[PAGE 1]
Kamtes Suugrojaet97

At
pato ef Grigimal Pertea Ties Extenéed · Alloternt
11 Cuguil 1959 Covered To Asovnt cT Colisetlea 6m100 8 25-1009-49 8 750.00

Inveica Sueber Ancont eea 250ugs .00 2Jeh60 50 0-0 .4 RENAL

[PAGE 2]
Final Accounting

-Balance Sept, 30, 1960

8.247.02

Disbursements:

Salaries and wages 4,757.70
Supplies and Sorvices 1,063.65
Equipment 2,059.89
Travel 365.78

Total Disbursements

8,247.02

This is a true accounting from the University of on the balance in Dr grant.

I have examined and ezsroved tho subaitteà exponditucs.

Nov. 1, 1962

[PAGE 3]
Soptepbor 19. 1960

As you tcos, ke toe a reqalrement on all aants fhat a final aceoeting and rarort ta auteattcd totho .Tho laet tho mrants ear in th2 aurunt of co,750.00 lave not Sson acoountod for. .I tono aroeeiate it ir pyou could arrenge to huve the accownting sont to us as soon as possible.

Thds is pnely an adidistrative sattor xel if you tould prefer that I vaats to the Uadversity direotly l shall be hapy to do so.

I hope that you had a ploasant sweser and that wo uill seo you 1 in tho noar lnture. Best personal regats.

Shnverely

assistant Troasurer

[PAGE 4]
Jenuory 28, 1960

Attsched is por check for \$4,375 whlch reproscnts half payment for continvctiog of to reasa ón

This covvatat ls formal notificotlon that sucpor for this ressorch has been extonded for an eddirionel 6 month perlod January 1, 132 to June 30, 190.

The condttioas stipulated In the orlginal crart opply acually to thls continvotion.

The Eoard of the ced Iis stelf nembers are cctremely plcosod viih tho perress medo unlor tds profeef In : Telllol pertod. We entictpote a moter ecatrioution in the aris of pyshotherapy os well es In the bosle theeries to reault froaa thdo inportont stody.

Sincerely youra,

toa 1

[PAGE 5]
0o

95

Cost Account 0525. 1009-4902

Objęct Class .

14

[PAGE 6]
23 Jamry 1900

ASURETON t Fipcnce Divisioa

GONIACT

1 1232A, Sugrojsct 97 Aubrisation pa

Voder tha authocity cranted in tha Mecorandua dated 13 Apc11 1953 Pro Uhe D0l to the 1o/e, end the extensioa of. Ois authority in svbcoaat senoranda, Sudrojeet 97 bos basu epproved ond 80,700.00 of the over-sll Yroject HaiaRA twmãa. tava baea obliaosted to cover tho sctprojeet\*a oxpenses kot shou13 bo charze4 to A11otamnt 0525-1009-bp02.

T83/Chaaioal Division

A2PROVED FOR OSLIGNTION

1

L CTY THAT UNOS ARE VARA - OHGATONRNN 0795109.4902

rotaL

168

Distvibution Crig 6 2 = ¿cdenaseo 1 . 532/00

8o

[PAGE 7]
BURCPANARA YOR: CHTP. FINAXCR DIVTOIOR

VIA 1 T3o/mágat ofxicor

:.Eaa76. Eubrojact 97. Invotee Ko.2 6120t020t 0532-100)-4902

1. Involco Eo. 2 is attaehed covering tho sbova sudprojcot. Payszat choola ba male as follovst

B

epicaso forwand-the-check-to- (hiot, Tos/ohonieal Dvision Uarouoà Tas/Eodgot ofricer by Teasday,: l6 Pabruary 1960.

3. sbia is a linal Luvoive.· Eavover, cince 1t is entidipated Uhat adaittonal fualo vill be obligated for ttis. proj-et, tha rilos ehoula not bo clocod.

Chios 20s/Chesical Divioton

Atteohoent: Trvotoa & Cortiriceticos

Plotrlbusiont Qria d 2 = Aldressoa 1 - TSS/FASB

-00 AVATAS
CCUCAION T
CEARSLT 1 1535-1003 4912

2 Pobresry 1960

[PAGE 8]
Invotcs

For sorviços

43,750.00

CERTLICATICNS

() It is hereby certitiod thsé thia 1s Invoics No. 2 applying to Öubpvojeet Ho. 97 of IaaRA, that porforaanco is catiofactory, that sorvices are boing acccplished in eccorãanco vith wutual agroensnte, that e dstailed aíenda ox tho payaonta aná recoipts is on file in Tos/cs, that this bill is juat cnd correct ead that paywent thereor has nos yot deen rsde.

Chter,

Datel

(2) It is hereby cortified that this iavoice applies to Gubprojoct Ko. 97 of Nonpaa which vas culy suprovod, end that the projoct is boing carried out in cceontance vith tho roeorendua or 13 April 1953 fros ths WCx to the Dp/A, and the extencioa os tais authority in subooqoent aeaoranda.

Pesoereh Directoe.

[PAGE 9]
Receipt is hereby acknowledged of the folloving:

[PAGE 10]
20 Jommary 1960

ES:03NOH POR1 CCGETROLER

Arsuctui1Finasce Dtvistoa

CUNJSOT

1ama4, 8okpaojeot 97
lntoaiaatica f2

Vader Va aothority gaeated 1n ths leaorantva datod 13 6or11 2953 8v3 th9 101 to vhe 20/6. 421 0.e sxtencica of. thio culkovlty an avloecvont sacteado, Cubyvojaot 97 bos been epp1oved caad o,750.00 o2 the over-all Projeot MULCA Cunda hsva bce5 cb13cat24 to covor tbs 6cbprojeat's expouaas cod cheua bo charzed to A11otoent G685-1002-kg02.

108 Cieoteal Dtvietca

roa cEIleNICU OP FOE31

LateL

plsiritetton 1 上 2  TSS/CD

TSS/cv/(28 Jan.60)

[PAGE 11]
SUBJECT : Contimuation of MKULTRA, Subproject 97

1. The purpose of Project MTRA, Subproject 97 1s University to supplement the resesrch program of Dr In accordance with the attached proposal and progress

2. Long tera support for this study has been provided The
by two grents from the
present rqquest is intonded to supplement the project and provide
a mechanism for evaluating certain techniques of influencing human
behavior that may have Ageney significance. This support will make
it possible to have continued free access to the project and, when
applicable, use the facility for consultation ard support. 3.The\_project wlll be funded through the

for security and cover will supply the purposes snd the University of with copies of the records of disburõements related to the operation of the project at its termination. Title to eny permanent equipment purchased under tbis projeet will be retained by the University in lieu of overhead charges. Any unused funds will be returned. to the strupon tereination of the grant.

MEMORANDUM FOR: THE RECORD

[PAGE 12]
h. The total cost of this project for a period of

six months 1s estimated not to excced \$8,750.00.. Charges should be made against A11otoent 0525-1009-4902.

5. Prof holds a covert Agency clearance and

is vitting of sponsorship, all others are unwitting.

APPROVED FOR OBLIGATION OF FUNDS:

D2te:2///60

Attached: Proposed Budget Proposal w/Progress Report

pistribution: Original Ooly

97.2.

97-10

[PAGE 14]
Inbroduction

Thio is a raport of progress doring tho pericd July 1, l958, to Deocrbor 1, 1959, on the above projcod. Pündo durirg tho period July 1, 1958 to the presoot have boen supplied by tuo grants from the Foundation throvgh tho Uriversity Research Coumittoe. Additional funds siree July 1, 1959 buve been supplied by The majority of the profeosioyal time on the projeat has beeu volunteered by combers of tho Dopartrents of Peychiatry aud Psychology, Univeroity of ond mmbars o? the stalf of Hospital. Without this effsotive and valuntary cooperation progross cn tho project vould have been inposalble.

Parb Y. Synopeip of Propgsod Pepearch

Full datsils of the researeh plm aro contained in an earlier proposal. If the readov is thoroughly Zandliar wioh thie, he might wish to tura ab oncu to Part Il. Hias Collous is a brief statemront of the major olcpenta in ths pesoarch dosigae

Genaro, Pucpogot Tho genoral ata of this roscaroh is to make an Actensivo study of the prozons of ehenzo in peraouality and behavior ao it cesura in sehisoplmoaie aud sormal indiviaaals doring tho period

I. Tao dagreo and tote of thovagoutle chaege vill- bo poudtively 0oroteéed vish the dogvoo to uhtch tho "oondttions of chovapy" axist

97.2

University ofape Decembor 1, 1059

Prógross Roport of Roooaroh Projeet

[PAGE 15]
in tho particuler client-thorapist relationship. Tho cordttions of theraps are those bypothesised byr

97-10

I. The proceus of porsonality chango in psychotherapy vill he found to be the ssno in tho chronio schizophrenio, the aeute schisophrenio, and tho woll-adjusted nornel porson.

TI. The process o? thorapy will occur to a significantly greater degreu in the groap of individuals to vhom therapy hes béon offered than in a contzol group paired end matohed to tho oxpsrinoutal groups in nhfoh such individasl therapy has not been offered.

Desiga: Eash of ight therapists is given a tried of clianta which includes an acite schisophronic, a. chronio schizophreuio, and a normal. Each of these three clieuts has a matched coutrol vho does not recsivo tharapy.

The design is a 3x2x2x2x2 feçtorial design indicated in the follosirg chart. Controla

1. Old tud young reñer to a6o couparod to median Zor group.
2. ligh and lou rofer to ecvcatiooclçoccupational. status.

3. Lottsro rafor to the therapioto, asoignod to a rantomiy soleatod talede

h. Eroh coatrol. (irdoutod by x) will veooive tho sama bsttory ot tosts and tcesuveo as tho erparimentel individuals, but no tbecary.

900.2

O

[PAGE 16]
Maior losiron Veriablos

97-10

1. Exporisentàl. subjocto (2h) anà coatrol (24). h8 individuala in doaign.

2 Acute  Cbronic - Normal

Aante: Loss than 8 months total hoopitalisstion, and current staff diagnosis of sohizophrsaia.

Chronic: Rore than 8 months hospitalization aed staff diageosis of schisophrenle vithin last five years.

Porual: Individcals aelsoted by tests end ratings as velle adjustod, vho matoh the hospital population on chavaotoriutigs beloã.

All six irdividuals in eny borisontel colvmn of the chart are matched

on the pext throe itonse

3. Ago: Matohed en "olda or "young" in toras of tho nadian age cbronies (33) and aouts sehisophrenios (33) in the state of

ho Soxo

5. Boncation-occupation: Cha ssed as bigh or low, using a modification of the Hollingohezd-Redlich Soele.

Each sxperinsntal-control pair is. tot only. matched on the above items,

but also on tho followingo

6. Rating of dsgreo of psyoho-secial disturdanco mado on basis of modified Iabopsky Health-Sickmoss Scale.

7. Netohing agos, with disereporoy of no more thea nino yoars uithin the goneral classification of "old" op "young".

The nonber of the pair to recsive thorapy is celscted by tha toss of a coin.

Critoris for Selection of Hospitol Fopalation

l. Diagaosis of selisophrenza vithout conplications saeh as broin damage or rental defect.

2. No uoro than 50 trastments of ESr and/or IsT prior to seleetion.

3. No psychosurgory.

le Noreal intalligenos (8o) confieued by project adminisbration of Weatislor, Adult Indolligenco Scale.

5. 1go botcou 15 and 59.

[PAGE 17]
Reorvitrout oz Fopulabions

Hospital: Nvery patient who soots the above eriteria is adnitted to the projeet regardloso of vard. In order to icontify all the paticats eho ncet tho criteria a distillation of alt hosoital recorde has been made.

Normals: High edycational-occupational nornals vere rooruited fron a local church couplos' club.

Loy, ednoational-occupational nonmals peleoted fron a goneral hospital porsonnel list of low jacomo employees.

Anoshov group reproseating the agricultural elemont evident in the bospital population is coning through referençes froa rural sooial tork agonosa

Toste: Ieitinl and at Siz Honths Tntervals

Exporizentals and controls receive the sano battsry of tests which

consists oft

Rorschach, laPI, TAP, Q Sort (a seriee of eighty cards oach containing a solf-roferens statenent vbich are plaeed cccording to a specified distribution from thoso statenents least liko the inöividual to thoso most like hin), WAIS, The Stroop Iotorference Test, F Soale, (or Fasuies soale as is is also krowo, bas boen vueful in diatinguishing botwaen people who respond to therapy ond thoso who do not), Truex Anxiety Soale, Banoaritiug sanple.

This battery is adtristored ao soon as a subject io.adaitted to the project, and at six month ittervals.

Tosts: Teisial and at Threo Months Intorvals

In asditien to the above there ero other moasures which are given at

shouber intervals.

Souoling Iototyiov: Both experinentals and cortrols are given an hals hour recopded interview condeotod by a psyohiatrist who is not one of tho projeot thsrapists and sho- has co other contaot with tho pabignts, Fron this data thc folloaing naterial will be availabls. l. Instrueonts dovoloped for bhs thorepeutio interviews will be appliosblo to izo seaplo intervisua.

2. For expopimontol subjests, conparicono are posoible betwsen their behavior vith tuo alftorent interviovers.

3. All subjeots con bo cospared in thoir interaction with one spandard iptervlcuor.

Whitterbora Echavior Ratirg Sonte: Applicable to hospital population only JWs.filled ort by word peroontol. Cilled

[PAGE 18]
Milteu Scale: Applicable only to experimontals aod is filled out, by tho thorapist.

Relationship Irvcntory: Doveloped by Barrott-Lennard. Administered to thereoy patients und thoir theraoists in order to moasura the therapcutic rolationchip. Also adniniatered to controls who aro esked to flll it out in regard to "tho peroon who has meant the most to you in ycur trouble."

Tho tosting schodulo is neintainsd phethor the patieats are in tho bospitel, traosforred or discharged.

Part Il. . Prograsa Already Made

Seleotion of Matohed fopulations

Hospital: 32 of the h8 cello in the design are to bo filled by hosoitelised indlvidvale. 3l of thoso have been filled.

In three instauces thvs far, the individeal refused to bo tested, refussd to be seen in thoragy, or rafused to have interviows recorded. Thus aajor blocks of data wero unobtainablo. In theso instances altornativo inoividuals wore seleoted and placed in the design. Hovover all possible data is being collectede-tests, therapy notea, ets.--fron the original selectees, so that the degres of bias (if any) involvod in tho uae of those altornates can be cstimated. Thus 3h . itdividals have beon scleoted in filling the 3l. oells.

Normal: Of tho l6 novnals to bo seleoted 5 have beon seleoted and 8 othevs ore in proooss of boing selected Yron an available group of h0. Progroos has been handlcapped by lack of funds and lack of psychometrist timeo

Adainintratlon of Tests erd Hsorureaしし

Initial: The ipitial battcry has been adainlatored to the esporiuontals and controlu adatttad to Ghe studye Sinoe it has not beon possibls to adaioloter evexy teot to every individaal erd since

[PAGE 19]
fron tost to test as folloaso

Threo lonths Teots and Neasures

Tha first chree mocth period has already been comoleted for a mugoer of individuals, and fron this souroe tho folloaing tosts aro available. (Tuose avo kn eddition to.cha initial tests.)

6ix Boutbs Battory

The six mohth battory is bodog administeved to 9 ax ęrimentals

and 6 controls. Tho following have beea completed.

Thepaot

Pistcen-of the exparinentals have boen cngaged in thorapy, but

of te 15, 73 havo been uilling to havo alt of thair taarapy

wocorded, end vo alveady havo la3 tuçe reeordsd Anterviavs

[PAGE 20]
fron this group. Io addition thoro avo a few diotated aoboints dr intcrvicus hald in the isolation roon or undor other cireumstanceo whore the rocorter failed or recordings were not possible.

Additional Data

Gomplote records of pationts redication and the muber and rolationship cf visitors hes been collected to date acd is being malntaiaqée

Prom the survey of patieats: records ve nou have complote data on all patients in the hospitel concerning ago, diegnosis, sonattc therapy in eoxoss of 50, logation in state, end filo musber.

Completo cociologiçal data is about to bo compiled on the patients iu the projoote

Troneoriptions

Work hag begua on trensoribing intervisvs..

Part IIT. Ourrent Evaluasion of Project

The Eerrisra to Theragz

One of the greatost diffiçulties wo have enoountered ls one whioh had been partially foreseen, nenely the absence of potivation or corseious dosirs for help.

Waen individuals are selooted by objective criteria of the sort wo have ueod, it moans thad mary of thon feel no need for therapy, aad ars not regarded by hospital staff as good bots for thorapy. When in nccitioa nany of thoso individuals ero of relatively lov sociooducational statvs, vhere according to Hollirgohoad end Redlich, tharapy is not a : porb of thoir axpcotstion, the diffioulties avo multiplied.

Ve peslsoad at tho outset that thio vas eo sovoro a tost of pryebotherapy as could bo devibed. Our axperienco to dets meroly enser vs to sadorsnoro thad ybatemend.

97-2

Lobated

[PAGE 21]
It has oftçn been maintained that the type of data collected in this projeot and tha type of rocording, stratifioatáon and control proceduos attompted in it aro impoosibls in a hospitalised sattinge Tre difficulties are said to plooo suoh limits upon ezperinental rigor as to make the pssults-seiontifically qusstionable.

The difficalties ve have encountered in this projeot corbainly shoy that most of the pablished diccuosions of. the dirfloulty of srch roscarch are very nearly sccurate.

Kost difficultses concern arraogemonts betveen people. For. examplo, ono persistont difficulty lies in fincins,, end remaining ia contacb with, specizia iadividuals. It heo often taken many hours os offord, expended over a. period of a veek or rors, befors a given patiend actuslly spends one hour vith a psyehomotrig)e Often may 1 attespts eust be made beforo one test io successfulty. adainistered. Somotines many ueska of such efforts are required defore an individual complstes a tost battery. Unforesoen events inseefere with the patieut's availeilityo :Drugs, trenpfor, discharge, or che ge in his paychological coudition somotisss invalidate the Pesults of many weeks of effort.

Tho smouot of tine and vork to be expendod for a givea researoh vesult is so rngnificd that it is ofben difficult to diotinguimh a shendodáll fron pointully slow progress. Only a devoted otaff oan : exoure this.

It the enorzons tire expandituro is onos eocepteo, the basio qpestion is: doss this very slow progress add up to a sufficlently migorwras recearoh to allow solontifio conslusionat Or does evon the olouly acormmlated dete su²fer from liultationa uhich throw doubt on ito veluc? la the prossrb otago of the projoçt vo cea bogin to cuovex this

O

O

Tho Barrioca to Rigorons Dosian

99-2

[PAGE 22]
question. Ne have cono far onovgh to bo able to dintirguiah sheer cifficalty snd timo loss from irhorent linitations placed on scientiße rigoro

Barriors to Data Analyeis

One of cur Ereatast bapriers has bsen lack of funds. Althongh there is a great deal of data acovaulated already ye have been vaable to make even a sxal). start on its eoalysis dee to lack of funds and porsonnel. This preblom is beconing nore aeute as the tost protocols, rocordings of ssupling intarvieao and of therapy intorvieus, and other measurexeut data contime to pilo up.

Te Acsured Aspzoss of the Resocrch

Prom the progross already made it appears that the following are dofinktoly possiblet

a) À population ssleotsd socording to a stratified design of variables, ege, sex, social class, end longth of hospitalisation.

b) Exporimoutal-control paivs matohed on theso variables end on an intorviow rating soalo of ths degres of disturbançee

c) A poriodic tost battory consistirg of the Horschach, MPI, TAT and several obber neaoyreq.

d) Periodic recorded samplirg intervicuo of all experinaatals end conorols with one stsndard interviesoro:.

e) Becordkngs of alnoat all thorapy hours.

x) Comparative analyais of the process of therapy in schizophrenics ad noraals, in tho many veyo alroedy plannod in thio study, ond in any nes vags which may bo davisod.

The Possibilitico Xoherent iu the Data

Ths great vango of the data wo aro collooting is inporbant both for
tosting our quo hypotheses ond for the tosting of hypotheses by others
uhea tho data is pnblichod er othernice mado aveilable. Hany sigrificant t. 7

ixtocilsgcicpe becoro posaible.

[PAGE 23]
The atratitylng varisblesago, gex, chroniolty, deg cooio-odecational level-can bo studied in relation to tte individpal'a accaptanco of theropy, procoso changes in therapy, outeoue of therapy.

The various measures-or the eliont personality, of the client's behavior, of the therapoutic relationship, of the procoss changes in therapr-cen be studiod in thoir many iutoprelationebips.

The relationebip of reasures applied to the sampling intorviovs to measures applied to tho therapeutio intoroiewvs opens a wide field of investigation. A firet study in this avea will bo to compare, in a sorios of paticnts, ths firot intorviews hold by the therapist with the fivst interviews hold by the peapling iaterviever.

Tho relationship of various psychometric instruronts to indioes of prooess in thoragy, and to degree of movennt in therapy, can bo studiede

In short, it alrordy appears cloar that tho dosign can bo oarried through, approxinatoly as plamnod, with a satisfaotory degree of rigor. The groups can be looated, tho individuals can be matohad, the tests can bo adainiotsred, therapy cen be offered, rocordings can be made, in nost inotoncee.. Thuo ve will be able to test not only tho major hycothoses cet forth ln the begineipg of this report, bus a vealth of additional lypothosss which the dats makes possibles

Io nou seeas olear that tho findingo of tho rosearch will. bo of the ordor suagestod by tho folloaing obatecents.

Io io (oy is not) posoiblo for thorapists to outrblish tho somo oondittons of therapy vith coaisoplienieo as vith aouals. Tha vreeeea ot tharaor involves (or does not involve) the sano charaatartstio changes ia schizophupenico as in sopnala. The corditions o? czloctivo therapy cad tho pregoss of effeotivo thovepy in schtsopheariog rud in nozealo io (op is not) the gane so tho condibkopo or thopaur and tha procoss of thepapy an previously tnvoctigated ia neurobio ineividvnse

97-2

[PAGE 24]
Tho procoss of therapy involves changos a, b, c, ete, in all froups, but not chanços x, y, 8, eto.

Thoro is (er ls not) a positivo corrolation botween the oxlotenco of the contitions of Guorapy in a relatiooship and the degree of rovonont on the procese coatimua.

97-10

Thero is a positivo corrolation betueen tho conditions of therapy aed orocecs changos a, b, c. eto, but to such correlation with proqsss chángeo X, y, S, ote.

The conditlons of therapy are (or are not) equally assooiated with proesac ebeases in inoividuolo desdring therapy and thoce qot cesiring. it, witb individuals of higber end lover sooio-educational statuo, uith waloo and fqales, vith msrkodly diotucbed crd leoo distusted sohizophirenles.

Condition. a in the relationohio is noro positivoly correlatcd vith procsss chcoge in tho clicnt, thon aro conditions b, c, or d.

Part IV. Nay Projacts

It vaa stabed in the original propoesl thet as vo yorhqd, neu projacts havirg to do with thorapy vith sohisophrenios would doubtlass be developod. One suoh is under way and vill he desoribed very brieflys In thinking about.neu vays of dealing uith the problea of motivation, wo devised a vay of making thorapy available, and are trying this out ou ono vard. -In thip vard thore aro 2h chronie paychotio patiente, nontal dofeetives and organie ceses hsving beon tranofopred.

Nino thorapists have sot up a sehedule naking taeaselves svailable, neurlly for tao hours cor wcok, on tho vurt. A roon has been resorved for their voe. Thia moans that sone thoraplob is avallable ccch day Sundop thrun Fridey. On eny given day tro to five hours of thorapist tizo is tims available. A patient mzy coma in for a short or longor contecs, or the.thorapist may go oat on the ward to offer conbact. All intorvises hovevor, are volentarye Hora are hold at tho peqnest of tho theraplot.

Thio proieod has bsan wdop vay fivo yonbhre To date there has besa coro conboot withy 23 of tho C wa on tho ucrde. Taoro havo beea

.0

21

[PAGE 25]
might bo expscted à largo msbor of tho intervioas are with a znall muaber of individuals, nearly one third sith opo men.

Thore is already clinlcal ovidence that scue of these chronc stato hospital pationts are already shosing therapeutio movemoat. We seoa to be Coslins, with some offectivenose, vith tha prohlom of uakirg thorepy psychologioally availsblo to "baok vard" patients.

97-10

[PAGE 26]
eptoobor 30, 1959

Tho accomtings arrived « few days ago.· lany thanke.

[PAGE 27]
Tireetors leavo perovei a gcant to tho Undvereity n tre aroint of fo,72o.00 for Ua study proposed by à cae is Gosefor 4,7.0 aea Ppoe: nts yycout or tho lirst bale of the grant. The socond payzent vil de lortbeesing on or adout Cotober lst.

Tha saə requírconts thot sçlácd to the previoas grant to your miversityae spllcablo.

1. A terriral rorort is to te sabaitted after the couplotlon of the plaso of pesearoz coveroo tç tás grant.

2.  terzial accvuotia: of funés econcoà an edtaining. prooossin: eod re erting data alall bo provided for our 10 oo.

3. F-aápzant puretasod aith theso fon's shall ba conveyed to thé Univervlty S in lion on ag inerobrod overiss. ratce.

4. . aay tretcãesl ro, oren or paçers vaách grow out of tho otudy cro.ortd uy tie prant shall cortain tho follcwing notice! satts atrz ves euported in part by a cant Dren tha

etlr dran td sbzve eniticns, it is roprired tlat the funds be ex ertes evdovty for Loe rezeereh dost nated and that no prorits accrue to ery bdvitaal.

t rd of Tivonters p: Che sotoutisio advisors to tho Jde e o den a tel da tii enicaver. riesee cadl mon ds o y 2 st ne t. 1.  hy b colo to roviñe.

O

Ausast 3. 1959

Areistant avcasmrer

[PAGE 28]
Q

August 3. 1259

is thving a mnoh eornel rest for a few days after a stramoons coursoat the

I telochoned ri von yeur lctter of Jely 2yth arrived,  Ho is so-ry abut tha dolay end unñortumatoly has boon unable to get the authori-atlon for a larger arount st, tris tine.

I an couovoing a cheel: fox (4.375.00 to tho Uuivereity whaoh reoresonts ovo-bolf of tho grant. The second payrent will be pade on or about Ootobo lst.

Beat porsenel rogards.

Sincerely,

[nc.

Assistant Tressuror

[PAGE 29]
I epprcofate very ruch ivesd yoar lettor of Juds 30. It is most helpful to ce to krow that we vill bo officislly sssurged of the great of e8,750. Tho coley in decidirg whothar it edght bo a largor sua will pot creats any dirficulty hero but uncortsinty as to vhother tho lossar asovnt could bo counted upen has boou troublesons.

Wo vill count on reoeiving the check for this eaount in lsto July se inicatod in your lettor. Knoving that it is coaing, I can borrou ronsy fron diflerent sources.to moet tho ncoessary payroll itons for July.

I appreoiate very ench your efíorts to expedito thia mattor, and I es, agaie, verg grateful to tho cooioty for ths grast which comss at a post opportrre cnd cruoiei nopsnt-co-far-do-the resoaroh ie conceroed.

I have telked vital aad kooshis snthsistafor tho conferoroo oa pójsiologlcal caesermsont. I an glad to krow that it osesnd very valnebls to jou too. I read your qssorendon ou thia with interest.

Very best rogerdo.

[PAGE 30]
O

June 30, 1939

I am in a rether heotic porlod, we cre stilì eitepting to obtaln the lorgor amouat, • It dppears as though I should be able to clve you a yos or no neo weck but please accept this lettor as confimatkon of my telephono convexotion thot the losser emoumnt of \$8, 7s0 ves eyprovod cad wiil be fransmatted ln one poyment (if tho forger amount ls not approved) In late July.

I ara shill enthustostic abeut the succcss of our first cocting on physlolegicat mcesuromenis and ca continolng edrinlalrative eflorts ia prepare etion of our next mecting.

Sincorely youu,

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O

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Receipt is hereby sanowledged of the folloving:

[PAGE 32]
Cost Account0525-1109-/902

Object Class

[PAGE 33]
Butprojeet 97, Irsotee lo, 1 A11c6:0st 0525-1009-4902

l. Irvoice No.l is attochod. covoring ths noove oubproject. Pavsat shoold be raade cs Tollove.

2. Pleoge forvcat tha Ceck to Chief, Tso/aheaical pivistoo througt ss/audçet Q1sleer by Tuoslkq, 8 Soptoater 1959.

3. Tio. to e firal involes. Novavar, einco at io entácipatod Ohat osoitiocal funas vill bo collgatoi xor this projoct, the filco saola cos te cloceá.

SEa/chcaical Diviston

Attedtyotat Frvoleo 6 Certtrieottons

Caotrllattons Ocig 8 2. =.Addres600 4

CSECT

25 lwgvet 1909

WEXWNEE PERI CELP, FTNOD TOVISION

T23/rulgat Otfieor

[PAGE 34]
For cervices

\$8,750.00

dipisntens

(1) It is hereby cortifiod that thio is Tuvoice Ho. 1 epplying to Subpooject Ho. 97 of Monzta, that partoreonce io satisfnetory, that services cro reins cccoaolished in eccozdaneo vith mutual egrcemonts, that a de» teilod ageada ot tho paynonts end receipto 1o on file. in Tss/cD, that this bill. is just and corroot eoì thet payaent thoreof has not yot boen sode.

Cor, T8S/Cheaical pivision

Datet

(2) It is hereby cortificd that this invoico epplieo to Subproject No. 97 of rTna vhieh wo duly spproved, and that tho yroject is toing carricd out in eccortance with tho monorandun of 13 Apuil 1953 froa the DCI to the Do/A, and the extonoion of this authority in subsequent cemoranda.

Date:

97.8

XIVOICE

[PAGE 35]
6 Avavst 1959

IETOTION 1 Fineeça Divisioa

CUGLOT 1 Fatam, Puprojeet 97

Uãer tlo muttority zaonted in tho Fasorerdoa dated 13 Aeril 1053 froa the b0X to tbe l0/à. an4 tho oztevaioa of thin cuthority in subeoquent ozsorarla, Bubprojeot 97 las boea erroved ond 23,75o.00 or tha over-ell. Projeet lauultA Cunds havo toqn obligatod to cover tho eubpro)iet'a ezersea cad. elcud to clarrel to Allotzent 0525-109-h902.

wes/ezcaleal Divioton

APPRONED FOR OLLIGNTTCGCF FNLO:

Datoi

TCS/cn(6 Aug.59)

[PAGE 36]
TO: TSS/OC

N/A 1. Date of Obligationie Support of

2. Purpone of Project: Dra

3. Progreoo to Date:/A

5. Project Monitor:.

FROM: TSS/GD

[PAGE 37]
1., It 1s réquested that Subproject 97 bo approved in order to supplement the research progreu of Dr. Üniversity In accordence with the attached proposal.

2. Long term support for this, stuly-has been providcd by the The presènt proposal is intended to supplement the project-and provide a wechanism for evaluating certain-tecboiques of influencing human behavior that may have Agency significance. This support will make it possible to have free access to the project and, when applicable, usetho facility for consultation. and support.

3. This project will be funded through th for security end'cover purposes and the Universitwtn will supply tha with copies of the reconds of disbursements related to the operation of the project at its teraination.. Title to permanent equipment purchased under.this projeet will be reteined by the Univeroity in lieu of overhead. charges. Any unusea fuods will be returõed to the Society upon termination of the grant.

[PAGE 38]
h. The total cost of this project for a period of six

months is estimated not to exceed \$8,750.00. Charges should be made

against A1lotment 0525-1009-4902.

5. Prof. holds a covert Agency clearance and is

witting of sponsorehip, all others ere unwitting.

APPROVED FOR OBLICATION OF FUNDS:

Research Director

Dete: 81159

Attached: Proposal & Budget

Distribution: Original Ooly

2

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[PAGE 39]
Less suppoct aveilable from University 5,000

PROPOSED BUOGET

2

[PAGE 40]
A Research Investication

Du afted For the Proieet Group

Geceral Furtose

The zenarel aia of this research projoct is tc make an ittensive study of tte pocess of cbance in personality and behavior as it occurs in schizorhreuic arid noraat individuals during a periud of psvchotherapy. sevelal therapists will each undertake psvehotherapy with a trio of clients sicuttarecuslv. One aember of the trio wi1l be a chronic schizvahrenie, another a wore acute schizophrenic and the third, a person of better than averai. adjustment ftom the cocmunitv. The tests and reseatch instruments adnipistered to this grou» of clients, and the recorded client-therapist iuterviews, will be the primary material fot analysis and corarison.

The ruscaren is.based on two assuaptions for which there is empirical support: (l) That the conditions which facilitate therapeutic change are measuable ;n the relatiouship between therapist and client or patient; (2) That the proeess of psychotheravy is, in some of its aspects. an orderly and peasu ahle process.

The central hypotheses are as follous.

(l) It is hupothesized that the ereater the deotee to which the conditions of therapy exist in the relatioashtp the greater will be the evidences of therapeutic process or moveuent in the clicut. (The contitions are those às necgssarv and sulticient for theral eutie hypothesized by change, These hypotheses have recvived sote-support-Lrea recent research.)

(2) It is hvpethesized that, piven equivalent conditions of therapy, the indices of precess or movement wili be the saae in the chronic schizophtenie, the wore acute schizophrenic, and the wel) ad justed person.

(3) It is bypozhesized that the process ot therapy will occur to a significantlv greater degree ir the group of individuais to whon therapy has been otfered then in a rontzol vtoup paired and maatthed to the exberimental gtoup, in whieh sueh indiviâual therepy has nor been offered.

Bnevg:oend of the Study

The wotk ot this investiyation will build upon several streatas of previous teeealch.Theze ate primari ly: stodies of psvebotherepy with sch zophreuics;

[PAGE 41]
studrs ut psvechotherapy witt eliuic clients; studies of the essential coritobs ot therapy; ard wort elucicating the process of therapy. Each of thsse stranis will be commented upon very briefly.

97-31

Althorn a coasioetable smount. of tesearch has been done on schizophrenia, reviiwers eoncur ir the opinion that almcst no conclusive studies have. beon aadr (4, 2a, . 31). Basie questious relating th the psychoiogical ant oreanic ractors itvolved in the origir, developuent snd treataent of senizo.tretia havé tot vet been answeren, Since the bul< of résearch in this ptublen arèa has been conhueted froa an organic point of view, psyeholve:cal irvestigations are especially lacking. Psychological publications on sctuzopàtenià, anj particutarly the psychotherapy of schizophrenis, ate mostiv case revorts, observations and theoretical formulations. Only five studies have been feund wbich atteupt to investigate psychotherapy with schizophrtnies experimentally. using contiols, pre and post-testing and statistical tecniques (3, 14, 27, 29, 30), Three of these five have ! investigated certarn gross aspects of the therapeutic relationship as correlated with outcoae. The other two uake a beginning in investigating. certain phuses pf outcoae. The present projeet pushes teyord these in its stoly cf more crucial aad subtle aspects of the relatiorship, and in its investigaticn of the process of change, ratter than foctsing on the more gross aspects of outcome.

As to non-tospitalized individuals, e very considerable amount of research has beenldonesto measure the cutcomes of psychotherapy in maladjusted and disturbed individuals, (24) The senior investigator has been wuch involved in this work. Scme of the most useful studies have been studies ef individual cases (9, 17, 18, 20, 21), both successful and unspegessfu) in their outcoaes. In these stusies. using methods developed by , the populetions for study consist of large nunbers of responses at one point in time which can be cotrelated with large nunbess of responses at & later point. By teking such measures before, during and aftel psychotherapy, and at a later followup point, we have been able to make valuable empirical studies of the process of chanee ir one indivzdual, using correlational techniques, factor analysis, and ptrer apotopriate statistical procedures. This study will utilize aany of these same research procedures, and sowe new ones, in work with hospitalized psychotic oatients, and welladjusted norma; individuals.

Two recent theoretical developuents have stimuleted the formation of tools which will be úseful in ttis irvestigation. The first of these is a thoory of the necessary and sulficient conditions for therapeutic chenge (22). This has been tested out on clients coving to a clinic (1, 8). The findings tend to stpport the theory, aud instruments have been developed for mersuring subtle relatioaship conditicus such as quality of empathy, degree of positive regard, drcrce of genuinenass in the therapist.

A second theerptical developuent has heprra theoty of the process of psychothetary (23). án operational has been based or this theory (25) aad thert is brginnirg, evicence that the Scate has some reliabilitv and va)idity (28).

[PAGE 42]
Puileinp en these foundatioas of previous wotk'the present stuoy aims,to test the tettewing ceperal jroposition. It bypothesizes that to the degrce.. that the thcervticalty detined conditions for theracy exist in the relationship, one will find inoices ot movenent or process in. the individual client, whethel that client is schizophrenie or normat. This hvpothesis is held for the t:eurotic client as well, but since a considerabie. body of research evidence exists for that sreup the present study will coneentrate oa the vrocess of tsvehotberapy in two extreme groups-the hospitalized schizophrenie and the thoroushly adequate normal individual,

THIE OVER-ALI. DESIGN OF TIE STUDY

The research itvolves the follcwing general steps, As given below, the st»s are in rougtly chronological order.

Brief Description of Phases of the Research

Using definite criteria, three population groups will be selected. I. Grour A will be a group of chronic schizophrenies. group R of more acute schizophrenics, group C will be normallv we:l-acjusted individuals.

lospital who Group A is so defired as to irclude patiénts from meet the folloyng criteria; a hospi tal diaęnosis of schizophrenia: bospitalized 8 mecaths or more; living within criving. distance of no prior evidence ot mental defect; not lobotomized; lese than 50 EST or IST; no somatić therapy in pest 2 months.

Group B includes those who meet similar criteria, except that they have been hospitalized for less than 8 months.

Group C. the normal or well-adjusted gzoup, will be cbosen in the followi.ng manner. These individuals wi1l be recruited ftom chureh and other groups. They will be esked to volunteer for research in personality. No mention will be made of the possibility of therapy. It will be explained that some will be asked to devote a short period of time, others longer periods, but that if they sre asked to devote a longer period ot time to the research, it is believed that they will find the experience useiul and educational. It is felt that this method avoids the selective factor which wouid opetate if people volunteered for therapv. It selects a well-adjusted group whe have not previously indicated any desire for therapy.

1I. Within these groups there will be'matched pairs of individuals, matched for age, sex, socio-elucationel status ard degree of psychosocial ralfurctioniug. Cne meaber of each such matched pair, chosen dy a toss of a coin; will have individual psychoiherapy made available to him. : The other will seive as a control.

Carelul rules have been set vp for carrying out the aatching of these pairs. The matchiug in sccio-educarioual status is based on the seates used by Hollingshead and Redtich (l0). The matehing. in degree of malfunetioning is based upon a rodification of the Luborsky Health-Sickness Scale (l6).

Il. A battery of research instruaents will be ádsintatered to both therapy . ie? roritol individvals or filled out by those siaff menbers who deal

97-21 7

[PAGE 43]
with them. In the case of the individuals in therapy these instruments witttteaeninisterel eithet pior to therary or duting the inttial uertu: of thetaey, The instruments have been seleeted to neasure the starr of process developreat of the indivicual, and the qualities ut the tclationship with tt therapist.

the. instrumente teins used include; an á-pcaisal interview. to obtain a samplino f tic versenal exnressiveness of each theravy and control individual the tersehacr; the fpl: a O-sot! of selt itrms: five cards seleeted from ttt Tàt; the troop Ititerference lest; the kelationship Inventory devised !y sarrett-Lranard (l) desipned to measurr the qualit:eș of the therapeutic relationsbi:. (o: in the case of the contro) individual, the relationship with ite person who means the most to him); the Wittenborn Behavior Rating Scale (32), filled out ty the hosvital staff; and several other instruments stilt in exttrinental form.

In addition to the above instruments which will be admiristered, the recorded
interviews will he available for analvsis by various meens. Some of the chwill be used are as follows; the rarine method developed by evaluate various qualities of the therapeutic relationship; rcentiv developed by hient attitodes towatd selfrthe
of tb 724 acnte schizovhteuic,

A trio of ses, oue chronic schi-zophrenic, one more acute schizorhrenic, and ore noraal, will be choseà. for each therapist. The method cf selection will be such as to preclude bias, and to provide overatl, a rouphlv representative sample -of more chronic and nore acute schizophrenics, and a group of normals matched with then in ape, sex, and socin-educational status.

The rather involved methed of stratification and matching by which this is achieved is indicated in the "Gkaphic Sursary" on tte next page which pives a pieture of the 48 clients in the study and the manner in which the 24 members in the therapy grous are assigned to the therapists.

If in general our findipes supvort our hypotheses, then the stratification desetibed in the Graphic Sunmary wiil have been largelv unnecessarv. But if our findinrs are ambicucus or necative, then the stratification will assist greatly in further snalysis.. We can deteraiue whether the process ot therapv occurs more markedly onlv in certain diagnostic groups, or primerily in a certain age group, or primarily with intivisuals of a errtain socio-educational status, or in more or less disturbed clients, or with individuals who work with a certein therapist, ete.

: Thus cur rationale of selection and matching, stated very briefly, is as follcws.

1. Our groups are chosen to be as tepresentative as possible, using stratification rather. than pure randouress to achieve this.

O

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[PAGE 44]
A Gre; bie Sunealy, of the indiviouals in kesearch

97-31

Controls

The Conttol Group

Group A Groop B Gropp C more áore Normal

Coups à. ?, and C (more chionfe, more acute, and nrtvais) ar? natchei to aee, socioréducational status and srx. し

In the ctarts to the titht. Y and 0 stard fot "yteng" ane "ohr", ttat is, atove or belou, the modian ave ot the sroup. u and i stapd dèr ntch ane tow sueir-ducational starvs, M andi ter nak. an t raie.

The Therary Group

This proup is stratified in a fashion icentical witl: the controls, and each indivioual is ra:red witt the cocr»gpond pg individual in the control «reup. 1 These pairs are matched net onlv for age, suciredncetional status and sex, but also for degree of psycto-social disturtance. Ibe decisicn as to which memher ot the pair teceives therapv is . 1 made bv flipping a coin.

Therapy Gr oup

The Therapists

Fach of the eight trerapists carries on thetapy with a diversified trio, made up ot one chronic, one acute, and one nerasl ndivilual. The cagcs with which each therasist works is incicated

O

[PAGE 45]
2. (mt triads will be selected in such a wav as to give cach therapist a vaiiei of cases with whrh to work. sn that if the process is similar. Uis will show up acress tndividuals ot differine charactetisties.

97.31

3. kac? tnrrapy case will be matched in are, sex, and socio-educational status witb a opired coiittol individual to provide an adequate test ot the thiri rvrottusir that there wi li be a sisnifirant difterence between & gcoup whi ras theran and one vhich docs not.

V. six or nors theravisrs ditterine ratber widely in amount of therapeutic experience and ditfering to sope degree in approach to therapy will undettake the psvehotherazv. ¿ach theravist wi lł work with th: trio of cases selected lor him, one chrouic sohizophrenic, one acute, and on rorsai individual. Interviews will be held as frequenttv as necessary or feasible. All interviews will be tape recorded. 1

The therapeutic interviews will he continuer as long as desired with members of all three erovos. If the tatients are discharged froa the hosrital juring the period ot therapy, they will conrinue to be seen on an out-palient basis.

In adJlition to trained thetapists it may te possible, during the course of the project, to utilize one or more lav persons selected for their naturally therapeutic attitudes. Such petsons would be encouraged to spend an aaount of tine equivalent to therapy with one or wore patients who would be studird in the same fashion as those in the therapy eroup. The ain here would be to see whether therapeutic attitudes, even without professionsl trainirg, may be influential in producing personality change.

In all of the hospitat therapy cases the patient will be placed in charge of one ot the phvsieians cocperatino eleselv with the prciect. This physician will have the final resuensibility tor the therapy and for the ratient's welfare. It will be à part of his responsibilitv to avoid the use of fsT or chemotherapy unless abso!utely necessary. The purpose of this condition is to ive as much of a triaì as possihle to the process of usvchotherapv without other treatment neans beine utilized.

VI. The battery of research instruaents wiil be readministered at intervals to all thcraev cases and all controls. S.xne reasures will he tereated every 3 months, others every 6 mcnths, Tbis will give reveated measurements of the depree to which tre conditions of therapv exist for anv given individual eithet in the therapy relationship of some other meaningful relatiouship. lt will also give rereated measurements of some of the indices of the process of therarontic change. (Most of the indices of process will, for the therapy eroup, be derived from the tecorded interviews.)

Since the length of therapy is likely to be differcnt in the schizophrenic and normal subjects, th only schodule which cau be set up is that the battery of reseerch inittuncnts will te rupeated every 6 months after therapy is over, Eor a minimum total period of l5 months. Testing should be carried on for one year sfter therapy is completed. The gatched control fhdividual wi Il be tested as long as the therapy case with which he is tatehed.

[PAGE 46]
Vit. The oa'a rcn the reseateh nstrusents and (equally importantlv) the data ir ra the rurorlet interviewe will beanatyzed to test the general hy… thes:s sonti nd previouslv: that the sreater the degree to whi hthe cond ti ons of theraty exis', the aure narked will be the theratatie movenen; that the proeess of theravv wilt not be sign iticantty difrorent in the thtre therapy prouvs; tha!. the proeess et thetaoy will cccur te à s:oniticanttv lesser desree in the control tran in the thetsny popelatton,

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Soré xtenced cosaents noon the way the data will he analvzed so as to test. these hsonth, ses is contained in tte section which follows en Analvsis of Process.

Vili, The tindines will be prepared in article or book fora for reporting to the rrofessions ot uvchologv ani psvchiatry,

The recorded int.rviews, test iata, and other materials !ron the project will be carotully preservel so as to be aade avai lahle to aav qualitied researeh worker who wishes to sursue turther stude ot the waterial. Sone of tte receledt !ntervivvs ay te made avai table fer tacbins purposes with pssrholoris's and nsvehiatrists.

Analvsis of Process

Since this irxestigation focuses largel upor the rrocess of theran rather than upon its outcoae, it seens worthwhile te dertue-our use of this teriu; and o dseuss the wavs in which we expect tn test hyrothases relating to proces.

In the experiential flow of events in a series of therapeutic interviows, certàin characteristic sequences have becn noted clinica:tv, These mav he thonght of as evi ience ot thera eutie movament or process. of the changing which is goine on. since reseaich can never studv (low itsolf, process becomes defiued operationallv as those discriminable cua'actetlsti sequences which exlibit chanse over relativety short petiods of time, Thus the individual way become more expressive of seif-relate: fgelings now than he was a uentà ago, or ccaminicate less of ton-selt material, and nore of seli-uescription. Thouch such iniicators of process ar» related to ortcoge, they come tron a different otaer ot discourse, and represent poinis in a sequential Flew of events, rather than single end-points such as cure,.recovery, or social adjustment, which are terms relatino to outcome.

As a basis for testing our propositions legarding movement in tneraoy we will have various "saanlings" of behavior gathered at difrerent points in time. There will be the intcrview iateraetions betwren client ani therapist; the interaction bo twcen tlie client and appraisal interviewer; the saapliags of client behavio by means of objective and rrojective tests: the observations of his tehavior. Oar hvpotheses are such that thev predict sequential change in these seranlines, in defined dicections.

In order to clarify.the direetions, we have set up some thirtv continua which define the qualities of chatge associ ated with psvchotherapy or with the development ot a wore intcgrated or rote optimra personalitv. Some ot these continna have,to do with: the wav the individuat perceives hiupelfihisttitudes ooard himselt; the manner in which he experiences.

[PAGE 47]
97-81

liase!t; tis certe oi freodoa to comaunicate himself, Gthers have to do wit: tho serner in which the individual relates to his ptobiems: his retat onshin fo hs oan teelines: his mannet of experiencine; nis maaner of perceiving. still others have to do with: his mannet of: construing ex-:ane; uis aanner ot relatipg tt: othets: hi: manner ot problem-soivinp U desre: ot rigidity in his hehavior, In each of these continua we have uperational means (sone imes orude) for neternining th, ptaccment of any viven saaole ot behavior, tiven saapie h hohavior samples

To hist a few ot these continua and the way in which behavior samples may be located on them, mav give a clearer picture of the method. The two tnis ot each continuua are trietly crfined, and the insttusents on which the aeésurement is based are listod. annoivcs self

1. Client petceives self rigidly, ia defansive fashion

Client perceives self as tluid, changing person, reasonably related to self-ideal.

9. Avoids ail exreriences of self as initiator of choice, action, or valos. kasin-Scale of Locus of Evatuation (19).

Acceptantlv exneriences self as initiator of choice, action, and values,

14. reelings evhibited. but ceni»d as feelings.

teartul exceriencing of teelings,

Acceutant exveriencing of feelings and personal meanings.

Process Scale

19. Percevtion is stereotyveu, . 19. Percevtion is stereotyped, poorly

Perception is reality oriented more tentetive, more fluid.

relateć to reality. Jonietz Scale tor analyzing Rorschacn (1l) Jone

Using these concepts of samplings of behavior and process continua, the hypotheses.o! the study cat now be stated in operational torm, in an order suited to their logicel presentation. suited to ultg tniddle.

Saxplings of behavior taken from the contrel group at. earlv, aiddie, 1. and late points in the study will sho no significant uovemeut on the process continua. process evuv lmiddle.

Saarlings of bebavior aaken froa the therapy group at earlv, middle, 11. and iate points in the study will show sienificant movemeut on the process continna and will stow significaativ greater móvement than is ouad ia the control group. 18 not be

I1. The tindiups regarding movemnent on the process contirua will not be signilicaatly difterent tor Groud A (ehconic) Group B (acute) or (rcun C (nornal). in uhaie er

Process changes trom lefi to right ou the continua for the whole group IV. (Groups A, B, G, and contro)s) will be positively correlated with the d.gre to which thé consitions of therapy (os operationelty defined) are wLccived by cach individual as existing in his relationship experience.

O

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9721

Nature of the findings It is anticipated.that the fiudings of the rescarch will include stetements of this order. s orger, n sstablish the ssme

It is (or is not) possible for therapists to establish the ssme conditions ot therap with schizophrenies as with nermals. Ths process of therapy involves (or does not involve) the same char-The process ot tir onies as in nortals. c-atiue

acteristie changes in schizoptrenies as in noraals. The coniitions ot effective therapy and the process of elfective therauy in schizophrenies and in normals is (or is not) the same as the coniitions of thęrapy and the prgress ot therapy as previously the cona: Lons dividuals 1αrouvs, investirated in neurotic individuals. The process of therapv involves changes a,b,c, etc, in all groups, The process o etc the existence bui not changes x,y,z, etc. There is (or is not) a positive correlation between the existence of the coaditions of therapy in a relationship and the degree of of the comuto continuá. :ne of therapy

movement on the process continua,
There is 3 positive correlation between the conditions of therapy
and orocess chanpes a.h,c, ete, but no such correlation vith process
atd orocess cno, ptr ollv ássociated with

changes x,y,z, ete, The conditious of therapy are (or are not) equally associated with proçess changes in individuals desiring therapy aud those not desiring it, with individuals of higher and loer socioeducational status, with males and fenaales, with aarkedly disturbcd and less statu,… L:nhrenics. (. aro not) as well established disturbed schizophrenics. The attitudinal conditions of therapy are (or are not) as well estat bv lay persons as by professionally trained persons. Condition a in the relationship is more positively correlated with process change in the client, than are coaditions b,c. or d. process change -€ come of the findings.

These stateuents may suggest the nature of some of the findings.

Significance of the inveslt
Some of the significant aspects of this progran may be mentioned briefly.
Some of the significant aspec -nla data not oniy for this

Interviews will be recorded, providing valuable data not oniy for this Interviews will be recorded, proviaing "a. study but for other investigations of sclizophreuia. study but for other investigaliv .t for other investigations of schizophreiia.

nermit accurate interpretation

The control vrocedures ere extensive, and will perait accurate interpretation of positive or negative findings. of positive or negative … tho therapists will be

Bv selecting reasonably representative groups the theravists will be forced to deal with two very dilficult problems which have not heretofore been studied;. therapy for the individual who does not consciously wish therapy, or consciously resists it; therapy for the individual of lower socio-cducaiional status, a problem highlighted by the recent study by lollingsheas and kedlich (l0). lollingsheas and keua, ale groups, the process

It will be possible to study, in directly comparable groups, the process. of psvchotherapy as it operates in psychoties, and as it operates in hcolthy individuals. This shouid throw light on a variety cf basic issues.

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97-91

In additior, whetter the tindiigs of the project are positive or negative, they, shouio throw light ou tho nature of schizooarenia or schizophrenie tarhávior; shoula throws further light on the natuúre of psvehethetapy and the theraneutie relationship; should add to our knowledge as tc the process by which pereonalitv changes; shoold indieate whether this process is the sane in the heurotie, setizoottenic and normal; should be thepretically sipnificant in indicating the deurce to which personality and behavior can change; should indicate whethet wel)-adiusted individuals ean profit troa. psvchotherapy; may supgest the basis for large-scale therapeutic procedures with psvehotic paiient:.

P'resett Status of the Program

On the basis of an initial grant froh through the University alrea3v vnder way. At the date ot-this writing-(April.15, 1959) sixteen hospital:zed schizophrenies and two well-adjusted normais are tested and matched. and wore than loo interviews have been held with the therapy meabers of the pairs. Five thecapists are condueting the therapy and three other theranists are ready to begin. A projeet eroup of ten individuals is activelv at vcrk on the vericus phases cf the study--selection and matching of individuals, testing, appraisal interviews, therapyDr carrv serves as the coordinator of this group, and be and Dr the major irvestigative responsibilities the projeft has the approval of Aospital and of tha Clinical Director., the keseerch Comittce of and the approval tand the Superratendent,-Dr.
Vpr The
of the Director of the Division of Mental Hygiene, L nas helped to generous cooperation of these men snd of the staff at make the project-possible.

The Developreent pf the Prohram

It is no doubt evident that the study described εbove is simply another step in a coatinuing program of investigation of many espects of psychotherapy with many types of individuals, Out of this study will coue leads for lurther work. While it cannot be predicted with certainty what directions the continuing program wilì take, teo possibilities, alrendy uder consideraticn, will indicate sone of the current tkinking.

Depending on the findings with the first block of 48 individuals, a secend block of siriiar basie design may be inaugnrated, selecting the new block. in such a way as to scttle issues raised in the initial study.

Another quite cifferent possibility will almost certainly be cąrried out in one fora or another. This will be to nake therapy available, on as siaple a basis as possible, during given hours on a given ward of either chronic or acute psychotics. A therapist will spend perhaps two hours ea two days per weeh in a ward, ond wili see for brief interviews (probably 20 minutes) esch patient who wishes to see hiu. All interviews will be recorded, vnd will te available for various types of analysis, This will extend the range of types of disturbed individuals seen, vill investigste the extent. to whiet, therapy will te sought if casily availaste, end may set a pattern which could be folliowed by hospital psychiatrists and peychologists wbosatimasfar therapy is vety linited.

[PAGE 50]
The reason ior meutioning these two future possibilities is to indicate that thc basic plan invulves not simply one project but & contiruing investtgarion or ti tossibilities and limitàtions of psyehotherapy with individuals with varvinp. degrees of disturbance,and the nature of the process of personality change in psyekotheravy.

[PAGE 51]
O

0

PEL EFENQES

97-21

[PAGE 52]
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26. Stephenson, W., The stuiy of bebavior. Ueiver, ot Chicaco Fress, 1953

27. Stotsky, 6., Paston, Panl G., and Vaidesk, N. An evaluation of the counsetinz cf chronie schizophtanies. J. of consult. Psychol. 1955 2, 248-255,

[PAGE 53]
51. Will, (. A.. Jr,, Psvchotherapeutics and the schizophrenie resction. 1. of kere, and Mental pis, 1958, vo1, 126, 2, 109-140. enu atino scales. N. Y;

32. Wittenborn, J. ., Wittenborn psvchiatrie rating -seales. N. Y. Psychoł, Corp. 1955.

[PAGE 54]
Buceet for carryine on progran at optimal level for 6 ponths (see  tequest. previous : page) B N

Support availatle from the Univetsity of Research Couraittee for this 6 montds

Funds requested for optinal progran

Budget for carvying on prvgrem at mininaal level for 6 wonths, until optinal funds aveilable

Suprort availzl,le froa the University Reseerch Committee for this 6 montl

Funds requested for tainimal program

Buaret requested frou

[PAGE 55]
froject Associaldnresearch coordinator.

TEA.M. D.

MC. S.

Project assor ate (full time, data analysis) 7500 Frojtct Ass stant (one full time or two half time)6o00 (psychouetrist)

AdministrativeAssistant(seletion,matching,5500 :.ve. of natiants schedeliae appointments)

Fayments to control subiects for testing time Sound-daapening of offices for recording

Surtotal Overhcad (153)

Proposed Rudgek

Other Source \$5000 2000 2500 8500

9721

Total Request

[PAGE 56]
Apm1 24, 1959

MAMORAN-DL9A TO: Tha Directons

UsJECT: Foofeet Propcsst - Or.e

Alcclel ls o propvel by Gr. ixr ths lnlieten of l otrervotions on the peecess of yeronaliry change duing μsycho-thempy. lts tocus is vpoo aellao,renies váith a control conpoted of naroel insividuah.

He tao crocasd en aatlaal qad o mlolaol crogram both of vhtch rhould bo considered. In coovrotien wiih hla, however, I devalopod tao fcellng thet tne irialvol progtoa vould mtet bh need and would eacovrego concentre. tica oa tas os:oct of tha proosol.

fnet 3

Exccutive Seerctaty

[PAGE 57]
bpril 22, 1959

I es attachins a deseription of the rezeerch progres in peychotkerepy
with schizophraplcs and aoreele vbich a group of ut kece ere cozsylvg Raeserta
on uith initial sepport froa the Uaivareity of
Coaalttes.
I weuld like to cek if this proarps-ccald be censiderod ter tesperory ra vhile te ave asdocvories to
erppert by ths Lecró of tha
cbteinspbateatial end coatinoirg cupport frea theg To thia cid you will find attoehad to

e. A descriptiea of the progre.sad. its resoarch desiga.

b. The bedget requast chich ve ara plensing to cebalt tod

rtheoin enths c. A doublo bedgat roquaat to the paried boginzlag Jely 1, 1959. Tele rezeast ie statsd in Veive el en eptival levsl et support, ead olso in tores e² a mteimet levol of support vhich voald encble ca to contiasa until co can obtoin more subatontiel beekivg.

le ie yovr fadressnt thie io s2 eppropriets requcot to-evtsit to ths Coaxd. I vcald ba heppy to here yoo send coplos q€ thia uatsrial (sad thio leeter) ts tho ceators ef the Board fer their coavidaretiea end ovolsesica.

GRO.

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4 Avgust 1959

MEMORAITUI4 FORI TES RECORD

SURJEOT. 1 KOLTRA

Tho omount of \$339.72 remaining in this projeet will be secounted for dy the University in their final accounting of Subproject 97.

Q