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Copyright 1986 by the American Psychological Association, Inc.

0022-0167/86/S00.75

Journal of Counseling Psychology


1986, Vol. 33, No. 1, 11-15

This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

Differential Effects of the Gestalt Two-Chair Intervention and Problem


Solving in Resolving Decisional Conflict
Katherine M. Clarke

Leslie S. Greenberg

Loyola University of Chicago

University of British Columbia


Vancouver, British Columbia, Canada

This study compared an affective (Gestalt two-chair intervention) and a cognitive-behavioral


(problem-solving) counseling intervention used to help clients resolve intrapersonal conflicts
related to a decision. Forty-eight people were randomly assigned to three groups: a problemsolving group (n = 16), a two-chair group (n = 16), and a waiting-list control group (n
= 16). Trained counselors saw clients for two sessions. Subjects were pretested and posttested on measures of indecision and stage of decision making. A one-way analysis of
variance revealed that the affective intervention was more effective than the cognitivebehavioral intervention or no treatment for reducing indecision. Both counseling approaches
were more effective than no treatment in facilitating movement through the stages of decision
making.

feeling torn apart by opposing tendencies, the affectively oriented


counselor may turn to the Gestalt two-chair intervention. The presence of opposing tendencies has been identified as an important
marker for its use (Greenberg, 1979, 1980). On the other hand,
a counselor working from a cognitive-behavioral stance will recognize this as an appropriate time to implement systematic problem solving. Because no clear preference is felt, a logical weighing
of the pros and cons may help resolve the conflict. The question
of differential effects may legitimately be raised because both
treatments could be effective in the situation.
The comparison of the Gestalt two-chair intervention and problem solving is meant to represent two distinct approaches to counseling. The interventions, however, by no means exhaust their
respective theoretical domains, and the results have limited generalizability to other affective or cognitive-behavioral approaches.
Problem solving (D'Zurilla & Goldfried, 1971) is a cognitivebehavioral counseling method that consists of the following:

A broad distinction can be drawn among counseling approaches


that are primarily affective from those that are focused on cognitive behavior. Cognitively oriented therapists attend primarily
to how clients think about their problems. Interventions are aimed
at changing thoughts, cognitive structures, and ways of processing
information, often to promote more effective problem solving.
Affective therapists, on the other hand, pay more attention to the
feeling domain. Their interventions focus on emotional experience
and are thought to lead clients to the wisdom of the organism,
which is regarded as having a rationality that integrates all the
affective and cognitive information available to the organism (Perls,
1969).
The controversy regarding affect and cognition has generated
extensive discussion (Rachman, 1981). Few studies, however,
have experimentally compared scientific procedures aimed primarily at affect or cognitive behavior as applied to a specific
therapeutic issue. The present study examined the differential effects of an affectively oriented intervention, the Gestalt two-chair
intervention (Greenberg, 1979, 1984), and a cognitive-behavioral
intervention, problem solving (D'Zurilla & Goldfried, 1971), used
to help people resolve conflicts. A specifically defined conflict
was chosen: an intrapersonal conflict related to a decision.
The importance of decisional conflict in human decision making
has been emphasized by Janis and Mann (1977). They described
decisional conflict as "occurring when there are simultaneous opposing tendencies within the individual to accept and reject a given
course of action" (p. 42). They stressed that people often avoid
making decisions because of the pain experienced in dealing with
decisional conflict. This type of conflict, then, contains characteristics that make it a suitable target for either an affective or a
cognitive-behavioral intervention, depending on the theoretical
stance of the counselor.
Because the decisional conflict is one of strong affect, that is,

A behavioral process, whether overt or cognitive in nature, which (a)


makes available a variety of potentially effective response alternatives for
dealing with the problematic situation and (b) increases the probability of
selecting the most effective response from among these various alternatives, (p. 108)

The basic premise of problem solving is that when a problematic


situation is recognized, by virtue of the fact that the client is upset,
the essential task is to refocus attention from the emotional state
to the situation creating the upset (Goldfried & Goldfried, 1975).
The Gestalt two-chair intervention (Perls, Hefferline, & Goodman, 1951) is an affective method that has been shown to be
effective in resolving conflicts (Greenberg, 1983; Greenberg &
Clarke, 1979; Greenberg & Dompierre, 1981; Greenberg & Webster, 1982). It consists of creating a dialogue between the two
sides of a conflict, often asking the client literally to change chairs
as he or she speaks. The basic premise of the Gestalt two-chair
intervention is that when a person is upset, the essential task is to
focus attention on what the client is experiencing in order to bring
unacknowledged aspects of experience into awareness. Awareness
of the disparate aspects of experience and contact between them

This study is based on a doctoral dissertation by the first author. Appreciation is expressed to Gloria J. Lewis, who directed the dissertation.
Correspondence concerning this article should be addressed to Katherine
M. Clarke, who is now at the Institute of Pastoral Studies, St. Paul University, 223 Main Street, Ottawa, Ontario, Canada JUS 1C4.

11

This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

12

KATHERINE M. CLARKE AND LESLIE S. GREENBERG

will lead to an integration and conflict resolution (Perls, 1969). It


is evident then that problem solving and the Gestalt two-chair
intervention differ considerably in their major focus. They are
similar, however, in that both methods are used to promote conflict resolution.
To increase control in the study, the target problem for comparing the therapeutic interventions was kept constant. All clients
were experiencing intrapersonal conflict over a personal decision.
The definition of decision was very broad, and conflicts ranged
from "I want to work but I feel guilty about leaving my children"
to "I want to tell off my boss but I can't." All of the decisions
were emotionally significant and current.
The following hypothesis was tested in the study: Problemsolving, two-chair, and control groups will not differ significantly
on a posttreatment measure of undecidedness or stage of decisionmaking attained.

Method
Subjects

The subjects in this study were 48 adults who voluntarily sought counseling to help them resolve a conflictual decision. There were 11 men and
37 women, ranging in age from 16 to 73 years old (M = 36 years old).
The sample was fairly well educated; of 48 participants, 44 had graduated
from high school, 32 had some university education, 9 had attended graduate or professional school, and 12 had vocational/technical school training. Various occupations were represented in the sample; 11 of the 48
were professionals; 14 were employed in skilled trades; and the rest were
housewives, students, or retired persons.

Counselors
Four counselors trained in the Gestalt two-chair intervention and four
counselors trained in problem solving each saw 4 clients. Two of the
Gestalt counselors and two of the problem-solving counselors were PhDs
and registered psychologists. The other counselors were advanced graduate
students in either counseling or clinical psychology. Each group of counselors had been trained by various experts in the respective treatments
before being asked to participate in the study. The two groups of counselors were matched for years of clinical experience.
Because the counselors were not trained in the respective treatments for
purposes of the study, briefing sessions were held separately for the twochair and problem-solving counselors. At these sessions the treatments
were reviewed and counselors were instructed to use only the defined
procedures and interventions described by D'Zurilla and Goldfried (1971)
for problem solving and those by Greenberg (1980) for the Gestalt twochair intervention.
Problem-solving counselors were told to conduct the steps of defining
the problem, generating alternatives, and deciding in the first session and
verifying and evaluating in the second session. The two-chair counselors
were instructed to work on the same conflictual decision in each session
and to use the appropriate interventions from the two-chair procedure.
To guard against possible bias in the implementation of treatment, counselors who ascribed to a cognitive-behavioral orientation and frequently
used cognitive interventions in their practice were chosen as problemsolving counselors. Counselors for the two-chair groups preferred affec-

tive-experiential treatments and frequently employed the two-chair intervention with clients.

Measures
Two instruments were used in this study to assess the effects of the
treatments. The subjects' degree of undecidedness, before and after treatment, was measured by an adapted form of Osipow, Carney, and Barak's
(1976) Scale of Vocational Indecision. Changes in the subjects' decisionmaking stage, particularly their degree of choice, were measured by Harren's (1979) Assessment of Career Decision Making, Part IV (DecisionMaking Task-Occupation, DMT-O, Choice scale), administered before
and after treatment. The instruments were chosen so that the goals of the
two treatments would be represented in the measures. The Scale of Vocational Indecision measures an affective variable, the feeling of indecision. The Assessment of Career Decision Making measures more cognitive
behaviors such as whether or not a choice has been made.
Scale of Vocational Indecision. The Scale of Vocational Indecision (Osipow et al., 1976) provides an overall index of undecidedness. The scale
consists of 18 items to be rated on a 4-point scale from not at all like me
(1) to exactly like me (4). A high score reflects indecision; a low score
reflects decidedness.
Because a number of items on the Scale of Vocational Indecision are
oriented to college students, some minor revision of wording was necessary to make it appropriate for this study (e.g., the item, "I know what
I'd like to major in, but I don't know what careers it can lead to that
would satisfy me," was changed to, "I know what I'd like to do now but
I don't know what it can lead to that would satisfy me"). The essential
meaning of each item was maintained.
In order to verify that these changes had not adversely affected the
validity and reliability of the scale, the adapted form was administered to
136 graduate students in another study (Greenberg & Webster, 1982). The
students responded to the questionnaire in terms of a current decision. A
Hoyt's analysis of variance (ANOVA) internal consistency reliability of .85
indicated that the revised items were consistent with the other items in the
test.
Assessment of Career Decision Making. The Assessment of Career Decision-Making Stage (ACDM; Barren, 1979) was designed to measure
progress through the decision-making process. It is based on Tiedeman
and O'Hara's (1963) model of decision making, which views human beings
as responsible for their behavior and capable of choosing through purposeful action. The decision-making task is resolved through sequential
stages involving the cognitive functions of differentiation and integration.
The stages of decision making (exploration, crystallization, choice, and
clarification) are closely related to the steps of problem solving described
by D'Zurilla and Goldfried (1971). For this reason the ACDM seemed
appropriate as a measure of the effects of the treatment.
The first part of the ACDM measures decision-making style. Parts II,
III, and IV measure progress through the stages of decision making. For
purposes of this study Part IV, Decision Making Task-Occupation (DMTO), was chosen because it contained a subscale for choice. The Choice
subscale (DMT-O) is composed of 10 items such as, "I'm pretty certain
about the choice I will make," and "I've decided on the choice I am
going to make." By using a weighted conversion formula on the raw
scores, change in the DMT-O score before and after treatment indicates
progress through the stages of decision making and increased choice.
Harren (1979) suggested that the converted scores on the individual DMT
scales of the ACDM are useful for comparing individuals with one another
and for measuring progress in decision making.
Other studies have used parts of the ACDM for evaluating treatment
effects (e.g., Barker, 1981; Phillips & Strohmer, 1983), investigating the
relation of decision-making style to vocational maturity (Phillips & Strohmer, 1982) and examining cognitive dissonance as a mechanism in the
vocational decision process (Thomas & Bruning, 1984).

GESTALT TWO-CHAIR INTERVENTION AND PROBLEM SOLVING

This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

Subject Selection and Assignment


Subjects were solicited through radio and newspaper advertisements, as
well as posters and brochures placed in community centers and libraries.
The announcements described a free, short program conducted under the
auspices of the university for people facing a difficult personal decision.
Radio and television announcements were the most effective advertising,
and approximately 125 inquiries were received in response to this publicity.
From the calls received, 48 people were selected for use in the study.
A preliminary screening occurred at the initial telephone contact. If callers
were not experiencing a current conflict related to a personal decision,
they were referred to an alternate community service. If they were currently experiencing such a conflict, they were invited to an introductory
interview.
The introductory interview and all subsequent contacts with the subjects
occurred in a university counseling center.
At the introductory interview, subjects were screened for evidence of
severe disturbance. Only persons who were relatively well functioning and
experiencing a decisional conflict were accepted for the study. Criteria
were based on Malan's (1976) notion of who is best suited for short-term
treatment, for example, those with realistic expectations and with no history of severe dysfunction.
Of 86 persons interviewed, 16 were screened out because they did not
meet the acceptance criteria or because of scheduling problems. The remaining 70 persons were randomly assigned to one of the three treatment
conditions. There were 15 people who did not show up for the first treatment session, and 7 subjects dropped out later in the study. Dropouts were
evenly distributed across treatment groups.
After the screening interview, volunteers accepted for the study were
provided with a written explanation of the study and were asked to sign
an informed consent form. The Scale of Vocational Indecision (SVI) and
the Assessment of Career Decision Making (ACDM) were then administered.

Treatment
Subjects were randomly assigned to a counselor or to the control group.
Four subjects were assigned to each of the four Gestalt two-chair (TC)
counselors (TC n = 16), and 4 subjects were assigned to the problemsolving (PS) counselors (PS n = 16). Thirty-two clients and eight counselors thus participated in the study, with 16 clients forming the waitinglist control group. The waiting-list control subjects were told that there
was currently no space in the program. They were pretested and returned
in 4 weeks for posttesting. After posttesting they received treatment from
practicum students.
Approximately 1 week after the screening interview, the subjects received a group briefing session that lasted about 1 hour. The TC group
was briefed separately from the PS group. The purpose of these sessions
was to describe the counseling approach to be used and to encourage the
notion that conflicts and problematic situations are a normal part of life.
One week after the briefing session, subjects met individually with their
counselors. Each subject described his or her conflict, and the counselor
then instituted the assigned counseling intervention. A week later, the
client and counselor met again, and the same counseling approach was
used.
The Gestalt two-chair intervention was conducted according to the principles delineated by Greenberg (1979). The client is directed to alternately
assume the two sides of an intrapsychic conflict. A client may say, "I
want to do this, but then, I'm not really sure it's a good idea," at which
point the counselor guides the client in a dialogue between the two sides.
Five principles constitute the main structure of the operation: (a) maintaining a contact boundary, (b) taking responsibility, (c) attending, (d)
heightening, and (e) expressing.

13

The problem-solving treatment was conducted according to the five


steps outlined by D'Zurilla and Goldfried (1971). The first step, which
occurred during the group briefing, involves the general orientation of the
client to the idea that problems are a normal part of life and that she or
he should behave as though it is possible to cope effectively with them.
The client is also encouraged not to act on impulse or to avoid problematic
situations. The next three steps of the problem-solving treatment (defining
the problem, generating alternatives, and deciding) were carried out in the
first treatment session. Verification and evaluation took place in the final
treatment session.
One week after the counseling sessions, the SVI and the ACDM were
again administered to all subjects. The experimenter then debriefed all
subjects and responded to any questions or concerns.

Check on Treatments
In order to verify that the assigned treatment was in fact conducted,
audiotapes of the counseling sessions were inspected by four raters. The
raters, trained in the treatment they were evaluating, were blind to the
experimental hypotheses. Two raters listened to the PS tapes and recorded
their evaluations on a checkist. Two different raters listened to the TC
tapes and recorded their evaluations on a checklist. In all cases the raters
agreed that the assigned treatment was conducted. This method of confirming treatment procedures was developed by Snodgrass and Healy (1979).

Results
Counselor Effect
To determine whether or not the counselors in each group were
differentially effective in applying the treatments, the posttest scores
on the SVI were submitted to a one-way, two-tailed ANOVA, considering counselor as a four-level fixed factor (a < .05). Planned
orthogonal comparisons were included in this analysis to determine the source of any differences. These comparisons were tested
(p < .05) with the t statistic.
Because one contrast in each of the groups was significant, the
data were submitted to a one-way analysis of covariance (ANCOVA),
where pretest score on the SVI was the covariate, posttest score
on the SVI was the dependent variable, and counselor was again
a four-level fixed factor. The same contrasts were used to determine the source of any differences and the BMDPIV computer
program was used for the analysis.
The results of these analyses indicated that despite random assignment, 4 clients assigned to a counselor in the TC group and
4 clients assigned to a counselor in the PS group had scores that
were elevated enough on the pretest to cause spuriously significant
differences between counselors for either group on the posttest
scores of the SVI.
Pretest scores on the SVI and DMT-O scale of the ACDM for
the TC, PS, and control groups were submitted to a one-way,
two-tailed ANOVA, considering treatment as a three-level fixed
factor. This was to determine whether or not the groups differed
significantly on undecidedness and at the choice stage of decision
making before treatment.
There was a .59 probability that the difference on undecidedness
between groups before treatment was due to chance and a .12
probability that this was true for the decision-making stage score.
It was assumed, therefore, that the groups did not differ significantly before treatment.
Posttest scores on the SVI and the DMT-O scale of the ACDM

14

KATHERJNE M. CLARKE AND LESLIE S. GREENBERG

This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

for all groups were then submitted to a one-way, two-tailed ANOVA,


again considering treatment as a three-level fixed factor. The ANOVA
of the SVI scores revealed a significant difference, F(2, 45) =
9.95, p < .05. Both the PS and the TC groups' scores showed
reduced indecision compared with the control group's. Post hoc
comparisons using Tukey's honestly significant difference test revealed that for the SVI, the TC group was significantly different
from the PS and control groups (p < .05). Inspection of the means
indicated that this difference was in the direction of reduced scores
on the SVI, reflecting a reduction of undecidedness. The ANOVA
of the DMT-O scale score did not indicate a significant difference,
F(2, 45) = 2.69, p > .05. The means and standard deviations
for the SVI and the DMT-O scores are presented in Table 1.
Discussion
The results of this study indicated that the two-chair intervention
reduced indecision more effectively than did either problem solving or the absence of treatment. Problem solving was superior to
no treatment but was not as effective as the Gestalt two-chair
intervention for reducing indecision.
Previous research (e.g., Greenberg & Clarke, 1979; Greenberg
& Dompierre, 1981; Greenberg & Higgins, 1980) has shown that
the Gestalt two-chair intervention is more effective than empathic
reflections (e.g., Carkhuff, 1969) or focusing (e.g., Gendlin, 1978)
for producing greater depth of experiencing (e.g., Klein, Mathieu,
Kiesler, & Gendlin, 1969) and more shifts in awareness for clients
working on resolving a conflict. Level of experiencing and shifts
in awareness are constructs thought to be conducive to conflict
resolution and decision making. The present study, however, is
important in that it shows a significant effect on a direct measure
of indecision rather than on constructs correlated with decision
making.
The results of the present study also show differential effects
on one dependent variable between the two-chair intervention and
a treatment specifically used to facilitate conflict resolution and
decision making. The premise of the problem-solving approach is
that at a point of indecision, when a person experiences feelings
Table 1
Scores on the Scale of Vocational Indecision (SVI) and the
Occupation Scale (DMT-O) of the Assessment of Career
Decision Making
Treatment
group

SVI

Pre.

DMT-O
Post.

Pre.

Post.

Problem solving

39.13
33.44
24.31
24.94
M
6.13
6.86
2.21
SD
2.39
Two-chair
41.44
29.13*
23.31
24.63
M
7.54
6.54
2.02
2.83
SD
Control
40.87
22.87
23.19
M
39.81
6.17
7.04
1.64
SD
1.45
Note. For all groups, n = 16. Pre. = pretest; post. = posttest. Higher
DMT-O scores indicate increased choice. Lower SVI scores indicate reduction of indecision.
*p < .01.

of conflict, fear, struggle, or paralysis, the best way to proceed


is to set aside these feelings and to focus on the problem to be
solved. It is believed that by setting aside the feelings and working
rationally on the problem, it will be solved, thus reducing the
distressing affective state. Subjects in the problem-solving group
did report that they were less undecided than those in the control
group after going through the problem-solving process, indicating
that the this treatment was effective. However, the Gestalt twochair intervention clients, having fully attended to the feelings
underlying the conflict, reported being more decided than clients
who tried to decide on a logical basis. This may suggest that
attending directly to affect is helpful in resolving decisional conflict.
It should be noted, however, that this study shows changes on
a self-reported measure of a state called indecision. It does not
show evidence of decision implementation or concrete behavioral
change emanating from a decision. The problem-solving approach
may have its place after indecision is reduced by an affectively
oriented approach. The problem-solving focus on tactics and strategies may complement the affective approach by providing a way
of implementing the decision once it is made.
The lack of significant differences between groups on the posttest ACDM (DMTO scale) indicates that the treatments did not
significantly affect movement through decision-making stages.
Although previous research indicates that the instrument is powerful enough to pick up gross differences between decided and
undecided groups, it appears to lack the fine tuning needed to pick
up more subtle differences brought about by a two-session treatment.
The counselors' and clients' observations obtained in termination interviews are interesting in light of objective results. A comment made by both the problem-solving counselors and their clients
was that it was often difficult to keep focused on the problem
when strong feeling was involved in the decision. Counselors
received comments from clients such as, "I know all that, but I
just can't do it," suggesting a block that was not amenable to the
cognitive-behavioral intervention alone.
Two-chair counselors commented that the original decision a
person wished to make often unfolded into a deeper, related decision. For example, a decision about whether or not to continue
an athletic career was resolved by the person deciding not to be
so hard on himself. The original decision, on which the measures
were taken, changed somewhat by the time posttest measures were
taken. So, not only was the person more decided but often new
decisions and resolutions had emerged that were not directly measured.
An interesting extension of the present study would be to conduct an experiment comparing the Gestalt two-chair intervention
alone, the problem-solving intervention alone, and a sequential
combination of the two approaches. Such a study should include
instruments designed to target particular stages of treatment.

References
Barker, S. B. (1981). An evaluation of the effectiveness of a college career

guidance course. Journal of College Student Personnel, 22, 354-358.


Carkhuff, R. (1969). Helping and human relations. New York: Holt,
Rinehart & Winston.

This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

GESTALT TWO-CHAIR INTERVENTION AND PROBLEM SOLVING


D'Zurilla, T. J., & Goldfried, M. R. (1971). Problem-solving and behavior modification. Journal of Abnormal Psychology, 28, 107-126.
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15

Janis, I. L., & Mann, L. (1977). Decision-making: A psychological analysis of conflict, choice and commitment. New York: Free Press.
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Received January 29, 1985
Revision received May 29, 1985

Call For Nominations


The Publications and Communications Board has opened nominations for the editorship of the
Journal of Counseling Psychology for the years 1988-1993. Charles Gelso is the incumbent editor.
Candidates must be members of APA and should be available to start receiving manuscripts in
early 1987 to prepare for issues published in 1988. To nominate candidates, prepare a statement
of one page or less in support of each candidate. Submit nominations no later than February 1,

1986 to:
Charles D. Spielberger
Department of Psychology
University of South Florida
Tampa, Florida 33620
The other members of the search committee are John L. Holland, Laurel W. Oliver, Samuel H.
Osipow, and Lyle D. Schmidt.

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