage Counselor to Other professional— will be maintained with respect to total annual income, since this income will depend on various sources including the principal occupa tion for the Other professionals. 182 Data on the average fees charged per session for six different clinical services are contained in Table 22. The expected pattern holds for each clinical activity, and for the computed mean fee for each professional designation regardless of specific therapeutic activity. These last computed averages must, however, be viewed with caution since the N*s upon which they are based are not independent observations, rather they are the cumulated responses for each subject regarding his usual fees. The means and standard deviations reported in Table 22 are used to obtain standard scores for each clinical activity. Table 23 con tains these findings. The hypothesis i3 completely supported in only one case that of individual therapy. There is a significant difference between all three professional groupings with Orthodox charging the highest fees for individual therapy, an average of $lM-J+9 per hour, Marriage Counselors charging the next highest fee, an average of $12.30 per hour, and Other professionals charging the lowest fees, an average of $9.9*4- per hour. For every other clinical activity on which data are available there is no significant difference between the fees charged by Marriage Counselors and those charged by Orthodox professionals, but there is a signifi cant difference between Marriage Counselors* fees and Other professionals* fees, and between Orthodox professionals* TABLE 22 AVERAGE BEES BOR CLINICAL SERVICES BY PROFESSIONAL RESIGNATION Professional Self-Resignation Types of Clini cal Services Marriage Counselor Orthodox Other Mean Standard Deviation Mean Standard Deviation Mean Standard Deviation Individual Therapy $12.30 $5.92 $lk.k9 $6.^9 $9.9^ $6. 8 if Conjoint Therapy 15.^0 6.97 16.23 7.67 12.10 9.07 Marriage Counseling 13.11 5.79 1^.64 6.35 10.97 6.81 Crises Consultation 13.67 6.61* 16.00 7.31 9.39 7. 3V Group Therapy 7 M i f .86 9.02 5.85 H-.Tk 5.27 First Session 13.39 7.00 15.87 6.90 9.25 7 M Total per Resignation 12.92 6.60 l i f .69 7.05 9.79 5Al H co u> TABLE 23 STANDARD SCORES FOR CLINICAL SERVICES BY PROFESSIONAL DESIGNATION Types of Clinical Services Z Sig. Direction Ind.ividu.al TRerapy MC x OriRo MC x Oilier OriRo x OiRer C onj o ini TRe rapy MC x OriRo MC x OiRer OriRo x OiRer Marriage Counseling MC x OriRo MC x OiRer OriRo x OiRer 2.07 2.00 4 .25 .62 2.06 2.72 1.66 2.00 3.43 Yes Yes Yes No Yes Yes No Yes Yes OriRo charge RigRer fees MC charge RigRer fees OriRo charge RigRer fees MG charge RigRer fees OriRo charge RigRer fees MC charge RigRer fees OriRo cRarge RigRer fees Crisis Consultation MG x OriRo MC x OiRer OriRo x OiRer Group TRe rapy MG x OriRo MC x OiRer OriRo x OiRer 1.52 2.63 5.80 1.22 1.54 3.37 No Yes Yes No No Yes MC charge RigRer fees OriRo cRarge RigRer fees OriRo cRarge RigRer fees Firsi Session MC x OriRo MC x OiRer OriRo x OiRer Toial per Designation MC x OriRo MC x OiRer OriRo x OiRer 1.88 2.86 5*21 3.29 3.01 4.81 No Yes Ye 3 Yes Yes Yes MC cRarge RigRer fees OriRo cRarge RigRer fees OriRo cRarge RigRer fees MC cRarge RigRer fees OriRo cRarge RigRer fees 185 fees and Other professionals * fees. Also in each case the anticipated ranking of fees holds. Data on annual income derived from counseling activities are also examined. Tahle 2 * f provides this income distribution, and shows the median income for the entire sample and for each professional designation. Here again, the anticipated ranking from Orthodox to Marriage Counselor to Other is maintained. These data are then analyzed (see Table 25) using the Kolmogorov-Smimov two- sample test for significance since these data are based on an open-ended scale not amenable for manipulation to 23 standard scores. The K-S test is capable of determining whether or not two samples represent similar or different populations. These differences in the distribution may refer to central tendency, dispersion, and/or skewness. Table 25 presents the obtained statistic D and the D neces sary to reject the null hypothesis at the .05 level of significance. The same pattern which was found in analyzing specific counseling fees obtains here. There is no difference in annual counseling income between Marriage Counselors and Orthodox professionals, but there is a sig nificant difference between Marriage Counselors and Other professionals, and between Orthodox and Other professionals. To examine whether the level of education achieved by the ^Siegel, op. cit.« pp. 127-136. 186 table Bi annual INCOME FROM COUNSELING ACTIVITIES BY PROFESSIONAL SELF-RESIGNATION Professional Designation Median Income Zero Order All professional designations Marriage Counselors Orthodox Mental Health Other $ 795oo,oo 7,4-00.00 io,335*oo 665*00 Lesa than a Doctorates All professional designations Marriage Counselors Orthodox Mental Health Other $ 6 , 50 0.0 0 6,*+30.00 7,190.00 4-27*00 Doctorate: All professional designations Marriage Counselors Orthodox Mental Health Other $ 9,320.00 8,160.00 12,030.00 798.00 187 TAELS 25 KQMQGOROV-SMIRNQV TEST ON ANNUAL INCOME FROM COUNSELING ACTIVITIES Obtained D D Needed to Reject H q Significant Zero Order: MC x Ortho :2& .205 No MC x Other .165 Yes Ortho x Other .265 .206 Yes Less than Doctorate: MC x Ortho .216 .311 No MC x Other .125 Al 7 No Ortho x Other .092 .393 No Doctorate: MC x Ortho .171 .28^ No MC x Other .325 .322 Yes Ortho x Other .^08 .283 Yes 188 respondent could also be Influencing the relationship, the analysis is repeated holding constant the level of educa tion. Table 25 indicates that for those individuals who do not hold a doctorate, the relationship between annual income from counseling fees and professional self designation vanishes, but for those who have earned a doctorate, the relationship remains. For those with a doctorate, there is a significant difference between Marriage Counselors and Other professionals, and for Ortho dox and Other professionals, but Marriage Counselors and Orthodox represent a similar population. Data on total annual income (see Table 26) indicate that the median incomes for the three groups are similar. However, the rank order of incomes changes from that seen in an examination of income from counseling activities. In this case, the Other professionals have the highest annual income with a median of $15,950, followed by the Marriage Counselors with a median of $1^,125, and the Orthodox Mental Health professionals with a median of $13 ,*+55* The Komogorov-Smirnov test stipulates that the entire sample represents a single population with respect to annual income • In summary, an examination of income from counsel ing activities and professional self-designation shows that the Orthodox Mental Health professionals and Marriage 189 TABLE 26 TOTAL ANNUAL INCOME BY PROFESSIONAL DESIGNATION Professional Designation Median Annual Income All Professional Designations $1^50.00 Marriage Counselors 1^,125.00 Orthodox 13,^55.00 Other Professionals 15,950.00 Komogorov-Smimov Test on Total Annual Income Professional Designation Obtained D D Needed to Reject H Sig. Marriage Counselor and Orthodox .081 .226 No Marriage Counselor and Other .133 . 2 1 * f r No Orthodox and Other •16^- .199 No 190 Counselors share similar incomes and that Other profes sionals receive less for their clinical interventions. This finding is supported by two sets of data: (1) data on average fees charged for various kinds of clinical ser vices; and (2) data on total annual income received from counseling. Data on total annual income, regardless of the source from which it is derived, indicate that all members of the American Association of Marriage Counselors, irrespective of professional self-designation have similar income s • Hypothesis IV: Perception of Carriage Counselors The fourth major hypothesis examines the percep tion of marriage counselors in four areas: reference groups, membership groups, evaluation of social status, and role models. Although each of these areas will be examined in detail, a single pattern is expected to emerge. It is hypothesized that perceptions will be guided by the individual's self-concept since perception itself is not a product of external reality alone, but is constructed through interaction with others. Using this theoretical frame of reference it is anticipated that the reference groups of dissimilar identity groups will be different, ^Dietrich C. Reitzes, "The Role of Organizational Structures," Journal of Social Issues. IX (1958), 37-Vf. Also see Shibutani. op. cit.. pp. 108-118. 191 and that perception of membership groups, social status, and role models will vary according to professional self- concept, 1, Reference Groups and Professional Self-Designation It is hypothesized that the reference group of each identity group will be congruent; that is, those identified as Marriage Counselors will use other marriage counselors as their reference group more frequently than those with other professional identities. Using the same logic it is also hypothesized that those identified as Orthodox profes sionals will cite members of the Orthodox mental health professions as their reference group, and that Other pro fessionals will choose members of other professions. How ever, it is also anticipated that some reference groups will be shared by all identity groups inasmuch as members of the American Association of Marriage Counselors may see themselves as part of a larger fraternity of mental health professionals• Data on reference groups were obtained by asking each respondent to rank three out of nine professions from whom they would be most pleased to receive praise regarding their professional competence. This device, it was hoped, would allow the respondent to indicate that group, real or imaginary, whose frame of reference he uses to evaluate and guide his behavior, Table 27 provides reference group data for the respondents* first two rankings of reference groups cross classified by professional designation* It should be pointed out that the reference groups designated by the respondent are grouped into the three identity categories used throughout this study; that is, psychoanalyst, psychiatrist, psychologist, and social worker are classi fied as Orthodox professionals; Marriage Counselors remain listed as Marriage Counselors; and Other professionals are made up of physicians other than psychiatrists, sociolo gist, ministers, and attorneys. The data show that the Orthodox professional is the dominant reference group for the entire sample, and at the same time there is a trend for each identity group to mention members of its own identity group as their reference group. For example, 32 per cent of the Marriage Counselors choose other marriage counselors as their primary reference group com pared to 11 per cent of the Orthodox and Other profes sionals. Statistical analyses are conducted; the results of these analyses are presented in Table 28. Chi square tests established a relationship between the first men tioned reference group and the identity of Marriage Counse lor, and also indicate that there is no relationship between reference groups and the identity of Orthodox and TABLE 27 RESPONDENTS * REFERENCE GROUPS BY PROFESS I ORAL SELF-DESI GMT I ON* Variable Central Professional Designation Marriage Counselor % Orthodox % Other $ Total $ First Ranked Reference Group (tt-72) (N=113) (N=88) (N=273) Marriage Counselor 31 o9 10.6 11.4 16.5 Orthodox 56.9 73.4 63*6 65.9 Other 11.1 16.0 25.0 17.6 Second Ranked Reference Group (N«69) (N=110) (N=85) (11=264) Marriage Counselor 15.9 18.2 10.6 15.2 Orthodox 73.9 62.7 64.7 66.3 Other 10.1 19.1 24,7 18.6 Table does not include NR. vo u> ANAX^SIS O F SFFFFFNCF &SOUP AND PROPSSSIONAL SiSX^P-XlES IGWATION 8 •rl ■ P 0 8 S ¥ ¥ ¥ d a d 3 S 3 1 I ft I W M b f l d H d 0 WO ftO ft o g e g o g o f t o f t t o 1 4 4 ~4 4 0 0 4 ) &8 2I2&2 m u - < H W < H A 5 ) 4 pA 5 ) 0 f t 0 f t 0 f t t d a ! < d W W W ■ P ¥ - P d A 4 o o o 2 2 2 3) to to d 4 d 0 P(0 ftO ft 0 d 0 d 0 Jj o o o o ft # ' ' 194 4 ® o ® f t o f t o f t o WWW n n n n n n b f l 0 t o ® t o o < H ‘ f t 4 9 A9A0 0 f t 0 f t 0 f t i d c d c d W W W 0 1 0 0 -H o o o o o o o o w H M H S S S S S ( 0 0 0 o o o o o o o o 00 0 o o o o o W !* & f t 0 1 J- O IO JO IJ -O IO IO J J-CMOICMj-CMCMCM j- 01 01 C M J- C M cvj C M '0coO'-oo\a)tfNON I NOUNt SOONl O O r n O J O I N r O l A O l 0 ) H rl O O H O t S v O r l C ' - rl 00 UN O r l O O l ' l t d O W lo N j- o • o i t o o « t o o N j - ' O r O U N r l ^ r l 00 ro 00 rl rl J t C M C M C M ^3 01 H J S O N ro r l ^0 r l A « • « • • r l J r C M ro 0 rl A c d •H f t 0 0 0 0 d d s * 0 d t f t f t 0 0 0 < H < H < H 0 0 0 P W W W p f t P P P -H 0 0 0 f t f t f t f t X) § o o 4 8 4 0 d o 0 w 0 A 0 f t 0 0 0 0 0 0 0 d d d 0 0 0 f t f t f t 0 0 0 <H <H <H 0 W r l rl rl K P,® ft® ft® WK ft A A A gagMgog g K X « nfiNhXliHhoK 4cA c5 cb cS40 ft -P • 0 ft -P 0 0 0 to04 0 0 00 o 4 O r l O P 040 0 ¥ 4 d m d f t d g d 4 d 0 doooOoOod® ft ft ft 3 f t h f t f t f t 3 f t d4 fJ4 d o 0X5 04 0 0 • N o d O O < H • ' H d ^ d ' f t O ' H <H ft 3 ft 3 ft4 ®<H ®9 0 3 ®4 0 00 0 O-Pfq Offl W WPffl 0 0 f t f t 0 0 f t ?! 2! 0 ft a g o P ¥ f t •H f t ¥ -rl 0 W f t 4 x5 0 0 0 0 4 d 0 0 4 d 0 0 0 f f l W W W M H M 0 f t 5 8 0 W W W X w® Wo WO WM W . d w d w d w d , d f t o 0 0 0 f t 0 o f t H f t f t H f t o f t 40 0 0 0 4 0 . . ¥ • Q ft -P 0 0 ® t o 04 0 0 ®0 ® 4 ¥ v v w | i n ^ y / v i i r w i i ; 4 § r a d f t d ^ d 4 § 04 0 0 0 0 0 0 0 d d d o o o ft ft ft 0 0 0 < H < H < H a A a ¥ -P ■ ¥ 0 0 0 f t f t f t •rl -rl -rl W W w H M X d O rl 0 0 A f t 0 ¥ 0 d4 d4 d o or _ . • 0 d 5 d o O H "ft §<ft dft O'H l H f t3ft3ft4 0 <H 0 0 0 0 04 p OcS c U OPOtOpc) w WPfq ftooftftooft w a s o w a s o 4 8 0 WWW d4 d4 d <!8S882 ob a b f t 0 0 w a s 4 d 0 4 4 0 3 «! 0 0 01 , . 0 0 K WO WO WO WX w a 8 ' 8 b 8“ 8 i,8 oftHftKftXftoft d O c5 cS U 4cS ¥ • 0 ft ¥ 00 b0o4 0 0 00 0 0r l0f 04g 0 4dmdftd+?d4d 8 S « ° S ° 5 8 S 0 04 04 0 0 0 < H * 5 H d < H f l < N 0 < H 4 o < h o3 g 3 o4 g fWpg w «+3g f t f t o 0 f t o w a s o H 0 f t ¥ 8 O f t 0 4 f t 0 0 f t 0 w 4&® 04H !> ftp • rl (dWR 0 r l • w * O-H-rj'H WM i 0 I tijj . H4 (dWW w > ^ a 0 Or!-HU Wo m ^ o 195 Other professions. The latter two groups do not show as great a tendency to identify different kinds of reference groups. The relationship between reference group and self- concept vanishes when a second reference group is used, and all identity groups predominately list Orthodox profes sionals as their reference group. Perception may also be organized around some cen tral principle so that those who perceive that their role has a great similarity with that of the physician may "be more likely to use an Orthodox reference group. In order to see whether reference groups are influenced by this role model, perceived similarity with the medical role is held constant. Data analysis (see Table 28) reveals that for those respondents who do not see their professional role modeled after that of the physician the relationship between reference group and identity as a Marriage Counse lor all but vanishes, although it remains unchanged for those who do see their role patterned after that of the physician. In other words, the perception of role influ ences the choice of reference group. 2. Membership Group Perception and Professional Self-Concept Closely aligned to reference group perception is membership group perception. If a reference group is a group which one uses to evaluate and guide one's conduct, 196 then a membership group is that group in which the individ ual perceives he is a member; he accepts and is accepted by other members as a colleague• It is assumed that the individual will identify himself as a member of that group which is most attractive to him and in which he feels accepted, and therefore it is hypothesized that the group he identifies as his membership group will have a close correspondence with the title he has assumed as his primary professional designation. Specifically, the hypothesis is that those who designate themselves as Marriage Counselors will identify other marriage counselors as their colleagues; those identified as Orthodox will name other orthodox professionals as their colleagues, and those who claim they are Other professionals will recognize other professionals as their colleagues. As was the case with reference groups, it is also anticipated that there will be many who will identify orthodox mental health profes sionals as their colleagues since they may perceive them selves as a special sub-grouping within that larger cate gory. Data on membership groups were obtained by asking each respondent to check off each of nine professional groups that they felt could be considered close profes sional colleagues. Table 29 indicates the percentage out of each professional identity group which chose members TABLE 29 DISTRIBUTION OP RESPONDENTS WHO STATED THEY PELT THAT MEMBER OP GIVEN OCCUPATION IS A COLLEAGUE Occupation Central Professional Designation Marriage Counselor (K=76) % Orthodox (N=ll8) $ Other (N=94) % Total (N=*288) % Marriage Counselor 82.9 75.4 71.3 76.0 Psychologist 77.6 79.7 67.0 75.0 Social Worker 72.b 81.4 63.8 73.7 Psychiatrist 67.1 76.3 80.9 75.4 Physician 51.3 49.2 61.7 53.8 Minister b8.7 53.4 64.9 55.9 Sociologist 39.5 39.8 34.0 37.9 Attorney 3^.2 36.4 43.6 38.2 Psychoanalyst 31.6 43.2 31.9 36.5 Total 56.1 59.5 57.7 58.0 VO from the nine occupational categories as belonging in their own membership group. That is, 83 P©*1 cent of the Marriage Counselors said that they considered other marriage counse lors to be their colleagues, but only 71 per cent of the other professionals stipulated marriage counselors to be members of their in-group. Statistical analyses are com puted on these data (see Table 30) and reveal that the hypothesis does not find support with two exceptions. The first exception refers to social workers. There is a statistically significant association between identifying oneself as an Orthodox professional and identifying social workers as colleagues when Orthodox professionals are com pared with Other professionals; this is not the case when Orthodox professionals are compared with Marriage Counse lors. The other exception refers to perceiving ministers as colleagues. When Marriage Counselors and Other profes sionals are examined there is a statistically significant difference between them in identifying ministers as colleagues, although this is not true when Other profes sionals are compared with Orthodox professionals. On the whole, the hypothesis concerning perception of membership groups does not find support. Even though the data exhibited a trend in the direction of the hypothesis, the respondents showed a tendency to choose their colleagues from a wide range of occupational areas. PERCEPTXON O E * G O X X J R E ^ G - X J E i S 3 C PROPS SSI ONAIi SELP-IiESIG-lfATXON 199 0 0 0 0 f e f e f e f e 0 1 H H H £ llftft P pf £ r l r I H H a ) a } 0 ' ' 0 00 o o Phh o a a o f t a X X a O f t f t f t o d < H X 0 0 A u o X p | f j ^ o o ftopofe® a HftXdPddd aPOHOHdH c o f t a a a a odad® a 'OdftdHOH ftXoHfflHfeH 0 0P 0 i 0 ■ t r l 0 0 CO ► r l a 0 x 0 f e p X o X o 0 0 0 0 f e f e f e f e 0 0 0 0 0 0 0 0 f e f e f e f e 0 0 0 0 o 5 f e f e 0 0 0 0 f e f e f e f e NON r l 0 r o t I I 0 C O 0 1 0 N \ 0 0 1 C O i n I I i f t i S N 0 1 I A 0 I t ro N C O i C O I < f t 0 1 rO 01 CO 00 O CO » I a . t f t f t N d CO CM i N in On in H in 01 d 0 m H H i * * • • 9 i CO H H N fO H a p p p ■ H X p a ■ h A o f e jftoogogo ijAgogog ft ft ft ft H f4 ft X 0 P P P o a a a *n a 0 0 0 H f t a a a X a f t f t f t d f t X X o o f t 0 $ Hft X ®PO CO ft . . ©'d ®'d ® a « 8 3 d a a | d oa o opo f t o o o o x o o rl ft Hdd d o oaa a f t o f t f t f t a oo o f e X ft ft ft S 0 dux 0 0 0 0 x 1 dfe a f t op a f e a ftftX 3 p pd opoho ' (Oft a . ad ad a • p d f t d H o h ftXaHaHfeH oa o opo jXftooooXo app p H f t f t HUH 000 OHH 00 Xfefe o p P !>*S 0 r l 0 A o f e a aPP p f t H o H 0 f t 0 0 CO a f t f t f t dftX X ftoftafea coft a a • o an dft Qci ft x 3h aHfeH 0 0 o OPO XftOOOOXO f t a s o H f t f t f t OHH H OOO 0 H H H X00 0 ft ft ft POO 0 fto 0 0 acoco c o o , dftX 0 0 0 0 X J ^ 2* f t o p a f e ® HftXpPddd opo HO Sid h coft a a a a od ad a a • odHdHOH ft X an oHfeH oa o OPO Xftooooxo ft S 2 o .XX X aoa a a A I M M H X X X H00 0 033 3 0 xajl a N N in ( M t « 0 1 ill I 0 0 0 0 HOO 0 H H oaa a OHH H A P 0 oomo f e f e . 0 f e f t o H H H (M ft ft H OI HH H « H H H ft H H H ft H H H ft H H H 0 \ i H O N ON 01 CO ro C O 0 1 X X X a fe p 0 X® ■ h ft ft d poo o f t O O o add d §ftx x ®a oo , fea o o X PH idfe a oh ftoppfea o HftXdPddo opo Ho dft ftoPafea x HftXdPddO aPO ho HdH dft a coo© d & J d O oa o oPo XftOOOO X3 f t 2 s 0 •odHdnod ftxanaHfed 0® 0 OPO XftOOOOXO H S o o X dftX X , 00 , f e 0 0 X P ftolafe® 0 ® HHXdPdfeS OPO H° Hd H d f t a a a a od ad a a ‘0 Sd ft x anaHfeH oa o oPo Xftooooxo f t S 2 ! o TABLE 30— Continued Variable x2 DP* Sig. Direction Prof. Self-Concept x Colleague Perception of Attorney 1.83 2 No MG and Ortho x Attorney Colleague .02 1 No MC and Other x Attorney Colleague 1.59 1 No Ortho and Other x Attorney Colleague •8k 1 No Yates* correction used when degrees of freedom equal one. 200 201 3• Status Perception and Profes sional Self-De sijgnaiion- Self-concept may influence how the individual per ceives others' status. That is, if the individual has a self-concept which ensures his self-respect he can per ceive others as his equal, but if his self-concept does not support his self-esteem then he may bolster this low 25 self-esteem by perceiving others as his inferiors. In expanding this conceptualization to professional self- concept it is probable that members of a new profession whose appropriate roles have not been clearly defined may find that the ambiguity of their profession fails to sup port a high level of self-esteem. Therefore, it is hypothesized that Marriage Counselors may overestimate their status more than either the Orthodox or Other pro fessionals who frequently identify with long-established and generally respected professions. Specifically, it is hypothesized that those who think of themselves as Marriage Counselors will perceive fewer occupations as having higher status than their own as compared to Orthodox professionals and Other professionals. Data on status perception were obtained by asking respondents to check from nine listed occupations those ^Salomon S, Rettig, et al., "Status Overestima tion Objective Status, and Job Satisfaction among Profes sions," American Sociological Review, XXIII (February, 1958), 75=81:------ ---------- 202 which, they felt were granted higher status in the community than that of marriage counselor. Table 31 shows the per centage within each professional identity group that checked an occupation as being accorded higher status than that of marriage counselor. In order to compare these data for each identity group, the average percentage of responses indicating superior status was computed. The average response for Marriage Counselors was 37*3 pe* cent for Orthodox it was *f6.6 per cent, and for Others it was M+.2 per cent. On the basis of this average response index for each professional identity group, the hypothesis receives support. Chi square analyses were also conducted, and are presented in Table 32. Three of these analyses indicate a relationship between status perception and professional self-concept and in each of these three cases the relation ship is in the excepted direction. Chi square indicates a relationship between professional identity and perceiving psychologists as having superior status. There is a sig nificant difference between Marriage Counselors and Ortho dox professionals in their perception of psychologists, and between Marriage Counselors and Other professionals* In both instances Marriage Counselors are less prone to judge the psychologist as having superior status• The same pattern holds for the status perception of both TABLE 31 DISTRIBUTION QP RESPONDENTS WHO STATED THAT MEMBERS OB GIVEN OCCUPATIONS ABE ACCORDED HIGHER STATUS IN THE COMMUNITY THAN MARRIAGE COUNSELORS Occupation Central Professional Designation Marriage Counselor (N=73) % Orthodox (N=115) % Other (N=88) % Total (N=276) $ Psychiatrist 89*0 91.3 94.3 91.7 Physician 80*8 88.7 84.1 85.1 Psychoanalyst 74,0 74.8 68*2 72.5 Psychologist 31.5 53.0 50*0 1* 6. 1* Attorney 32*9 51.3 1*7.7 45.3 Minister 17*8 33.0 1* 1*.3 32.6 Sociologist 6.8 14.8 18.2 13.8 Social Worker 2.7 8.7 6.8 6.5 School Teacher 0.0 **.3 6.8 4.0 Total 37.3 1*6.6 1*6.7 44.2 ro o OJ TABLE 32 ANALYSIS OF STATUS PERCEPTION BT CENTRAL PROFESSIONAL SELF-DESIGNATION Variable Sig . Direction Prof. Self— Desig. x Superior Stains of Psychoanalyst 1.20 MC and. Ortho x Superior Status of Psychoanalyst 0.00 MC and. Oilier x Superior Status of Psychoanalyst .39 Ortio and Oilier x Superior Status of Psychoanalyst 0.77 Prof. Self—Desig. x Superior Status of Psychiatrist 1 .*+-9 MG and. Or “ trio x Superior Stains of Psychiatrist .07 MC and Oilier x Superior Status of Paychiatrist .86 Ortdao and. Oilier x Superior Status of Peyohiatrist .30 Prof. Self—Desig. x Superior Status of Ehyaician 2.30 MC and. Ortho x Superior Status of Physician 1.66 MC and Oilier x Superior Status of Physician .11 Ortho and Other x Superior Status of Physician .56 Prof. Self—Deaig. x Superior Status of Psychologist 9*01 MC and Ortho x Superior Status of Psychologist 7*53 MC and Oilier x Superior Status of Psychologist h- .92 Ortho and Oilier x Superior Status of Psychologist .08 Prof. Self—Deaig. x Superior Status of Social Worker 2.62 MC and Oriho x Superior Status of Social Worker 1.75 MC and Oilier x Superior Status of Social Worker .67 Or ill o and Oilier x Superior Status of Social Worker .05 Prof. Self—Concept x Superior Status of Sociologist * + ■ .*+9 MC and Ortho x Superior Status of Sociologist 2.01 MC and Oilier x Superior Status of Sociologiai 3*57 Ortlio and Oilier x Superior Status of Sociologiai .21 2 1 1 1 2 1 1 1 2 2 2 2 2 1 1 1 2 1 1 1 2 1 1 1 No No No No No No No No No No No NO Yes Yea Yes No No No No No No No No No Oriho perceive higher stains Orilio perceive iiiglier stains Other perceive higher stains ro TABLE 32— Continued Variable X2 DF* Sig. Direction Prof. Self-Concept x Superior Status Other perceive higher of Minister 12.78 2 Yes status MC and Ortho x Superior Status of Ortho perceive higher Minister 4.50 1 Yes status MC and Other x Superior Status of Other perceive higher Minister 11.72 1 Yes status Ortho and Other x Superior Status of Minister 2.23 1 No Prof. Self-Concept x Superior Status Ortho perceive higher of Attorney 6.4-3 2 Yes status MC and Ortho x Superior Status of Ortho perceive higher Attorney 5.^2 1 Yes status MC and Other x Superior Status of Attorney 3.02 1 No Ortho and Other x Superior Status of Attorney -13 1 No Prof. Self-Concept x Superior Status of School Teacher 2 No MC and Ortho x Superior Status of School Teacher 1.80 1 No MC and Other x Superior Status of School Teacher 3.60 1 No Ortho and Other x Superior Status of School Teacher .21 1 No *Yates’ correction used when degrees of freedom equal one. ro o v n 206 ministers and attorneys• In tooth cases Marriage Counselors are less likely than Orthodox professionals to see those occupations as having a superior status. There is no sig nificant difference between Marriage Counselors and Other professionals in their perception of attorneys. Overall then, the hypothesis regarding status perception receives support even though only three of the nine occupations differentiated the professional identification groupings. b . Role Perception and Profes sional Designation It is conjectured that professional identification influences the perception of professional role. Two aspects of professional role are examined; the first deals with role model, and the second with role satisfac tion. Role model data are obtained toy asking the respon dent to what degree he feels his current role is similar to that of the physician. It is hypothesized that Ortho dox professionals will see their role as toeing closely patterned after that of medicine since the traditional psychotherapists in the United States have been psychia trists. However, those identified as Marriage Counselors and Other professionals are not expected to have adopted this model since they have more recently entered the field of psychotherapy, and may use some of the growing numbers 207 of nonmedical psychotherapists as their model. Perception of role satisfaction is based on the respondents* answer to an item asking them to indicate the degree to which they are satisfied with their current pro fessional role. In this case, unlike the one dealing with role model, it is hypothesized that there will be a sig nificant difference between Other professionals and Marriage Counselors as well as Orthodox professionals. Other professionals are not expected to be as pleased by their role since at least one aspect of their current work- counseling— is not central to their self-concept. Data on perception of role model cross-classified by professional self-concept is presented in Table 33* The model view of all marriage counselors is that their role as a counselor shows only some similarity with that of a physician. Statistical analyses— including and excluding the fifteen respondents who are physicians and who thus might influence the findings— fail to support the hypothe sis. There is no relationship between professional self- concept and perceiving the role of a counselor as being patterned after that of a physician. Data on role satisfaction cross-classified by pro fessional self-concept are also provided in Table 33* Two-thirds of the entire sample report that they are highly satisfied with their professional role, and only TABLE 33 ROLE PERCEPTION BY PROFESSIONAL RESIGNATION* Central Professional Designation Variable Marriage Counselor % Orthodox % Other $ Total % Role Perceived as Similar to Physicians (N=7*0 (N=ll5) (N=92) (N=28l) Almost identical 1.^ 5.2 6.5 ^.6 Strong Similarities 1^.9 17 A 15.2 16.0 Some Similarity Mf .6 J+7.0 *f0.2 Mf.l No Similarity 12.2 7.0 15.2 11.0 Role Satisfaction (U=A) (N=ll8) (N=9^) (N=286) Highly Satisfied 71.6 69.5 62.8 67.8 More or Less Satisfied 27.0 26.3 31.9 28.3 Somewhat Dissatisfied l'b 2.5 5.3 3.1 Quite Dissatisfied 1.7 .7 *Table dies not include NR. ro o co 5 per cent indicate that they are somewhat or very dis satisfied with it. Analysis of these data (see Table 3*0 provides no support for the hypothesis that Marriage Coun selors and Orthodox professionals are more satisfied with 26 their roles than Other professionals. In order to examine these data more carefully income received from counseling activities is controlled, but this did not influence the relationship. Summary In summary, perception of reference groups, member ship groups, status of other occupations, and role models have been examined. It has been hypothesized that percep tion in these four areas will be associated with profes sional self-designation. In two areas, reference group perception and evaluation of social status, the hypotheses received at least partial support, and in the other two areas the hypotheses are not supported. In the first hypothesis, reference group percep tion, there is a relationship between identifying oneself as a Marriage Counselor and having marriage counselors as a reference group. There is no apparent tendency for the other self-concept groupings to favor a given type of 26In analyzing these data the categories labelled more or less satisfied, somewhat dissatisfied, and quite dissatisfied had to be collapsed into one category due to the small size of the cells. ANALYSIS O.B1 ROT . E i^JEtCS £11OU BY PROFES SIONAL KES XGNAT ION 2 1 0 0 0 0 0 & a & & 0 0 0 0 a a a f t 0 0 0 0 15 & a a 0 0 0 0 & & a & 0 ro C O 01 0\ c0 01 H 1 • • • vfl rn p0 i i n 0 I S O N N i H I 0 s • c < i n 0 1 0 1 i rO 01 N IS 0 rl IS I I I ' rl rl (0 01 rO 0 I I 0 0 I 0 01 01 0 1 rl H H H 0 0 0 ■rl p Pt J 0 • 3 3 0 0 ■ r l H ■ p f f t .ft *Pi 'da OflftflOflO o • 0 • 0 o d a d a d a p I D 0 0 X, f t o h o f t o , d p p P d f t X X, X. ftft d p. d 0 rl p d 0 rl p ofl 0 p, .ft *ft * d a ’ V I rl ' ' <r ' ' ' ' ffi.HO'HO-H r f f l t o t o W (OH f t f t o • (!) d ® d o> opq <HH 3h 00 0 0PH d t f q p j o f t d o 1 n o 0 ' 0J 0 'fto d a d a d a p j) o ) o X, f t of tof to , d p p P d f t 1 4 « Mr! d d d £ | H « ( t f 0 si ^ cfl-P £ Wrljdrf ® r | O r rl H rl ¥ P P (0 nl (0 ® to to to rl s ID 0 0 f t r l H H o o o f t f t f t 0 HI 0 rl rl rl ¥ ¥ ¥ cd a) cd to to to [0 to ( O w n H H ftH CdH X , d H X X s . f t f t • o d J , S S m* d ¥ P 0 Or) ¥ Ip o ft ft X X • 0 1 0 f t ■rl* f d rl 0 f t ftd P0 O H p f t 0 0 0 0 0 f t f t f t f t 0 0 0 0 f t f t f t f t O O i i i O J i i 01 rl H rl f t H H H O l r l H H 01 rl rl rl O l r l H H * 9 r o f t O ( 0 i O f f l N • i • 0 CO H CO i 0 0 rl 0 f t X d (D ftd PO O H ¥ ft o o q q o f H d f t O f t O P l d O ft a 2 1 o fto 0 odft H f t H f t H to • P d P d P O H H O B O f t O f t P Oft ft ftPft d H o w g n d t o ft a 2 i o io o N ' h H f t H f t H • P d P d P O H H O B O f t O f t P Oft ft ftP f t MQWO<Hji|tO ft a a o f t a f t d 0 0 d ID H rl H p p p f t f t f t to to to H H H o o o f t j f t f t X X x • o d t o f t H * P Oil d |0 0 O f lH H ft H ft H i p r i p d p o r l H o B O o q f t P O f t f t f t p f t j l H O H g H d t O I 0 0 m H 0\ (DID ON ftfli 0 » 001 rl H p p to to to H rl o q f t f t P i X X X (D H 0 f t X d H H H ¥ ¥ ¥ ft ft ft ID to to to H j ) J ) 0 f t H H H o q f t p P 0 O H p fto • 0 NL A ■ H! f ID* X 0 flO H f t H f t H in • P d P ftp O H H O B O B O f t P Oft ft ftPft d H Q H g H d t O pi a a 0 I 0 0 in X d ID a d H PO 0 O H ft ¥ P fto d H H $ " H O s ft ft ft x x x • o \ a H * P to* d 0 0 OftH H f t H f t H 0 • pdPBPOH H 0 ft 0 ft O f t P O f t f t f t P f t d H g n g H d t o pi a a o 0 0 0 too" doi s a H Sot s a g sas rl H ID H P 0 to f t (D rl id H I D a H 0 P f t f t <D tO H ® 0 H H 0 fl B 0 ID ID I) h d aj o • a f t f t d ® f t t o 0) 9 oi d 0 A J d o rl P 9 ' 0 9 f t 0 0 d n PH 0 1 ftH ftP P 3'H ft ofl jH 0 * 4 0 * P H $ f t reference group, For the second hypothesis, perception of membership groups, there is no significant relationship between pro fessional identification and selection of membership group ings even though the data exhibited a trend in the direc tion of the hypothesis, The data provide partial support for the third hypothesis, evaluation of other occupations status. The status of psychologists, ministers and attorneys are asso ciated with the respondents' central professional designa tion; and the overall average rate accorded to other occupations high status supported the hypothesis. Data on role perception, covering both role model and role satisfaction, provide no support for the hypothe sis that professional identification will influence percep tion. Hypothesis Vi Therapeutic Orientation of Marriage Counselors The fifth hypothesis examines the therapeutic orientation of members of the American Association of Marriage Counselors. Two measures of theoretical thera peutic orientation are employed. The first measure refers to the criteria used by marriage counselors to categorize the work of other professionals; and the second is the respondents' therapeutic orientation based on responses to 212 a forty-five item Therapeutic Orientation Scale, con- 27 strueted hy Sundland and Barker. The general hypothesis is that those individuals whose self-concept is that of Marriage Counselors, and who therefore may ho expected to have identified with other mental health practitioners will resemble Orthodox Mental Health professionals, hut Other professionals who it may he assumed have not identified as closely with the tradi tional mental health professions, will he more idiosyn cratic in the criteria they use to categorize the work of others, and in their therapeutic orientation. Bata on criteria used to classify other mental health professionals were obtained by asking each respon dent to check one out of five possible criteria that he might use in differentiating or categorizing professionals in the mental health field. The criteria included: (1) the professional designation and membership of the practitioner, that is his occupational affiliation such as psychiatrist, clinical psychologist, marriage counselor, or psychiatric social worker; (2) the functions and activi ties of the practitioner, such as therapist, researcher, teacher or administrator; (3) the therapeutic orientation of the practitioner, such as psychoanalytic, 2?Bonald M. Sundland and Edwin N. Barker, "The Orientations of PsychotherapistsJournal of Consulting Psychology, XXVI (1962), 201-212. 213 sociotherapeutic, or somatotherapeutic; (k) the setting of the practitioners* practice, for example, private practice, or practice in an agency or institution; and (5) the amount of experience in therapeutic work. The responses, cross-classified by professional self-designation, are presented in Table 35. The modal response of the sample is to use the professional designa tion and membership of the practitioner for purposes of classification; however, a second choice centers on the functions and activities of the practitioner. Although, these are the two most frequent responses of the entire sample, there is a great deal of variation in the criteria selected according to professional self-concept. For example, the modal response for both Marriage Counselors and Orthodox professionals is the practitioners* functions and activities, but for the Other professionals it is the professional designation and membership of the practi tioner. Table 36 gives the results of the statistical analysis of these data. An overall significant chi square indicates that there is a relationship between criteria used for categorizing professionals and professional self- concept. Then taking two groups at a time, the statistical analysis provides greater support for the hypothesis. There is no significant difference between Marriage Coun selors and Orthodox professionals, and there is a TABLE 35 CRITERIA USED EUR CATEGORIZING PROFESSIONALS BY PROFESSIONAL RESIGNATION* Central Professional Resignation Criteria Marriage Counselor % Orthodox % Other % Total % Criteria Used for Categori zation (N=72) (N*89) (N=115) (N»276) Professional Resignation and Membership 34.7 28.1 44.3 36.6 Functions and Activi ties 4o.3 32.6 29.6 33.3 Amount of Experience 5.6 20.2 18.3 15.6 Therapeutic Orienta tion 11.1 11.2 3.5 8.0 Setting and Other Criteria 8.3 7.9 4.3 6.5 *Table does not include NR. TABLE 36 ANALYSIS OF CRITERIA USED FOR CATEGORIZING PROFESSIONALS BY PROFESSIONAL SELF-DESIGNATION Variables e g DF Sig. Direction Prof. Self-Concept x criteria 19.^1 8 Yes Other use Prof, Desig. and Membership more than others, and Funct. and Activities less MC and Ortho x Criteria 7.^2 * f No MC and Other x Criteria 13.19 I f Yes Other use Prof. Desig. and Membership more than others, and Funct. and Activities less Ortho and Other x Criteria 9.36 k No 216 significant difference between Marriage Counselors and Other professionals. The data on Orthodox and Other pro fessionals yields a chi square of 9.362 with four degrees of freedom, which falls just short of significance at the •0? level. On the whole, the data support the hypothesis. Data on the respondents* theoretical orientation were obtained by calculating their scores on the forty- five item Therapeutic Orientation Scale, The scoring was based on a seven-step Likert scale, responses ranging from strongly agree to strongly disagree. The scale has been factor analyzed; the scale is said to differentiate people along a continuum ranging from a Freudian psychoanalytic dimension to a Rogerian experiential dimension. Although the scale consists of forty-five items, there are two statements, one positive and one negative, for each attri bute which makes up the scale. These attributes include the following items: Affective therapeutic gains referring to the importance that is attached to the patient*s increased ability to experience his own feelings. Creative aspects of the therapist, which refers to the question of whether the training of the therapist or his personality is the most impor tant therapeutic factor. The criteria used to judge the success of therapy whether it emphasizes adjustment to society or not. Cognitive therapeutic gains referring to the value placed on the patient*s increased under standing of himself. Conceptualization of the therapeutic relationship, that is, the emphasis placed by the therapist on the intellectualization of the patient’s relation ship to him. Directiveness of the therapist’s interventions, or the degree to which the therapist offers overt advice to the patient. The emphasis placed on the importance of ego con trols; that is whether or not the presence of anxiety or depression is always considered unhealthy. The frequency of activity which refers to the desirabilily as seen by the therapist in his tak ing an active role in relation to the patient* Goals of therapy refers to whether or not the therapist has particular goals for his patient. Interruptive activity which refers to the therapist’s view of interrupting his patient while he (the patient) is talking. Informal behavior which refers to the view that the therapist has of seeing the patient only in a formal setting, or if he feels that it is alright to have some informality in the thera peutic setting, such as going for a walk together. Learning process in therapy which focuses on the kind of learning that takes place in therapy placing emphasis on verbal conceptual learning or on affective non-verbal learning. Personal involvement refers to the way the therapist views his personal involvement with the patient• Planning of the therapeutic relationship, and spontaneity in the therapeutic relationship are closely related which refer to the therapist’s view of his own behavior in relation to spontane ous or carefully thought-out behavior. Type of activity, which refers to the "depth of interpretations" that the therapist offers his patient. 218 Topics important to therapy refers to whether the therapist feels that discussion of the patient’s early childhood is crucial. Theory of motivation focuses on the importance the therapist gives to explaining behavior on the basis of unconscious processes. Theory of personal growth, or the commitment that the therapist has in a self-actualizing theory of growth. The importance that the therapist gives to his own sense of security in the therapeutic situa tion. - The use of auxiliary techniques such as drugs to lessen anxiety or shock treatment. The use of psychoanalytic techniques including the analysis of resistance and interpretation of dreams In order to analyze these data, the respondents' score on each item was determined, with high scores indi cating a Freudian conceptualization and a low score an experential orientation. Total scores could range from a low of *+5 to a high of 315 • 5fhe mean score fox* each iden tity group was computed. The mean score on the Therapeutic Orientation Scale for Marriage Counselors was 170.1*+ with a standard deviation of 22.10; for Orthodox professionals it was 169.*+7 with a standard deviation of 19.52; and for Other professionals it was 168*02 with a standard devia tion of 29. 06. Statistical analysis revealed that in no Ibid. 219 29 case was the null hypothesis rejected. ' In order to examine these data more closely, a one way analysis of variance was carried out on each item, that is twenty-three tests were made* (See Appendix 0 for the complete tables on these analyses.) Out of the twenty- three analyses, one (or 4 - per cent) yielded an F ratio sufficiently large to reject the null hypothesis at the *05 level of significance • This item referred to the theoiy of personal growth. The mean score for Marriage Counselors on theory of personal growth was 3*67» for Orthodox it was 3«95> and for Other professionals it was *+.82. It may be concluded that professional self-concept and therapeutic orientation are not significantly related variables if one can accept the validity and sensitivity of this scale. The latter is somewhat questionable, or at least the evidence for it is not available since this scale has not been extensively used, and is only based on the responses of psychologists who have listed psycho therapy as their first or second field of interest. The authors state that ... the sample is representative of therapists practicing individual psychotherapy with adults, but probably under-represents those who practice mainly as group therapists, or as child therapists. 29Zs .19 for Marriage Counselors and Orthodox; Z= .53 for Marriage Counselors and Other professionals; and Z=.U-1 for Orthodox and Other professionals. 220 A second limitation, which is inescapable, refers to the sampling of items. Although the litera ture was searched exhaustively for issues on which therapists might differ, it is possible that there are important categories of attitudes^ and methods which did not appear in this study ,^u In conclusion, the hypothesis concerning the thera peutic orientation of Marriage Counselors, based on two measures, partially supports the hypothesis that self- concept is associated with the criteria used to judge other mental health professionals, and with their theoreti cal therapeutic orientation. The first part of the hypothesis, referring to criteria used to judge mental health professionals was supported. Marriage Counselors and Orthodox professionals use similar criteria, and Other professionals use different criteria. The second part of the hypothesis, referring to therapeutic orientation per se, as measured on a Likert scale of Therapeutic Orientation fails to support the hypothesis. However, it must be pointed out that the scale itself might not be sensitive to whatever underlying differences may exist. The authors of the seale--Sundland and Barker— suggest that the scale may not be representa tive of this kind of a clinical population. ^Sundland and Barker, loc. cit. 221 Summary In this chapter, the sample was described and data referring to five different hypotheses were tested. These hypotheses included: (1) the social characteristics of marriage counselors and their parents in relation to pro fessional self-designation; (2) preparation for a profes sional career in marriage counseling in relation to pro fessional self-designation, which focused on educational preparation and didactic psychotherapy; (3) careers in marriage counseling and professional self-concept focused on the structure and amount of practice, the independence or dependence of the profession, types of therapy conducted, social characteristics of the patient, and income earned; (4-) perception of marriage counselors and professional self-designation with respect to reference groups, member ship groups, evaluation of the social status of other occupations, and role models; and (5) the therapeutic orientation of marriage counselors and professional self- concept with emphasis on the criteria used to categorize other professionals in the mental health field, and theo retical orientation in psychotherapy. The summary tables on the following pages present the findings for these hypotheses and list the null hypotheses as well as indi cating what the original prediction was. In general, professional self-concept was found TABLE 37 SUMMARY TABUS , HYPOTHESIS I: SOCIAL CHARACTERISTICS OP MARRIAGE COUNSELORS AND PROFESSIONAL SELF—DESIGNATION 1. Social Charaeteristica of Marriage Counselors and Professional Self-Concept Nu.ll Hypothesis Prediction Findings There is no difference in age, sex, marital status, family of procreation, race, reli gion, and. political orienta tion among tLe tLree profes sional identify groups. Anticipated null hypothesis. Null hypothesis was not rejected except in tlie case of sex; Marriage Counselors Lave higher proportion of females. There is no difference in ecological variables of regional location, size of area, and nativity among tLe three professional, identity groups, Anticipated null hypothesis. Null hypothesis was not rejected. There is no relationship between highest level of attained. education and pro fessional self-concepts. Anticipated null hypothesis. Null hypothesis was not rejected. 2. Sor*.i ql sti na of Pami 1 y nf nrientation and Professional Self-Concept Nu.ll Hypo flie sis Pre die tion Findings There is no difference in parental education, socio economic level, nativity, religions affiliation, political orientation, and presence of parental illness among the three professional identity groups. Anticipated null hypothesis. Null hypothesis was not rejected for the follow ing: education, socio economic level, nativity, and parental illness . Null hypothesis was rejected for parental, religious, and political orientation . TABLE 38 SUMMARY TABLE, HYPOTHESIS II: PREPARATION FOR PROFESSIONAL CAREER AND PROFESSIONAL SELF-CONCEPT Null Hypothesis Prediction Findings There is no difference in educational specialization and professional self- concepts o There is no difference in engaging in continued training and professional self-concepts. There is no difference in engaging in psychotherapy and professional self- concepts . Anticipated rejection of null hypo the sis, and acceptance of alternative hypothesis that there will be congruence between self-concept and educa tional specialization. Anticipated rejection of null hypothesis and acceptance of alternative hypothesis that Orthodox will engage in continued training more frequently than the other two iden tity groups. Anticipated rejection of null hypothesis, and acceptance of alternative hypothesis that Orthodox will have the most con tact with psychotherapy, followed by Marriage Counselors, and then by Other professionals. 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PHO OOr i H 4 ® fflp TABLE hi SUMMARY TABLE, HYPOTHESIS V: THERAPEUTIC ORIENTATION OP MARRIAGE COUNSELORS Null Hypothesis Prediction Bindings There is no difference in the criteria used to cate gorize the work of other professionals and profes sional self-concepts. There is no difference in theoretical orientation and professional self- concepts . Anticipated rejection of null hypothesis with respect to Other profes sionals, hut null hypoth esis expected to hold for Marriage Counselors and Orthodox professionals. Anticipated rejection of null hypothesis with respect to Other profes sionals, but null hypoth esis expected to hold for Marriage Counselors and Orthodox professionals. Null hypothesis rejected; there is a significant difference in criteria used by Marriage Counselors and Other professionals, but no difference between Marriage Counselors and Orthodox, or between Ortho dox and Other professionals, Null hypothesis was not rejected. ro r o oo to discriminate certain /behaviors quite well. These behaviors included preparation for practice in terms of educational specialization; the structure and amount of practice with reference to primary position, location of office, amount of time spent in practice, and in the carrying of liability insurance; in the type of therapy practiced, and in the choice of title for addressing the patient; in the social characteristics of the patient, and in the fees paid for professional services; and in the criteria used to categorize other professionals. On the whole, professional self-concept did not differentiate the sample with respect to most social characteristics, nor to perception of reference groups, role models, role satis faction, and theoretical therapeutic orientation. CHAPTER V CONCLUSION AND DISCUSSION OP FINDINGS Introduction Beginning with a brief summary of the study, this chapter presents general conclusions based on the data analysis, and then discusses the implications of the find ings. Only tentative statements can be incorporated since the study has focused on only one aspect of the research problem; namely, the influence of professional self-concept on behavior. The other half of the work must latex* examine the influence of membership groupings so that a valid com parison can be made regarding the relative effect of these two variables. Based on the responses to a mailed questionnaire of 292 members of the American Association of Marriage Counselors certain patterns relevant to professional self- concept and behavior emerge. Professional self-concept refers to the way the individual identifies himself. This identification is determined by the subjects answer to a question asking him what is his central professional desig nation. These responses are then placed into one of three 230 231 categories: Marriage Counselors; Orthodox Mental Health professionals; and Other professionals. The 292 respon dents divide themselves fairly evenly into these three categories with 77 respondents stating that they think of themselves primarily as Marriage Counselors; 120 respon dents indicating that they identify themselves as Orthodox Mental Health professionals; and 95 stipulating that they consider themselves to be Other professionals, that is professionals not identified with clinical psychotherapy. Although these respondents are all members of the same profession since they are all clinical members of the Association, they do not represent a homogeneous identity group. In fact, it is clear that there is no dominant professional identification among them. The problem then focuses on the question whether differentiation of the responses of these three identity groups suggests a pattern, and if so, what implications does this pattern have. In order to answer this question, data relevant to five major areas of behavior have been examined. These areas include: the social characteristics of marriage counselors and of their parents; preparation undertaken to enter a profes sional career in marriage counseling; conduct of a career in marriage counseling; perception of ancillary profes sionals; and theoretical therapeutic orientation. The possible combinations relevant to this study that can emerge from this analysis encompass the following: (1) that the responses of those identified as Marriage Counselors resemble those of the group identified as Ortho dox Mental Health professionals; (2) that the responses of those identified as Marriage Counselors are similar to those made by respondents who think: of themselves as Other professionals; and/or (3) that those identified as Marriage Counselors behave in a way that is different from either of the other two identity groups* Each one of these five areas will now be discussed to determine the patterns of association that did emerge so that it will be possible to suggest in which ways those identified as Marriage Counselors are different from their colleagues and in which ways they are similar to one seg ment or another of their colleagues* The place of the Association in the hierarchy of the mental health profes sions may be influenced by professional identification if that identification is associated with certain kinds of behavior* General Summary Eirst, turning to the social characteristics of the respondents it is clear that they represent a homo geneous group. In only two areas did professional identi fication differentiate any of the ten social characteris tics examined; and in these two areas— sex and level of attained education— those identified as Marriage Counselors and those identified as Orthodox professionals are similar. The differences that do appear are between Marriage Counse lors and Other professionals and between Orthodox and Other professionals. The analysis shows that Other professionals are characterized by a greater proportion of males and include moire respondents who have attained doctorates or other professional degrees than either of the other two identity groups. Since the category of Other professionals includes ministers, sociologists, and physicians who are not psychiatrists, this finding is not surprising. These occupations are traditionally male dominated and charac terized by specific professional training which is manda tory to gain admittance to the occupation. The social characteristics of the respondents' families of origin reveal that professional self-concept does not differentiate the respondents except for parental political and religious affiliations. Parents of the respondents who identified themselves as Orthodox profes sionals are politically more liberal than the other two identity groups, and they have a higher proportion of Jewish parents. However, in only one of four comparisons is there a significant difference between Orthodox profes sionals and Marriage Counselors. This difference refers to the political orientation of the respondents* fathers. 23^ Mothers' political orientation and both parents' religious affiliations do not discriminate between Orthodox profes sionals and Marriage Counselors, but they do discriminate between Orthodox and Other professionals* The hypothesis concerning preparation for a career in marriage counseling is based on three indices: educa tional specialisation, continued professional training, and personal contact with psychotherapy. Educational specialisation differentiates the three identity groups so that each group is characterized by an academic training that is different from that of any other group. Those identified as Marriage Counselors have the highest propor tion of respondents whose training has been specifically directed towards marriage counseling, and Orthodox profes sionals have the smallest number of subjects who have majored in marriage counseling per se. The congruence of academic training and professional self-designation sup ports the idea that professional education includes more than just learning appropriate skills, but also includes 1 an entire socialization process. Professional self-concept does not differentiate those who engaged in continued training except in one Robert K. Merton. George C. Reader, and Patricia L. Kendall (eds.3, The Student Physician: Intro ductory Studies in the Sociology of Medical Education (Cambridge: harvard University Press, 235 instance, and that is that older Marriage Counselors (between forty and eighty-nine years of age) are more fre quently involved in this type of training than are older Orthodox professionals. Since the difference does not hold for the younger respondents it might seem that they have greater confidence in their training, or at least they do not feel that they have a greater deficiency in their training than do Orthodox professionals. Another possibility is that many of the younger respondents are still trainees, and therefore are not engaged in continued education beyond that required by the rules of the Associa tion. Professional self-concept does not differentiate respondents* behavior in relation to personal contact with psychotherapy. In fact, in only one of the three variables used to examine preparation for a professional career does professional self-concept clearly differentiate the respon dents. The one significant variable is the academic train ing of the respondent which is congruent with professional self-de signation. The third major hypothesis refers to five areas which are all related to the way a career in marriage counseling is conducted. Data on the first of these five areas are based on the structure and amount of time spent in the practice of marriage counseling. These data 236 demonstrate that those who think of themselves as Marriage Counselors resemble Orthodox Mental Health professionals more than they do Other professionals. Only one out of five variables used to measure structure and amount of time spent in the practice of marriage counseling differentiates Marriage Counselors from Orthodox professionals and that variable is the amount of time spent in this practice. On the other hand, three of the five variables yield a sig nificant difference for Marriage Counselors and Other pro fessionals. These variables include: the respondent’s most important position; his description of his primary position; and the time spent in the practice of marriage counseling. Two variables fail to discriminate between those identified as Marriage Counselors and Orthodox pro fessionals or between Marriage Counselors and Other pro fessionals, but do differentiate between Orthodox and Other professionals. These two variables are the location of the office used to conduct a private practice, and the acquisi tion of liability insurance. Based on these observations, it may be concluded that Marriage Counselors and Orthodox professionals structure their practice in similar fashions, and that Marriage Counselors devote more time to the prac tice of marriage counseling than do either Orthodox or Other professionals. The second area to be examined under the general hypothesis of careers in marriage counseling refers to the independence or dependence of the profession. Data on the respondents* referral sources and on interaction with others in the mental health field are indices of the independence of the profession. It was predicted that both Marriage Counselors and Other professionals would be associated with a more independent profession than would Orthodox professionals, however, data on referral sources did not support this position. The referral sources for all three identity groups are not differentiated by pro fessional self-concept; all three identity groups rely primarily on a professional referral system which is divorced from that of the traditional mental health pro fessions. It is possible that this can be explained by the fact that other professionals in the mental health field do not see members of the American Association of Marriage Counselors as offering a service which they do not themselves offer to their patients. Otherwise, one might expect them to refer patients to those members of the Association whose education also entitles them to recognition as members of the Orthodox Mental Health pro fessions, since many professionals feel that only others 2 like themselves are qualified to practice. ^Richard X. Kerckhoff, "Interest Group Reactions to the Profession of Marriage Counseling," Sociology and Social Research. XXXIX (February, 1955), 179”1S3• 238 Data on interaction with, others in the mental health field including psychoanalysts, psychiatrists, psychologists, social workers, and marriage counselors also fail to support the original prediction that Orthodox professionals will interact with these other professionals more than Marriage Counselors or Other professionals. Analysis of these data only indicates that those identified as Marriage Counselors have a greater tendency to interact with other marriage counselors than either of the other two identity groups; and that both Marriage Counselors and Orthodox interact with social workers more than do Other professionals. Private practice, introduced as a control variable, fails to influence the general negative findings concerning the independence or dependence of marriage counseling in relation to professional self-concept. The third area that is examined in reference to the conduct of a career in marriage counseling focuses on the type of therapy offered. Data on type of therapy include what the respondent calls his therapeutic inter vention; the frequency of patient contact; and the title ascribed to the person seeking the professional's help. It had been hypothesized that the behavior of Marriage Counselors and Other professionals would be similar, and that both of these identity groups would behave in a way different from that of the Orthodox professionals. Data on type of therapeutic interventions used by the respon dents support the hypothesis: both Marriage Counselors and Other professionals offer their clients relatively little individual therapy and rely on marriage counseling and conjoint therapy, while Orthodox professionals engage in individual therapy more frequently* The second index for type of therapy— frequency of patient contact— fails to distinguish the behavior of the three identity groups. The third measure— title ascribed to those seeking the services of the professional— is associated with profes sional self-concept although not in the predicted direc tion. All three identity groups use the title client, however, those who designate themselves as Other profes sionals show a marked preference for the title counselee. These findings point to a general trend that the way the patient is approached is related to self-concept. Those identified as Marriage Counselors are unlike Ortho dox professionals in their choice of treatment approaches; they are similar to the Orthodox in the way they address the patient; and there is no difference in the frequency of seeing patients. The general pattern that has been observed already is furthered by these observations* Marriage Counselors and Orthodox professionals behave in similar ways except for the greater emphasis placed on marriage counseling by those identified as Marriage 2^0 Counselors. Both groups address the patient using the same titles, they both maintain the same frequency of patient contacts, hut they differ in their treatment approaches. Those designated as Other professionals seem, to vary their behavior in a random fashion offering counseling services to their patients, but conducting themselves in a unique way by calling those who seek their aid neither patients nor clients, but counselees. It has also been suggested that the social charac teristics of the patients would vary according to profes sional self-concept. Patients seen in private practice were examined separately from those seen in an agency prac tice. However, the hypothesis covering patients was the same although it had been anticipated that private patients would show a stronger relationship with self-concept than agency patients. The hypothesis was that the patients would not show any marked variation in terms of age, sex, race or religion in relation to the therapists* profes sional self-concept, but that the higher socioeconomic status would be the patients of the Orthodox professionals more frequently. In addition, it had been hypothesized that the more severely disturbed patients would be seen by the Orthodox professionals rather than either of the other two identity groups. The findings on private patients suggest that patients1 sex and race are not related to therapists’ pro fessional designation, but age, income, education, and diagnosis are associated variables* Significant differ ences are observed between those identified as Marriage Counselors and Orthodox as well as between Marriage Counse lors and Other professionals* Not all of these differences are in the expected direction* J?or example, Marriage Coun selors see significantly fewer very young patients— those less than twenty-one years of age— than do the Orthodox professionals* This fact can be explained as belonging to the same pattern, that argues that those identified as Marriage Counselors concentrate more of their specific activities on the practice of marriage counseling* There are relatively few married couples below the age of twenty- one who might be seeking professional help for their mari tal problems— they have hardly had time to develop them. The findings dealing with income and education are more difficult to interpret. Orthodox professionals see a few more wealthy patients than do Marriage Counselors, but r patients of Marriage Counselors have attained higher levels of education than those of the Orthodox profes sionals. One possible explanation is that many of the Marriage Counselors' patients may be associated with pro fessional occupations that have high educational require ments but are not well-remunerated, such as the academic 2*+2 professions. However, without information pertaining to the patients* occupation it is impossible to determine whether this conjecture is accurate. The data on patients* diagnosis support the original hypothesis that Orthodox professionals will see more severely disturbed patients than Marriage Counselors; Orthodox professionals see more patients diagnosed as character disorders and psychotics. Again, this fits the pattern that Marriage Counselors restrict their practice, to some degree at least, to cases involving interpersonal problems more than intrapersonal problems. A comparison between those designated as Marriage Counselors and Other professionals shows that significant differences exist in terms of patient income, education, and diagnosis. The findings indicate that those with a higher socioeconomic status, as measured by education and income, and those who are seen as needing more skilled help are seen by Marriage Counselors rather than by Other pro fessionals . Turning to patients seen through an agency a simi lar but more definite pattern is observed. Significant differences between Marriage Counselors and Orthodox pro fessionals are found with respect to patients* age, sex, religion, income, education, and diagnostic assessment. Marriage Counselors show a tendency to see relatively more young adults, more women, and more Homan Catholics than those designated Orthodox professionals. The association of age and the professional designation of Marriage Counse lor can be explained again on the basis that it is during the period of young adulthood (twenty-one through thirty- nine years of age) that marital difficulties are most likely to arise. It is difficult to explain wby Marriage Counselors see significantly more women than do Orthodox professionals unless one is willing to postulate that marriage is a more crucial role for women than for men who frequently have an outside career which is as important to them as is their role of husband. Nor is it easy to explain the association of Homan Catholicism and the thera pists’ designation of Marriage Counselor^ Perhaps there is less of an evil stigmata attached for the Catholic in seek ing professional help from a Marriage Counselor than in seeking help from an Orthodox professional who might be more easily identified with "Preudian sexuality." In order to ascertain the possible accuracy of such a conjecture, it would be necessary to have data on the process which patients go through in deciding from whom they will seek help. The trend that was observed in the therapists* private practice with respect to income and education con tinues in the agency practice in a more unambiguous fashion. 2¥f Analysis of these variables suggests that Marriage Counse lors see patients with a higher socioeconomic status than do either Orthodox or Other professionals. It is difficult to deduce what accounts for this unexpected finding unless one has more information concerning the policies of the agencies in which these patients are seen, and more infor mation on the selection process undertaken by both patients and therapists. The results on diagnostic assessment parallel those seen in private practice and suggest that whether or not the patient is seen in an agency or in a private practice those who are defined as needing the most, skilled help are seen by Orthodox professionals followed by Marriage Coun selors and then by Other professionals. The same variables that differentiated the practice of Marriage Counselors and Orthodox professionals differ entiate the practice of Marriage Counselors and Other pro fessionals. Marriage Counselors* agency practice is asso ciated with female, young adult patients. Again specific ity of practice may be used to explain this finding. The fact that Other professionals see more Protestants than do Marriage Counselors may be explained by the fact that so many of the Other professionals are Protestant ministers. The Protestant minister may be the first person that the distressed person turns to when he experiences marital trouble s• 2^-5 Data used, to determine the patients* socioeconomic status— education and income— separated the Other profes sional from the Marriage Counselor just as these data differentiated the Orthodox from the Marriage Counselor. Once again, more of the Marriage Counselors' agency patients are found to he from the higher socioeconomic classes. As was the case with data on private practice, it is not possible to determine why this relationship between socioeconomic status and professional self designation occurs without having data about the selection process of clinic patients and therapists. However, it will be possible to determine if this finding is true for all members of the American Association of Marriage Coun selors compared with members of other mental health pro- 3 fessional associations. Re suits on the data analysis of diagnostic assess ment support the original hypothesis. Other professionals see comparatively more healthy patients and fewer severely disturbed patients than either of the other identity groups • In general, data on the social characteristics of patients, regardless of whether seen in a private practice or in an agency practice show a definite association with ^Data from the national study on "Careers in Mental Health" will make it possible to compare groups by membership rather than by self-concept. 2^6 the therapists' self-concept. Marriage Counselors' patients are more frequently in the age range where there is a great likelihood that marital problems will emerge, and they see patients who are from higher socioeconomic strata. In addition, Marriage Counselors patients are given less markedly pathological diagnoses than those of Orthodox professionals, but these patients are considered to be more disturbed than those of Other professionals. Apparently, there is a trend for each identity group to perceive and organize its practice in a specific way. i Marriage Counselors specialize in marital counseling, Other professionals offer generalized counseling services, and Orthodox professionals work with those who are seen as more severely disturbed and with those who are less well- adapted to the society in terms of education and income. The last subhypothesis under the general heading of type of therapy refers to the respondents' income and professional self-designation. It was hypothesized that the fees charged for professional services, and the income derived from professional services would be associated with self-concept, although this hypothesis postulated that this relationship would not hold for total annual income. Specifically, it was expected that Orthodox professionals would rank first in professional income, followed by Marriage Counselors, who would be followed by Other 2b 7 professionals. Data analysis did not fully support the hypothesis, but did point to the continuation of the trend that Marriage Counselors and Orthodox share greater simi larities in behavior than either of them do with Other professionals. For example, with reference to the average fees charged for seven types of professional services, in only one case was there a significant difference between those designated Marriage Counselors and Orthodox profes sionals, and in six instances there was a significant difference between Marriage Counselors and Other profes sionals . Examination of total annual income derived from counseling activities fully supports the pattern of simi larity between Marriage Counselors and Orthodox profes sionals. No significant differences are found in counsel ing income between Marriage Counselors and Orthodox, nor does controlling for education affect this relationship. But there is a significant difference between Marriage Counselors and Other professionals; controlling for educa tion shows that this relationship is influenced by level of education. No significant differences are found for those who do not hold a doctorate, but for those who do Marriage Counselors make a higher annual counseling income than do Other professionals. The fourth major hypothesis focused on differential perceptions of reference groups, membership groups, status 2hQ and role. The findings indicate that reference group per- ception is influenced by self-concept with each group show ing a greater tendency to identify with those groups whose identity they have adopted. However, membership or colleague perception shows little relationship with pro fessional self-concept. In only two cases— perception of social workers and ministers— is there a clear-cut rela tionship. Orthodox professionals perceive social workers as their colleagues more frequently than do the other identity groups, and Other professionals perceive ministers as their colleagues more frequently than the other identity groups. Since the Orthodox professionals include 19 per cent of the sample who identified themselves as social workers, and the Other professionals include 1*+ per cent of the sample who identified themselves first as ministers, this finding is not surprising. However, the fact that this differential recognition of colleagues occurs in only two out of nine listed occupations is important. The lack of a clearly delineated relationship for colleagues' per ception coupled with the significant relationship for reference group identification may be seen as further evidence that professional identity allows the respondent to identify with a segment of his profession which is associated with a specific activity such as marriage 2^9 1 a counseling, but at the same time allows him to incorporate his larger identification with the entire mental health field. Status perception was included in this study as a 5 measure of professional self-esteem. It was argued that members of a newer segment of a profession where appro priate roles have not yet been clearly defined will mani fest greater difficulty in supporting a high-level of pro fessional self-esteem. This lack of self-esteem can be identified by overestimating one’s own status in relation to others. Specifically, it was hypothesized that Marriage Counselors will indicate this low-level of professional self-esteem to a greater degree than the other identity groupings since they are the only ones who do not cling to an older, well-defined professional identity. The data supported the hypothesis to some extent. Where an associa tion between status estimation and self-concept did occur (for three out of the nine occupations evaluated) Marriage Counselors showed the greatest amount of status over estimation. ^See Hue Bucher and Anselm Strauss, "Professions in Process," American Journal of Sociology, LXVI (January, 1961), 325-33^ ^Salomon S. Rettig, et al.. "Status Overestimation Objective Status, and Job Satisfaction among Professions," American Sociological Review. XXIII (February, 1958), 75- BI7 250 The last area to toe examined under the general theme of perception was role perception and role satisfac tion. No relationships were found toetween either of these two variables and professional self-concept. The last major hypothesis focused on the therapeu tic orientation of the respondents and professional self designation. Two measures of this orientation were employed: (1) criteria used to classify other mental health professionals; and (2) scores on a Therapeutic Orientation Scale.^ The similarity in the behavior of Marriage Counselors and Orthodox professionals continued to find support in the data on the criteria used to classify other professionals. Both of these groups use similar criteria, and Marriage Counselors and Other professionals use dissimilar criteria. Scores on the Therapeutic Orien tation Scale did not reveal an association between thera peutic orientation and professional self-concept. General Conclusions In general, then, it may t o e concluded that those identified primarily as Marriage Counselors act as if they offer unique services to their patients. That is, they focus more of their energy and attention specifically on £ Donald M. Sundland and Edwin N. Barker, "The Orientations of Psychotherapists," Journal of Consulting Psychology. XXVI (1962), 201-212. 251 the practice of marriage counseling. Other than this main point of differentiation, those designated as Marriage Counselors have more in common with those identified as Orthodox professionals than they do with Other profes sionals • Data that point directly to this specialization of practice include respondents* educational specialization, the amount of time devoted to the practice of marriage counseling, the type of therapy most frequently conducted, and some social characteristics of patients. Other data which support the view that Marriage Counselors act in a manner independent of the other identity groups included the greater amount of interaction that those identified as Marriage Counselors have with other marriage counselors, reference group perceptions, and evaluation of status. However, this picture of an emerging segment within a larger profession is distorted unless one notes that in many respects Marriage Counselors share similarities with Orthodox professionals, which are not shared with Other professionals, fhese points of similarity include the respondents' sex, and level of attained education; the political orientation of the subjects * fathers; subjects' perception of their most important position; the way they address their patients; fees charged for various profes sional services; annual income derived from counseling 252 activities; and the criteria used to classify other mental health professionals. To finish this picture of similari ties and dissimilarities between different identity groups, it is necessary to point out areas which suggest that Marriage Counselors and Other professionals engage in behaviors which are not engaged in by Orthodox profes sionals. The only variables which suggest that those designated as Marriage Counselor and Other professionals engage in similar behaviors is in the type of therapy offered (both concentrate on marriage counseling, and con joint therapy), and in the relative lack of emphasis placed on the importance of liability insurance. There are several areas which suggest that profes sional self-concept does not discriminate between respon dents, that is, the respondents represent a homogeneous group. These undifferentiated areas include the social characteristics of the respondents with the exception of sex; the social characteristics of the respondents* parents with the exception of religious and political orientations; personal contact with psychotherapy; referral sources; frequency of patient contact; racial characteristics of patients; total annual income; perception of membership groups; role models and role satisfaction; and theoretical therapeutic orientations. One other area in which members of the American 253 Association of Marriage Counselors present a homogeneous group, and where they are not distinguished from the rest of the mental health profession is in their racial composi tion, Only 1.3 per cent or four respondents out of 292 were non-Whites. In light of the current discussion of the plight of the urhan Negro family, it is apparent that mem bers of the Association will not serve this group any more adequately than psychoanalysts have been known to serve 7 the lower class in general. This statement has validity only to the extent that American Association of Marriage Counselors1 members are either unaware of their possible contribution towards the solution of this problem, or to the extent that they feel that they can not cope with it with their present White middle-class cultural background. It is also possible that this lack of involvement with the Negro family can be partially explained by the fact that marriage counselors are today fighting for professional recognition within the orthodox mental health field, and therefore they may be too absorbed to pay much attention to a problem long neglected by psychiatry; or they may feel too timid in grasping leadership in working on this incendiary issue. ^ August B. Hollingshead and Fredrick C, Redlich, Social Class and Mental Illness (New York: John Wiley & Sons, Inc., 195ti), pp. 3^-3517 Limitations of the Study These general conclusions, however, must he viewed with caution since in some cases there is douht concerning the validity of the data. For example, it has already been pointed out that the social characteristics of patients proved to be associated with professional self- concept. Yet the data provided by the respondents about their patients displayed a great deal of ambiguity. The questionnaire asked each person to indicate the actual number of patients he saw, and then asked him to indicate how many of these were male, female, Caucasian, and so on. Over one-fourth of the respondents provided this informa tion by giving the total number of patients seen each week, and then filled in the rest of the information by giving crude proportions for the data on social characteristics. The fact that the proportions are based on rough estimates easily can be concluded since the respondents frequently stated that they had three patients, half of whom were male. This is one area in which it is apparent, that the data themselves presented a problem. One of the basic difficulties met with in using any mailed questionnaire is the factor of interpretation of the questions. Even though this questionnaire was pretested and redesigned to elimi nate problems of interpretation, there is no assurance that all of these problems were worked out. Therefore, 255 there may be other mtaiown areas where the data should be viewed with caution. The scale used to measure theoretical therapeutic orientations must also be mentioned here. Although this instrument was validated, it was validated only on a sample of clinical psychologists. The authors of the scale did state that the scale might not be valid for those engaged Q in the practice of group therapy. Since both those iden tified as Marriage Counselors and Other professionals con centrate on marriage counseling, and/or conjoint therapy, it might well be argued that the findings based on this scale are invalid. Another limitation of the study refers to the fact that the data which were gathered for this research are not exhaustive. Although, every attempt was made to acquire relevant data, some of the kinds of information that should have been gathered did not become apparent until the study was well under way. For example, one obvious lack of information is that concerning the bases on which members of the American Association of Marriage Counselors decide to take on a new patient. Wot only is information lacking for the respondents* private practice, but it is also lacking concerning agency patients. Perhaps 8 Ibid. 256 if this information were available it might be possible to determine why those designated as Marriage Counselors fre quently have more patients from the upper social strata than do their colleagues who have different self-concepts* One more difficulty must be mentioned in this con text • A total of 292 respondents who make up 66 per cent of the total population might seem adequate to the study, but it must be pointed out that several different groups had to be compressed into the one category entitled Ortho dox professionals* This merging of professional identities raises the possibility that the findings on the behavior of the Orthodox professionals are a conglomerate of disparate behaviors. If it had been possible to treat psychiatrists, psychologists, and social workers as separate identity groups it might have clarified some of the findings* How ever, this amalgamation of traditional mental health pro fessionals probably did not bias the findings, but rather obscured some issues. Another, and a more serious difficulty encountered in this study refers to the underlying population. Although the 66 per cent sample in all probability did represent the population of the American Association of Marriage Counselors at the time the data were gathered, these data cannot be said to represent all those qualified or unqualified who engage in the practice of marriage counseling. Therefore, in generalizing on the hasis of this sample, one is inferring not only to the then consti tuted population of the Association, but also to a larger hut unlaiown population. Because of this it makes predic tions concerning the future of marriage counseling an extremely hazardous undertaking. Discussion With these cautions in mind, it is possible to argue that the data suggest that the future of the profes sion of marriage counseling probably lies in a gradual assimilation into the larger body of the mental- health field. It is probable that as marriage counseling becomes better defined more of the respondents will think of them selves primarily in terms of being marriage counselors. It has been shown that those who see themselves in this light also share many characteristics with the older mental health professions. The primary question must be whether or not those designated as marriage counselors will main tain as much of a unique identity as they have today. It is difficult to make a prediction regarding this, yet one might suggest that the path of a new segment within a profession is not smooth, and that the chances are that the conflict attendant to establishing one's rightful place within the larger mental health professions will force marriage counselors to maintain their own identity. 258 It is also probable that increasingly fewer individuals will adopt the ambiguous role of the Other professional, if for no other reason than the fact that the American Association of Marriage Counselors is demanding a more specialized training than it had in the past* Two factors, however, may upset this prediction that marriage counselors will be assimilated into the larger mental health field while maintaining their own self-concept* Pirst, there are many today who are engaged in the practice of marriage counseling who are neither members of the traditional mental health professions, nor are they members of the Association* The large number of people engaged in this practice who are not members of the American Association of Marriage Counselors can be docu mented by examining those who are licensed to practice marriage counseling in the State of California* In 1965, there were nearly 1,000 licensed marriage counselors in California, and the Association claimed only sixty-seven members in the state. In addition, there are many more who practice marriage counseling who are not licensed since ministers, physicians, attorneys, and those who are working in a nonprofit organization are exempt from the law* The requirements for licensing are much less rigor- o ous than those of the Association. It is highly probable Q 7See p. 36 for licensing requirements in California. 259 that many who practice marriage counseling both licensed and unlicensed are not qualified to become members of the Association, Unless the Association can make legitimate its claim that they and only individuals like themselves can engage in this practice, it is possible that this prac tice can become so diluted that it will not gain profes sional recognition. The present study explored only the behavior of those who are members of the Association and who therefore may be considered to be the standard-bearers of marriage counseling. Whether or not they will be able to divorce themselves from less qualified practitioners so that both professionals and laymen can recognize them as qualified marriage counselors remains to be seen. The other possibility is that marriage counselors in their struggle to gain recognition from those in the traditional mental health fields may imitate the dominant group so completely that they lose any separate identity. Should this latter possibility occur it would seem likely that marriage counseling would become just one more tech nique practiced by qualified psychoanalysts, psychiatrists, psychologists, and social workers. The data contained in this study, however, are not really designed to help predict this development. To do this one would need recent data regarding how other pro fessionals perceive marriage counseling, as well as infor mation on how the public defines marriage counselors. 260 Perhaps of greater importance than attempting such predic tions on the basis of inadequate data, it is important to note that this, study has demonstrated that self-concept influences behavior. That is, some empirical support has been found for the statement suggested by many social- psychologists that ". . • the things a man does voluntar ily, and in some cases involuntarily, depend upon the 10 assumptions he makes about the kind of a person he is." The fact that the data in this study are based on individ uals who share a membership group identification and a pro fessional skill, and at the same time maintain separate professional identities provides an unusually opportune basis to examine the role of self-concept. It is hardly necessary to indicate that this is but one small part of the work that must be done to answer the basic question which focuses on the relative importance of membership groupings or self-concept factors in deter mining behavior. This research will be continued since comparable data will be available covering the other four traditional membership groups in the mental health field. In addition, it would be fruitful that other groups not associated with the mental health field, but groups which l°Tamotsu Shibutani, Society and Personality; An Interaction!at Approach to Social Psychology (Englewood Cliffs, New Jersey: Prentice-Kall, Inc•, 1961), p. 2l5« ■*-^Data from the national study on "Careers in Mental Health." aspire to gain professional recognition within an estab lished profession should he examined in relation to the influence of self-concept. In this way, knowledge con cerning the development of a profession may he gained, and information.on the growth of professional identifications may he advanced. APPENDIXES APPENDIX A • v LETIER AND POSTCAHD 3ENI 10 EACH RESPONDENT H4! 4 4 0 p CJ.B ® 0 (3 f f l d a o g p 4> (D p 03 f f l dM H-E ft P P P » d® H Ohj HH3 p4 H H H P 4 p ) ® f f l P d P S ft P'tt Q 4 ® ® p 0 M 0 (D 4 f f l H 5 3 5 6 ' S P p.® d H HH f f l 0 H 0 H 4 P P P 0 0 *5 d d Hi 0 ® ® ^ 4 d < ! d ® p4 h- tr w ® HF'rf 0 HO 0 0 0 d H Es, sh p ® p H a a ® f f i d P-PHP *SW 0 0 P- a h s ! S ® b h O M H P a P • w O O ff a p ® ° g ? 4 4 o' P-4 H PP o 0 . _ ip a p ® 4 p d P 0 p P d P 4 W P P'H ® P p j ( D ( D c f * 0 ^ p 1 ? a 3 a p® f t ® H a ® dP- ^ E L H‘ H ' ay d® P H . f t V P j ® f f l Pi p 0 J p a . H 0 4 0 0 S 4 P a o a ft d b 4 d 4 t0 a p4 6a * a® P - d d P d l . o p a a p d a a 0 4 o d a a p h > • 4P 0 H - a HP P a p P p < P H O P p b a p p 4 a 4 p d S a a d® Q • d a p P P H Pi 4 .§ ?*b88 glo"1 p a 4 a H Pi® p p a h P 4 Hj S pi i Q d P P P 0 P P P Ip P05 4 H 4 p a a a p a p a 4 a a a p a a p p o d p p a a h- a p H d , 4 h P'S a a o h o P o p a 4> d d P ® d ® 6 n P'HO P a o S •PS < y a p p 4 0 HH i m 0 - P 0 d 4 PS o P 0 0 a < 1 P 4)10 H 0 h 3 p4 H H ffl HP Hip4 o d 4 a oft a P p a a H t) H H O Hffl H H b P d O a 4 • 4 H' h p a o a P p fi- H -otj p a o P o 4 p a ‘MSB 15 c + p p p h a p a p p >d ft4 d d 0 dP-P4 a p p * p 0 o $ a 4 $4)® o h h a a 4 0 a a p d o a a dot) c |a h v < g p n > p 4 d a 0 p H a d p4 a s o < | o p4 ■ d 4 o a p a P“ ft * c 4* a h h p a h d P h a h h p 4 a h P * o a a d P H ® 4 0 0 d 5 H® H* HjdH d H b Oft B a p M4 P r hj g o d R 0 H 0 p p 0 H ® d d d H a d« •EtiSfo o a h o a o H) P 0 OSP S p’. ttq H4 P o<j a p H 4 a p a p Hi h d 4 ® K j H a o p ® d p p a 4ft p dHG®HPfl> H 0 * 1 4 P H H P 0 p d P P O P a dhj H f t « 0 P . 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I have returned the questionnaire I plan to return the questionnaire by (specify date):__________________________________ I would like a copy of the findings when they are available• APPENDIX B QUESTIONNAIRE CAREERS IN MENTAL HEALTH MARRIAGE COUNSELORS UNIVERSITY OR SOUTHERN CALIFORNIA C A R E E R S IN M E N T A L H E A L T H -- M A R R I A G E C O U N S E L O R S S T R I C T L Y C O N F I D E N T I A L P i e a s e an sw e r all of the following q u e stio n s to the b e s t of your ability even if the a n s w e r s you give are only rough appro x im atio n s; do not sk ip any q u e s tio n s b e c a u s e you are unable to provide p re c ise information. Feel free to qualify any a n s w e r s you deem n e c e s s a r y . I. PERSONAL DATA: PRESENT AND PAST 1. Of the follow ing p ro fessio n al d e s ig n a tio n s , c h ec k all th o se which apply to you. (If you feel th at none of th e s e is appropriate or su ffic ie n tly sp e c if ic , p le a s e in d ic a te the p ro fessio n al d e sig n a tio n you prefer.) I I P s y c h o a n a ly s t I I P s y c h o l o g i s t I I Social Worker ; I I P s y c h i a tr i s t I I S o c io lo g ist I I Minister I I P h y s ic ia n I I Marriage C ounselor I I Attorney I I Other (specify).______________________________________________________________________________________________________ 2. If you ch ec k ed more than one p ro fessio n al d e sig n atio n , circle the one which is central or primary for your pro f e ssio n a l identification. 3. Sex: I I Male I I Fem ale 4. Age (at la s t b irth d a y ): Yours S p o u s e ’s 5. R ace: C a u c a s ia n Negro Oriental Yours rzi rzn I I S p o u s e ’s I \ I I I I 6. A n c e s try : T o which c o u n try (ies) do you trace your national o r i g in s ? _____________________________________________________ 7. Current Maritai Status: i 1 Single I i Married I I Sep arated 1 I Divorced 8. Age at first m arriage: _____ 9. Age at s u b s e q u e n t m arriage(s), if any: i 1 Widowed 1 I R emarried following divorce i I R emarried follow ing widowhood Yours S p o u s e 's Yours S p o u s e ’s IQ If you are s in g le , d ivorced, se p a ra te d or w idow ed, do you live: I I alone I I with a d u lt r e la tiv e s other than p a ren ts I 1 with p a ren ts I I with children I I with a friend or friends 11. Do you have any children: 1 I y e s i I no 12. If y e s, p le a s e list the a g es of your children in chro n o lo g ical order (include all children of p re se n t and former marriages):__________________________________________________________________________ 13. B irth p lace: In the s p a c e s below, p l e a s e in d icate the birth p lace of yourself, your s p o u s e and your p aren ts: Town or City State or Region Cou n try You Spouse Mother Father 14. If either you, your sp o u s e or your parent(s) were not born in the United S ta te s, at w h at age did you, or they, come to this country? ---------------Your Age S p o u s e ’s Age Mother’s Age F a t h e r ’s Age 15. Where did you spend most of your childhood years? I I Large city (over 25,000 population) I 1 Small town (less than 2,500 population) I I Suburb I I Rural (non-farm) I I Small City (less than 25,000 population) I I Rural (farm) I 1 Other (please specify)__________________________________________ .____________________________________________ 16. Where do you live now? I I Large city (over 25,000 population) | | Small town (less than 2,500 population) L...J Suburb | | Rural (non-farm) I I Small city (le s s than 25,000 population) | 1 Rura| (farm) I I Other (please specify)______________________________________________________________________________________ 17. In the town where you practice marriage counseling is there a university which grants higher and/or professional degrees: 1 1 Yes . Is there a medical school: Does your community have a cc Religious background of your fa is an adherence to one of the fc Religious Position 1 1 No □ Yes mmunity menta 1 h mily. For you, yo llowing religious Your Own 1 1 No ealth agency: ur spouse, and positions: SDouse's 1 1 Yes your parents, ind Father’s ' 1 1 No icate on the chart whether there Mother’s Protestantism Catholicism Judaism Agnosticism ro Atheism VO N one Other (specify! 21. Cultural affinity of your family: For you, your spouse, and your parents, indicate whether you or they share a cul tural affinity with one of these religious groups even though there may be no adherence to its religious position. Religious Group Your Cultural Affinity Spouse’s Cultural Affinity Mother’s Cultural Affin itv Father's Cultural Affinity Protestant Catholic Jewish None Other (specify) How would you characterize Political Orientation he political orier Your Own itations of your: Spouse’s .elf, your spouss Mother’s , and your parents? Father’s Moderate liberal Moderate conservative Strong conservative None Other (specify) -2- 23. What is the highest academic degree attained by: Academic Degree You Spouse Mother • Father Less than High School graduate High School graduate Some college College graduate (B.A.degree) Some graduate work Master's degree - M.A. or M.S. Master’s degree - M.S.W. Theological degree - B.D. Some graduate work bevond Master's Doctorate - Ph.D. M.D. D.S.W. Ed.D. Other doctoral degrees (specifv) Other Drofessional degrees fSDecifv) 23a. Name the school from which you received your highest degree:_______________________________________________________ 24. If you hold a graduate or professional degree, indicate what your area of specialization is:_________________________ 25. Do you hold any state license or certification: I I Yes I I No If yes, please indicate w h ic h ___________________________________________________________________________________________ 26. Are you currently receiving any instruction or training on a part-time or informal basis (e.g., taking university courses, participating with colleagues in a study group, etc.) which is relevant to your professional practice but not a part of your official duties? I I Yes t I No ro 26a. If yes, please describe the nature of these activ ities:________________________________________________________________ 0 27. Have you ever served in the Armed Forces? I i Yes I I No 27a. If yes, when? From ___________________________________ T o ________________________________________________________ 27b. If yes, while you were in the military service did you receive any training or experience which was relevant to the mental health field and/or your career? I I Yes | | No 27c. If yes, please describe it briefly:______________________________________________________________________________________ 28. In what year were your parents bom? Year of father’s birth________________ Year of mother's birth_______________ 29. If either or both of your parents are deceased, how old were you at the time of their death? When father d ie d __________________ When mother d i e d ____________________ 30. Were you I iving with both of your biological parents from birth through your high school years? I I Yes I I No 30a. If no, please e x p lain :__________________________________________________________________________________________________ 31. If any family member, including yourself, was seriously ill (physically or emotionally) during the time you lived at home, please describe in the table below: Family member (including i Type of illness vourself) who was i 1 1 Length of i 1 Iness Your age at onset of illness ] - 7 ., 32. How many sib lin g s do you have that are older than you? _________male _______female ________ none 32a. How many sib lin g s do you have that are younger than you? _______ male female none 33. What w a s your fath er’s major occupation when you first became self-supporting (if father w as d e c e a s e d or retired at that time, indicate his previous occupation? _____________________________________________________________________________ 33a. What kind of work did this involve? 34. Was your mother employed for a year or more during the period in which you were living at home? I I Yes i I No 34a. If yes, what w a s her principal occupation during that tim e?___________________________________________ 34b. What kind of work did this involve? 35. P le a s e check the membership category in the American A sso ciatio n of Marriage C ounselors which a p p lie s to you: I I Fellow I 1 A sso c ia te Member I I Member I I A sso ciate-in -T rain in g II. PREPARATION FOR MARRIAGE COUNSELING 1. Did you serio u sly consider preparing for an occupation other than your current one at any time after you graduated from High School? I I Yes I I No la . If yes, what o c cu p a tio n (s)? _____________________________________________________________________________________________________ 2. Did you ever practice any other occupation other than marriage counseling? I I Y es I I No 2a. if yes, what occupation did you practice?_____________________________________________________________________________________ 3. Do you currently practice any other occupation other than marriage counseling? I I Y es I I No 3a. If y e s, what occu p atio n ?_______________________________________________________________________________________________________ 4. How much of your current professional activity is devoted to marriage counseling? □ less than 10% □ 50% - 74% I Z H 10% - 24% d H 75% or more □ 24% - 49% 5. F irst, p le a se indicate the approximate age at which you initially becam e interested in any of the following pro fessio n al fields. Second, p le a se indicate the age at which you decided to pursue a career in any of the following pro fessio n s. ( P l e a s e enter information about all that apply.) P rofession Ape of Interest Age of decisio n P sy ch o lo g y C linical Psychology Marriage C ounseling Medicine P sychiatry P s v c h o a n a lv s is Social Work P s y ch ia tric Social Work Min istrv Law T e a c h ine 6. Have you ever received any kind of personal therapy? | | Y es I I No 6a. If yes, what w as the length of time you s p e n t in therapy? I I under 300 hours I I over 300 hours 6b. !f you have been in therapy, p lease use the following categ o ries to describe your therapeutic experience: Category 1st experience in theraov 2nd experience in theraov Additional experiences in theraov Your age From: To: Professional Designation of Therapist (e.g., psychiatrist, social worker, psy chologist. analyst, etc.f Therapeutic Orientation of Therapist Type of Treatment (e.g., drugs, analysis, psychotherapv. counseling, etc.) Purpose of therapy (please check one:) A. Principally for personal problems B. Principally for training C. More or less equally for both A & B 7. Has your sp o u se ever received any kind of therapy ? I I Yes I I No 7a. If yes, p lease specify s p o u s e 's age when therapy began and profession of therapist: ___________ Age of sp o u se. Profession of therapist. III. PROFESSION A L CAREER IN MARRIAGE COUNSE LING. - 1. Marriage c o unselors frequently hold several positions. P l e a s e rank your three most important positions. (Mark the appro priate blanks with a 1, 2, a n d /o r 3.) ________ Private practice____________________________________ Training ________ Public agency______________________________ ________ T each in g ________ Private agency Consultation ________ Administration ________ Other ( s p e c i f y ) _________________________________________________________________________________________________________ 2. Describe your present primary position briefly: 3. If you conduct a private practice, where are your offices? (Check the appropriate blank.) I I A part of a home I H In a professional building -- medical I I In a professional building - general I I In your office in an agency or institution I I Other (specify)________________________________________________________________________________________ 4. Do you carry p rofessional liability in su ra n ce ? I i Yes I I No 5. From whom do you get most of your referrals? (Rank the six most frequent referral s o u r c e s from the list below. P le a s e number 1 next to the most frequent referral source, 2 for the next most frequent, etc.) ________ M inisters ________ Friends ________ Social Workers ________ P h y s ic ia n s (non-psychiatrists) ------------ C linics ------------ Marriage counselors ________ P s y c h ia tr is ts ________ Courts ________ Former patients ________Attorneys ------------ P sy ch o lo g ists ________ Current patients ________ Other (sp e cify ) _ _ _ _ _ _ ____________________________ ^_________________________________________ 6. How do you o rd in a rily d e s c r i b e the p e o p le you work w ith ? (C h e c k the a p p ro p ria te box.) □ P a t i e n t s [IZ ] A n a l y s a n d s C— 1 C l i e n t s I I C u s to m e rs I I C o u n s e l e e s | | I I Other (Specify)___________________________________________________________ r o --a r o -5- In d escrib in g yourself, which of the following do you ca I yourself? (C heck the appropriate s p a c e s .) a. P s y c h o lo g ist ______ b. Family T h e r a p is t__ c. Marriage C ounselor. d. P s y c h i a t r i s t ________ e. P s y c h o a n a ly s t_____ f. Social worker------------ g. Doctor. h. Behavioral s c ie n tis t i. T h e r a p is t_____________ j. L aw y e r________________ k. T e a c h e r _______________ Ca It Se If or print on stationery Al low others to call you Object to or correct when ca I led________ Describe your primary and secondary treatment a p p ro ac h es by placing a number ________ Intensive and extended individual pschotherapy ________ C la s sic a l p sy c h o a n aly sis ________ Group and individual therapy for the same patient ________ Group therapy alone ________- Brief therapy or counseling ________ Marriage counseling- seein g husband and wife separately ________ Conjoint therap y — seein g husband wife together ________ Pre-marital counseling ________ Divorce counseling ________ Family therapy ________ Other (specify)___________________________________________________ 1 and 2 before the two appropriate ap p ro ach es: 10. While conducting psychotherapy do you ordinarily se e p atients: (C heck the appropriate box) I | 3 or more times per week I 1 le s s than 1 time per week I | 2 times per week j I item not applicable to my practice I I once per week P le a s e check those o c cu p atio n s listed below which you feel are accorded higher sta tu s in your community than that of marriage counselor. I I Y ° u (marriage counselor) [) | P s y c h ia tr is ts I I P s y c h o lo g ist Social Workers I I Sociologist Public School tea ch e rs I I P s y c h o a n a ly s t Attorneys □ □ Ministers P h y s ic ia n s □ □ □ ro o3 n . 1 2 . Which of the following do you consider to be your c lo s e professional c o lle a g u e s? (Check as many a s you w ish.) I I P s y c h o a n a ly s t I I P s y c h o lo g ist | [ Marriage counselor □ P s y c h ia tr is t □ □ Sociologist □ □ Minister I I P h y sic ian other than p sy ch iatrist | j Social Worker | | Attorney I I Other ( sp e c ify )_________________________________________________________________________________________________________________________ From whom would praise mean the most in terms of your professional com petence? (Rank the THREE most important. Put a 1 next to the person from whom praise would be the most gratifying, 2 next to the next most gratifying, etc.) □ P s y c h o a n a ly s t P s y c h o lo g ist q Marriage counselor □ □ P s y c h ia tr is t Sociologist m—i Minister d ] Ph y sic ian other than p sy ch iatrist q Social Worker < -----: Attorney I I Other (specify)___________________________________________________________________ ;____________ 13. Which of the following are you prepared to do independently, on the b a sis of your training and experience? (Check the appropriate s p a c e s .) a. Individual psychotherapy b. Group p s y c h o t h e r a p y _____ c. D iagnostic a s s e s s m e n t__ Marriage c o u n s e l i n g ______ Family c o unseling Giving advice on sexual problems Conjoint therapy Community consultation Very well prepared Moderately well prepared Poorly prepared Not a t all p repared 14. To what degree are you satisfied with your current professional role? (Check the appropriate space.) I I highly satisfied | | somewhat dissatisfied I 1 more or less satisfied I I quite dissatisfied 15. As a practicing counselor to what degree do you feel that your current role is modeled after the image of the physician? (Check the appropriate space.) I I aimost identicaI | I little similarity I I strong similarities I I no equivalence I I some similarity 16. In the chart below, indicate the frequency and nature of professional contact that you currently have with the following mental health personnel: Seldom or never Occasion- allv 1 Often Nature of Activity Psvchnanalysts Psychiatrists Marriage counselors Psychiatric social workers Clinical psychologists Psychiatric aides Therapists (other than those listed) Other (specifvl ny therapeutic organizations, approaches or schools of thought in the mental health field, accurately as such labels permit, what therapeutic orientation, school of thought or approach L 'J (Ohaol/ m . o n i f oo trnu ui i o \ IV. THERAPEUTIC ORIENTATION 1. Considering that there are ma. would you please specify as accurately <jo oulu mucia ......... BEST characterizes your work? (Check as many as you wish.) □ F r e u d i a n a S o m a l i c L—1 Jungian I I Sociological S Adler.an [— ] Rankian I I Social Psychiatric I I Eclectic (please specify the components of your orientation) ro I I Rogerian I I Existential I I Community I I Pharmacologic 2. If you listed more than one orientation, approach or school of thought, please circle the o n e which you judge to be most important in characterizing your current work. 3. What is the most significant criterion for differentiating and/or categorizing professionals in the mental health field? (Check ONE of the alternatives.) I I Their professional designation and membership, e.g., psychiatry, clinical psychology, marriage counseling, psychiatric social work. I I Their functions and activities, e.g., therapy, research, teaching, administration, etc. I I Their therapeutic orientation, e.g., psychoanalytic, sociotherapeutic, somatotherapeutic, etc. I I The setting of their practice, e.g., primarily private practice or primarily practice in an organization or institution. I I Their amount of experience in therapeutic work. I I Other (sp ecify )_________________________________________________________________________________________________ -7- The next se t of items constitute a Therapeutic Orientation Scale. You will agree with some of the sta te m en ts and disagree with others. Check each statem en t according to the amount o>f your agreement or disagreem ent. ( P l e a s e work as quickly a s you can.) P le a s e Check Each Item 1. The most beneficial outcome of therapy is the p a tie n t’s becoming more open to his feelings. 2. The most important variables in the outcome of therapy are the th era p is t’s professional training in therapy techniques and his expert use of these techniques. 3. A mature, mentally healthy person will n ecessarily move in the direction of so c ie ty ’s goals. 4. The most beneficial outcome of therapy is for the patient to know the r e aso n s for his behavior. 5. A good therapist constantly and deliberately u se s his thorough knowledge of psychopathology and his training in psychotherapeutic techniques. S. Frequently, strong advice or actual commands by the therapist are indicated. 7. It is alw ays unhealthy for a person to feel free-floating anxiety. 8. I am a fairly active, talkative therapist, compared to most therapists. 9. A therapist should have long-range goals for his patients. 10. It is quite acc ep ta b le to interrupt a patient while he is talking. 11. It is som etim es all right to take a walk with a patient during the therapy hour. 12. The most important learning in therapy is affective, non-verbal, and non- conceptual in nature. 13. Whatever the intensity or nature of the p a tie n t’s emotional ex p ressio n , the therapist is most effective when he feels detached, objective and impersonal 14. T h e ra p is ts should make an overall treatment plan for each case. 15. The more effective therapists do things during the therapy hour for which they have no reasoned basis, merely a feeling that it is right. 16. A good therapist will “ interpret” his p a tie n t’s behavior in the s e n se of telling him its real significance--m eaning of which he is unaware. 17. For a patient to improve his current way of life, he must come to understand his early childhood relationships. 18. It is p o ssib le to make s e n s e of a patien t's behavior without assum ing motives of which he is unaware. 19. Inherent in human beings is a natural propensity toward health, both physical and menta I. 20. My own attitudes toward some of the things my patients say or do, stop me from really understanding them. 1 AGREEMENT DISAGREEMENT Strong S u p p o r t Moderate S u p p o r t Slight S u p p o r t Slight O p p o s i t i o n Moderate O p p o s i t i o n Strong O p p o s i t i o n ro -•a vn -8- Please answer each questio n . 21. M edications are valuable a s a part of p sychotherapy to lower a nxiety or to help “ u n co v er” m aterial. 22. With m ost p a tie n ts I do analy tic dream interpretation. 23. T h e p a tie n t's coming to ex p erien c e his feelin g s more fully is n o t the m ost important th era p eu tic result. 24. P a tie n ts get better more b e c a u s e their th era p ists are the kinds of persons they are than b e c a u s e of their t h e r a p is t’s pro fessio n al training. 25. Having the p a tie n t move in the direction of the g o als of so c ie ty is n o t the major factor in correcting o n e ’s behavior. 26. U nderstanding why one d o e s things is n o t the major factor in correcting o n e ’s behavior. 27. It is N O T important for the th era p is t to c o n ce p tu a liz e the p sy c h o d y n a m ics of the p atient. 28. It is u su a lly unw ise for the th era p is t to d e lib e ra tely influence a p atient toward certain b ehaviors and a ttitu d e s. 29. Ideally, a person should never c o n s c io u s ly have p sy ch o tic-lik e thoughts or feelings. 30. I am a fairly p a s s iv e sile n t th era p ist, compared to most th e ra p is ts. 31. T h e th e r a p is t s e t s the broad g o a ls of therapy and attem pts to influence the p a tie n t’s behavior and fe elin g s in that direction. 32. A th e r a p is t should never interrupt a p atient while he is talking. 33. It is never all right for the th era p is t and p a tie n t to have refreshm ents to gether during the therapy hour, 34. T h e crucial learning p r o c e s s in therapy is a verbal and c onceptual p ro c ess. 35. It is important for the th era p ist to feel a deep personal and emotional in volvement with his patient. 36. N either a thorough c a s e history nor a proper d ia g n o s is is important to treat a c a s e effectively. 37. It is u n w i s e for a t h e r a p is t ’s remarks and re ac tio n s to a patient to be un p lanned, sp o n ta n e o u s , not thought-through. 38. As a th era p ist, I avoid a sk in g probing q u e stio n s . 39. It is u n n e c e s s a r y for a p a tie n t to learn how early childhood e x p e r ie n c e s have left their mark on him. 40. Without a c o n ce p t like “ u n c o n sc io u s d e te rm in a n ts of b e h av io r,” people could not be understood 41. T here is N O T an innate tendency in human bein g s toward emotional health 42. A p a tie n t can be very critical of me or very a p p rec ia tiv e of me w ithout any re su ltin g change in my feeling toward him. 43. E le ctro sh o c k is a n e c e s s a r y part of therapy with certain types of p a tie n ts. 44. I a lw a y s (with proper timing) a n a ly z e the r e s ista n c e . 45. It is n e c e s s a r y for a p s y c h o th e ra p is t to be a p h y sician him self or to be su p e rv ise d by one. A G R E E M E N T D ISA G R EEM EN T O Mo der at e S u p p o r t o • —1 C / O C x O Slight O p p o s i t i o n Moderate O p p o s i t i o n Strong O p p o s i t i o n V. P A T I E N T S O R C L I E N T S In order for us to discern how the patient population distributes itself among the various mental health professions, we would like you to answer the following questions about your marriage counseling practice. In answering these questions focus on your current practice. Please answer each question first on the basis of those patients you see in private practice (if any) and then on the basis of those patients you see as part of your work in an institution or as part of your salaried work for an agency or organization (if any). Those seen in private practice 1. A p p r o x i m a t e l y h o w m a n y p a t i e n t s d o y o u s e e r e g u l a r l y p e r w e e k : 2 . H o w m a n y o f t h e m a r e : u M a l a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2) F a m a l a . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 . H o w m a n y o f t h e . m a r e : A d u l t * (40 o r m o r < ? » o n | . . . . . . . . 2) A d u l t * (21-39 y . a r . ) . . . . . . . . . . . . . . 3) A d o l a s c a n t * . . . . . . . . . . . . . . . . 4) C h I I d r a n . . . . . . . . . . . . . . . . . . . . 4. H o w m a n y o f t h e m a r e : ') C a u e a « i a n . . . . . . . . . . . . . . . . . . . . . . . . . 2) N . g r o . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3) O r i e n t a l . . . . . . . . * . . . . . . . . * . . . . . . 4) M a x l e a n - A m e r i c a n . . . . . . . . . . . . . . . 5 . H o w m a n y h a v e a s t h e i r r e l i g i o - i> p t o t e « t o n i i « m . . . . . . . . . . . . . . . . . c u l t u r a l b a c k g r o u n d s : 2 ) C a t h o |l c , , m . . . . . . . . . . . . . . . . . . . . 3) J u d o l s m . . . . . . . 4) D o n ' t K n o w . . . . . . . . . . . . . . . . . . 6 . H o w m a n y a r e f r o m h o m e s w h i c h D U n d e r 55,000 . . . . . . . . . . . . . . . . . h a v e a t o t a l i n c o m e o f ; 2) 55,000 - $ 10,000. . . . . . . . . . . . . . . 3) $ 10,000 - 520,000 . . . . . . . . . . . . . . 4) $ 20,000 - 550,000 . . . . . . . . . . . . 5) O v e r $ 50,000 . . . . . . . . . . . . . . . . . . 6) D o n ' t K n e w . . . . . . . . . . . . . . . . . 7 . H o w m a n y a r e a t t h e f o l l o w i n g l) l . . . t h a n H i g h s c h o o l . . . . . . . . e d u c a t i o n a l l e v e l s : _. . . , , , . 2) H i g h S c h o o l g r a d u a t e . . . . . . . 3) S e m e C o l l e g e . . . . . . . . . . . . . . . . . 4) C o I T e g e g r a d u a t e . . . . . . . . . . . . . 5) P h . D . o r M . D . . . . . . . . . . . . . . . . . . 6) D o n ' t K n o w . . . . . . . . . . . . . . . . . 8 . H o w m a n y w o u l d y o u c l a s s i f y a s 1) R . i a t i v . i y h . a i t h y . . . . . . . . . . . . b e i n g i n e a c h o f t h e f o l l o w i n g 2 ) p . y = h a n . u r o t i o . . . . . . . . . . . . . . . . g e n e r a l d i a g n o s t i c c a t e g o r i e s : 3) C h a r a c t e r d i s o r d e r . . . . . . . 4) p s y c h o s o m a t i c r e a c t i o n s . . . . . . 5) F u n c t i o n a l P s y c h o s e s . . . . . . . . 6) O r g a n i c p s y c h o s e s . . . . . . 7) A d d i e t s & A l e o h o l l e a . . . . . . . . . 8) O t h e r ( s ) . . . . . . . . . * . . . . . . . . . . . Those seen through an organization ro — -n 9. If you could modify your practice to your own choice, which of the above characteristics of people would you choose to work with. (Place a circle around the number to the left of the characteristics which describe the patient you would prefer.) 10. Counseling fees: Indicate your usual charges for each of the following kinds of therapy. (Answer by checking the appropriate s p a c e s which most closely represent your usual fee; a ssu m e a 1-hour se s s io n for individual counseling, and a 1 hour se ssio n for conjoint or group counseling.) COUNSELING FEES 55 or $5359 $10 $15 $20 $25 $30 $35 Sliding scale less from_________ to ». individual therapy b group therapy c. conjoint therapy d. first or informational session r crisis consultation f. marriage counseling session 11. What percentage of your private counseling clients or patients are seen a t a fee lower than indicated in item 10. (Check the appropriate box.) □ none IZZ 21% to 30% I 1 * 0 % o r ^e s s I J 31% or more I i 11% to 20% 12. What is your annual income from your professional counseling a ctiv ities? (Check the appropriate box.) □ $5,000 of less Z Z $10,000 - 512,499 Q $25,000 - $29,999 □ $5,000 - $7,499- Z Z 512,500 - $14,999 □ $30,000 - $34,999 CID $7,500 - $9,999 Z Z $15,000 - $19,999 □ $35,000 or more I I $20,000 - $24,999 13. Do you have any additional income? I i yes I I no 14. What is your total annual incom e.________ _________________________________________________________________________________ ORGANIZATIONAL AFFILIATIONS AND PROFESSIONAL ACTIVITIES Below is a list of 4 p o ssib le levels of participation in professional organizations. P le a s e list the organizations to which you c u r r e n t l y belong and next to each indicate your current levei of involvement by placing a check in the appropriate column. Hold an Office Member of 1 or more Committees Active Member Usually Attend Meetings Minimal or No Active Partici pation What professional or professionally-related journals and publications do you subscribe to? P le a s e indicate with a check the . extent to which you read them. Usually Read Thoroughly Read Partia 1 Iv Glance through On the back of this page, p lea se describe the elem ents of your graduate training which you feel were the most helpful in pre paring you for your current professional situation; and indicate what modifications in current graduate training you would recommend in order to better prepare marriage counselors for professional roles. 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OR 0 IP 0)0 a H 00 5 R o H 0 ' 0 o a f f l r i 0 > HR 00 ri fflP OR < OR 8ll> 0 1 C O C O P O •83 • i P O £ ■ * O N P O P O 0 1 N O N N O N O ( 0 0 1 U N O N ro i U N 0 C O > t r i N P O 0 0 U N 0 O N • i 0 1 C O > 0 U N 0 1 rl 0 1 R 0 ) f f l S?5J *358 ^ C i r i C D H OR f fl N H RR N ro RP •81 ' fflO a N ro H 0 0 A C O 0 RP U N O n RR •83 ' ®0 a C O 0 1 H 0 • N O 0 0 n O IN f lj •83 • Ra C O 0 1 I D a R 0 ri h f f l 8 1 P r i & ri 0 R J U R f l 0 I D 0 3 ■ d f f l 2 f t C O P fl r o f f l Rft « ri P 0 1 ft A R 0 R f f l A ffl E l 0 O N N O •fl 0 1 On PR i i fflri ri 0 0 HR O l R > IN 0 1 U N N IN ft N (N 0 1 fl 0 1 0 1 1 0 0 N O i 0 U N O N U N 1 8 1 i • i ri 0 3 0 1 (0 n Q 0 1 i n o o 0 1 + U N 0 1 0 1 0 1 HR 00 ri R ffl f f l fflP fflftflft ri OR fflflrifl ri 0 Rri 3OU30 R P pR PRPR P 0 OR f f l c D r i t i 0 E l 81> f l * E l ANALYSIS OI1 THERAPEUTIC ORIENTATIOH SCALE BY PROFESSIONAL SELB1 —CONCEPT C ontiiiue d . Use of Auoci 1 iary Te chni que s Source of Variation SS BP Est. Variance Obtained P Decision Mean of M.C. Mean of OriEio Mean of Other Between Groups W-i -hlii n Groups 1 + .33 2869 .31 2 275 2.17 lO .1+3 ^ .81 NS 8 .71 S 3.29 8.1+9 S 3 .25 8 .76 S 3 .08 Total 2873-65 277 Use of Psychoanalytic Techriiques Scrmrce of V ariation SS BP Est. Variance Obtained P Decision Mean of M.C . Mean of Oi-bfcio Mean of O’ tiuei’ Be’ tween. Groups Within. Groups 31-33 236^.83 2 275 15.57 8 .60 1 .81 NS 6.38 S 2.69 7.21 S 3 -Ol 6.95 S 2.95 To"tal 2395.96 277 Medical Responsibility Source of Variation SS BP Est o Variance Obtained P Decision Mean of M.C. Mean of Ox-tlxo Mean of OHier* Between Groups WiiE-in Groups 20.22 1313 -lO 2 2 75 10.11 i* .77 2.12 NS 2.39 S 2.1+3 1.98 S 1.87 2.59 S 2.19 Total 1333 -33 277 BIBLIOGRAPHY BIBLIOGRAPHY Books American Association of Marriage Counselors, Inc. 1965 Directory of Members. Caplow, Theodore. The Sociology of Work. Minneapolis: University of Minnesota Press, 1^54. Cuber, John P. Marriage Counseling Practice. New York: Appleton-Century-Crofts, Inc., 1948V Edwards, Allen. Statistical Analysis for Students in Psychology and Education. New York: Rinehart and Company, Inc ., 19^6. Guilford, J. P. Fundamental Statistics in Psychology and Education. 4th ed. New York: McGraw-Hill Book Company, 1965* Hall, Calvin S., and Lindzey, Gardner. Theories of Personality. New York: John Wiley and Sons, Inc., 1957. Harper, Robert A. Psychoanalysis and Psychotherapy: 36 Systems. Englewood Cliffs, New Jersey: Prentice- Hall, Inc., 1959. Hollingshead, August B., and Redlich, Frederick C. Social Class and Mental Illness; A Community Study. New York: John Wiley and Sons, Inc•, 1958 . Hughes, Everett C. Men and Their Work. Glencoe: The Free Press, 1958'* Johnson, Dean. Marriage Counseling: Theory and Practice. Englewood Cliffs: Prentice-Kail, Inc • , 1961. Mace, David R. What Is Marriage Counseling? Public Affairs Pamphlets, &25o7 New York: 1957. 286 2 87 Marton, Robert K. Social Theory and Social Structure, Glencoe: The Free Press, 1957* Mudd, Emily H. The Practice of Marriage Counseling. New York! Association Press, 19 51. Profe ssionalization, eds. H. M. Vollmer, and Donals L. Mills. Englewood Cliffs, New Jerseys Prentice- Hall, Inc., 1966* The Professions in America, ed. by Kenneth S. lynn and the Editors of Daedalus. Boston: Beacon Press, 1965. Reiss, Albert J., Jr. Occupations and Social Status. Glencoe: The Free Press, Inc., 19611 Rushing, William A* The Psychiatric Professions. Chapel Hill: The University of North Carolina Press, 196^. Shibutani, Tamotsu. Society and Personality: An Inter- actionist Approach to Social Psychology. Englewood Cliffs, New Jersey: Prentice-Hall, Inc., 1961. Siegel, Sidney. Nonparametric Statistics for the Behavioral Sciences. New York: McGraw-Hill Book Company, Inc ., T9 56. Slocum, Walter L. Occupational Careers. Chicago: Aldine Publishing Company, 1966. Strauss, Anselm L. Mirrors and Masks: The Search for Identity. Glencoe: The Free Press, 195£* , , and Rainwater, Lee. The Professional Scientist: A Study of American Chemists.Chicago:Aldine Publishing Company, 1962. The Student Physician: Introductory Studies in the Sociology of Medical Education. Ed. by Robert K. Merton, George C. Reader, and Patricia L. Kendall. Cambridge: Harvard University Press, 1957. U. S. Bureau of the Census. Statistical Abstract of the United States: 1966. 87th ed. Washington, D. C.: Government Printing Office. Wylie, Ruth C. The Self Concept. Lincoln, Nebraska: University of Nebraska Press, I96I. Zander, Alvin, Cohen, Arthur, and Stotland, E. Role Rela tions in the Mental Health Professions. Ann Arbor, Michigan: University of Michigan Press, 1957. Articles Alexander, Irving. "Family Therapy," Marriage and Family Living, XXV (May, 1963), lH-o-l^ • Barker, Edwin R. "Research Strategy in Studying the Training of Psychotherapists," International Mental Health Research Newsletter, IV (Fall-Winter, 1962), Becker, Howard S. 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"The Independence of the Professions in Helping People," Social Casework, XXXIV (Rovember, 1953), 371-378. Cohen, Michael. "Some Characteristics of Social Workers in Private Practice," Social Work, II (April, 1966), 69-77* 289 Committee on Private Practice of the Division of Clinical and Abnormal Psychology. "Recommendations of Standards for the Unsupervised Practice of Clinical Psychology," American Psychologist. VIII (1953)> Cottrell, Leonard S., Jr., and Shelton, Eleanor B. "Relationship Expectations," Professionali z a ti on. Ed. by H. M. Vollmer and Donald L. Mills. Englewood Cliffs, New Jersey: Prentice-Hall, Inc., 1966. Pp. 232-236. Ehrlich, Howard J. "The Study of Role Conflict: Explora tions in Methodology," Sociometry, XXV (1962;, 85- 97. Erickson, Kai. "Patient Role and Social Uncertainty: A Dilemma of the Mentally 111," Behavior Disorders. Ed. by Milton Ohmer. New York: J. P. Lippincott Company, 1965. Pp. 273-289* Festinger, Leon, et al. "The Influence Process in the Presence of Extreme Deviates," Human Relations, V (1952), 327-3^6. Fiedler, Fred. "The Concept of an Ideal Therapeutic Rela tionship," Journal of Consulting Psychology, XIV (1950), 239-24-5. Plexner, Abraham. "Is Social Work a Profession?" Proceed ings of the National Conference of Charities and Correction^ V "(l9l5), 576.-------------------- Poote, Nelson. "Identification as a Basis for a Theory of Motivation," American Sociological Review, XVI (February, 1951), 14—21. Priedson, Eliot. "Client Control and Medical Practice," American Journal of Sociology, LXV (January, I960), 374-382. G-old, David. "Some Problems in Generalizing Aggregate Associations," The American Behavioral Scientist, VIII (December, 196*0, 16-16. Goode, William J. "Community within a Community: The Professions," American Sociological Review, XXII (April, 1957), 19^-200. 290 Goode, William J* "Norm Commitment and Conformity to Role- Status Obligations," American Journal of Sociology, LXVI (November, 19o0), 24-6-2543. Greenwood, Ernest, "Attributes of a Profession," Social Work, II (July, 1957), *+**-55. Gross, Edward. "The Occupational Variable as a Research Category," American Sociological Review. XXIV (October, 19 59), 6t +0-6l f9• Gusfield, Joseph R. "Occupational Roles and Forms of Enterprise," American Journal of Sociology, 1XVI (May, 19615, 371-580.---- ---------- Hanford, Jeanette. "The Place of the Family Agency in Marital Counseling," Social Casework, XXXIV (June, c 1953), 2^7-253. Hubbard, Harold G., and McDonagh, Edward C. "The Business Executive as a Career Type," Sociology and Social Research, XLVII (January, 1963), lW-155• Karpf, Maurice J. "Marriage Counseling and Psychotherapy," Readings in Marriage Counseling. Ed. by Clark E. Vincent. New York: Thomas Y Crowell Company, 1957. Pp. 23^-256. Kerckhoff, Richard K. "Interest Group Reactions to the Profession of Marriage Counseling," Sociology and Social Research, XXXIX (February, 1955), 179“163 • ________. "The Profession of Marriage Counseling as Viewed by Members of Four Allied Professions: A Study in the Sociology of Occupations," Readings in Marriage Counseling. Ed. by Clark E. Vincent. New York: Thomas Y. Crowell Company, 1957* Pp. ^68-4-73 • Xuhn, Manford. "The Interview and the Professional Rela tionship," Human Behavior and Social Processes. Ed. by Arnold Rose • Boston: Houghton Mifflin Company, 1962. Pp. 193”206. , and McPartland, Thomas S.' "An Empirical Inves tigation of Self Attitudes," American Sociological Review, XIX (February, 195M , 68-76. Laidlaw, Robert W. "The Psychiatrist as Marriage Counse lor," Readings in Marriage Counseling. Ed. by 291 Clark E. Vincent. New York: Thomas Y. Crowell Company, 1957. Pp. 52-60. Mace, David R. 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Creator Alexander, Francesca (author)

Core Title An Empirical Study On The Differential Influence Of Self- Concept On The Professional Behavior Of Marriage Counselors

Degree Doctor of Philosophy

Degree Program Sociology

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag OAI-PMH Harvest,psychology, social

Language English

Contributor Digitized by ProQuest (provenance)

Advisor Peterson, James A. (committee chair), Jacobs, Alfred (committee member), McDonagh, Edward C. (committee member)

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c18-614302

Unique identifier UC11360155

Identifier 6812023.pdf (filename),usctheses-c18-614302 (legacy record id)

Legacy Identifier 6812023.pdf

Dmrecord 614302

Document Type Dissertation

Rights Alexander, Francesca

Type texts

Source University of Southern California (contributing entity), University of Southern California Dissertations and Theses (collection)

Access Conditions The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the au...

Repository Name University of Southern California Digital Library

Repository Location USC Digital Library, University of Southern California, University Park Campus, Los Angeles, California 90089, USA