Presentational style of therapeutic directive and response to cold pressor pain.

Abstract

Both therapists and physicians give people directives to perform acts that are presumably therapeutic for them. Noncompliance with such therapeutic directives is surprisingly high (1). Styles of giving such directives often differ markedly. The present experiment compared three styles of giving therapeutic directives (persuasion, collaboration, and written directives) to manage the discomfort of the cold pressor, a treatment for strains and sprains and a frequent analogue for short-term counseling. Female undergraduate volunteers (N = 60) from psychology classes at a large urban university were randomly assigned to one of three experimental conditions and were individually pre- and posaested for ice-water tolerance (10-min. limit) by one of two male experimenters blind to treatment condition. After each test, participants rated their pain on a 100-point scale. Berween tests, rhey received training in the use of pleasant imagery as a pain palliadve. Training was conducted using one of three presentational styles. Persuasion consisted of the trainer giving directives in a clear, straightforward manner. Written instructions used a script identical to persuasion. In the collaborative style, the trainer solicited from the women expressions that imagery might be used to cope with pain, then he reinforced that and asked the women to elaborate on how rhey might use imagery, type of imagery, and content of specific scenes. An analysis of covariance, using the pretest tolerance as the covariate, was performed for posttes: tolerance and self-reported pain. For tolerance, groups did not differ. For self-reported pain, however, there was a significant effect for presentational style. Women hearing the persuasive style reported lower psin than those reading the same instructions. Women collaborating with the trainer did not differ from other women. Acrusl reported imagery use was significantly correlated with less self-reported pain. Theories of counseling indicate that enh~ncing clients' perceived self-control should increase their compliance with therapeutic directives. Samaan and Parker (2) found collaborative directives better than persuasive directives at inducing career exploration. On the other hand, physicians have traditionally issued directives without consulting patients. The present experiment indicates that for simple therapeutic directives, a persuasive style is superior to writren instructions and not different from a collaborative style in producing therapeutic gain. This may be true because persuasion maximizes