The Cork Person Centred Gestalt Project PDF

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The Cork person centred gestalt project:

Two outcome studies
a a a
Eleanor O'leary , Una Purcell , Eileen McSweeney , Deborah
a b a a
O'flynn , Kathleen O'sullivan , Noreen Keane & Nicola Barry
a
Department of Applied Psychology, National University of Ireland,
Cork, Eire
b
Department of Statistics, National University of Ireland, Cork, Eire
Version of record first published: 27 Sep 2007.
To cite this article: Eleanor O'leary , Una Purcell , Eileen McSweeney , Deborah O'flynn , Kathleen
O'sullivan , Noreen Keane & Nicola Barry (1998): The Cork person centred gestalt project: Two
outcome studies, Counselling Psychology Quarterly, 11:1, 45-61
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Counselling Psychology QuarterEy, Vol. 11, No. 1, 1998, pp. 45-61 45
RESEARCH REPORTS
The Cork person centred gestalt

project: two outcome studies
ELEANOR O'LEARY"', UNA PURCELL', EILEEN
MCSWEENEYl, DEBORAH O'FLY"', KATHLEEN
O'SULLIVAN2, NOREEN KEANE' 8z NICOLA BARRY'
Department of Applied Psychology', Department of Statistics2, both UCC, National
Downloaded by [92.247.236.60] at 12:24 16 February 2013
University of Ireland, Cork, Eire
ABSTRACT The present paper considers two studies that investigated the outcomes of person
centred gestalt groups with graduate trainee therapists. The treatment group in both studies underwent
24 hours in a person centred gestalt group. Study 1 compared 12 graduate students who were trainee
jirst year therapists with 12 graduate students who served as a control group. Results indicated that
the treatment group had higher scores than the control group on empathy, congruence,
unconditionality and level of regard at the 0.01 level. In Study 2, seven graduate trainee therapists
were compared with 10 graduate students who served as a control group. Results indicated a
significantly higher score on the part of the graduate trainee therapists for acceptance of others in
comparison to the control group at the 0.05 level. Trust was the greatest reported change by the
treatment group as assessed by Van Kaam's phenomenal analysis. They also reported the
development of various aspects of awareness and this development was further supported by the
reports of spouses/partners/best friends. The studies offer research support for person centred gestalt
therapy as proposed by O'Lea y (1 997c).
Introduction
The possibility of an integration of the person centred and gestalt approaches was
first mentioned in the literature by Cochrane and Holloway (1974). They
considered that similarities existed between the two areas with respect to their
outlook on the nature of the person, their process orientation, their goals and the
nature of maladjustment. They further claimed that the unique contribution of
person centred therapy was in knowing how to listen and hear, while the singular
contribution of gestalt therapy was in knowing how and what to do. The work of
Cochrane and Holloway was pioneering in that the possibility of a merger was
expounded long before a movement towards integration of therapies became
fashionable in the therapeutic field. However, this publication was their sole
contribution.
*Correspondence to: Eleanor O'Leary PhD, Department of Applied Psychology, UCC, National
University of Ireland, Cork, Eire.
0951-5070/98/010045-17 0 Carfax Publishing Ltd

46 Eleanor O’Leay et al.
Prior to this in 1964, Gloria in the film Three Approaches to Psychotherapy

(Shostrom (1964)) had stated that a combination of Rogers and Perk would be ideal
for her. Two other publications by Stanley and Cooker (1977) and O’Hara (1984)
also considered the subject. Stanley and Cooker (1977) held that the core conditions
of the person centred approach could strengthen gestalt techniques. However, they
did not use the core conditions as outlined by Rogers (1961) but rather those of
Carkhuff (1969a,b). O’Hara (1984) held that neither Stanley and Cooker or
Cochrane and Holloway (1974) had dealt with the seeming contradiction first
mentioned by Rogers (1977) namely the therapist directed process of gestalt therapy
and the nondirective nature of person centred therapy. She held that deliberating in
such a manner is based on a way of thinking that separates individuals from their
relational context. She also pointed out that in describing their practice most
therapists listed in the Association for Humanistic Psychology Resource Directoy (1980)
used more than one type of therapy. A possible solution she suggested was in
thinking holistically where the therapeutic relationship is seen as a whole and allows
a meaningful synthesis of the person centred and gestalt approaches.
Two papers by the first author in the major gestalt journals in the 1990s
explored empathy in both approaches. In the first of these papers, O’Leary (1993)
took each of the five components of empathy as defined by Rogers (195 1, 1980) and
showed that each of these was also used in the literature on gestalt therapy.
Furthermore, she claimed that gestalt therapy enhances and broadens empathy as
outlined in the person centred approach by recognizing the separateness of
therapists from clients and retaining the boundary between the emotional lives of
therapists and their clients. Apparent dissimilarities in the two approaches when
responding empathically were due, she concluded, to ‘idiosyncratic modes of the
two schools rather than with fundamental differences’ (p. 111).
In a second paper, O’Leary (1997a) used the concepts of background, figure
and confluence in order to understand confluence even more clearly. In empathy,
the awareness of the phenomenal world of the other is figure since it is the primary
concern in the relationship, while the realization of difference is background. In
addition, foreground confluence contains the shared emotion while background
confluence allows both perspective taking and attention to therapists’ experience of
themselves.
Recently, O’Leary (1997b) pointed out that an integration that combined the
relationship emphasis of the person centred approach with self-support and
client-counsellor interdependence in gestalt therapy would account for 70% of the
variance as outlined by Duncan and Moynihan (1992). In a further paper, O’Leary,
(1997~)held that change occurred in person centred gestalt therapy due to the
willingness clients bring to discuss their problems, their ability to centre themselves,
the particular type of relationship which exists between therapists and clients and the
changing and developing awareness which clients possess of their inner subjective
lives. The relationship between therapists and clients, she further held, is
characterized by empathy, congruence, level of regard, unconditionality and respect
on the part of therapists and trust on the part of clients.
Cork person centred gestalt project 47
The first research study on the subject of person centred therapy was carried
out by O’Leary and Page (1990). In an investigation of seven American
postgraduate students, they found that the group participants had stronger feelings
about love, the future and gestalt therapy subsequent to their involvement in a
person centred gestalt group. The authors held that members had more intense
feelings towards gestalt therapy and love since they had participated in a person
centred gestalt group, and one of the topics discussed was how they experienced
their interpersonal relationships with significant other people in their lives. The
change in their feelings towards the future was viewed as occurring as individuals
worked through unfinished situations from their past. As emotion linked to these
experiences was expended, individuals were free to pay attention to their futures in
a way that was impossible when some of their energy was bound to the past.
Although the O’Leary and Page (1990) study measured self-esteem and the
main concepts of gestalt therapy, it did not assess the core conditions of empathy,
congruence, unconditionality and level of regard. The two studies reported in the
present paper do so. Their aim was to explore the outcomes of two person centred
gestalt groups with postgraduate trainee therapists in an Irish University. The
second study was a development of the first, in that a different measure of the self
was used and a qualitative analysis is also employed.
Study 1
Subjects
The 24 subjects in the present study were enrolled in a one-year postgraduate course
in the same faculty in an Irish University. The treatment group consisted of 12
members who were undertaking a gestalt therapy course while the control group
contained a further 12 members who were participating in an educational course.
Both groups consisted of 10 females and 2 males. The mean age of the treatment
group was 33.8 years with a standard deviation of 4.9 years and a range of 22-41
years, while the mean age of the control group was 33.3 years with a standard
deviation of 7.0 years and a range of 22-39 years.
Facilitators
Two person centred gestalt therapists facilitated the treatment group. One had eight
years experience as a therapist while the other worked as a school counsellor and had
recently obtained a postgraduate qualification in gestalt therapy.
Treatment
The group was conducted for 24 hours and consisted of two weekends, each
weekend comprising of two 6-hour days. There was an interval of 38 days between
the first day of the first weekend and the second day of the last weekend. The
method used was that of person centred gestalt therapy as outlined by O’Leary
(1997a,b). The empty chair, dreams and language awareness exercises were used.
Participants were encouraged to assume responsibility for themselves. The group
consisted of both structured and unstructured sessions.
Design
A pre-post-control group design was used to evaluate the outcomes of the person
centred gestalt group on subject’s attitudes and feelings as measured by the semantic
differential and the Rosenberg (1965) Self-Esteem Scale. The level of empathy,
congruence, level of regard and unconditionality perceived by the client was
measured by the Barrett-Lennard Relationship Inventory. The control group was
matched with the treatment group on age and educational level.
The Rosenberg Self-Esteem Scale is an overall measure of self-esteem

consisting of 10 items. Using a sample of 93 college students, Goldsmith and
Goldsmith (1982) found an internal consistency coefficient of 0.93, while
Goldsmith (1986) found an alpha coefficient of 0.8 with a sample of 87 adults. A
test-retest coefficient of 0.85 was found by Sibler and Tipett (1965) over 2 weeks.
Evidence of discriminative validity was found by Fleming and Courtney (1984), who
obtained correlations of - 0.64 with anxiety, - 0.54 with depression, 0.78 with
self-regard, 0.5 1 with social confidence and 0.42 with physical appearance.
Correlation coefficients ranging from 0.56 to 0.83 were obtained with similar
measures of self-esteem and clinical assessments (N= 44) by Crandall (1973) thus
providing evidence of convergent validity.
The O’Leary and Page (1990) modification of the Semantic Differential
(Osgood et al., 1957), which employs the evaluative and potency scales of 12
concepts, was used in the present study. Nine of these concepts were those
employed by O’Leary and Page (1990): awareness, responsibility, gestalt therapy,
anger, fear, love, my real self, my ideal self, past and future. The two concepts
‘present’ and ‘contact’ were substituted instead of guilt and self-acceptance. Osgood
et al. (1957) reported an internal consistency coefficient of 0.85 for the semantic
differential and test-retest reliabilities ranging from 0.87 to 0.93 for the different
scales. Warr and Knapper (1968) found ratings of individuals on the semantic
differential scales correlated 0.82 with the Adjective Checklist thus providing
evidence of concurrent validity.
The Barrett-Lennard Relationship Inventory (1964), a 64 item inventory, that
measures the core conditions of the person centred relationship identified by Rogers
(1961). Sixteen items make up each of the four scales: empathy, congruence,
unconditionality and level of regard. Gurman (1977) reviewed 10 studies that had
obtained test-retest coefficients and found mean coefficients of 0.83 for empathy,
0.83 for level of regard, 0.80 for unconditionality and 0.85 for congruence and 0.90
for the total score across the studies. Hollenbeck (1961) reported test-retest
coefficients ranging from 0.61 to 0.81 for the four scales over a 6-month period
while Kiesler et al. (1967) obtained correlations of 0.81 to 0.91 for the four scales
for intervals ranging from 4 to 12 months. Gurman’s review of 26 predictive studies,
which considered the relationship between the Inventory assessed conditions and
outcome, provided strong evidence of predictive validity.
Method
Subjects in both groups completed the Rosenberg Self-Esteem Scale and the
evaluative and potency scales of the O’Leary and Page (1990) modification of the
semantic differential before the commencement of the group or lectures. Treatment
group members filled in the questionnaires on the first day of the group before the
session began. In the case of the control group, the questionnaires were posted to the
15 students in the class and 12 were returned within the 2-week time period before
the commencement of lectures. All participants were told that the study was being
conducted to explore personal attributes and relationships.
After the participants had 3 hours contact with the group facilitators or the
lecturer involved, a Barrett-Lennard Relationship Inventory was administered for
each of the two facilitators in the case of the treatment group and for the lecturer in
the case of the control group.
After 24 hours participation in the person centred gestalt group, the treatment
group members completed the Rosenberg Self-Esteem Scale, the O’Leary and Page
modification of the Semantic Differential and the Barrett-Lennard Relationship
Inventory. The control group completed the same questionnaires after the same
amount of time as the treatment group had elapsed.
Data analysis
Twenty-nine one-way analyses of covariance were conducted on the post-test scores
using age and prescore as covariates. Due to the multiplicity of the ANCOVA tests,
a significance level of 0.01 was used. In the case of the Barrett-Lennard Relationship
Inventory, the scores relating to the least positively perceived facilitator were used.
If a significant difference was obtained, this difference would also hold for the
subject’s experience of the most positively perceived facilitator. If no difference was
obtained, the scores relating to the subject’s experience of the most positively
perceived facilitator were analysed. This approach to the analysis was taken on the
personal advice of Barrett-Lennard (1996) (Personal communication).
TABLE
I. Adjusted means and standard deviations for empathy, unconditionality, congruence and level
of regard at post-intervention stage
~ ~
Variable Treatment group Control group

( N = 12) ( N = 12)
M Adj Mean S.D. M Adj Mean S.D.
Empathy 25.1 22.5 9.2 - 6.4 - 3.9 12.9

Unconditionality 2 1.8 19.1 9.6 - 4.3 - 1.6 8.9
Congruence 27.5 24.9 12.0 - 5.5 - 2.9 13.3
Level of regard 29.1 26.2 12.2 + 1.7 + 4.0 14.4
Results
Adjusted means and standard deviations for empathy, congruence, unconditionality
and level of regard are given in Table I. Significant F values were obtained
for empathy (F = 22.86, P< O.OOO), unconditionality ( F = 32.65, P < O.OOO),
congruence ( F = 20.34, P< 0.000) and level of regard ( F = 10.36, P< 0.004) at the
post-intervention stage having adjusted for age and pre-score as covariates. Hence
there was a treatment effect for empathy, unconditionality, congruence and level of
regard.
No significant interaction effects or differences were obtained between the
treatment and control groups for any of the gestalt concepts or self-esteem at the
0.01 level.
Discussion
The gestalt treatment group viewed their facilitators as more empathic, more
congruent, more unconditional and as having a greater level of regard in their
behaviour than did the control group at the post-intervention stage. The study is
important in that for the first time research evidence has been obtained that the core
conditions outlined by Rogers (1961) and Barrett-Lennard (1962) existed in a
gestalt group.
In the development of a person centred gestalt group, the core conditions are
regarded as essential (Cochrane & Holloway, 1974; Stanley & Cooker, 1977;
O’Hara, 1984; O’Leary, 1997b,c). The particular measure used in the present
study, namely the Barrett-Lennard Relationship Inventory, measures the perception
of these characteristics by clients. Although self-report measures have been criticized
as providing only the personal views of the testee, their use in the present study was
precisely what was needed since the subjective experience of clients was the focus of
the study. Clients in the gestalt group saw the facilitators as possessing empathy,
congruence, unconditionality and level of regard. It may be concluded that the title
‘person centred gestalt group’ is appropriate.
In evaluating the effectiveness of therapy, Lambert and Bergin (1994)
advocated that, where possible, researchers use already developed measures that are
both reliable and valid. The three measures used in the study, the Barrett-Lennard
Relationship Inventory, the Semantic Differential and the Rosenberg Self-Esteem
Scale, meet these criteria and have been used in a wide range of studies (Osgood et
al., 1957; Lieberman et al., 1973; Gurman, 1977; Barrett-Lennard, 1982; O’Leary
81Page, 1990; Blascovich & Tomaka, 1991; Page & O’Leary, 1992).
In evaluating outcomes of therapy groups, it is important that the variables
chosen for assessment purposes are related to the goals of the group. This occurred
in the present study since the person centred conditions were measured by the
Barrett-Lennard Relationship Inventory while the semantic differential assessed
the key concepts of gestalt therapy. The Rosenberg Scale was used to measure
self-esteem. However, this questionnaire was used by Rosenberg for an adolescent
population and may not be suitable for the adults in the present study. Other
measures relating to the self should be used in future investigations.
The present study provides evidence that the core therapeutic conditions of the
person centred approach exists in a person centred gestalt group. Person centred
gestalt therapy reflects the movement within psychotherapy towards the integration
of therapeutic approaches (Lambert & Bergin, 1994; Clarkson, 1995). Although
there was a significant difference at the 0.05 level between the treatment and control
groups for the evaluative scale of responsibility ( P = 0.03 l), there were no significant
differences for either the evaluative or potency scales which measured the other key
concepts of gestalt therapy. An increase in responsibility is in keeping with the goal
of gestalt therapy, which seeks to move individuals from environmental support to
self-support. Responsibility is also the hallmark of the self-actualizing integrating
person, the goal of person centred gestalt therapy (O’Leary, 1997b,c). The
facilitators of the treatment group invited participants to use ‘I’ statements, thereby
taking responsibility for their own behaviour, feelings and experiences. Members
also participated in a language awareness exercise which involved changing their use
of verbs, e.g. can’t into won’t.
The significance of responsibility at the 0.05 level is encouraging as the
development of a sense of responsibility was one of the areas focused on by the
facilitators. When asked to describe what they did in the sessions, it was the only
gestalt concept apart from unfinished business referred to by them. Unfinished
business was not measured in the present study.
The lack of significance relating to the other key concepts of gestalt therapy is
in contrast to the only previously reported study of a person centred gestalt group
by O’Leary and Page (1990). They found that American students scored
significantly higher than a control group on the potency of gestalt therapy, love and
future. However, they used a lower significance level, 0.05, thereby increasing the
likelihood of significant results. The significance levels obtained by them were gestalt
therapy (0.01), love (0.04) and future (0.05).
The person centred gestalt group used in the present study was of 24 hours
duration. It may be that this was not of sufficient length to produce changes in
measures relating to the self or to emotions. In the O’Leary and Page (1990) study,
changes in anger were obtained. This study was of 20 hours duration and conducted
over three weekly 2 hour sessions, a 10 hour marathon and two final weekly sessions
of 2 hours each. Hence although participants assembled for a shorter period of time
they met more often than in the present study. It may be that frequency of meetings
is more important than length.
Study 2
Subjects
Seventeen subjects in all participated in the study, seven in the treatment group and
10 in the control group. The participants were female postgraduate students in the
same faculty of an Irish University. The mean age of the treatment group was 47.6
years with a standard deviation of 5.9 years and a range of 37-56 years, whiIe the
mean age of the control group was 27.4 years with a standard deviation of 8.8 years
and a range of 22-52 years.
Facilitators
Two person centred gestalt therapists facilitated the treatment group. The senior of
the two had 30 years experience as a social worker and five years experience as a
therapist. The second facilitator had worked as a therapist for seven years.
Treatment
The treatment group met for 24 hours spread over two weekends 4 weeks apart.
Each weekend was comprised of two 6-hour days. The process included a discussion
of participants’ personal understanding of confidentiality, three exercises and the
interlinking of theory and practice as appropriate. The exercises took the form of
fantasy and were used in order to raise awareness. Individual work emerged from
these exercises relating to introjection and polarities. The facilitators paid attention
to language and encouraged the use of ‘I’ statements. Each participant also drew a
painting of herself as she saw herself in the group.
Design
A pre-test post-test control group design was used to evaluate the outcomes of the
treatment group. As in Study 1, the O’Leary and Page (1990) modification of the
semantic differential and the Barrett-Lennard (1964) Relationship Inventory were
used. However, the Berger Self-acceptance and Acceptance of Others Scale was
used to measure self-acceptance since it was felt that this scale was more suitable to
an adult population. A qualitative questionnaire containing the question, ‘What do
you understand by personal growth?’ was also administered.
The Berger Self-acceptance and Acceptance of Others Scale is a 36 item scale
that uses a Liken five-point scale ranging from 1 ‘not at all true of myseIf to 5 ‘true
of myseIf’. The direction of the scoring is reversed for negatively worded items. The
scale is divided into two subscales, self-acceptance and acceptance of others. Split
half reliabilities of 0.894 or better was reported by the author for five groups ranging
in size from 18 to 183.
Evidence of validity was obtained by Berger (1952) by asking 20 students to
write freely about their attitudes towards themselves and a second group of 20 to
write about their attitudes towards others. These essays were then rated by four
judges and the mean ratings correlated with the corresponding scale scores.
Correlations of 0.897 for self-acceptance and 0.727 for acceptance of others were
obtained. When a group of prisoners was compared with a group of college students
who were matched for age, sex and race, a significant difference was obtained for the
acceptance of others scale at the 0.02 level and at the 0.01 level for the
self-acceptance scale with prisoners scoring lower in both instances.
Method
Participants in both groups completed the Berger Self-acceptance and Acceptance of
Others Scale, the O’Leary and Page modification of the semantic differential and a
qualitative question before the commencement of the group or lectures. Treatment
group members completed the questionnaires at the beginning of the first day of the
group while the questionnaires were posted to the control group and returned within
a 2-week period before lectures began. Participants were told that the purpose of the
study was to explore personal attributes and relationships.
After the treatment group had 3 hours contact with the two facilitators, they
were asked to fill in the Barrett-Lennard Relationship Inventory for each of them.
The control group filled in this questionnaire on two different occasions after 3
hours contact with each of their two lecturers.
After 24 hours in the treatment group, participants were asked to complete all
the scales and the qualitative question. In the case of the control group, these
questionnaires were completed after 24 hours of lectures. The Barrett-Lennard
Scale was administered to both groups after 24 hours from its first administration.
In addition, treatment group members were asked a further open-ended question,
‘What changes do you see in yourself as a result of participation in the group?’. Their
spousedpartners were asked to respond to the question, ‘What changes do you
observe in your spouse/partner as a result of participation in the group?’. For those
participants who had neither spouse or partner, their best friends were asked to
respond.
Data analysis
Data for the three questionnaires were computed. In the case of the Barrett-Lennard
Relationship Inventory, the scores relating to the least positively perceived facilitator
were used. If a significant difference was obtained, this difference would also hold
for the subject’s experience of the most positively perceived facilitator. If no
difference was obtained, the scores relating to the subject’s experience of the most
positively perceived facilitator were analysed. This approach was similar to that
outlined in Study 1.
Means, adjusted means and standard deviations were obtained for both groups
on all the variables. One factor, ‘group’, and two covariates, ‘age’ and ‘pre-score’,
were employed. This resulted in 30 ANCOVA tests being performed in all. Due to
the multiplicity of ANCOVA tests, a significance level of 0.01 was used.
The open-ended questions were analysed qualitatively using the method of Van
Kaam (1959). A panel of three judges, all with a postgraduate qualification in the
field of therapy or psychology, was used. With respect to each script, the three
judges worked together to record each descriptive statement found in the responses.
Each of these statements was written on a separate sheet of paper. In some cases,
more than one sentence was included under the heading. In such instances, a rule
of consensus was made. This inclusiveness avoided selectivity on the part of the
judges.
Having completed these initial steps, the judges then randomized the
statements so that no link between the different statements could be established.
Statements considered to be similar in content were placed together whereas those
that did not fit readily with others were placed in a separate group. Instances in
which the judges could not reach consensus were isolated for later consideration.
Reduction and elimination of statements then occurred. Each statement was
taken from its group and evaluated by the judges on the basis of two questions: (1)
what in this statement is related to understanding the concept under investigation?
and (2) what are the unnecessary parts of this statement as it relates to the concept
under analysis? Superfluous elements were removed. In one case this meant that an
entire statement was rejected as being of no direct relevance to the experience under
consideration. This reduction and elimination occurred only after consensus was
reached among the judges.
The remaining statements were replaced in the groups from which they had
been taken. The three judges evaluated these statements with respect to whether a
particular statement belonged to the group in which it was originally cast and what
was the best way to label the group of statements in order to reflect its content
through a label. The judges then tentatively labelled each group. Final identification
occurred by checking random cases of the sample to see whether they fitted the
assigned label.
Each script in a particular sample was evaluated for the presence or absence of
each of the identified categories. The subject received a zero if a category was absent
and a one if it was present. Each judge worked independently. Comparisons were
then made between the evaluations of the judges. The level of agreement among
judges was evaluated by the formula
no. of agreements - no. of disagreements
total no. of judges
An unreliable category was judged to be one that yielded a coefficient less than 0.80.
Categories that had a frequency of occurrences below 10% were eliminated.
Results
No significant difference between the treatment group and control group was
obtained on any of the variables at the 0.01 level. However, there was a significant
difference for acceptance of others at the 0.05 level ( F = 6.95, P = 0.021) with the
treatment group scoring higher at the post-intervention stage having adjusted for age
and prescore as covariates. Adjusted means and standard deviations for this variable
are given in Table 11.
The treatment and control group’s understanding of personal growth at
pre-intervention stage is given in Tables I11 and IV, while their understanding at
post-intervention stage is given in Tables V and VI. The self-report of changes
observed in themselves by the treatment group due to participation in the group is
given in Table VII. Finally, changes observed in the treatment group participants by
their spouse/partner/best friend are reported in Table VIII.
Discussion
Although no significant differences were obtained between the treatment and
control groups at the 0.01 level, a trend towards significance was found for
acceptance of others at the 0.05 level. This is not surprising since one of the key
concepts of person centred gestalt therapy is contact, including better contact with
oneself and others. The treatment group in this study discussed the meaning of
confidentiality in the group. This provided an opportunity to hear the views of the
other participants on the topic. In addition, participants drew a painting of how they
saw themselves in the group. These activities allowed an opportunity for group
members to become aware of other people in the group.
No significant differences were obtained for any of the semantic differential
evaluative or potency scales for the gestalt therapy concepts. As mentioned in the
first study, this is in contrast to O’Leary and Page (1990), who found that the
TABLE V. Treatment group’s understanding of

personal growth (post-intervention stage); N = 7
Categories generated
Awareness of feelings
Awareness of others
Impact of past on present
Learning
Fulfilling potential
Personal responsibility
There was 100% agreement between the three

judges on all categories.
potency scales of the semantic differential concepts, gestalt therapy, love and future,
were higher for the treatment group than the control group at post-intervention
stage. However, O’Leary and Page used a less stringent significance level of 0.05,
although their finding in relation to gestalt therapy was significant at 0 .O 1.
The different time arrangement of the groups may be responsible for these
differing outcomes. In the O’Leary and Page (1990) study, the investigation lasted
for 20 hours spread over 5 weeks consisting of three weekly 2 hour sessions, a 10
hour marathon and two final weekly sessions of 2 hours each, while in the present
study two weekends, 4 weeks apart with each weekend comprising two 6 hour days,
were used. It may be that a combination of weekly sessions and a marathon is more
effective in bringing about change than two marathon-type sessions. Alternatively,
the extra week in the O’Leary and Page study may have allowed more time for
integrating awareness and bringing about change.
A further difference in the two studies was that the O’Leary and Page study was
conducted with American students while the present study was carried out with Irish
students. O’Leary (1990) found that Americans discussed their problems with
friends while Irish people tended to keep their problems to themselves, turn to God
or to family members. While it appears that American postgraduate students may be
more willing to discuss their problems in a group, Irish students may need a longer
TABLE VI. Control group’s understanding of

personal growth (post-interventionstage); N = 10
Improved interpersonal relationships 2

Ongoing process 2
Renewal 1
There was 100% agreement between the three

judges for the first two categories and 80% agreement
for rhe category ‘renewal’.
Cork Person.Centred Gestalt Project 57
TABLEVII.Treatment group’s self-report on changes in the

self (post-intervention stage); N = 7
Trust 3
Confidence 2
Journaling 2
More focused 2
Increased energy 2
Self-awareness 1
Responsibility 1
More integrated between head and heart 1
Becoming more present centred in therapy work 1
Self-knowledge 1
There was 100% agreement between the three judges for

all categories.
period of time to self-disclosure. This may result in change being observed more
rapidly in American students.
Qualitative changes in the treatment group came from three sources: the
understanding of participants of personal growth at post-treatment, changes
members noticed in themselves due to participation in the group and changes
reported by spouses/partners/best friends. Their own reports indicated that both
awareness of feelings and awareness of others took place. Since none of theSe
categories were reported at the pre-treatment stage by either the control group or
themselves, it can be concluded that awareness occurred due to the treatment.
Interestingly, the treatment group did speak of self-acceptance and the control group
of emotional well-being at the pre-treatment stage, but this emphasis had moved to
awareness of feelings and awareness of others at the post-treatment stage. This
represents a movement from a more static orientation to the self to a more dynamic
TABLE VIII. Treatment group’s report of spouse/

partnerhest friend on changes in self of participant
(post-intervention stage); N = 6
Care of self 2
Emotional awareness 1
More free to be herself 1
Emotional well-being 1 (N=5)
There was 10Oo/o agreement between the three judges

for the four categories. One spouse felt that insufficient
time had elapsed for any change to have occurred.
one. Perls (1969) considered awareness to be curative in and of itself. Further

indications of awareness were obtained in the reports of spouses/partners/best
friends who cited such changes as care of oneself, emotional awareness and
well-being and more freedom to be oneself.
The most frequently noted changes reported by participants were trust,
confidence, a greater focus, increased energy and use of a journal. Trust was the
most frequently noted change. The three statements relating to trust were ‘increase
in trust’, ‘gained trust in myself and ‘greater trust of myself in a group setting’. The
reporting of trust in this study indicates that participants gained a greater trust of
themselves in the group setting. This increase was further supported by a reported
gain in confidence.
A greater focus reflects the process of centring discussed by O’Leary (1997~).
It is usually accompanied by an increase of energy since it permits trivial matters to
disappear and allows attention to be directed to what is most essential. Since a

journal was used by all participants, it is not surprising that its use was noted as a
change.
Conclusion
Study 1 provides evidence that the core conditions of empathy, congruence,
unconditionality and level of regard as perceived by clients were present in a person
centred gestalt group. The fact that this finding was not replicated in the second
study may have been due to the process used. Study 2 employed a greater amount
of structured exercises, three fantasy exercises and an art exercise. It may be that the
greater the use of structured exercises the less able participants are to perceive the
core conditions. It would be desirable to conduct a study that used a structured
person centred gestalt group, an unstructured person centred gestalt group and a
control group, thus allowing an assessment of the relative effectiveness of structured
and unstructured formats.
The present investigation points to the need for examining different time
arrangements for the same total number of hours within the same period. Future
studies could, for example, use three comparison groups and a control group: the
first group could receive twice-weekly group therapy sessions of 2 hours each for 6
weeks, the second group could obtain two weekends of group therapy 6 weeks apart,
each weekend consisting of 12 hours each, the third group could participate in a 24
hour marathon group therapy session while the control group could be involved in
a non-group related activity for a total of 24 hours. This would allow a comparison
of weekly sessions with both a marathon group and a staggered marathon group.
A group intervention that would have a longer time frame is also desirable since
no significant differences were found between the treatment and control groups in
either study on measures relating to the self. However, O’Leary (1995) pointed out
that test scores are but one way of assessing change. The second study showed that
aspects of change not obtained through quantitative methods are identified through
qualitative approaches, which consider both the views of participants and a third
party. The use of a journal was recognised by participants as being associated with
personal growth at post-treatment. The possibility of analysing these personal

growth journals qualitatively is worthy of exploration.
An area that requires further investigation is therapists’ level of regard for
participants. Level of regard includes therapists recognizing their feelings towards
clients. Research has yet to establish if it is necessary to have a certain minimum
level of liking of clients by therapists for effective therapy to occur. Furthermore,
there may be differences in the importance of this condition depending on whether
it is a group situation or individual therapy.
There was no change in either the evaluative or potency scales for the semantic
differential concept awareness in either of the two studies, although there were a
number of reported changes relating to it from qualitative measures. It may be that
the concept awareness is too global for assessment of treatment outcomes. Future
use of the semantic differential in evaluating awareness should consider dividing this
concept into components such as self-awareness, awareness of feelings and

awareness of others. Hence the use of a qualitative method in the present study
illustrates how information derived from it can be used to inform future studies that
may use quantitative methods.
Qualitative methods should continue to be used in this new area of person
centred gestalt therapy. Thoresen (1995) pointed out that, when an area is in
a discovery context, the processes are mostly creative and divergent such as
constructing conjectures, altering concepts and revising theory. The present studies
offer support for the existence of the core conditions of empathy, congruence, level
of regard and unconditionality in a person centred gestalt group. Person centred
gestalt therapy as outlined by O’Leary (1997~)is worthy of further research
investigation.
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The Cork person centred gestalt

University of Ireland, Cork, Eire

0951-5070/98/010045-17 0 Carfax Publishing Ltd

Prior to this in 1964, Gloria in the film Three Approaches to Psychotherapy

The Rosenberg Self-Esteem Scale is an overall measure of self-esteem

Variable Treatment group Control group

M Adj Mean S.D. M Adj Mean S.D.

Empathy 25.1 22.5 9.2 - 6.4 - 3.9 12.9

TABLE V. Treatment group’s understanding of

There was 100% agreement between the three

TABLE VI. Control group’s understanding of

Improved interpersonal relationships 2

There was 100% agreement between the three

TABLEVII.Treatment group’s self-report on changes in the

There was 100% agreement between the three judges for

TABLE VIII. Treatment group’s report of spouse/

There was 10Oo/o agreement between the three judges

one. Perls (1969) considered awareness to be curative in and of itself. Further

disappear and allows attention to be directed to what is most essential. Since a

personal growth at post-treatment. The possibility of analysing these personal

concept into components such as self-awareness, awareness of feelings and

achievement. Unpublished doctoral dissertation, University of Wisconsin.

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