Date of Award
Doctor of Philosophy
Norman A. Scott
Paradoxical interventions are psychotherapeutic directives that appear counterintuitive in comparison to more conventional treatment approaches. Concerns regarding the potential manipulative nature and ethical viability of these interventions have been expressed in the literature. This survey study was designed to test the impact of two experimentally manipulated variables (reactance potential of the client, presence or absence of a therapeutic rationale), presented as components of written therapy vignettes, on psychologists' ratings of treatment acceptability of a paradoxical intervention. It was hypothesized that cognitive dissonance would mediate this relationship. The paradoxical strategy was predicted to be perceived as contradictory to psychologists' usual treatment approaches, thus arousing psychological discomfort;Respondents were administered a 63-item mail survey instrument with one clinical vignette as a reaction stimulus. Each vignette included a paradoxical intervention and varied client reactance potential (high or low levels) and the therapeutic rationale (present or absent from the intervention). Two-hundred and eight usable surveys were returned from five-hundred and forty-five licensed psychologists, located in four states, yielding a response rate of 38.2%;Multi-item scales were developed to measure respondent experience containing paradoxical interventions, dissonance arousal, treatment acceptability, and dissonance reduction. Multiple regression analyses showed that demographic variables were not predictive of dissonance arousal or treatment acceptability scores. The effects of the rationale and reactance manipulations were not significant. Regression analyses indicated that higher levels of experience with paradoxical interventions were associated with lower levels of dissonance arousal and higher levels of treatment acceptability. Predicted two-way interactions of experience X dissonance arousal and experience X treatment acceptability were found. A rationale X reactance X experience interaction was significant for dissonance arousal scores;Post-hoc analyses suggested that the proposed mediational role of cognitive dissonance did fit the data as hypothesized. A majority of respondents reported that they indeed had used paradoxical interventions, that they had received training and supervision in the use of such interventions, and that such training and supervision is an important condition for the use of paradoxical interventions.
Digital Repository @ Iowa State University, http://lib.dr.iastate.edu/
Michael Christopher March
March, Michael Christopher, "Treatment acceptability of paradoxical interventions: the role of dissonance " (1997). Retrospective Theses and Dissertations. 12222.