acting crazy a training program that strengthens empathic listening, awareness, and creativity for...

8/8/2019 Acting Crazy a Training Program That Strengthens Empathic Listening, Awareness, And Creativity for Psychology St

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Acting Crazy: A training program that strengthensempathic listening, self-awareness, and creativity forpsychology students

Abigail A. Bradecich

A D issertation Submitted to the Faculty ofThe Chicago School of Professional PsychologyIn Partial Fulfillment of the Requiremen tsFor the Degree of Doctor of Psychology

June 10, 2008


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Unpublished WorkCopyright (2008) by Abigail A. Bradecich

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Acting Crazy: A Training Program that StrengthensEmpathic Listening, Self-Awareness, and Creativity forPsychology Students

A Dissertation Submitted to the Faculty ofThe Chicago School of Professional PsychologyIn Partial Fulfillment of the RequirementsFor the Degree of Doctor of Psychology

Abigail A. Bradecich2008

Approved By:

White, PsyD, ChairpersonAssociate Professor, The Chicago School of Professional Psychology

Ted Rubenstein, MFA , RDT , PsyD, M em be rAssistant Professor, The Chicago School of Professional Psychology

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Acknowledgements

I would like to thank m y chair, Dr. Grant W hite, for initially taking m e on as adissertation student with my ideas of blending acting and psycholog y. Y ou helped me tofind a focu s for this dissertation, and I am truly grateful.

I would also like to thank my reader, Dr. Ted Rubenstein, whose wisdom aboutall things acting/improvisation/art, psycho logy, and the blend ing of these fields helpedme to structure this dissertation and the training program. Y our encouragemen t andfeedback helped to keep m e invested in this project and continually provided directionmoving forward.

I cannot thank Keith W hipple, M.A., enough for leading the pilot course, theactual research po rtion, of this dissertation. Thank you for meeting w ith me to structurethe pilot course as well as to share your know ledge about im provisation, drama therapy,psychodram a, and teaching. Thank y ou also to all of the students who participated in thepilot course. Thanks for taking risks and sharing your experiences.

Diana Castle was the initial inspiration for this dissertation as w ell as a catalystfor me to go back to school in the field of mental health. Her acting class, for me, was n otabout acting per se, but about truly understanding the human co ndition and the hum anexperience, through imagination, empathy, and allowance.

My m other and step-mother were my role models in this process. Both wome nmodeled going back to graduate school and writing their dissertations w hile I wasgrowing up; you are both inspirations. Thank yo u to my father for always believing in m e

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and being a suppo rtive presence in m y life. And to my sisters and girlfriends, who I lovedearly and feel blessed to have in my life, thank yo u for checking in on m e andencouraging me throughout this process.

Mike, Sop hie, and Sara, nothing I can write here can truly express how m uchsupport and love you have given to me throughout th is process. Mike, thank yo u forwatching the girls weekend after weekend so that I would have time to write, and Sophie,Sara, and M ike, thank you fo r taking m e away fro m all of this to focus on what m attersmost.

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AbstractActing Crazy: A Training Program that Strengthens Empathic Listening, Self-Awareness,

and Creativity for Psychology StudentsAbigail A. Bradecich

The proposed program asp ires to strengthen helping skills for pre-practicumpsychology students in training. Although helping skills training is a com mon first step intraining program s today, the impact and effective ness of this training is not fullyunderstood. Research suggests that novice therapists can learn basic helping skillsrelatively quickly (B aker, Daniels, & G reeley, 1990), but also indicates that anxiety canimpact the beginner therapist's self-efficacy which negatively im pacts the utilization ofhelping skills in counseling related behaviors and clinical situations (Larson & Daniels,1998; Lent, Hill, & Hoffman, 2003).

Research indicated that role-play and mod eling increase a trainee 's self-efficacycompared to a control group without these experiential teaching techniqu es (Shurts,Cashwell, Spurgeon, Degg ges-White, Barrio, & Kardatzke, 2006). Ro le-play is atechnique taken from the d ramatic tradition. Throughout h istory, drama has been utilizedin healing, education, and entertainment (Em unah, 1994). Employing dram a in thetraining of psycholog ists blends the healing and educational elements in an experientialtraining approach. By incorporating action m ethods such as improvisation and playbacktheatre, educators can pass on and construct meaning through m ultiple intelligences(Weinstock-Wynters, 1997). Improvisation techniques w ill be utilized to strengthenempathic listening, self-awareness, and creativity in the novice psychology student in

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attempt to decrease anxiety, increase self-efficacy and , as developmen t co ntinues,increase here-and-now engagement and active listening skills.

Eight subjects participated in a two-hour pilot class for this program developmentdissertation. The pilot course consisted of seven ex periential im provisation ex ercises.Overall feedback on the pilot program was positive. Written feedback suggested th efollowing strengths in the cou rse: potential to decrease an xiety in students, potential toincrease self-awareness and self-discovery, and a potential fo r more student interaction.All participants responded ye s to believing creative arts should be a part of psycho logytraining.

Participants suggested allowing for more time in working experientially, andproposed more discussion surrounding the connections between improvisation andpsychology. These sugg estions were incorporated in the final creation of this trainingprogram. The proposed program utilizes improvisation and playback theatre in thetraining of psychology students. It is hoped that this program w ill be enacted andevaluated fo r further research in this area.

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Table of Contents

Copyright iiSignature Page iiiAcknowledgements ivAbstract viCHAPTER 1: INTRODUCTION 1

Introduction 1CHAPTER 2: REVIEW OF THE LITERTURE 6

Overview of Training History 6Relationship Com petency 11Carl Rogers/Client-Centered Therapy 14Helping Skills Training/Pre-practicum Training 17Helping Skills Training and Self-Efficacy 22Research on Trainees 24Empathy 25Listening/Empathic Listening 30Self-Awareness 31Creativity 33Role-Play 36Drama History and the Evolution of Acting 39Psychodrama 47

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Drama Therapy 55Drama in Education 63Experiential Action Methods of Improvisation and Playback Theatre 64

CHAPTER 3: THEORETICAL FRAMEWO RK 74Theoretical Framework 74

CHAPTER 4: METHODS 76Goal 76Obj ectives/Anticipated Outcom es 76Target Population 77Identify Stakeholders 78Content of Program 79Select Measures 81Personnel 83Training Requirem ents of Personnel 83Materials, Space, and Time Needed 84Funding Sources 85Budget 85Program Implementation Timeline 85

CHAPTER 5: PILOT PROGRAM 87The Class 87The Feedback/R esults 94

CHAPTER 6: TRAINING PROGRA M 98ix


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The Program 98CHAPTER 7: DISCUSSION 105

Discussion 105REFERENCES 109APPENDIX A: INFORME D CONSEN T FORM 119APPENDIX B: PILOT PROGRA M OUTLINE 120APPENDIX C: PILOT PROGR AM TRANSC RIPTION 124APPENDIX D: PILOT PROGRAM FEEDBACK FORM 187APPENDIX E: PILOT PROGRAM FEEDBACK RESPONSES 188APPENDIX F: PROGR AM SYLLABUS 192

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CHAPTER 1: INTRODUCTIONIntroduction

Research on th e training of basic skills necessary f or psychotherapy has declineddramatically since the late 1960s and early 1970s (Baker, Daniels, & Greeley, 1990;Carkhu ff, 1966; Hill & Lent, 2006; Ivey, Normington, Miller, Morrill, & Haase, 1968).Basic helping skills training programs w ere developed at that time to teach distincthelping skills such as empathy (i.e., reflection of feelings), listening, warmth, openquestions, and interpretations. Th ese skills were typically taught in training programs

prior to individualized sup ervision or practicum training, thus these skills were alsotermed pre-practicum training (Bak er et al.; Carkhuff; Hill & Lent; Ivey et al ).

Although helping skills training is a common first step in training program s today,the impact and effectiveness of this training is not fully understood. Research suggeststhat novice therapists can learn basic helping skills relatively quickly (Baker et al., 1990),but also indicates that anxiety can imp act the beginner therap ist's self-efficacy whichnegatively impacts the utilization of h elping skills in co unseling related behaviors andclinical situations (Lent, Hill, & Hoffman, 2003). S pecific training devoted to thesehelping skills would lessen anxiety and strengthen self-efficacy in the novice therapist.

This dissertation will create a training p rogram for novice therapists focusing onstrengthening basic helping skills such as empathic listening, and higher order counselingskills (Nutt-Williams, Judge, Hill, & Hoffman, 1997), such as self-awareness andcreativity, in order to strengthen the psychology studen t's confide nce and ability in a

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therapeutic situation. To strengthen helping skills, this program will utilize acting andimprovisation techniques.

How can an acting class lessen anxiety and deepen understanding? A brief look atdrama and acting will elucidate its therapeutic ben efits as well as its ability towa rd skilltraining. In ancient Greece, theatre was central to the society. In his work, The Poetics,Aristotle established rules in theatre and playwriting, and developed the idea of catharsis,an emotional release on the part of the spectator (Worthen, 1996). Aristotle presented therole of the theatre as one of healing (Siroka, 1978). In modern theatre, this em otionalrelease has m igrated fro m within just the audience, to an emotional shift in the actor aswell. Inspired by Stanislavski and his work, many Am erican acting teachers begantraining actors in "The M ethod " or M eisner techniques in the early to mid 1900s(Worthen). The actors focused on imagining them selves as the character and bringing inpersonal m emories to authenticate performance (Worthen). Th is emotional shift allowsthe actor, or in the case o f this dissertation, the psychology student, to experience beinganother person, to iden tify the pa rts of herself that resonate w ith the character, and topractice "p erforming " in front of others in the class, thus lessening the an xiety anddeepening understanding.

The healing ben efits of theatre and drama h ave existed throughout history, andspecific approaches have blended drama and therapy, u tilizing the ben efits of bothmodalities. The fields of psychodrama and drama therapy identify the therapeuticbenefits of drama in working with clients. Psychodrama tak es the metaphor o f theatre tothe personal by acting and reenacting the lives of group m embers in order to facilitate a

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catharsis within each client, the idea being that truth is displayed throu gh action andspontaneity, rather than talk therapy (Blatner, 1999; Mo reno, 1946). While psychodram awas found ed by a psychiatrist, Jacob Levy M oreno, drama therapy developed from theart form of drama and is rooted in various disciplines (Emunah, 1994). One of m anydefinitions, "Drama therapy is the intentional and systematic use of d rama/theatreprocesses to achieve psychological grow th and chang e" (Emunah, p. 3).

But h ow do the bene fits of drama impact the psychology student in training?Through exp eriential learning of dramatic action, the psychology student will experiencethe catharsis experienced in theatre, as well as the psychological growth and change theclient may ex perience in psychodrama and drama therapy. In learning improvisation andother techniques, the psychology student in training will be placed in situations w hichnecessitate active listening and empathy. Self-awareness will be strengthened as thestudent explores the role of the character, thereby understanding m ore about th e self.Further, the stu den t's creativity w ill increase as a result of strengthening these skills aswell as through the process of learning as an artist.

The benefits described above, particularly related to self awareness, are abilitiesusually only obtained via individual therapy. However, individual therapy is not amandatory com ponent of doctoral training, and av enues for self-understanding and self-reflection are missing from the training o f doctoral students. An acting training programfocusing on these skills could be another oppo rtunity for the student to gain insight intothe self.

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The field of drama therapy clarifies the need to train therapists through th e use ofdramatic enactment. Emu nah (1989 ) indicated that the use of drama in training can helppeople practice or prepare for real-life situations. She indicated that the world of m ake-believe is a safe place in which a therapist in training can deal with anxieties and developconfidence.

Graduate psychology training already utilizes experiential techniques in itscurriculum. R ole-play, a skill used in teaching that is borrowed from the dramatictradition, is a method often utilized in the experiential training of psychotherapists. Role-play has been accepted as a standard component of therapist education programs (B akeret al. 1990; Shurts, Cashwell, Spurgeon, Degges-White, Barrio, & Kardatzke, 2006).Research indicates that role-play and modeling increase a train ee's self-efficacycompared to a control group without these experiential teaching techniques (Shu rts etal ). Howev er, other research noted that performance anxiety and the fear of judgm entcan negatively impact the bene fits of in-class role-play s (Styles, 1999). Further, thevalidity, generalizability, and replicability of role-play has been difficult to assess inresearch given the nature of social interaction and the comp lexities of behavior are oftendifficult to recreate in a classroom or laboratory setting (Rubenstein, 20 06). A lthoughdifficulties assessing the v alue of role-play remain, th e bene fits of learning about the self,others, and various roles outweigh inconclusive or lacking research in this area.

An acting program geared toward psychology students has the potential to lessenanxiety in futu re training role-plays, futu re practicum experiences, and fu ture practice. Italso creates the possibility of increasing the stude nt's con fidence and self-efficacy. Long

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term po tentials include increasing here-and-now engagement and active listening skillsas well as deepening the therap ist's ability to understand, empathize w ith, and portrayclients (Emunah, 1989). Most likely, performance anxiety will slowly dissipate in animprovisation class by allowing students sufficient time to explore and perform.

This training program for graduate students in professional psychology willstrengthen the skills discussed above: empathic listening, self-awareness, and creativity.The program will take place weekly througho ut on e semester. Each class will be threehours long. These sessions will incorporate experiential learning through improvisationand playback theatre.

Dramatic enactment can change us as people. We are deepened and broadenedby the roles we play. New parts of ourselves become accessible, parts that can bemobilized in ou r work as healers... Therapy is not only a science; it is an art.Perhaps we can best express the art of psychotherapy v ia an artistic process.(Emunah, 1989, pp. 35-36)

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CHAPTER 2: REVIEW OF THE LITERATUREOverview of Training H istory

In 1949, Abraham L uchins noted the increase of clinical psychologists intherapeutic practice without adequate training in therapy. He o ffered his observation tostimulate discussion, as well as encourage change in the curriculum o f training fo r theclinical psychologist. Today, training fo r psychologists is valued in psychologicalliterature; however, research on training effective ness and ev aluation is limited (Hensley,Smith, & Thom pson, 2003; Hill & Kellems, 2002; Roberts, Borden, C hristiansen, &Lopez, 2005). C urrent research focuses on the training experiences received insupervision in practicum and internship, rather than on education and curriculum(Aronson, Akamatsu, & Page, 1982; Hill & Lent, 2006; Norcross & Stevenson, 1984).

The field of psychology wa s and is still today, fragmented w ith a separatist nature(Henriques & Sternberg, 2004). The degrees of doctor of philosophy (PhD) and do ctor ofpsychology (PsyD) are in constant deba te and competition about best practices, or morespecifically, the preferable degree for practicing psychology (Craighead & Craighead,2006; Maher, 1999; Peterson, Peterson, Abrams, & Strieker, 1997, Norcross & Castle,2002). The varying ideas about practice, research, education, concepts, orientation, andterminology prom ote confusion within the field (Henriques & Sternberg). Thedelineations between clinical, counseling, and school psychology are unclear and createmisunderstandings within the field of psychology overall. Theoretical orientations withinthe field create additional confusions. Further, the differences between the field of

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psychology and other helping professions (i.e., psychiatry, clinical social work, or generalcounseling) are blurred (Lindskoo g, as cited in Henriques & Sternberg). This diversity ofthought and conceptualization w ithin the field of psychology has led to various trainingmodels.

With respect to training, PhD and PsyD training prog rams are usually dividedbetween the B oulder Model (also called scientist-practitioner m odel) and the Vail M odel(or practitioner-scholar m odel), respectively (N orcross & C astle, 2002). The Bou lderMo del was established in 1949, and is linked to the PhD deg ree (Norcross & Castle). Itfocused more on research in psychological education. The Vail Mo del was established in1973 and wa s linked to the PsyD degree (Norcross & Castle). It was born out of the needfor a professional focu s in psychology and was equated with professional degrees in thefields of medicine, dentistry, and law (Norcross & Castle). Norcross and C astlesuggested, "Boulder p rograms aspire to train producers o f research; Vail program s trainconsumers of research" (p. 22). Although established as complemen tary training models,the different degrees have blurred th e distinction b etween standards for practice andstandards for research (Craighead & C raighead, 2006; Norcross & Castle). Instead,unhealthy com petition, divisiveness, and defensiveness emerged between supporters ofeach training model (Craighead & Craighead).

Researchers and practitioners have suggested various methods to solve theconfusion. Henriques and Sternberg (2004) suggested a unified psychological scienceincorporating a com bined-integrated doctoral training program. Craighead and Craighead(2006) suggested a distinction between th e degrees, the PhD reserved solely f or research,

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the PsyD solely fo r practice while incorporating research findings. Donald R. Peterson,"one of the most prominent and vocal leaders in the professional psychology mov ement"(Henriques & Sternberg, p. 1056) suggested that "science begins and ends in a body ofsystematic kno wled ge... professional activity begins and ends in the condition of theclient" (Peterson, 2006, p. 52). Further, he stated,

The best thing scientists in psychology can do to improve p ractice is not to deridetheir professional colleagues for going beyond tested k nowledge but to extend thebase of disciplined knowledge and improve the p rocedures that professionals needto meet the demand s of public service. (Peterson, p. 56)As this dissertation will focus on th e training of clinical psych ology students in a

PsyD program, the history of training will focu s on the creation and continuation of theNational Council of Schools and Programs of Professional Psychology (NCSPP).Founded in 1976, the NCS PP "h as devoted itself to the deliberate, systematic, reflectiveexamination of standards fo r the education and training o f professional psycholog ists bymeans of a series of annual conferences" (Peterson, Peterson, Abrams, & Strieker, 2006,p. 17). It is an organization of professional schools and p rograms with a m ission o f"progressive improvement, enhancement, and enrichment of professional psychologyeducation and training" (Peterson et al., p. 18).

The NCS PP evolved out of the need to prepare psychologists for professionalwork and th e desire to expand training to professional schools rather than only universitysettings (Peterson et al., 1997). Befo re the establishment o f the NCSPP , the Vailconference of 1973 instituted the intellectual agenda and institutional sanction fortraining in professional schools (Peterson et al., 2006). This conference discussed th e

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need for professional schools. The doctor of psychology (PsyD) degree had also attainedcredibility around this time wh ich furth er allowed fo r the development of the professionalschool (Peterson et al., 1997). It initiated the models of training and development forstudents in professional psychology and sparked th e creation of the NCSP P (Peterson etal., 1997; Peterson et al., 2006).

Several conferences of the NC SPP focused on training and developm ent of theprofessional psycho logist. The first major national con ference entitled "Qu ality inProfessional Psychology T raining" occurred in 1981 and resulted in the initial NCSPPvolume of standards (Callan, 1986 as cited in Peterson et al., 1997). Initial discussionsabout the core curriculum for professional schools transpired (Peterson et al ).

The NCSPP's Mission Bay conference in 1986 was the next significantconference related to the training of professional psychologists (Bent, 2 001; Peterson etal., 1997). At this conference, six core training com petencies were established as follows:relationship, assessment, intervention, research and evaluation, consultation andeducation, and m anagement and supervision (Bent). This conference marked a shift fromthe traditional emphasis on g athering know ledge in content areas to identifyingprofessional competencies as the goal of psychological education (Peterson et al., 2006 )."For those wh o think in terms of learning theory, the competencies suggest a muchclearer way o f thinking about education g oals" (Peterson et al., p. 32).

In 1992, and in line with the American Psychological A ssociation 's (APA) focuson evaluation, the NCS PP turned its attention to evaluation of students (Peterson et al.,1997). In 1993, Peterson et al. (199 7) noted that the title of the organization changed to

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incorporate programs, although the acronym remained NCSP P. A fter the 1993conference, the AP A asked two representatives from N CSP P to sit on its Committee onAccreditation (Peterson et al., 2006).

In 1994, the NCSP P reflected upon their educational m odel in attempt to integratework that was occurring in the field (Peterson et al., 1997). Related specifically tocurriculum and training, this conference addressed "the requirement of a comp etency-based core curriculum in which practical and scientific knowledge, skills, and attitudesare integrated" (Peterson et al., p. 375).

The core comp etencies were again discussed in 2002 at the "C ompetenciesConference: Future Directions in Education and C redentialing in ProfessionalPsycholog y" (Bieschke, Fouad, C ollins, & Halonen, 2004 ; Kaslow et al., 2004;Krishnamurthy et al., 2004; Spruill et al., 2004). The m ission of this conference w as"toward gaining greater agreement about dom ains and levels of competence by b ringingtogether representatives from diverse education, training, practice, public-interest,research, credentialing, and regulatory constituency groups" (Kaslow et al., p. 701). Thethemes acknowledged across each of the comp etency dom ains were identification,training, and assessment.

In the past year, the NC SPP completed a review and revision of the, now, sevenCore Com petencies (Dobbins, 2007). Th ese competencies are: "(1) Relationship, (2)Assessment, (3) Intervention, (4) Diversity, (5) Research/Evaluation, (6)Management/Supervision, and (7) Consultation/Education (Dobbins, p. 1)." Thesecompetencies are now placed within Developmental A chievement Levels (DALs), which

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"describe the knowledge, skills, and attitudes within each com petency across three stagesof training (begin practicum, begin internship, completion of degree)" (Dobbins, p. 1).Each of the competencies is further broken down into specific domains. Each domain isassessed in terms of knowledge, skills, and attitudes across the three levels of training.The Developmental Achievement Levels (DALs) model was approved by the NCSPPmem bership on August 15, 2007 as the NC SPP education and training model inprofessional psychology (Dobbins).

Relationship Competency"The NCSPP competency-based model of training is a dynamic and evolving

education approach that successfully responds to the societal need s and shifts ineducation priorities" (Dobbins, 2007, p. 3). It should be noted that the competenciesestablished by the NCSPP are consistent with the APA's Committee on Accreditationrequirement that programs hav e a philosophy about edu cation and training that is fittingto the practice of psychology (Kaslow et al., 2004; Peterson et al., 1997; Peterson et al.,2006) .

For the interest of this dissertation, th e relationship competency will be the focusof furth er training discussion. Wh ile the skills discussed in this dissertation ove rlap intoeach of the competencies, the com petency specified is most relevant. According to theStandards for Education in Professional Psychology (in press):

Relationship is the capacity to dev elop and maintain a constructive workingalliance with clients and includes the ability to work in collaboration with otherssuch as peers, colleagues, students, supervisors, and members of other disciplines,11


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consum ers of services and comm unity organ izations.. .The relationshipcompetency is a foundation and prerequisite of the other competencies. (Peterson,Peterson, Abrams & Strieker, in press, as cited in Peterson et al, 2006, p. 27)Peterson (200 7) further indicated that "the relational fu nctioning of professionalpsychologists is greatly impacted by their aw areness and connection to their self-identity"(P- 11).

The current NCSPP education and training model divides the relationshipcompetency into six domains as follows: professional demeanor, self, other, interpersonalconnection, cultural adaptability, and ethics (Dobbins, 2007). Most relevant to the skills

of this dissertation are the domains of self, other, and interpersonal connection. The "self'domain em phasizes and evaluates self-awareness and self-understanding. The "oth er"domain emp hasizes the understanding and appreciation of other individuals. The"interpersonal con nection" dom ain focuse s on issues such as perspective taking,comm unication, and negotiation (Dobb ins). These domains require that studen ts aretaught and must learn skills such as empathic listening and self-awareness; skills gainedfrom the training program in this dissertation. T he relationship com petency does notspeak to creativity directly. It is likely that creativity is embedded in each of thecompetencies at some level, but is less likely measurable as a knowledge, skill, orattitude. The need for creativity within the field of psychology and, specifically, withintraining, will be discussed in detail later.

Peterson et al. (2006) indicated the need for training of interpersonal skills is alsoembedded within the relationship com petency. Training for the development ofinterpersonal skills included "training in empathy, respect for others, and personal

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relatednessexperiential learning with self-reflection and direct observation o f behaviorand feedback by peers and experts" (Peterson et al, 1997, p. 380). These skills aretypically taught in basic clinical skills courses (Peterson et al., 1997).

"A certain degree of relational competency must exist prior to entering a graduateprogram. Thus, this competency calls for an admissions level baseline competency inareas such as respectful comm unication, self-awareness, basic relationship skills,openness to others, and lack of obvious psychop athology" (Dobbins, 2007, p. 9). Thisfalls in line with the notion that empathy and comm unication skills are either innate ordifficult to teach (Spruill et al., 2004). Th is topic will be discussed further in the em pathyand trainee sections of this dissertation. H owever, this notion within the NC SPP modelfor education and training in professional psychology that students must come in withbaseline relational skills may be related to the fact that there is a lack of research focusingon helping skills training today.

In the 2002 Core C ompetencies Co nference, valued aspects of training wereexperiential techniques such as role-play and vignettes, the im portance of m entoringrelationships, the integration of science and research into practice, the commitment tocontinuous life-long learning, and the need to train students to be self-aware (Kaslow etal., 2004). Spruill et al. (2004) indicated that training for relationship and communicationskills should include experiential techniques such as empathy training throu gh role playand self exploration activities along with didactic training. They indicated that individualand cultural differen ces were best learned through experience.

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As mentioned above, training on specific helping skills such as empathy,listening, and self-awareness are likely under th e umbrella of the relationshipcompetency. How ever, training for these skills was not found in the professionalpsychology training literature. Counseling and counseling psycho logy literatureaddressed these skills using the terms helping skills or pre-practicum skills (Hill & Lent,2006). First, we will look at Carl Ro gers' and client-centered therapy as a basis forunderstanding helping skills and relationship training. It is the belief of this writer thatRo gers' techniques and theories are utilized in many helping pro fessions as well asdifferent theoretical orientations w ithin psychology.

Carl Rogers/Client-Centered TherapyClient-centered therapy focuses on the helping relationship between th e client and

therapist. One of the parties in the relationship is focused on "prom oting the growth,development, m aturity, improved fun ctioning, improved coping w ith life of the other"(Rogers, 1961, p. 40). It is assumed that the person intent on helping is the therapist. Thethree main aspects within this relationship that the therapist needs to em phasize areempathy, unconditional positive regard, and genuineness (Ro gers, 1961). In 1942, Rogersstated as a basic hypothesis for psychotherapy as follows,

Effective counseling consists of a definitely structured, permissive relationshipwhich allows the client to gain an understanding of himself to a degree whichenables him to take positive steps in the light of his new orientation, (p. 18)In 1959, Rog ers' defined empathy "to perceive the internal fra me of reference of

another with accuracy, and with the emotional comp onents and meanings wh ich pertain14


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thereto, as if one were the other person, but without ever losing the "as i f ' co ndition"(Hackney, 1978, p. 210). However, d efinitions of empathy have changed and developedover time and Rogers' own definition is no exception. Rog ers' later described empathyas a process rather than a concept and as "entering the private perceptual world of theother and becoming thoroughly at home in it" (Rogers, 1995, p. 142). Empathy as aconstruct will be discussed in detail later.

Rog ers described uncon ditional positive regard as the therapist expressingpositive attitudes of warmth, caring, liking, interest, and respect toward the client(Rogers, 1961). Genuineness within the relationship between therapist and clientmanifests by the therap ist's words or actions matching his or her own internal feelings(Rogers).

"Although Rog ers (1942) first considered the facilitative conditions as skills (e.g.restatements, reflections of feelings) that could be taught, he later came to the conclusionthat they w ere attitudes that could not be taught (1957)" (Hill & Lent, 20 06, p. 155). In1951, Rogers indicated significant trends in the training of therapists as follows: a trendaway from technique toward relationship, a trend of utilizing o ne 's attitudes to developindividual techniques, a trend toward the stud ent's experience o f therapy within th e self,and a trend toward the p ractice of therapy within training (Ro gers, 1951).

Rog ers also believed role-taking and simple interviewing to b e important in thetraining o f psychotherapists (1951 ). He described role-taking as follows,

Students are encouraged to take the role of someone whom they kno w well, andtalk out some of the problems of this person, with another student acting ascounselor. As described, this device may seem artificial, but it develops a


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surprising amo unt o f reality and at times can becom e just as real for the counseloras actual therapy. (Rogers, 1951, p. 469)He encouraged students to counsel one anoth er's m inor problems to further enact therelationship between therapist and client (Rogers).

Rog ers also focused on the supervisory relationship in the training of thetherapist.

The general principle which seems to apply here is that if the climate of theteaching situation, and the relationship between th e teacher and the beginningcounselor, are the same as the climate and the relationship which exist in therapy,then the young therapist will begin to acquire a knowledge in his viscera of whatthe therapeutic experience is. (Rogers, 1957, p. 81, as cited in Truax, C arkhuff, &Douds, 1964, p. 241)

Rog ers developed a training curriculum for graduate education similar to the premise ofclient-centered therapy (Rogers, 1969). He indicated the major focu s of the programwould be to set up an environment in which creative learning and self-directed studycould take place (Rogers, p. 190). He believed that students should be selected forgraduate programs based on their intelligence, their empathic ability, and their degree ofspontaneous curiosity and originality (Rogers).

In A Way of Being, Rog ers reiterated th e value of comb ining experiential learningwith cognitive learning as he had suggested throughout his career related to ideas ofteaching and learning (Rogers, 1995). "Rogers w as the first person to move the trainingof counselors out of the realm of the m ysterious to the realm o f the observable andtrainable by m aking audiotape recordings of sessions using a one way-m irror" (Baker etal., 1990, p. 357). Rog ers' theories led to further research on helping skills training,models fo r such will be discussed below.


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Helping Skills Training/Pre-practicum TrainingHelping skills training is focused on techniques such as reflection of feelings,

listening, warmth, open questions, and interpretations (CarkhufF, 1966; Hill & Lent,2006; Ivey et al., 1968). These skills were typically taught in training programs prior toindividualized supervision o r practicum training, thus these skills were also termed p re-practicum training (Carkh uff; Hill & L ent; Ivey et al ). Although helping skills training isa comm on first step in training program s today, the impact and effectiven ess of thistraining is not fully understood Research on helping skills training declined dramaticallyafter the late 1960s and early 1970s (Carkhu ff; Hill & Lent; Ivey et al ). Researchsuggested that novice therapists can learn basic helping skills relatively quickly, butnoted an assum ption of training effectivene ss has decelerated research in this area (Bakeret al, 1990). Research also indicated that anxiety can impact the beginner therapist's self-efficacy which negatively impacts the utilization of helping skills in counseling relatedbehaviors and clinical situations (Lent, Hill, & Hoffman, 2003). H elping skills trainingmodels that received the most em pirical attention will be discussed below.

Each of the training m odels discussed was based in Carl Ro gers' theories ofclient-centered therapy (Hill & Lent, 2006). In 1964, Truax et al. indicated therapistsneeded didactic training to shape behavior and ex periential training to prom ote growthand development. By 1972, Carkhuff developed the Human Relations Training model(HRT), also called Integrated Didactic Experiential Training (IDE T) (Hill & Len t, 20 06)or the Human Resource Developmen t Model (H RD ) (Baker et al, 1990). This model wa sclosely tied with R ogers' theories in that "Training and therapy share a common g oal in

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this system by providing the facilitative conditions necessary to enable the trainee orclient to grow tow ard greater self-actualization" (B aker et al, p. 359). It was also the mostinfluential and widely used of the training m odels in counselor education programs(Baker et al ).

The three m ajor stages therapists progress through with a client were: self-exploration, understanding, and action (Hill & Lent, 2 006). These stages w ere facilitatedthrough the use of empathy as an objective measure, attending or comm unicating skills,and through the use of problem-solving o r behavioral techniques (Hill & Lent). Empathy,genuineness, and respect were considered the co re conditions (Toukm anian & R ennie,1975). There are two ph ases in HRT . The first is discrimination training wh ere thetrainees listen to audiotape recordings of counselor com munications, the second iscommun ication w herein trainees role-play and practice communicating skills(Toukmanian & Rennie).

Ivey 's microcounseling (M C) or microtraining was another popular trainingprogram (Bak er et al., 1990; Hill & Len t, 2006; Ivey et al., 1968). Derived fro m social-learning theory, "MC introduced the idea of identifying clearly delineated discretebehaviors, such as attending, reflection of feeling, summ arization, or self-disclosure andteaching them systematically, one at a time, and then integrating them " (Baker et al., p.358). MC focused on similar skills used in HRT, but did not utilize a stage model as didHRT (Hill & Lent). MC focused on the hierarchy of attending behavior, m inimal activityresponses, and following behavior (Toukmanian & R ennie, 1975).

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MC involves teaching helping skills through (a) having trainees perform abaseline interview; (b) providing instruction and mod eling on a specific skill; (c)having the trainee practice; and (d) providing feedback on how w ell the skill w asimplemented. (Hill & Lent, p. 156)In contrast to HRT, M C utilized role-play as a focal point of training throughout eachstep and worked through a video medium in the training of counselors (Touk manian &Rennie).

Kagan developed another major training approach called Interpersonal ProcessRecall (IPR) based on the discovery model of learning (Baker et al., 1990; Hill & Lent,2006; Kagan & Schauble, 1969).

The IPR system is based on the theory that counselors, even beginningcounselors, perceive and understand m uch more of their communication w ith theclient than o ne would suspect, and that beginning counselors do not attend toportions of interviews because of performa nce anxiety and a preoccupation withimpression managem ent. (Baker et al., p. 360)In IPR, trainees watched a videotape, practiced responses to th e videotape, conducted aninterview, and then we re asked questions by an "inquirer" abo ut their though ts andfeelings during the interview (Baker et al.; Hill & Len t). They were asked ab out w hatthoughts and feelings may have interfered with the process of the interview (Hill & Lent).The trainees then processed th e questions asked by the inquirer with their interviewee(Baker et al ). The overall p urposes of IPR encouraged students to foster self-awarenessabout own beh aviors, thoughts, and the importance o f the therapeutic relationship (Bakeret al.).

Narrative reviews of these training p rograms revealed incon sistent findings(Baker et al., 1990; Hill & Lent, 2006). Some studies suggested that previous research on


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HRT had methodological problems, wh ile others found HRT to be effective (Baker et al.;Hill & Lent). Other studies indicated that M C could be taught effectively, especiallywhen combined w ith IPR (Baker et al.; Hill & Len t).

Meta-analytic studies found that trainees benefited mo re from HR T than MC orIPR, and m ore from M C than IPR (Baker et al., 1990; Hill & Lent, 2006 ). However, theresearch indicated d ifferences in ho urs needed in each training model, HR T th e longestamount of time and M C the least amou nt of time. The hou rs spent in training was relatedto cost-effectiveness of the program (Baker et al ). Baker et al. found evidence of support

for all three models, but indicated further research and development would be needed.Another m ajor finding from this research suggested th e importance of the trainer.

Both H RT and M C relied on the ability of the trainer in providing m odeling and d idactictraining, w hereas EPR depended up on an "inquirer" to aid the trainee in their ownfindings (Hill & Len t, 2006). This suggested that IPR might be m ore beneficial afterbasic helping skills training occurred (Hill & Lent). In their meta-analytic study of theliterature, Hill and Lent, found support fo r HRT and MC as valid h elping skills trainingprograms.

Hill and Kellems (2002) developed a Helping Skills Me asure (HSM ) to assessbeginning h elpers in sessions. They fou nd that HSM was valid and could be used toevaluate client perception o f counselo r's helping skills (Hill & Kellems). The trainingprograms assessed in their research integrated aspects of HRT, MC, and IPR (Hill &Lent, 2006). T he training m odel followed three stages:

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Exploration (involves attending skills, open questions, restatements, andreflections of feelings), insight (involves challenges, interpretations, self-disclosures of insight, and immediacy), and action (involves inform ation anddirect guidance). (Hill & Lent, p. 158)The researchers found increases over the course of training in the use of h elping skills,relationship building, and in-session aptitude (Hill & Kellems).

In looking at the specific methods within these programs, Hill and Lent (2006)found that narrative reviews cited modeling, rehearsal/practice, instruction,feedback/supervision, self observation/confrontation, cocounseling, and deconditioningof anxiety as effective. In their own meta-analytic study, Hill and Lent confirmed theresults found in narrative studies. They concluded that instruction, modeling, andfeedback were effective in teaching exploration skills (Hill & Lent). They also found thatthe modeling m ethod outperformed instruction and feedback (Hill & Lent).

Hill and Lent (2006 ) noted that much o f the research is based on M C, which, asmentioned earlier, was influenced by Ban dura 's social-learning theory, thus the researchis reliant o n cognitive con structs such as instruction, mod eling, practice, and feed back.They indicated a need to understand these processes and skills in a flexible, client-centered manner. However, other research supported the cognitive approach tosupplement behavioral skills training (M orran, Kuprius, Brack, & Brack, 1995). Empathyand other skill definitions were also noted as vague terms (Hill & Lent). Theseresearchers were surprised to find no investigations of trainer effe cts and structuralvariables within the literature (Hill & Lent).

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Larson (199 8) described a social cognitive model of counselor training using adrama metaphor. The counselor portrayed th e ma jor character, and the client and thesupervisor played supporting roles. A triadic, reciprocal causation process was exploredand discussed as a dynam ic interplay (Larson).

Other research on early counselor training has called for a shift in focus toproblem-solving strategies rather than listening skills (Lopez, 1985). The researcherindicated that anxiety, lack of m anagement, inadequate problem clarification, andpremature intervention was due to lack of instruction in verbal skills and structuringmethods (Lopez).

Helping Skills Training and Self-Efficacy"Counseling self-efficacy is described as on e's beliefs or judgm ents about ones

capabilities to effectively counsel a client in the near future" (Larson et al. (1992) as citedin Larson, 1998, p. 221). Larson indicated that self-efficacy is a term within B and ura'ssocial-learning theory, but is usually studied on its own. Leach and S toltenberg (199 7)indicated that trainees experience anxiety and low self-efficacy related to evaluationanxiety, perform ance anxiety, and lack of understanding surrounding the comp lexities ofcounseling, even though they receive basic knowledg e and skills. S elf-efficacy related toa trainee's perception of his or her skill set rather than the actual skill set (Bandura, 1986,as cited in Larson).

Self-efficacy is assumed to impact traine e's clinical functio ning (Larson, 1998).Larson and D aniels (1998) noted that counselor self-efficacy correlates positively with

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satisfaction, and negatively with anxiety in relation to the counseling role. In beginningtrainee's, Hill and Lent (2006) noted that self-efficacy can decline when trainees realizethat helping skills utilized in friendships may differ from the skill set needed in therapy.In a study evaluating self-efficacy, anxiety, counter-transference management, andtherapeutic skills, Nutt-Williams et al. (1997) found that although trainees displayedevidence of growth during a training semester, they continued to struggle with feelings ofanxiety, frustration, inadequacy, and distraction. Another study found that self-efficacyincreased over time in a counseling program and in practice (Melchert, Hays, Wiljanen,& Kolocek, 1996).

Melchert et al. (1996) noted a 1986 review of psychotherapy outcom e research byOrlinsky and Howard and stated that, "in two thirds of the research results, clientoutcome w as positively related to therapist self-confidence, whereas therapist'unsure ness' was never positively related to outcome" (p. 640). Levitt (2001) found that atraining program focusing on listening skills over other microskills used in teachingbeginning counselors was a contributing factor to increases in self-efficacy andperformanc e in other areas. Larson and Daniels (1998 ) further indicated that role-play,modeling, and positive feedback promote self-efficacy.

Another study looked at the training techniques of role-play and videotapemodeling and their impact upon trainee self-efficacy (Larson et al., 1999). They foundthat both techniques im pacted self-efficacy in the counselor in training. R ole-play wasmore volatile, increasing self-efficacy significantly in trainee's w ho felt they performedwell, but for trainee's wh o believed they perform ed less well, se lf-efficacy dropped

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significantly (Larson et al ). Videotape mod eling was less potent as far as the impact onself-efficacy. It was a safe method for increasing self-efficacy minimally (Larson et al ).They suggested that utilization of videotape m odeling can increase the chance ofsuccessful role-plays later in training (Larson et al.).

In developing an assessment of self-efficacy, Lent et al. (2003) conceptualized amodel of self-perceived capability across three sub-domains. These subdom ains were asfollows: to perform basic helping skills, to manage session tasks, and to neg otiatechallenging situations and presenting issues (Lent et al ). They fou nd the m easure to bereliable and that self-efficacy increased with am ount of experience. They furth er foundthat self-efficacy can be divided into two concepts, task self-efficacy and coping self-efficacy. Both task and coping are necessary fo r development, and it appeared thatcoping self-efficacy builds upon the mo re basic task self-efficacy (Lent et al.).

Research on TraineesIn their analysis and review of the literature, Hill and Lent (2006) noted that

students entering training programs may have more ability tow ards support and guidance.They further asserted that people with natural helping abilities will be easier to train. Incontrast, they indicated that training may not impact persons with a greater skill level asmuch as persons with a low er skill level. Th is idea is similar to a finding by B aker et al.(1990) in that undergraduates displayed greater im provement with helping skills trainingthan graduate students, although undergraduates lost these skills more quickly than didthe graduate students.

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There are m any variables that factor in to ability to be trained appropriately.Factors include type or value of school, trainer, and previous experience (Hill & L ent,2006). An other issue to consider is the quality of the student being accepted into graduateprograms. Research indicated that character and fitness are of great importance todirectors in evaluating applicants (Johnson & C ampbell, 2004). How ever, the assessmentwork g roup in the 2002 com petencies conference noted a lack of preparedness inincoming students (Krishnamurthy et al., 2004). Overall, there seems to be a lack ofresearch o n trainee variables

The n ext sections will be devoted to the specific skills this training program willwork to strengthen in psychotherapists. It should be noted that there is overlap betweenthese skills and others in counselor training.

EmpathyEmpathy was translated into English from the term einfuhlun g (in-feeling) in the

last century (Escalas & Stern, 2003). Be fore that, the term empathy was enm eshed withthe idea of sympathy and the term m itgefuhlung (with-feeling). The difference betweenthese words lies in the ability to remain emo tionally conscious. To experience sympathyone may be aw are of the feelings of another but is not absorbed in the feelingsthemselves, while, when experiencing empathy, o ne may forget their own personalexistence by sharing the feelings of the other (Escalas & Stern).

The earliest therapeutic use of the term em pathy was by Carl Rogers in client-centered therapy, although other researchers may have described the phenom enon b efore


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Rog ers labeled it (Hackney, 1978). Rogers introduced em pathy as "one of the sixnecessary and sufficient conditions fo r positive personality chang e to occu r" (Rogers,1957, as cited in Hackney, p. 36). Over the years, the definition of empathy ha s changed.As mentioned in the section about C arl Rogers, his description of empathy changed fromhis first discussion in 1957 to a later depiction of deep empathy in 1980 (Glanzer, 2006;Hackney).

The term empathy has several definitions, some of which have been notedpreviously. Rogers (1957) defined empathy "to perceive the internal frame of referenceof another with accuracy, and with the emotional compo nents and mean ings whichpertain thereto, as if one were the other person, but without ever losing the "as i f 'condition" (p. 210, as cited in Hackney, 1978). Other leading researchers in the field ofempathy defined it as, "an affective response m ore appropriate to someone e lse'ssituation than to one 's own," (H offman , 1987, p. 48), "an affectiv e response that stemsfrom the apprehension or comprehension of anoth er's emotional state or condition, andthat is similar to what the other person is feeling or would be expected to feel"(Eisenberg, 2002, p. 135), and "the capacity to think and feel oneself into the inner life ofanother person" (Kohut, 1984, p. 82). Some researchers suggested em pathy could bebroken down into separate entities of emotional empathy and cognitive empathy (Davis,Hull, Young, & W arren, 1987). Smith (2006, p. 3) defined cognitive empathy as "m entalperspective taking" and described em otional empathy as "the vicarious sharing ofemotion."

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But how d oes one learn to use empathy in life, and, fo r mental health workers, intherapy? Patterson (2002) indicated that the capacity for empathy has som e biologicalcomponent. By age two, infants are able to iden tify themselves as separate individuals.Once this separation is established, the infant can feel empathy for others (Eisenberg,1995). Ho ffman (1979) suggested that there is a developmental schedule fo r thedevelopment of empathy in children; from the two-year-old toddler w ho can un derstandothers' distress, to a six-year-old wh o can cognitively "walk in anoth er's shoes," to anadolescent wh o can begin to think abstractly enough to empathize with a group ofindividuals.

Yet experience also impacted one's development of empathy. Although it isbiologically programmed, experience may enhance or interfere with a child's emergingability to empathize (Hoffman, 1987). This experience is usually related to the parent-child relationship. The parent either engenders em pathy in the child by discussingfeelings and displaying their own em pathy fo r others, or negates the development ofempathy by threatening, scolding, or punishing the child using inappropriate m ethods(Eisenberg, 1995).

There is debate surrounding the notion of teaching em pathy. S ome believe thatempathy and listening are innate skills that cannot be taught (Spruill et al., 2004).However, each of the helping skills training programs discussed earlier d escribedmethods attempting to increase empathic ability in the beginning trainee. M ethods suchas role-play, m odeling, instruction, and feedbac k were used to improve trainees'

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empathic ability in HR T, M C, and IRP (Baker et al., 1990; Hill & Lent, 2 006; Ivey et al.,1968; Kagan & Schauble, 1969; Truax et al., 1964).

Hackney noted incongruity in the training of em pathy.Counselor trainers add a different dimension by seeking to create empathy in theirstudents, thus leading to an apparent paradox. T heir efforts are directed toward thetraining to be spontaneous in o ne 's response to an affective state of a secondperson. (Hackney, 1978, p. 35)

Further, he observed that the definition of empathy has changed from R oge rs' subjectivedescription of a condition and process to a more d efinable and m easurable condition thatcan be studied (Hackney). A s often occurs in research, empathy needed to becom e m oremeasurable, thus the focus switched to the comm unication of emp athy rather than thecondition. Edu cators understood that comm unication sk ills' training was easier thanempathy skills training (Hackney). Hackney u rged trainers to remind themselves not toconfuse the terms of communication and empathy. "These are (we hope) themanifestations of empathy and we c an't be altogether sure that they are that" (Hackney,p. 37). Hackney recommend ed trainees work to allow fo r empathy rather than train for it.

Of note related to this dissertation is the use of drama in other helping professionsempathy training. T he education and m edical fields have studied how t o teach empathy tochildren and medical students, respectively. C rosser (2002) indicated specific methods toeducate children about empathy. These method s were as follows: model caring behaviors,name em otions, interpret em otions, role play help ful behaviors, be supportive, and teachconflict resolution. Current research in child and medical education expanded on the idea

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teaching empathy to students. Larson and Yao (2005 ) suggested that techniques such as"deep acting" and "su rface acting" can be taught to medical students to prom ote empathywith their patients. Deep acting methods used "imagination and emotional mem ories togenerate genuine feelings of empathy fo r the patient," and, in the su rface acting m ethod,the "doctor forges emotional expressions inconsistent with internal feelings" (Larson &Yao, p. 4). Deep acting was preferred.

Listening/Empathic ListeningListening is a skill that, in research literature, is tied to the construct of empathy.

In some cases, the construct is labeled empathic listening (Irwin, 1986; Myers, 2000).Murphy and Dillon (2003) asserted that clinical listening refers to focused attention andvigilance to everything that is going on in the session and in the relationship, bothverbally and non -verbally. They further indicated that what w e are able to listen to andhear is shaped by our own experience (Murphy & Dillon).

In reference to a previously mentioned study, emphasizing active listening overother skills in helping training was found to increase self-efficacy (Levitt, 2001). To ller(1999) described listening as the heart of the counseling approach. Spruill et al. (2004)discussed listening as a component of commu nication. "Therapists need to learn how tolisten attentively, both to w hat is being said and what is not being said, sometimesreferred to as "listening with the third ear"(Spruill et al., p. 744).

Spruill et al. (2004) noted that listening skills can be learned from textbook sdevoted to comm unication and listening, topics usually presented in beginning


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psychotherapy classes. They later noted that experiential activities focusing ondevelopment of oral and written skills should be used in training.

Although it is important to note that empathy and listening are distinct concepts,for the purposes of this project, these con structs will be linked as emp athic listening. Asmentioned above, empathy is a condition or process that must be allowed fo r, whilelistening is a commu nication skill that is more easily measured. H owever, w ithin th eboundaries of an improvisation or drama class, these conce pts are more fluid. Training ofthese skills will be representative of how they are enacted in a therapeutic relationshiprather than as the ob jective measures that are needed for research situations.

Self-AwarenessSelf-awareness is integral to counselor effectiveness and a critical com ponent of

being a skilled therapist (Corey, Corey, & Callahan, 1998; Jennings & Skovholt, 1999)."Self-awareness is the consciousness a person has o f specific events that influence his orher psychological, social, emotional, and cultural attributes" (Sommers-Flanagan &Sommers-Flanagan, 1993, as cited in Brown , Parham, & Yonker, 1996). They fartherstated that self-awareness includes identity as influenced by the perception of self andothers (Brown et al.).

Hill and Lent (2006) noted that self-awareness of one 's own intentions andmotivations may be necessary fo r trainees in order to employ helping skills. Theyindicated that self-awareness facilitation techniques might best b e utilized b efore training

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in helping skills (Hill & Lent). However, it is likely that self-awareness needs to b e anon-going process throughout training and beyond.

Self-awareness was also represented in the literature within the therapeuticsituation. Sometimes referred to as self-talk, self-awareness was foun d to be effective inhelping the trainee understand use ful self-information in relation to their clients (N utt-Williams et al., 1997). They found that self-awareness could he lp a trainee manage his orher own reactions. Howev er, while early research indicated that neg ative self-talk withina therapeutic situation led trainees to believe them selves to b e less helpful, and linkedself-awareness to increased anxiety (Nu tt-Williams & H ill, 1996, as cited in Hale &Stoltenberg, 1988), later research results indicated that self-awareness within atherapeutic situation w as helpful to trainees rather than hindering (Fauth & Nu tt-Williams, 2005).

Self awareness w as a component of the relationship com petency as part of the sixcore comp etencies in training professional psychologists (Peterson et al., 1997). Of notewas the "belief in the v alue of self-awareness" (Peterson et al., p. 380). Self-awarenesswas also an important component in the training of psychotherapists at the NC SP P's CoreCom petencies conference in 2002 (Krishnamurthy et al., 2004; Spruill et al., 2004)."There was widespread acknow ledgement of the importance of self-assessment, inclusiveof a cultural self-awareness (i.e., reflecting on personal biases, assumptions, and values,and evaluating their potential impact on clients and the processes of psychological wo rk)"(Krishnamurthy et al., p. 737). Self-awareness was also highly valued within th e

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relationship competency of the most recent NCSPP model for education and training forprofessional psychologists (Dobbins, 2007).

Irwin (1996) indicated that self-awareness could be facilitated through o ne's ownpersonal therapy. Spruill et al. (2004) indicated that self-awareness could be garneredthrough work with on e's supervisor as personal issues arise in therapy. In his article,"Kno w T hyself," Hulnick (1977), utilizing the Socratic term, indicated self-awarenesscan be achieved in knowing; nothing is impossible, openness to experiences, andforgiving ourselves. H e stated, "W e need t o be able to skillfully guide our clients andstudents down into the hell of their own pain, distortion, and illusion; we need to workwith them until they are literally and sym bolically born anew " (Hulnick, p. 69).

CreativityOne of the training m ethods cited by the S cientific Found ations and Research

Competencies work group of the NCS PP's 2002 Core Com petencies conference was,"teaching science as a creative enterprise" (B ieschke et al., 2004, p. 720). Although m uchof the research and literature in psychology relates to science, there is recognition thatcreativity exists within a therapeutic relationship. Irwin (1986) noted that creativity iscentral to therapy, as "therapy is, after all, a healing process involving renewal and re-creation" (p. 194). In the 2005 NCS PP con ference which centered on imp rovingteaching, one of the m ain asp ects was to learn how teachers of psychology incorporatedcreativity into their classrooms (Dittman, 2005). Howev er, as creativity is not objective

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and measurable, research in this area is limited and disparaged fo r not being 'sc ient ific'enough.

Rog ers defined the creative process as, "the em ergence in action of a novelrelational product, grow ing out of the uniqueness of the individual on th e one hand, andthe materials, events, people, or circumstances of his life on the other" (Rogers, 1961, p.350). Related to therapy, he stated,

The mainspring of creativity appears to be the same tendency wh ich we discoverso deeply as the curative force in psychotherapy - m an 's tendency to actualizehimself, to becom e his potentialities. By this I mean the directional trend w hich isevident in all organic and human life - the urge to expand, extend, develop,mature - the tendency to express and activate all the capacities of the organism, tothe extent that such activation enhances the organism or the self. (Rogers, pp.350-351)Rogers tied the creative potentials of the individual to the client, the therapist, and therelationship itself.

In his studies of the psychology of creative persons at Berkeley, Frank Barrondiscussed creativity as "the ability to bring som ething new into existence" (Rothenb erg &Hausman, 1976, p. 190). His research suggested that creative personalities wereassociated to the capacity to generate novelty (Rothenberg & H ausman ).

In "The C ourage to C reate," Rollo May stated "creativity is the stepchild ofpsychology " (May, 1975, p. 37). He defined creativity as "the process of bringingsomething new into being" (May, 1975, p. 39). He further identified a process ofcreativity starting with an encounter between a person and the world, the engagem ent ofthe person in this encounter, and finally the absorption, in which the person is whollyinvolved with this engagem ent (May). He discussed creativity as subjective and therefore

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difficult to study. As it is difficult to define objectively and measure, it is generallyavoided compared to the measurable attributes within the science of psychology .

Ma y also discussed creativity within psychoanalytic theory. In this context, hedescribed creativity as a reductive process, usually attributed to a client's regression(May, 1975). He discussed A dler's compen satory theory of creativity in which hum ansproduce art, science, and other aspects of culture to com pensate for their owninadequacies (May). While he applauded the discussion o f creativity, he disagreed withthe idea of reducing creativity to some other process (M ay).

Related to creativity, May discussed imagination in juxtaposition to form (May,1975).

Imagination is the outreaching of m ind. It is the ind ividua l's capacity to accept thebomb ardment of the conscious mind with ideas, impulses, images, and everyother sort of psychic phenomena welling up from the pre-conscious. It is thecapacity to "dream dreams and see visions," to consider diverse possibilities, andto endure the tension involved in holding these possibilities befo re one's attention.(May, p. 120)He discussed the disparagement o f imagination as un scientific within the realm ofpsychology compared to the preferred notions of objectivity and facts (May). He furtherdepicted imagination in comparison to the field of psychology.

Throughout Western history our dilemma has been whether imaginationshall turn ou t to be artifice or the sou rce of being. Is psychotherapy anartifice, a process that is characterized by artificiality , or is it a process thatcan give birth to new being? (M ay, p. 125)Other studies of creative personalities indicated that the creative persons tend tobe m ore open to experience, m ore flexible, less rigid, m ore tolerant to am biguity, andmore sensitive to problems than less creative persons (MacKinnon, 1960; Taylor, 1964;

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as cited in Cicirelli & Cicirelli, 1970). Cicirelli and Cicirelli quote Torrance (1964, p.165) in his parallel between the ideal therapeutic relationship and the creativerelationship,

.. .to achieve the relationship... one must enter imaginatively into the thinking andfeeling experiences of another. Only by doing this can o ne participate com pletelyin anothe r's commun icating, keep his commen ts in line with what the other istrying to say, understand his feelings, follow his line of though t, and share hisfeelings. (Cicirelli & Cicirelli, p. 178)

Role-PlayAs role-play is discussed a s one o f the main experiential techniques in

psychological literature, it will be discussed as a technique within this field, and laterdiscussed in relation to theatre and drama. A brief look at role-theory will inform theorigins of role-play.

In his work, T he Study of Man , Ralph Linton presented the idea of role as thedynamic aspect of status (Linton, 1937). He stated,

Every individual h as a series of roles deriving from the various patterns inwhich he participates and at the sam e time a role, general, whichrepresents the sum total of these roles and de termines what h e does for hissociety and what he can expect from it. (Linton, p. 114)Erving G offm an (1959) developed a d efinition of role-theory as a theatrical metaphor.Com paring the presentation o f self with the presentation of an actor, he linked the hum anperson to his appearance to others, and to himself via others (Goffman; Wilshire, 1982).He described interactions between people, where one m akes any attempt to influence the

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other, as performance. He assumed that an individual has many m otives for trying tocontrol the impression they receive and giv e in any situation (Goffm an).

Dayton (2005) discussed Jacob L. Moreno's view of role-theory from apsychodramatic, sociometric, and sociodramatic perspective. She indicated that feelings,thoughts, and behaviors tend to be role specific, and that the self emerges from th e roleswe play from infancy through adulthood (Dayton, p. 149). Landy indicated severalassumptions at the heart of role theory (Landy, 200 1).

The first is that hum an beings are role-takers and role-players by n ature... humanbehavior is highly co mplex and contradictory and any one thought or action in theworld can be best und erstood in its counterpart., .(and) personality can beconceived as an interactive system of roles (Landy, p. 31).Role playing involves playing out the many roles within oneself (Emunah, 1994).

In psychotherapy training situations, it usually invo lves taking on the role of client ortherapist. Role-play has been accepted as a standard com ponent of therapist educationprograms (Baker et al., 1990; Shurts et al., 2006).

It is widely agreed that teaching effectiven ess can b e improved with deliberaterole-playing, but there is a lack of framework to enable classification, analysis,and understanding o f a variety of roles and the ways to u se them effectively.(Baruch, 2006, p. 44)Research indicated that role-play and mod eling increase a traine e's self-efficacycompared to a control grou p without these experiential teaching techniqu es (Shurts et al ).However, other research has noted that pe rformance anxiety and the fear of judgm ent cannegatively impact the benefits of in-class role-plays (Larson et al, 1999; Styles, 2000).Further, the validity of role-play ha s been difficult to assess in research given the

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and to use theater skills to understand, empathize with, and portray clients (Emunah, p.32).

As training in psychology has been discussed, I will now move to the benefits ofdrama and elucidate how drama will aid in the training of psychologists.

Drama History and the Evolution of A ctingDrama is derived fro m the Greek w ord, dran, meaning a thing don e (Landy,

1986). In ancient Greece, and first discussed in relation to Aristotle's Poetics, catharsis is

described as a purging, "an em otional release on the part of the spectators, or as therecognition and purging of wrongdoing in the action of the play" (W orthen, 1996, p.1302). "A ristotle proposed that the function of tragedy was to induce the emotional andspiritual state of catharsis - a release of deep feeling s that originally had a conno tation o fpurification of the senses and the soul" (Jones, 1996). Jones indicated Aristotleestablished a them e that would be reiterated throughout the history of writing abouttheatre in which,

The theme can be characterized as drama having a un ique and direct relationshipwith human feelings, and as being able to produce change in peop le's lives. Atdifferent times in history different kinds of change have been em phasized - fromreligious to political change, from an individu al's psychological make-up to masssocietal change. (Jones, p. 44)Be fore Aristotle, drama developed in Palaeolithic times from m imesis, a simple

imitation of real action (Burton, 1962). Mim esis developed into mime as symbols ofactions were constructed and mim es developed into ritual (Burton). Later, ritual becameenshrined in liturgy, which facilitated drama and the developm ent of characters (Burton).


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Burton (1962) discussed the C oronation Play of Ancient Egypt as the oldestwritten drama know n. From this play, he discussed the constructs of kenosis andplerosis. Kenosis was described as an "emptying, by pu rification and preparation" andplerosis as "the filling with new life" (Burton, p. 40). Kenosis prepares the audience forthe reception of the plerosis (Burton). Burton further indicated literature originated indrama and that the development of the Bible likely stemmed from drama.

Fox (1986) d iscussed the oral theatre as tradition befo re the developmen t o f theliterary theatre. Fox discussed H om er's Odyssey as created in the oral tradition which wasrecounted by memorization of tales and improvisation and presented by Bards. Hefurther noted the purpose o f oral theatre was to entertain, to instruct, to recite history, andto make known the moral values of the society (Fox).

World theatre and drama d iffered in eastern and w estern traditions. Briefly,theatre from non-westem tradition is said to share common features.

It blends aristocratic and popular affiliations; it is ritualized, descending fromsocial and religious ritual traditions; it coordinates acting, dance, music, andspectacle; many of its plots and characters are derived from familiar literary andhistorical narratives and legends; its performance conventions are elaboratelystylized and refined; and its performers are often trained with a level o f formalitynot found in Western theatre. (Worthen, 1996, p. 117)Eastern drama includes but is not limited to No h Theatre and Kab uki T heatre of Japan,the Sanskrit epic poems of India, the Kamyongu k m asked dance drama of Korea, and thePeking Opera of China (Worthen). Eastern theatre is mentioned as it relates to modernpolitical theatre to be discussed later.

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Western und erstanding of drama and thea tre began in Greece, where it played acentral role in politics, religion, and society (Worthen, 1996). In Greece, plays wereperformed in the celebration of the god Dionysus (W orthen). In both Greek and R omantheatre, acting was m ore of a song-like recitation by the chorus, rather than the acting w ethink of today. In The Poetics, Aristotle discussed key term s within dramatic wo rks andthe six elements of a tragedy. H e proposed the unities of action, time, p lace whichcontinues to be relevant in theatre and art today. T he unity of action: a play should haveone main action that it follows, with no or few subplots. The unity of place: a play shouldcover a single physical space and should not attempt to compress geography, no r shouldthe stage represent m ore than one place. The unity of time: the action in a play shouldtake place over no more than 24 hours (M andleberg, 2006). H e further developed theideas of plot, character, language, theme, and the performative elements o f music andspectacle (Wo rthen). According to Aristotle, the role of theatre became o ne of healing(Siroka, 1978).

Aeschylus, Sopho cles, Euripides, and Aristophanes we re also profoundplaywrights of the time. Their works w ere central to life in the City Dionysia (Worthen,1996). During the 6 th and 7 th centuries, actors beca me part o f the festivals in order tomake the narrative experience m ore dramatic and imme diate for the audience (Siroka,1978). Around this time in Rome, th eatre and drama were also central to the society.However, R oman drama w as related to mo re secular entertainment than wa s Greek drama(Worthen). Drama and theatre waned w ith the fall of the Roman Emp ire.

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Afte r a period of no theatrical perform ance, the Midd le Ages d efined a period oftheatre and drama existing to support the church. Plays were performed around religiousoccasions. For example, m orality dramas enacted the sym bolic structure of Christian life(Worthen, 1996). Secular plays were also performed, but lacked social and institutionalsupport (Worthen). Theatre and drama re-emerged with the aspects of theatre we seetoday during the Renaissance of the 15th and 16th centuries (Worthen).

The Renaissance transformed theatre and drama into an "art" as well as theatricalentertainment that was a commercial enterprise (Worthen, 1996). Theatre in RenaissanceLondon was reminiscent of the Greek dramas in that it was connected to the political andsocial pressures of the new era (Worthen). While there was still religious unrest, the atressuch as Shakespeare's company, Lord Chamberlain's Men, were able to work under theroyals, and were able to profit from their newly formed corporations. In one of his manyfamous plays, Hamlet, Shakespeare meditated on the purpose and limits of theatre. In thefirst scene, Hamlet explains his and the p lay 's "obsession w ith the arts of seeming, withacting, performan ce, and theatre" (Worthen, p. 246). Hamlet questioned the notions ofperforman ce and truth, constructs that are challenged in modern theatre and similar to themasks of truth and reality that are apparent in psychotherapy.

After the Renaissance, theatre and drama m oved into a neoclassical period.Neoclassicism w as a revival of the classical ordering of the arts (Worthen, 1996).Aristotle's u nities were again prominent in drama, as well were the constructs of tragedyand comedy. Neoclassicism was m ore prominent in French theatre compared to Englishtheatre (Worthen).

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Periods of romanticism and restoration occurred in the 18th and 19th centuries. Inthese periods, art was symbolic, but, at the same time, artists and audiences wereinterested in reality. Plays were also written to be read as literature rather than staged in atheatre (Worthen, 1996). By the 19th century, famou s playwrights like Ibsen, C hekhov,Strindberg, and Shaw w rote plays in opposition to the values of contemp orary society,and new theatre strategies were devised to find new audiences (Worthen).

Mod ern theatre, beginning in the latter half of the 19th century, established adivision between popular o r mainstream theatre and experimental, avant-garde, or

modernist theatre (Worthen, 1996).This modernist tendency has itself produced a kind o f reaction, a desire to bringthe devices of popular culture and m ass culture into drama, as a way of alteringthe place of the theatre in society and chan ging the relationship between thespectators and the stage. (Worthen, p. 7)

Mod ernist art also arose due to the popular forms of film, radio, and television, and itsmarginalization in modem society.

Different forms of modern drama em erged. Naturalism and realism criticized thevalues and institutions of middle-class society (Worthen, 1996). In realistic drama, theindividual accepts the world as unchanging, but continues to search fo r freedom, value,and meaning. Exp ressionistic theatre then evolved in displaying dreamlike, exaggeratedcharacterizations, bu t continued to discuss the dehum anizing proce ss of life. Other formsthat emerged were symbolist theatre, constructivist theatre, epic theatre, and surrealisttheatre (Wo rthen).

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Acting style changed in modern theatre as well. Stanislavski developed th e m ostwell-known actor training program of the time.

Stanislavski trained the actor to associate his or her personal history withthe invented actions of the dramatic character so that the actor could tapthat emotional spontaneity, a " life in art," as part of the performance. Byusing the magic if - imagining themselves as the character, rather thanapplying a stock line of business - and using their own em otion m emoryto vivify the cha racter's inner life, Stanislavski's actors were taught tobring authentic emotional experience into their performances. (Wo rthen,1996, p. 570)

Actor and director Joseph Chaiken also described this shift in acting,In former times acting simply meant putting on a disguise. When youtook off the disguise, there was the old face under it. No w it 's clear thatthe wearing of the disguise changes the person. As he takes the disguiseoff, his face is changed from having w orn it. The stage performanceinform s the life performan ce and is informed by it. (Emunah, 1989, p. 35)In the United States, 20 th century acting training is derived from

Stanislavski's teachings of the 1930's. Mem bers of

acting crazy a training program that strengthens empathic listening, awareness, and creativity for...

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