Date of Award


Degree Name

Doctor of Education


Counselor Education and Counseling Psychology

First Advisor

Dr. Robert Betz

Second Advisor

Dr. Avner Stern

Third Advisor

Dr. James Lowe

Fourth Advisor

Dr. Robert Brashear


The purpose of this study was to determine the applicability of Karon's Pathogenesis Index as a selection measure for persons entering graduate programs in the mental health field. The fundamental problem generating the research was the need for such selection indicators because of the present inadequacy of personality measures which adequately discriminate between those who have the capacity to become competent therapists and those who do not.

Analysis of the literature revealed many attempts to delineate those characteristics which defined a competent therapist. However, the results were mixed. Only one study VandenBos and Karon (1971) clearly identified a personality variable which correlated positively with therapist effectiveness. This study showed that the Pathogenesis Index, when used with therapists of schizophrenics, could differentiate between those therapists whose clients got better and those therapists whose clients did not.

To determine if the Pathogenesis Index could also be used to distinguish between therapists in general, and, thus, provide a selection measure, a random sample of 20 beginning therapist trainees were selected from persons enrolled in the beginning phases of the Counseling and Personnel Master's Program who were enrolled in the Counseling Techniques Course during the Winters of 1981.

The trainees were administered a set of Thematic Apperception Test (TAT) cards. Their responses were tape-recorded, transcribed, and scored by two independent judges who determined the Pathogenesis Index for each subject according to Bertram Karon's "Pathogenesis Revised Scoring Criteria."

After the subjects had completed the first ten weeks of the Counseling Techniques Course, they were considered to have been exposed to comparable training. To ascertain therapist effectiveness the subjects were then placed in a 30 to 40 minute therapy session with a coached client. Following the session both the therapist and coached client completed forms of the Barrett-Lennard Relationship Inventory (BLRI). The BLRI served as the measure of therapist effectiveness with p (LESSTHEQ) .05 as the a priori level of confidence.

T-tests of differences between client and therapist scores on the BLRI indicated that the five therapists with the lowest Pathogenesis Index scored significantly higher than the six therapists with the highest Pathogenesis Index on three of the four BLRI client scales: Regard, Empathy and Total Score. The Congruence score indicated a trend towards a significant difference. The therapist scales, however, were not significantly different. T-tests for therapist and client scored on the BLRI indicated that there was a significant difference on all four BLRI scales between client and therapist scores. A Pearson Product Moment Correlation Matrix revealed that, while significant differences were found when comparing "high" pathogenesis therapists with "low" pathogenesis therapists, there was not a direct relationship between scores on the BLRI and the amount of pathogenesis as measured on the Pathogenesis Index. Finally, a Verimax Factor Analysis indicated that there were two factors involved in the data: one factor included client BLRI scores and Pathogenesis Index scores, and the second included BLRI therapist scores.

It was concluded that the Pathogenesis Index could discriminate between effective and ineffective therapists. In addition it was shown that client's perception of the therapeutic relationship differs significantly from the therapist's perception and is more accurate in reflecting the therapeutic relationship. Feasibility and ethical considerations for using the Pathogenesis Index were discussed. It was suggested that the measure may be more useful as an integral part of a graduate program than as a selection indicator.

Access Setting

Dissertation-Open Access