The Impact of Metaphor on Clinical Hypothesis Formation and Perceived Supervisor Characteristics By: J. Scott Young and L. DiAnne Borders

An analogue methodology was used to examine clinical hypothesis formation and perceived supervisor characteristics when metaphorical or literal language was used by a counselor supervisor. Article: In the clinical practice literature, the use of metaphorical communication has been widely cited as an effective intervention (e.g., Bandler & Grinder, 1975; Fine, Pollio, & Simpkinson, 1973; Gore, 1977; Haley, 1987; Martin, Cummings, & Hallberg, 1992; T. Strong, 1989). It is believed that metaphors help clients gain new perspectives on their counseling concerns by generating a wide variety of associations among previously unrelated cognitive structures. As a result of creating new relationships between these structures, clients identify new possibilities for behaving and effecting change in a problem area (Fine et al., 1973; Martin et al., 1992; T. Strong, 1989). In fact, Pollio, Barlow, Fine, and Pollio (1977) found that therapeutic insight often co-occurs with the production of novel metaphorical communications (i.e., language whereby one object is compared to another in a direct manner although in a literal sense the objects are not the same). They found this was true regardless of who generated the figurative expression, the counselor or the client. In general, then, metaphor is considered an effective means for helping clients achieve alternative interpretations of situations and gain increased insight into the functioning of self and others. One reason metaphor is believed to be an appropriate means to promote clinical change is that it relies on communication at both the conscious and the unconscious levels. It disrupts "the client's conscious frame of reference while generating an unconscious search for new or previously blocked meanings or solutions" (Matthews & Dardeck, 1985, p. 12). In this way, metaphor promotes more complex thinking, because clients use divergent thinking patterns to develop alternative conceptualizations of difficult situations in their lives (T. Strong, 1989). Such cognitive changes also have great relevance for counselor supervision. In particular, supervision goals include the encouragement of greater divergent thinking and reconceptualizations of client concerns as ways to promote counselors' awareness of previously unrecognized strategies for change (e.g., Blocher, 1983; Loganbill, Hardy, & Delworth, 1982; Stoltenberg, 1981). According to Blocher, characteristics of the highly functioning counselor include abilities to "take multiple perspectives," "differentiate among and manipulate a wide range and large number of relevant facts and causal factors," and "integrate and synthesize in creative and unusual ways large amounts of such information to arrive at an understanding of the psychological identity and life situation of a wide range of other human beings" (p. 28). In fact, numerous researchers and theorists, in both counselor training and supervision, have argued that the development of counselor cognitive processes and strategies must be an integral component of counselor preparation (e.g., Borders, 1989; Fuqua, Johnson, Anderson, & Newman, 1984; Kurpius, Benjamin, & Morran, 1985). These experts argue that cognitive processes are central in counselors' attempts to formulate and select behavioral responses while engaged in a counseling interaction, as well as their ability to generalize attained skills to unique situations. The cognitive counseling skills involved include the ability to deftly collect information about a client, weigh alternatives, formulate viable clinical hypotheses, and select appropriate intervention strategies (Morran, Kurpius, Brack, & Brack, 1995). Proficiency in these areas is important, because it is the use of these cognitive skills that ultimately determines the productiveness of the counseling process. Given the importance of cognitive skill development, it seems ironic that most research to date has focused on performance skills (i.e., empathy, self-disclosure, confrontation) even though it has been argued that the development of the cognitive counseling skills are equally, if not more, important in the development of the counselor-in-training (Fuqua et al., 1984). In fact, as early as 1980, Holloway and Wolleat noted that counselors with more developed cognitive abilities were better able to produce effective clinical hypotheses; subsequent work has supported their conclusions (e.g., Holloway & Wampold, 1986). Furthermore, there is some evidence that counselors who produce better hypotheses are more effective clinicians (Morran, Kurpius, Brack, & Rozecki, 1994). Despite consensus on the importance of cognitive skill goals, few authors have identified supervision methods specifically focused on achieving these goals. These desired outcomes of supervision, however, are similar to the desired effects of the intentional use of metaphor. For example, a spoken metaphor can be used to synthesize various components of an existing situation by suggesting new relationships among the variables involved. This creates in the individual who hears it a previously unrecognized perspective and new understanding. Similarly, the combination of pieces of information into new understanding is a desired outcome of supervision. Yet very few authors have discussed the use of any form of metaphorical intervention in supervision. One of the few metaphorical approaches that has been discussed are the case drawings described by Amundson (1988) and Ishiyama (1988). Both authors describe metaphorical drawings, a technique in which supervisees create drawings (i.e., metaphors) of the dynamics that they believe exist in their difficult cases. Neither Amundson nor Ishiyama, however, provided empirical support for the effectiveness of their metaphorical interventions, although Ishiyama did report that 13 of 19 participants in a supervision group preferred the metaphorical approach to case conceptualization "without reservation," considering it superior to the traditional case report method. In addition to the potential for the intentional use of metaphor to facilitate the cognitive skill development of counselors-in-training, its use may also affect the counselor's perception of the supervisor. There is some evidence, for example, that a counselor's use of metaphor has a direct influence on the client's perception of counselor desirability or social influence (Gore, 1977; Suit & Paradise, 1985). Suit and Paradise found that when counselors used narrative analogy metaphors (e.g., those that make a direct rather than implied comparison between a subject and an object) to discuss clinical issues, they were rated as "more expert" by undergraduate psychology students; this was as opposed to counselors who used cliches or very complex metaphors. Similarly, Gore found that high-quality, creative metaphors presented in the early stages of counseling were useful in arousing client interest in the counseling process. It may be, then, that the intentional use of metaphor by clinical supervisors would have an impact on (a) the cognitive counseling skills of synthesizing extraneous clinical information into viable hypotheses and (b) counselors' perceptions of their supervisors' social desirability and influence. Thus, the purpose of this study was to examine the impact of a supervisor-generated metaphor on supervisees' formulation of a clinical hypothesis. Specifically, we investigated how the use of metaphor affected perceptions of a supervisor in terms of social influence dimensions for a sample of counselors-in-training, as opposed to the undergraduate sample examined by Suit and Paradise (1985). To study the impact of supervisor-generated metaphorical communications on supervisees' formulation of clinical hypotheses and perceptions of supervisor social influence characteristics, a methodological approach was needed that could manage the ambiguity inherent in variables such as metaphors and cognitive processes. In addition, because metaphors need to be relevant to a particular client or issue, it would be inappropriate to use the same metaphor across clients, across supervision sessions, or across counselors (Muran & DiGiuseppe, 1990). Therefore, conducting this study in a naturalistic setting would be difficult to manage, because the treatment (metaphor) could not be replicated. The analogue approach is useful in controlling variables for specificity and allows for greater precision (Heppner, Kivlighan, & Wampold, 1992). Furthermore, the analogue design provides more direct and unambiguous answers to research questions that are not always possible to investigate in naturalistic settings (Heppner et al., 1992). By isolating the variable of interest (i.e., metaphor versus direct language), it was hoped that the effect of metaphorical communications in clinical supervision could be examined more accurately. In summary, this study was designed to address the following research questions: 1. What impact does a supervisor's intentional use of verbal metaphorical communications about clinical situations have on supervisees' generation of more varied and complete clinical hypotheses? 2. What impact does a supervisor's intentional use of metaphorical communications about clinical situations have on supervisees' perceptions of the expertness, attractiveness, and trustworthiness of the supervisor?