Journal of Counseling Psychology1986, Vol. 33, No. 1, 11-15

Copyright 1986 by the American Psychological Association, Inc.0022-0167/86/S00.75

Differential Effects of the Gestalt Two-Chair Intervention and ProblemSolving in Resolving Decisional Conflict

Katherine M. ClarkeLoyola University of Chicago

Leslie S. GreenbergUniversity of British Columbia

Vancouver, British Columbia, Canada

This study compared an affective (Gestalt two-chair intervention) and a cognitive-behavioral(problem-solving) counseling intervention used to help clients resolve intrapersonal conflictsrelated to a decision. Forty-eight people were randomly assigned to three groups: a problem-solving group (n = 16), a two-chair group (n = 16), and a waiting-list control group (n= 16). Trained counselors saw clients for two sessions. Subjects were pretested and post-tested on measures of indecision and stage of decision making. A one-way analysis ofvariance revealed that the affective intervention was more effective than the cognitive-behavioral intervention or no treatment for reducing indecision. Both counseling approacheswere more effective than no treatment in facilitating movement through the stages of decisionmaking.

A broad distinction can be drawn among counseling approachesthat are primarily affective from those that are focused on cog-nitive behavior. Cognitively oriented therapists attend primarilyto how clients think about their problems. Interventions are aimedat changing thoughts, cognitive structures, and ways of processinginformation, often to promote more effective problem solving.Affective therapists, on the other hand, pay more attention to thefeeling domain. Their interventions focus on emotional experienceand are thought to lead clients to the wisdom of the organism,which is regarded as having a rationality that integrates all theaffective and cognitive information available to the organism (Perls,1969).

The controversy regarding affect and cognition has generatedextensive discussion (Rachman, 1981). Few studies, however,have experimentally compared scientific procedures aimed pri-marily at affect or cognitive behavior as applied to a specifictherapeutic issue. The present study examined the differential ef-fects of an affectively oriented intervention, the Gestalt two-chairintervention (Greenberg, 1979, 1984), and a cognitive-behavioralintervention, problem solving (D'Zurilla & Goldfried, 1971), usedto help people resolve conflicts. A specifically defined conflictwas chosen: an intrapersonal conflict related to a decision.

The importance of decisional conflict in human decision makinghas been emphasized by Janis and Mann (1977). They describeddecisional conflict as "occurring when there are simultaneous op-posing tendencies within the individual to accept and reject a givencourse of action" (p. 42). They stressed that people often avoidmaking decisions because of the pain experienced in dealing withdecisional conflict. This type of conflict, then, contains charac-teristics that make it a suitable target for either an affective or acognitive-behavioral intervention, depending on the theoreticalstance of the counselor.

Because the decisional conflict is one of strong affect, that is,

This study is based on a doctoral dissertation by the first author. Ap-preciation is expressed to Gloria J. Lewis, who directed the dissertation.

Correspondence concerning this article should be addressed to KatherineM. Clarke, who is now at the Institute of Pastoral Studies, St. Paul Uni-versity, 223 Main Street, Ottawa, Ontario, Canada JUS 1C4.

feeling torn apart by opposing tendencies, the affectively orientedcounselor may turn to the Gestalt two-chair intervention. The pres-ence of opposing tendencies has been identified as an importantmarker for its use (Greenberg, 1979, 1980). On the other hand,a counselor working from a cognitive-behavioral stance will rec-ognize this as an appropriate time to implement systematic prob-lem solving. Because no clear preference is felt, a logical weighingof the pros and cons may help resolve the conflict. The questionof differential effects may legitimately be raised because bothtreatments could be effective in the situation.

The comparison of the Gestalt two-chair intervention and prob-lem solving is meant to represent two distinct approaches to coun-seling. The interventions, however, by no means exhaust theirrespective theoretical domains, and the results have limited gen-eralizability to other affective or cognitive-behavioral approaches.

Problem solving (D'Zurilla & Goldfried, 1971) is a cognitive-behavioral counseling method that consists of the following:

A behavioral process, whether overt or cognitive in nature, which (a)makes available a variety of potentially effective response alternatives fordealing with the problematic situation and (b) increases the probability ofselecting the most effective response from among these various alterna-tives, (p. 108)

The basic premise of problem solving is that when a problematicsituation is recognized, by virtue of the fact that the client is upset,the essential task is to refocus attention from the emotional stateto the situation creating the upset (Goldfried & Goldfried, 1975).

The Gestalt two-chair intervention (Perls, Hefferline, & Good-man, 1951) is an affective method that has been shown to beeffective in resolving conflicts (Greenberg, 1983; Greenberg &Clarke, 1979; Greenberg & Dompierre, 1981; Greenberg & Web-ster, 1982). It consists of creating a dialogue between the twosides of a conflict, often asking the client literally to change chairsas he or she speaks. The basic premise of the Gestalt two-chairintervention is that when a person is upset, the essential task is tofocus attention on what the client is experiencing in order to bringunacknowledged aspects of experience into awareness. Awarenessof the disparate aspects of experience and contact between them

11

12 KATHERINE M. CLARKE AND LESLIE S. GREENBERG

will lead to an integration and conflict resolution (Perls, 1969). Itis evident then that problem solving and the Gestalt two-chairintervention differ considerably in their major focus. They aresimilar, however, in that both methods are used to promote con-flict resolution.

To increase control in the study, the target problem for com-paring the therapeutic interventions was kept constant. All clientswere experiencing intrapersonal conflict over a personal decision.The definition of decision was very broad, and conflicts rangedfrom "I want to work but I feel guilty about leaving my children"to "I want to tell off my boss but I can't." All of the decisionswere emotionally significant and current.

The following hypothesis was tested in the study: Problem-solving, two-chair, and control groups will not differ significantlyon a posttreatment measure of undecidedness or stage of decision-making attained.

Method

Subjects

The subjects in this study were 48 adults who voluntarily sought coun-seling to help them resolve a conflictual decision. There were 11 men and37 women, ranging in age from 16 to 73 years old (M = 36 years old).The sample was fairly well educated; of 48 participants, 44 had graduatedfrom high school, 32 had some university education, 9 had attended grad-uate or professional school, and 12 had vocational/technical school train-ing. Various occupations were represented in the sample; 11 of the 48were professionals; 14 were employed in skilled trades; and the rest werehousewives, students, or retired persons.

Counselors

Four counselors trained in the Gestalt two-chair intervention and fourcounselors trained in problem solving each saw 4 clients. Two of theGestalt counselors and two of the problem-solving counselors were PhDsand registered psychologists. The other counselors were advanced graduatestudents in either counseling or clinical psychology. Each group of coun-selors had been trained by various experts in the respective treatmentsbefore being asked to participate in the study. The two groups of coun-selors were matched for years of clinical experience.

Because the counselors were not trained in the respective treatments forpurposes of the study, briefing sessions were held separately for the two-chair and problem-solving counselors. At these sessions the treatmentswere reviewed and counselors were instructed to use only the definedprocedures and interventions described by D'Zurilla and Goldfried (1971)for problem solving and those by Greenberg (1980) for the Gestalt two-chair intervention.

Problem-solving counselors were told to conduct the steps of definingthe problem, generating alternatives, and deciding in the first session andverifying and evaluating in the second session. The two-chair counselorswere instructed to work on the same conflictual decision in each sessionand to use the appropriate interventions from the two-chair procedure.

To guard against possible bias in the implementation of treatment, coun-selors who ascribed to a cognitive-behavioral orientation and frequentlyused cognitive interventions in their practice were chosen as problem-solving counselors. Counselors for the two-chair groups preferred affec-

tive-experiential treatments and frequently employed the two-chair inter-vention with clients.

Measures

Two instruments were used in this study to assess the effects of thetreatments. The subjects' degree of undecidedness, before and after treat-ment, was measured by an adapted form of Osipow, Carney, and Barak's(1976) Scale of Vocational Indecision. Changes in the subjects' decision-making stage, particularly their degree of choice, were measured by Har-ren's (1979) Assessment of Career Decision Making, Part IV (Decision-Making Task-Occupation, DMT-O, Choice scale), administered beforeand after treatment. The instruments were chosen so that the goals of thetwo treatments would be represented in the measures. The Scale of Vo-cational Indecision measures an affective variable, the feeling of indeci-sion. The Assessment of Career Decision Making measures more cognitivebehaviors such as whether or not a choice has been made.

Scale of Vocational Indecision. The Scale of Vocational Indecision (Os-ipow et al., 1976) provides an overall index of undecidedness. The scaleconsists of 18 items to be rated on a 4-point scale from not at all like me(1) to exactly like me (4). A high score reflects indecision; a low scorereflects decidedness.

Because a number of items on the Scale of Vocational Indecision areoriented to college students, some minor revision of wording was neces-sary to make it appropriate for this study (e.g., the item, "I know whatI'd like to major in, but I don't know what careers it can lead to thatwould satisfy me," was changed to, "I know what I'd like to do now butI don't know what it can lead to that would satisfy me"). The essentialmeaning of each item was maintained.

In order to verify that these changes had not adversely affected thevalidity and reliability of the scale, the adapted form was administered to136 graduate students in another study (Greenberg & Webster, 1982). Thestudents responded to the questionnaire in terms of a current decision. AHoyt's analysis of variance (ANOVA) internal consistency reliability of .85indicated that the revised items were consistent with the other items in thetest.

Assessment of Career Decision Making. The Assessment of Career De-cision-Making Stage (ACDM; Barren, 1979) was designed to measureprogress through the decision-making process. It is based on Tiedemanand O'Hara's (1963) model of decision making, which views human beingsas responsible for their behavior and capable of choosing through pur-poseful action. The decision-making task is resolved through sequentialstages involving the cognitive functions of differentiation and integration.The stages of decision making (exploration, crystallization, choice, andclarification) are closely related to the steps of problem solving describedby D'Zurilla and Goldfried (1971). For this reason the ACDM seemedappropriate as a measure of the effects of the treatment.

The first part of the ACDM measures decision-making style. Parts II,III, and IV measure progress through the stages of decision making. Forpurposes of this study Part IV, Decision Making Task-Occupation (DMT-O), was chosen because it contained a subscale for choice. The Choicesubscale (DMT-O) is composed of 10 items such as, "I'm pretty certainabout the choice I will make," and "I've decided on the choice I amgoing to make." By using a weighted conversion formula on the rawscores, change in the DMT-O score before and after treatment indicatesprogress through the stages of decision making and increased choice.Harren (1979) suggested that the converted scores on the individual DMTscales of the ACDM are useful for comparing individuals with one anotherand for measuring progress in decision making.

Other studies have used parts of the ACDM for evaluating treatmenteffects (e.g., Barker, 1981; Phillips & Strohmer, 1983), investigating therelation of decision-making style to vocational maturity (Phillips & Stroh-mer, 1982) and examining cognitive dissonance as a mechanism in thevocational decision process (Thomas & Bruning, 1984).

GESTALT TWO-CHAIR INTERVENTION AND PROBLEM SOLVING 13

Subject Selection and Assignment

Subjects were solicited through radio and newspaper advertisements, aswell as posters and brochures placed in community centers and libraries.The announcements described a free, short program conducted under theauspices of the university for people facing a difficult personal decision.Radio and television announcements were the most effective advertising,and approximately 125 inquiries were received in response to this public-ity.

From the calls received, 48 people were selected for use in the study.A preliminary screening occurred at the initial telephone contact. If callerswere not experiencing a current conflict related to a personal decision,they were referred to an alternate community service. If they were cur-rently experiencing such a conflict, they were invited to an introductoryinterview.

The introductory interview and all subsequent contacts with the subjectsoccurred in a university counseling center.

At the introductory interview, subjects were screened for evidence ofsevere disturbance. Only persons who were relatively well functioning andexperiencing a decisional conflict were accepted for the study. Criteriawere based on Malan's (1976) notion of who is best suited for short-termtreatment, for example, those with realistic expectations and with no his-tory of severe dysfunction.

Of 86 persons interviewed, 16 were screened out because they did notmeet the acceptance criteria or because of scheduling problems. The re-maining 70 persons were randomly assigned to one of the three treatmentconditions. There were 15 people who did not show up for the first treat-ment session, and 7 subjects dropped out later in the study. Dropouts wereevenly distributed across treatment groups.

After the screening interview, volunteers accepted for the study wereprovided with a written explanation of the study and were asked to signan informed consent form. The Scale of Vocational Indecision (SVI) andthe Assessment of Career Decision Making (ACDM) were then adminis-tered.

Treatment

Subjects were randomly assigned to a counselor or to the control group.Four subjects were assigned to each of the four Gestalt two-chair (TC)counselors (TC n = 16), and 4 subjects were assigned to the problem-solving (PS) counselors (PS n = 16). Thirty-two clients and eight coun-selors thus participated in the study, with 16 clients forming the waiting-list control group. The waiting-list control subjects were told that therewas currently no space in the program. They were pretested and returnedin 4 weeks for posttesting. After posttesting they received treatment frompracticum students.

Approximately 1 week after the screening interview, the subjects re-ceived a group briefing session that lasted about 1 hour. The TC groupwas briefed separately from the PS group. The purpose of these sessionswas to describe the counseling approach to be used and to encourage thenotion that conflicts and problematic situations are a normal part of life.

One week after the briefing session, subjects met individually with theircounselors. Each subject described his or her conflict, and the counselorthen instituted the assigned counseling intervention. A week later, theclient and counselor met again, and the same counseling approach wasused.

The Gestalt two-chair intervention was conducted according to the prin-ciples delineated by Greenberg (1979). The client is directed to alternatelyassume the two sides of an intrapsychic conflict. A client may say, "Iwant to do this, but then, I'm not really sure it's a good idea," at whichpoint the counselor guides the client in a dialogue between the two sides.Five principles constitute the main structure of the operation: (a) main-taining a contact boundary, (b) taking responsibility, (c) attending, (d)heightening, and (e) expressing.

The problem-solving treatment was conducted according to the fivesteps outlined by D'Zurilla and Goldfried (1971). The first step, whichoccurred during the group briefing, involves the general orientation of theclient to the idea that problems are a normal part of life and that she orhe should behave as though it is possible to cope effectively with them.The client is also encouraged not to act on impulse or to avoid problematicsituations. The next three steps of the problem-solving treatment (definingthe problem, generating alternatives, and deciding) were carried out in thefirst treatment session. Verification and evaluation took place in the finaltreatment session.

One week after the counseling sessions, the SVI and the ACDM wereagain administered to all subjects. The experimenter then debriefed allsubjects and responded to any questions or concerns.

Check on Treatments

In order to verify that the assigned treatment was in fact conducted,audiotapes of the counseling sessions were inspected by four raters. Theraters, trained in the treatment they were evaluating, were blind to theexperimental hypotheses. Two raters listened to the PS tapes and recordedtheir evaluations on a checkist. Two different raters listened to the TCtapes and recorded their evaluations on a checklist. In all cases the ratersagreed that the assigned treatment was conducted. This method of con-firming treatment procedures was developed by Snodgrass and Healy (1979).

Results

Counselor Effect

To determine whether or not the counselors in each group weredifferentially effective in applying the treatments, the posttest scoreson the SVI were submitted to a one-way, two-tailed ANOVA, con-sidering counselor as a four-level fixed factor (a < .05). Plannedorthogonal comparisons were included in this analysis to deter-mine the source of any differences. These comparisons were tested(p < .05) with the t statistic.

Because one contrast in each of the groups was significant, thedata were submitted to a one-way analysis of covariance (ANCOVA),where pretest score on the SVI was the covariate, posttest scoreon the SVI was the dependent variable, and counselor was againa four-level fixed factor. The same contrasts were used to deter-mine the source of any differences and the BMDPIV computerprogram was used for the analysis.

The results of these analyses indicated that despite random as-signment, 4 clients assigned to a counselor in the TC group and

4 clients assigned to a counselor in the PS group had scores thatwere elevated enough on the pretest to cause spuriously significantdifferences between counselors for either group on the posttestscores of the SVI.

Pretest scores on the SVI and DMT-O scale of the ACDM forthe TC, PS, and control groups were submitted to a one-way,two-tailed ANOVA, considering treatment as a three-level fixedfactor. This was to determine whether or not the groups differedsignificantly on undecidedness and at the choice stage of decisionmaking before treatment.

There was a .59 probability that the difference on undecidednessbetween groups before treatment was due to chance and a .12probability that this was true for the decision-making stage score.It was assumed, therefore, that the groups did not differ signifi-cantly before treatment.

Posttest scores on the SVI and the DMT-O scale of the ACDM

14 KATHERJNE M. CLARKE AND LESLIE S. GREENBERG

for all groups were then submitted to a one-way, two-tailed ANOVA,again considering treatment as a three-level fixed factor. The ANOVAof the SVI scores revealed a significant difference, F(2, 45) =9.95, p < .05. Both the PS and the TC groups' scores showedreduced indecision compared with the control group's. Post hoccomparisons using Tukey's honestly significant difference test re-vealed that for the SVI, the TC group was significantly differentfrom the PS and control groups (p < .05). Inspection of the meansindicated that this difference was in the direction of reduced scoreson the SVI, reflecting a reduction of undecidedness. The ANOVAof the DMT-O scale score did not indicate a significant difference,F(2, 45) = 2.69, p > .05. The means and standard deviationsfor the SVI and the DMT-O scores are presented in Table 1.

Discussion

The results of this study indicated that the two-chair interventionreduced indecision more effectively than did either problem solv-ing or the absence of treatment. Problem solving was superior tono treatment but was not as effective as the Gestalt two-chairintervention for reducing indecision.

Previous research (e.g., Greenberg & Clarke, 1979; Greenberg& Dompierre, 1981; Greenberg & Higgins, 1980) has shown thatthe Gestalt two-chair intervention is more effective than empathicreflections (e.g., Carkhuff, 1969) or focusing (e.g., Gendlin, 1978)for producing greater depth of experiencing (e.g., Klein, Mathieu,Kiesler, & Gendlin, 1969) and more shifts in awareness for clientsworking on resolving a conflict. Level of experiencing and shiftsin awareness are constructs thought to be conducive to conflictresolution and decision making. The present study, however, isimportant in that it shows a significant effect on a direct measureof indecision rather than on constructs correlated with decisionmaking.

The results of the present study also show differential effectson one dependent variable between the two-chair intervention anda treatment specifically used to facilitate conflict resolution anddecision making. The premise of the problem-solving approach isthat at a point of indecision, when a person experiences feelings

Table 1Scores on the Scale of Vocational Indecision (SVI) and theOccupation Scale (DMT-O) of the Assessment of CareerDecision Making

Treatmentgroup

Problem solvingMSD

Two-chairMSD

ControlMSD

SVI

Pre.

39.136.13

41.447.54

40.876.17

Post.

33.446.86

29.13*6.54

39.817.04

DMT-OPre.

24.312.39

23.312.02

22.871.45

Post.

24.942.21

24.632.83

23.191.64

Note. For all groups, n = 16. Pre. = pretest; post. = posttest. HigherDMT-O scores indicate increased choice. Lower SVI scores indicate re-duction of indecision.*p < .01.

of conflict, fear, struggle, or paralysis, the best way to proceedis to set aside these feelings and to focus on the problem to besolved. It is believed that by setting aside the feelings and workingrationally on the problem, it will be solved, thus reducing thedistressing affective state. Subjects in the problem-solving groupdid report that they were less undecided than those in the controlgroup after going through the problem-solving process, indicatingthat the this treatment was effective. However, the Gestalt two-chair intervention clients, having fully attended to the feelingsunderlying the conflict, reported being more decided than clientswho tried to decide on a logical basis. This may suggest thatattending directly to affect is helpful in resolving decisional con-flict.

It should be noted, however, that this study shows changes ona self-reported measure of a state called indecision. It does notshow evidence of decision implementation or concrete behavioralchange emanating from a decision. The problem-solving approachmay have its place after indecision is reduced by an affectivelyoriented approach. The problem-solving focus on tactics and strat-egies may complement the affective approach by providing a wayof implementing the decision once it is made.

The lack of significant differences between groups on the post-test ACDM (DMT—O scale) indicates that the treatments did notsignificantly affect movement through decision-making stages.Although previous research indicates that the instrument is pow-erful enough to pick up gross differences between decided andundecided groups, it appears to lack the fine tuning needed to pickup more subtle differences brought about by a two-session treat-ment.

The counselors' and clients' observations obtained in termina-tion interviews are interesting in light of objective results. A com-ment made by both the problem-solving counselors and their clientswas that it was often difficult to keep focused on the problemwhen strong feeling was involved in the decision. Counselorsreceived comments from clients such as, "I know all that, but Ijust can't do it," suggesting a block that was not amenable to thecognitive-behavioral intervention alone.

Two-chair counselors commented that the original decision aperson wished to make often unfolded into a deeper, related de-cision. For example, a decision about whether or not to continuean athletic career was resolved by the person deciding not to beso hard on himself. The original decision, on which the measureswere taken, changed somewhat by the time posttest measures weretaken. So, not only was the person more decided but often newdecisions and resolutions had emerged that were not directly mea-sured.

An interesting extension of the present study would be to con-duct an experiment comparing the Gestalt two-chair interventionalone, the problem-solving intervention alone, and a sequentialcombination of the two approaches. Such a study should includeinstruments designed to target particular stages of treatment.

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GESTALT TWO-CHAIR INTERVENTION AND PROBLEM SOLVING 15

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Received January 29, 1985Revision received May 29, 1985 •

Call For Nominations

The Publications and Communications Board has opened nominations for the editorship of theJournal of Counseling Psychology for the years 1988-1993. Charles Gelso is the incumbent editor.Candidates must be members of APA and should be available to start receiving manuscripts inearly 1987 to prepare for issues published in 1988. To nominate candidates, prepare a statementof one page or less in support of each candidate. Submit nominations no later than February 1,1986 to:

Charles D. SpielbergerDepartment of PsychologyUniversity of South FloridaTampa, Florida 33620

The other members of the search committee are John L. Holland, Laurel W. Oliver, Samuel H.Osipow, and Lyle D. Schmidt.