Research Background & Future Directions
Recent episodes of teen violence in schools have heightened the publics sensitivity to the need for effective interventions for aggressive, socially alienated, depressed and anxious youth. Fortunately, the integration of research in developmental psychology and child and adolescent counseling promises to lead to the development of more effective treatments and interventions for such problems. Derived from both developmental psychology and counseling psychology research, pair counseling is method of counseling youth in dyads or pairs, and it serves as one form of secondary prevention of emotional and behavioral disorders among youth in the schools (Karcher, 1996). Pair therapy, its predecessor, is the practice of treatment of children and adolescents with severe emotional and behavioral disorders in pairs. There is some evidence that pair therapy produces effects not often gained through individual or group therapy among youth in residential treatment (Watts, Nakkula, Jones, Harris, Salvador, Selman, 1997). Both of these modalities are based on a long line of research in child development and have been studied through several case studies, single-case experiments, and small group studies.
Currently, Dr. Michael Karcher, at the University of Wisconsin-Madison, is examining the effectiveness of pair counseling and pair therapy in two sitesa state hospitals child and adolescent treatment units (Mendota Mental Health Institute) and the public school system (Madison, Wisconsin). This web page describes pair counseling, overviews several techniques used in pair counseling, and serves to prepare students who wish to take Dr. Karchers 4-week summer course on play therapy and pair counseling at UW-Madison. Those interested in this modality should read the information provided on this web page, refer to the two primary texts on pair therapy (Selman & Schultz, 1990; Selman, Watts, & Schultz, 1997), or contact Michael Karcher at the address listed below.
Between 1960 and 1980 private and federal agencies funded research projects studying the effects of role-taking skills on child and adolescent development, and specifically looking at the relationships between role-taking skills and altruism, delinquency, and aggressiveness (e.g., Feffer, 1959; Ianotti, 1978; Jurovic, 1980). Role-taking (also called perspective-taking) refers to the individual's ability to understand different social perspectives (e.g., to recognize that ones own and others wants and needs are different) and to coordinate these perspectives in the service of social reasoning, social problem-solving, and behavior regulation (see Chandler, in press; Feffer, 1960; Flavell, 1992; Selman, 1980). Between 1960 and 1980, this body of research grew to include an impressive set of findings that promised to make significant contributions to youth development efforts through the creation of new child and adolescent treatment techniques (Bobbit & Keating, 1983; Chandler, 1973; Chandler, 1974; Silvern, Waterman, & Ryan, 1979; Rosen, 1985; Waterman, Sobesky, Silvern, Aoki, & McCauley, 1981). Then, just as treatment interventions were beginning to take into account these findings on role- or perspective-taking, there was a sharp decline in research in this area and in its use in clinical treatments. What happened?
In the early 1980s the publication of a few papers citing methodological controversies over how best to measure role-taking created considerable confusion among scholars about what research should be published as most representative of the role-taking phenomenon (Chandler, in press; see Chandler, 1978; Kurdek & Rodgon, 1975; Roberts & Patterson, 1983; Rotenberg, 1974). Concerned, many scholars shifted the focus of their research efforts (Chandler, personal communication). Left in the wake of this controversy was the promise of enhancing child counseling and treatment through the application of applied research on role-taking and its relationship to social skills development, delinquency, affective disorders, and aggression.
Although most developmental researchers had all but abandoned the study of role-taking by the mid 1980s, clinicians remained hungry for insights into how this phenomenon might facilitate their work. In Hugh Rosens (1985) Piagetian Dimensions of Clinical Relevance the final chapter suggests that the role-taking literature provides clear support for dyadic treatment of aggressive, anxious, and depressed youth through the application of the role-taking techniques described by Chandler (1974), Feffer (1970), Selman (1980), and others (e.g., Doise, Mungy, & Perret-Clermont, 1975, 1976). Rosen suggests, "We should consider exploring the potential of structured dyadic or couples therapy with preschool and middle-childhood children. An initial assessment might seek to identify those children who are having interpersonal problems partly due to what appears to be a level of egocentrism below what would appear to be appropriate for their age group. Children who tend to be isolated and withdrawn might also be prime candidates."(p. 231-232) Rosen continues with a exhortation of the need for a similar perspective-taking therapy with delinquent and aggressive youth to promote altruism and social skills, and supports his point by citing studies of perspective-taking promotion interventions in the developmental psychology research such as those of Chandler (1973, 1974), Doise and colleagues (1975, 1976), Flavell (1974; 1992), and Selman (1980; Schultz & Selman, 1990; Nakkula & Selman, 1991).
One of the models of perspective-taking to survive the 1980s was Robert Selmans (1980) model of social perspective-coordination. This model is unique from the others that permeated the developmental psychology literature of the 1960s and 70s. Most of the role-taking literature before Selmans work took Piagets initial perspective-taking tasks and either used them directly or adapted them slightly to the phenomenon of role or perspective coordination (Chandler, in press). Flavell, Feffer, Chandler, and others all considered these extensions the best way to stay true to the Piagetian roots of the concept (Chandler, in press; Flavell, 1992). Yet, when it was found that in several cases these assessments were not highly correlated with one another, there was little clear and objective evidence for which assessment methods were superior. Selmans model, while directly informed by Piagets work (especially Piagets writings on moral development), was built on a long line of psychologists work going back to Meads (1934) first writings on perspective-taking. Most directly, Selmans social perspective-coordination model was built on the methodological foundation of Kohlbergs work on moral development and drew heavily from Kohlbergs methodology. It was subjected to considerable tests of reliability and validity which were reported in Selmans (1980) The Growth of Interpersonal Development: Clinical and Developmental Analyses. Lastly, of the many models of role-taking that proliferated the developmental psychology literature in the 1970s, Selmans model of social perspective-taking has been one of the few models to sustain a course of rigorous applied and clinical research consistently over the past twenty years.
Selmans early work on social perspective-taking focused mostly on the developmental course of perspective-coordination and the methodological rigor of his assessment interviews, which turned out to be a wise approach given the methodological critiques of the 1980s that effectively halted other researchers. Following this lengthy period of model validation, Selman and his colleagues began to test the relationships between social perspective-taking and important clinical and developmental phenomena such as how children negotiate relationships (Schultz, Yeates, & Selman, 1989; Selman, Beardslee, Schultz, Krupa & Podorefsky, 1986). Their work showed a direct link between the level of perspective-taking and the type of interpersonal negotiations that children used (Schultz & Selman, 1990; Yeates, Schultz, & Selman, 1991). For example, their research suggested that promoting perspective-taking should increase the degree of interpersonal competency and social maturity a child demonstrates in social interactions (Yeates & Selman, 1989; also see Dodge, Pettit, McClaskey, & Brown, 1986).
These findings paved the way for two important extensions of Selmans developmental theory. The first extension of Selmans line of perspective-taking research was an attempt to build a bridge between perspective-taking (thoughts) and interpersonal negotiation strategies (actions) among youth in everyday as well as clinical settings. These analyses of the link between the perspective-taking that supports particular social negotiations illustrated that emotionally disturbed, aggressive, and socially withdrawn youth often demonstrate large gaps between the developmental complexity of their thoughts and their actions relative to what is normative for their age (Beardslee, Schultz, & Selman, 1987; Leadbeater, Hellner, Allen & Aber, 1989; Marsh, Serafica, & Barenboim, 1980). This led to the second extension of theory in which social perspective-taking and interpersonal negotiation strategy research were extended to clinical and educational interventions (e.g., Yeates, Schultz, & Selman, 1990). Broadly, this area of research has become known as clinical-developmental psychology. It reflects the attempt to apply developmental psychology in the service of child and adolescent treatment (see Shirk, 1988).
It was out of this second extensionthe application of research on social perspective-taking and interpersonal negotiation to the treatment of aggressive, isolated, and emotionally disturbed youththat the intervention of pair therapy developed (Selman & Schultz, 1990). Pair therapy is a clinical intervention for children with severe social, behavioral and emotional disorders. In pair therapy two children are "paired" together, and meet each other once or twice a week in the presence of a therapist who helps them develop and manage a friendship (Barr, Karcher, & Selman, 1997). The pair therapists goals are two-fold: first, to help the children manage the basic relationship functions of intimacy and autonomy, and second, to help the children use age-appropriate social perspective coordination and interpersonal negotiation strategies. There have been some writings on the role of psychodynamic processes (Schultz & Selman, 1989; Selman & Schultz, 1990) and the use of social problem-solving training (Yeates, Schultz, & Selman, 1990) in pair therapy; but some important inroads to understanding its effectiveness have yet to be made. Most importantly, although there is some evidence that pair therapy can effect changes in everyday behaviors among youth in residential treatment that do not result from individual or group therapy (Selman & Demorest, 1984; Nakkula and Watts, 1999) to date no aggregate studies of the general efficacy of pair therapy or of the various techniques that are typically used in its practice have been published. Secondarily, this modality has been extended to work in the schools, but the tools, techniques, and structure of its use in schools requires more systematic study. This is the work Michael Karcher is currently undertaking with the Pair Counseling Research Team at the University of Wisconsin-Madison.
Over the past five years, Michael Karcher has been developing a manual for "pair counseling" to guide the use of the pair modality for youth development in the schools (Karcher, 1996, 1997; Karcher & Nakkula, 1997). Like pair therapy, pair counseling is a psychosocial intervention in which two children are paired together in a counseling relationship and coached in relationship development skills through the therapeutic use of toys, talk, guided reflections on their behaviors, and social problem-solving. The goal is to help socially less competent children develop better friendship-making and friendship- maintaining skills through the establishment and maintenance of a close relationship with a peer over a 3-month span of time.
Pair counseling, like pair therapy, is more structured than both traditional play therapy and child group therapy. Pair counseling sessions typically last 50 minutes, and include a number of structured opportunities for social negotiation and for reflection on the pairs social interactions. During each session, the partners in the pair decide together what activity they will engage in that day. Negotiation and agreement are emphasized by the three rules: 1) the pair decides together what to do; 2) whatever they do, the must do together; and 3) they are not to hurt each other, the counselor, or the property in the room. The sessions start off with the selection of an activity to play. The counselor ensures that the activity is safe by providing a predetermined set of games (e.g., "Sorry," "UNO," "8-ball" and puppets). The children can use the toys and games that are provided or can bring and share their own toys or games. The pairs are encouraged to find a favorite activity that they enjoy together and can return to repeatedly over the course of pair counseling. This is considered the "home base activity" and allows them to use this activity as background for more in depth discussions about their relationship. When conflicts arise, the counselor helps the youth use problem-solving and conflict resolution techniques. At the end of each session, for the last ten minutes, the children are asked to reflect on their conflicts during the hour, to evaluate the effectiveness of their conflict resolution that day, and to anticipate how they might handle such conflicts differently in future sessions. The counselor also asks the children to identify their positive shared experiences, to describe what allowed for their cooperation and intimacy at those moments, and to identify activities they could engage in during subsequent sessions that would allow similar intimacy and agreement to be achieved between the two. While this basic structure can be applied to pair therapy and pair counseling, the two interventions differ in practice.
A few procedures for pair therapy were developed by Selman and Schultz (1990) based on their developmental theory, but aside from a handful of case studies, there has been little process research on "pairs" and almost no direct examination of these developmentally-driven intervention techniques. To this point in the development of pair therapy, standard developmental assessments and three intervention techniques have been employed: 1) empowering impulsive children to articulate their needs (e.g., articulating single perspectives); 2) linking the perspectives of two children who cannot do this independently (e.g., helping youth coordinate two perspectives); and 3) enabling children to see the long-term consequences of individual actions on their collective relationship (i.e., helping them take a third-person perspective)(Selman & Schultz, 1990). These are the primary techniques being used presently by pair therapists in residential treatment centers, schools, and day-treatment centers in the United States and Canada.
Dr. Michael Karchers research attempts to place the practice of "pairs" more fully in the child treatment literatures, and to move it beyond its current status as a unique application of developmental psychology. Several important new paradigms in child counseling have been introduced since the early 1980s. Four promising techniques derived from these paradigms are self-development techniques, social problem-solving training, a hierarchy of verbal interventions, and the use of structured reflection and planning activity in the sessions. First, the self psychology literature (Kohut, 1977; Kohut & Wolf, 1992; Wexler, 1991) provides affective techniques that promote self-esteem and social competence through the use of praise, empathy, consistency in responding, and the establishment of safety in the pairs sessions. Second, problem-solving techniques help children develop mental templates for generating novel solutions to interpersonal problems in the pair counseling sessions that they can generalize beyond the pair (Dodge & Price, 1994; Dodge, Pettit, McClaskey, & Brown, 1986; Yeates, Schultz, & Selman, 1987). Third, a hierarchy of verbal interventions, proposed by Kernberg and Chazen (1991), helps counselors think both clinically and developmentally about how and when to intervene with verbal interventions that structure and guide the pair sessions. Lastly, the use of reflection and planning during the session have been common but unsystematic and unstudied techniques used in pairs. In pairs they are brought into the social problem-solving training, such that children are encouraged to reflect on their actual interactions so that they recognize the effects of their actions on the pairs relationship and learn to anticipate alternative solutions to future problems in their immediate relationship. One or more of these techniques are typically incorporated into the practice of pair counseling (Karcher, 1996) and pair therapy (Barr, Karcher, & Selman, 1997; Karcher, 1999). The work of the Pair Counseling Research Team is to test the use and effects of these interventions on the outcome of pairs in the treatment of youth with social, emotional, and behavioral disorders or who are at risk of developing such disorders.
Although the study of perspective-taking has a long history in the field of developmental and social psychology, an impressive body of research on role-taking and its clinical relevance seems to have been thwarted by methodological critiques in the 1980s. One line of research that rose above these critiques, the work of Robert Selman on social perspective-coordination, has been extended to the study of both interpersonal behaviors and the treatment of children in pairs. However, there remains considerably research to be done in three areas. Michael Karcher is examining the effectiveness of pair counseling in the treatment of youth with conduct, mood, and anxiety disorders as well as with less disturbed but socially aggressive, withdrawn, anxious, and hyperactive youth in schools. He is studying the application of the clinical-developmental techniques proposed by Selman and Schultz for use in pairs, and extending the practice of pairs to include four other counseling techniques. These techniques reflect recent developments or time-tested techniques in the current child and adolescent treatment literature and the Research Team's goal is to study the effects of their use in the pairs sessions.
This course of research will help to expand the repertoire of empirically-validated, youth development intervention modalities available to child and adolescent counselors and to applied developmental psychologists. It could help reinvigorate an important line of research in social perspective-taking and bridge its application to the field of child and adolescent counseling. If you are interested in finding out more about pair counseling, please contact Dr. Karcher.
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