Measuring counselor’s attitudes toward crying: Development of an instrument

Counselor Attitude

Running head: COUNSELOR’S ATTITUDES TOWARD CRYING

Measuring counselor’s attitudes toward crying:

Development of an instrument

Miles Matise, Ph.D., M.Div., LPC

Troy University

[email protected]

1

mailto:[email protected]

Counselor Attitude

Acknowledgements

Thanks to Dr. Susan Hutchinson for her expertise and input

on this project.

Abstract

The purpose of this study was to determine the validity and

reliability of the Tears-Inventory (TI), a 47 item

questionnaire, which measured the attitudes of counselors

and counselors-in-training (CIT) toward crying. A principle

component analysis was conducted on the TI. The analysis

yielded four factors and Cronbach’s alpha measured the

internal reliability of each factor. The results were

obtained from a convenient sample of 157 graduate level

counselors and counseling students attending a CACREP

accredited university. Implications of this study suggested

that the TI could be used to aid counselors and CITs to

become more aware of their emotions. It also could be used

in counseling programs as a supervisory tool to aid

supervisors in determining which supervisory style may be

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Counselor Attitude

most effective in working with counseling professionals and

students.

Measuring counselor’s attitudes toward crying:

Development of an instrument

Tears have been described as a language that transcends

words (Kottler, 1996). Only in Homo sapiens have tears

evolved as part of an intricate system of language in which

complex feelings could be expressed in capsulated form.

Kottler (1996) wrote,

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Counselor Attitude

Tears are unparalleled as a powerful language system, a

way to communicate

the essence of a feeling, sometimes overriding all

semblance of control. Tears

heighten our awareness of self and others. They

override cognition and rational

decision making to the extent that we could easily

conclude that feelings are the

essence of human experience. (p. 97)

Crying is a response all people have in common and is

one of the most powerful demonstrations of emotional

expression. Darwin (1873) concluded that expressions of

emotions are universal among humans and the expression of

crying is innate, serving an important function in the

welfare of the human species. No current valid and reliable

instruments exist to measure counselors’ attitudes toward

crying until the TI.

Individuals in helping professions such as nurses,

psychologists, and counselors may be vulnerable to a wide

variety of emotionally charged situations. Blankenship’s

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Counselor Attitude

(1984) research on nurses perceptions of crying indicated

that emotional tears were a form of non-verbal communication

which conveyed messages to the caregiver. These situations

might be at times uncomfortable and unpleasant to the

counselor and, as a result, influence his or her behavior

during sessions. Bugen (1997) concluded that although

emotions affect behavior and perceptions, emotions affect

perceptions before they affect the actual behavior.

The rationale for this study was based on the paucity

of research on crying as an appropriate function to relieve

stress caused by the build up of emotions. Crying not only

has certain health benefits (Davis, 1990; Frey, Hoffman-

Ahern, Johnson, Lykken, & Tuason, 1983; Matise, 2006) but

could serve to enhance empathy for a client, thus

facilitating the therapeutic alliance (Horvath, 2001) of the

counselor-client relationship. Of the studies that have been

done, most have been qualitative in nature and used a

questionnaire, survey, data gathered from diaries, or

retrospective recall. The present study is a step toward

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Counselor Attitude

providing descriptive data to facilitate the construction of

a theory of crying.

Literature Review

Crying is a natural coping mechanism which helps buffer

against the pathogenic effects of stress (Davis, 1990; Frey

et al., 1983). According to Frey et al., emotional stress

alters the chemical balance of the human body. When the

stimulation of the lacrimal gland in the brain increases due

to emotional intensity, it results with the production of

tears (Botelho, 1964). In this study, crying is defined as

the state of lacrimose secretions pouring from the eyes in

response to emotional stimulation. Although the social

expression of crying implies differences in degree, for this

study tearing up and crying are used synonymously.

Ethics of Crying in the Counseling Situation

Individuals in helping roles are vulnerable to a wide

variety of emotionally charged situations where the

counselor or client is emotionally vulnerable and has the

potential for reactionary overt behaviors. These behaviors

can lead to overt expressionism such as crying, screaming,

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Counselor Attitude

angry outbursts, and seemingly irrational demonstrations of

emotion. Emotionally charged situations can be

uncomfortable, unpleasant, and can induce a state of

anxiety, especially in professional situations such as

counseling. When a counselor has an emotional response to

his or her client, feelings can intensify resulting in a

spontaneous reaction, even to the point of crying. A study

by Curtis, Matise, and Glass (2003) suggested that crying

with clients could be a genuine expression of emotions and

facilitate the therapeutic relationship.

Hill, Mahalik, and Thompson (1989) offered two

explanations to the counselor’s emotional reaction of crying

during a session. The first was self-disclosure--the counselor’s

personal emotional response to the client. When self-

disclosure was appropriate, the counselor would share a

segment from his or her own life with the client with the

purpose of either reassuring or challenging the client’s

experience. The focus in this situation is on the client and

not the therapist. When a therapist finds him or herself in

a situation that stirs powerful emotions, self-disclosure

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Counselor Attitude

can deepen the counselor-client connection or can reflect

the counselor’s inability to contain his or her own

feelings.

A second explanation was empathy-- the active attention

toward the feelings of others. This Rogerian concept

(Rogers, 1980) emphasizes the therapeutic function of the

counselor’s ability to fully experience the attitude

expressed by the client and reflect back what he or she is

experiencing. Empathy is considered to be a significant way

to enhance and deepen the therapeutic relationship.

Sometimes counselors might discount the behavior of

crying as a way to avoid an inappropriate reaction that

crying might trigger in the counselor’s experience of

anxiety and discomfort, an overly sympathetic response or

detachment from the client to quell the counselor’s

discomfort or to maintain an objective stance. A withdrawing

behavior could be used to protect the therapist’s own needs

over the needs of the clients. By detaching, the counselor

may unintentionally emotionally abandon the client at a time

when the client needs support the most.

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Counselor Attitude

Therapeutic Effectiveness of Crying

Few studies examined the effectiveness of counselors

crying in session. Waldman (1994) and Counselman (1997)

suggested that counselors’ emotional tears could be

therapeutic to the client. The connection between emotional

stress and biological process suggested that crying is a

function of the body to maintain homeostasis, thus helping

to relieve emotional stress. In a study on why grown-ups

cry, emotional tears seemed to be associated with tension

reduction. Waldman (1994) interviewed 10 licensed

psychologists with at least 5 years clinical experience.

Each psychologist discussed their thoughts and feelings

relating to an incident where they cried with a client

during a session. Waldman found that nine of the

participants believed their emotional tears were helpful in

facilitating the therapeutic process. One of the therapists

in the aforementioned study reported that emotional tears

were the result of personal unresolved issues, which was not

helpful to the client. With this in mind, it is possible

that counselors tearing up can be the result of the

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Counselor Attitude

counselor’s own struggles and counter-transference. In this

instance, objectivity could be lost and the therapeutic

relationship hindered. Therefore, counselors might perceive

crying or tearing up as non therapeutic and unethical.

Despite that one report, Waldman (1994) concluded that

crying or tearing up with clients enhanced the counselor-

client connection and facilitated the client’s work in

session.

Counselman (1997) conducted a case study exploring the

therapeutic effectiveness of a counselor crying or tearing

up in session with a client. She reported on her work with a

couple in which the wife was dying of cancer. After several

sessions of marriage therapy relating to an affair by the

husband, the author described tearing up when the couple

disclosed that the wife’s breast cancer had recurred.

Counselman (1997) admitted that her biggest fear was that

she would not be able to stop crying and presumably might be

viewed as unprofessional. However, she decided that her

first priority was to be fully present with the couple, even

if this meant crying with them in session. She reported that

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Counselor Attitude

her willingness to share her emotions with this couple

deepened the therapeutic relationship and facilitated the

family’s counseling goals all the way through her client’s

death. She also indicated that this self-exposure “was

healing for me in the way our work as therapists often is”

(p. 237). Corey (2001) suggests, “If you use your own

feelings as a way of understanding yourself, your client,

and the relationship between the two of you, these feeling

can be a positive and healing force (p. 108).”

Social Acceptability of Crying

As a result of specialized training, counselors may be

regarded as more competent in human relation skills, such as

emotional expression, and thus bear more of a responsibility

to model positive and appropriate expressions of intense

emotions to clients. It is hypothesized that most counselors

who encounter crying or tearing up behavior are apt to

discourage it in some way, perhaps because of an underlying

cultural meta message that crying is unacceptable in public

and considered a form of weakness.

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Counselor Attitude

The social message of crying as an unacceptable public

behavior seems to be focused on men. Males in our society

have consistently been taught not to cry and to downplay

emotions. Counselors who find themselves on the verge of

emotional tears may find the experience more profitable if

they have access to images that portrayed this behavior as

acceptable and natural rather than a shameful and a weak

demonstration of emotions, especially for male therapists

(Hoover-Dempsey, Plas, & Wallston, 1986).

Another possible explanation for a counselor’s

unwillingness to tear up in session could relate to the fact

that crying might trigger the counselor’s anxiety and

discomfort, prompting an overly sympathetic response or

emotional detachment from the client. Detachment from the

client in order to maintain an objective stance could result

in a withdrawal reaction in an attempt to protect the

therapist’s own needs over the needs of the client. Given

that much therapeutic work is dedicated to helping clients

express his or her deepest feelings, it is surprising that

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Counselor Attitude

so little research exists regarding counselors tearing up in

session.

Methodology

Participants were drawn from a convenience sample of

counselors and counselors-in-training who were administered

the Tears Inventory (TI). The following illustrates the method

by which the questionnaire was constructed. After an

extensive literature review of articles related to

therapists crying, two studies proved most helpful. One was

an unpublished doctoral dissertation by Waldman (1995) and

the other was a published article by Counselman (1997). Both

dealt specifically with therapists crying in session,

whereas all of the other literature dealt with the client

crying and the therapist’s reaction. Because there were no

previous instruments found that had been used, normed, and

validated, the researcher created the questions on the TI,

seeking to emphasize simplicity, clarity, and brevity. The

questions were created based on the theoretical perspectives

observed in the literature (e.g., gender, social factors,

and stress relief) as well as previous data from an article

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Counselor Attitude

on counselors’ tears (Curtis, Matise, & Glass, 2003). The

questions were written and then given to counselors and

counselor educators to be critiqued for content validity.

According to Likert (1932), a person’s attitudes are an

extension of that person’s beliefs about the world around

him or her. He continued that a person’s attitude is not an

inflexible and rigid element in personality but rather a

range within which responses move. Likert continued that

attitudes are dispositions toward overt action and can be

clustered or linked together to have some predictive value

in relation to conduct in the future. The decision to use a

Likert scale in developing the TI was a way to capture value

judgments of the participants by allowing the participants

to choose from a range of alternatives by using the

following scale: 1 = Strongly Disagree, 2 = Disagree, 3 =

Undecided, 4 = Agree, and 5 = Strongly Agree. For the

present study, the goal was to create a concise instrument

to measure the range of attitudes of counselor’s and CITs

toward tears without sacrificing the reliability and

validity of the instrument.

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Counselor Attitude

Participants of Study

The participants in this study were graduate level

counselors and counselors-in-training (CITs) in a counselor

education program in the Midwest region of the United

States. The counselor education program is accredited by the

Council for Accreditation of Counseling and Related

Educational Programs (CACREP) and consisted of master’s

students in school, community, and marriage and family

tracks as well as doctoral students in a counselor education

and supervision program.

A convenience sample of 157 participants from a

counselor education program was asked to volunteer for the

study. Of the 157 potential participants, 97 participants

completed the survey, a 62% response rate. Guidelines for

the required sample size to conduct a factor analysis have

been indeterminate (Floyd & Widaman, 1995; Gorsuch, 1983;

Nunnally, 1978). Floyd and Widaman as well as Nunnally

suggested that fewer subjects are required to obtain a

satisfactory reliability for instruments with multi-point

item scales. Although more participants are ideal, DeVellis

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Counselor Attitude

(1991) suggested that scales have been successfully

developed with smaller samples. However, a risk of too few

participants, according to Comrey and Lee’s (1992), is less

powerful; a smaller effect size (Cohen, 1988) may increase

the risk of a Type II error in which the researcher may find

significance of a variable incorrectly.

The sample for this study included 23.7% males (n = 23)

and 73.2% females (n = 71) with an age range from 23 to 61

years (M = 35.8, SD = 9.68). Of the 97 subjects, 79.8% (n =

75) were master’s students and 20.2% (n = 19) were doctoral

students. Thirty-six percent (n = 34) of the CITs were

enrolled in the marriage and family therapy track, 33% (n =

31) were enrolled in the community counseling track, and 10%

(n = 10) were enrolled in the school counseling track.

Seventy-eight percent (n = 76) of the participants were of

European descent, 2.1% (n = 2) were of Asian descent, 3.1%

(n = 3) were of Latino descent, 4.1% (n = 4) were of Native

American descent, 3.1% (n = 3) were of Middle East descent,

and 8.2% (n = 6) chose not to specify their ethnicity.

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Counselor Attitude

Table 1

Demographic Information of Participants

Demographics N Min Max Mean SD

Age 93 23 61 35.76 9.68

Gender: Male Female

9423 (23.7%)71 (73.2%)

11

22

1.761.76

.43

.43

Ethnicity: 94 African-American 0 2 2 2.00 .00 European 76 (78%) 1 2 1.19 .39 Asian 2 (2.1%) 1 2 1.98 .15 Latino 3 (3.1%) 1 2 1.97 .18 Native American 4 (4.1%) 1 2 1.96 .20 Middle Eastern 3 (3.1%) 1 2 1.97 .18 Other 6 (8.2%) 1 2 1.91 .28

Counseling Track: 94 Community 32 (33%) 1 2 1.67 .47 School 10 (10%) 1 2 1.89 .31 Marriage & Family 35 (36%) 1 2 1.64 .48 Masters 77

(79.8%)1 2 1.20 .40

Doctoral 20 (21.2%)

1 2 1.73 .41

Experience: 91 None 5 (5.2%) 1 2 1.95 .23 Less than 1 year 36

(37.1%)1 2 1.60 .49

1-2 years 13 (13.4%)

1 2 1.86 .35

2-4 years 12 1 2 1.87 .34

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(12.4%) More than 4 years 24

(24.7%)1 2 1.74 .44

Theoretical Orientation:

91

Cognitive Behavioral

26 (26.8%)

1 2 1.71 .45

Family Systems 25 (25.8%)

1 2 1.73 .44

Psychoanalytic 5 (5.2%) 1 2 1.95 .23 Existential 14

(14.4%)1 2 1.85 .36

Reality Therapy 7 (7.2%) 1 2 1.92 .27 Person-Centered 26

(26.8%)1 2 1.71 .45

Adlerian 23 (23.7%)

1 2 1.75 .43

Feminist 7 (7.2%) 1 2 1.92 .26 Gestalt 2 (2.1%) 1 2 1.98 .15

Instrumentation

The TI is a self-report questionnaire consisting of 47

statements assessing counselors’ attitudes toward crying in

session. Each statement has a 5-point Likert scale

consisting of Strongly Disagree to Strongly Agree: 1 =

Strongly Disagree, 2 = Disagree, 3 = Undecided, 4 = Agree,

and 5 = Strongly Agree.

The initial version of the TI was given to a panel of

experts from the School of Applied Psychology and Counselor

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Counselor Attitude

Education and the Statistics and Research Methods Department

at a Midwestern university for review. The panel of experts

was determined by education, field of expertise, licensure,

and experience.

Procedures

Permission was obtained through the Institutional

Review Board (IRB) of the university. Next, permission was

received to conduct the study from the department head of

the School of Applied Psychology and Counselor Education.

Finally, permission was obtained from each of the

instructors whose classes were sampled for the study. To

ensure confidentiality, all students who completed the

questionnaire were asked not to write their names on the

surveys and to put their answers in a large envelope, which

was provided, after they completed the TI. The average

administration time for completing the TI was 10 minutes;

student’s grades were not influenced by not participating.

Data Analysis

The data analysis was completed in two steps. First,

preliminary analysis of frequencies, distribution, and

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Counselor Attitude

histograms was done to check for item structure and coding

errors. Next, transformation recode was run for item numbers

3, 5, 7, 8, 9, 10, 11, 12, 13, 19, 21, and 22. A principle

component analysis (PCA) was conducted to validate the TI

and determine the dimensionality for the purposes of

constructing summated scales. A PCA is a common statistical

technique which is based on a correlation method. It is used

to discover which variables in the set or items in a

questionnaire form coherent subsets that are relatively

independent. Variables or items that are correlated with one

another but largely independent of other subsets of

variables or items are combined into a factor (Tabachnick &

Fidell, 1996). Criteria for the solution of the factors or

components were based on examination of Cattell’s scree

plot, percent common variance of > 50%, salient loadings of

> .3.0, Eigenvalue > 1, and interpretability of items.

Solutions based on Varimax orthogonal and Promax oblique

rotation were examined for closest approximation to simple

structure. The rotation was used to maximize high

correlations and minimize low ones (Tabachnick & Fidell,

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Counselor Attitude

1996). Orthogonal rotation minimizes covariance of factors,

while oblique rotation allows factors to co-vary. A Varimax

orthogonal rotation was run to make high-factor loadings

higher and low-factor loadings lower (Tabachnick & Fidell,

1996, p. 595).

An item analysis to help determine the reliability of

each of the factors was run using Cronbach’s alpha as a

standard. A descriptive analysis was run on the four-factor

solution. The criterion used for omitting items were (a) a

need to obtain a minimum reliability of > .80, (b) the

increase of reliability due to dropping an item, (c) item

content, and (d) item total correlation (item correlation

< .3 was taken out) to check for weak items. Descriptive

analysis including means, standard deviation, and histograms

were run to check for skewness (with a cut off + 1) and

kurtosis (with a cut off –1 to +2) distribution.

Results

Three main procedures were conducted to obtain the

results. First, descriptive statistics of means, standard

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Counselor Attitude

deviations, and variations were obtained on each of the TI

items to receive a general picture of the data. No coding

errors were found and the sample met the assumptions of

normality, equality of variance, homogeneity, and

independence.

The initial version of the TI could be grouped into

four sections. The first section was Subjective Perceptions of

Crying in Session. This section included statements about

acceptance of crying such as “I believe that crying is a

healthy form of emotional expression.” Other statements were

related to attitudes of crying as a negative reaction, e.g.,

“To tear-up or cry in a session with a client is considered

a weakness.” This section included six items.

The second section was Social Acceptability of Crying which

focused on the extent to which counselors perceived crying

as socially acceptable, e.g., “Crying in public is socially

unacceptable” and “There are times when I wanted to cry in

session with a client and held back because it was socially

unacceptable.” This section included five items.

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Counselor Attitude

The third section was the Therapeutic Effectiveness of Crying.

This section included statements exploring possible

consequences of counselors’ crying in session, e.g., “Crying

with a client indicates a more supportive relationship” or

“When I tear-up or cry in a session, the client feels more

understood.” This section consisted of six items.

The last section measured the Professional Ethics of Crying.

This section included statements that examined whether

counselors perceived crying in session as a professional

response such as “I perceive crying as an effective form of

self-disclosure” or a negative response such as “Crying in

session is irresponsible.” This section consisted of five

items. In addition to the 47 statements in this section, the

TI included a number of demographic questions on age,

gender, ethnicity, counseling track, duration of counseling

experience, theoretical counseling approach, and whether the

counselor had ever cried in a counseling session. Below

(Table 2) are the factors which clustered after running a

factor analysis on the initial (47 questions) TI version

(see Appendix A). The revised TI version consists of 23

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Counselor Attitude

questions (see Appendix B) based on the factors listed in

Table 2.

The first factor loading included six items expressing

the Therapeutic Effectiveness of Counselors’ Crying in a Session, e.g.,

“When I tear up or cry in a session the client feels more

understood” or “Tearing up enhances empathy for the client.”

The second factor included six items. These items

represented the Subjective Perception of Crying, e.g., “Crying is an

effective way of coping with stress” or “I do not have a

fear of crying in session and not being able to control my

emotion” (after recoding the response). This factor was

found to be negatively skewed with a value of –1.48 and a

kurtosis value of 5.19.

The third factor theme focused on the Ethics of Crying. This

factor contained five items; four of them expressed the

negative effect of counselors’ crying in a session, e.g.,

“To tear up or cry in a session with a client was considered

a weakness.” The other two items expressed social negativity

toward crying in session, e.g., “Crying in a session with a

client is socially unacceptable.”

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Table 2

Factors Pattern Matrix PCA Using Promax Rotation Method

FactorsTherapeuti

cEffectiveness ofCrying

SubjectivePerception

sof Crying

Professional Ethicsof Crying

SocialAcceptabil

ityof Crying

Item 34Item 33Item 32Item 36Item 35Item 38

0.9110.9100.8920.8690.8450.423

Item 39Item 41Item 37Item 19Item 15Item 18 (-0.383)

0.7720.7650.7270.7150.5340.498

(0.325)

Item 12Item 27Item 7 Item 17 Item 13

(0.308)

0.8220.6410.5930.5690.518 (0.324)

Item 20Item 21Item 22

0.8060.7930.527

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Counselor Attitude

The fourth factor contained three items, two of which

loaded on other factors. The theme for this factor was the

Social Acceptability of Crying. The overall mean for this factor was

3.04, interpreted as participants’ being undecided on

whether or not crying was perceived as socially

unacceptable. Most of the participants (62%) seemed to

struggle with this factor and could not decide if they

agreed or disagreed with a negative social perception of

crying. Of the four factors on the TI, this factor had the

lowest Cronbach alpha, indicating it contributed least to

the internal consistency of the TI. The eigenvalues for

Factor 1 ranged from .42 to .91 for an average eignenvalue

of .80 for the factor. The eigenvalues for Factor 2 ranged

from .49 to .77 for an average eigenvalue of .66 for the

factor. The eigenvalues for Factor 3 ranged from .51 to .82

for an average eigenvalue of .62 for the factor. The

eigenvalues for Factor 4 ranged from .52 to .80 for an

average eigenvalue of .70 for the factor. The item total

correlation was used to check for weak items, omitting those

items with a correlation less than or equal to .30.

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After recoding certain items, the second statistical

procedure was to run a principle component analysis (PCA) to

validate the TI. The result showed six components with

eigenvalues > 1. Item 14 (“to allow myself to cry means I am

more in touch with my feelings”) loaded on three different

factors. The fact that 47% of the participants could not

decide whether or not they agreed with this statement as

well as the problematic interpretability of this item

convinced the researcher to omit it. Based on a review of

Cattell’s scree plot, interpretability of items, the

percentage of common variance, and the fact that some items

were not highly correlated, a four-factor model using PCA

with promax rotation was used.

To reduce the number of variables and to detect

structure in the relationships between variables in order to

classify the variables to form coherent clusters with common

themes, a factor analysis was conducted as a data reduction

method on the original 47 items of the TI. The decision of

when to stop extracting factors was dependent on when little

random variability remained. The primary guideline followed

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Counselor Attitude

was the Kaiser criterion in which factors with eigenvalues

greater than one were retained (Kaiser, 1960). The second

guideline followed was the observation of the scree test

(see Appendix D). Cattell (1966) suggested finding the place

where the smooth decrease of eigenvalues appears to level

off. Lastly, only loadings > .30 were included in the

factors. Adhering to these guidelines, the TI survey was

condensed to the present format of 23 questions. One

question was added to increase the reliability and create a

more valid instrument. The 24th question was qualitative

(“What does crying mean to you?”) for a total of 24

questions on the TI’s revised format.

Table 3

Distribution of Subject’s Answers in Percents on Each of the Four Factors

Distributions

TherapeuticEffectivene

ssof Crying

SubjectivePerceptionof Crying

Professional Ethicsof Crying

SocialAcceptabil

ityof Crying

Number ofItemDisagree 1-2

18.5% 0% 1% 16.5%

Disagree to Undecided

39.8% 8.3% 1% 38.1%

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2.1-3Undecided3.1 –3.9

17.7% 24.5% 15.5% 24.7%

Agree 4-5

8.3% 52.6% 79.3% 17.5%

Missing Data

3.1% 3.1% 3.1% 3.1%

Overall Mean

2.85 3.9 4.28 * 3.04

Overall Std. deviation

0.80 0.64 0.57 ** 0.77

To determine if the TI was a reliable instrument, a

Cronbach’s alpha was used and reliability for each of the

four factors was determined. Factor 1, the Therapeutic

Effectiveness of Counselors Crying in a Session, was found to be reliable

with a high Cronbach’s α = .91. Factor 2, Subjective Perceptions

of Crying, was found to be reliable with a Cronbach’s α = .79.

No items could be deleted to obtain a higher alpha. Factor 3

and Factor 4 had somewhat lower reliabilities with Cronbach

α = .65 and Cronbach α = .62, respectively.

Limitations

Limitations of this study included no test-retest

reliability to correlate the paired scores. Threats to

internal validity may have included instrumentation and the

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inconsistent testing conditions which may have affected

treatment integrity of the study. Threats to external

validity that may have limited generalizability may have

included the Hawthorne effect in which participants answered

the questions differently simply because they knew they were

being tested. Other validity threats were artifacts or non

anticipated confounding factors that may have affected the

results. These included the “good” subject who tries to help

the researcher as well as the “faithful” subject who is

loyal to the profession and may try to be overly objective

in answering the questions. Artifacts associated with the

researcher included researcher expectations which may have

come across to the participants. Also, the fact that the

researcher knew some of the participants may have placed

expectations on the participants to take the TI.

Discussion and Implications for Counselors

The main purposes for exploring this important subject

were to (a) increase counselors awareness of their

perceptions of crying, (b) promote dialogue for counseling

supervisors and educators who train counselors to integrate

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this knowledge into counselor training curriculum to promote

awareness by helping CITs learn how they may react in

intense emotional situations, and (c) create an instrument

to aid supervisors in determining which style may be

effective to supervise counselors and students.

Supervision is an essential element of counselor

development. Supervisors work with supervisees using a

variety of styles, perspectives, and roles (Bernard &

Goodyear, 2004; Ladany, Walker, & Melincoff, 2001).

Friedlander and Ward (1984) identified different supervisory

styles considered important by supervisees at various levels

of training in different settings. They noted that

supervisors’ approaches depend on their predominant style or

role. An understanding of these individual differences and

their effects can assist counselor educators to determine

which styles work best with a particular supervisee at a

given developmental level. If counselor educators and

supervisors are able to identify specific variables that

influence the outcome of supervision, they may be able to

(a) evaluate their particular styles, (b) target

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interventions that address factors that may interfere with

using a particular style in supervision, and (c) be more

flexible in their approach and style (Fernando & Hulse-

Killacky, 2005; Ladany et al., 2001).

The TI was determined to be valid according to the

extent that the instrument measured what it was supposed to

measure. According to the standards prepared by the American

Psychological Association (APA), American Educational

Research Association (AERA), and the National Council on

Measurement in Education (NCME), evidence of validity are

classified into the following categories: content-related,

criterion-related, and construct-related. Because content-

related evidence is not usually expressed in numerical form,

it was based on the researcher’s judgment and a critical

examination to determine that the content measured by the

test was representative of the content domain. Criterion-

related evidence was based on the relevance of the TI as an

instrument to accurately measure counselors’ attitudes

toward crying in session with a client. In terms of

construct-related evidence, a logical approach was taken to

32

Counselor Attitude

inspect the items to determine their appropriateness for

assessing the construct of crying.

The TI was determined to be reliable according to the

standard error of measurement and Cronbach’s alpha for each

factor (F1 = .91, F2 = .79, F3 = .65, F4 = .62). Some of the

items could be changed or discarded and other items added to

increase the reliability of the TI. As a result of this

study, the TI has been revised to its present format of 23

questions and is accessible as an instrument for supervisors

and professionals in the helping fields to gain awareness on

the importance of crying as an experience to be utilized in

the therapeutic relationship.

33

Counselor Attitude

References

Bernard, J., & Goodyear, R. (2004). Fundamentals of clinical

supervision (3rd ed.).

Boston: Allyn & Bacon.

Blankenship, V. A. (1984). A comparative study of student nurses,

nursing faculty, and

staff nurses in their perceptions of weeping, their weeping behaviors and

their

interventions with the weeping patient. Unpublished doctoral

dissertation, The

University of Texas at Austin.

Botelho, S. Y. (1964). Tears and the lacrimal gland. Scientific

American, 32, 78-84.

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Counselor Attitude

Bugen, L. A. (1983). Emotions: Their presence and impact upon the

helping role.

Unpublished manuscript, The University of Texas at

Austin.

Cattell, R. B. (1966). The screen test for the number of

factors. Multivariate Behavioral

Research, 1, 245-276.

Cohen, J. (1988). Statistical power analysis for the behavioral sciences

(2nd ed.).

New York: Academic.

Comrey, A. L., & Lee, H. B. (1992). A first course in factor analysis

(2nd ed.). Hillsdale: NJ: Lawrence Erlbaum Associates,

Publishers.

Corey, G. (2001). The art of integrative counseling. Belmont, CA:

Wadsworth

Publishing.

Counselman, E. F. (1997). Self-disclosure, tears, and the

dying client. Psychotherapy,

34(3), 233-237.

35

Counselor Attitude

Curtis, R., Matise, M., & Glass, S. (2003). Counseling students’ views and concerns

about weeping with clients: A pilot study. Counseling and Psychotherapy

Research, 3(4), 300-306.

Darwin, C. (1873). Expression of the emotions in man and animal. New

York, NY:

Appleton,

Davis, W. E. (1990). Crying it out: The role of tears in stress and coping

of college

students. Unpublished doctoral dissertation, The

University of Colorado, Boulder.

DeVellis, R.F. (1991). Scale development: Theory and applications.

Newbury Park:

Sage Publications.

Efran, J. S., & Spangler, T. J. (1979). Why grown ups cry.

Motivation and Emotion.

23, 63-72.

Fernando, D., & Hulse-Killacky, D. (2005). The relationship

of supervisory styles to

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Counselor Attitude

satisfaction with supervision and the perceived self-

efficacy of master’s-level

counseling students. Counselor Education & Supervision, 44,

293-304.

Floyd, F. J., & Widaman, K. F. (1995). Factor analysis in

the development and

refinement of clinical assessment instruments.

Psychological Assessments, 7, 286-

299.

Friedlander, M., & Ward, L. (1984). Development and

validation of the supervisory

styles inventory. Journal of Counseling Psychology, 31, 541-

557.

Gorsuch, R. L. (1983). Factor analysis (2nd ed.). Hillsdale, NJ:

Erlbaum.

Hill, C., Mahalik, E., & Thompson, B. J. (1989). Therapist

self-disclosure.

Psychotherapy, 26(3), 290-295.

Hoover-Dempsey, K. V., Plas, J. M., & Wallston, B. S.

(1986). Tears and weeping

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Counselor Attitude

among professional women: In search of new

understanding. Psychology of Women Quarterly, 10, 19-34.

Horvath, A. O. (2001). The alliance. Psychotherapy: Theory,

Research, Practice,

Training, 38, 365-372.

Kaiser, H. F. (1960). The application of electronic

computers to factor analysis.

Educational and Psychological Measurement, 20, 141-151.

Kottler, J. A. (1996). The language of tears. San Francisco:

Jossey-Bass.

Ladany, N., Walker, J., & Melincoff, D. (2001). Supervisory

style: Its relation to the

supervisory working alliance and supervisor self-

disclosure. Counselor Education

& Supervision, 40, 263-275.

Likert, R. (1932). A technique for the measurement of

attitudes. Archives of Psychology,

140, 5-43.

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Matise, M. J. (2006). Counselors’ attitudes toward their crying in session

and perceived

emotional intelligence: An exploratory study. Published Doctor of

Philosophy

dissertation, University of Northern Colorado, 2006.

Nunnally, J. C. (1978). Psychometric theory (2nd ed.). New York:McGraw-Hill.

Rogers, C. R. (1980). A way of being. New York, NY: Houghton

Mifflin Co.

Tabachnick, B. G., & Fidell, L. S. (1996). Using multivariate statistics (4th ed.). Boston:

Allyn and Bacon.

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psychotherapist cries

during the therapy session. Unpublished doctoral

dissertation. Massachusetts

School of Professional Psychology, Boston.

Appendix A

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Counselor Attitude

Tears- Inventory (TI)_________________________________________________________________

____________

Please answer the following questions, while thinking about

yourself tearing-up or crying in session with a client. Since no

names are used, please answer as truthfully as possible about

your experiences with tears. Even if you are uncertain about

something, answer as closely as you can about what is true for

your tears, and answer every question. There are no right or

wrong answers.

_________________________________________________________________

_____________

FREQUENCY OF CRYING:

1. As a counselor I tear-up or cry in session with clients.

1 2 3 4 5 never rarely sometimes often

very often

2. I have teared-up or cried in front of someone during the

last 6 months.


very often

3. I have often cried or teared-up during the last 2 weeks.

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Counselor Attitude


very often

4. During the past 6 weeks, I have allowed myself to cry or

tear-up on more than one occasion.


very often

5. As a counselor, I have cried in a session at least once,

during the past 6 months.


very often

TEARS AND COPING WITH STRESS:

6. Tearing-up or crying can be an effective way of coping

with stress.


very often

7. Tearing-up or crying makes me feel relieved?

1 2 3 4 5

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Counselor Attitude

never rarely sometimes often

very often

8. My perception is that clients cry when their emotions

overwhelm them.


very often

9. I cry or tear up when I feel down in order to feel better.


very often

10. I usually tear-up or cry when I am under a lot of

stress or pressure.


very often

PERCEPTIONS OF TEARS:

11. I believe that tearing-up or crying is a healthy form

of emotional expression.


very often

12. I have a fear of tearing-up or crying in session and

not being able to control my emotions.

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Counselor Attitude


very often

13. To allow myself to cry or tear-up means I am more in

touch with my feelings.


very often

14. To tear-up or cry in a session with a client is

considered a weakness.


very often

15. I perceive myself as a sensitive counselor in training

because I’m not ashamed to cry with a client.


very often

16. I perceive crying as a sign of weakness.


very often

CRYING AND SOCIAL INFLUENCES:

17. Tearing-up or crying in public is socially

unacceptable.

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Counselor Attitude


very often

18. Tearing-up or crying in a session with a client is

socially unacceptable.


very often

19. There have been times when I wanted to cry at work but

have held back because it is socially unacceptable.


very often

20. There are times when I wanted to cry in session with a

client and held back because it was socially unacceptable.


very often

21. There are times when I wanted to cry or tear-up in a

public place but have held back.


very often

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Counselor Attitude

GENDER AND TEARS:

22. I am more willing to tear-up or cry in session when my

client is male.


very often

23. When my client is female I am more willing to tear-up

or cry in session with her.


very often

24. I define my gender role as traditional in social

settings.


very often

25. I define my counseling role as traditional while in

session.


very often

26. When someone is crying, I try to get them to stop so

that they feel better.

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Counselor Attitude


very often

CONTEXT OF CRYING:

27. I tear-up or cry at work or in public.


very often

28. When I am alone I am more prone to cry or tear-up.


very often

29. I am more prone to cry or tear-up when I am at home.


very often

30. When I am with close friends I am more prone to cry.


very often

31. When I need support I am more prone to cry with

immediate family.

1 2 3 4 5

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Counselor Attitude


very often

THERAPEUTIC EFFECTIVENESS OF CRYING:

32. When I tear-up or cry in a session, the client feels

more understood.


very often

33. By tearing-up or crying in a session, it enhances

empathy for the client.


very often

34. When I tear-up or cry in a session it increases

rapport with the client.


very often

35. I feel more connected with a client when I tear-up or

cry with them.


very often

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Counselor Attitude

36. Tearing up or crying with a client indicates a more

supportive relationship.


very often

PROFESSIONAL ETHICS AND CRYING:

37. Crying or tearing-up in session is irresponsible.


very often

38. I perceive tearing-up or crying as an effective form

of self-disclosure.


very often

39. I believe that tearing-up in session is

unprofessional.


very often

40. I believe that crying in session is unethical.

1 2 3 4 5

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Counselor Attitude


very often

41. I perceive tearing-up or crying in session as

unethical for counselors.


very often

CAUSES OF CRYING:

42. At the death of a loved one I am more likely to cry or

tear-up.


very often

43. I am more likely to tear-up or cry because of the end

of a romantic relationship.


very often

44. I am more likely to cry or tear-up while watching a

sad movie.


very often

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Counselor Attitude

45. At a celebration, such as a wedding or graduation I am

more likely to cry or tear-up.


very often

46. I am more likely to tear-up or cry when listening to

sad music.


very often

47. I am more likely to cry when I feel powerless?


very often

What do crying and tears mean to you?________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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Counselor Attitude

_____________________________________________________________________

Age: _____

Gender: ___Male ___Female

Ethnicity: ____African Descent ____European Descent

____Asian Descent

____Latino Descent ____Native American ____ Middle

Eastern Descent ____ Other

Counseling Tract: ____Community (Masters) ____School

(Masters)

____Marriage and Family (Masters) ____Other tract

How long have you been counseling? ____None ____Less than

a year ____1-2 years

____2-4 years ____More than 4 years

Faith Preference: ____Christian ____Jewish ____Muslim

____Hindu ____Buddhist

____Islam ____Other

Please describe your current theoretical approach (check all

that apply):

Cognitive behavioral theory ____ Person

centered theory _____

Family systems theory ________ Adlerian

theory __________

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Counselor Attitude

Psychoanalytic theory ________ Feminist

theory __________

Existential theory ___________ Gestalt theory ___________

Reality theory ______________ Other __________________ (please specify)

Please provide your comments on how we can make the TI a more clear and concise Instrument.________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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Measuring counselor’s attitudes toward crying: Development of an instrument

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