Journal ofConsultingand Clinical Psychology1989, Vol. 57, No. 5, 590-598

Copyright 1989 by the American Psychological Association, Inc.Q022-006X/89/S00.75

You're Changed if You Do and Changed if You Don't:Mechanisms Underlying Paradoxical Interventions

Varda Shqham-SalomonUniversity of Arizona

Ruth Avner and Rivka NeemanTel-Aviv University, Tel-Aviv, Israel

We examined 2 mechanisms of change under paradoxical interventions: reactance and increasedsense of self-efficacy. Procrastinating college students were randomly assigned to either paradoxicalor self-control interventions. Effective study time and perceived self-efficacy were measured before

and after treatment. In Study 1 nonverbal measure of initial reactance was employed. In Study 2

reactance was experimentally manipulated. Under paradoxical interventions, Ss higher on initialreactance benefited more from therapy than did Ss with low reactance; nonreactant Ss did not in-crease their effective study time, but they did improve in perceived efficacy to control their procrasti-

nation; increased study time was negatively correlated with increased self-efficacy. In self-controltreatment, increased study time was accompanied by increased self-efficacy. Paradoxical interven-tions seem to reduce procrastination through the mechanism of reactance in some clients, whereasin others they lead to a cognitive change, possibly mediating a subsequent behavior change.

The term paradoxical interventions refers to a wide variety

of therapeutic injunctions and directives, the common denomi-

nator of which is essentially their attempt to induce change by

discouraging it (Seltzer, 1986). Although there are enthusiastic

clinical reports attesting to the efficacy of all types of paradoxi-

cal interventions, empirical evidence from controlled studies

indicates that there are vast differences in the efficacy of differ-

ent types of paradoxical interventions (see Shoham-Salomon &

Rosenthal. 1987, for a review). Moreover, the differential psy-

chological factors that mediate the effects of paradoxical inter-

ventions were rarely investigated in a controlled way.

In one of the first attempts to understand how paradoxical

interventions operate, Watzlawick, Beavin, and Jackson (1967)

explicated the logic of what they called the therapeutic double

bind. It was seen as a mirror image of the pathogenic double

bind: The directive to deliberately engage in the symptomatic

behavior, the very same behavior the client wishes to change, is

similar to a "be spontaneous" paradox. The only way to obey

such a directive is by disobeying it. According to Watzlawick

et al. (1967), two possible consequences follow a paradoxical

directive (e.g., to bring about one's anxiety). In many cases the

client is not able to produce such a spontaneous occurrence on

demand. In each attempt to bring the symptom about, he or

she will experience reduced symptomatology. Such a success is

expected to lead to a sense of controllability, a feeling of mastery

We thank Hal Arkowitz and the three anonymous reviewers for theirinsightful comments on an earlier version of this article. We also thankAnat Goren-Falach and Eyal Dahari for their tremendous amount ofhelp at all stages of this research.

Correspondence concerning this article should be addressed to VardaShoham-Salomon, Department of Psychology, University of Arizona,

Tucson, Arizona 85721.

over the symptom, which, in turn, may stabilize the change. Al-

ternatively, the client is able to bring about or increase his or

her level of anxiety. However, as the experienced symptomatol-

ogy was prescribed by the therapist, it becomes refrained as the

client's ability to follow the therapist's directive rather than as

an uncontrollable symptomatic behavior. According to this ex-

planation, the clients are "changed if they do and changed if

they don't" (Watzlawick et al., 1967, p. 241). If the symptom-

atic behavior itself does not change, at least the way it is per-

ceived is changed. Thus clients undergo either a behavioral

change or a cognitive one. The latter change is predicted to free

the client from feeling helpless vis-a-vis the symptom. As

Raskin and Klein (1976) put it, behaviors over which one has

control might be sins, but they are not neurotic complaints.

Such an increase in one's perceived ability to control the symp-

tom is predicted to lead to a behavioral change (Bandura, 1986).

To date, no researchers have yet empirically examined Wat-

zlawick et al.'s (1967) model of change processes. What are the

mechanisms that underlie clients' inability to produce the

symptom when prescribed? Who are the clients whose symp-

toms are reduced after paradoxical interventions? Does a sense

of symptom control actually increase in clients whose symp-

tomatic behavior does not change? In these studies we examined

the two mechanisms postulated to underlie the operation of par-

adoxical interventions.

The first mechanism, reactance, is a state of mind aroused by

a threat to one's perceived legitimate freedom, motivating the

individual to restore the thwarted freedom (Brehm & Brehm,

1981). Whereas Brehm and Brehm (1981) focused mainly on

the situational determinants of reactance, others (e.g., Beutler,

1979) emphasized the dispositional tendency of clients to act

in a reactant way. Regardless of the origin of their reactance,

reactant clients can be expected to try to regain their perceived

freedom not to engage in the symptomatic behavior when ex-

590

MEDIATING FACTORS OF PARADOXICAL INTERVENTIONS 591

posed to a directive that prescribes it (Brehm, 1976). Clients

with high reactance potential would thus tend to defy therapeu-

tic directives and are therefore expected to benefit more from

paradoxical interventions than from other, nonparadoxical be-

havioral interventions (Rohrbaugh, Tennen, Press, & White,

1981).

The second mechanism, perceived self-efficacy or efficacy ex-

pectation (Bandura, 1986), pertains to the clients' belief that

they can successfully carry out behaviors that produce desired

outcomes, such as gaining control over their symptom. As re-

ported by Bandura (1986), changes of perceived self-efficacy

have often been found to result from experiences of successful

control. Clients who continue to engage in the symptomatic be-

havior after a paradoxical directive to do so are usually congrat-

ulated by the therapists for their success in carrying out the ther-

apeutic assignment. Such clients are expected to come to be-

lieve in their ability to control their symptom. A person who

can produce the symptom at will can also reduce it at will. Such

increased perceived self-efficacy to reduce the symptom would

be expected also to lead to actual reductions in symptomatol-

ogy (Bandura, 1986).

The mediating variables, reactance and perceived self-effi-

cacy, operate in different ways. Reactance-based reduction of

symptomatology is not likely to be accompanied by increased

self-efficacy. Increases in the latter require that the clients be-

lieve that it is their own efforts and ability that caused the de-

sired change (e.g., Weisz, 1986). In reactance-based symptom

reduction, the changes are experienced as counterintuitive, un-

predictable, and puzzling—that is, not perceived to be control-

lable (Lopez & Wambach, 1982)—and hence not to lead to in-

creased self-efficacy. Such a defiance-based symptom reduction

would be expected for highly reactant clients. On the other

hand, clients who exhibit low levels of initial reactance are the

ones who are expected to experience continued symptomatol-

ogy (as prescribed by the directives). However, that continuous

engagement in the symptomatic behavior, being reframed as an

indicator of one's controllability over the symptom (i.e., being

able to produce it on command), is expected to lead to in-

creased self-efficacy (Watzlawick et al., 1967). For low-reac-

tance clients, it is the increase in perceived self-efficacy, rather

than the spitefulness toward the directives, that is expected to

lead to subsequent reductions in symptomatology; spitefulness

is expected to relieve the high-reactance clients of their symp-

toms following the directive to engage in the symptomatic be-

haviors.

In the two analogue studies to be reported, procrastinating

college students were exposed to self-control interventions (Lo-

pez & Wambach, 1982) or to paradoxical interventions of the

"neutral symptom prescription" type (Shoham-Salomon & Ro-

senthat, 1987). We hypothesized that clients who are exposed

to paradoxical interventions, and who are highly reactant, will

manifest behavioral change but not increased perceived self-

efficacy. On the other hand, nonreactant clients will not mani-

fest behavioral change but will experience higher levels of per-

ceived self-efficacy. Together, both cases support the claim that

under paradoxical interventions, "you're changed (cognitively)

if you do and changed (behaviorally) if you don't (engage in the

symptomatic behavior)." No such differential mechanisms were

hypothesized to underlie nonparadoxical interventions, such as

self-control directives. For those interventions, changes in

symptomatology, brought about by the clients and under their

control, should not be a function of reactance; they should be

accompanied by increased perceived self-efficacy.

Because of the difficulties in the measurement of reactance

(Brehm & Brehm, 1981), and as a first attempt to directly ex-

amine the causal role of reactance as an underlying mechanism

of change, our studies were designed to maximize internal valid-

ity: The correlational approach used in the first study was com-

plemented by an experimental approach used in the second. In

the first study, reactance, perceived self-efficacy, and effective

study time were measured before the treatments. In the second

study, clients' reactance was experimentally manipulated. In-

creases in effective study time and in perceived self-efficacy

served as dependent variables in both studies.

Study 1

This study was designed to compare the differential roles of

reactance and perceived self-efficacy under paradoxical inter-

ventions and under self-control interventions. Unobtrusive,

nonverbal indices of reactance and problem-specific measures

of perceived self-efficacy were designed to overcome measure-

ment problems of both concepts (Seltzer, 1983; Weisz, 1986).

We hypothesized that under paradoxical interventions, the cli-

ents who do not manifest a behavioral change (i.e., will not

study more effectively) increase then- levels of perceived self-

efficacy to control and overcome their procrastination. These

clients were also expected to be the more cooperative clients or

at least the ones who have started the therapeutic process with

lower levels of reactance. Clients who do manifest a behavioral

change under paradoxical interventions do not necessarily in-

crease their perceived self-efficacy. These clients were expected

to be the ones who started the therapeutic process with higher

levels of reactance. No such negative relations between behav-

ioral change and increased perceived self-efficacy were expected

for the self-control therapy: These two variables were expected

to go hand in hand, suggesting that the phenomenon of "you're

changed if you do and changed if you don't" is unique to para-

doxical interventions.

Method

Subjects

Undergraduate Israeli students were recruited through a cross-de-partmental survey administered in introductory psychology classes.The 64 students who voluntarily identified themselves as having a prob-lem of procrastination were invited to attend a screening session during

which they completed several self-report questionnaires. Participationin the study allowed students to receive credit for fulfilling their courserequirements.1

Screening procedures. All the subjects filled out a demographic back-ground questionnaire, the Procrastination Inventory, and the Procrasti-nation Log. In addition, they were asked to rate their perception of theirprocrastination severity on a 5-point scale ranging from not severe at all

(1) to very severe (5). Of the 64 students who participated in the screen-

1 The subjects received credit for 3 hr only, whereas in fact they in-vested in the therapeutic program far more time than that.

592 V. SHOHAM-SALOMON, R. AVNER, AND R. NEEMAN

ing session, 52 were selected for being the most severe procrastinators;they had received a score of 3.5 (i.e., one standard deviation above the

students' population mean) or more on the Procrastination Inventory

and a score of 3 (i.e., moderate severity) or more on the subjective sever-ity scale. After we excluded 2 subjects currently in psychotherapy and 1

who was depressed (and was referred to a therapist), the final number

of subjects was 49 (33 female and 16 male). They were randomly as-

signed to either the paradoxical treatment (n = 24) or to the self-control

treatment (n = 25). The subjects' mean age was 24 years, and the range

was 20-37.

Instruments

Pretreatment self-reports. In addition to demographic data, subjects

rated, on 5-point scales, their willingness to receive treatment, their ex-pectation to be helped by the treatment, and their perceived problem

severity.Procrastination Inventory. A 54-item questionnaire developed by

Sroloff (1983) was administered. The questionnaire was designed to

measure the severity of the subject's procrastination in three major ar-

eas; work and studies, household and chores, and interpersonal respon-

sibilities. Subjects marked each item as being relevant or irrelevant to

their present life and then rated each of the relevant items on a 5-point

scale ranging from / do it right away (1) through intermediate levels of

postponement to / don'! do it (5). The subjects' genera) procrastination

score was the mean score of all the relevant items (Cronbach alpha reli-

ability coefficient = .91). The Inventory correlated negatively with Ro-

senbaum's (1980) Self Control Scale (r - -.41) and positively with

SrololTs (1983) Hedonistic Value scale (r = .56). In addition, the items

that pertained to work and studies were highly correlated (r = .62) with

the Study Log (to be described).

Perceived self-efficacy (PSE). The same 54 items of the procrastina-

tion inventory were given to the subjects again, but this time subjects

were asked to rate each relevant activity as to the extent to which they

felt efficacious in carrying it out on time. In order to minimize the carry-

over from one measure to the other, subjects were given an introductory

probe in which they were asked to make sure they differentiated be-

tween performance and perceived self-efficacy: "We'd like you to rate,

for each task, the extent to which you feel that you are efficacious in

carrying it out on time. We ask you to rate the way you perceive your

personal efficacy or ability to perform on time, not your actual perfor-

mance. Tell us what you think you are able to do, rather than what you

usually or actually do." Each item was rated on a 5-point scale; the

higher score indicated higher perceived self-efficacy (Cronbach alpha

reliability = .87). The correlation between effective study time and PSE

at baseline indicated that they measured different constructs (r = .26).2

Study log. The log yielded a measure of subjects' daily effective study

time (EST). The instrument consisted of tables with seven columns, one

for each day of the week, and 20 rows, for hours ranging from 7 a.m. to

3 a.m. Subjects first filled out their regular study and work schedules for

the current semester. Then, subjects continuously marked for each day

all the hours in which they studied and rated each hour of study for its

effectiveness / wasted the time (1) and / studied very effectively (5). Wecomputed subjects' scores on the study log by multiplying the number

of weekly studying hours by their respective effectiveness ratings; this

yielded a measure of weekly EST.Reactance. Given the nature of the construct, reactance is not easily

amenable to direct questioning (in fact, the level of reactance of a sub-

ject who would openly admit to this state should be doubted). Thus

clients' reactance was inferred from their tone of voice, a nonverbal

channel of communication that "leaks" uncensured affective states ofmind. According to Zuckerman, DePaulo, and Rosenthal (1986), tone

of voice is the least controllable channel of communication; people areusually not aware of the way their voice sounds. To avoid confounding

tone of voice with verbal content, judges rated the amount of spiteful-ness' in subjects' tone of voice, after the content had been filtered out

(Rogers, Scherer, & Rosenthal, 1971). At the beginning of the first ses-

sion, clients were individually asked by the therapist to describe theirproblem of procrastination and to estimate the extent to which they

could control and overcome their problem without outside help. The

first 20 s of uninterrupted speech, when they answered the question,were recorded. These 20-s excerpts were then rated by four naive female

judges (undergraduate psychology students) on six 9-point rating scales:

spiteful-nonspiteful, anxious-nonanxious, aggressive-not aggressive,

uninhibited-inhibited, friendly-unfriendly, and active-passive. Of

these, three scales (spiteful-nonspiteful, uninhibited-inhibited, and ac-

tive-passive) were closely related to each other (mean r = .52) across

judges and were clustered to form a composite reactance score. Each

subject then received four such combined reactance scores, one from

each judge. The interjudge effective reliability (Rosenthal & Rosnow,

1984) was then computed and yielded a correlation of .77. The other

three scales did not correlate with each other or with the combined

reactance scores and did not reach an acceptable level of interjudge reli-

ability, and they were dropped from further analyses. In sum, subjects

were considered to be more reactant the more spiteful, uninhibited, and

active their content-filtered tone of voice sounded.

In order to test the construct validity of the reactance measure, 3 min

of recorded clients' speech were presented to four clinical psychology

graduate students for content analysis. In these excerpts, taken from the

beginning of the first session, clients responded to the therapist's ques-tion "To what extent do you think that you can control and overcome

your procrastination problem without outside help?" We assumed that

clients who say to the therapist from whom they seek help that they can

overcome their problem without the therapist's help are highly reactant.

The four judges rated, on a 9-point scale, clients' reported controllabil-

ity. Interjudge effective reliability was .71. The correlation between this

reported initial controllability and clients' content-filtered reactance

composite score was .52 (p < .001). Reported initial controllability cor-

related even more highly with clients' amount of vocal spitefulness,

/•(47) = .63, p < .001. In addition, clients' reactance composite scores

correlated negatively with two pretreatment motivational questions:

willingness to receive treatment, r(47) == — .38,/>< .01, and expectations

to be helped, r(47) = -.46, p < .001. Furthermore, clients who wererated higher on vocal reactance reported lower levels of subjective sever-

ity, r(47) = -.36, p < .05. However, their actual level of severity, as

recorded by the behavioral measure EST, was not lower than that ofclients with lower vocal reactance, f(47) = .28. In sum, clients who were

rated as exhibiting a highly reactant (spiteful, uninhibited, and active)

tone of voice were those who, together with seeking help for their pro-

crastination problem, also conveyed this message to the therapist: "I'm

not very excited or optimistic about your ability to help me; I don't

2 This correlation is low, in comparison with the correlations between

PSE and actual performance, reported by Bandura (1986). However,

only highly procrastinating clients, those manifesting a truncated range

of EST scores (3.5 to 5.0), were included in this study. The range of PSE

scores was appreciably wider (2.4 to 5.0) than that of EST, which sug-

gests that some procrastinating clients felt they were capable of nonpro-crastination.

3 The measure of reactance, as inferred from clients' content-filtered

tone of voice, could be culturally bounded. The study was conducted in

Israel, where there is a special, colloquial word for reactant behavior.This word, davka. is hard to translate. Spitefulness is the closest one,though not yet capturing the full meaning of the word davka in Israeli

society. It is somewhat more positive than spitefulness, and indeed, was

found here to be related to uninhibited and active. (E.g., "Thanks for

your help, but I'll davka do it my own way.")

MEDIATING FACTORS OF PARADOXICAL INTERVENTIONS 593

really need you to help me overcome my problem; it is not that bad

anyhow; and I can do it myself pretty well."

Procedure

Measurement procedures. One week after the screening session, eachsubject underwent two 30-min sessions, spaced 1 week apart and similarto those of Lopez and Wambach (1982). During that period subjects

filled out at home the study log and handed it in at the beginning of each

session. This log was handed in again 1 week after the second sessionand at a follow-up session that took place 3 weeks later (i.e., 4 weeks aftertreatment termination). During the follow-up session, subjects filled out

the Perceived Self-Efficacy Scales and were debriefed about the study.Therapists. The therapists were four advanced graduate students in

clinical psychology (3 female and 1 male, 26-30 years old) who hadhad at least 2 years of clinical experience. They received 15 hr of pre-experimental training in the administration of the two types of interven-tions used in this study, according to a written manual. Training, similar

to that of Lopez and Wambach (1982), included memorizing and re-hearsing the differential therapeutic interventions and homework as-signments, as well as the therapeutic elements that were common to

both interventions. During the sessions, the therapists relied on a flow-chart list that highlighted the key elements of the therapeutic process,as well as the different responses to clients' behaviors. Therapists were

assigned to the two therapeutic methods in a counterbalanced way, sothat each of them had 12-13 clients, or about 6 from each method. In

order to avoid potential biases, the therapists did not have access to

the subjects' questionnaire materials and were unaware of the study'shypotheses.

Treatments. Subjects attended two 30-min individual sessions of ei-

ther paradoxical or self-control interventions, in which their experi-ences with procrastination were discussed and the condition-appropri-

ate directives were presented; this procedure closely replicated the pro-cedures described by Lopez and Wambach (1982). The beginning of thefirst session of both treatment conditions was uniform. Therapists askedthe clients to describe the nature of their procrastination behavior

within the contexts of their lives: in what ways it was a problem, how itaffected their lives, and how much they felt they had control over it. In

addition, concrete information regarding their study and procrastina-tion habits was gathered. After the clarification and therapeutic rapportphase, therapists administered one of the two therapeutic protocols.

Paradoxical interventions. In response to clients' descriptions of thenature of their problems, therapists were very careful not to confrontor challenge clients' perceived reality. Rather, remarks concerning the

impulsive or uncontrollable nature of the problem were refrained. Theproblem was described as "something you don't fully understand yet,something worth exploring in order to reach a better awareness of." Af-

ter the problem discussion, the therapists asserted that the clientsneeded to observe their procrastination while it occurred in order tobetter understand it. Building on this rationale, the therapists then toldthe clients that "although it might sound a bit strange, it is very impor-tant that you try to bring your procrastination about deliberately." Cli-

ents were then instructed to organize all the material for a specific studytask on the desk but not to do the studying then. Instead, they were topull the chair away from the desk, sit there and resist studying while

they "concentrate on producing the procrastination." The therapist em-phasized that the clients should focus their attention on trying to pro-duce their problem (e.g., engage in their specific ruminating thoughts)in the same way they usually did, and he or she explained that the under-standing of the nature of the problem would then follow naturally. Cli-ents were instructed to do this for a Vi-hr period each day. Studying atthese times was prohibited. At the end of the first session, clients weretold that if they succeeded in the therapeutic task for 6 days, they couldtake the 7th day off and study or not study, as they wished and whenever

they wished. During the second session, experiences with the homework

prescription were discussed. Clients who followed the procrastination

assignment were congratulated and questioned about their experiences.

Continuous procrastination was refrained as "giving yourself a chanceto better understand your procrastination as it occurs." Reports of posi-tive behavior change (i.e., studying more) were de-emphasized by thera-

pists, who reacted with skepticism to such reports (e.g., "Maybe it wouldbe best not to place too much stock in this—after all, it may just be atemporary change"; Lopez & Wambach, 1982, p. 118). The 6 clientswho did not comply—that is, studied when they should have procrasti-

nated—were redirected to resist studying at these times. When clientshad not scheduled "procrastination time" at all, the therapists blamedthemselves for not being clear or helpful enough concerning the sched-

uling. They helped the clients to reorganize and reschedule the thera-peutic assignments and reminded them of its nature and importance.

Clients' report of continuing procrastination was then pointed out asevidence in support of the "procrastination practice" rationale. Regard-less of their individual experience with the homework assignment, all

clients were again directed to schedule and practice their procrastina-tion during the following week. At no time in either of the two paradoxi-cal interventions sessions were clients directly encouraged to procrasti-nate less or to study more.

Self-control interventions. These interventions were designed to becomparable with the paradoxical interventions by including all the non-

paradoxical elements of the paradoxical interventions and by replicat-ing, as closely as possible, the procedures described by Lopez and Wam-

bach (1982). In essence, therapists referred to procrastination as a"learned habit" and emphasized that the clients needed to "developnew behaviors" that were "incompatible" with procrastination. Theydirected the clients to select a place where they could study effectively

and to "study as much as possible" at that location, under improved"stimulus control" conditions. Reported successes were appropriatelyreinforced.

Results and Discussion

Of the 49 subjects, 4 had to be dropped from the analyses

pertaining to the final (follow-up) measure of EST as they re-

ported only amount of time devoted to study but not the extent

to which that time was used effectively. Of these 4 subjects, 3

were from the self-control group and 1 was from the paradoxical

interventions group. Comparisons between their scores and the

scores of all other subjects combined revealed no differences.

No significant differences were found between the two thera-

peutic groups on any of the pretherapy measures and demo-

graphic data, as revealed by a series of t tests. A Bonferroni

correction (Rosenthal & Rosnow, 1984) was used to adjust for

multiple significance tests. The two therapeutic interventions

were not expected to differ on the main dependent variables of

the study. A 2 (treatments) X 2 (baseline and follow-up) re-

peated-measures analysis of variance (ANOVA) was performed

on EST. A similar analysis was performed on the measures of

PSE. Both analyses revealed significant effects due to time of

measurement, F(l, 43) = 20.09, p < .0001, and F(\, 47) =

13.45, p < .0001, respectively, but no main effects due to treat-

ment and no Time X Treatment interactions. Further analyses

that included all four times of EST measurement (baseline,

midtreatment, end of treatment, and follow-up) yielded sig-

nificant linear trends, jp( 1,41) = 18.77, p < .0001. In sum, both

treatment groups' EST and PSE scores at follow-up were higher

than at baseline, and the groups did not differ from each other.

In order to test the main hypotheses of the study, subjects

594 V. SHOHAM-SALOMON, R. AVNER, AND R. NEEMAN

Table 1

Perceived Self-Efficacy for Behaviorally Changed and

Behaviomlly Unchanged Clients

Clients

Changed Unchanged

Treatment BL FU BL FU

ParadoxicalMSDn

Self-controlMSDn

4.830.55

10

4.800.77

12

4.750.78

10

5.130.75

12

4.850.81

12

5.020.54

11

5.250.62

12

5.110.79

11

Note. BL = baseline; FU = follow-up.

were divided into a "behaviorally changed" group and a "be-

haviorally unchanged" group, according to the extent of change

between baseline and follow-up in effective study time, obtained

from the study logs. Subjects were assigned to either group ac-

cording to whether their change scores were above or below the

grand mean of change (50.60). The mean change score of the

behaviorally changed group was 116.40 (n = 22), and that of

the unchanged was -12.30 (n = 23).

A three-way 2 (treatments) X 2 (behaviorally changed and

unchanged) X 2 (baseline and follow-up) ANOVA with repeated

measures was performed on the PSE scores (see Table 1). The

analyses yielded a significant main effect of the time of measure-

ment, f[l, 41) = 9.05, p < .005, and a significant three-way

interaction, F(\, 41) = 8.32, p < .007. Analyses of simple main

effects (Winer, 1962) revealed that whereas increased PSE oc-

curred among the behaviorally changed in the self-control treat-

ment (p < .01), such increases occurred among the behaviorally

unchanged in the paradoxical interventions (p < .01). In other

words, decreased procrastination was accompanied by in-

creased PSE under the self-control treatment condition; under

the paradoxical conditions, however, subjects showed either in-

creased effective study time or increased levels of PSE.

Correlational data upheld this observation (see Table 2): In

the self-control group the correlation between increases in EST

and increases in PSE was. 16, but it was -.41 in the paradoxical

interventions group (z = 1.86, p < .07, for the difference be-

tween the two coefficients). These findings tend to corroborate

the general argument "you are changed if you do and changed

if you don't" that pertains to paradoxical interventions. Further

examination of the correlational patterns within the paradoxi-

cal interventions group, in comparison with the self-control

group, sheds additional light on the underlying processes.

First, increased EST was positively correlated with the non-

verbal measure of initial reactance in the paradoxical interven-

tions group, r(20) = .49 p < .05, but not in the self-control

group, r(21) = -.11 (z of difference = 2.08, p < .05). Second,

whereas initial controllability was positively correlated with in-

creased EST in the paradoxical intervention group, r(20) = .39,

the correlation was a negative one in the self-control group,

r(21) = -.45, p < .05 (z of difference = 2.89, p < .01). As men-

tioned earlier, initial controllability and initial reactance inter-

correlated positively in both groups, r(43) = .52, p < .001. Thus

both initial reactance and initial controllability yielded a sim-

ilar correlational pattern that suggested that higher initial reac-

tance was conducive to increased EST in the paradoxical inter-

vention condition and irrelevant, even somewhat debilitating,

in the self-control condition. In keeping with these results, ini-

tial controllability was negatively related to increased PSE in

the paradoxical interventions group, r(20) = -.40, and hardly

related at all in the self-control group, r(21) = .12 (z of

difference = 1.82, p < .07). As expected, whereas reported ini-

tial controllability was highly correlated with initial reactance,

it was not related at all to clients' initial perceived self-efficacy

as measured by the pretreatment self-efficacy questionnaire. It

seems that subjects who told their therapists, at the beginning

of the therapeutic process, that they felt in control of the very

problem for which they were seeking treatment also exhibited

greater reactance and, when confronted with paradoxical inter-

ventions, manifested actual change of study time but not in-

creased PSE. On the other hand, subjects who did not report

feeling high controllability over their procrastinating behavior

exhibited less reactance and were more amenable to increased

perceived self-efficacy, but their effective study time did not

change after paradoxical interventions.

In sum, these differential patterns suggest that reactance may

play a central role under paradoxical, but not self-control, con-

ditions, as already suggested by previous authors (e.g., Seltzer,

1983; Shoham-Salomon & Jancourt, 1985). Under paradoxical

interventions, reactance was positively related to behavioral

changes but unrelated to changes in PSE, whereas increases in

PSE were negatively related to behavioral changes.

How then can such findings be explained? Reactance, accord-

ing to Brehm and Brehm (1981), motivates one to restore

threatened freedom through adverse or spiteful behavior—that

is, behavior that is the opposite of the expected or demanded

one. Hence we come to reject the chicken soup we so love only

because it has been forced upon us, and we come to value a

product that we did not initially want only because it is denied

us. The clients in the paradoxical intervention group who re-

Table 2

Intercorrelations Among Reactance (Nonverbal), Reported

Controllability, Increased PSE. and Increased EST

Variables/group 1

1.

2.

3.

4.

Increased ESTPISC

Increased PSEPISC

Initial reactancePISC

Initial controllabilityPISC

—

—

-.41.16

.49-.11

.39-.45

-.09.03

-.40.12

——

.53

.48

Note. PI = paradoxical interventions; SC = self-control interventions.EST = effective study time; PSE = perceived self-efficacy.

MEDIATING FACTORS OF PARADOXICAL INTERVENTIONS 595

ported, when starting therapy, that they were in control of their

problem were also exhibiting a high level of initial reactance in

their tone of voice. These clients, when instructed to produce

their problem on demand, may have felt a threat to their free-

dom. A reactance-appropriate response under such conditions

is to do the exact opposite: to fail to procrastinate. Once this is

achieved a number of times, leading to accomplishments and

to satisfaction, procrastination behavior would tend to de-

crease. No such pattern would be expected in nonparadoxical

interventions, as indeed was the case in the self-control treat-

ment in this study.

On the other hand, when initial levels of perceived controlla-

bility over the problem are low, there is no room for reactance:

When clients do not believe they can choose and regulate the

amount of their procrastinating behavior, the freedom has not

been threatened by the instruction to engage in procrastination.

In the absence of reactance, if the clients comply with the in-

struction (i.e., engage in procrastination behavior), they would

also come to discover that the "symptom" is under their control

and thus to believe in their self-efficacy in handling it. Accord-

ing to Bandura (1986), such changed perceived self-efficacy

should subsequently lead to reduced symptomatology. One of

the weaknesses of Study 1 is that we did not take steps after the

follow-up measures to examine this possibility.

Study 1 has demonstrated the potential contribution of reac-

tance to the operation of paradoxical intervention. However, the

causal status of reactance has not been established in this corre-

lational study. Thus a more direct, theory-driven manipulation

of reactance was called for. This was done in Study 2.

Study 2

Is reactance a central mediator of the operation of paradoxi-

cal interventions, as indicated in Study 1? An alternative to the

reactance hypothesis can be suggested: Subjects who experience

high levels of reactance may differ from other subjects in other,

more important ways (e.g., broader personality factors or cogni-

tive styles). Reactance may thus be no more than a proxy for

these other factors. Moreover, reactance in the first study was

inferred from subjects' content filtered tone of voice. To further

study the role of reactance in mediating the effects of paradoxi-

cal interventions, it became necessary to bring it under experi-

mental control by manipulating it. This was done in Study 2.

We hypothesized that clients whose reactance was experimen-

tally induced benefit more from paradoxical interventions than

clients whose reactance was experimentally reduced. The latter

group's perceived self-efficacy, however, was expected to in-

crease more than that of the group whose reactance level was

experimentally induced. We used a factorial design with three

levels of induced reactance (low, high, and no reactance induce-

ment) and two treatments (paradoxical and self-control direc-

tives).

Method

Subjects

Seventy-one undergraduates were recruited and screened as in Study1. A final sample of 58 subjects (39 female and 19 male) met the require-

ment and were randomly assigned to six experimental conditions. The

subjects' mean age was 24 years, and the range was 20-35.

Instruments and Procedure

One week after a screening session, each subject underwent a 5-min

meeting with an experimenter in which subject's reactance was manipu-lated. This was followed by a 30-min session with a therapist (see

Method section of Study 1), according to a preexisting random assign-

ment to either the paradoxical or the self-control interventions. Oneweek after the first therapeutic session, the second, and last, therapeuticsession was held. From the screening session and on, subjects filled out

at home the study log and handed it in at the beginning of each session.This log was handed in again 1 week after termination and at a follow-

up session that took place 3 weeks later (i.e., 4 weeks after treatmenttermination). During the follow-up session, subjects filled out the Per-ceived Self-Efficacy Scale and were debriefed about the study. Although

the follow-up session also included subjects' reports on their effectivestudy time, these data were not included in the analyses because for 16of the subjects, summer vacation had already started, leaving us with a

potentially biased subsample of 42 subjects.Manipulation of reactance. Two single-paragraph descriptions of

therapeutic methods were designed to be different in their level of attrac-

tiveness to potential clients: One was designed to be attractive and theother to be less attractive but not appalling. This manipulation was in-

spired by the work of Devine and Feraald (1973), who provided clientswith preferred versus nonpreferred therapeutic methods. Three changeswere introduced: (a) Subjects of Study 2 read descriptions of hypotheti-cal methods, rather than watching real videotaped excerpts; (b) the de-

scriptions were fairly general so that each of them could suit either theparadoxical or the self-control interventions; and (c) subjects who were

assigned to the nonpreferred treatment were told, before they read thedescriptions, that they would have the right to choose their treatment.Thus they were faced with a threat to their freedom that was clearer

than that facing Devine and Femald's (1973) subjects.The construction of the manipulation included several pilot tests with

more and less attractive descriptions. The version that was chosen forthe final instrument was given, in a counterbalanced order, to 10 judgesdrawn from the same subject population as the study's prospective cli-

ents. The judges were asked to mark which method they would chooseif they were to undergo brief therapy and to rate the strength of theirpreference on a 4-point scale (very strong, pretty strong, pretty weak, andvery weak). Of the 10 judges, 9 preferred one version of the attractive

method with a pretty strong rating; I preferred the unattractive version,again with a pretty strong rating. This version of the attractive methodwas chosen over another version that received very strong preferencesby all 10 judges, in accordance with Brehm and Brehm's (1981) recom-

mendation to reduce the potential counfounding effect of frustration.However, none of the study's actual clients chose the unattractivemethod.

The final instrument had four parts: introduction, descriptions of thetwo methods (attractive and unattractive), and an informative closing

remark. The introduction read as follows: "In this study we employ twodifferent therapeutic methods. You are free to choose the one that suitsyou the most, that which will help you to solve your problem moreeffectively." The description of the attractive method (referred to as

Method A or B, in a counterbalanced order) read as follows: "This is anold and established method that proved to be effective and suitable forthe resolution of the problem of procrastination. It demands a shortterm investment. It is designed to overcome the problem of procrastina-tion via focused directives and homework exercises. From our experi-ence and from the reports in the literature this method seems to behighly effective in a relatively short time." The description of the unat-tractive method read as follows: "This is a fairly new method that is still

596 v. SHOHAM-SALOMON, R. AVNER, AND R. NEEMAN

being tested. However, the studies that were already completed showthat it seems to be effective for the resolution of the problem of procras-tination. It demands a lot of effort on your behalf. It is designed to over-come the problem of procrastination via a series of homework direc-tives, routine tasks, and systematic work. From our experience, it seemsthat after an intensive investment concentrated in a relatively shorttime, the results are quite satisfactory." The information section read asfollows: "In each of the two methods, there are two therapeutic sessionsin which you'll discuss your procrastination problems with a psycholo-gist who will suggest ways to overcome it."

Before the first session began, all clients met with an experimenterwho administered, according to a random-assignment schedule, one ofthe three reactance conditions (low-, high-, and no-reactance manipula-tion). The experimenter asked two thirds of the clients to read the twodescriptions and to choose their preferred method. The third group(baseline control condition) read the attractive description only and wastold nothing about having any choice. This group's reactance level wasneither increased nor decreased by the experimenter. In according withBrehm and Brehm's (1981) suggestion, the control group did not faceeither a frustrating procedure or a choice situation. The clients of thefirst group (low reactance) were then informed that the attractivemethod, which they had all chosen, indeed, was the treatment that theywere going to undergo. The clients of the second group (high reactance)were told that they could not undergo the treatment that they had cho-sen (again, the attractive one). No explanation or apology was given bythe experimenter. All clients were then shown to the therapy room,where they met their therapist. The latter then administered either theparadoxical or the self-control interventions, according to a preparedrandomized schedule. The therapists were not told which reactancecondition the client was exposed to.

Therapists and experimenters. The therapists were the same four ad-vanced graduate students who had served in Study 1. The four therapistswere assigned in a counterbalanced fashion to the 2 X 3 conditions.Each therapist thus had 14-15 clients, with close to equal numbers ofclients from each of the six conditions. The manipulation of reactancewas administered by an experimenter (one of the remaining three thera-pists who were not involved in the therapy of the specific client). Assign-ment of experimenters to conditions was also rotated in a counterbal-anced way, so that each of the four therapists served as an experimenterfor each of the remaining four under the different conditions.

Results and Discussion

Methodological Checks

Randomization. To ensure comparability of the randomlyassigned subjects to the treatment groups, we performed a seriesof independent t tests with a Bonferroni correction (Rosenthal& Rosnow, 1984) on all the preinter vention measures: age, yearsof study, initial EST, self-reported rating of problem severity,perceived pretreatment self-efficacy, and self-rated motivationto receive therapy. There were no pretreatment differences be-tween the two groups.

Therapists. Although the four therapists were assigned in acounterbalanced fashion to the 2 X 3 conditions, a check forpossible therapists' effects was performed. According to a 4(therapists) X 2 (pre- and posttest EST scores) ANOVA with re-peated measures, both therapist and interaction effects were in-significant (Fs < 1). The same analysis, with PSE instead of ESTscores, yielded nonsignificant results of the same magnitude,which suggests that the counterbalancing of therapists acrosstreatments eliminated therapists' effects. The same analyses

Lo-ReactanceHi-Reactance

Paradoxical Self-Control

Figure). Mean increases of effective study time (EST) from baseline toposttest as a function of the level of manipulated reactance and treat-ment condition.

performed in order to check for possible experimenters' effectsyielded similar results.

Treatment and Manipulation Effects

The EST data were analyzed in a 2 (type of intervention) X3 (level of reactance) X 2 (baseline and posttreatment EST) AN-OVA with repeated measures. The analysis yielded a significanteffect of time, F(\, 52)= 12.46, p<.001. Clients in both treat-ment groups increased their effective study time. The hypothe-sized interaction between type of intervention and level of reac-tance relied on a theoretical prediction that specified the direc-tions of improvement of clients with high and low manipulatedreactance under paradoxical and self-control conditions. Thusa 2 (type of treatment) x 2 (level of manipulated reactance)focused contrast test was performed on the EST change scores(posttest minus pretest of EST). This test yielded an interactioneffect between type of treatment and levels of reactance, con-trast F(\, 35) = 2.96, r(37) = 1.72,p < .05, one-tailed. Whereasin the paradoxical group, high-reactance clients showed im-pressive improvements in effective study time at the end of thetherapeutic process (average improvement in EST was 64.1),low-reactance ones showed very little improvement (M = 7.6).On the other hand, high- and low-reactance clients under theself-control conditions showed similar and moderate improve-ments (Aft = 38.6 and 34.0, respectively; see Figure 1).

Simple main effect analyses (Winer, 1962) revealed that it wasthe difference between the high- and low-reactance conditionswithin the paradoxical intervention group that contributedmainly to the interaction effect, F(lt 18) = 8.46, p < .01. Inaddition, within each reactance level, there was a difference be-tween the two treatment conditions. Within the low-reactancelevel, clients who were exposed to the paradoxical treatmentimproved less than those who were exposed to the self-controltreatment, F(I, 18) = 5.67, p < .05; the converse was the casewithin the high-reactance condition, in which the paradoxicalintervention was more effective than the self-control one, P( I,18) = 5.16>;p<.05.

Similar statistical analyses were performed on the PSE scores.

MEDIATING FACTORS OF PARADOXICAL INTERVENTIONS 597

Lo-ReaclanceHi-Reactance

Paradoxical Self-Control

Figure 2. Mean increases in perceived self-efficacy (PSE) from baselineto follow-up as a function of the level of manipulated reactance andtreatment condition.

First, a 2 (treatment) X 3 (reactance level) X 2 {baseline andposttest of PSE) repeated-measures ANOVA yielded a maineffect due to time, F(l, 56) = 13.47, p < .001. No additionalmain effects or interactions were obtained; however, the differ-ences between the means were all in the expected direction. Inorder to further examine these differences and in light of thedirectional hypothesis pertaining to PSE, a contrast analysiswas performed on the PSE difference scores of the low- andhigh-reactance clients in the two treatments. This analysisyielded a significant interaction effect between treatment andreactance, contrast F(l, 35) = 4.21, f(37) = 2.05, p < .05. Ashypothesized, whereas high-reactance clients under paradoxi-cal interventions showed hardly any increase in PSE (M = .05),low-reactance clients receiving the same treatment showed alarger increase (M = .53). This was not the case under self-con-trol conditions, in which high-reactance clients showed some-what larger increases in PSE than did low-reactance ones (Ms =.35 and .19, respectively). Simple main effect analyses showedthat the high-reactance paradoxical and the low-reactance self-control subgroups did not differ significantly from each otherbut did differ from the other two groups (Figure 2).

The findings of this experiment are congruent with those ofthe preceding one. The study shows the effects of aroused reac-tance as an experimentally induced state on EST and PSE underparadoxical and self-control treatment conditions. Unlike thepreceding, more naturalistic study, reactance in Study 2 wasnot part of a possible constellation of correlated variables. Thedifferential effects obtained can therefore be more validly at-tributed to different levels of reactance. These effects confirmedour preceding findings and supported our hypotheses concern-ing the differential roles that reactance and PSE play in para-doxical interventions.

General Discussion

These studies were of the analogue type with college studentsas clients in brief therapies. How generalizable are the findingsto other populations with more severe symptomatology that re-ceive longer treatments under field rather than laboratory con-

ditions? Although one can argue that the students in our studiessuffered from subjectively disturbing symptoms, one may won-der whether these symptoms would be considered sufficientlysevere under common therapeutic conditions. Moreover, thefact that the students participating in the studies received par-tial credit for participation in the study may have affected theirmotivation; as the mechanisms studied are related to motiva-tional factors, differences between the students and regular pop-ulations of clients may exist, thus limiting the generalizabilityof the findings.

Although these considerations cannot be easily dismissed,one would need to see our studies in a wider context of an eco-logically oriented research program (Gibbs, 1979), entailing aseries of studies that range from the controlled analogue studyto observations in natural therapeutic contexts (Shoham-Salo-mon, in press). The hypotheses that we tested, which pertainedto the mediating role of specific differential mechanisms, wererepeatedly mentioned and discussed in the psychotherapeuticliterature (e.g., Weeks & L'Abate, 1982) but were not empiri-cally tested. A first step in that direction calls for the testing ofthese hypotheses under relatively controlled conditions, for onlyunder such conditions can the causal role of therapeutic mediat-ing mechanisms be established. Given encouraging and consis-tent findings, the next step in the series of studies is, then, toconduct additional studies under nonanalogue conditions withmore typical psychotherapy clients.

With these limitations in mind, one can see clear and consis-tent patterns emerging from the two studies. Procrastinating cli-ents who were given paradoxical interventions either experi-enced reactance and came to manifest more effective studyingbehaviors or experienced less reactance and showed an increasein their perceived self-efficacy in controlling their procrastina-tion problem. Reactance-driven reduction in procrastinationwas not associated with increased perceived self-efficacy,whereas increases in perceived self-efficacy were unrelated toreduced procrastination. This pattern appears to be unique toparadoxical interventions; no such either-or effects have beenobserved when comparable clients were given a self-controltreatment.

The two methodologically different studies augment the va-lidity of each other's findings. In this respect, the two studiescomplement rather than replicate each other. The first study leftopen the question of whether the kind of reactance that medi-ates the effects of paradoxical interventions is a situationallyaroused or personological variable; the second study suggestedthat it could easily be a situational one. Reactance potential—that is, one's tendency to experience reactance—can of coursebe a factor sensitizing one to the potential threat to freedom inparadoxical directives (Rohrbaugh et al., 1981; Swann, Pelham,& Chidester, 1988), but as the second study showed, it is suffi-cient to arouse clients' situational reactance to obtain the ex-pected effects.

Apparently, the findings pertaining to the role of reactance inmediating the effects of paradoxical interventions are notbounded to the nonverbal measure of reactance or to the typeof clients treated in our studies. While this article was written,Goheen (1988) reported that clients' reactance potential corre-lated positively with therapeutic effectiveness under paradoxi-cal interventions (r = .47), whereas under stimulus control con-

598 V. SHOHAM-SALOMON, R. AVNER, AND R. NEEMAN

ditions the correlation was negative (r = -.37). In that study,

the reactance potential of insomniac clients (recruited by a

newspaper advertisement) was measured by a self-report ques-

tionnaire (the Therapeutic Reactance Scale; Dowd, Milne, &

Wise, 1986).

The studies raise an important question about the long-term

maintenance of the observed changes. If indeed reactant clients

manifest reduced procrastination up to 4 weeks after termina-

tion of the paradoxical treatment, does such an improvement

sustain itself in the absence of increased perceived self-efficacy?

If the observed changes are unaccompanied by the reactant cli-

ents' attribution of the change to themselves (thus the absence

of increased perceived self-efficacy) and are only a function of

the directives' threat to perceived freedom, then one of two de-

velopments would be expected. Clients either gradually experi-

ence an increase in procrastination or come to experience an

increase in problem controllability. The same would be the case

with the nonreactant clients who manifest increased perceived

self-efficacy but no reduction of procrastination. Also, they

should either come to match their improved perceived self-

efficacy with less procrastination or return to poorer perceived

self-efficacy. Further research should focus on the long-term re-

lations between perceived self-efficacy and behavioral change

under paradoxical interventions.

The two treatments used in these studies produced, on the

average, equal amounts of change. However, as already shown

elsewhere (Shoham-Salomon & Rosenthal, 1987), such com-

parisons of average effectiveness can be rather misleading as

they conceal dramatic differences in the kinds of psychological

states and processes that are differentially activated. Our studies

shed light on the process of change that is characteristic of one

type of paradoxical interventions—that is, the neutral symp-

tom prescription. Indeed, as was hypothesized by Shoham-Sal-

omon and Rosenthal (1987), the relatively poor mean effect size

of this type of intervention may obscure its differential effec-

tiveness and its unique contribution to reactant clients. Ques-

tions for further research are (a) whether similar differential

effects characterize other types of paradoxical interventions as

well and (b) whether such effects are found in longer term thera-

pies with more severely dysfunctional clients as well.

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Received November 23, 1988

Revision received April 6, 1989

Accepted April 13,1989 •