Self-study training and stress inoculation technique

Behavior modification techniques they have been one of the central elements on which cognitive-behavioral intervention is traditionally based. When it was created, the Theories of Learning proposed by Thorndike, Watson, Pavlov or Skinner underlined the role played by the stimulus that accompanies the learning situation (by association or by contingency).

Subsequently, after the rise of cognitive theories, it seems to have been shown that the psychological change in the individual is deeper and more complete. when you are also working on changing deep cognitions and beliefs, And not just the most behavioral part.

Accordingly, let’s look at two of the techniques that attempt to illustrate what this change is and how it occurs on a more internal and mental level: Self-study training and stress inoculation.

Self-study training (EA)

The self-instruction training emphasizes the paper that has the internal verbalizations that the own person realizes about his future execution at the moment of the execution of a certain behavior.

Internal verbalization (or self-verbalization) could be defined as a set of commands or instructions that the person gives to guide the management of his conduct during his performance. Depending on how this instruction is, the person will feel more or less able to perform the behavior effectively.

This technique can be applied as a therapeutic element in itself or it can also be considered as a component of stress inoculation therapy, As will be discussed below.

Components of self-study training

The EA consists of several elements: modeling, behavioral testing and cognitive restructuring. We 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 through observation and imitation (Social learning). It is used to acquire or reinforce new, more adaptive response patterns, weaken inappropriate ones, or facilitate those the person already has but is not implementing for various reasons (execution anxiety, for example).

In order to complete 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 a way that gradually increases their autonomy as the help received by the model decreases. . In addition, it informs the person of the adequacy of the performance of the behavior and indicates possible aspects for improvement.

2. Behavior test (CE)

This technique is similar to the one above, as it is also used to learn new behavioral skills, especially social or interpersonal skills. It consists of staging a potentially anxious behavioral repertoire as part of the professional’s consultation, so that the subject can feel more secure being the artificial reproductions and easily manipulated.

Therefore, the EC allows a decrease in the subject’s level of anxiety prior to execution and a greater predisposition to “train” their behavior without fear of the consequences that this would have if the situation were in the real context. At the beginning the proposed performances 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 how a person interprets their environment and circumstances. Which means an event in itself has no positive or negative emotional valueBut the appreciation that is made of that event is what causes one type of emotion or another. If the event is conceptually interpreted as a positive thing, the resulting emotional state will also be pleasurable. Conversely, if a negative cognitive assessment is made, it will result in a state of emotional distress.

The idea of ​​a negative interpretation of the event is usually immediately followed by a series of thoughts called irrational beliefs, As they are expressed in an absolutist and dogmatic (all or nothing) way and do not take into account other possible alternative explanations. Like, for example, overestimating the negative, exaggerating the unbearable, or condemning people or the world if they don’t provide the person with what they think they deserve.

Cognitive restructuring is the mainstay of Albert Ellis’ Rational Emotional Behavior Therapy, which aims to change this inappropriate belief system and provide the individual with a new, more adaptive and realistic philosophy of life.

The central practice of CR falls in performing an exercise (mental or written) in which the initial irrational cognitions derived from the situation are to be included, the emotions they generated and finally, a set of reflections of an objective and rational character that challenge the negative thoughts mentioned. This recording is known as the ABC model.

procedure

The EA procedure begins with self-observation and recording the verbalizations that the person makes about themselves in order to eliminate those that do not match and that they interfere with the successful execution of the behavior (For example: everything is wrong for me, I am responsible for everything that has happened, etc.). Later, the most correct installation and new self-verbalizations are performed (For example: sometimes making a mistake is normal, I will get it, I am calm, I feel capable, etc.).

More specifically, the EA consists of five phases:

  1. Modeling: the person observes how the model copes with the negative situation and learns how to do it.
  2. External guidance out loud: the person copes with the negative situation by following the therapist’s instructions.
  3. Loud self-instruction: the person faces the negative situation as they self-direct out loud.
  4. Self-instruction in a low voice: the person faces the aversive situation at the same time as he is moving, but this time in a very low voice.
  5. Secret self-instructions: the person faces the negative situation by guiding their behavior through internal verbalizations.

Stress Inoculation Techniques (IE)

Stress inoculation techniques aim to facilitate the acquisition by the subject of certain skills allowing him to both to decrease or cancel tension and physiological activation as well as to eliminate previous cognitions (Pessimistic and negative, often) for more optimistic statements that facilitate an adaptive adaptation to the stressful situation that the subject has to do.

One of the theories in which this technique is supported is the Lazarus and Folkman stress management model. This procedure has proven to be effective especially in generalized anxiety disorders.

procedure

The development of stress inoculation is divided into three phases: training, training and application. This intervention acts both in the cognitive domain and in that of self-control and behavioral adaptation to the environment.

1. Educational phase

In the educational phase information is provided to the patient on how anxious emotions are generated, Emphasizing the role of cognitions.

Subsequently, an operational definition of the specific problem of the person is carried out, using different data collection tools, such as an interview, a questionnaire or a direct observation.

finally a series of strategies are put in place which promote and facilitate the subject’s adherence to the treatment. Through 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 major blocks: cognitive, control of emotional activation, behavioral and palliative adaptation. To work each of these blocks, the following technical elements are put into practice:

  • Hcognitive abilities: In this blog We work on cognitive restructuring strategies, problem-solving techniques and the practice of self-learning exercises with subsequent positive reinforcement.
  • VSactivation control: This is a training in relaxation techniques focused on the sensation of muscle tension-distension.
  • behavioral skills: Techniques such as behavioral exposure, modeling and behavioral testing are discussed here.
  • Adaptation skills: Finally, this block includes resources for improving mindfulness control, changing expectations, correctly expressing affection and emotions, and managing perceived social support well.

3. Application phase

In the application phase we try to get the person exposed to anxious situations (real and / or imagined) gradually, Implement everything that has been learned in the training phase. In addition, the effectiveness of the application of the techniques is checked and evaluated and any doubts or difficulties are resolved during their execution. The procedures used are as follows:

  • imagined test: The individual gives as vivid a vision as possible of the confrontation with the anxious situation.
  • behavioral tests: The individual stages the situation in a safe environment.
  • Graduated in vivo exposure: The individual is in the real situation naturally.

Finally, to complete the intervention in inoculation against stress some additional sessions are scheduled to perform maintenance successes and avoid possible relapses. This last section deals with aspects such as the conceptual differentiation between fall – one-off – and relapse – more sustained over time – or the programming of follow-up sessions where a form of indirect contact with the therapist mainly continues).

To conclude

Throughout the text, it was possible to observe how, as initially proposed, the psychological intervention which addresses different components (cognitions and behaviors, in this case) can increase its effectiveness in achieving the psychological change posed by a person. . Thus, as the principles defended by the psychology of language demonstrate, the messages that a person gives themselves tend to shape their perception of reality and therefore the ability to reason.

Therefore, an intervention that also focuses on this component will allow a greater probability of maintaining the psychological change obtained in the individual.

Bibliographical references:

  • Pages, FJ (2008). Behavior modification techniques. Madrid: Pyramid.
  • Marín, J. (2001) Social psychology of health. Madrid: Synthetic psychology.
  • Olivares, J. and Méndez, FX (2008). Behavior modification techniques. Madrid: New library.

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