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The Effects Unconditional Positive Regard on Psychotherapy Outcome

Damien Tilliman

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A Dissertation Submitted to the Faculty of
The Chicago School of Professional Psychology

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In Partial Fulfillment of the Requirements

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For the Degree of Doctor of Psychology

March 7th, 2016

ProQuest Number: 10108864

All rights reserved
INFORMATION TO ALL USERS
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In the unlikely event that the author did not send a complete manuscript
and there are missing pages, these will be noted. Also, if material had to be removed,
a note will indicate the deletion.

ProQuest 10108864

Published by ProQuest LLC (2016). Copyright of the Dissertation is held by the Author.
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Unpublished Work
Copyright 2016 by Damien Tilliman

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All Rights Reserved

The Effects of Unconditional Positive Regard on Psychotherapy Outcome
______________________________________________________________________________

A Dissertation Submitted to the Faculty of
The Chicago School of Professional Psychology
In Partial Fulfillment of the Requirements

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For the Degree of Doctor of Psychology

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______________________________________________________________________________

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Damien Tilliman
2016

Approved By:

________________________________________________________________________________
Dr. Ali Jazayeri PhD, Chairperson
Associate Professor, The Chicago School of Professional Psychology

_________________________________________________________________________________
Dr. Guy Balice, PhD, Chairperson
Associate Professor, The Chicago School of Professional Psychology

_________________________________________________________________________________
Dr. Guy Balice, PhD, Reader
Associate Professor, The Chicago School of Professional Psychology

Acknowledgments
Many people have been involved in the research, development, and final product of my
dissertation. I would like to thank my dissertation chair Dr. Jazayeri for guiding me throughout this
long process. I would also like to thank my dissertation reader Dr. Balice who graciously spent many
patient hours helping me fully explore and understand every aspect of my dissertation.
I would also like to thank Dr. Bonnie Burstein for believing in me and encouraging me to
believe in myself.

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Most of all, I would like to thank my girlfriend Ligia, she more than anyone I have ever met,
best encompasses the concept of unconditional positive regard. Her constant support, encouragement

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and most importantly, unconditional acceptance has made me who I am today.

Abstract

The purpose of this study was to measure the relationship between therapist unconditional positive
regard and psychotherapeutic outcome. Research in the last 30 years generally supports the
effectiveness of Carl Rogers' core conditions within the therapeutic relationship. Out of Rogers’ core
conditions (empathy, congruence, and unconditional positive regard) numerous writers and person
centered approach practitioners consider unconditional positive regard (UPR) as the curative factor in

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person centered psychotherapy. Unconditional positive regard is an attitude of unconditional
acceptance. Rogers’ believed that when the therapist is able to convey to his or her client a genuine

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caring for him or her as a whole person with human potential, a deep caring that places no conditions of
interpretation or judging of his or her feelings, thoughts, or even behaviors on his or her unconditional

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acceptance, the therapist is expressing unconditional positive regard (Rogers & Truax, 1967). Levels of
perceived therapist unconditional positive regard were hypothesized to be positively correlated to
improvements in client's overall global functioning, which includes the dimensions; subjective wellbeing, life/social functioning, symptoms/problems, and risk to self and others. In order to test this
hypothesis, 31 participants, who were comprised of students who attended a two year community
college located in western United States and sought therapy at the college counseling center, were
administered The Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM) and the
Barlett-Lenard Relationship Inventory (RI) in order to assist the measurement of therapeutic outcome
and levels of congruence, empathy, and unconditional positive regard. The present study indicated that
levels of positive regard, congruence, and empathy were positively correlated to improvements to
participants’ life/social functioning and symptom reduction of the CORE-OM.

Table of Contents
Chapter 1: Nature of Study……………………………………………………………………………...1
Introduction………………………………………………………………………………………….…1
Person Centered Approach…………………………………………..…………………………..….….3
Definition of Terms………………………………………………………………………………..…...4
Purpose of Study…………………………………………………………………………………….....4
Statement of the Problem ……………………………………………………………………….……..5

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Hypothesis……………………………………………………………………………………….…….5
Chapter 2: Literature Review…………………………………………………….………………….…...6

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Introduction……………………………………………………………………………………….…....6

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Psychotherapy Outcome Research……. ……………………………………………………….……...8
Person Centered Theory…………..………………………………......................................................10
Person Centered Approach Research………....................................................................................... 18
Unconditional Positive Regard………………………………………………….................................19
Unconditional Positive Regard Research…………………………………..........................................23
Limitations of Research……………………………………………………………………...…….....25
Chapter 3…………………………………………………………………………………………...…...28
Hypothesis………………………………………………………………………………………...…..28
Research Design…………………………………………………………………………………...….28
Participants…………………………………………………………………………………………....29
Participant Inclusion……………………………………………………………………………….....29
Instrumentation……………………………………………………………………………………….29

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Procedure............................................................................................................................................31
Data Analysis…………………………….…………………………………………………..……….32
Ethical and Legal Considerations…….…………………………………..........................................32
Chapter 4: Results……………………………………………………………………………..…..…....33
Demographics……..…………………………...................................................................................33
Descriptives……....……………………………………………………..………………………........33
Multivariate Tests and Hypotheses…………….…………………………………….……………….34

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Chapter 5: Discussion, limitations and Future Research……………………………………………….46
Summary…………………………………………………………………….……………………....46

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Linking Results……….……………………………………………………………………………..48

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Discussion…….……………………………………………………………………………………..49
Clinical Implications……………………………………………………………………………......52
Limitations….……………………………………………..………………………………………..53
Further Research……………...…………………………………………………………………….53
References………………………………………………………………………………………….…...55
Appendix A: Oral Recruitment Form ………………………………………..………………….……...66
Appendix B: Informed Consent Form...………………...……………………………………….…..…67
Appendix C: Exploratory Factor Analysis Tables ………………………..…………………….……....70

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List of Tables
Table 1: Descriptive Statistics for CORE-OM subtests Symptoms, Risk and Functioning
Pre and Post Treatment…………………..…………………………..…...…….……….....35
Table 2: Descriptive Statistics for the RI subtests, Regard, Unconditionality, Congruence and
Empathy.................................………….…………………...…………….………………..35
Table 3: Multivariate Repeated Measures Analysis of Covariance with The Symptoms Subtest of
the CORE-OM Inventory and the RI Subtest Empathy ……………………….……….....36

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Table 4: Multivariate Repeated Measures Analysis of Covariance with The Symptoms
Subtest of the CORE-OM Inventory and the RI Subtest Regard …..…………….……....37

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Table 5: Multivariate Repeated Measures Analysis of Covariance with The Symptoms

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Subtest of the CORE-OM Inventory and the RI Subtest Unconditionality ..…..…...…....38
Table 6: Multivariate Repeated Measures Analysis of Covariance with The Symptoms
Subtest of the CORE-OM Inventory and the RI Subtest Unconditionality……..…….......39
Table 7: Multivariate Repeated Measures Analysis of Covariance with The Functioning
Subtest of the CORE-OM Inventory and the RI subtest Empathy…………………….......41
Table 8: Multivariate Repeated Measures Analysis of Covariance with The Functioning
Subtest of the CORE-OM Inventory and the RI subtest Regard………………………......42
Table 9: Multivariate Repeated Measures Analysis of Covariance with The Functioning
Subtest of the CORE-OM Inventory and the RI subtest Unconditionality…….……......…43
Table 10: Multivariate Repeated Measures Analysis of Covariance with the Functioning
Subtest of the CORE-OM Inventory and the RI subtest Congruence………..……...…..44

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