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Dissertations & Theses

2009

Mental Health Professionals’ Perceptions of

Voluntarily Childless Couples
Felizon C. Vidad
Antioch University - Santa Barbara

Follow this and additional works at: http://aura.antioch.edu/etds

Part of the Clinical Psychology Commons, and the Family, Life Course, and Society Commons

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Vidad, Felizon C., "Mental Health Professionals’ Perceptions of Voluntarily Childless Couples" (2009). Dissertations & Theses. 126.
http://aura.antioch.edu/etds/126

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 MENTAL HEALTH PROFESSIONALS’ PERCEPTIONS
OF VOLUNTARILY CHILDLESS COUPLES

A dissertation submitted to the Faculty of

Antioch University, Santa Barbara in
partial fulfillment of the requirements for the
Degree of Doctorate of Psychology in
Clinical Psychology with a Family
Psychology specialization and a concentration
in Family Forensic Psychology

By

FELIZON C. VIDAD, M.A.

Dissertation Committee

__________________________________________________________________
Juliet Rohde-Brown, Ph.D.
Chair

__________________________________________________________________
Catherine Radecki-Bush, Ph.D.
Second Faculty

__________________________________________________________________
Katherine Marie Burrelsman, M.F.T, Psy.D.
Student Reader

__________________________________________________________________
Heidi Zetzer, Ph.D.
External Expert
 Abstract

Mental Health Professionals’ Perceptions of Voluntarily Childless Couples

By

Felizon C. Vidad, M.A.

Studies conducted in previous decades have examined attitudes toward and

perceptions of voluntarily childless men and women. Participants in these studies
were usually comprised of high school, college, and university students. The
results showed that, compared to those who were parents, voluntarily childless
men and women were mostly perceived in a less favorable light. This study
sought to investigate how voluntarily childless heterosexual couples are currently
viewed and whether attitudes toward the voluntarily childless have changed since
the earlier research was conducted. Participants in this study consisted of
individuals who were practicing in the field of mental health and who might
encounter voluntarily childless couples as clients. The collected data was
analyzed, and areas of statistical significance were examined. Compared to the
previous studies among student participants that indicated either more negative
perceptions of the voluntarily childless, or very little or no bias at all, the current
study’s findings suggest that mental health professionals have more positive
perceptions of individuals who choose to be childfree. Results were utilized to
formulate recommendations for further research.
 DEDICATION

For my mama, Corazon Lugares Cabonce Vidad, who did not choose to be

childfree.

iv
 ACKNOWLEDGEMENTS

Here is where I get to break away from the academic voice and give a

shout-out to all the peeps who helped make this dissertation happen.

To the 134 women and 47 men who took the time to participate in my

study, thank you for your contributions. I am honored to be your colleague in the

field of mental health.

Many thanks to my committee for all the feedback, guidance, and

encouraging words throughout this whole process, especially in those times of

panic and freak-outs. To Katherine Marie Burrelsman, M.F.T, Psy.D, friend,

classmate, colleague, and student reader extraordinaire, special thanks for figuring

out how to manage the technical difficulties and computer glitches just when I

thought all hope was lost. And extra special thanks for keeping me stocked up on

your delicious homemade jams.

Scott Musgrove, aka Poppa Charlie, also deserves recognition for sharing

the surveymonkey.com site with me and for being my BGFFILAITP.

Last, but of course not least, a huge Chris Rock thank you goes to Sean

Carswell, my husband, best friend, and partner in childfree coupledom. You get

the big piece of chicken.

v
 TABLE OF CONTENTS

CHAPTER ONE - INTRODUCTION 1

Background to the Problem 1
Purpose of the Study 6

CHAPTER TWO - REVIEW OF THE LITERATURE 8

Terminology 8
Experiences of Marginalization 9
Existing Studies of Attitudes and Perceptions 12

CHAPTER THREE - STATEMENT OF THE PROBLEM 15

Research Questions and Primary Hypothesis 15

CHAPTER FOUR - METHODS 17

Overview 17
Instruments 19
Procedures 20
Participants and Methods of Recruitment 23
Data Collection and Analysis 26

CHAPTER FIVE - RESULTS 30

Analysis of the Entire Sample 30
Summary of Significant Findings 34
Exploratory Analyses 37

CHAPTER SIX - DISCUSSION 38

Overview 38
Delimitations and Limitations of the Study 41
Recommendations for Further Research 43

REFERENCES 46

Appendix A: Vignette 1 49

Appendix B: Vignette 2 50

Appendix C: Vignette 3 51

Appendix D: Vignette 4 52

vi
Appendix E: Information and Consent Form for Non-Medical Research 53

Appendix F: Demographic Questionnaire 55

Appendix G: Survey of Impression Formation 57

Appendix H: Letter of Introduction and Request for Participation 61

Appendix I: Form B, Ensuring Informed Consent of Participants in Research 62

vii
 List of Tables

Table 1: Means and Standard Deviations of Participants’ Responses

to Couple’s Traits

Table 2: Means and Standard Deviations of Participants’ Responses

to Aspects of the Couple’s Future and Their Sex Life

Table 3: Means and Standard Deviations of Participants’ Responses

to Factors that May Have Influenced Their Choice of

Ratings

Table 4: Dependent Variables with Statistically Significant Findings

Table 5: Means and Standard Deviations of Participants’ Responses

to the Couple’s Degree of Happiness

viii
 List of Appendices

Appendix A Vignette 1

Appendix B Vignette 2

Appendix C Vignette 3

Appendix D Vignette 4

Appendix E Information and Consent Form for Non-Medical Research

Appendix F Demographic Questionnaire

Appendix G Survey of Impression Formation

Appendix H Letter of Introduction and Request for Participation

Appendix I Form B, Ensuring Informed Consent of Participants in Research

ix
 1

INTRODUCTION

Background to the Problem

Parenthood has always been a natural part of life. Obviously, childbearing

is an essential biological function that keeps the human race from becoming

extinct. Couples must reproduce to preserve the species. The earth’s population

could not purely consist of childless individuals; parents are necessary. To this

day, the continuation of families cycling from one generation to the next is so

customary that it is generally perceived as a normal way of life.

The prevalence of families in the United States is evident in any well-

populated community. Countless places offer services and products designed to

accommodate and draw parents and their children. “Family specials” are offered

to patrons at amusement parks, bowling alleys, skating rinks, video rental stores,

and restaurants. Special prizes for children are included with their meals at fast

food chains. Shopping centers, shopping malls, department stores, and box stores

such as Wal-Mart, K-Mart, and Target all emphasize their versatility in fulfilling

the needs of every member of the family, including the family pet.

Along with commercial establishments, various forms of media steadily

feature stories, news, messages, and images pertaining to different issues

encountered by families. Commercials and television shows prominently feature

storylines that typically revolve around a family’s problems or concerns. A more

recent trend in television has been the emergence of reality shows focused on
 2

“real-life” families and their day-to-day experiences, with one of these shows

featuring an extremely large family and parents who have expressed a desire to

continue procreating (19 Kids and Counting); another show highlights a large

family in which the parents conceived twins and sextuplets with the assistance of

fertility treatments (Jon and Kate Plus 8).

This attention to families extends beyond the “real-life” families of reality

television; much emphasis is placed on pop icons and their families, as well. A

common topic for speculation is whether or not a celebrity is having a child, be it

a biological birth or through adoption. Popular national magazines consistently

feature cover pictures and stories of celebrities with their children, celebrities who

are pregnant, or celebrities’ possible pregnancy “bumps.” In talk shows, news

shows, and radio programs, much attention is drawn to whether or not any given

high-profile individual is a “good” or “bad” mother or father. Throughout all of

these varying messages, the underlying premise remains the same: parenthood is

the norm. Additionally, heterosexual parents are represented more so than same-

sex parents, so not only is parenthood constantly reinforced in American pop

culture as the norm, heterosexual parenthood is more widely accepted and defines

what is normal in this country.

Given the pronatalist nature of American society, the desire to have a

family and to become a parent is not questioned. In comparison, the desire to not

have children is more unusual. People who express a dislike for children or a
 3

disinterest in having them are considered deviant. Furthermore, adults who choose

not to have children are usually perceived as immature and selfish (Casey, 1998;

Dever & Saugeres, 2004; Letherby, 2002). Because becoming a parent is treated

as an accomplishment of adulthood, an individual who refuses to become a parent

may be viewed as not wanting to “grow up.” A basic principle of parenthood is

that, in order to raise a child effectively, one cannot be a child. Should an

individual express refusal to become a parent, a prevailing assumption about that

person is that he or she lacks the capabilities required of an effective parent,

including a sense of responsibility and nurturance.

While pronatalism contributes greatly to the marginalization of those who

choose to be childless, women who choose not to have children are further

stigmatized by sexist attitudes and beliefs. A man who displays no desire to

become a father could be considered as “sowing his wild oats” or unwilling to

“settle down”; any number of reasons could be made for his choice, but most

likely, as a man, he would not have to defend his choice to refuse fatherhood. A

woman, on the other hand, will more likely find herself having to provide some

explanation or reason for her choice because it suggests a rejection of her

expected gender role of mother. In a society that promulgates the notion of an

innate “biological clock” in every woman and genders are assigned “feminine”

and “masculine” traits, a woman’s role is equated with motherhood. Women who

choose not to have children are an aberration; their choice is questioned. By

 4

contrast, a woman who desires to have children does not have to explain why she

wants children; women are generally expected to want to be mothers.

In psychology, life-span developmental models include childbearing and

rearing as normal components of the life cycle (Broderick & Blewitt, 2003; Carter

& McGoldrick, 2005; Rowland, 1982). For example, according to Carter and

McGoldrick’s model, The Stages of the Family Life Cycle (2005), single young

adults move out of their homes to join with partners and create new families.

Normative stages of the family life cycle include having children, raising them,

“launching” them from the home, and subsequently becoming grandparents as the

second generation creates new families and continues the cycle.

Given that these developmental models are taught to students of

psychology (who, most likely, have already been exposed to societal, cultural, and

familial messages of pronatalism), these stages of life become reinforced as the

norm among those who proceed to work in the field of mental health. What

happens, then, is the subtle cultivation of a bias within the individual that he or

she may bring into a clinical session without even being aware of it.

Because the nature of the relationship between therapist and client can

influence the outcome and success of therapy (Bender & Messner, 2003; Cormier

& Hackney, 1999; Root, 2005; Sommers-Flanagan & Sommers-Flanagan, R,

2003), it really is necessary for mental health professionals to be aware of their

biases and to keep them from affecting clinical evaluation and treatment. If he or
 5

she does not recognize the presence of a bias, the clinician’s ability to empathize

with the client and build an alliance could be impaired. In a case where the client

is a woman who does not wish to have children, the clinician’s bias could lead to

inaccurate assumptions about the woman’s personality; the client might be

perceived as having unresolved childhood issues or difficulties with interpersonal

relationships, for example. Treatment could also be affected, with the practitioner

imposing values onto the client and inadvertently setting the agenda for the

session, when it may not be the direction that the client wants to take.

Frequently, women who express their choice not to have children are

faced with a dismissive attitude and comments such as “You’ll want them some

day,” or “It will be different because they’ll be yours” (Casey, 1998; Letherby,

2002). This insensitivity to the woman’s feelings is another outcome of a

pronatalist bias, and because therapists are not infallible, they are capable of

having the same reaction to a voluntarily childless woman. Should this occur in a

session, the client consequently could choose not to return to therapy. Like any

other member of a marginalized population who encounters bias and prejudice,

the voluntarily childless woman could feel misunderstood, disappointed, and

disillusioned with the whole experience of therapy. In this instance, the therapist

has (perhaps unwittingly) violated a key code of ethics: do no harm.

 6

Purpose of the Study

Over the years, attention to issues of diversity has grown. Today, mental

health professionals are encouraged to be mindful of the experiences of

marginalized populations. Frameworks and models have been developed to guide

clinical practitioners (Hays, 2001; Pedersen, Draguns, Lonner, & Trimble, 2002;

Sue & Sue, 2003), to help them be aware of advantages that they hold as members

of various dominant groups and to be mindful of personal biases and perceptions

that may impede their effectiveness as therapists. Because of this increased

attention to diversity issues, as well as the prevalence of literature pertaining to

multicultural counseling, most mental health professionals have a working

knowledge of the assorted factors that lead to clients’ experiences with prejudice

or bias. Generally, these factors include age, developmental and acquired

disabilities, religion, ethnicity, socioeconomic status, sexual orientation,

indigenous heritage, national origin, and/or gender (Hays, 2001). Less prevalent

in the literature, however, is the issue of pronatalism and how it contributes to

bias toward the voluntarily childless. Subsequently, this is an area of their own

professional development that mental health clinicians may overlook.

Therapists are human, too. Having been exposed to pronatalist messages

in society, their culture, their family of origin and even in developmental

psychology classes that perpetuate the notion that a normal life cycle includes

mating and having children, therapists may have unexamined biases against
 7

voluntarily childless men and women. They may make assumptions about or

assign attributions to these childless individuals. Whether or not this actually

happens, however, is not documented. Unfortunately, at this time, the existing

body of literature that examines people’s perceptions of the voluntarily childless

does not include any studies specifically conducted among mental health

professionals.

It would behoove the mental health profession to be aware of whether or

not there exists a bias against voluntarily childless individuals, particularly since

the number of women who are choosing to remain childfree seems to be on the

increase (Abma & Martinez, 2006; Schapiro, 1980). If the problem is defined,

then recommendations for improvement could be made. Being in a position to

help or hurt an individual’s sense of self-worth, a mental health practitioner has an

ethical obligation to do no harm. Therefore, it is highly important for clinicians to

be aware of their biases and to be apprised of more effective approaches to

counseling those who belong to a marginalized population, such as the men and

women who choose to be childless in a society where having children is the norm.

Currently, there is an absence of literature pertaining to pronatalist

biases among mental health professionals. Therefore, the purpose of this study

was to measure mental health professionals’ perceptions of childless couples and

to provide information to fill the void. This study is the missing piece.
 8

REVIEW OF THE LITERATURE

Terminology

Within the research concerning people’s perceptions of individuals and

couples without children, the terms used by the authors to describe parental status

vary. There is the descriptor “childless,” and there is the descriptor “childfree.”

For different people, the two adjectives have significant meanings and may carry

more or less weight than the other. Being “childless” denotes that the individual

has no children, but the reasons for the childlessness are unclear. Adding the

adverb “voluntarily” or “involuntarily” to the word “childless” marks the

distinction: to be voluntarily childless means that the status is a decision made of

one’s free will; to be involuntarily childless means that the status is not a choice.

By comparison, the word “childfree” is less ambiguous than “childless.”

Being “childfree” indicates that the individual is free of children; the notion of

being “free” of children suggests that the individual is not affected or restricted by

the circumstance of having children. Some people who view raising children as

impeding or obstructing a particular lifestyle may prefer to use the term

“childfree” rather than “voluntarily childless,” because of the word’s association

with freedom. Nevertheless, both the terms “childfree” and “voluntarily childless”

signify choice, which marks the difference from being “involuntarily childless.”

For this reason, the words “childfree” and “voluntarily childless” will be used

interchangeably throughout the body of this dissertation.

 9

Experiences of Marginalization

Within the existing literature regarding voluntary childlessness, women

provide reasons for their decision not to have children and recount experiences of

being stigmatized because of their choice to be childless (Casey, 1998; Dever &

Saugeres, 2004; Gillespie, 2003; Goodbody, 1977; Landa, 1990; Letherby, 2002;

Letherby & Williams, 1999; Mollen, 2006). Additionally, Connidis and McMullin

(1996) examine the reasons for and perceptions of childlessness among older

persons, including both men and women. Throughout these narratives, common

themes are echoed among the experiences.

In Pride and Joy: The Lives and Passions of Women without Children,

Casey (1998) presents a collection of interviews with 25 women who voluntarily

chose not to have children. A common theme that emerges from the women’s

narratives is the experience of being dismissed and disregarded by others because

of their choice to be childfree. For example, one woman was treated as if she

didn’t know what was best for her; she was told by a family member, “You’ll

change your mind when you get older.” (Social pressure to change one’s mind

and to start a family was also commonly experienced by many childfree

individuals quoted in the literature.) Another woman who worked in childcare

was taken to task by a parent, who demanded, “What do you know about being a

parent?” This type of attitude suggests a belief that childfree individuals, by lack

of their own children, are unqualified to care for the young. In any case, whether
 10

the comment came from a friend, acquaintance, family member, or stranger, the

premise remained the same: a woman’s choice not to have children automatically

invited questioning because it deviated from the norm.

The sense of being “other” to the expected female role of motherhood is

another common experience voiced by the voluntarily childless women in the

literature. Many felt that they were viewed as an oddity because of their choice.

Usually, they were regarded as being at fault somehow. One woman summarized

the experience felt by many when she stated, “You can almost see it in (other

people’s) eyes. A woman and she doesn’t want to get married and settle down and

have babies. There must be something wrong with her” (Gillespie, 2000, as cited

in Letherby, 2002, p.11). This automatic assumption that there is “something

wrong” with a childfree woman when she voluntarily chooses to be childless

further illustrates how deeply the pronatalist bias is entrenched in people’s values.

McGuire (2007) also focuses on the experiences of women who choose

to be childfree and how they experience bias and judgment from others who do

not understand the decision. McGuire notes that, while feelings among the

voluntarily childfree range from “not really minding breeders and their offspring”

to “the more militant antibreeders,” the childfree movement is united by the desire

for a community, so that childfree individuals may feel less alone and more

supported by others. The availability of the Internet has allowed online

communities to form and provide forums for individuals to speak freely about the
 11

difficulties of living in a child-centered culture. Among the organizations that

focus on specific issues that face childfree people are Childfree.net,

HappilyChildfree.com, and No Kidding! (www.nokidding.net).

Common complaints voiced by members of these childfree communities

include the experience that the needs of parents are often given priority over the

needs of those without children (by restaurants, shopping centers, or airlines, for

example); the difficulty of obtaining sterilization (a tubal ligation) if they have

never had children; feeling pressured by family members to reproduce; and

feeling criticized, scrutinized, and judged because of their choice. Employment

law which allows for paid maternity leave and excused employee absences for

child illnesses or school events are another source of preferential treatment for

parents that can be a source of resentment for childless employees. Then, too,

there are tax breaks that do not apply to childfree individuals, such as the

exemptions for the head of household and for people with children. These kinds

of experiences of the voluntarily childless are not typically examined or

considered by the majority of the population, and this obliviousness continues to

contribute to the childfree’s experiences of marginalization.

 12

Existing Studies of Attitudes and Perceptions

Several studies have been conducted to examine whether or not there are

biases and negative perceptions of voluntarily childfree women. In a study

performed by Calhoun and Selby (1980), participants were given information

about a couple that was described as either having two children, voluntarily

childless, or involuntarily childless. Results showed that the voluntarily childless

woman was liked less and viewed more negatively on general personality

descriptors than the involuntarily childless woman. In another study, Jamison,

Franzini, and Kaplan (1979) found that a sterilized, childfree woman was rated as

less sensitive and loving, less happy, less well-adjusted, less likely to get along

with her parents, and less likely to be happy and satisfied at age 65, compared to

an otherwise identically described mother of two.

It could be argued that both studies were conducted nearly three decades

ago and therefore are not necessarily reflective of the current times. However,

some might argue that we have become more child-centered rather than less in

this culture. In fact, in a later study conducted by Lampman and Dowling-Guyer

(1995), results supported the prior research that indicated there is a stigma of

voluntary childlessness. In this study, participants were presented with a scenario

of a couple that either had no children (due to choice or infertility) or had two

children. Compared to the women in the involuntarily childless couple and the

couple with children, the female member of the couple that was childless by
 13

choice was rated as less caring, ambitious, determined, hardworking, successful,

success oriented, competent, confident, reliable, and well-adjusted. Furthermore,

the findings in a study done by LaMastro (2001) showed that childless individuals

were rated less positively, regardless of the attributions made for their

childlessness. Both voluntarily and involuntarily childless women were seen as

possessing less interpersonal warmth (e.g. caring, sensitivity, and kindness) than

those who were mothers.

At the same time, other studies have demonstrated little or no support for

negative perceptions of the childfree by choice. Shields and Cooper (1983) found

no support that the intentionally childfree individual imparts a strong negative

stereotype. More recently, findings in a study conducted by Koropeckyj-Cox,

Romano, and Moras (2007) indicated that delayed parenthood was viewed as

normative and that the participants had few negative biases regarding infertility or

childlessness by choice.

It should be noted, however, that all of these studies (from Calhoun and

Selby’s research published in 1980 to Koropeckyj-Cox, Romano, and Moras’s

research published in 2007) were performed with students as participants. With

the exception of the 1979 study by Jamison, Franzini, and Kaplan that involved

undergraduate, high school, and adult school students, the other studies involved

the participation of undergraduate university students who usually earned extra

course credit for their participation and were mostly enrolled in introductory
 14

liberal arts courses, particularly psychology and sociology. Considering that

undergraduate students lack the experience and academic coursework obtained by

the graduate student or licensed professional who has met the requirements to

work in a mental health setting, the findings of these studies can hardly be

generalized to the greater population of mental health professionals.

Since it appears that no research has been collected to specifically

examine mental health professionals’ perceptions of childless couples, it seems

especially vital to gather data of this sort. Even though education, training, and

licensure distinguishes a mental health practitioner from a layman, having

personal biases is a universal human trait. Just because their field of expertise

includes helping others manage intrapersonal and interpersonal difficulties,

psychologists and therapists are not exempt from being prejudiced in some

manner; having been socialized in this culture, they may harbor the same negative

attitudes and biases toward childlessness as the greater society. The existing

literature already demonstrates an array of reactions to voluntary childlessness.

The body of research could be further enhanced by a study that reveals mental

health professionals’ perceptions of the minority that chooses to be childfree.

 15

STATEMENT OF THE PROBLEM

Research Questions and Primary Hypothesis

The current study, while intending to be exploratory in nature, was

guided by the following research questions:

1. What positive and negative attributions do mental health

professionals assign to voluntarily childless couples?

2. Does the couple’s reason for childlessness (voluntary vs.

involuntary; lifestyle choice vs. infertility) make a difference in the

mental health professional’s perception of a childless couple?

3. Do mental health professionals have negative biases toward

couples who voluntarily choose not to have children?

Although therapists are encouraged in their training and education to pay

closer attention to issues of prejudice and marginalization, they usually have been

socialized in a predominantly pronatalist society and are typically taught the life-

span developmental models. For this reason and because the existing literature

demonstrates that childfree individuals do experience biased treatment and

attitudes from others, the following hypothesis was developed to be tested through

the collection of data and its subsequent analysis:

1. Mental health professionals will demonstrate a more negative

perception through less favorable ratings of the voluntarily childless

 16

couple than of the couple with children or the couple with no

children due to infertility.

 17

METHODS

Overview

The available body of research pertaining to attitudes toward and

perceptions of voluntarily childless individuals was mainly conducted among high

school, undergraduate, and adult school students. The current study intended to

obtain new data that could be compared to the existing data and, unlike the

previous studies, participants comprised of the specific population of mental

health professionals. This study was a quantitative research study modeled after

two earlier studies that examined attitudes toward childless couples. By using a

similar model, the researcher hoped to make comparisons and note whether any

changes or shifts in perceptions had occurred since the earlier studies.

The two studies that were emulated by this study included the research

conducted by Lampman and Dowling-Guyer (1995) and Kopper and Smith

(2001). Lampman and Dowling-Guyer’s study was chosen for its ease,

straightforwardness and simplicity; subjects were presented with a scenario of a

couple that either had no children by choice, no children because of infertility, or

two children. The participants then rated each member of the couple on 26

characteristics and responded to 12 items pertaining to the quality and strength of

the couple’s relationship. In the discussion of their study, Lampman and Dowling-

Guyer suggested that future studies address reactions to childlessness when the

reason (voluntary or infertility) was unknown. A goal of the Kopper and Smith
 18

study was to extend the work of Lampman and Dowling-Guyer; therefore, as

suggested, they included a vignette about a childless couple in which no

explanation was given for the couple’s childlessness.

Participants in Lampman and Dowling-Guyer’s study read one of six

vignettes that described a couple. The vignettes varied in the description of the

couple’s professional status (their jobs ranged from auto mechanic and beautician

to bank manager and career counselor), as well as child status (the couple wanted

to have children, but were unable to have children of their own; had two children;

or were not planning on having any children). For the current study, to control for

variance due to economic status, the professional status of the couple remained

the same in all of the vignettes presented to respondents. The couple was

described as employed as teachers in their county’s public schools. Also, because

the current study was modeled similarly after the studies by Lampman and

Dowling-Guyer (1995) and Kopper and Smith (2001), the couples presented in

the vignettes remained heterosexual. Additional research in the future could

expand on this current study and include vignettes comprised of same-sex

couples.

Like the Lampman and Dowling-Guyer study (1995), the current study

included a vignette in which the couple either had no children by choice, no

children because of infertility, or two children. Furthermore, like the Kopper and

Smith study (2001), the current study included a vignette in which the reason for
 19

the couple’s childlessness was unknown. Because the primary aim of this study

was to collect data on mental health professionals’ perceptions of the voluntarily

childless and to examine any negative attributes or biases, including a vignette in

which the couple’s reason for childlessness was unknown allowed the researcher

to compare differences in perception when mental health professionals were given

reasons for childlessness and when they were not informed.

Prior to data collection, the researcher obtained approval from the

Antioch University, Santa Barbara Institutional Review Board. Form B, Ensuring

Informed Consent of Participants in Research, is included as Appendix I to

provide further details of the researcher’s ethical assurances.

Instruments

The research study was conducted solely online. Four different web

pages with their own unique hyperlinks and web addresses were created through

www.surveymonkey.com. All four web pages featured the same components: 1)

an Information and Consent Form for Non-Medical Research (Appendix E), 2) a

Questionnaire to Collect Demographic Information (Appendix F), 3) a Vignette,

and 4) a Survey of Impression Formation (Appendix G). The four web pages

differed only by the vignettes they contained. The first included Vignette 1

(Appendix A), the second included Vignette 2 (Appendix B), the third included

Vignette 3 (Appendix C), and the fourth included Vignette 4 (Appendix D).
 20

The vignettes utilized in this study were modeled after the ones used in

Lampman and Dowling-Guyer’s study (1995), with modifications to the couple’s

place of residence and their occupational positions. To minimize threats to

internal validity, the couple in each vignette was described as living in the city

and working as teachers in their county’s school district. The couple’s names,

Frank and Elena, were chosen because of their versatility among different ethnic

groups. The ambiguity of the couple’s cultural background and place of residence

was intentional, so that participants’ responses to the vignette could not be

influenced by specific places or ethnicities. Later, in the survey measuring

participants’ perceptions of the couple, the participant was asked whether the

couple’s ages, length of marriage, size of the family, place of residency, and

employment status influenced the participant’s choice of ratings. This allowed the

researcher to determine whether or not these variables contributed to the

participant’s decision-making process when choosing a rating for the couple.

Procedures

Prior to reading a vignette and providing responses to it, participants

were required to read an Information and Consent Form for Non-Medical

Research (Appendix E). In this form, participants were given a brief description

of the study and procedures. They were informed of potential risks, discomforts,

and benefits; assured of their rights to confidentiality and withdrawal from the

study at any time; and provided with contact information in the event that they
 21

had any questions or concerns about the research. Because the study was

conducted online via the Internet, participants did not have the option to sign their

name to a written document. Instead, if they agreed to the terms outlined in the

consent form and were willing to participate in the study, they simply clicked on

the button indicating “Next” to proceed to the following page. This action served

as implicit consent. If they did not agree to the terms and chose to decline

participation, they could simply close the browser window to exit the study.

Additionally, if the participant wished to withdraw at any point during the survey,

he or she could click on the link stating “Exit this survey,” located in the right-

hand corner of the page. At no point during the process was the participant

required to provide a name or email address; responses were purely anonymous.

After clicking “Next” and therefore confirming agreement to participate

in the study, participants were directed to a second page that consisted of a

demographic questionnaire (Appendix F) that collected the following variables:

age, gender, birth order, marital status, parental status, education, clinical

orientation, title of occupational position, length of clinical experience, religious

affiliation, and race or ethnicity with which they identify. To determine what

particular variables would be included in the survey of participants’ demographics

for this study, the researcher consulted other studies that included mental health

professionals as participants. While there were no available studies of mental

health professionals’ perceptions of childfree individuals, a study of

 22

psychologists’ attitudes toward gay and lesbian parenting (Crawford, McLeod,

Zamboni, & Jordan, 1999) also utilized vignettes and collected demographic

information from participants. Because the variables that comprised the

demographic profile of respondents in that study seemed most applicable to this

study and because the participants in this study also worked within the field of

psychology and mental health, variables that comprised the demographic profile

of respondents in the Crawford et al. survey were selected for use in the current

study.

Upon completing the demographics questionnaire, the participant was

directed to a third page with instructions to read the vignette before proceeding to

the questions. Below these instructions, one of the four aforementioned vignettes

was provided. The Survey of Impression Formation (Appendix G) followed the

vignette. In this survey consisting of twenty items, the participant was asked to

rate various characteristics of the couple, including the couple’s degree of

happiness, loneliness, ambition, success, stress, anxiety, confidence, reliability,

competence, and demonstration of love and affection toward each other (items 1

to 10). Responses consisted of a 5-point Likert scale, ranging from a rating of “not

at all” to a rating of “very.” Additionally, participants were asked to rate the

strength and quality of the couple’s relationship by answering items regarding the

couple’s likelihood of staying together, their sex life, their worries about the

future, and whether they would have a happy life together (items 11 to 14).
 23

Responses to these items ranged from a rating of “strongly disagree” to a rating of

“strongly agree.” Last, participants were asked to indicate to what extent the

couple’s ages, length of marriage, size of the family, place of residency, and

employment status influenced their choice of ratings (items 15 to 20). Again,

responses to these items ranged from a rating of “strongly disagree” to a rating of

“strongly agree.” The first fourteen items in this survey were adapted from items

included in the earlier study by Lampman and Dowling-Guyer (1995). Items 15 to

20 were added by this researcher to determine whether other factors aside from

the couple’s reason for childlessness influenced the participant’s choice of ratings.

Last, when the participant clicked “Next” to proceed to the page after

item 20, a new page would appear. The text of this page stated, “You have

completed the survey! Thank you for your participation. Your responses are much

appreciated.” The participant could then close the browser window to terminate

the session.

Participants and Methods of Recruitment

Participants in the study consisted of male and female adults who

worked in the field of mental health. These individuals included master’s level

students in clinical traineeship programs and social work internships, registered

Marriage and Family Therapist Interns, licensed Marriage and Family Therapists,

licensed Clinical Social Workers, Pre- and Post-Doctoral Interns, and licensed

Clinical Psychologists.
 24

To recruit participants, the researcher called and emailed department

heads of graduate programs in psychology, as well as representatives of

associations of mental health professionals. The researcher introduced herself as a

graduate student collecting data for her dissertation and requested that the

department head or association head forward a letter (Appendix H) via email to

members of the graduate program or the professional organization, encouraging

participation in a study intended for mental health professionals. At the bottom of

each email request was a hyperlink to one of the four web pages. The links were

randomly selected and evenly distributed among the contacts made.

The graduate schools that were contacted included Antioch University,

Santa Barbara (both the MACP and PsyD programs); Antioch University, Los

Angeles; Antioch University, New England; Antioch University, Seattle; Fielding

Graduate University; Pacifica Graduate Institute; Alliant International University,

Fresno; Alliant International University, San Francisco; Pepperdine University,

Graduate School of Education and Psychology; and the University of California,

Santa Barbara. The professional associations that were contacted included the

Santa Barbara County Psychological Association, the Ventura County

Psychological Association, the National Council of Schools for Professional

Psychology, the California Psychological Association, the Conejo Valley Mental

Health Professionals Association, and the Ventura Chapter of the California

Association of Marriage and Family Therapists.

 25

Additionally, the researcher posted to four division listservs of the

American Psychological Association (APA), requesting members to participate in

the study. These divisions were the Society for the Psychology of Women

(Division 35), the Society for Family Psychology (Division 43), the Society for

the Psychological Study of Lesbian, Gay, Bisexual, and Transgender Issues

(Division 44), and the Society for the Psychological Study of Men and

Masculinity (Division 51). A link to one of the four web pages was randomly

selected and included in each request for participation.

Last, the researcher called and emailed colleagues who worked in the

field of mental health and who provided psychotherapeutic services to clients at

inpatient, outpatient, community, non-profit, and/or private agencies. Among

these agencies were the Ventura Youth Correctional Facility, Aurora Vista Del

Mar Hospital, Sharper Future in Los Angeles, School Street Counseling Institute

in Massachusetts, and Child Abuse Listening and Mediation (CALM) in Santa

Barbara. Colleagues were invited to participate in the survey and received emails

with a randomly selected hyperlink to one of the four web pages. The researcher

also encouraged colleagues to forward the link to their colleagues in the mental

health profession and to request their participation.

Through all of these efforts, 181 mental health professionals were

recruited for participation in this study.

 26

Data Collection and Analysis

Because the surveys had been administered through an online site

(www.surveymonkey.com), results were collected and stored electronically. Each

participant’s anonymous responses were automatically saved to the site’s server.

Four separate pages had been created on the site, with each page including a

different vignette, its accompanying surveys, and a unique hyperlink. Therefore,

the data collected was automatically separated according to group (voluntarily

childless, two children, childless because of infertility, and childless with no

reason provided), and all responses were electronically stored under different file

names (Vignette 1, Vignette 2, Vignette 3, and Vignette 4). Only the researcher

had access to this information after entering a protected login name and password

at the surveymonkey.com home page.

Upon completion of data collection, surveymonkey.com offered an

electronic option in which participants’ responses were automatically uploaded

and transferred from the website into Microsoft Excel spreadsheets. Responses to

items on the Survey of Impression Formation were numerically coded to

correspond to participants’ answers. Thus, items with a response of “not at all” or

“strongly disagree” were coded as 1, items with a response of “very slightly” or

“disagree” received a 2, items with a response of “slightly” or “neither agree nor

disagree” received a 3, items with a response of “moderately” or “agree” received

a 4, and items with a response of “very” or “strongly agree” received a 5.

 27

The Statistical Package for the Social Sciences (SPSS) predictive

analytics software was then utilized to analyze the collected data. Through SPSS,

a new file was created, in which a blank data editor was opened and separate

columns were established to represent a variable. Each item from both the

Questionnaire to Collect Demographic Information and the Survey of Impression

Formation was recorded as a variable. A final variable was included to indicate

which vignette had accompanied that participant’s set of responses. This last

variable was designated as Vignette Type and coded 1 for Vignette 1, 2 for

Vignette 2, 3 for Vignette 3, and 4 for Vignette 4.

Once all of the variables and value labels were established in the data

editor, participants’ responses and vignette type were transferred from the

Microsoft Excel spreadsheets into the newly created SPSS file. The software was

then utilized to generate descriptive statistics of the whole sample of respondents.

The descriptive statistics included the mean and standard deviation of

participants’ responses to each of the items on the Survey of Impression

Formation. Additionally, the frequency distributions of the participants’

demographic information (gender, birth order, marital status, parental status,

professional degree, religion, and race or ethnicity) were calculated. Next, a

univariate analysis of variance (ANOVA) was conducted to determine whether

group means differed among the four sets of respondents who received different

vignettes. Group means among the four sets were examined to determine whether
 28

responses indicated more or fewer favorable perceptions toward the voluntarily

childless couple. Items with a statistical significance of less than .05 were

identified and noted. Last, post hoc tests were conducted to compare the means of

all combinations of pairs of experimental condition. Tukey’s test and Scheffe’s

test were applied.

Exploratory analyses were also conducted to determine whether

demographics of participants (subject variables) may have influenced ratings

among the sets of vignette types. Through factor analysis, the researcher created

three subscales: a positivity index, a work index, and a lack of ambition index.

Each index comprised of ratings from selected items on the survey. The positivity

index included participants' ratings of the degree of the couple's happiness,

success, anxiety, reliability, competence, confidence, love and affection toward

each other, likelihood of staying together, and likelihood of having a happy life

together. The work index included ratings of the couple's anxiety, reliability, and

competence. The lack of ambition index included ratings of the couple's

ambitiousness.

Several univariate analyses of variance were then calculated. The first

three ANOVAs included each of the three indexes (positivity, work, and lack of

ambition) as the dependent variable, with the vignette type (voluntarily childless,

two children, childless because of infertility, and childless with no reason

provided) as independent variables. In seven subsequent ANOVAs, the positivity

 29

index was utilized as the dependent variable, paired with the following groups of

independent variables: vignette type, marital status, and gender of participants;

vignette type, parental status, and gender of participants; vignette type, parental

status, with female participants only; vignette type, parental status, with male

participants only; vignette type and professional degree of the participant,

ungrouped; vignette type and professional degree, grouped; vignette type and

participant's religion.

Additionally, the work index was utilized as a dependent variable in four

further ANOVAs and paired with the following independent variables: vignette

type and participants' professional degrees, grouped; vignette type and gender;

vignette type, with male participants only; vignette type, with female participants

only. Last, correlation between the positivity index and age of participants was

examined.
 30

RESULTS

Analysis of the Entire Sample

This study recruited a total of 181 participants (134 women and 47 men)

who worked in the field of mental health. The mean age was 41.3 years, with a

range from 22 to 86. Fifty-three percent of the participants were married, 18.8%

single, 11% in committed relationships but not married, 11% divorced or

separated, 5% in a domestic partnership, and 1.1% widowed. Parents or caretakers

of minors comprised 46.4% of the total sample, while 53.6% were without

children. Nearly half (47.5%) of the participants held a Master of Arts degree,

11% Psy.D., 7.2% Ph.D. Counseling, 6.6% Ph.D. Clinical, 5.5% M.S.W., 10.5%

B.A., and 11.6% Other, which included degrees such as an Ed.S. in Counseling,

M.S. in Psychology, and B.S.W. The majority of participants (70.7%) identified

themselves as European American, 6.1% Mexican American, 3.9% African

American, 1.7% Native American, and 17.7% Other, which included Multi-Racial

and Bi-Racial.

Each participant was assigned a vignette that featured a couple described

as either voluntarily childless, having two children, childless because of infertility

issues, or childless with no reason provided. Fifty participants responded to the

vignette featuring the voluntarily childless couple, 43 responded to the vignette of

the couple with two children, 45 responded to the vignette of the couple who were
 31

childless and infertile, and 43 responded to the vignette that featured the couple

who had no children with no reason provided.

Items 1 to 10 on the Survey of Impression Formation called for

participants to consider and rate the extent of the couple’s happiness, loneliness,

ambition, success, stress, anxiety, confidence, reliability, competence, and

displays of love and affection toward each other. Among these qualities

describing the couple in the vignette, the most highly rated by the whole sample

of participants were success (M = 4.1, SD = .58), reliability (M = 4.2, SD = .69),

and competence (M = 4.3, SD = .63). The lowest rated characteristics were

loneliness (M = 3.0, SD = .88) and anxiety (M = 3.0, SD = .84), indicating that

participants neither agreed nor disagreed that the couple was either lonely or

anxious. Table 1 presents the means and standard deviations of the whole

sample’s responses to items 1 to 10 on the Survey of Impression Formation.

Mean SD

Couple’s happiness 3.8 .62

Couple’s loneliness 3.0 .88

Couple’s ambition 3.8 .81

Couple’s success 4.1 .58

 32

Couple’s stress 3.5 .72

Couple’s anxiety 3.0 .84

Couple’s confidence 3.7 .77

Couple’s reliability 4.2 .69

Couple’s competence 4.3 .63

Couple’s displays of love and 3.6 .79

affection to each other

Table 1: Means and Standard Deviations of Participants’

Responses to Couple’s Traits

Next, items 11 to 14 on the Survey of Impression Formation asked

participants to rate the likelihood that the couple would stay together, that they

had a fulfilling sex life, that they worried about the future, and that they would

have a happy life together. Of these four items, participants assigned the highest

ratings to the likelihood that the couple would stay together (M = 3.8, SD = .69),

indicating that they mostly agreed that the couple would stay together. The item

regarding whether the couple had a fulfilling sex life, on the other hand, received

the lowest ratings (M = 3.0, SD = .64), indicating that participants neither agreed

nor disagreed with this statement. Table 2 presents the means and standard

deviations of the whole sample’s responses to these variables.

 33

Mean SD

Couple’s likelihood to stay together 3.8 .69

Couple’s sex life 3.0 .64

Couple’s worry about the future 3.7 .59

Couple’s likelihood to have a happy life together 3.4 .56

Table 2: Means and Standard Deviations of Participants’ Responses to Aspects of

the Couple’s Future and Their Sex Life

The last five items on the Survey of Impression Formation pertained to

participants’ reasons for their choice of ratings. These items inquired about factors

that may have influenced the participant in selecting a particular response. The

couple’s place of residency influenced participants’ choice of ratings the least (M

= 2.5, SD = .92), while the couple’s employment status had the most influence on

participants’ choice of responses (M = 3.8, SD = .89). Table 3 presents the means

and standard deviations of the whole sample’s responses to these items.

 34

Mean SD

Couple’s ages 2.8 1.1

Couple’s length of marriage 3.4 .97

Size of the family 3.1 1.03

Couple’s place of residency 2.5 .92

Couple’s employment status 3.8 .89

Table 3: Means and Standard Deviations of Participants’ Responses to Factors

that May Have Influenced Their Choice of Ratings

Summary of Significant Findings

A univariate analysis of variance (ANOVA) was chosen to test the

hypothesis that mental health professionals would demonstrate a more negative

perception through less favorable ratings of the voluntarily childless couple than

of the couple with children or the couple with no children due to infertility.

Among the dependent variables, none of the items were found to demonstrate

statistical significance except for two: a) the couple’s happiness and b) age as a

factor that influenced the participant’s choice of ratings (see Table 4).
 35

Sum of Mean
Squares df Square F Sig.
Couple’s happiness Between Groups 5.516 3 1.839 5.190 .002
Within Groups 62.716 177 .354
Total 68.232 180
Ages influenced choice Between Groups 11.128 3 3.709 3.187 .025
of ratings Within Groups 206.033 177 1.164
Total 217.160 180
Table 4: Dependent Variables with Statistically Significant Findings

Post hoc tests were conducted to perform multiple comparisons among

participant groups and the dependent variables. Both Tukey’s test and Scheffe’s

test were applied. For the item asking participants to rate the couple’s degree of

happiness, results showed that, among the four groups, the group that received the

vignette describing an infertile couple demonstrated a statistically significant

mean difference from other groups. Participants’ ratings of the infertile couple’s

happiness were the lowest (M = 3.5, SD = .89), while the couples with no children

(both the voluntarily childless couple and the couple with no reason for

childlessness given) received the highest ratings on their degree of happiness (see

Table 5). These results do not support the primary hypothesis that mental health

professionals would demonstrate a more negative perception of the voluntarily

childless couple; rather, the results suggest the opposite.

 36

N Mean SD

Voluntarily Childless Couple 50 3.94 .47

Couple with Two Children 43 3.83 .48

Infertile Couple 45 3.51 .89

Childless Couple, No Reason 43 3.93 .40

Total 181 3.80 .62

Table 5: Means and Standard Deviations of Participants’ Responses to the

Couple’s Degree of Happiness

The second variable found to exhibit statistical significance among

group means was the survey item that inquired whether age was a factor that

influenced participants’ choice of ratings. Again, among the four sets of

participants, the group that was assigned the vignette about the infertile couple

demonstrated a statistically significant mean difference from the others. When

responding to whether age was a factor that influenced their choice of ratings,

participants who rated the infertile couple responded with a mean number of 2.4,

indicating that, on average, participants in this group chose to disagree that the

age of the couple in the vignette influenced their choice of ratings in the survey.
 37

Exploratory Analyses

Exploratory analyses were also conducted to determine whether any

statistically significant relationships existed between respondents’ ratings and the

demographic variables of marital status, parental status, professional degree,

religion, age, and gender. The resulting output did not reveal any statistically

significant findings.

Interpretations and implications of the significant findings of the study

will be further discussed in the following chapter.

 38

DISCUSSION

Overview

The current study was conducted to examine mental health

professionals’ perceptions of voluntarily childless couples. Three main research

questions guided the study: What positive and negative attributions do mental

health professionals assign to voluntarily childless couples? Does the couple’s

reason for childlessness (lifestyle choice vs. infertility) make a difference in the

mental health professional’s perception of a childless couple? Do mental health

professionals have negative biases toward couples who voluntarily choose not to

have children? After the collection and analysis of the data, the results of the

study appear to provide some answers to these questions.

Participants were asked to rate various traits of four different couples

presented in four different vignettes; each participant read only one of these four

vignettes. The characteristics to be rated were happiness, loneliness, ambition,

success, stress, anxiety, confidence, reliability, competence, and displays of love

and affection toward each other. Of these traits, the whole sample of participants

mostly agreed that the couple in the vignette was successful, reliable, and

competent. These are all positive attributions. The lowest rated characteristics

were loneliness and anxiety with a mean of 3 for both. These results indicated

that, on average, participants neither agreed nor disagreed that the couple was

lonely or anxious. Therefore, the results reflected that mental health professionals
 39

did not assign any negative attributions to voluntarily childless couples, or to any

of the other couples described in the study. On the contrary, mental health

professionals appeared to attribute more positive qualities to the couples,

particularly the traits of success, reliability, and competence.

A second research question that the study aimed to answer was whether

or not the couple’s reason for childlessness (lifestyle choice vs. infertility) made a

difference in the mental health professional’s perception of a childless couple. In

examining the results of the statistical analyses, two variables were found to

demonstrate statistical significance: a) the couple’s happiness, and b) age as a

factor that influenced the participant’s choice of ratings. Closer inspection of the

results of the post hoc tests revealed that, for these two variables, the group means

of participants who responded to the vignette about the infertile couple stood out

from the other groups. Participants in this group provided the lowest ratings on

the couple’s happiness, and they disagreed that the couple’s age influenced their

choice of ratings. The independent variable in this case was the couple’s parental

status of being childless because of infertility. From these results, it appears that

the couple’s reason for childlessness does make a difference in the mental health

professional’s perception of a childless couple.

Last, the study sought to discover whether or not mental health

professionals had negative biases toward couples who voluntarily choose not to

have children. Because mental health professionals usually have been socialized
 40

in a predominantly pronatalist society and are typically taught the life-span

developmental model (Broderick & Blewitt, 2003; Carter & McGoldrick, 2005;

Rowland, 1982), and because the current literature provided numerous examples

of childfree individuals’ experiences of biased treatment and attitudes from others

(Casey, 1998; Dever & Saugeres, 2004; Gillespie, 2003; Goodbody, 1977; Landa,

1990; Letherby, 2002; Letherby & Williams, 1999; Mollen, 2006), it was

hypothesized that mental health professionals would demonstrate a more negative

perception through less favorable ratings of the voluntarily childless couple than

of the couple with children or the couple with no children due to infertility.

This hypothesis, however, was not supported by the data. On the basis of

the study’s findings, it appears that mental health professionals actually attributed

more positive traits toward and had no negative perceptions of the voluntarily

childless couple. In fact, overall, the couples with no children (both the

voluntarily childless couple and the couple with no reason for childlessness given)

received the highest ratings on their level of happiness. Compared to the previous

studies among student participants that indicated either more negative perceptions

of the voluntarily childless (Calhoun & Selby, 1980; Franzini & Kaplan,1979;

LaMastro, 2001; Lampman & Dowling-Guyer, 1995), or very little or no bias at

all (Shields & Cooper, 1983; Koropeckyj-Cox, Romano & Moras, 2007), this

study’s findings suggest that mental health professionals have more positive

perceptions of individuals who choose to be childfree.

 41

Considering that the majority of the participants in this study held

Master of Arts degrees and were practicing either as licensed Marriage and

Family Therapists or MFT interns and trainees, it could be surmised that they

have been exposed to many unhappy and emotionally troubled families in their

work. After all, the mental health profession involves helping those who are

struggling with interpersonal problems. In providing therapy, the mental health

clinician is privy to the accounts of a client’s personal life and relationships with

family members. Perhaps because the participants of this study were mental

health professionals and consequently have been exposed to so many narratives of

unhappy clients who are either parents or children, the respondents were more

likely to view the childfree couple as being happiest. This could explain why,

rather than what was originally hypothesized, mental health professionals in the

study demonstrated more positive perceptions of the voluntarily childless couple.

Delimitations and Limitations of the Study

The current study was subject to methodological delimitations and

limitations. Because there is an absence of literature pertaining to pronatalist

biases among mental health professionals, the study sought to measure mental

health professionals’ perceptions of childless couples and to provide information

to fill the void. Therefore, a delimitation of this study was that the target

population of participants specifically and only consisted of individuals who

worked in the field of mental health.

 42

The fact that participants in the study were trained and educated to be

mental health professionals posed a limitation to the study. The field of mental

health is a helping profession that aspires to assist those who struggle with mental

and emotional difficulties. Clients seek professional support to alleviate

intrapersonal and interpersonal problems, and because the troubled client is in an

emotionally vulnerable position, therapists are usually taught to demonstrate

empathy and a nonjudgmental approach. By virtue of their profession, therapists

are expected to perform a full assessment before formulating a diagnosis or

making any clinical judgments. A limitation of the study, then, was that

participants may have been less inclined to form an opinion about the couple

presented in the vignette because minimal information about the couple was

provided. This proclivity could explain why group means of some of the variables

hovered around a 3.0, which indicated that the participant neither agreed nor

disagreed with the item.

A second limitation of the study was that it was purely quantitative. No

narratives were collected from participants. This lack of narrative disallowed the

inclusion of qualitative nuances within the study. The researcher had to rely on

the statistical analyses of the collected data to formulate conclusions. Without

narratives to supplement the data, conclusions were more limited and less rich

than they could have been with narratives.

 43

The vignettes featured only heterosexual couples and not couples of the

same gender, and this posed a third limitation. The study aimed to examine

whether biases against voluntarily childless couples exist, yet it did not include

both heterosexual and same-sex couples. This study therefore was unable to

provide data pertaining to mental health professionals’ perceptions of voluntarily

childfree couples who are gay or lesbian.

Last, because the study was offered online only, the participant was

expected to proceed to the survey website on his or her accord, on his or her own

time. Not all mental health professionals are proficient with the Internet or have

regular access to a computer. This was a limitation that may have prevented more

individuals from taking the time to participate in the study. Also, no

compensatory incentive to participate was offered, so potential participants may

have been dissuaded from responding to the survey because of the lack of a

tangible incentive in exchange for their time and effort. Although 181 participants

provided sufficient data for the purpose of this study, the group is still a relatively

small sample size, and a larger participant pool would increase reliability and

validity within the study.

Recommendations for Further Research

The intent of the current study was to determine whether mental health

professionals had negative perceptions of couples who chose to be childfree. The

rationale for this study emphasizes the importance of attention to the experiences
 44

of marginalized populations. Individuals who identify as gay or lesbian are part of

another minority group that experiences bias and discrimination. However, the

instruments utilized in the research only involved vignettes that featured

heterosexual couples and not couples of the same gender. Therefore, there is no

available data pertaining to mental health professionals’ perceptions of voluntarily

childfree gay or lesbian couples. Would voluntarily childless couples who are gay

or lesbian be subject to more negative perceptions than voluntarily childless

heterosexual couples? This is a question that could be answered through further

research and perhaps serve as an extension of the current study.

Another recommendation for further exploration pertains to differences

between mental health professionals and the general population in their attitudes

toward and perceptions of voluntarily childless men and women. Considering that

the earlier studies were conducted among high school, college, and university

students and this study was conducted among mental health professionals, no

current research exists to indicate adult Americans' attitudes toward and

perceptions of childfree couples in the twenty-first century. The exploratory

analyses conducted in this study revealed no statistically significant findings that

could suggest any remarkable relationships between respondents’ ratings and the

demographic variables of marital status, parental status, professional degree,

religion, age, and gender. In this case, participants shared the common feature of

working in the mental health field. Would responses differ, if the participants
 45

were not mental health professionals? A comparison of the results of a study

examining differences between mental health professionals' and the general

population's perceptions of voluntarily childfree men and women would be an

interesting concept for future study and could reveal noteworthy outcomes.

As it stands, this study contributes one meaningful piece to the greater

body of existing literature. It would benefit the mental health profession to

continue exploring the issue of pronatalism and how it contributes to assumptions

and attributions toward those who are childless, both voluntarily and

involuntarily. After all, professionals in the field of mental health have an ethical

obligation to do no harm. Hopefully, being more informed and further educated

on the implications of indoctrinated values regarding childbearing will allow

mental health professionals to provide less biased and more effective treatment to

clients who choose to be childfree.

 46

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Bender, S., & Messner, E. (2003). Becoming a therapist: What do I say, and why?
New York, NY: The Guilford Press.

Broderick, P. C., & Blewitt, P. (2003). The life span: Human development for
helping professionals. Upper Saddle River, NJ: Pearson Education.

Calhoun, L. G., & Selby, J. W. (1980). Voluntary childlessness, involuntary

childlessness, and having children: A study of social perceptions. Family
Relations, 29, 181-183.

Carter, B., & McGoldrick, M. (2005). Overview: The expanded family life cycle.
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Individual, family, and social perspectives (pp. 1-26). Boston, MA: Allyn
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 48

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 49

APPENDIX A

Vignette 1

Frank and Elena have been married for seven years. Frank is 33 years old; Elena

is 30. They met at a party given by a mutual friend and decided to get married

about a year later. Frank and Elena live in the city and have made the decision not

to have any children. Both have been steadily employed throughout their marriage

and are teachers in their county’s public schools. Lately, they have been thinking

that they don’t have enough time for themselves. Frank thinks that they need to

work on improving their communication. Elena thinks that they are not spending

enough time together in activities that they both used to enjoy.

 50

APPENDIX B

Vignette 2

Frank and Elena have been married for seven years. Frank is 33 years old; Elena

is 30. They met at a party given by a mutual friend and decided to get married

about a year later. Frank and Elena live in the city and have two children. Both

have been steadily employed throughout their marriage and are teachers in their

county’s public schools. Lately, they have been thinking that they don’t have

enough time for themselves. Frank thinks that they need to work on improving

their communication. Elena thinks that they are not spending enough time

together in activities that they both used to enjoy.

 51

APPENDIX C

Vignette 3

Frank and Elena have been married for seven years. Frank is 33 years old; Elena

is 30. They met at a party given by a mutual friend and decided to get married

about a year later. Frank and Elena live in the city and have no children because

of infertility issues. Both have been steadily employed throughout their marriage

and are teachers in their county’s public schools. Lately, they have been thinking

that they don’t have enough time for themselves. Frank thinks that they need to

work on improving their communication. Elena thinks that they are not spending

enough time together in activities that they both used to enjoy.

 52

APPENDIX D

Vignette 4

Frank and Elena have been married for seven years. Frank is 33 years old; Elena

is 30. They met at a party given by a mutual friend and decided to get married

about a year later. Frank and Elena live in the city and have no children. Both

have been steadily employed throughout their marriage and are teachers in their

county’s public schools. Lately, they have been thinking that they don’t have

enough time for themselves. Frank thinks that they need to work on improving

their communication. Elena thinks that they are not spending enough time

together in activities that they both used to enjoy.

 53

APPENDIX E

Information and Consent Form for Non-Medical Research

This study has been reviewed and approved by the Antioch University, Santa
Barbara Institutional Review Board.

You are being asked to participate in a research study conducted by Felizon C.

Vidad, MA, a doctoral candidate completing her dissertation in the Psychology
Department at Antioch University, Santa Barbara. You were selected as a possible
participant in this study because you elected to open this webpage.

DESCRIPTION OF STUDY AND PROCEDURES

This is a study about impression formation. The purpose of this study is to
measure how perceptive one can be about a couple, given a limited amount of
information. You will be asked to read a vignette and then complete a
questionnaire rating your impressions of the couple presented in the vignette. You
will also be asked to complete a questionnaire to provide demographic
information. The entire survey can be completed in approximately 15 minutes or
less.

POTENTIAL RISKS AND DISCOMFORTS

There are no anticipated risks to your participation. You may feel uncomfortable
assigning a rating to a couple based on limited information. You may be
inconvenienced from taking time out of your day to complete the questionnaire.

POTENTIAL BENEFITS
Participation in this study may benefit others in the mental health profession
through the educational results it could provide.

CONFIDENTIALITY
The survey is anonymous; you will not be required to provide your name or email
address. Only the author of this study will have access to the data associated with
this study. The data will be stored in the investigator's office in a locked file
cabinet and a password protected, external computer storage drive. After the study
is completed, the data will be stored for five years and then destroyed. When the
results of the research are published or discussed in conferences, only group
demographics may be shared. Demographic information pertaining to individual
participants will not be revealed.

PARTICIPATION AND WITHDRAWAL

 54

Participation in this study is voluntary. You may refuse to enter it, or you may
withdraw at any time without creating any harmful consequences to yourself.
Additionally, the investigator may withdraw you from the analysis of this research
if circumstances arise which warrant doing so.

RIGHTS OF RESEARCH SUBJECTS

You may withdraw your consent at any time and discontinue participation without
penalty. You are not waiving any legal claims, rights, or remedies because of your
participation in this research study. If you have any questions regarding your
rights as a research subject, you may contact the Antioch University Santa
Barbara IRB, 801 Garden Street, Santa Barbara, CA 93101, ATTN: Michele
Harway, Ph.D. or [email protected].

If you have any questions or concerns about the research, please feel free to
contact Felizon Vidad at [email protected].

Proceeding with this questionnaire by clicking “next” confirms your agreement to

participate in this study.
 55

APPENDIX F

Demographic Questionnaire

1. What is your age? ______

2. What is your gender?

o Male
o Female
o Other (please specify) ______________

3. What is your birth order?

o Oldest
o Second Oldest
o Middle
o Second Youngest
o Youngest
o Only
o Other (please specify number in birth order) _________

4. What is your marital status?

o Single
o Married
o Domestic partnership
o Committed nonmarried
o Divorced or separated
o Widowed

5. Are you a parent or caretaker of one or more children?

o Yes
o No

6. What is the highest professional degree that you currently hold?

o PhD Clinical
o PhD Counseling
o PsyD
o EdD
o MA
o MSW
o BA
 56

7. Which of the following best describes your clinical orientation?

o Behavioral or cognitive-behavioral
o Dynamic, object relations, or analytic
o Feminist or multicultural
o Humanistic or existential
o Systems
o Other (please specify) __________________

8. What is the title of your occupational position?

_______________________________

9. How long have you been practicing as a mental health clinician?

_________ months _________ years

10. Which of the following best describes your religious affiliation?

o Catholic
o Jewish
o Protestant
o None
o Other (please specify) _______________________

11. Which of the following best describes the race or ethnicity with which you
identify?
o African American
o Asian American
o European American
o Mexican American
o Native American
o Other (please specify) ___________________
 57

APPENDIX G

Survey of Impression Formation

Considering the information provided, please answer the following questions the
best that you can.

1. How happy is the couple?

o not at all
o very slightly
o slightly
o moderately
o very

2. How lonely is the couple?

o not at all
o very slightly
o slightly
o moderately
o very

3. How ambitious is the couple?

o not at all
o very slightly
o slightly
o moderately
o very

4. How successful is the couple?

o not at all
o very slightly
o slightly
o moderately
o very

5. How stressed is the couple?

o not at all
o very slightly
o slightly
 58

o moderately
o very

6. How anxious is the couple?

o not at all
o very slightly
o slightly
o moderately
o very

7. How confident is the couple?

o not at all
o very slightly
o slightly
o moderately
o very

8. How reliable is the couple?

o not at all
o very slightly
o slightly
o moderately
o very

9. How competent is the couple?

o not at all
o very slightly
o slightly
o moderately
o very

10. How loving and affectionate is the couple to each other?

o not at all
o very slightly
o slightly
o moderately
o very

11. This couple is likely to stay together.

o strongly disagree
o disagree
 59

o neither agree nor disagree

o agree
o strongly agree

12. This couple has a fulfilling sex life.

o strongly disagree
o disagree
o neither agree nor disagree
o agree
o strongly agree

13. This couple worries about the future.

o strongly disagree
o disagree
o neither agree nor disagree
o agree
o strongly agree

14. This couple will have a happy life together.

o strongly disagree
o disagree
o neither agree nor disagree
o agree
o strongly agree

Please read the following statements and select the response that is most
appropriate to your experience.

15. The couple’s ages influenced my choice of ratings.

o strongly disagree
o disagree
o neither agree nor disagree
o agree
o strongly agree

16. The length of the couple’s marriage influenced my choice of ratings.

o strongly disagree
o disagree
o neither agree nor disagree
 60

o agree
o strongly agree

17. The size of the family influenced my choice of ratings.

o strongly disagree
o disagree
o neither agree nor disagree
o agree
o strongly agree

18. The couple’s place of residency influenced my choice of ratings.

o strongly disagree
o disagree
o neither agree nor disagree
o agree
o strongly agree

20. The couple’s employment status influenced my choice of ratings.

o strongly disagree
o disagree
o neither agree nor disagree
o agree
o strongly agree
 61

APPENDIX H

Letter of Introduction and Request for Participation

Hello,

I am a doctoral student in the Department of Clinical Psychology at Antioch

University Santa Barbara. For my dissertation, I am conducting a research study
on contemporary couples’ issues and impression formation among mental health
professionals. This study has been reviewed and approved by the Antioch
University Santa Barbara Institutional Review Board. Participants include
individuals who work in the field of mental health and who provide
psychotherapeutic services to clients at inpatient, outpatient, community, and/or
private agencies. Participants may include licensed clinicians, graduate students,
interns, and trainees.

I am gathering data via an online survey hosted by surveymonkey.com. The

survey takes approximately 5 to 10 minutes to complete, and it is wholly
anonymous. By clicking on the link below, you will be connected directly to the
survey. The first page includes a consent form that provides further information
about the study. Also, feel free to forward this email to your colleagues and
acquaintances in the mental health profession, as I am attempting to obtain a wide
demographic representation of participants.

Thank you in advance for your participation and support!

Sincerely,

Felizon Vidad, M.A.

Survey Link:

(If the link above does not take you directly to the survey, you can copy and paste
it directly into your browser.)
 62

APPENDIX I

Form B

Ensuring Informed Consent of Participants in Research:

Questions to be answered by AUSB Researchers

1. Are your proposed participants capable of giving informed consent? Are

the persons in your research population in a free-choice situation? Are
they constrained by age or other factors that limit their capacity to choose?
For example, are they adults or students who might be beholden to the
institution in which they are enrolled, or prisoners, or children, or mentally
or emotionally disabled? How will they be recruited? Does the inducement
to participate significantly reduce their ability to choose freely or not to
participate?

All individuals in the research population are in a free-choice situation.

Participants will be non-incarcerated adults (age 18 and over) recruited
from graduate schools in psychology, local public mental health agencies,
private practices, and various associations of mental health professionals.
They will be contacted via email with an invitation to participate in this
study and a link to follow to the survey website. Participation will be
purely voluntary and there will be no inducement to participate, ensuring
that participants may freely choose to participate or decline to participate
in the study. All potential participants will be provided with a consent
form to read prior to participating in the study.

2. How are your participants to be involved in the study?

Participants will read a vignette about a couple and then complete a

questionnaire rating their impressions of the couple. Additionally, they
will provide demographic information about themselves.

3. What are the potential risks – physical, psychological, social, legal, or

other? If you feel your participants will experience “no known risks” of
any kind, indicate why you believe this to be so. If your methods do create
potential risks, say why other methods you have considered were rejected
in favor of the method chosen.
 63

There are no known physical, social, legal, or psychological risks to

individuals involved in the study. Care was taken in the development of
the vignettes and questionnaire, avoiding provocative language or
phrasing that might cause potential risks to the participant’s emotional
well-being.

4. What procedures, including procedures to safeguard confidentiality, are

you using to protect against or minimize potential risks, and how will you
assess the effectiveness of those procedures?

In order to protect against and minimize potential risks, the procedures of

this study involve only a few steps. Prior to participation in the study,
participants will be given a consent form that informs them that their
participation is purely voluntary and that they may withdraw from the
study at any time. Therefore, participants are ensured freedom of choice
and if they feel any discomfort at any point during the process, they may
choose to terminate their participation. After consenting to the study,
participants will complete a demographics questionnaire, read a vignette,
and then complete a survey in which they provide responses based on the
information in the vignette. By keeping the steps simple and requiring no
more than fifteen minutes of the participant’s time, potential risks are
minimized.

To safeguard confidentiality, the survey is anonymous. Participants will

not be required to provide a name or email address. Only the author of this
study will have access to the data associated with this study. The data will
be stored in the investigator's office in a locked file cabinet and a
password protected, external computer storage drive. After the study is
completed, the data will be stored for three years and then destroyed.
When the results of the research are published or discussed in conferences,
only the demographic information about participants may be revealed.

5. Have you obtained (or will you obtain) consent from your participants in
writing?

An information and consent form will be provided to the participant to

read and accept or reject before any further steps in the study are taken. A
copy of the form is included in the Appendices.
 64

6. What are the benefits to society and to your participants that will accrue
from your investigation?

The information and results obtained in the study may further educate
mental health professionals and assist them in their treatment of
individuals who have voluntarily chosen to be childless. Participants may
benefit by knowing that they have helped contribute to increased
awareness and education among mental health professionals through their
participation in the study.

7. Do you judge that the benefits justify the risks in your proposed research?
Indicate why.

The benefits to this study appear to outweigh any possible risks; therefore,
the benefits seem to justify the risks in this proposed research study.

Both the student and her Dissertation Chair must sign this form and submit it
before any research begins. Signatures indicate that, after considering the
questions above, both students and faculty persons believe that the conditions
necessary for informed consent have been satisfied.

Signed:_________________________________ Date: ________________

Felizon C. Vidad, M.A. Doctoral Student

Signed:_________________________________ Date: ________________

Juliet Rohde-Brown, Ph.D., Dissertation Chair