Meichenbaum's stress-inoculation therapy (1985)



Meichenbaum's stress-inoculation therapy (1985)

Preparing people for stress can be likened to giving an injection to prevent a disease. The 'inoculation' proceeds in stages. Meichenbaum and Cameron (1983) suggested the following stages:

1) Conceptualisation — identifying and expressing feelings and fears. Clients should be

educated about stress and encouraged to relive stressful situations, analysing what was

stressful about them and how they attempted to deal with them.

2) Skill acquisition and rehearsal — for example: learning how to relax; experiencing desens-

itisation and emotional discharge; turning to others; and finding out about cognitive redef-

inition. Specific skills might be taught, such as parenting techniques, communication skills,

time-management or study skills.

3) Application and follow through — the trainer guides the patient through progressively

more threatening situations so that the patient can apply his/her newly acquired skills. The

techniques become reinforced and this makes the practices self-sustaining.

Strengths

Meichenbaum's model focuses on both the nature of the stress problem (enabling clients to appraise their lives more realistically) and the ways of coping with stress (giving clients greater understanding of the strengths and limitations of specific techniques).

Stress-inoculation has been effective in a variety of stressful situations, including anxiety about mathematics in college students, managing hypertension in all age groups and stress management in general. It has been successfully combined with other treatment methods to allex'iate stress.

Weaknesses

Psychological techniques require considerable input and effort on the part of the client. The long-term benefits are only gained as a result of considerable time spent learning the skills associated with stress-inoculation.

A further weakness with this technique is that the benefits may be due to factors other than the steps laid down for stress-inoculation. For example, benefits may be gained just from learning to take greater control over one's life rather than having to go through the prolonged training.

A study of stress-inoculation

Novaco (1975, 1977) has demonstrated the usefulness of stress-inoculation training and relaxation in helping people to control their anger. He trained patients who identified themselves as having serious problems controlling anger and who were also clinically assessed as having such problems. The patients then learned about the role of arousal and cognitive processes in feelings of anger. Then they learned muscle relaxation with accompanying statements; for example:

Preparing for a provocation

This could be a rough situation; you have the know-how to deal with it. You can work out a plan to handle this. Easy does it. Remember, stick to the issues and don't take it personally. There won't be any need for an argument. You know what to do.

Impact and confrontation

As long as you keep your cool, then you are in control of the situation. You don't need to prove yourself. Don't make more out of this than you have to. There is no point in getting mad. Think of what you have to do, look for the positives and don't jump to conclusions.

Coping with arousal

Muscles are getting tight. Relax and slow things down. Time to take a deep breath. Let's take the issue point by point. Your anger is a signal of what you need to do. Time for problem-solving. He probably wants you to get angry, but you're going to deal with it constructively.

Subsequent reflection, conflict unresolved

Forget about the aggravation. Thinking about it only makes you upset. Try to shake it off. Don't let it interfere with your job. Remember relaxation. It's a lot better than anger is. Don't take it personally. It's probably not so serious.

Subsequent reflection, conflict resolved

You handled that one pretty well. That's doing a good job. You could have got more upset than it was worth. Your pride can get you into trouble, but you're doing better at this all the time. You actually got through that without getting angry.

The participants practised the techniques while imagining and role-playing realistic anger situations arranged in a hierarchy from least to most provoking. When provoked in a laboratory they were able to control their anger, as measured by self-reports and their blood pressure.

References

Meichenbaum, D. (1985) Stress Inoculation Training, Pergamon Press.

Meichenbaum, D. and Cameron, R. (1983) 'Stress inoculation training: toward a general

paradigm for training coping skills', in D. Meichenbaum and M. E. Jaremko (eds), Stress

Reduction and Prevention, pp. 115-54, Plenum Press. Novaco, R.W. (1975) Anger Control: the Development and Evaluation of an Experimental Treatment,

Lexington Books. Novaco, R. W. (1977) 'Stress inoculation: a cognitive therapy for anger', journal of Consulting

and Clinical Psychology, Vol. 45, pp. 600-8.

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