Use Of Confrontation Research Articles

The Effectiveness of Direct Versus Indirect Confrontation as a Function of Stave of Consultation: Results of an Exploratory Investigation

In this analogue study, which builds upon our previous research on confrontation in consultation, we investigated the relation of type of confrontation (direct or indirect) and the stage of consultation (entry, diagnosis, implementation, and disengagement) in which confrontation occurs on consultees' perceptions of the use of confrontation. Thirty-eight graduate trainees in consultation viewed and then rated the consultant's use of confrontation in 8 videotaped scenarios of a consultative interaction representing combinations of the independent variables. Participants rated each scenario on a scale containing 9 dimensions of consultant effectiveness. The results indicated that, as predicted, direct confrontation was rated as more effective in the disengagement stage of consultation, and indirect confrontation was rated significantly higher in the entry stage. However, direct confrontation was not rated as more effective for the diagnosis and implementation stages of consultation. The implications of these findings are discussed in terms of effective practices and suggestions for future research initiatives.

The Relation of Level of Facilitative Conditions, Consultant Experience, and Stage of Consultation to Consultees' Perceptions of the Use of Direct Confrontation

Controversy surrounds the use of confrontation in human services consultation. This analogue study investigated the effects of facilitative consultative conditions, consultant experience, and the stage of consultation in which confrontation occurs on consultees' perceptions of the use of direct confrontation. Graduate student participants viewed and then rated the consultants' use of confrontation in 16 videotaped scenarios of a consultation interaction representing combinations of the independent variables (facilitative conditions, consultant experience, and stage of consultation) and containing a consultant-initiated direct confrontation. The study was replicated with a group of undergraduate students taking counseling courses. Results for both groups suggest that facilitative conditions, consultant experience, and the stage of consultation in which confrontation occurs interact in influencing consultees' perceptions of confrontation. Results are discussed in terms of implications for practice and future research efforts.

Integration of medical and psychiatric management in self-mutilation

The traditional management of factitious patients with self-inflicted injuries consists of medical/surgical treatment of the physical lesions, followed by psychiatric referral. The former is assigned to the dermatologist, the surgeon, or the primary care physician. More often than not, the subsequent psychiatric referral for treatment of the psychiatric disorder underlying and actually causing the self-mutilation fails because of self-mutilators' notorious resistance to psychiatric help. The integration of a psychiatric strategy into the medical management is more effective than a sequential division of medical/surgical and psychiatric treatment. This integrated treatment strategy is based on three key issues: education of the medical team in understanding the self-mutilation as a morbid form of help-seeking behavior, the judicious use of confrontation as a therapeutic tool, and the combination of psychotropic drug treatment with psychotherapeutic techniques.

The use of confrontation in group treatment: Attack or challenge?

This paper considers the use of confrontation as a part of group treatment. When done carefully, confrontation leads to expanded awareness by the members and strengthens group cohesion. When done awkwardly, it leads to increased resistance and defensiveness. The author explores ways in which confrontation can be used to challenge discrepancies, distortions, games and smoke screens, and resistance. There is also a discussion of therapeutic guidelines for the practitioner.

Group psychotherapy with alcoholics: special techniques.

I approached the article on group psychotherapy for alcoholics by Vannicelli (1) from three perspectives. First, as a recovering alcoholic of almost 10 years sobriety I was acutely aware of the positive impact of group therapy in my own treatment. Second, as a clinician currently in part-time outpatient private practice I concur with Vannicelli that group therapy is invaluable in working with alcoholics and their families. Third, as the director of a training program for potential alcohol and drug counselors I was impressed with the work done by Vannicelli and plan to include as required reading for students taking the course Principles, Methods, and Techniques in the Treatment of Alcoholics. My faculty agreed that provided a useful learning tool in its clear presentation of the six key issues: (1) Questions regarding the group leader's drinking, (2) group meetings missed because of drinking, ($) expectations possibly conflicting with a second group, such as A.A. or an educational group, (4) confidentiality, (5) drinking contracts, and (6) talking about drinking as a defense against group work. It is helpful for the group leader to be familiar with these issues as well as the meaningful suggestions made by Vannicelli for implementing them. However, there is one major point which I believe was presented in a misleading manner; namely, the role of direct confrontation in group psychotherapy with alcoholics. Although in the introductory paragraph Vannicelli cites confrontation as the second of the three unique opportunities afforded by group psychotherapy, she states that it should be remembered that direct confrontation, though sometimes necessary, should be used sparingly (italics added) and with a clear idea of the intended purpose .... The therapist who sees his task primarily as learning 'to invite' and 'encourage' discussion will do more to help his group grow than the one who learns only to confront (pp. $$-$4). My own conclusion is that there is a need for the generous use of confrontation as a method, albeit not the only one, in working with alcoholics. I will try to clarify the meaning of confrontation especially in relationship to tough love. It has been my experience that much of the confusion about confrontation comes from three major sources. First,

Modalities of psychotherapy with the elderly.

Emphasized is the view that geriatric psychotherapy can be effectively administered only with knowledge of the biology, psychology, and sociology of old age. The concepts of transference, countertransference, interpretation, conflict and defense mechanisms are crucial for understanding the various treatment modalities. Five intervention patterns are offered for the therapeutic approaches, i.e., interpretation, suggestion, reinforcement, confrontation, and clarification. The different modalities of geriatric psychotherapy may be viewed as variations of different clusters of these interventions, e.g., psychoanalysis makes most use of interpretation whereas group therapy makes most use of confrontation and clarification. For the psychologic treatment of disorders in late life, there are five basic modalities and one adjunct. The basic psychotherapies are classified as psychoanalytic, supportive, group, family, and behavioral; the adjunct is psychopharmacologic treatment, which is not a substitute for effective psychotherapy. Much semantic confusion has centered around this adjunctive treatment. Conceptual confusions about the meaning of the word "cure" are discussed.

Methods of resolving superior-subordinate conflict: The constructive use of subordinate differences and disagreements

Three investigations are reported. In the first, questionnaire data from 74 managers, describing the way they and their immediate superiors dealt with conflicts between them, made it possible to relate five different methods of conflict resolution (withdrawing, smoothing, compromising, forcing, and confronting or problem solving) to two dependent variables: (1) constructive use of differences and disagreements, and (2) aspects of the superior-subordinate relationship in planning job targets and evaluating accomplishments. In general, withdrawing and forcing behaviors were negatively related to the dependent variables. Compromising was not related to these variables. Use of smoothing was inconsistently related (sometimes positive and sometimes negative). Only confronting or problem solving was always related positively to the dependent variables. In the second investigation, 57 managers provided written descriptions of times when they felt particularly “good,” and particularly “bad,” about the way an interpersonal conflict was resolved. They were then coded into one of the five methods of conflict-resolution mentioned above. Confrontation was found to characterize effective resolution; forcing and withdrawing, ineffective resolution. The third investigation examined an attitude underlying use of confrontation versus forcing methods—the superior's encouragement and acceptance of subordinate disagreement versus discouragement and rejection of subordinate disagreement. Perceived supervisory acceptance and encouragement of subordinate disagreement and differences were associated with higher subordinate satisfaction in five areas, and with selected supervisory behaviors. Certain aspects of the confrontation method of conflict resolution are then outlined.

The paraprofessional and the use of confrontation in the mental health field.

The paraprofessional and the use of confrontation in the mental health field.