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The Differential Effectiveness Of External Versus Self-Reinforcement On The Acquisition And Performance Of Assertive Responses

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The Differential Effectiveness Of External Versus Self-Reinforcement On The Acquisition And Performance Of Assertive Responses

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University Microfilms
300 N orth Z e e b R oad
Ann A rbor, M ichigan 48106
A X erox E d u catio n C om pany
| 74-21,455
t
t.
I B O O R A E M , C urtis D e il, 1943-
f T H E DIFFERENTIAL EFFECTIVENESS O F E X T E R N A L
t VERSUS SELF-REINFORCEM ENT O N TH E ACQUISITION
! A N D P E R F O R M A N C E O F ASSERTIVE RESPONSES.
i'
I -
| U n iv ersity o f Southern C a lifo r n ia , Ph.D., 1974
I Psychology, c lin ic a l
i I
\ University Microfilms, A X E R O X Company, Ann Arboi, Michigan
THIS DISSERTATION HAS BEEN M ICROFILMED EXACTLY AS RECEIVED.
THE DIFFERENTIAL EFFECTIVENESS OF EX TERN A L
VERSUS SELF-REINFORCEMENT O N THE ACQUISITION
A N D PERFO RM AN CE OF ASSERTIVE RESPONSES
by
Curtis Deil Booraem
A Dissertation Presented to the
FA CU LTY OF THE G R A D U A TE SCH O O L
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
D O CTO R OF PHILOSOPHY
(Psychology)
January 1974
UNIVERSITY O F SOUTHERN CALIFORNIA
THE GRADUATE SCHOOL
UNIVERSITY PARK
LOS ANGELES. CALIFORNIA 9 0 0 0 7
This dissertation, written by
................C urtIs D el1 Booraem.....................................
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 of
the degree of
D O C T O R OF P H IL O S O P H Y
Dtan
DISSERTATION COMMITTE!
Chairman
A C K N O W L E D G E M E N T S
Aside from the always ready and valuable
assistance of my committee the following agencies and
individuals have contributed sincere and friendly
assistance:
The United States Veterans Administration
provided an administrative structure, freedom from
constraint, and a subsidy to the author, all of which
are gratefully acknowledged. Dr. George F. Seacat
and Dr. Allan E. Edwards, both with the Veterans
Administration, were invaluable in th eir criticism
and technical aid.
Finally, Dr. John V. Flowers of the
University of California, Irvine, is acknowledged
for his constant av ailability, c ritic a l evaluations
and unending support.
A BSTRA CT
32 male psychiatric in-patients, all diagnosed as psychotic,
were employed in a 2x2 factoral design assessing the differential
effectiveness of external versus self-reinforcement within a behavioral
rehearsal procedure. External Reinforcement (ER) was defined as a
positive evaluative statement administered by the therapist or coach
following the performance of an assertive response. Self-Reinforcement
(SR) was defined as a positive self-evaluation administered following
the performance of an assertive response. Blue tokens accompanied all
positive evaluations for the purpose of quantification. White tokens
were employed to halt the behavioral rehearsal process and were also
administered by the coach or the S, depending on the experimental
conditions. Experimental conditions consisted of; 1) a group receiving
both external and self-reinforcement; 2) self-reinforcement only;
3) external reinforcement only; and 4) neither systematic external nor
self-rei nforcement.
Results demonstrated significant performance changes in
frequency of assertive responses, response latency, self-evaluation,
and a subjective measure of anxiety as a function of self-reinforce
ment. External reinforcement failed to produce predicted performance
increments and a predicted significant interaction between external
and self-reinforcement was also not observed. Token data indicated
that while white tokens were employed to halt a rehearsal exchange,
they may have in fact have served as punishers, thereby washing out
the predicted ER SR interaction. Token data also indicated a d if
ferent reception rate of white tokens for the SR-only group,
suggesting self-reinforcement allows the S to establish his own
c rite ria for what he perceives as an assertive response likely to be
reinforced. W hen the appropriate response is performed and a s e lf
reinforcement is administered, i t appears to have greater (intensity)
impact,as indicated by subsequent performance, than similar reinforce
ment administered externally.
TABLE O F C O N T E N T S
Acknowledgements ............................................................................................... ii
A b s tra c t.................................................................................................................ii i
Table of Contents ............................................................................................ v
List of T a b le s................................................................................................... vi
List of I l l u s t r a t i o n s ............................................................................... v iii
CHAPTER I - HISTORICAL REVIEW................................................................... 1
Assertion Training Literature ...................................... 1
Self-Reinforcement Literature ...................................... 7
Current Problem .................................................................. 11
Hypothesi s .............................................................................. 13
CHAPTER II- METHOD........................................................................................... 15
S u b je c ts................................................................................... 15
M a t e r i a l s ............................................................................... 16
T h e r a p i s t ............................................................................... 16
P r o c e d u r e ............................................................................... 16
Pre-Treatment Group Assignment and
Assessment...................................................................... 16
T re a tm e n t...................................................................... 17
Post-Treatment Assessment ..................................... 22
CHAPTER III - RESULTS................................................................................... 23
I-E Scores, Pre-Treatment ............................................. 23
I-E Scores, Post-Treatment ............................................. 24
Assertion Response Latency ............................................. 24
Self-Evaluation Ratings ................................................. 26
Pulse R a t e s .......................................................................... 28
SUDS........................................................................................... 28
Token Administration .......................................................... 31
CHAPTER IV - DISCUSSION.............................................................................. 36
BIBLIOGRAPHY....................................................................................................... 41
APPENDIX A - SESSION 1 INSTRUCTIONS ...................................................... 45
APPENDIX B - M ASTER SCHEDULE O F ASSERTIVE REQUESTS ........................... 47
v
LIST O F TABLES
Table Page
1. Manova of Pre-treatment Rotter I-E Scores by ER,
SR, and Coaching C o nditions............................................................... 24
2. Manova of Post-treatment Rotter I-E Scores by ER,
SR, and Coaching C o nditions................................................................25
3. Manova of Performance Latency for Post-treatment
Assertion Situation #1 by SR, ER, and Coaching
C o n d i ti o n s ............................................................................................... 25
4. Manova of Performance Latency for Post-treatment
Assertion Situation #2 by SR, ER, and Coaching
Condi ti o n s ............................................................................................... 26
5. Manova of Self-evaluations of Post-treatment
Assertion Situation #1 by SR, ER, and Coaching
C o n d i ti o n s ............................................................................................... 27
6. Manova of Self-evaluations of Post-treatment
Assertion Situation #2 by SR, ER, and Coaching
C o n d i ti o n s ............................................................................................... 27
7. Manova of Pulse Rates Following Performance of
Assertive Situation #1 by SR, ER, and Coaching
C o n d i ti o n s ............................................................................................... 29
8. Manova of Pulse Rates Following Performance of
Assertive Situation #2 by ER, SR, and Coaching
C o n d i ti o n s ............................................................................................... 29
9. Manova of SUDS Following Performance of Assertive
Situation #1 by SR, ER, and Coaching Conditions . . . . 30
10. Manova of SUDS Following the Performance of
Assertive Situation #2 by SR, ER, and Coaching
C o n d i t i o n s ............................................................................................... 30
11. Performance Frequency of Post-treatment Assertive
Situation as a Function of the Self-reinforcement
Condition ............................................................................................... 31
12. Mean of Dependent Variable Measure (N = 8) by
Experimental C o n d i t i o n .........................................................................32
vi
LIST O F TABLES (CONT'D)
Table Page
13. Difference in ER Token U s e ..................... 33
14. Difference in SR Token U s e ....................................................... 34
15. Difference in ER and SR Token Use Between Systematic
ER and Systematic SR Conditions .......................................... 34
16. Correlations of Dependent Process Measures for
Situation # 2 ....................................................................................... 35
17. Correlation of Dependent Process Measures by
Token A c q u i s i ti o n .......................................................................... 35
vi i
LIST O F ILLUSTRATIONS
Figure
1. Diagram of Design
C H A P T E R I
HISTORICAL REVIEW
Assertion Training Literature
Mental health professionals have traditionally recognized
assertive behavior as an adaptive human response. Operating from a
neo-analytic theretical framework, Cameron (1951) developed a four-step
procedure for teaching assertive responses. The stepwise procedure
included: 1) recognition by the patient of his or her h o stility and
the key figure in its production, 2) preparation of the patient for
assertion against the key figure, 3) assertion phase (always in vivo),
and 4) management of post encounter period. Similarly, Kelly's (1955)
fixed role psychotherapeutic technique employed behavioral rehearsal
procedures of assertive responses. Specifically, Kelly (1955)
determined life situations which had given patients difficulty in the
past because of the p atient's inability to act assertively. Kelly
(1955) assigned his patients "enactments" to perform both during
therapy and in between sessions as homework. Kelly (1955) also
included "enactments" of current d iffic u ltie s and anticipated future
problems.
Despite the work of Cameron (1951) and Kelly (1955), Salter
(1949) probably did more to stimulate current assertion research than
any other investigator. In his conditioned reflex therapy, Salter
(1949) expressed a belief that man, like animal, is conditioned to
inh ibit his assertiveness from birth in order to conform to societal
1
living. Salter (1949) further hypothesized that neurosis often
results when an individual is in conflict over "excitatory feelings"
and "conditioned inhibitions." Salter (1949) stated, "It certainly
appears that the breaking of conditioned inhibitions is the objective
of psychotherapy—teaching the patient new excitations will eliminate
anxious excitations." In pursuit of this end Salter (1949) asked his
clients to use "feeling talk" (deliberate verbalizations of sponta
neously felt emotions) to increase their ability to express feelings
such as dislike, praise, impatience, etc. Salter (1949) considered
this procedure an effective way to externalize emotional responses that
were conditionally inhibited.
Wolpe (1958),stimulated by the work of Salter (1949), presented
the f i r s t systematic discussion of assertion training, and was the
f ir s t investigator to employ the Assertion Training label. Employing
a reciprocal inhibition model, Wolpe (1958) maintained that assertive
responses were incompatible with anxiety and, like relaxation, could
be used to inhibit anxiety. Wolpe (1958) proceeded to demonstrate a
generalized reduction of anxiety to social situations as a function of
the acquisition and performance of assertive responses in problematic
social encounters.
Despite the apparent therapeutic potential of assertion
training procedures, clinical researchers were slow in investigating
the mertis of such procedures in either the laboratory or in controlled
clinical settings.
However, Lazarus (1966) initiated what was to become a
concerted effort aimed a t identifying the components comprising the
assertion training procedure. Lazarus (1966) demonstrated that
behavioral rehearsal was significantly more effective than direct
advice or non-directive reflection in replacing d e fic it or inadequate
social or interpersonal responses under the direction and supervision
of the therapist. The goal in Lazarus' (1966) groups was to increase
congruence between verbal and non-verbal communication, decrease
anxiety, and foster assertive, as opposed to aggressive or withdrawing
messages.
Following the work of Lazarus (1966), subsequent assertion
research examined two discrete experimental variables, task and subject
In keeping with the task examination approach of Lazarus (1966),
McFall and Marston (1970) sim ilarly demonstrated a behavioral rehearsal
procedure to be significantly superior in improving subjects'
assertive responses when compared with placebo therapy or no treatment.
The findings of McFall and Marston (1970) were more dramatic than those
of Lazarus (1966) insofar as behavior, physiological, self-report and
an "in vivo" unobtrusive tests were employed as dependent measures,
and effectively discriminated between treatment modalities.
In this f i r s t of a series of studies, McFall and Marston (1970)
suggest that the best strategy for developing behavioral rehearsal as
a usable treatment method is to take an empirical "constructive"
approach:
"(The investigator) s ta r ts by isolating the most fundamental,
or theoretically significant, treatment component, and assesses its
effects on behavior. Then, building on th is base, new treatment
components are systematically added to determine whether they
significantly enhance the fundamental treatment effects .. ." (p. 302).
In keeping with this strategy, McFall and Lillesand (1971)
demonstrated that both a covert rehearsal procedure, coupled with
modeling and coaching, and an overt procedure, coupled with modeling
and coaching, were superior to a control condition in the performance
of assertive refusal responses. Covert rehearsal tended to produce
the greatest improvement. With regard to this tendency, McFall and
Lillesand (1971) put forth the interesting hypothesis that refusal
behavior is anxiety provoking to many subjects because i t involves
emitting an explicitly negative response under conditions likely to
invoke social disapproval. In the McFall and Lillesand (1971)
procedure, subjects in the overt condition heard playbacks of their
tape-recorded practice responses. The McFall and Lillesand (1971)
discussion suggests that the anxiety provoked through audio presenta
tion of refusal response inhibits to some extent the performance of
subsequent assertive responses.
While Lazarus (1966) and the empirical constructive approach
of McFall and Marston have contributed considerably to our current
understanding of assertion training procedures, other investigators
have endeavored to expand the applicability of assertion training in
the clinical setting. Employing a somewhat crude and much less
rigorous assertion training procedure, Lomont, Gilmer, Spector and
Skinner (1969) demonstrated the applicability of assertion training to
the group therapy setting. Comparing group assertion training with
5
group insight therapy, Lomont, Gilmer, Spector and Skinner (1969)
demonstrated significant decreases on clinical scales D & PT of the
M.M.P.I., as a function of group assertion training. Nearly
significant (p < .10) decreases were also observed on scales PD, PA,
and SC of the M.M.P.I., and a nearly significant (p < .06) increase
was observed on the dominance-submission dimension of the Leary ICL.
The insight therapy group demonstrated no t e s t score changes that
approached significance.
Similarly, Hedquist and Weinhold (1970) examined the applica
b ility of assertion training to the group therapy situ atio n . However,
the work of Hedquist and Weinhold (1970) employed the Lazarus (1966)
assertion training procedure and compared i t with a social learning
procedure based on the work of Mainord (1968) and a control condition.
Hedquist and Weinhold (1970) found that both experimental conditions
produced significantly more verbal assertive responses in unassertive
college students than the control conditions with the same population.
The dependent variable was the performance of assertive responses
outside of the therapy setting. An interesting re s u lt of the Hedquist
and Weinhold (1970) research was the observation th a t the treatment
effects lasted only for the duration of the treatment.
I t has been demonstrated th a t the rigorous assertion training
procedures of Lazarus (1966), and McFall and Marston (1970, 1971) as
well as the loosely defined procedures of Lomont, Gilmer, Spector and
Skinner (1969) are applicable in eith er group or individual treatment
with unassertive college students, socially anxious veterans, and
passive depressed middle-aged housewives. Endeavoring to further
extend the applicability of assertion training, Booraem and Flowers
(1972) developed and adopted additional procedures for use with
severely disturbed psychiatric in-patients. In a rather loosely
defined fashion, Booraem and Flowers (1972) employed "negative
assertion" techniques aimed at teaching patients how to avoid unwar
ranted punishment and then followed with "positive assertion"
techniques, which were designed to teach sk ills in social acquisition.
Booraem and Flowers (1972) demonstrated a decrease in anxiety and
personal space requirements as a function of assertion training when
compared to a control condition.
Subsequent research by Flowers and Guerra (in press)
demonstrated that client coaching is a valuable and useful procedure
in assertion training with large groups. Employing clien t's
selection of the proper assertion strategy as a dependent measure,
Flowers and Guerra (in press) demonstrated that a subject coached by
a fellow client performed better in later assertion performance than
clients coached by a professional. Secondly, Flowers and Guerra
(in press) demonstrated that a client who experiences coaching,
performed better than clients who did not have the coaching
opportunity.
In reviewing the assertion training lite ra tu re, we can draw
several general conclusions. Behavioral rehearsal and coaching by
either therapist or client are well defined procedures which produce
effective behavior change. W e can also conclude that behavioral
rehearsal and coaching of assertive responses increase the likelihood
of S/s performing assertively subsequent to the assertion training
procedure. There is some evidence to indicate that an increase in
assertive behavior is coupled with a decrease in anxiety, fear of
social situation and interpersonal distance. Finally, research
indicates that assertion training procedures are applicable to the
severely disturbed as well as the moderately disturbed as long as the
procedures deal with the basic deficits of the population.
Self-Reinforcement Literature
W hen assertion training is reviewed in general therapy context
(Krumboltz and Thorenson, 1969; Sager and Kaplan, 1973), i t is often
referred to as a self-control technique. However, while the anxiety,
behavioral rehearsal and coaching aspects of assertion training have
received at least preliminary attention, the self-control aspect of
assertion training remains merely an armchair theoretical issue. Only
in the work of Rehm and Marston (1968) has self-control in assertion
training been considered. However, while the Rehm and Marston (1968)
research demonstrated therapeutic advantages in employing self-
reinforcement procedures, the self-reinforcement procedures were not
compared with other systematically controlled reinforcement conditions.
Skinner (1953) contended that the individual "controls himself
precisely as he would control the behavior of anyone else — through
the manipulations of variables of which behavior is a function."
Discussing at length methods with which the individual effects and
maintains self-control, Skinner (1953) attempted to deal with the
observation that much of our learned behavior is maintained without
the continued external administration of even highly generalized
reinforcers. Operant reinforcement was one of the methods of self-
control mentioned by Skinner (1953). Operant self-reinforcement,
defined in the context of self-control as the self-administrati on of
reinforcement without restrictio n s, has become a continuing target for
clinical investigation.
Laboratory research has examined variables which influence the
pattern of self-reinforcement as well as the effects of self-reinforce
ment on the behavior being self-evaluated. Variables found to affect
administration of self-reinforcement (SR) include: incentive associated
with the reinforcement (Marston and Kanfer, 1963) level of learning of
the behavior being evaluated (Kanfer and Marston, 1963B); prior
reinforcement for varying rates of self-reinforcement (Kanfer and
Marston, 1963A); social imitation of a model's pattern (Bandura and
Kupers, 1964); a general tendency for the (SR) experience and the
reinforcing of another subject, regardless of the model condition, to
raise the rate of self-reinforcement (Marston and Smith, 1968); and an
increased rate of self-reinforcement following success (Masters, 1972).
Research examining the effects of self-reinforcement on the
behavior being self-evaluated has appeared with lesser frequency.
Marston (1967) demonstrated self-reinforcement to be superior to
external reinforcement in visual-motor learning. In the context of
that research, Marston (1967) reported "the same incentives s e lf
administered seem to have a more uniformly positive effect than
external reinforcement. Self-evaluations in the present study can be
described as reinforcing events in the simple operational sense of
increasing the probability of correct response above that produced by
information alone."
Marston (1965) discussed the relevance of the self-reinforce
ment research to psychotherapy but i t wasn't until three years hence
that the f i r s t systematic investigation examining the merits of se lf
reinforcement procedures within a therapeutic procedure involving
assertive responses was forthcoming. In an investigation conducted in
the Marston laboratory, Rehm and Marston (1968) found a self-reinforce
ment procedure in which S/s increased both their rate and accuracy of
positive self-reinforcement to be superior to both a non-directive
technique a no-treatment control on: (a) self-reports of anxiety and
overt behavior, (b) verbal output in a te s t simulating social inter
action, (c) generalization scores on the Manifest Anxiety Scale and
Adjective Check List (Rehm and Marston, 1968).
However, as tenuous as the component research is , the issue of
self-reinforcement and i ts specific relationship to assertion training
as a self-control form of therapy is even less well denoted and
investigated. Given that the contribution of self-reinforcement to
assertion training procedures has received so l i t t l e attention, i t is
not surprising that the differential contributions of self-reinforce
ment and external reinforcement to the training or maintenance of
assertive responses has been, for all practical purposes, uninvesti
gated. The present study addresses this specific issue.
While the development of self-reinforcement applications in
psychotherapy research has been slow, discussions on the.merits of
self-control, self-management, self-reinforcement and the like have
proliferated. Kanfer (1970), in discussing the acquisition of self-
knowledge and its effect on behavior, states that "the most striking
feature about self-knowledge, however, is that i t is often absent in
areas th a t are most crucial to social functioning. The social
environment provides direct and immediate feedback about an individual's
effects on i t only rarely. Although a person's behavior has
continuing consequences, environmental feedback is frequently delayed,
too vague, or withheld. What a man's best friend cannot or will not
tell him is often the discrepancy between judged and actual
effectiveness." In developing a therapeutic program that employs self-
reinforcement as i t s primary source of reward the therapist is
circumventing the delayed, vague or often withheld feedback and/or
reinforcement provided by the external environment. Rehm and Marston
(1968) sta te that "therapy designed to shape positive self-reinforce
ment, along with the performance of a specific set of behaviors ( i .e . ,
assertive responses) has a dual advantage in that positive s e lf-
reinforcement is shaped in such a way as to increase its probability
of occurrence in the presence of the discriminative stimuli arising
from the performance of the desired behavior as well as increasing the
probability of performing the desired behavior." Under these
circumstances Rehm and Marston (1968) state that "the therapist acts,
in theory, almost as i f the patient were two organisms: one socially
responding and one self-evaluating. In practice, both socially
responding and self-evaluating behavior are being shaped, each to the
fa c ilita tin g e ffect of the other.
The therapeutic use of teaching self-evaluation behavior can
be used to attack one of two client problems. The client may already
be evaluating his performance covertly, but may be doing so negatively
with consequent performance suppression. Secondly, the client may
simply not be self-evaluating at all (covert deficit) and therefore
neither be cuing nor maintaining behavior in the absence of external
reinforcement. In the f i r s t case the client has an internal locus of
control (Rotter, 1965) but i t is maladaptive. In the second case,
the client is externally controlled. W e would presume that therapy
designed to shape positive sel f-reinforcement would also change the
locus of control from external to internal, as opposed to merely
changing the content of the self-control. The present study will
examine this theoretical extension of the self-reinforcement concept.
Current Problem
The current investigation is concerned with assessing the
differential effectiveness of self-reinforcement versus external
reinforcement in the performance of assertive behavior. While the
efficacy of self-reinforcement procedures has been demonstrated, no
systematic clinical evaluation of the relative merits of se lf
reinforcement versus external reinforcement has been reported. While
such an endeavor would be valuable in its own right, i t is of perhaps
greater importance when evaluated within an assertion training
procedure. Assertive responses are unique in that negative assertion
tends to be immediately and continuously reinforced as a function of
withdrawal of the noxious stimuli, while positive assertion is
12
generally maintained by interm ittent reinforcement which is often
delayed. Training in negative assertion techniques is generally
successful immediately; while training in positive assertion
techniques, especially those aimed at acquiring interpersonal
relationships, is often effected only a fte r repeated t r ia ls in the
treatment setting as well as "in vivo".
These observations suggested that self-reinforcement would be
more effective in maintaining the performance of assertive acquisition
behaviors than external reinforcement, the contention being that s e lf
reinforcement responses, i f appropriately acquired, would serve to
maintain an assertive acquisition response until that response was
appropriately rewarded externally.
In order to examine the relative merits of external versus
self-reinforcement, a system was needed that would appropriately
discriminate and quantify external reinforcement from self-reinforce
ment. Employing a procedure developed by Flowers, Booraem, Brown and
Harris (1974) SJs in the current investigation were reinforced by
positive evaluations accompanied by tokens unrelated to tangible
reinforcers, thus providing an observable procedure. The tokens were
either se lf or therapist administered and all S^'s kept track of th eir
tokens, thereby providing quantification. The reception of all tokens
was accompanied by a positive self-evaluative statement. The Flowers,
Booraem, Brown and Harris (1974) procedure required an overt self-
evaluation as opposed to the covert self-evaluation required by the
above-mentioned authors. Marston (1965) suggested that covert s e l f
reactions act in self-rewarding ways parallel to the operation of
13
overt self-reinforcement and that variables that affect overt self-
reinforcement also affect covert self-reinforcement similarly. That
this is the case had been amply established (Anant, 1968, e t a l ,
above). The advantage of the Flowers, Booraem, Brown and Harris (1974)
technique was its ease of quantifiability and the fact that i t did not
rely on subject-monitored self-report.
Hypothesis;
The current investigation proposed several general hypotheses.
Subjects in the self-reinforcement conditions would demonstrate
greater performance increments when compared to S/s not experiencing
systematic self-reinforcement procedures. The S_'s in external rein
forcement conditions would demonstrate greater performance increments
when compared with S/s experiencing neither systematic self-reinforce
ment nor external reinforcement. Finally, S/s in the coaching
condition would demonstrate greater performance increments when
compared with S/s not experiencing coaching procedures. Performance
. t
was assessed by recording the frequency and latency of post treatment
assertive responses. Related dependent variables assessing anxiety
associated with performance of the post treatment assertive
situations included: recording of S_'s pulse rates, a subjective
measure of anxiety, and a self-evaluation of task performance.
Finally, pre- and post-measures of locus of control (Rotter's I-E
rule) were used to assess the effect of assertion training on this
dimension.
14
No Coaching
Coaching
Systematic
Self-rei nforcement
Non-Systematic
Self-rei nforcement
Non-systematic External
Systematic External
Reinforcement Reinforcement
Figure 1. Diagram of Design
C H A P T E R I I
M ETH O D
Subjects
Forty male psychiatric in-patients, diagnosed as psychotic,
all voluntarily consenting subjects, residing at the Long Beach
Venerans Administration Hospital, were employed in the current
investigation. For the purpose of the current study, a psychotic
patient was defined as an individual who had been evaluated by the
professional s ta ff of the psychiatric service, diagnosed psychotic,
and subsequently confined to the hospital for treatment. Only subjects
without known organic impairment, or mental deficiency, and who were
able to read and understand the English language, were included in the
investigation. Individuals involved in any ongoing group therapy were
also excluded from participation in the study.
The c rite ria for referral for participation in the current
project was dependent upon the S/s physician's judgment that the ^
was deficient in assertion sk ills and was in need of an assertion
training program. Of approximately 400 available patients 164 subjects
who met the study's c rite ria were referred. Forty S/s were randomly
selected from the referral subject pool with six S_'s declining
inclusion in the investigation. The age range of S_'s was 22 to 55,
with a mean age of 29.7.
15
16
Materials
Depending on the treatment condition, subjects and therapist
were given 20 blue and 20 white 2x2 inch tokens made of construction
paper. Each group member was also given a one-pound coffee can (empty)
in which to store tokens received. The Rotter I-E (1966) locus of
control questionnaire was also administered to all S/s.
Therapist
The experimenter (E) was the therapist in all groups. Outcome
measures were recorded by an independent rater. The therapist was ex
perienced in therapeutic contact with severely disturbed psychiatric
patients as well as in assertion training and behavioral rehearsal
techniques.
Procedure
Pre-Treatment Group Assignment and Assessment
S^'s were randomly assigned in groups of 10 to one of the four
treatment conditions. The groups were run successively with a new group
beginning approximately every 5 to 7 days. All groups met daily for a
total of 10 sessions. During the pre-treatment sessions S/s were ad
ministered the Rotter I-E. The S's were also instructed to compile a
l i s t of social requests that the S_'s perceive as especially d iffic u lto r
impossible to propose. They were then instructed on hierarchy construc
tion employing the SUDS (Krumboltz and Thorensen, 1969; Wolpe and
Lazarus, 1966) method for rating subjective anxiety. A SU D S
(Subjective Units of Disturbance Scale) was a numerical scale ranging
from 0 to 100 on which 0 represented the most relaxed an individual
could imagine himself as being, and 100 represented the most anxious an
individual could imagine himself as being. Given this range of scores,
an individual self-determined his subjective anxiety for any given
situation. They then assigned a SUDS level to each previously recorded
request. Since the treatment procedure employed a desensitization
model for rehearsal, S's were instructed to l i s t all group members,
including therapist, and to assign a SUDS level to each member which
would reflect the requestor's subjective anxiety upon making a common
request of each member. S's were informed that the current investiga
tion was a research project and that th e ir participation was s tric tly
voluntary. If S/s wished to continue in treatment they were instructed
to f i l l out and sign a consent form. Upon completion of the pre-treat-
ment assessment and group assignment, requests were compiled into a
master schedule in which the request occurring with the greatest
frequency was designated Request #1 and wa.s followed by the remainder
of the requests in descending order of frequency. Requests were then
rehearsed in accordance with the master schedule in each treatment
session. The Rotter I-E was also scored a fte r Session 1, and the 4 S's
in each group with the lowest I scores were assigned to the coaching
condition.
Treatment
The therapeutic format was identical for all treatment
conditions. The reinforcement procedure was the primary independent
variable. All S_'s rehearsed for approximately 9 minutes during each
session. All S/s rehearsed each situation the same number of tria ls .
All S/s rehearsed with all other group members in hierarchical order.
S/s in the coaching condition served in that capacity for approxi
mately 15 minutes each session. E began Session 2 by announcing that
4 group members had been randomly selected to serve as coaches and
that their selection was in no way related to their competence. E
then proceeded to write the f i r s t four requests from the master
schedule on a blackboard located in the therapy room. Upon completion,
E then handed out the group membership hierarchies constructed during
the pre-treatment session. Beginning with Request #1, E asked each
group member to assign a SU D S level to that request. The group
member with the highest subjective anxiety level for that item was
then instructed to begin the rehearsal procedure with that group
member lowest on his group membership hierarchy. S ^ then rehearsed
until he was appropriately reinforced or until he was satisfied with
his performance depending on the reinforcement condition. The number
of tria ls required for reinforcement for the S^with the highest
reported subjective anxiety on Request #1 was then the number of
times the remainder of the group members would rehearse that request.
W hen all group members completed Request #1, the procedure was
repeated with Request #2. During Session 2, E served as coach for all
groups and set standards of performance for all members.
Group 1:Systematic Self-Reinforcement—Systematic External
Reinforcement. S_'s in the rehearser role had before them 20 blue and
20 white tokens. Each request interchange was broken down into single
sentences. Following the statement of each sentence, was instructed
to evaluate his performance with a token and a statement. The S/s
were instructed to take a blue token i f they f e l t they performed the
f i r s t sentence of the request being rehearsed in an assertive manner.
£ 's were also instructed to make a positive self-evaluative statement
about his performance. He was assisted in this by the coach.
Assistance consisted of asking the i f he thought he performed well.
If responded in the affirmative, the coach then instructed to
verbalize that he (S) did well. If S _ responded that he did not know
i f he did well, the coach informed S _ that he did well and that
should acknowledge that observation verbally. S/s were instructed to
take a white token i f they wished help with their performance. S/s
were also instructed to take a token following each statement. S/s
in the coaching condition also had 2 0 blue and 2 0 white tokens.
Coaches were instructed to give a blue token i f the rehearsing had
taken a blue token himself, had made a positive self-evaluative s ta te
ment, and the coach concurred with the evaluation. The coaches were
instructed to give a white token to the rehearsing only i f the coach
determined that the had taken a blue token inappropriately. W hen
inappropriate token dispensing occurred, the coach simply asked the
rehearsing to try the sentence again. The coaches were instructed
never to give negative feedback when administering a white token,
since the purpose of the white token was to stop the interchange so
the statement could be repeated. As long as blue tokens were taken
and not challenged by the coach, the interchange continued until its
completion. If persisted in taking white tokens following the
20
performance of an appropriate assertive response, the coach instructed
the to take blue token and informed S _ that his response was
appropriately assertive. During each treatment session, all S's
assumed the roles of rehearser for approximately 10 minutes. All S/s
assumed the role of rehearsee for approximately 1 0 minutes during
each treatment session. S/s assigned to the coaching condition
assumed the coach role for approximately 15 minutes during each tre a t
ment session.
Group II:Non-systematic Self-reinforcement-Systematic
External Reinforcement. All tokens were administered by the coaches
in Group II. S's in the rehearser role were instructed to begin with
the f i r s t sentence of Request #1. Upon completion of the f i r s t
sentence of Request #1, S _ was administered a token by the coach.
was instructed that the reception of a blue token and its accompanying
positive evaluative statement indicated appropriate performance and
the was to continue to the second sentence. S _ m s also instructed
that the reception of a white token indicated that the interchange had
been stopped and the rehearsing ^ was to try the sentence again. It
was emphasized that negative evaluative statements were never to
accompany the administration of a white token. As long as blue tokens
were administered the interchange was allowed to continue to its
completion. The coach assisted the rehearser in following the format
of the rehearsal procedure, assured that the S/s rehearsed with each
other in hierarchical order, rehearsed for the same amount of time
each session, and that all S^'s rehearsed each request situation the
21 :
i
same number of tr ia ls .
Group III: Systematic Self-reinforcement—Non-systematic
External Reinforcement. In Group III a ll tokens were administered by
the rehearser. S/s in the rehearser role were instructed to begin with
the f i r s t sentence of Request #1. Upon completion of the f i r s t
sentence of Request #1, S^s were instructed to take either a blue or
a white token. If a blue token was selected, SJs were instructed to
make an appropriate self-evaluative statement and to proceed to the
next sentence. If a white token was taken, S/s were instructed to
repeat the f i r s t sentence again, until S.'s were satisfied with their
performance. Subsequently, S^'s awarded themselves blue tokens
accompanied by an appropriate self-evaluative statement. The therapist
emphasized that negative statements were never to accompany white
token reception. As long as an awarded himself blue tokens, the
interchange continued until its completion. The coach assisted the S
in following the format of the rehearsal procedure, monitored S/s
performance, and assured that S_'s rehearsed with each other in
hierarchical order, rehearsed for the same amount of time each session,
and that all £ 's rehearsed each request situation the same number of
t r ia ls . In the event that ^ p e r s is te d in taking white tokens following
the performance of an assertive response, the coach instructed the
to take a blue token and informed the S. that his performance was
appropriate.
22
Group IV: Non-systematic Self-reinforcement, Non-systematic
External Reinforcement. In Group IV tokens were not administered by
either rehearsing S/s or the coach nor were systematic self-evaluative
statements requested. The format for rehearsal was identical to that
of Groups I, II and III. The coach assisted the rehearsing S_'s in
following the format of the rehearsal procedure, assured that S/s
rehearsed each hierarchical order, for each session rehearsed for the
same amount of time, and that all S/s rehearsed each request situation
the same number of tria ls . It was emphasized to all S's that negative
statements were seldom beneficial and that the S^with the highest
reported subjective anxiety in each rehearsal situation should
rehearse for enough tria ls to be satisfied with his own performance.
Post-Treatment Assessment
O n the day following the 10th treatment session, all S_'s were
readministered the Rotter I-E in groups. Upon completion of the Rotter
I-E, S/s were given an appointment for later that day with a hospital
employee, unknown to them, who administered the "in vivo" assertion
te st. The assertion test consisted of the performance of one previously
rehearsed assertive response and one previously unrehearsed assertive
response. The responses required were; 1) request the temporary use of
a pen from an unknown secretary, and 2 ) request an appointment with the
_S's physician for the purpose of requesting a special pass to leave the
hospital for one day. Following the performance of the assertive
responses, the E's confederate recorded response latency, frequency,
SUDS and pulse rates. S/s were also requested to evaluate their own
performance on a 4-point scale.
C H A P T E R I I I
RESULTS
The major questions posed in the current investigation concern
the relative contributions of self-reinforcement, external reinforce
ment and coaching experience variables on the outcome of assertion
training with severely disturbed psychiatric in-patients. The
dependent variables employed in the current research were pre=post
I-E scores, response latency, pulse rates, self-reported anxiety, se lf-
evaluations, and the occurrence or non-occurrence of targ et assertive
responses in two assertion situations of increasing d iffic u lty .
The data were analyzed using the biomedical computer program
X63 of the U CLA Health Sciences Computing Facility (Dixon, 1969). The
program computes the usual F values for between group hypotheses. The
m ultivariate te s t is described by Anderson (1958) and is a general
ization of the Hotelling's T2 t e s t (Winer, 1962). There were three
between variables (self-reinforcement, (SR); external reinforcement,
(ER); and coaching, (C)) within the current design.
I-E Scores, Pre-treatment
Examining the effects of the independent variables on I-E
scores (Table I), no significant self-reinforcement (F = .934) or
external reinforcement (F = .270) differences were found prior to
treatment. However, there was a significant main effect for
coaching (F = 45.75, 1, 24, P < .01) which was confounded by assign
ment of low "I" S^'s to the coaching condition and high "I" S^'s to the
......................................................................... 23 .............................................................
24
non-coaching condition. There were no significant interactions among
independent variables.
TABLE 1
M A N O V A OF PRE-TREATM ENT ROTTER I-E SCORES
B Y ER, SR, A N D COACHING CONDITIONS
Source of Variance df F
SR 1, 24 .934
ER 1, 24 .270
C 1, 24 45.751
SR X ER 1, 24 1.994
SR X C 1, 24 .448
ER X C 1, 24 .448
SR X ER X C 1, 24 .049
I-E Scores, Post-Treatment
There were no significant main effects for the self-reinforce-
ment variable (F = .076, 1, 24, NX) or the external reinforcement
(F = 1.701, 1, 24, N X ) (Table 2) variable. However, because of subject
assignment to the coaching condition, there was again a significant
main effect for coaching (F = 15.26, 1, 24, p < .0 1 ). There was no
significant interaction among independent variables on post-treatment
I-E scores.
Assertion Response Latency
In examining the effects of the independent variables on
response latency in Assertive Situation #1 (Table 3), no significant
main effects for self-reinforcement (F = .969, 1, 24, NS), external
25
TA B LE 2
M A N O V A OF POST-TREATM ENT RO TTER I-E SCO RES
B Y ER, SR, A N D CO A CH IN G CONDITIONS
Source Variance df F
SR 1, 24 .076
ER
1, 24 1.601
C 1, 24 15.260
SR X ER
1, 24 1.092
SR X C 1, 24 .875
ER X C
1, 24 .076
SR X ER X C 1, 24 .681
TA BLE 3
M A N O V A O F PER FO RM A N C E LA TEN C Y FOR POST-TREATM ENT ASSERTION
SITUATION #1 B Y SR, ER, A N D CO A CH IN G CONDITIONS
Source of Variance df F
SR 1, 24 .969
ER
1, 24 .517
C 1, 24 .013
SR X ER
1, 24 .573
SR X C 1, 24 .006
ER X C
1, 24 .038
SR X ER X C 1, 24 .694
reinforcement (F = .517, 1, 24, NS), or coaching (F = 1.349, 1,24, NS).
However, a significant main effect was observed for self-reinforcement
s' "
(F = 7.197, df 1, 24, p. <.01) in the direction of decreased perform
ance latency for the systematic self-reinforcement groups.
26
There were no significant interactions in the latency analysis of
Assertive Situation #2.
TABLE 4
M A N O V A OF PERFO RM AN CE LA TEN CY FOR POST-TREATM ENT ASSERTION
SITUATION #2 B Y SR, ER, A N D CO ACH IN G CONDITIONS
Source of Variance df F
SR 1, 24 8.500
ER 1, 24 1.690
C 1, 24 1.848
SR X ER 1, 24 . 0 1 0
SR X C 1, 24 .095
ER X C 1, 24 3.640
SR X ER X C 1, 24 .265
Self-Evaluation Ratings
The self-evaluation data for Assertive Situation #1 (Table 5)
demonstrated no significant main effects for external reinforcement
(F = .00, 1, 24, NS) or coaching (F = 1.349, 1, 24, NS). However,
again the self-reinforcement variable demonstrated a significant main
effect (F = 5.36, df, 1, 24, p. <.05) in the direction of higher self-
evaluation for the systematic self-reinforcement groups. There were
no significant interactions.
The self-evaluation data for Assertive Situation #2 indicated
no significant main effect of external reinforcement (F = .103, 1, 24,
NS) (Table 6 ). The SR variable demonstrated a significant main effect
in the direction of higher self-evaluation (F = 6.62, 1, 24, p. <.05)
for the systematic self-reinforcement conditions. The coaching
variable also exhibited a significant main effect (F = 6.62, 1, 24,
pi < .05) with coaches demonstrating significantly higher self-eval
tions than non-coaches. There were no significant interactions.
TABLE 5
M A N O V A OF SELF-EVALUATIONS OF POST-TREATM ENT ASSERTION
SITUATION #1 B Y SR, ER, A N D CO A CH IN G CONDITIONS
Source of Variance df F
SR 1, 24 5.400
ER 1, 24 . 0 0 0
C 1, 24 1.349
SR X ER
CM
*
. 0 0 0
SR X C 1, 24 1.349
ER X C
*
P O
• f *
1.349
SR X ER X C 1, 24 .149
TA BLE 6
M A N O V A O F SELF-EVALUATIONS OF POST-TREATM ENT ASSERTION
SITUATION #2 B Y SR, ER, A N D CO A CH IN G CONDITIONS
Source of Variance df F
SR 1, 24 6.620
ER 1, 24 .103
C 1, 24 6.620
SR X ER 1, 24 . 0 0 0
SR X C
CM
.931
ER X C 1, 24 .414
SR X ER X C 1, 24 .931
28
Pulse Rates
Examining the effects of the independent variables on pulse
rates, immediately following Assertive Situation #1 (Table 7), no
significant self-reinforcement (F = .052, 1, 24, NS), external rein
forcement (F = 3.057, 1, 24, NS) or coaching (F = .005, 1, 24, NS)
effects were found. There were no significant interactions.
Similarly, the effects of the independent variables on pulse
rates immediately following Assertive Situation #2 (Table 8 ) indicated
no significant self-reinforcement (F = 2.156, 1, 24, NS), external
reinforcement (F = 4.226, 1, 24, NS) or coaching (F = .086, 1, 24, NS)
main effects. There were no significant interactions.
SU D S
Examining the effects of the independent variables on sub
jectively reported discomfort in Assertive Situation #1, no external
reinforcement (F =.395, 1, 24, NS) or coaching (F = .746, 1, 24, NS)
main effects were observed (Table 9). However, a significant main
effect on the self-reinforcement variable was observed on the
subjective units of discomfort dependent variable in the direction of
less self-reported discomfort (F = 4.499, 1, 24, p <.05) for systemat
ic self-reinforcement conditions. No significant interactions were
observed.
The data for the independent variables on subjectively re
ported discomfort for Assertive Situation #2 indicated no significant
main effects (Table 10) for external reinforcement (F = .001, 1, 24,
NS) or coaching (F = .679, 1, 24, NS).
TABLE 7
M A N O V A OF PULSE RATES FO LLO W IN G PERFO RM A N CE OF ASSERTIVE
SITUATION #1 B Y SR, ER, A N D CO A CH IN G CONDITIONS
Source of Variance df F
SR 1, 24 .052
ER
1, 24 3.057
C 1, 24 .005
SR X ER
1, 24 .283
SR X C 1, 24 .145
ER X C
1, 24 .052
SR X ER X C 1, 24 .145
TABLE 8
M A N O V A OF PULSE RA TES FO LLO W IN G PERFO RM A N CE OF ASSERTIVE
SITUATION #2 B Y SR, ER, A N D CO A CH IN G CONDITIONS
Source of Variance df F
SR 1, 24 2.156
ER 1, 24 4.226
C 1, 24 .086
SR X ER 1, 24 2.157
SR X C 1, 24 4.227
ER X C 1, 24 .469
SR X ER X C 1, 24 .469
30
TABLE 9
M A N O V A OF SUDS FOLLOW ING THE PERFORM ANCE OF ASSERTIVE
SITUATION #1 B Y SR, ER, A N D COACHING CONDITIONS
Source of Variance
df F
SR 1, 24 4.499
ER 1, 24 .395
C 1, 24 .746
SR X ER 1, 24 . 2 2 2
SR X C 1, 24 1.783
ER X C 1, 24 1.58
SR X ER X C 1, 24 4.839
TABLE 10
M A N O V A OF SUDS FOLLOW ING THE PERFO RM AN CE OF ASSERTIVE
SITUATION #2 B Y SR, ER, A N D COACHING CONDITIONS
Source of Variance
df F
SR 1, 24 10.168
ER 1, 24 . 0 0 1
C 1, 24 .679
SR X ER 1, 24 .103
SR X C 1, 24 .463
ER X C 1, 24 .935
SR X ER X C 1, 24 3.082
31
Again, however, there was a significant main effect for self-reinforce
ment (F = 10.168, 1, 24, p < .01) in the direction of decreased self-
reported discomfort for the systematic self-reinforcement groups. No
significant interactions were observed.
The occurrence or non-occurrence of the post-treatment
assertive responses were analyzed by a Fisher's Exact Test (Table 11)
because one cell frequency was too low to permit employment of
chi square. Results indicated that S^s in the systematic self-rein
forcement condition were more likely to perform the post-treatment
assertive responses than S's in all other conditions (p = .0259).
TABLE 11
PERFO RM A N CE FREQ U EN CY OF POST-TREATM ENT ASSERTIVE SITUATIONS
AS A FUNCTION O F THE SELF-REINFORCEM ENT CONDITION
Refuse Refuse
SR 5 27
SR 0 32
Table 12 presents the means of all dependent variables across
treatment groups. This table is presented as a summary of the effects
of the four treatment conditions on the dependent measures.
Token Administration
Since the three groups which employed tokens were each different
experimental conditions, token data examination had to be conducted by
TABLE 12
M E A N OF DEPENDENT VARIABLE M EA SU RES
(N = 8 ) B Y EXPERIM ENTAL CONDITION
ER SR ER SR ER SR ER SR
IE Pre 13.88 13.50 12.25 14.25
IE Post 15.38 13.88 12.75 13.63
Latency
Situation - 1
21.75 22.50 16.88 22.63
Latency
Situation - 2
35.88 83.38 56.13 107.00
Self-
Evaluation - 1
3.38 3.63 3.38 2.63
Self-
Evaluation - 2
3.00 2 . 0 0 3.13 2.13
Pulse - 1 13.63 13.88 15.50 14.88
Pulse - 2 15.00 15.00 17.25 15.38
SUDS - 1 41.88 50.00 33.13 53.75
SUDS - 2 55.00 80.00 51.88 82.50
separate analysis. Three comparisons contributed to the understanding :
of the differential effectiveness of external versus self-reinforcement'
were possible.
Comparison 1 was conducted between token use in the non-
systematic self-reinforcement - systematic external reinforcement
condition and the external reinforcement token data from the systematic
self-reinforcement - systematic external reinforcement condition. As
Table 13 indicates, there were no significant differences between total
t r ia ls , blue tokens administered, or white tokens administered.
TABLE 13
DIFFERENCE IN ER TO K EN U SE
Variable
Condition
T P ER ER SR
X a S.D. X o S.D.
Trials 43.13 25.33 53.50 34.67 . 6 8 N S
Blue 38.62 23.49 47.87 32.11 .67 N S
White 4.62 3.11 5.38 3.07 .49 N S
Comparison 2 was conducted between token use in the systematic
self-reinforcement - non-systematic external reinforcement condition.
Again, as Table 14 indicates, there were no significant differences
between total tr ia ls , blue tokens taken, or white tokens taken.
Comparison 3 conducted between the systematic self-reinforcement
- non-systematic external reinforcement condition and the non-systematic
external reinforcement condition requires some explanation. While the
34
TA BLE 14
DIFFERENCE IN SR TO K EN U SE
Condition
Variable SR ER SR
T P
X a S.D. X
0 S.D.
Trials 60.87 22.56 53.50 34.67 .50 N S
Blue 47.00 17.88 44.62 30.30 .19 N S
White 13.88 12.91 8 . 8 8 4.70 1.03 N S
processes of self-reinforcement and external reinforcement are obvious
ly different, a comparison of token usage will indicate reinforcement
frequency differences based on the source of administration. A s
Table 15 indicates, there were no significant differences between total
tria ls or blue token usage. However, there was a significant d if
ference in white token usage (T = 2.00, p < .05) between the systematic
self-reinforcement (M = 13.88) and systematic external reinforcement
conditions (M s. 4.62). Note that white tokens denoted a halt in the
assertion sequence and repetion of a response.
TA BLE 15
DIFFERENCE IN ER A N D SR TO K EN U SE B ETW EEN
SYSTEM ATIC ER A N D SYSTEM ATIC SR CONDITIONS
Variable
Condi ti on
T P ER
SR
X
< y s.d. X
a S.D.
Trials 43.13 25.33 60.87 22.56 1.48 N S
Blue 38.62 23.49 47.00 17.88 *
o
00
N S
White 4.62 3.11 13.88 12.91 2 . 0 0 N S
35
Intercorrelations among dependent process measures (latency,
pulse rates, SUDS, self-evaluation) were performed. Post-treatment
Assertive Situation #1 yielded no significant correlations. However,
as Table 16 demonstrates, on Situation #2 there were significant
correlations between decreased latency and decreased SUDS (r = .62,
p < .01); decreased latency and increased self-evaluation (r = .76,
p < .01); and decreased SUDS and increased self-evaluation (r = .56,
p < .01). Correlations between token measures and performance measure
were non-significant and showed no clear pattern (Table 17).
TABLE 16
CORRELATIONS OF D EPENDENT PROCESS M EA SU RES FO R SITUATION #1
Latency Pulse SUDS Self-Evaluation
Latency
Pulse .31
SUDS .62** .27
Self-
Evaluation
-.76** . 1 2 -.56**
**
P < .01
TABLE 17
CORRELATIONS OF DEPEN DENT PROCESS
M EA SU RES B Y W HITE TO K EN ACQUISITION
Latency Pulse SUDS Self-Evaluation
M Number
White Tokens .27 .13 .09 .13
Total Number
White Tokens .16 . 2 2 . 1 1 .08
C H A P T E R IV
DISCUSSION
While the current investigation lends considerable support to
the efficacy of self-reinforcement conditioning procedures, several of
the other findings deserve initial consideration. Perhaps the most
surprising observation was the total ineffectiveness of the external
reinforcement condition. Our in itial expectation that the self
reinforcement condition would demonstrate the greatest performance
increments was supported. However, the secondary expectation that the
external reinforcement condition would demonstrate significantly
greater performance increments when compared to the non-systematic
reinforcement condition was not supported. The lack of support for
this hypothesis was demonstrated across all dependent variables.
Given the tautological definition of reinforcement i t is
obvious that what the experimenter defined as appropriate external
verbal reinforcement, was in fact not reinforcing. Verbal reinforce
ment has often been singled out as the vehicle responsible for
therapeutic change. However, psychotherapy research rarely employs
subjects as severely disturbed as those in the current population. The
failure of external verbal reinforcement in the current investigation
seems to indicate that we know l i t t l e about what reinforces severely
disturbed psychiatric patients.
Failure of the coaching variable to produce any significant
behavior change may also be attributed to the characteristics of the
36
37
subject population. The work of MeFa11 and Marston (1970) and Flowers
and Guerra (i.p .) appears to substantiate the efficacy of coaching
procedures, yet these procedures were totally ineffective in the
current research. I t has been pointed out that the coaching variable
was confounded by subject assignment, yet even with this confounding
i t was reasonable to expect a trend for S/s in the coaching conditions
to demonstrate greater performance increments than S/s in the non
coaching conditions. Such was not the case. It is possible that
subject confounding eliminated possible coaching effects; that is , S's
high on the internal end of the I-E scale may be poor coaches.
However, there was not observation of coaches' incompetence. I t may
also be true that the advantage of coaching found in e arlie r studies
(McFall and Lillesand, 1972, Flowers and Guerra, i.p .) may depend on
more rapid acquisition of the response cognitively in the coaching role
and/or stronger performance of the response in the subsequent assertion
role. In the current research i t appears that either the more rapid
cognitive learning did not occur in the coaching situation; or, i f the
response was learned faster, this was not demonstrated by the pre
dicted performance increments in the assertion condition.
The explanation of the benefits of self-reinforcement in this
experiment is complex. The advantages of self-reinforcement procedures
have been discussed by a number of authors (Marston, 1965; Kanfer and
Phillips, 1970; Yates, 1970), yet neither the potential immediacy nor
frequency of the self-reinforcement response can explain the findings
of the current study. Self-reinforcement did not lead to a greater
number of tr ia ls ; neither did the addition of more reinforcement
per se (external reinforcement plus self-reinforcement) lead to
greater performance increments. The significant findings that may
help us understand why there was no significant interaction between
self-reinforcement and external reinforcement is the finding that the
group receiving only self-reinforcement took more white tokens than the
combined self-reinforcement external reinforcement group. Thus, while
the procedure was designed to employ positive reinforcement to increase
performance, the data suggests that the frequency of taking white
tokens (negative self-evaluation) was the actual critical factor in
subsequent performance increments. Without feedback from the coach, the
S's in the self-reinforcement-only condition responded with an increased
frequency in negative self-evaluation despite the fact that the
procedure was specifically designed to be positive. While the overall
number of tria ls in the self-reinforcement-only group was not signifi
cantly different from the condition in which the coach also evaluated
the response, the data suggest that in the self-reinforcement-only
condition there was a greater number of tria ls following negative self-
evaluation. It appears that practice is more effective when i t follows
either negative self-evaluation or negative self-evaluation confounded
by positive external evaluation. A possible explanation of why the
addition of external reinforcement leads to S/s taking fewer white
tokens (thereby producing smaller performance increments) revolves
around the possibility that the may no longer be administering se lf
reinforcement on the basis of his own c riteria; but rather, that the S .
is attempting to match his self-reinforcement to the coach's external
reinforcement.
39
The effect of the independent variables on the dependent t r a i t
variable (I-E) was negligible. As previously discussed, this may be
accounted for by subject assignment in the coaching condition.
The effects of self-reinforcement on the dependent process
measures were also negligible in Assertive Situation #1. In retrospect
i t is clear that Assertive Situation #1 produced a ceiling effect as
a function of its ease of performance. The resulting decrease in
variance prevented the observation of performance differences across
independent variables. A n examination of the intercorrelations between
dependent process variables in Assertive Situation #1 also suggests
th at this was the case. However, in Assertive Situation #2 (with the
exception of pulse rate), there were significant intercorrelations
among the dependent process variables.
Given the changes in the dependent process variables as a func
tion of self-reinforcement, the relationship among the dependent
variables is of interest. The current investigation employed SUDS as
a dependent process measure in light of other investigators'(Wolpe and
Lazarus, 1966) reports that i t was a valuable subjective indicator of
S_'s anxiety. Despite these reports (Wolpe, 1966), no systematic study
of SUDS as a measure of anxiety has been presented. In tandem with
other dependent process measures employed in the current investigation,
i t was possible to conduct a preliminary assessment of SUDS as an
anxiety measure. As the results indicate (Table 13), SUDS correlated
significantly with response latency in Assertive Situation #2. In
addition, there was a trend approaching significance (p . 1 0 ) in the
relationship between SUDS and pulse rates. The data suggest that SUDS
40
is to some extent an anxiety related measure. However, when one
considers that response latency is a performance measure (infinite
latency equals no performance), SUDS is also a performance indicator.
Furthermore, the data suggests that SUDS is even more .complex than a
combined anxiety—performance indicator. The highest obtained cor
relations between dependent variables were those between SU D S and
self-evaluation. The reader should remember that self-evaluation was
employed in the current investigation not as a measure of self-esteem,
but rather as an indicator of tendency to self-reinforce. Thus,
while SU D S has been conceptualized as a subjective measure of anxiety
(Wolpe and Lazarus, 1966), the current investigation indicates that
its usefulness may also lie in its predictability of performance and
self-evaluation as well as a subjective indicator of anxiety. This
finding is not surprising considering the work of Rehm and Marston
(1968) in which they demonstrated that self-reinforcement reduced both
verbal latency and a number of anxiety indicators on a verbal social
encounter task. I t is clear from these findings (along with Rehm and
Marston's) that one must add self-evaluation to the complex of anxiety
outcome measures that already include: anxiety test scores, reports
of experienced anxiety, performance and psysiological measures. It is
not yet clear what the causal patterns are among these various
components of a very complex construct.
BIBLIOGRAPHY
Anant, S. S., Treatment of Alcoholics and Drug Addicts by Verbal
Aversi&n Techniques, Internation Journal of The Addictions,
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Anderson, T. W., Introduction to Multivariate Analysis, New YorkrWiley,
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Bandura, A., and Kupers, C. T., Transmission of Patterns of Self-
Reinforcement Through Modeling, Journal of Abnormal and
Social Psychology, 1964, 69, 1-9.
Booraem, C. D., and Flowers, J.V ., Reduction of Anxiety and Personal
Space as a Function of Assertion Training with Severely
Disturbed Neuropsychiatric Inpatients, Psych Reports, 1972, 30,
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Cameron, D. E ., The Conversion of Passivity Into Normal Self-
Assertion, American Journal of Psychiatry, 1951, V.108, 98.
Cautela, J.R ., Covert Reinforcement, Behavior Therapy, 1970, 1,
459-468.
Cautela, J .R ., Covert Sensitization, Psycholoqical Reports, 1967, 20,
459-468.
Davison, G. C., Elimination of a Sadistic Fantasy by a Client
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Fensterheim, H., Behavior Therapy: Assertive Training in Groups,
in Sager, C .J., and Icaplan, H.S. (eds.), Progress in Group
and Family Therapy, New York: Brunner/Mazel Publishers, 1972,
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Flowers, J.V., Booraem, C.D., Brown, T. R., and Harris, D. E.,
An Investigation of a Technique for Facilitating Patient
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Community Psych., 1974, 2(1), 39-42.
Flowers, J.V ., and Guerra, J . , The Use of Client-Coaching in Assertion
Training with Large Groups, Journal of Community Mental Health,
in press.
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42
Goldiamond, I ., Self-Control Procedures in Personal Behavior Problems, I
Ps.ych Reports, 1965, 17, 851-868.
Hedquist, F. J . , and Weinhold, B. K., Behavior Group Counseling with
Socially Anxious and Unassertive College Students, Journal of
Counseling Psychology. 1970, 17, 237-242.
Kanfer, F. H., and Marston, A. R., Conditionong of Self-Reinforcing
Responses: An Analogue to Self-Confidence Training, Psych.
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Kanfer, F. H., and Marston, A. R., Determinants of Self-Reinforcement
in Human Learninq, Journal of Experimental Psychology, 1963,
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Kanfer, F. H., and Phillips, J. S., Learning Foundations of Behavior
Therapy, John Wiley & Sons, In c., New York, 1970.
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Advice in Effecting Behavior Change, Behavior Research and
Therapy, 1966, 4, 209-212.
Lomont, J.F ., Gilmer, F. H, Spector, N. J ., and Skinner, K. K.,
Group Assertion Training and Group Insight Therapies, Psych.
Reports, 1969, 25, 463-470.
McFall, R. M , The Effects of Self-Monitoring on Normal Smoking Behavior,
Journal of Consulting and Clinical Psych., 1970, 35, 135-192.
McFall, R. M., and Marston, A. R., An Experimental Investigation of
Behavioral Rehearsal in Assertive Training, Journal of
Abnormal Psych., 1970, 76, 295-303.
McFall, R. M., and Lillesand, D. B., Behavioral Rehearsal with
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Abnormal Psych., 1971, 77, 3, 313-323,
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Louisville, 1967.
Marston, A. R., and Kanfer, F. H., Human Reinforcement: Experimenter
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Marston, A. R., Self-Reinforcement: The Relevance of a Concept in
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Marston, A. R., and Smith, F. J . , Relationship Between Reinforcement
of Another Person and Self-Reinforcement, Psychological Reports,
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Masters, J.C ., Effect of Success, Failure and Reward Outcome Upon
Contingent and Non-Contingent Self-Reinforcement, Developmental
Psychology, 1972, 7, (2), 110-118.
Neuman, D. R., Using Assertive Training, In Krumboltz, J. D. and
Thorensen, C. E. (Eds.), Behavioral Counseling: Cases and
Technigues, New York: Holt, Rhinehart & Winston, 1969, 433-442.
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Modification of Self-Reinforcement: An Instigation Therapy
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Control of Reinforcement, Psychological Monographs, 1966, 80
(1, whole No. 609).
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Girex, In c., 1949 (republished: New York: Capricorn, 1961).
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Skinner, B. F ., Beyond Freedom and Diqnity, New York: Alfred A. Knopf,
1971.
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Winer, B. J . , S ta tistica l Principles in Experimental Desiqn, New York:
McGraw-Hill, 1962.
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44
Wolpe,
Yates,
J ., and Lazarus, A. A., Behavior Therapy Techniques, New York:
Pergamon Press, 1966.
A. J . , Behavior Therapy, New York: John Wilev & Sons. Inc..
1970. ----------------------
APPENDIX A
SESSION 1 INSTRUCTIONS
S's then instructed as follows:
The program you are about to begin is designed to teach you
how to be b e tter askers. That i s , how to more effectively ask for
those things you desire. You should understand that while good
therapy will be provided to all of you, this is a research project and
participation is s t r i c t l y voluntary. Is there anyone who would rather
not participate? Before we begin, I will ask you all to answer th is
b rie f questionnaire.
Administer Rotter I-E.
Now I want each of you to make a l i s t of requests that are
d iffic u lt or impossible for you to make. Before you begin I will give
you some examples of common requests that are often d iffic u lt to make.
Can and/or would you ask to go to the head of a line in a crowded
supermarket i f you had but one or two items? Can and/or would you ask
a co-worker or neighbor whom you do not know to have a cup of coffee
with you? Finally, can and/or would you ask someone who you drive to
and from work to pay for the gasoline? Now on the paper I've provided
you make a l i s t of requests d if f ic u lt or impossible for you to make.
Prepare Request Lists.
Before we begin to practice making requests I will in struct
you in a convenient scale for rating how uncomfortable you feel making
45
46
a request. W e refer to this scale as SUDS, Subjective Units of
Disturbance. The scale extends from 0 to 100, where 0 represents total
relaxation and 100r represents absolute panic. Can you assign a number
to how you feel right now? Let me give you some examples; How would
you feel about asking the person next to you for a cigarette or to use
his pen? Assign a number to that feeling. Now, how would you feel
asking your la s t employer for a raise? Assign a number to that request
on the basis of its difficulty.
Now I want you to assign a SUDS number to every item on the
l i s t of requests you ju s t made up.
Collect All Request Lists Upon Completion.
There is s t i l l another issue we must discuss before we begin
practicing. I would like you to make a l i s t of all other group members
including myself. Now assign a SUDS number to each member in terms of
how d iffic u lt i t would be to make a common request of that and every
other group member. For instance, i t may be easier to request a
cigarette from the person next to you than from me. If so, the person
next to you should be assigned a lower SUDS number than myself.
Collect All Group Member Lists Upon Completion.
Finally, I would like you to f i l l out a form that indicates
you have volunteered to participate in this project.
Collect Consent Forms, Terminate Session 1.
APPENDIX B
M A STER SCH ED U LE O F ASSERTIVE REQUESTS
Q: Do you have the time?
A: Yes, the correct time is two fifty-eight.
Q: M ay I borrow your pen for a moment?
A: Yes you may.
Q: M ay I read that book when you're finished?
A: Yes, of course.
Q: I'd like to make an appointment to see m y physician.
A]: He's not in today.
Ag: Then I'd like to see him tomorrow morning.
A 3 : Fine, I 'l l set i t up for 9:30.
Q: I would like to make an appointment to see my social worker.
A-j: Would this afternoon at 2:00 be O K ?
A 2 : Yes, that will be fine.
Q: I would like something for m y sore throat.
A: OK, I 'l l get something for you.
Q: Dr I would like to discuss discharge plans with you.
A: Yes, Mr come into m y office.
Q: I would like to file for a service-connected disability. Will you
make an appointment with the contact representative for me?
A: Yes, surely.
Q: I would like to f ile for Social Security Benefits, please.
A: All right, fine - won't you have a seat?
Q: I'd like to apply for the job you have available.
A -]: Fine, will you please fill out the application?
A 2 : Yes, thank you.
Q: Since you're going to the store, would you pick up one half gallon
of milk for me?
A: Sure.
Q: Would you like to join m e in a round of golf?
A]: I'm busy this afternoon. How about to-morrow morning?
A 2 : That will be fine. I 'l l meet you here at 9:30 to-morrow morning.
47
48
Q: I'm giving a party next week. I'd like you to be there - won't
you come?
Ai: Sure, what time is it?
A^: 7:30
A 3 : Fine, I 'l l be there.
Q: Will you mail this le tte r for me, please?
A: I sure w ill.
Q: Our regular babysitter is sick. Would you s i t for me i f you
are n 't busy?
A: Yes, I'd be glad to.
Q: Since you're going downtown, may I ride with you?
A: Yes, l e t 's go.
Q: M ay I have some more coffee, please?
A: Yes.
Q: Would you give m e a hand with this job?
A: Yes, I'd be glad to.
Q: I'm expecting a phone call soon. Would you deliver a message for
me?
A: Sure, I w ill, What is it?
Q: Would you please turn down the radio?
A: Yes.
Q: M y car is in the shop. Would you mind taking me to work?
A-|: Of course not, I leave at 7:30.
A 2 : That is fine with me.
Q: I believe you've made an error. I would like you to refigure try
b i l l , please.
A: I'd be glad to, s ir.
Q: I'm busy right now. Will you please come back later?
A: Yes.
Q: I would like to discuss our b ills with you. Will you try to talk
with m e about them without getting angry?
A: Yes, I 'l l try.
Q: Waiter, check please.
A: Yes.
Q: Will you help me find a sexy negligee for my wife?
A: I'd love to.
49
Q: I bought these pants a week ago and they're already splitting at
the seams. I'd like a replacement or a refund.
A]: D o you have your receipt?
A 2 : No, but that salesman was the one who helped me.
A 3 : OK, fine, We'll get on i t right away.
Q: M ay I go ahead of you? I only have this one item.
A: Surely.
Q: I ordered m y steak rare and this is well done. I would like
another steak prepared as I requested.
A: Yes, sir.
Q: I had this room reserved and i t ' s currently occupied. I'd like to
see the manager.
A: Right away, sir.
Q: Hi, you must be new with the company?
A: Yes, I am, I've only been here two weeks.
A2 ’ - W hy don't we have lunch some time soon? I'll give you the inside
scoop.
A 3 : Sounds exciting.
A 4 : W hen can you get away?
A 5 : To-morrow at 11:30.
Q: Hi, I'm ..., aren't you in my English class?
A]: Yes.
A£: W hy don't we have a cup of coffee and discuss the class assignment.
Q: Hi, I pass by here everyday and I'd sure like to get to know you.
How about a cup of coffee some time soon?
A- ]: Sure.
Ag: W hen would be a good time for you?
A 3 : To-morrow at 10:00 A M .
A 4 : I'll meet you here then.

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Asset Metadata

Creator Booraem, Curtis Deil (author)

Core Title The Differential Effectiveness Of External Versus Self-Reinforcement On The Acquisition And Performance Of Assertive Responses

Degree Doctor of Philosophy

Degree Program Psychology

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

Tag OAI-PMH Harvest,Psychology, clinical

Language English

Contributor Digitized by ProQuest (provenance)

Advisor Marston, Albert R. (committee chair), Myerhoff, Barbara G. (committee member), Wolpin, Milton (committee member)

Permanent Link (DOI) https://doi.org/10.25549/usctheses-c18-836096

Unique identifier UC11356626

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Legacy Identifier 7421455.pdf

Dmrecord 836096

Document Type Dissertation

Rights Booraem, Curtis Deil

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

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