The training and analysis of consultation process using transactional analysis

THE TRAINING AND ANALYSIS OF CONSULTATION PROCESS USING TRANSACTIONAL ANALYSIS

RICHARD PARSONS’ AND JOEL RlEYERS

‘I’emple Uiiiversity

The present investigation was an attempt to examine the possibility of experimentally manipulating the process of consultation. In this instance, the process of consultation was conceived in terms of the Transactional Analysis paradigm. The study employed a small-N analogue to consultee-centered consultation with the experimental treatment consisting of a training session in Tiansactional Analysis for the consultants. The treatment effect was assessed against three dependent measures: (a) the subjective evaluations of the consultant-consultee pairs; (b) the percent of behavioral change toward goal; and (c) the number of AdulbAdult transactions characterizing the consultation exchange. The data indicate increases in the number of Adult- Adult transactions the Average Subjective Evaluation, and the Percent of Goal Attainment /or two of the four experimental subject pairs. However, the result for only one subject met the requirements of the multiple baseline design, so that it could be concluded that the observed gains for this subject probably could be attributed to the T.A. training session. In addition to suggesting the influence of Adult-Adult transactions on consultation, this study is felt to offer insight to researchers seeking appropriate experimental designs for manipulating relevant process variables in consultation and de- tecting the effects of these manipulations

Approaches to mental health consultation have received considerable impetus in the past 20 years as a result of the increased focus on preventive methods and indirect service delivery models (e.g., Berlin, 1956; Caplan, 1970). Consultee- centered consultation is one approach which has been recommended as a part of the delivery of psychological services with teachers (Fine & Tyler, 1971; Meyers, 1973), with nurses (Caplan, 1970), and with police (Mann, 1973). Despite this emphasis in the literature, consultation has not been implemented on a widespread basis, and the related research has been minimal. There are three weaknesses of the previous consultation research which have hindered both the development and practice of consultee-centered consultation (Meyers, Freidman, Gaughan, & Pitt, 1978): (a) The choice of criteria to assess consultation outcome have been inadequate. Most research efforts have relied on questionnaires and other self-report techniques, rather than on directly observable behavior (e. g., Mann, 1973; Schmuck, 1968; Schowengerdt, Fine, & Poggio, 1976; Tobiessen & Shai, 1971; Tyler & Fine, 1974). (b) Prior research designs in consultation have been weak in that there has been too much emphasis on large-iV designs, and these investigations typically have been plagued by vague definitions of consultation procedures (e.g., Mann, 1973; Tobiessen & Shai, 1971). (c) With the exception of Caplan’s (1970) description of theme interference reduction, most of the efforts to define consultee-centered consultation have been inadequate.

Transactional Analysis (Berne, 1964) is an approach to personality and psycho- therapy which has been applied recently to consultation (Fine, note 1) . This approach makes particular sense for consultee-centered consultation because it provides

‘Now at Our Lady of Angels College. Requests for reprints should be sent, to Richard Parsons, Our Lady of Angels College, Ast,on,

PA 19014.

545

536 Psychology in the Schools, October, 1978, Vol. 16, No. 4.

a model for the analysis of social interaction (transactions), as well as for under- standing those factors which act to facilitate or inhibit normal communications. An additional strength of T.A. is that its principles are communicated easily (Thomson, 1971) and therefore can be utilized as an efficient model for training (Brown, 1974).

In view of the issues discussed above, the research reported in this paper emphasizes a detailed description of experimental procedures; it focuses on directly observable behavior as well as questionnaire data as the criteria; and i t uses a small-N design, thus allowing for intensive investigation of each unique consultation relationship.

METHOD Rather than utilizing existing consultation relationships in the field, the

investigation developed an analogue to applied consultee-centered consultation in order to allow for greater experimental control. This analogue employed behaviorist self-control techniques, where each consultee developed a program to control his own behavior, with the consultant serving as a resource person assisting the consultee in program development. The experimental treatment consisted of a training session in T. A. for the consultants. The purpose of this study was to see whether training the consultants in Transactional Analysis would result in improved behavior control.

Subjects The consultants were five school psychology graduate students enrolled in a

practicum in mental health consultation. The five consultees were randomly selected from a group of school psychology graduate students enrolled in an introductory course in behavior modification. Originally there were six consultant-consultee pairs; however, one pair was dropped from the analysis because the consultation sessions for this pair were not always scheduled in a manner consistent with the experimental design. All of the participants in the study took part voluntarily.

Consultation Procedures Prior to the first week of the study, the consultants were given a brief (60

minutes) lecture on the fundamentals of relationship building following the principles outlined by Caplan (1970). The information for this presentation was taken directly from Caplan’s (1970, Chapter 5) Building a Relationship with the Counsultee. A t this time, the consultants also were provided with a schedule of procedures and tasks to be accomplished for each of the seven consultation sessions to follow.2

In addition to relationship building skills, consultants were instructed to follow behavioral consultation procedures. During the first week of the study, the consultant and consultee met to discuss, identify, and define the consultee’s desired goal for change. The target for the self-control study and also the goal for change were defined in clear operat,ional terms; however, each consultee chose a different target behavior.

2Copies of: (a) the Schedule of Procedures, (b) the Subjective Evaluation Scales, and (c) a ver- batim account of the Experimental Training Session may be obtained by writing the senior author nt Oiir Lady nf Angels College, Aston, PA 19014.

The Training and Analysis of Consultation P1.oce.s 547

I n order to permit comparisons among consultees focusing on different target behaviors, the criterion used to assess weekly outcome was the percentage toward goal attainment. In addition to the criterion of percentage of goal attainment, each consultant and consultee filled out a scale providing their evaluation of the consultation session at the conclusion of each session. Baseline data were collected for one week following this first consultation session.

The consultant and consultee met for a second consultation session a t the beginning of the second week. This session was used to determine the self-control procedures to be implemented by the consultee. Then, during the third, fourth, fifth, sixth, and seventh week of the investigation, the consultant and consultee met to discuss the progress of the treatment program and to make alterations as needed. During these sessions, the consultant verbally reinforced the consultee if progress had been made with the treatment program. Each consultee thus received a total of seven consultation sessions lasting a maximum of 45 minutes, and each consultation session was tape-recorded in order to permit assessment of the consultation process.

Consultation Training Sessions Each consultant received six consultation training sessions lasting a maximuri

of one and a half hours each. These sessions were held once a week beginning during the second week of the study. Each consultant received five control training sessions and one experimental session. The week in which each consultant received the experimental session was randomly determined, with the exception that each week only one consultant received the experimental session. This was consistent with the multiple time series design which is described below.

Control Training Sessions. In the control sessions, the consultants’ trainer focused attention on variables relevant to the content of the consultation sessions, such as the reinforcement program employed, the literature relevant to self-control techniques, schedules, observation methods, data collection, etc. While content was discussed, the control sessions avoided any discussion of process variables. Even though these sessions were designed as an experimental control to be used as a basis of comparison with the experimental session, the trainer’s goal was to help maximize the performance of the consultant during the following week. It was felt that this would provide a conservative test for the effects of the experimental training session.

Experimental Training Session. The experimental session consisted of a 90- minute workshop on the basic concepts of Transactional Analysis as applied to consultation. The workshop consisted of three parts:

Par t I was an introductory statement on consultation which consisted of four predominant subsections; (a) a definition of consultation consistent with Caplan (1970) ; (b) a statement of the importance of the relationship between the consultant and the consultee for successful consultation; (c) an emphasis on communication between the consultant and consultee for successful consultation ; and (d) a statement that Transactional Analysis provided a framework for under- standing communication which is appropriate for consultation.


Part I1 of the workshop focused didactically on the T. A. model - specifically on three important aspects of this model; (a) Ego states; (b) transactions; and (c) games (Berne, 1964). During this section of the workshop, the concept of Ego dtates was introduced by having the trainees read the paper “What is a Person” (Thomson, 1971). The concept of transactions was then explained by the trainer, who indicated that analysis of transactions involves the identification of: (a) which Ego state of the person initiates the stimulus, (b) which Ego state in the respondent it is directed toward; (c) which Ego state of the respondent initiates the response; and (d) to which Ego state the response is directed. Part I1 was concluded by reading aloud excerpted versions of a Transactional Analysis Training manual (Abbey & Owstons, 1973). The trainer and trainee alternately read sections of this manual to insure active involvement of both parties.

Part 111 of the experimental training session occurred after the didactic parts were concluded. This section consisted of listening to a tape of one of the consultant-trainee’s consultation sessions. The trainee and the trainer attempted to analyze the tape, using Transactional Analysis principles, with a focus on the identification of Ego states, types of transactions, the presence of games, and the generation of the consultant-trainee’s ideas on ways to improve the communication process.

Experimental Design This study used a multiple time series design (Campbell & Stanley, 1966).

The basis for experimental control with this design is that subjects are given experimental treatment one a t a time, in a random order. Each time a subject receives the experimental treatment, those subjects who have not yet received treatment serve as a control. Consultant 1 received the experimental training session a t the beginning of the second week of the study; consultant 2 received the experimental session at the beginning of the third week of the study; consultant 3 received the experimental session at the beginning of the fourth week of the study; and consultant 4 received the experimental session a t the beginning of the sixth week of the study. A clear outline of the design is depicted in each table which reports the results. The change in performance from baseline for each experimental subject is thus compared with the change in performance of the control subjects. Three dependent measures were assessed : (a) the subjective impression of the consultant and consultee of each session’s effectiveness; (b) the percent of change toward goal; and (c) the number of parallel, adult-adult transactions.

Analysis of Tapes The extensive taping was reduced to a workable size by systematically removing

segments from the tape for analysis. The system utilized was to subdivide each tape into 10 equal time segments and then to extract the third and seventh of these time segments for purposes of analysis. Typescripts from the extracted por- tions of the tapes were read and scored by two graduate students trained in the fundamentals of Transactional Analysis. Interrater reliability of 80% was achieved prior to this actual scoring. Then, reliability checks were made mid-way (reliability = 86%) through the typescripts materials, as well as a t the end (reliability = 82y0) in order to insure that a minimum of SOYo reliability had been maintained.

The Training and Analysis of Consultation Process 549

RESULTS The data were analyzed in a manner consistent with the multiple baseline

design of this investigation. The mean score from the most recent baseline week is subtracted from the mean score of the treatment week for each dependent variable. This difference score for the consultant who has received the treatment session is then compared- to comparable difference scores for the control subjects who have not yet received the T. A. training session. In those instances where the difference score is highest for the consultant who had received the T. A. training, it was concluded that the observed increase was probably due to this training session.

TABLE 1

COMPARING BASELINE TO TREATMENT WEEKS ACCORDING TO THE MULTIPLE BASELINE DESIGN

I)IFFERENCE SCORES FOR THE NUMBER OF ADULT-ADULT TRANSACTIONS

Weeks 2 3 4 5 6

Subject 1 Subject 2 Subject 3 Subject 4 Subject 5

29* 12 - 30* 43 - 43 15*

-31 2 - 6 34 - 44 - 12

2* 9

** **

~ ~ ~ _ _ _ _ _ ~

*Indicates the subject pair who received the treatment each week. **NO difference scores are reported during fifth week, since the consultsnt who was to receive

treatment that week was dropped from the analysis.

Subject 1 This subject was the first to receive the T. A. training session, as it occurred

following one week of baseline data and simultaneous to the introduction of self- control procedures for all subjects. This subject showed an increase in the number of Adult-Adult transactions (pre = 22, post = 51), average subjective evaluation score (pre = 49, post = 52), and percent of goal attainment (pre = 34%, post = 50%). However, none of these gains can be confidently attributed to the T.A.

TABLE 2 DIFFERENCE SCORES FOR THE AVERAGE SUBJECTIVE EVALUATIONS


Weeks 2 3 4 5 6

Subject 1 Subject 2 Subject 3 Subject 4 Subject 5

3' 3 5 0

-3

- O*

- 3 7* 4 0 3 2

6* ** ** -4

*Indicates the subject pair who received the treatment each week. **No difference scores are reported during fifth week, since the consultant who was to receive

treatment t,hat week wea dropped from t,he analysis.


training. Table 1 reveals that two of the control subjects showed greater increases in number of Adult-Adult transactions; Table 2 reveals that two control subjects increased their subjective evaluation scores as much as or more than subject 1; and Table 3 shows that two control subjects had consistently greater gains in the percent of goal attainment.

Subject 2 The second subject to receive treatment did so during the third week of the

investigation. In this instance there was a reduction in Adult-Adult transactions (pre = 44, post = 14), and essentially no change in the average subjective evaluation score (pre = 49, post = 48), or in percent of goal attainment (pre = 79%, post = 82%). The data reported in Tables 1, 2, and 3 further confirm that for subject 2 there were no effects which could be attributed to the T.A. training, since for each dependent variable there was at least one control subject who had a greater gain than subject 2.

Subject 3 The third subject received the treatment during the fourth week of the investi-

gation. This subject showed an increase in total number of Adult-Adult transactions (pre=4, post = 19), an increase in the average subjective evaluation score (pre= 49, post = 56), and an increase in the percent of goal attainment (pre = 17%, post =

TABLE 3 DIFFERENCE SCORES FOR THE PERCENT OF GOAL ATTAINMENT


WMkS 2 3 4 5 6

Subject 1 Subject 2 Subject 3 Subject 4

34' 32 3* 33 - 16 17* 50 4 11 3* **

38 ** Subject 5 87 0 - 25

*Indicates the subject pair who received the treatment each week. **No difference scores are re orted during fifth week, since the consultant who was to receive

treatment that week w&s droppeg from the analysis.

34%). Tables 1, 2, and 3 indicate that each of these increases was greater that that of any of the control subjects, and consequent.ly it is concluded that the observed changes for consultant 3 probably can be attributed to the training session.

Subject 4 Subject 4 was the last to receive treatment, which occurred during the sixth

week. This subject showed essentially no change in number of Adult-Adult transactions (pre = 20, post =22), in the subjective evaluations (pre=47, post =48), or in percent of goal attainment (pre = 106%, post = 109%).

The Training and Analysis of Consultation Process 551

DISCUSSION There were increases in the number of Adult-Adult transactions, the avarage

subjective evaluation, and the percent of goal attainment for two (subject 1 and subject 3) of the four experimental subject pairs in this investigation. However, only the results for subject 3 met the requirements of the multiple baseline design, so that it could be concluded that the observed gains for this subject probably could be attributed to the Transactional Analysis training session.

An important principle which was examined is that the process of consultation can be manipulated experimentally. A second question which was considered is whether such changes in process have a relationship to the outcome of consultation. In this instance, the process of consultation was assessed by calculating the number of Adult-Adult transactions occurring in samples of each consultation session. Only subject 3 showed an increase in Adult-Adult transactions which could be attributed to the training session. There was evidence that change in consultation process had an impact on outcome, since this was the one case where it could be concluded that the training had an effect on both the percent of goal attainment and the average subjective evaluation score.

Several cautions are necessary in the interpretation of these data. First, the workshop itself was not successful in changing the behavior of consultants and consultees, since it is only probable that it had an impact on the behavior of one out of four consultant-consultee pairs. Second, the Transactional Analysis training session lasted only 90 minutes, in contrast to the more typical 12-16 hours of training involved in an introductory level T.A. course (e. g., T.A. 101). Also, the present approach was more didactic (reading, discussion, and analysis of one of the trainee’s tapes), whereas T.A. training is typically more experiential. As a result of these latter limitations, it is indeed striking that change did appear to occur in one of the four subjects. Third, due to the small N and the fact that this was an analog rather than an in-school consultation paradigm, the results can not be generalized beyond the subjects and setting of this particular experiment.

Fourth, a careful inspection of the data reflecting change in the number of Adult-Adult transactions (Table 1) and the percent of goal attainment (Table 3) reveals considerable variability of the data. Sidman(l960) has pointed out that in research using a design based on a small N it is important to obtain good control over the baseline behavior in order to make the treatment effects clearly under- standable. The self-control technique of this investigation was chosen to provide this initial control over the baseline data. Since this was not, accomplished, all of the data reported as well as the resultant conclusions should be treated tentatively. It is evident that considerably more research with this sort of design is necessary before clear conclusions will become apparent.

One contribution of this study is that it seeks to fll an existing void in the school psychology literature, which has paid too little attention to training the school psychologist. It is felt that the focus on the details of the training workshop provides an instructional model (ie., miniworkshop) for training in Transactional Analysis which can be implemented relatively easily by others.

In addition to suggesting the influence of parallel, Adult-Adult transactions upon the outcome of consultation, this investigation is significant because of its consideration of consultation process. Recent research in consultation has examined a variety of process variables. For example, using an adapted version of the Barrett-


Leonard relationship inventory, Schowengerdt, Fine, and Poggio (1976) have observed a significant relationship between teacher ratings of a consultant’s facili- tative characteristics and consultation outcome. Yet another approach has been attempted by Bergan and Tombari (1975), who have begun to demonstrate the impact of process variables derived from a behaviorist frame of reference.

The present investigation is important because i t is one of the first to experimentally manipulate the consultation process. Although the experimental manipula- tion (Transactional Analysis training) worked with only one of the four pairs, this represents an important first step. The implementation of this design shows that although it is very difficult to accomplish, it is possible to experimentally control the process of the consultation relationship and to determine whether such changes affect the outcome of consultation. . By manipulating consultation process, this investigation has made a methodological advance beyond the previous studies, which have addressed only the general question of whether consultation can result in behavior change (e. g., Meyers, Freidman, & Gaughan, 1975). It is hoped that the present investigation off em insight to researchers who are seeking appropriate experimental designs for manipulating relevant process variables and de- tecting the effects of these manipulations on consultation outcome.

REFERENCE NOTE 1. FINE, M. J. Applying T .A . theory and skills to the school psychologist-teacher consullation. Paper

presented at meeting of the National Association of School Psychologists, Atlanta, April, 1975.

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The training and analysis of consultation process using transactional analysis

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