Article Review

I need assistance with an article review.See the attached article and instructions.Please let me know if there are any questions prior to completion.

ARTICLE REVIEW INSTRUCTIONS

You will write an article review,

 

relevant to this week’s learning module and readings. You will select the article yourself by searching the UWA Library Databases. The article you choose should be a research article (has a hypothesis that is empirically tested). Pick an article relevant to a topic covered in the weekly readings. Each review is worth 20 points.

  

The review should be 1-2 single-spaced pages in a 12-point font. It is in your best interest to submit your review before it is due so you may check your originality report and correct any spelling and grammatical errors identified by the software program. 

The purpose of the review is to provide students knowledge of how research is conducted and reported. The main part of your review needs to include the following information. Please comment on these aspects of the article as part of your review. Provide only the briefest summary of content. What I am most interested in is your critique and connection to weekly readings.  

Reference.Listed at the top of the paper in APA style. 

Introduction. Read the introduction carefully. The introduction should contain:

·

A thorough literature review that establishes the nature of the problem to be addressed in the present study (the literature review is specific to the problem)

· The literature review is current (generally, articles within the past 5 years)

· A logical sequence from what we know (the literature review) to what we don’t know (the unanswered questions raised by the review and what this study intended to answer

· The purpose of the present study

· The specific hypotheses/research questions to be addressed. 

· State the overall purpose of the paper. What was the main theme of the paper?

· What new ideas or information were communicated in the paper? 

· Why was it important to publish these ideas?

Methods. The methods section has three subsections. The methods sections should contain:

· The 
participants and the population they are intended to represent (are they described as well in terms of relevant demographic characteristics such as age, gender, ethnicity, education level, income level, etc?).

· The number of participants and how the participants were selected for the study

· A description of the 
tools/measuresused and research design employed. 

· A detailed description of the procedures of the study including participant instructions and whether incentives were given.

Results. The results section should contain a very thorough summary of results of all analyses. This section should include:

· Specific demographic characteristics of the sample

· A thorough narrative description of the results of all statistical tests that addressed specific hypotheses

· If there are tables and figures, are they also described in the text?

· If there are tables and figures, can they be interpreted “stand alone” (this means that they contain sufficient information in the title and footnotes so that a reader can understand what is being presented without having to go back to the text)?

Discussion. The discussion is where the author “wraps up the research”. This section should include:

· A simple and easy to understand summary of what was found

· Where the hypotheses supported or refuted?

· A discussion of how the author’s findings compares to those found in prior research

· The limitations of the study

· The implications of the findings to basic and applied researchers and to practitioners 

 

Critique.

In your opinion, what were the strengths and weaknesses of the paper or document? Be sure to think about 
your impressionsand the reasons for them. Listing what the author wrote as limitations is not the same thing as forming your own opinions and justifying them to the reader.

·

. Were the findings important to a reader?

. Were the conclusions valid? Do you agree with the conclusions?

. If the material was technical, was the technical material innovative?

 

Conclusion.

Once you provide the main critique of the article, you should include a final paragraph that gives me your overall impression of the study. Was the study worthwhile? Was it well-written and clear to those who may not have as much background in the content area? What was the overall contribution of this study to our child development knowledge base?  

 

APA Format Review

 

If you are unfamiliar or a bit “rusty” on your APA format, you may want to use the tutorial available through the APA website which is listed on your syllabus. 

 
  

Grading Criteria

 

I will grade your paper based upon:

· How well you followed directions (as indicated in this page) 

· How thoroughly you used examples to support the critique 

· How accurately you used APA format 

· your organization, grammar, and spelling 

· Integration of assigned weekly readings 

Professional Psychology: Research and Practice
1993. Vol. 24. No. 2,

160

-163

Copyright 1993 by the American Psychological Association. Inc.
0735-7028/93/S3.00

Practical Benefits of an Informed-Consent Procedure:
An Empirical Investigation

Therese Sullivan, William L. Martin, Jr., and Mitchell M. Handelsman

Seventy-eight women and 46 men rated a hypothetical therapist described as either a paraprofes-
sional (BA in English) or professional (PhD in psychology) with either less than 1 or greater than 9
years of experience. They received either a transcript containing a conversation about informed-
consent issues accompanied by a written form or a control transcript with no informed-consent
discussion. Participants gave higher ratings to a therapist who used an informed-consent proce-
dure and reported more willingness to recommend him to a friend and to go to him themselves.
They rated professionals who used informed consent as more expert and trustworthy than those
who did not. They rated experienced therapists higher overall and as more expert than inexperi-
enced therapists.

Despite growing attention to the ethical and legal issues
surrounding informed consent (Haas, 1991), there is no con-
sensus on the impact of consent procedures on the relationship
between clients and therapists. Some have argued that clients
would think highly of therapists who show respect for client
rights and that consent procedures would facilitate the thera-
peutic relationship (Everstine et al., 1980; Handelsman, 1990;
Hare-Mustin, Maracek, Kaplan, & Liss-Levinson, 1979).
Others have expressed concern that consent procedures may
interfere with the therapeutic relationship and hinder treat-
ment (Handelsman, Kemper, Kesson-Craig, McLain, &
Johnsrud, 1986; Kimmons, 1980, cited in Muehleman, Pick-
ens, & Robinson, 1985).

To test the impact of written consent forms, Handelsman
(1990) had participants rate a hypothetical psychologist after
being provided with introductory materials, including either no
consent form or some combination of forms. Participants rated
the psychologist who used written forms more positively on a
number of measures. Handelsman and Martin (1992) per-
formed two studies to determine whether the positive effects of

THERESE SULLIVAN is a graduate of the University of Colorado at
Boulder and is currently pursuing a master’s degree at the University
of Colorado at Denver. Her interests include ethics and cognitive be-
havioral therapy.
WILLIAM L. MARTIN, JR., received his MA in clinical psychology
from the University of Colorado at Denver in May 1992. He is
currently doing therapy with adolescents and their families for the
Juvenile Diversion Program of the Eighteenth Judicial District in
Colorado. His interests include family therapy and ethics.
MITCHELL M. HANDELSMAN holds degrees from Haverford College
and the University of Kansas and is currently Associate Professor of
psychology at the University of Colorado at Denver. He is a former
APA Congressional Science Fellow and has interests in ethics and the
teaching of psychology.
THE AUTHORS GRATEFULLY ACKNOWLEDGE the assistance of Sheryl
Otto and Ellen B. Braaten, who always manage to correlate above .90.
CORRESPONDENCE CONCERNING THIS ARTICLE should be addressed
to Mitchell M. Handelsman, Department of Psychology, Campus Box
173, University of Colorado at Denver, P.O. Box 173364, Denver, Colo-
rado 80217-3364.

a consent form would be maintained when accompanied by
more information about a psychologist’s actual behavior in a
therapy session. They also assessed the effects of readability of
the consent form. They found no effects of the consent forms
on participants’ impressions of therapists. In the second study
only, men who received a less readable consent form gave less
favorable ratings. With this single exception, it appeared that
therapists’ actual behavior is a more important influence on
client impressions than are written consent forms.

To date, then, there is no empirical support for the notion
that written consent forms adversely affect people’s first im-
pressions as long as the form is readable. The consent process
does not end, however, once written material is provided; con-
versations between clients and therapists should also occur.
Given the evidence that oral interaction has more influence on
impressions than does written consent material, oral presenta-
tion of informed-consent material in a session may influence
first impressions.

The first purpose of the present study was to assess the im-
pact of an informed-consent procedure—including both oral
and written components—on first impressions of potential
clients. Thus, we asked participants to rate a hypothetical thera-
pist after receiving either (a) a transcript that was accompanied
by a written consent form and that included a conversation
about such topics as risks and benefits of treatment, limits of
confidentiality, and alternatives to therapy or (b) a therapy tran-
script containing no informed-consent material. We hypothe-
sized that therapists using an informed-consent procedure
would elicit more favorable reactions.

Many therapists are paraprofessionals who do not have grad-
uate degrees in a mental health field (Windle, Poppen, Thomp-
son, & Marvelle, 1988). The general ethical reasons for obtain-
ing informed consent from clients of paraprofessionals are no
different from those cited for professionals. There are no data,
however, on the impact of informed-consent procedures on
first impressions toward paraprofessional therapists. The sec-
ond purpose of this study was to assess the impact of an in-
formed-consent procedure on paraprofessionals as well as pro-
fessionals. Does a consent procedure influence client percep-
tions differently depending on the status of the therapist?

160

PRACTICAL BENEFITS OF INFORMED CONSENT 161

The above question could also be applied to experience level;
thus, the third purpose of this study was to assess the impact of
therapist experience on the impact of an informed-consent
procedure.

The influence of therapist status and experience on client
perceptions has not been well established. The research has
consistently confounded the effects of status and experience.
Although some studies have shown that therapists with more
experience and high status are seen as more expert (Angle &
Goodyear, 1984; McKee & Smouse, 1983), the confounded vari-
ables make these results difficult to interpret. Separating these
two variables would help establish their individual influences.

Only three studies have varied therapist status (PhD vs. BA)
with experience held constant (Corcoran, 1985; McCarthy,
1982; Simonson & Bahr, 1974). Only two of these analogue
studies reported significant main effects for status. McCarthy
(1982) found that paraprofessionals were rated as more trust-
worthy and attractive than were professionals. Corcoran (1985)
found participants more willing to discuss interpersonal prob-
lems with a paraprofessional student than with a PhD psycholo-
gist. On the basis of these findings, we expected paraprofes-
sionals to be favored in the present study.

In a study of the effects of introductory material on first
impressions, Handelsman (1990, Study 2) manipulated thera-
pist experience and held status constant. He found that moder-
ate and high levels of therapist experience (9 and 19 years) elic-
ited more positive reactions and more willingness to see and
recommend the psychologist than did a low level of experience
(less than 1 year). We hypothesized that highly experienced ther-
apists would elicit more positive ratings than would less experi-
enced therapists.

Method

Participants

Participants were 124 students (78 women and 46 men) in an Intro-
ductory Psychology class at the University of Colorado at Denver, who
received extra credit for their participation. The mean age was 22.7
years, with a range of 17-53. They were randomly assigned to one of
the eight conditions, with 13-17 participants per condition.

Design

The design was a 2 X 2 X 2 factorial, with the between-subjects
independent variables of Informed Consent Procedure (absent vs. pres-
ent), Status (paraprofessional vs. professional), and Experience (low
vs. high).

Transcripts

Two therapy transcripts were used in this study: a control transcript
and an informed-consent transcript. The control transcript was based
on one first used by McCarthy and Betz (1978) in their study of thera-
pist self-referent responses; we omitted the self-referent responses. The
therapist was identified as a man, John Doe, and the client was identi-
fied as a woman, Karen.

The informed-consent transcript was created by adding dialogue to
the control transcript. Early in the session, the therapist says, “At the
end of the session, I want to save a few minutes to talk with you about
the process of therapy.” At the end of the session, the therapist reintro-

duces this theme and asks the client if she has received the consent
form (Handelsman & Galvin, 1988) that was given to participants in
this condition. The client asks about risks; the therapist explains that
some clients do not improve, and if the client feels she is not progress-
ing, they can discuss it and arrange a referral if necessary. The client
asks about alternative treatments, confidentiality and its limits, and
the length of treatment, and the therapist responds to each of these
questions. At the end of the session, the therapist says, “We will discuss
these issues further as we get to know each other and as they come up
again. At some point later on, we’ll discuss this sheet again.. . .”Both
transcripts ended with the therapist inviting the client to come back
next week. Adding dialogue made the transcript longer, but it was
judged that holding the content of the therapy session constant was
more important than holding length constant.

Procedure

After agreeing to participate, participants were given a packet of
materials that included a description of a therapist, the control or
informed-consent transcript, and several dependent measures. Partici-
pants in the informed-consent condition also received the written con-
sent form, purportedly used by the therapist. Participants were in-
structed to read through the materials and answer the questions as if
they were the client in the transcript.

The therapist was described as working at a fictitious mental health
center. Status was manipulated by describing the paraprofessional ther-
apist as having a BA in English and the professional as having a PhD in
psychology. Experience was manipulated by describing the therapist
as having either less than 1 year or greater than 9 years of experience.
The status and experience information was reiterated at the top of the
therapy transcript.

The first dependent measures checked the status and experience
manipulations, as follows:

In the transcript you read, how many years of experience did the
therapist have? . . . In the transcript you read, what was the high-
est degree earned by the therapist? (check one answer).

BA MA PhD

Participants then completed the Counselor Rating Form—Short
Version (CRF-S; Corrigan & Schmidt, 1983). The CRF-S asks partici-
pants to rate a therapist on 12 characteristics, each on a 7-point Likert-
ty pe scale. The CRF-S yields a total score as well as subscale scores for
trustworthiness, expertness, and attractiveness.

Participants then answered three questions on a 7-point scale (1 =
disagree completely; 4 = neither agree nor disagree; 7 = agree com-
pletely): (a) “I would recommend Dr. [Mr.] Doe to a friend”; (b) “If I
were experiencing problems, I would go see Dr. [Mr.] Doe”; and (c) “My
overall reaction to Dr. [Mr] Doe is very positive.” Finally, participants
responded to several demographic questions, including one that asked
if they had ever been in therapy.

Results

The four CRF-S scores (Total, Trustworthiness, Expertness,
Attractiveness) and the three additional attitude questions were
each analyzed in a 2 X 2 X 2 analysis of variance (ANOVA), with
the between-subjects factors of Informed-Consent Procedure
(absent vs. present), Status (paraprofessional vs. professional),
and Experience (low vs. high). Sex of participant was not used
as an independent variable due to the low number of men in
some cells.

To help determine the generalizability of these data to people
with experience in psychotherapy, all analyses were performed

162 T. SULLIVAN, W MARTIN, JR., AND M. HANDELSMAN

with Therapy Experience (no vs. yes) as a fourth independent
factor. There were no differences due to this factor on the re-
sults; thus, results from only the three-way ANOVAs are re-
ported.

Manipulation Checks

The two manipulation checks revealed that participants at-
tended to the status and experience manipulations. Fifty-three
(88.3%) of the participants in the paraprofessional status condi-
tion accurately identified the status of the therapist; 59 (92.2%)
of those in the professional status condition did so. An ANOVA
showed that participants reported significantly more years of
experience in the high-experience condition (M = 8.79) than
did those in the low-experience condition (M = 1.10), F(l,
111) = 1995.54, p < .001. It is interesting that participants in the professional condition reported more experience (M= 5.24) than did those in the paraprofessional condition (M = 4.28), F(l, 111) = 4.58, p = .035. It appears that part of participants' perception of professionals is that they have about 1 year more experience.

Informed Consent and Status

The informed-consent manipulation yielded several signifi-
cant effects. Analysis of the total CRF-S score revealed a main
effect, F(\, 116) = 5.78, p = .018, such that participants gave
higher ratings to therapists who used the informed-consent
procedure (M = 56.69) than to therapists who did not (M =
51.52).

Analysis of the CRF-S Trustworthiness scale yielded a main
effect favoring the informed-consent procedure, F(l, 116) =
11.01, p = .001. This main effect was qualified by a trend for the
Informed Consent X Status interaction, F(l, 116)= 3.57, p =
.061. Means and standard deviations are shown in Table 1. Sub-
sequent Duncan’s multiple range tests revealed that partici-
pants rated professionals who used the consent procedure as
more trustworthy than did professionals who did not ( p < .01); there were no differences between paraprofessionals. Profes- sionals received higher ratings than paraprofessionals only when the informed-consent procedure was present (p < .05).

A similar pattern emerged in the analysis of CRF-S Expert-

Table 1
Cell Means and Standard Deviations of CRF-S Trustworthiness
and Expert ness Subscale Scores by Experimental Conditions

CRF-S Subscale

Trustworthiness Expertness

Procedure M SD n M SD n

No informed consent
Paraprofessional 18.37 4.10 30 16.40 5.23 30
Professional 18.06 3.66 32 16.78 4.31 32

Informed consent
Paraprofessional 19.33 4.53 30 16.37 5.25 30
Professional 21.81 3.48 32 19.66 4.38 32

Note. CRF-S = Counselor Rating Form-Short Version.

ness scores. There was a trend for an Informed-Consent X Sta-
tus interaction, F(\, 116) = 3.44, p = .066, which qualified a
main effect for Status, F(l, 116) = 4.39, p = .038. Table 1 shows
the means and standard deviations. Duncan’s tests revealed
that participants rated professionals who used the consent pro-
cedure as more expert than professionals who did not ( p < .05). There were no differences between paraprofessionals who did and did not use the consent procedure. Once again, profes- sionals were rated as more expert than paraprofessionals only when the consent procedure was present (p < .05).

Analysis of participants’ willingness to recommend the thera-
pist to a friend yielded a main effect, F(l, 116) = 8.45, p = .004,
favoring therapists who used the consent procedure (M= 4.42)
over therapists who did not (M = 3.69).

There was also a main effect for the consent procedure on
participants’ willingness to see the therapist, F(l, 116) = 12.24,
p= .001. Participants were more willing to go to the therapist
when he used the consent procedure (M =4.13) than when he
did not (M= 3.08).

Analysis of participants’ overall positive reactions revealed a
main effect, F(l, 116)= 7.24, p = .008, such that ratings were
more positive when the consent procedure was present (M =
4.19) than when it was absent (M = 3.47).

The status manipulation yielded no effects other than those
on the CRF-S Trustworthiness and Expertness scales, dis-
cussed above.

Experience

There were two main effects for level of experience. Analysis
of the total CRF-S scores yielded a main effect for Experience,
F(\, 116) = 6.29, p= .014, such that more experienced thera-
pists received higher ratings (M = 56.92) than did less experi-
enced therapists (M = 51.38). There was also a main effect for
experience on the CRF-S Expertness ratings, F(l, 116) = 28.75,
p < .001. Participants gave higher Expertness ratings to more experienced therapists (M = 19.52) than to less experienced therapists (M = 15.21).

Discussion

Our first hypothesis, regarding the effects of the consent pro-
cedure, was confirmed: When oral and written consent mate-
rials are presented together, there is a positive impact on peo-
ple’s first impressions toward therapists. Two interactions indi-
cated that not all of the positive effects of the consent procedure
were consistent across levels of status. The consent procedure
increased ratings of expertness and trustworthiness for profes-
sional therapists but not for paraprofessional therapists.

These results provide evidence that an informed-consent
procedure, when done well, can be used to provide ethical
treatment to clients without risking damage at the beginning of
the therapeutic relationship. Indeed, clients may be more favor-
ably disposed to therapists who take the time and effort to
provide information. For professional therapists, this consent
procedure also seems to enhance impressions of trustworthi-
ness and expertness.

It could be argued that the positive effects of the consent
discussion were not because of the content of the discussion but

PRACTICAL BENEFITS OF INFORMED CONSENT 163

because it portrayed a more highly skilled therapist. We do not
know the mechanism behind the positive effect we found. It
could be that the informed-consent portion of the transcript
was better written than the rest of the transcript or that the
provision of any information may itself be seen as an indication
of competence.

It may also be argued that there is other information relevant
to informed consent that could damage a therapeutic relation-
ship. The present transcript incorporated several important
and relevant topics, including confidentiality, alternative treat-
ments, and risks. More research is needed to test the limits of
the positive eifects of this study. On the basis of the existing
empirical literature, we believe that therapists can meet their
ethical requirements and provide benefit to clients without
reaching those limits.

Our second hypothesis, that paraprofessionals would be
rated more favorably than professionals, was not confirmed.
The only status differences found favored professionals on rat-
ings of trustworthiness and expertness and were present only in
the informed-consent condition. Thus, status differences
seemed to reflect only an absence of the positive effects of the
consent procedure for paraprofessionals rather than a general
preference for professionals. It is unclear why paraprofessionals
would not also be rated more expert and trustworthy when
using informed consent. Perhaps people expect paraprofes-
sionals to interact with clients as partners on their level, willing
to provide information, whereas they expect professionals to
interact with clients in a more traditional doctor-patient rela-
tionship in which the doctor is not expected to welcome too
many questions. These participants may have been pleasantly
surprised to find the professional so willing to initiate and en-
gage in this type of discussion.

Our third hypothesis received partial support: More experi-
enced therapists received higher ratings than did less experi-
enced therapists. Therapists with more than 9 years of experi-
ence were rated higher on the total CRF-S score and on the
Expertness subscale than were therapists with less than 1 year
of experience. These results are consistent with those of Han-
delsman (1990) and—given that status and experience manipu-
lations both worked—suggest that experience may be a more
salient variable than status.

The consent material presented in this study represented
only one possible method of presentation; different informa-
tion or different ways of presenting it may have a different
impact (Andrews, 1984). In addition, client and therapist char-
acteristics, such as gender and ethnicity, may interact with con-
sent procedures. The generalizability of the results to a current
clinical population is limited, even though participants came
from an atypical student population with a mean age of 22.7
years and many had experience as therapy clients. In no in-
stance in the present study did the presence of a consent proce-
dure lead to more negative impressions of therapists. Our tenta-
tive conclusion is that doing ethical practice and doing good
therapy are not mutually exclusive.

References

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Angle, S. S., & Goodyear, R. K. (1984). Perceptions of counselor quali-
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Corcoran, K. J. (1985). Unraveling subjects’ perceptions of paraprofes-
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Corrigan, J. D., & Schmidt, L. D. (1983). Development and validation
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Muehleman, T., Pickens, B. K., & Robinson, F. (1985). Informing
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Windle, C., Poppen, P. J., Thompson, J. W, & Marvelle, K. (1988).
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Received May 19,1992
Revision received July 28,1992

Accepted September 14,1992 •