Self-Instruction Training And The Stress Inoculation Technique
Behavior Modification Techniques They have been one of the central elements on which cognitive-behavioral intervention has traditionally been based. At their birth, the Learning Theories proposed by Thorndike, Watson, Pavlov or Skinner emphasized the role played by the stimulus that accompanies the learning situation (by association or contingency).
Later, after the rise of Cognitive Theories, it seems to have been demonstrated that the psychological change in the individual is deeper and more complete. when the modification of deep cognitions and beliefs is also worked onand not just the most behavioral part.
Accordingly, let’s look at two of the techniques that try to illustrate what it consists of and how said change is made on a more internal and mental level: Self-Instruction Training and Stress Inoculation.
Self-Instruction Training highlights the role that the internal verbalizations that the person himself makes about his future execution have when carrying out a specific behavior.
An internal verbalization (or self-verbalization) could be defined as a set of commands or instructions that the person gives to himself to guide the management of his behavior during his performance. Depending on this instruction, the person will feel more or less capable of performing the behavior effectively.
This technique can be applied as a therapeutic element in itself or can also be considered as a component within Stress Inoculation therapyas will be explained later.
Components of Self-Instruction Training
The EA is made up of several elements: modeling, behavioral rehearsal, and cognitive restructuring. Let’s detail what each of them consists of:
1. Modeling (M)
Modeling is a behavioral technique that It is based on the idea that all behavior can be learned by observation and imitation (Social Learning). It is used in order to acquire or strengthen new, more adaptive response patterns, weaken those that are inadequate, or facilitate those that the person already has but that they do not put into practice for various reasons (execution anxiety, for example).
To carry out the procedure, it is necessary for a model to perform the successful behavior in the presence of the person and for the person to practice it in such a way that their autonomy gradually increases as the help received by the model decreases. In addition, it informs the person about the appropriateness of the execution of the behavior and indicates possible aspects to improve.
This technique is similar to the previous one, since it also serves to learn new behavioral skills, especially social or interpersonal skills. It consists of staging a potentially anxiety-inducing behavioral repertoire in the context of the professional’s consultation, in such a way that the subject can feel safer as the reproductions are artificial and easily manipulated.
Therefore, the CS allows a decrease in the subject’s level of anxiety regarding the execution and a greater predisposition to “train” their behavior without fear of suffering the consequences that it would have if the situation were in the real context. At first, the proposed representations are very guided by the professional and gradually become more flexible and natural.
3. Cognitive Restructuring (CR)
It is based on the idea that psychological problems are caused and maintained by the way a person interprets their environment and circumstances. That is to say, that an event by itself has no positive or negative emotional valuebut rather the evaluation made of this event is what provokes one type of emotion or another. If the event is conceptually interpreted as something positive, the resulting emotional state will also be pleasant. On the other hand, if a negative cognitive evaluation is made, a state of emotional discomfort will result.
The idea of a negative interpretation of the event is normally followed immediately by a series of thoughts that are known as irrational beliefssince they are expressed in an absolutist and dogmatic way (all or nothing) and do not take into account other possible alternative explanations. How, for example, to overemphasize the negative, exaggerate what is unbearable or condemn people or the world if they do not provide the person with what they believe they deserve.
Cognitive Restructuring is the main element of Albert Ellis’ Rational Emotive Behavioral Therapy, which has the objective of modifying this inadequate belief system and providing the individual with a new, more adaptive and realistic philosophy of life.
The core practice of CR It involves performing an exercise (mental or written) in which the initial irrational cognitions derived from the situation that occurred, the emotions that these have generated and finally, a set of reflections of an objective and rational nature that question the mentioned negative thoughts must be included. This registry is known as the ABC Model.
The EA procedure begins with self-observation and the recording of the verbalizations that the person makes about themselves with the aim of eliminate those that are inappropriate or irrelevant and that they are interfering with the successful execution of the behavior (For example: everything goes wrong for me, I am to blame for everything that has happened, etc.). Subsequently, the establishment and new, more correct self-verbalitzations are carried out (For example: making a mistake is sometimes normal, I will get it, I am calm, I feel capable, etc.).
More specifically, the EA is made up of five phases:
Modeling: the person observes how the model deals with the negative situation and learns how to do it.
External guidance out loud: the person faces the negative situation following the therapist’s instructions.
Self-instructions out loud: the person faces the negative situation while directing himself out loud.
Self-instructions in a quiet voice: the person faces the aversive situation while directing himself but this time in a very low voice.
Covert self-instructions: the person faces the negative situation by guiding his behavior through internal verbalizations.
Stress Inoculation (IE) Techniques
Stress Inoculation Techniques have the objective of facilitating the subject’s acquisition of certain skills that allow him both reduce or cancel physiological tension and activation and eliminate previous cognitions (of a pessimistic and negative nature, frequently) by more optimistic assertions that facilitate adaptive coping with the stressful situation that the subject must carry out.
One of the theories on which this technique is based is Lazarus and Folkman’s Stress Coping Model. This procedure has proven its effectiveness especially in Generalized Anxiety Disorders.
Procedure
The development of Stress Inoculation is divided into three phases: one educational, one training and one application. This intervention acts both in the cognitive area, as well as in self-control and behavioral adaptation to the environment.
1. Educational phase
In the educational phase information is provided to the patient about the way in which anxiety-inducing emotions are generatedemphasizing the role of cognitions.
Subsequently, an operational definition of the person’s specific problem is carried out, using different data collection instruments such as an interview, a questionnaire or direct observation.
Finally, A series of strategies are implemented to promote and facilitate the subject’s adherence to the treatment.. For example, establishing an appropriate therapeutic alliance based on the transmission of trust.
2. Training phase
In the training phase, the person is shown a series of procedures in order to integrate skills related to four large blocks: cognitive, control of emotional activation, behavioral and palliative coping. To work on each of these blocks, the following techniques are put into practice:
3. Application phase
In the application phase The attempt is made to expose the person to anxiety-producing situations (real and/or imagined) gradually.putting into action everything learned in the training phase. In addition, the effectiveness of the application of the techniques is checked and assessed and doubts or difficulties are resolved during their execution. The procedures used are the following:
Finally, to finish complementing the intervention in Stress Inoculation some more sessions are scheduled in order to achieve maintenance of the achievements obtained and prevent possible relapses. In this last component, aspects such as the conceptual differentiation between fall – punctual – and relapse – more sustained over time – or the scheduling of follow-up sessions where continuing with a form of indirect contact with the therapist, mainly) are worked on.
By way of conclusion
Throughout the text it has been observed how, as initially proposed, the psychological intervention that addresses different components (cognitions and behaviors, in this case) can see its effectiveness increased to achieve the psychological change proposed by a person. Thus, as demonstrated by the principles supported by the Psychology of Language, The messages that a person sends to himself tend to shape his perception of reality. and therefore, the ability to reason.
Therefore, an intervention also focused on this component will allow a greater probability of maintaining the psychological change obtained in the individual himself.
