Professional Documents
Culture Documents
Self Inst Training
Self Inst Training
f%qmdmminWorinREutofgrlamLs~qrIh6
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r t r e ~ k m r s w 3 r i c t r a e c o n g . n ~ ~ ~
of the fitm.
fn t h e Faculty
of
~
A, Horvath
Instructor
I/
In r e c e n t y e a r s , c o g n i t ive-bahuvloral t r a i n i n g procadorem,
heen s t u d i e d
t r a i n h g and s t r e s u - i n o c u l a t i o n t r a i n i n g o - a r t revie,&.
P
R e s u l t s o f t h e s e a n a l y m r are
considered i n r e l a t i o n t o l a i c h e n h u m ' s t h e o r y o f
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I'
+
f
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arelf -in6t
t r a i n i n g are
"
s t r e s s - i n e m l a t i o n t r a i n f n g t y p i c a l l y are obscured i n t h e
f r p l e m a t i o n of t h e s e t w o t r a i n i n g procedures in applied and
experimental c o n d i t i o n s .
F u n c t i o n a l d i f f e r a n c e s noted in t h e
~orponentd
%.
At
appear to be -11-f'olmded
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in the g.ner.1
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and f a c i l i t a t i v e i n s t r u c t i o n ,
-
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during a l l but t h e f i n a l s t a g e o f t h i s t h e s i s .
vii
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rr
Rehearsal colepoqent s ~ d i e s . . . . . . . . , . . . . , . . . . . . . . . p
....................................T..p.
i
Stress-Inoculatiou-Training Studies...,,.............p,
66.
67.
60.
70.
......p.
76.
96,
Conclusion. . . . . . . , . . . . . . . . . . . . . . . . . . , ~ . . . . . . p
Conclusion:
104.
Comparative q t c o m e Studies...~..~...~,.,....,.,......,...p~
119.
ctional ~tudiea....,.....,~.,,.,,~,,.~..~,p~
Self-control studies.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . p .
3
119,
120.
. 130.
138.
139,
Summary of S t r u c t u r a l C o n s i b e r a t i o n s , . . . , . . . L . . m . o . . e . . o p . 168,
LIST OF.TABLES
1
Table 1.
Training,.
.......:.,.......,...........k....e.........pp.
Table 2.
in Stteas-Inoculation ~ r a i n i Dismantling
i ~
Studies..
Table 3 .
106a,b.
.. p ,
109.
and I n e f f e c t i v e Treatments....,.....................~.p.
113.
F i g u r e 1,
. . treatment
F i g u r e 2..
Stress-inuculatiun training:
components........,..............................p.
17.
19.
T h i s p a p e r examines s e l f - i n s t r u c t i o n a l t r a i n i n g and
strese-inoculation
/" .
I t s p u r p o s e is t o d e t e r m i n e w h e t h e r t h e s e two
t o the prese
d i f f e r e n t n'aoes i n d i c a t e c o n c e p t u a l a n d / o r f u n c t i o n a l
distinctions,
An o v e r v i e w o f n e i c h e n b a u m ' s r e s e a r c h i n t r o d u c e s
,,--.,
s e l f - i n e t r u c t i o n a l t r a ' i n i n g and s t r e s s - i n o c u l a t i o n t r a i n i n g .
T.
T h e n , these p r o c e d u r e s a r e compared s t r u c t u r a l l y , i n r e l a t i o n t o
-
F i n a l l y , t h e p a p e r b a s e s its c o n c l u s i o n s on
p o i n t s o f s i m i l a r i t y and d i f f e r e n c e between t h e s e t w o p r o c e d u r e s
and the c o n c e p t u a l f o u n d a t i o n s t h a t u n d e r l i e them,
t o t h e p o t e n t i a l of s e l f - i n s t r u c t i o n .
Raving t a u g h t
&
Goodman, 1 9 7 1 ) i n d i c a t e d t h a t c o g n i t i v e m o w l i n g ,
a s d e v e l o p e d i n his d i s s e r t a t i o n , is a n e c e s s a r y b u t i n s u f f i c i e n t
9
c o n d i t i o n f o r b e h a v i o r a l change w i t h i m p u l s i v e c h i l d r e n .
Yowever, when s e l f - i n s t r u c t i o n a l
r e h e a r s a l , c o n s i s t i n g of
p r a c t i c e u s i n g o v e r t and c o v e c t v e r b a l i z a t i o n s o f p e r f o r m a n c e
r e l e v a n t i n s t r u c t i o n s , was used w i t h t h e s e c h i l d r e n , s u c h
S e l f - i n s t r u c t i o n a l t r a i n i n g c o d i n e s elements of s o c i a l
l e a r n i n g t h e o r y and s e l f - r e g u l a t o r y a s p e c t s of language.
C o g n i t i v e modeling r e s e a r c h p r o v i d e s e v i d e n c e t h a t b e h a v i o r s
d- e m o n s t r a t e d by m d e l s a r e l e a r n e d by o b s e r v e r s (Bandura, 1 9 6 9 ) .
To p r i n c i p l e s o f s o c i a l l e a r n i n g t h e o r y , Heichenbaum added v e r b a l
m e d i a t i o n , i n s p i r e d from t h e work of L u r i a (1961) and Vygotsky
(1962)
into 'a f i v e - s t e p l e a r n i n g p r o c e s s ( 1 9 7 7 a ) .
An i n s t r u c t o r o r
I n t h i s f i r s t step, c o g n i t i v e modeling, a n a d u l t
- -
same t a s k - - o v e r t ,
i n s t r u c t i o n s , a c l i e n t performs t h e
e x t e r n a l guidance.
Then a c l i e n t performs t h e
t a s k r e p e a t i n g t h e i n s t r u c t i o n s aloud--overt,
self-guidance.
In
t h e n e x t s t e p , a c l i e n t performs t h e t a s k w h i s p e r i n g i n s t r u c t i o n s
--faded,
overt self-guidance.
F i n a l l y , a c l i e n t performs t h e
t a s k g u i d e d .by i n t e r n a l speech--covert
self-instruction.
Heichenbaum a l s o a p p l i e d s e l f - i n a t r u c t i o n a l t r a i n i n g t o
other popttiatims (Asarnov
Ciwaercm,
19731,
&
Further r-&
queathw &sed en
s e l f - i n s t r u c t i o n a l t r a i n i n g followed.
Modifications frequently
f l e x i b i l i t y and i n d i v i d u a l i z a t i o n p o s s i b l e w i t h i n t h i s p a r a d i g m
(Heichenbaurn, 1977a)
Meichenbaum (1974) h y p o t h e s i z e d t h a t
R e c e n t r e s e a r c h b a s e d on t h e
p r o d u c t i o n d e f i c i t h y p o t h e s i s (Asarnow
used s e l f - i n s t r u c t i o n a l
&
~ e i c h e n b a u m , 1979) h a s
t r a i n i n g w i t h k i n d e r g a r t e n c h i l d r e n who
OBher a p p l i c a t i o n s o f s e l f - i n s t r u c t i o n a l
, adult
s c h i z o p h r e n i c 6 (Meichenbaum
&
t r a i n i n g have
&
Rasmussen ,
Cameron, 1 9 7 3 ) , p h o b i c
o f p o s s i b l e f a i l u r e and had d e v e l o p e d s y s t e m s of c o p i n g
s e l f - s t a t e m e n t s s p e c i f i c t o this p o s s i b i l i t y ,
Their attempts t o
minimize d i s a b l i n g e f f e c t s o f f e a r and t h e e x p e r i e n c e o f f a i l u r e ,
h i g h l i g h t e d i n t h e work w i t h s o c i a l i s o l a t e s (Gottman e t a l . ,
1 9 7 2 ) based on Meichenbauh and Goodman's 1 9 7 1 w o r k , c o n t a i n e d t h e
However, t h e a c t u a l g e n e s i s o f s t r e s s - i n o c u l a t i o n
t r a i n i n g came
,
p'\
was as effective as
In
Bn inverted
a.
self-statenents as instruc;ions
Subjects
----
positively-as
~ h discovery
h
underscored the
'--,
Coping
client.
'
A therapist
doses of a stressor.
@
-
3
'
Their
r e s u l t s i n d i c a t e d t h a t s e l f - i n s t r u c t i o n a l t r a i n i n g and
s t r e s s - i n o c u l a t i o n t r a i n i n g were e q u a l l y e f f e c t i v e i n t e r m s o f
b e h a v i o r a l outcomes.
D i f f e r e n c e s were n o t e d on t h e s e l f - r e p o r t
rprste6 as more
Y
changes on b o t h b e h a v i o r
e f f i c a c i o u s o v e r a l l b e c a u s e it produced
I n examining t h e p r o c e s s e s o f s e l f - i n s t r u c t i o n a l t r a i n i n g
and s t r e s s - i n o c u l a t i o n t r a i n i n g , Meichenbaum t h e o r i z e s t h a t
--
4'
c o g n i t i v e - b e h a v i o r change i n v o l v e s t h r e e b a s i c t a s k s :
r e c o g n i t i o n and r e d e f i n i t i o n o f m a l a d a p t i v e t h o u g h t s and
b e h a v i o r s ; inducement of c o g n i t i v e - b e h a v i o r change; and
maintenance of change t h r o u g h c o g n i t i v e r e s t r u c t u r i n g .
In
c o n f r o n t i n g t h e f i r s t t a s k , t h e r a p i s t and c l i e n t e x p l o r e c l i e n t
b e h a v i o r s and t h o u g h t s t h a t l e a d t o m a l a d a p t i v e r e s p o n s e s .
#
'
J o i n t l y t h e y d e v e l o p a common c o n c e p t u a l i z a t i o n of t h e p r e s e n t i n g
b e h a v i o r s need k~ he - T r e a t m e n t t a r g ~ t s
includ~:--U
c l i e n t b e h a v i o r s and t h e r e s p o n s e s t h e y e l i c i t ; ( 2 ) c l i e n t
Cognitive s t r u c t u r e s contain
a t t r i b u t i o n a l , e v a l u a t i v e , and b e l i e f systems; t h e y s t r o n g l y
influence evaluative content o f i n t e r n a l dialogue.
=
Pleichenbaum
a+
problem, a c l i e n t can a l t e r c o g n i t i v e b e l i e f s t r u c t u r e s .
Altered
c o g n i t i v e s t r u c t u r e s a l l o w a c l i e n t t o e v a l u a t e symptoms and
-
behaviors d i f f e r e n t l y .
c l i e n t recognizes herL o m
*
c o n t r i b u t i o n s t o maladaptive i n n e r d i a l o g u e , c o n s i s t i n g o f
n e g a t i v e s e l f - s t a t e m e n t s o r t h e absence of a p p r o p r i a t e
self-statements.
4i
c l i e n t l e a r n s t o i n t e r p r e t maladaptive
behavior a s a s i g n a l t o produce d i f f e r e n t s e l f - s t a t e m e n t s .
e i t h e r sex.
--
--
--
- -
s e n s e of p o t e n t i a l s e l f - e f f i c a c y ,
--
- --
engendered from t h e j o i n t
c o n c e p t u a l i z a t i o n of t h e problem, a l s o a l t e r s i n n e r d i a l o g u e . The
c o n c e p t u a l i s a f i o n is a powerful t h e r a p e u t i c t o o l .
6.-,
. basis
It provides a
f o r new i n .n e. r d i a l o g u e , f o r a l t e r e d c o g n i t i v e s t r u c t u r e s ,
-3
evident.
i n t e r n a l d i a l o g u e . U r e d s e l f - s t a t e m e n t s i n i t i a t e ne;
c h a i n s t h a t i n t e r f e r e w i t h maladaptive behavior.
-
behavior
Altered inner
--
P e r c e p t i o n 8 and c o g n i t i v e s t r u c t u r e s are.
'cognitive structures.
reorganized t o e v a l u a t e a l t e r e d b e h a v i o r s and c o g n i t i o n s i n
*
p o s i t i v e terms.
The r e f o c u s i n g of t h e c l i e n t ' s a t t e n t i o n , t h e
a l t e r a t i o n i n a p p r a i s a l , and t h e p h y s i o l o g i c a l .
r e a c t i o n s w i l l h e l p change t h e i n t e r n a l
d i a l o g u e t h a t t h e c l i e n t brought i n t o therapy.
I n t u r n , t H e i n t e r n a l d i a l o g u e comes t o g u i d e
new b e h a v i o r , t h e r e s u l t s o f which have an
impact upon the i n d i v i d u a l I s c o g n i t i v e
s t r u c t u r e d , {Meichenbaum, l W 7 a , p. 224)
-
--
The f i n a l t a s k i n c o g n i t i v e - b e h a v i o r change i n v o l v e s
i
tbe
i.r
*.
-$&
Changed
maintenance of change t b r o a g h c o g n i t i v e r e s t r u c t u r i n g .
i n t e r n a l d i a l o g u e encourages a c l i e n t t o t r y o u t - n e w b e h a v i o r s
To
C o g n i t i v e s t r u c t u r e s t h a t do n o t
For l a s t i n g change, a
Therapy must
~ c i c h e n b a u m theory
~s
of
cognitive-behavior change r e c o f i z e s
and c o g n i t i v e s t r u c t u r e s on behavior.
t h e i n f l u e n c e of t h o u g h t s
d
I t interweaves a network
of s k i l l s and a t t i t u d e s t h a t r e c i p r o c a l l y s u p p o r t changed
b e h a v i o r s , c o g n i t i o n s , and c o g n i t i v e s t r u c t u r e s ,
-
Success of
t h e r a p y is d i r e c t l y r e l a t e d t o * t h e degree t o which a g i v e n
c o n c e p t u a l i z a t i o n l e a d s t o s p e c i f i c b e h a v i o r a l changes t h a t can
be t r a n s f e r r e d t o t h e r e a l - l k e s i t u a t i o n m Weichenbaum, 1977a,
p. 2 2 2 ) .
-
Meichenbaum s t r e s s e s t h a t e f f e c t i v e t h e r a p y a p p l i e s . and
-
in r e a l - l i f t a i t u a t i a a s ,
a p p l i c a t i o n provides feedback
on t h e p r o c e s s of t h e r a p y , o p p o r t u n i t i e s ' t o f u r t h e r llodify
k d a v i o r a l o r c o g n i t i v e e v e n t s , and g r a d u a l i n c r e a s e in e f f e c t i v e
use of s k i l l s t h a t comes fro* p r a c t i c e and succes's.
H i s w o r k developing a t h e o r y o
o r n o t t h e y a r e s u b s t a n t i v e l y d i f f e r e n t is a f o c a l q u e s t i o n of
t h i s review.
The t h i r d and f o u r t h
k
The f i n a l c h a p t e r d i s c u s s e s
s u b s t a n t i v e i s s u e s p r e s e n t e d i n t h e preceding d i s c u s s i o n s .
The
paper concludes w i t h s u g g e s t i o n s f o r f u t u r e d i r e c t i o n s w i t h i n
this area of resear&.
of s e l f - i n s t r u c t i o n a l t r a i n i n g and s t r e s s - i n o c u l a t i o n t r a i n i n g as
This h n a l y s i s f i r s t
s t r u c t u r a l components o f s e l f - i n s t r u c t i o n a l t r a i n i n g '
'
l e a r n i n g t h e o r y ( e s p e c i a l l y c o g n i t i v e modeling) and
s e l f - r e g u l a t o r y a s p e c t s o f language ( i n c l u d i n g o v e r t and c o v e r t
c h i l d r e n , 'Goals o f t r a i n i n g were t o p r o v i d e a
p r o c e d u r e by which these ~ h i l d r e nc o u l d l e a r n (1) t o bomprehend
demands of a t a s k ; ( 2 ) s p o n t a n e o u s l y t o produce s e l f - i n s t r u c t i o n s
I
and p l a n s ; and ( 3 ) t o u s e s e l f - i n s t r u c t i o n s , t o
guide, monitor,
cognitive
In the cognitive
t h o u g h t processes i n t b e dorm of s e l f - i n s t r u c t i o n s .
Meichenbaum
overt guidance,
P
self-instructions.
cmgrrftfve d e l f n g compmmt, a
The client
whispers self-instructions.
At this point,
positively in
luencing.behaviors , This process follows research
evidence (Heiehnbam, 1937af t h a t private speech initially
facilitates task perfar-laanca and then disapgears
proficiency increases.
s_s
task
--"-
*-
error-correcting.behaviors.
L
These t r a i n i n g i n s t r u c t i o n s a r e
Within each t r a i n i n g s e s s i o n , a s e t of
S e l f - i n s t r u c t i o n _ a l t r a i n i n g p r o v i d e s a package of
s e l f - i n s t r u c t i o n s t h a t is a p p l i c a b l e t o a v a r i e t y of c o g n i t i v e
tasks,
Research 4Asarnow
'.
&
and c o r r e c t t h e i r performances.
--
t o guide, monitor,
-
S ~ r ~ ~ f u r ~ l - ~ a m ~ ~ ~ n f s ~ ~ f ~ S f x ~ ~ ~ i = Z ~
MeichenbaumJs concern f o r t r e a t m e n t g e n e r a l i z a t i o n l e d t o
t h e development of s t r e s s - i n o c u l a t i o n t r a i n i n g , w h i c h f o c u s e s on
coping t e c h n i q u e s and s e l f - i n s t r u c t i o n s .
Unlike
s e l f - i n s t r u c t i o n a L t r a i n i n g , s t r e s s - i n o c u l a t i o n t r a i n i n g is n o t a
s p e c i f i c t r e a t m e n t program developed by Meichenbaum ( 1 9 7 7 a ) .
Not a l l seven
In
cements.
B e a l s o n o t e d t h a t e f f e c t i v e coping s k i f f s and
kechniques v a r i e d a c r o s s experiments.
H i s a n a l y s i s suggested
Meichenbaum f u r t h e r suggested
- t h a t a v a r i e t y of coping s t r a t e g i e s would be a p p r o p r i a t e .
In
t h i s s n s e , s t r e s s - i n o c u l a t i o n t r a i n i n g resembles a smorgasbord,
In
Component 3, training in
problem-solving
procedures, contains problem definition,
:..
P
.
i
Component 4 is modeling of
Component 5
I n t h e r e h e a r s a l p h a s e , sets o f b e h a v i o r a P and
c o g n i t i v e coping s k i l l s a r e l e a r n e d and r e h e a r s e d ,
inc-lude d i r e c t a c t i o n f e ,g
., r e l a x a t i o n
These s k i l l s
t e c h n i q u e s and
i n f o r m a t i o n g a t h e r i n g ) and - c o g n i t i v e coping s k i l l s ,
Cognitive
c q i n g s k i l l s i n f l u e n c e a c l i e n t t o r e d e f i n e and change p r o c e s s e s
of a p p r a i s a l , e x p e c t a n c y , a t t r i b u t i o n , and s p l f - p e r c e p t i o n s
(i.e.,
t o modify c o g n i t i v e s t r u c t u r e s ) .
T h i s ' r e d e f i n i t i o n of
c o g n i t i v e s t r u c t u r e s h e l p s a c l i e n t t o f o r m u l a t e new
self-statements.
newly-learned
,
I n t h e a p p l i c a t f i n p h a s e , a c l i e n t tests
coping s k i l l s i n a v a r i e t y o f s t r e s s f u l s i t u a t i o n s ,
s e l f - i n s t r u c t i o n a l t r a i n i n g i s used i n t h e a p p l i c a t i o n phase t o
.
S , t r e s s - i n o c u l a t i o n t r a i n i n g d e r i v e s i t s name from t h e
p r o c e s s i n v o l v e d i n t h e a p p l i c a t i o n phase.
The g r a d u a l i n c r e a s e
i n s t r e s s o r i n t e n s i t y a c r o s s s u c c e s s i v e s i t u a t i o n s is analogous
t o an i n j e c t i o n of a weakened v i r u s i n o r d e r t o p r o v i d e immunity
a g a i n s t - a v i r u l e n t one.
A g o a l of t h e a p p l i c a t i o n phase
is
Figure I shows , t h e
and images
I -
7.
t
1
I
!
i
1
.....................................................................
1 3.
Application Phase
Figure I.
I
1
ZD x i application
~ ~
Stress-inoculation training:
I
I
treatment components.
Components and phases overlap and blend together; they are
'%
I-
Educational and
In
Component 2 ,
/*
s e l f - m o n i t o r i n g o f s e a f - s t a t e m e n t s and images, l i n k s e d u c a t i o n a l
>
and r e h e a r s a l p h a s e s ,
T h i s l ' e a r n i n g is c o n t i n u e d and e x t e n d e d i n -
s e l f - i n s t r u c t i o n s a r e l e a r n e d a n d _ u s e d t o compete w i t h formers
maladaptive cugnitions.
c l i e n t ' s cognitions,becorne s i g n a l s t o
r e p l a c e m a l a d a p t i v e c o g n i t i o n s w i t h new, p o s i t i v e , c o p i n g
s e l f - s t a t e m e n t s and i m a g e s ,
I n t h e a p p l i c a t i o n p h a s e , t h e s e new
s e f f - s t a t e m e n t s a n 8 s e l f - i n s t r u c t i o n s a r e t e s t e d anct
s t r e n g t h e n e d . . With i t s u s e o f s e l f - i n s t r u c t i o n s ,
stress-inoculation
t r a i n i n q- c o n t a i n s s i m i l a r i t i e s w i t h
training.
comparison o f t h e components o f
.these two t r a i n i n g p r o c e d u r e s -i l l u s t r a t e s p o i n t s of s i m i l a r i t y
PJ'
and d i f f e r e n c e .
'"
s e l f - i n s t r u c t i o n a l theme o c c u r s i n b o t h t r a i n i n g
P
procedures b u t t h e o b j e c t i v e s of t r e a t m e n t d i f f e r .
S e l f - i n s t r u c t i o n a l t r a i n i n g t e a c h e s a c l i e n t how t o p e r f o r m a
t a s k e f f e c t i v e l y by u s i n g s e l f - g u i d i n g
instructions;
s t r e s s - i n o c u l a t i o n t r a i n i n g t e a c h e s a c l i e n t how t o h a n d l e
d i f f i c u l t situations b y u s i n g s e l f - i n s t r u c t i o n s
to cepe.
Figure
t 1.
1
1
1
1
I
I
C o g n i t i v e modeling:
1 3.
problem d e f i n i t i o n
a t t e n t ion f o c u s i n g
response guidance
self-reinforcement
sef f-euafuat ion
coping s k i l l s
error correction
I
I
t
1 2. C o g n i t i v e and b e h a v i o r a l
f r e h e a r s a l of s e l f 1 instructions:
t
1
o v e r t e x t e r n a l guidance
1
o v e r t s e l f -guidance
f
faded s e l f - g u i d a n c e
I
c o v e r t self-instruction
training:
i
f
!
I
problem d e f i n g t i o n
a n t i c i p a t i o n o f consequences
feedback
eva Ittat ion
I
I 4. modeling of s e l f - s t a t e m e n t s
1 and images
f
1 5 , modeling and r e h e a r s a l o f
I s e l f - f n s t r u c t i o n q , including:
I
I
1
I
positive selfbvaluation
coping s k i l l s
a t t e n t i o n - f o c u s i n g skills
f 6. t r a i n i n g :
f procedures
1
t
Figure - 2 .
problem-solving
f procedures, including:
behavior therapy
Comparison of components i n s e l f - i n s t r u c t i o n a l
t r a i n i n g and s t r e s s - i n o c u l a t i b n t r a i n i n g .
'
,Many s k i l l s a r e common t o b o t h t r a i n i n g p r o c e d u r e s ,
The
self-instructional,
co,zponents.
Cognitive modeling in
The concept
A therapist deliberately
Throughout training,
A client
-&
themselves.
Self-instructions initially
In stress-inoculation training,
self-instructional
p e r f o r ~ n c edeficits rath
cognit ions,
-\ -
maladaptive
General
. -Tumpunnen-t
-
self-instructional training.
Component 6, behavior therapy strategies, is exclusive to
stress-inoculation training.
A client learns a
A concept underlying
h x i y ~
stre3sful situation.
P
The difference between the generalieability of these
By
stress-inoculation training:
problem-solv~hg, w e l i n g o f
training procedures,
This core
and self-instructions,
self-instructions,
self-statements are
Self-instructional training
These
self-instructions,
In
of stress-inoculation training.
By influencing cognitive
-,
In self-instructional training,
'
I n c o n t r a s t , s t r e s s - i n o c u l a t i o n t r a i n i n g f o c u s e s on t r a i n i n g a
v a r i e t y of coping s k i l l a and techniques; c l i e n t s l e a r n coping
d=-
s k i l l s i n o r d e r t o handle s i t u a t i o n s t h a t a r e s t r e s s f u l , p a i n f u l ,
or unpleasant.
Coping, r a t h e r t h a n t a s k performance, is a
primary o b j e c t i v e of s t r e s s - i n o c u l a t i o n t r a i n i n g .
Another a s p e c t
of t h i s d i s t i n c t i o n is m s t e r y v s . coping performance,
S e l f - i n s t r u c t i o n a l t r a i n i n g might be i n t e r p r e t e d a s %t r a i n i n g f o r
m a s t e r f u l performanqe while s t r e s s - i n o c u l a t i o n t r a i n i n g
e x p l i c i t l y t - r a i n s f o r coping performance.
I n t h e a p p l i c a t i o n component, coping s k i l l s a r e qehearsed
-7
situations.
I n c o n t r a s t , s e l f - i n s t r u c t i o n a l t r a i n i n g concludes
with covert s e l f - i n s t r u c t i o k .
S e l f - i n s t r u c t i o n a l t r a i n i n g seems
b e s t s u i f e d t o problems t h a t can be d e f i n e d by c o n c r e t e t a s k
behaviors r e q u i r i n g h i g h l y s i m i l a r c o g n i t i v e demands.
In
c o n t r a s t , s t r e s s - i n o c u l a t i o n t r a i n i n g is an ' a p p r o p r i a t e
i n t e r v e n t i o n f o r a v a r i e t y of maladaptive responses caused by .
c o g n i t i v e and a f f e c t i v e r e a c t i o n s t o a p e r c e i v e d problem.
focus of t h e r a p y h a s changed from a s e l f - i n s t r u c t i o n a l
'How can I
t h e s e two t f a i n i n g * p r o c e d u r e s .
They a h a r e a theme of
procedures.
processes.
Components 3, 4, and 5 in
Component 7 incorporates
stressful
J T Q
experiences.
evident.
perform a task
c o g n i t i o n s , and b e h a v i o r s a r e t a r g e t s f o r c h a n g e .
This procedure
f o c u s e s on a c l i e n t ' s r e a c t y o n t o s t r e s s , a n x i e t y , p a i n , a n g e r ,
o r s i m i l a r s t r e s s - p r o d u c e d r e a c t i o n s and r e s p o n s e s r a t h e r t h a n on
s p e c i f i c task behaviors.
C e n t r a l f o c i of t h i s t r a i n i n g a r e
s e l f - s t a t e m e n t s and s e l f - i n s t r u c t i o n s .
c l i e n t learns t o handle
s t r e s s f u l s i t u a t i o n s w i t h b o t h c o p i n g s e l f - s t a t e m e n t s and
\.
self-instructions.
Self-statements,
of s e l f - i n s t r u c t i t t n s ,
which d e t e r m i n e t h e n a t u r e
s e l f - i n s t r u c t i o n s and b e h a v i o r s ,
Self-statements,
which
t r a i n i n g a p p e a r s t o have b e e n
Self-instructions
o c c u r w i t h i n t h e s t r e s s - i n o c u l q t i o n t r a i n i n g t r e a t m e n t paradigm
i n b o t h p a r t i a l and c o m p l e t e f o r m s .
-Stress-inoculation training
Kg
a p p e a r s t o expand and t o e x t e n d s e l f - i n s t r u c t i o n a l t r a i n i n g .
bexamining t r e a t m e n t o u t c o m e s , s i m i l a r i t i e s and d i f f e r e n c e s
f u n c t i o n between t h e s e two t r a i n i n g p r o c e d u r e s c a n be a n a l y z e d .
C h a p t e r s 111 and I V r e v i e w r e s e a r c h s t u d i e s a s a means o f
conducting a f u n c t i o n a l a n a l y s i s of s e l f - i n s t r u c t i o n a l t r a i n i n g
and s t r e s s - i n o c u l a t i o n t r a i n i n g ,
functional analysis
p r o v i d e s i n f o r m a t i o n a b o u t t h e -effects produced by p r o c e s s e s o r
procedures--in
t h i s c a s e , s e l f - i n s t r u c t i o n a l t r a i n i n g and
stress-inoculation
training.
E x p e r i m e n t a l i n f o r m a t i o n is u s e d t o
~el4)-instruct ional
t r a i n i n g and s t r e s s - i n o c u l a t i o n t r a i n i n g s t u d i e s & e
separately.
examined
E x p e r i m e n t s f o r e a c h t r a i n i n g p a c k a g e a r e grouped
i n t o four categories.
These c a t e g o r i e s w i l l p r o v i d e a framework
f o r analyzing t h e e f f i c a c y of t h e r e s p e c t i v e t r a i n i n g procedures.
D i f f e r e n t c a t e g o r i e s o f e x p e r i m e n t s a r e d i s t i n g u i s h e d by t h e
kind of f u n c t i o n a l information t h e y provide about
self-instructional training or stress-inoculation
training.
E x p e r i m e n t s o f s e l f - i n s t r u c t i o n a l t r a i n i n g and s t r e s s - i n o c u l a t i o n
%
t r a i n i n g reviewed i n t h i s p a p e r were g r o u p e d a c c o r d i n g t o t h e
d i f f e r e n t r e s e a r c h p u r p o s e s a d d r e s s e d by t h e e x p e r i m e n t e r :
(1)
s t u d i e s concerned w i t h g e n e r a l e f f e c t i v e n e s s of a s i n g l e
t r e a t m e n t , ( 2 ) d i s m a n t l i n g s t u d i e s t o d e t e r m i n e e f f e -c t i v e n e ~ so f
-LA
.,
The purpose
Dismantling
theoretically-based
Because
outcome studies.
stress-inoculation training.
Dismantling and
coping skills.
All the
above.
the L x ~
application
~ Q phase.
The following
general
Chapter IV
The
1 9 4 2 ) ~Hateking P&fiar
Pi-
Test
t k m t I ~ W Z
observations of
period.
assessment instruments.
Attention control subjects met with the same experimenter
for the same number of times.
,'
Social reinforcement
assessments.
Assessment control
p o s t e r i o r i a n a l y t i c purposes,
s u b t e s t s r e v e a l e d t r e a t m e n t x t r i a l s e f f e c t s t h a t approached
s t a t i s t i c a l r e l i a b i l i t y , each f a v o r i n g t h e s e l f - i n s t r u c t i o n a l
,
t r a i n i n g group.
There'were no
On t h e P o r t e u s
No r e l i a b l e d i f f e r e n c e s
T h i s l a c k of g e n e r a l i z a t i o n
i n s e n s i t i v i t y i n assessment measures.
A t a 1-month follow-up,
t h e c o g n i t i v e l y t r a i n e d group
demonstrated s t a t i s t i c a l l y r e l i a b l e s u p e r i o r i t y t o c o n t r o l groups
Both
d i r e c t i o n s i n behavior m o d i f i c a t i o n s t u d i e s .
2
z-
I n c o n c l u s i o n , a & u x i @ f i ~assumption
underlying t h e p r e s e n t l i n e of i n v e s t i g a t i o n
has been t h a t symbolic a c t i v i t i e s obey t h e
same p s y c h o l o g i c a l f a c t s a s do o v e r t b e h a v i o r s
and t h a t p r i v a t e speech is t e a c h a b l e . Thus,
behavior m o d i f i c a t i o n t e c h n i q u e s which. have
been used t o modify o v e r t b e h a v i o r s may be
applied t o cognitive processes,
Only f u t u r e
r e s e a r c h , w i l l i n d i c a t e t h e v a l i d i t y of t h i s
assumption, b u t t h e by-products, i n terms of
t h e development of new t r e a t m e n t t e c h n i q u e s ,
w i l l be s i z a b l e .
(Meichenbaum & Goodman,
1971, pa 125)
Meichenbaum and Goodman's (1971) s t u d y was followed by
s e l f - i n s t r u c t i o n a l t r a i n i n g s t u d i e s focusing on i n c r e a s i n g
s e l f - c o n t r o l in:
impulsive, h y p e r a c t i v e , - a n d / o r d i s t r a c t i b l e
c h i l d r e n (Argulewicz, E l l i o t t ,
&
Spencer, 1982; B o r n s t e i n
&
O'Leary, 1 9 7 9 ~Kendall
c h i l e e n tea-,
mom, ftebert,
Akamatsu, 1978) ;
h Van
&
&
Garson, 1976;
Pinch, 1 9 7 8 ) ~i n a g r e s s i v e
-ei n a d u l t s c h i z o p h r e n i c 8 (Margolis
&
&
Cameron, 1973)
. Another
topic
bf
Johnston, 1983).
(1971) work.
Training was
Eight-day intervals
B i ~ s t ,t h e experitaenter self-instmeted
the
39
experimente; s g b f - i h s t r u c t e d i n a whisper.
I n i t i a l l y , M & H r s were
used t o i n c r e a s e s u b j e c t s g a t t e n t i o n , b u t t h e s e were q u i c k l y
phased o u t i n f a v o u r of s o c i a l r e i n f o r c e r s .
from t h e S t a n f o r d - B i n e t
(Terman
T r a i n i n g t a s k s were
H e r r i l l , 1 9 7 3 ) , WISC (Wechsler,
1 9 4 9 ) , o r t h e McCarthy S c a l e s f o r C h i l d r e n s w A b i l i t i e s (McGarthyr
1972)
.a
Tasks i n c r e a s e d i n c o m p l e x i t y from s e n s o r i m o t o r t o
problem-solving
items.
On-task c l a s s r o o m b e h a v i o r was r e c o r d e d
t w i c e d a i l y f o r 2 w e e k s by t r a i n e d o b s e r v e r s naive t o t h e d e s i g n
of t h e experiment
from p r e t r e a t m e n t t o p o s t t r e a t m e n t .
follow-up,
experiment
22 1 / 2 - w e e k s
I n c r e a s e s were m a i n t a i n e d a t
f o l l o w i n g t h e b e g i n n i n g of t h e
a g e o f s u b j e c t s , massed o r s p a c e d p r a c t i c e , use o f m a t e r i a l
The a u t h o r s h y p o t h e s i z e d t h a t c o v e r t r e h e a r s a l o f
t e a c h e r a s s i g n e d t a s k s would i n c r e a s e g e n e r a l i z a t i o n and t r a n s f e r
of t r a i n i n g an7 t h a t t h i s f a c t o r nay i n f l u e n c e t h e e f f i c a c y o f
self-instructional training.
F r i e d l i n g and OILeary (1979) a t t e m p t e d t o r e p l i c a t e
There were f o u
of 7 year8 7
\
A
4'-
Stickers
No self-instructional
'
On-task b e h a v i o r
I n t e r o b s e r v e r r e l i a b i l i t y was r e c o r d e d
t o t r a i n i n g , and 2-week o b s e r v a t i o n s f o l l o w e d e a c h t r a i n i n g
sequence.
/
No t r e a t m e n t
Even though a c c u r a c y s c o r e s f o r
tde
e x p e r i m e n t a l group had i n c r e a s e d r e l i a b l y f o l l o w i n g t h e f i r s t
s e l f - i n s t r u c t i o n a l t r a i n i n g s e q u e n c e , s u b j e c t s had n o t been
3
f o r t h i s r e s u l t c o u l d n o t be e l i m i n a t e d .
Because o f d i s a p p o i n t i n g r e s u l t s , t o k e n s were used t o
-a
r e i n f o r c e on-task behavi0.r.
rC
The t o k e n t r e a t m e n t
I n s t a n c e s o f t e a c h e r a p p r o v a l and d i s a p p r o v a l
d e c r e a s e d a s a r e s u l t of t h e t o k e n t r e a t m e n t .
F r i e d l i n g and O t L e a r y were u n a b l e t o r e p l i c a t e Bornskein and
p l e v i l l o n l s ( 1 9 7 6 ) work.
F r i e d l i n g and O I L e a r y
s t u d y , and d i f f e r e n c e s i n t e a c h e r s ' b e h a v i o r a s s e s s m e n t s .
i d e n t i f i e d f o r f u t u r e research included:
Areas
(1) s u b j e c t commitment
t o b e h a v i o r c h a n g e , ( 2 ) i d e n t i f i c a t i o n and m o d i f i c a t i o n o f
maladaptive self-statements,
and ( 5 )
i n v e s t i g a t i o n o f which d e f i c i t ( p e r f o r m a n c e o r p r o d u c t i o n ) i s
more e f f e c t i v e l y t r e a t e d by s e l f - i n s t r u c t i o n a l
training.
A r g u l e w i c z e t al. ( 1 9 8 2 ) r e p o r t e d a n e x p e r i m e n t t o modify
t h e i n a t t e n t i v e b e h a v i o r o f a g r a d e 4 boy; a c l a s ~ m a t ew i t h
exemplary a t t e n d i n g s k i l l s s e r v e d a s a c o n t r o l .
Dependent
T r a i n i n g took p l a c e i n f o u r s e s s i o n s spread
over 6 d a y s , f o r a t o t a l 0 ~ 5 m
0 inutes,
t r a i n i n g procedures:
d i r e c t i n s t r u c t i o n of attending, behaviors
Self-instructional
t r a i n i n g was used t o
f o c u s the b o y ' s a t t e n t i o n on a p p r o p r i a t e t a s k s , s u c h a s s i l e n t
reading.
264 t o a p o s t t r a i n i n g 768.
The c o n t r o l boy's a t t e n d i n g b e h a v i o r s
The
The r e s u l t s were i n t e r p r e t e d c a u t i o u s l y b e c a u s e t h e
e x p e r i m e n t a l l d e s i g n d i d n o t a s s e s s s o c i a l o r academic b e h a v i o r s
nor t h e r e l a t i v e c o n t r i b u t i o n s o f t h e two t r a i n i n g p r o c e d u r e s .
Dbuglas e t a l .
(1976) i n v e s t i g a t e d t h e e f f i c a c y o f
s e l f - i n s t r u c t i o n a l t r a i n i n g w i t h h y p e r a c t i v e boys u s i n g a
t r e a t m e n t modeled on Heichenbaum and Goodman ( 1 9 7 1 ) .
Contingency
P a r e n t s and
t e a c h e r s were e n c o u r a g e d t o a s s i s t t h e c h i l d r e n i n itmplementing
new s e l f - c o n t r o l l i n g ,
self-monitoring,
behaviors.
of h y p e r a c t i v i t y and i m p u l s i v e n e s s , were a s s i g n e d t o e x p e r i m e n t a l
and control g r o u p s , 1 8 a n d ' l l i n e a c h , r e s p e c t i v e l y .
Dependent
n e a s u r e s i n c l u d e d C o n n e r s ' R a t i n g S c a l e ( 1 9 6 9 ) and
psychoeducational tests.
R e s u l t s demonstrated s t a t i s t i c a l l y
r e l i a b l e d i f f e r e n c e s on a l l v a r i a b l e s .
T r a i n e d boys improved
on o n l y o n e v a r i a b l e .
3-month follow-rap,
were i n t e r p r e t e d a s s u b s t a n t i a l s u p p o r t f o r
t n e e f f i c a c y of c o g n i t i v e t r a i n i n g w i t h i m p u l s i v e c h i-.
ldren.
R e n d a l i and P i n c h ( 1 9 7 8 ) i n v e s t i g a t e d . t h e
Y
e f f i c a c y of
s e l f - i n s t r u c t i o n a l t r a i n i n g combined w i t h r g s e o a s e cost
contingency.
and s e l f - r e i n f o r c i n g
A response
cost was a d m i n i s t e r e d c o n t i n g e n t on t h e
The c h i l d was g i v e n p o i n t s
e x c h a n g e a b l e f o r a r e w a r d a t t h e end o f t h e t r a i n i n g s e s s i o n ; t h e
c h i l d was t o l d t h a t a p o i n t would b e t a k e n by t h e e x p e r i m e n t e r
Twenty i n - p a t i e n t s a t a p s y c h i a t r i c h o s p i t a l f o r
f o r each e r r o r .
$T
e m o t i o n a l l y d i s t u r e d.-a h i l d r e n were s e l e c t e d on t h e b a s i s o f
t h e i r s c o r e s on Matching F a m i l i a r F i g u r e s (Kagan, 1 9 6 6 ) .
Mean
S i x t e e n w h i t e and f o u r b l a c k c h i l d r e n
,each c o n d i t i o n .
The e x p e r i m e n t a l t r e a t m e n t combined
s e l f - i n s t r u c t i o n a l t r a i n i n g and r e s p o n s e c o s t c o n t i n g e n c y .
The
self-instructiona1,training and r e s p o n s e c o s t c o n t i n g e n c y .
T r a i n i n g c o n s i s t e d of s i x 20-minute
sessions.
&
T h e s e measures were
foilow-up.
p o s t e r i o r i k-comparisons.
follow-up.
s t a t i s t i c a l l y r e l i a b l e e f f e c t s f o r t r e a t m e n t s , p e r i o d s , and
t r e a t m e n t x p e r i o d i n t e r a c t i o n s on b o t h l a t e n c y and e r t o r s c o r e s ,
Self-report
results.
i n s t r u m e n t s r e v e a l e d no s t a t i s t i c a l l y r e l i a b l e
&ta
from t h e I m p u l s i v i t y C l a s s r o o m B e h a v i o r S c a l e
snowed a r e l i a b l e t r e a t m e n t x p e r i o d i n t e r a c t j o n .
experimental subjects had been r e l i a b l y mo&
controls.
At
pretest,
impulsive than
hr p i t t e s t , these s u b j e c t s wekeiiess
'impulsive than
R e l i a b l e g r o u p d i f f e r e n c e s were- r e a c h e d a t
I
1
follow-up:
e x p e r i m e n t a l s u b j e c t s had m a i n t a i n e d d e c r e a s e d
i~ i n p u l s i v e n e s s .
T e a c h e r r a t i n g s on the Locus of C o n f l i c t s c a l e
C o r r e l a t i o n a l a n a l y s i s s u g g e s t e d t h a t t h e more f r e q u e n t l y a
r e s p o n s e cost contingency occurred d u r i n g t r a i n i n g , t h e g r e a t e r
= h e classroom improvement.
Results were i n t e r p r e t e d a s s u p p o r t f o r s e l f - i n s t r u c t i o n a l
training combined w i t h r e s p o n s e c o s t c o n t i n g e n c y .
Generaldzatfon
'
group.
veeks
On performance
On t e a c h e r r a t i n g s oi a g g r e s s i o n , s u b j e c t s
normal-control p r o u p .
i
)1
controls.
P r o s o c i a l b e h a v i o r o f t h e t r a i n e d boys was r e l i a b l y
However, the
1-
t h e i r usual a g g r e s s i v e behaviors,
~ e s u ~ l were
ts
i n t e r p r e t e d as
p r o v i d i n g s u p p o r t f o r c o g n i t i v e t r a i n i n g w i t h young, a g g r e s s i v e
to:
s e l f - i n s t r u c t i o n a l t r a i n i n g , a t t e n t i o n c o n t r o l , .or
assessment c o n t r o l .
S e l f - i n s t r u c t i o n a l t r a i n i n g was modeled on
(1971) paradigm.
An
attention control
g r o u p r e c e i v e d t h e same m a t e r i a l s and p r a c t i c e o p p o r t u n i t i e s
without s e l f - i n s t r u c t i o n 6 1 t r a i n i n g .
r e c e i v e d p r e - and p o s t t e s t s .
s e s s i o n s , 1 week a p a r t .
An a s s e s s m e n t c o n t r o l group
T r a i n i n g took p l a c e i n two
before treatment.
Picture Arrangement measures were in the predicted directions. On Hatching Familiar Figures, the scores of the self-instructional
training and attention control groups were reliably different
from those of the assessment control group, but not from each
other.
Boys were
No
Heiche~baumand Cameron
s c h i z o p h r e n i c s c o u l d be t r a i n e d t o s e l f - i n s t r u c t and t o improve
i
Their f i r s t s t u d y showed>~mising
r e s u l t s , and a second s t u d y
extended and r e f i n e d t h e o r i g i n a l f i n d i n g s .
The second s t u d y
s e l e c t e d 10 m e d i c a t e d , h o s p i t a l i z e d , male s c h i z o p h r e n i c s
r e p r e s e n t a t i v e o f the h o s p i t a l p o p u l a t i o n .
They-were a s s i g n e d
randomly t o s e l f - i n s t r u c t i o n a l t r a i n i n g o r c o n t r o l c o n d i t i o n s .
S e l f - i n s t r u c t i o n a l t r a i n i n g took p l a c e i n e i g h t , 45-minute
individual s e s s i o n s spread over 3 weeks.
Experimental s u b j e c t s
C o n t r o l s u b j e c t s m e t f o r t h e same number
were yoked t o c o n t r o l s ,
of s e s s i o n s and r e c e i v e d t h e same p r a c t i c e a s e x p e r i m e n t a l
s u b j e c t s b u t r e c e i v e d n e i t h e r modeling nor s e l f - i n s t r u c t i o n a l
training.
Dependent measures i n c l u d e d a s t r u c t u r e d i n t e r v i e w , Parallel
P r o v e r b s Tests (Kaufman, 1 9 6 0 ) , A u d i t o r y D ~ i s t r a c t i o nD i g i t ~ e c a l l
T e s t (Chapman & McGhie, 1962), and I n k b l o t T e s t s (Holtzman e t
al,, 1 9 6 1 ) .
'
T r a i n e d s u b j e c t s e m i t t e d 42% less g s i c k - t a l k m i n t h e
structured interviews,
The e x p e r i m e n t a l s u b j e c t s gave
On the digit
perceptions, evaluations,
control group.
&
TBe
sessions.
Seer-
6tt
pretests
mre v a r i a b i l i t y ,
None of t h e h y p o t h e s i z e d = i n
i n t e r a c t i o n s were r e l i a b l e .
effects o r
The r e s u l t s of t h i s s t u d y d i d n o t
M a r g o l i s and
Shemberg s u g g e s t e d p o s s i b l e r e a s o n s f o r t h i s f a i l u r e t o
replicate:
(1) d i f f e r e n t g r o u p i n g s o f s u b j e c t s ;
on dimensions r e l a t i v e t o t a s k performance;
(2) variability
(3) subject
r e l u c t a n c e t o s e l f - i n s t r u c t and a p p a r e n t f a i l u r e t o s e l f - i n s t r u c t
...
on t h e p o s t t e s t ; and
(I) t h e
possibility t h a t self-instructional
t r a i n i n g is highly task s p e c i f i c .
s e l f - i n s t r u c t i o n a l t r a i n i n g t o s t u d e n t performance on s c h o o l
tasks.
Malarnuth i n v e s t i g a t e d t h e e f f i c a c y o f s e l f - i n s t r u c t i o n a l
t r a i n i n g i n enhancing r e a d i n g i n low-achieving, n o r m 1 c h i l d r e n ,
S u b j e c t s were s e l e c t e d by s c o r e s on a r e a d i n g p r e t e s t .
All
Black
In t h e modeling c o n d i t i o n , t h e
experimenter m d e l e d t a s k - o r i e n t e d behaviors w i t h o u t t r a i n i n g t h e
c h i l d r e n t 3 perfom t h ~ .B e t h groups were exposed to the same
n a t e f i d l s and tasks,
weekly f o r 2 weeks.
sex) were trained and were kept blind to the nature of the
experiment.
experiment
To
pereeptsal t a s k t3 a p e e r .
a on s t u d e n t distractibility was
Reading measures
On t h i ~
errors.
rehearsal only.
TI.$% results of this study supported self-instructional
Reading scores
.,
86 concluded t h a t
groups of e d u c a b l e m e n t a l l y - r e t a r d e d c h i l d r e n ,
Three g r o u p s o f
t h r e e c h i l d r e n p e r g r o u p , n i n e c h i l d r e n , s e l e c t e d by t h e i r
t e a c h e r s , were s u b j e c t s i n t h i s m u l t i p l e b a s e l i n e e x p e r i m e n t ,
Mean a g e of t h e seven boys and two g i r l s was 11 y e a r s and 10
mnths.
T r a i n i n g took p l a c e d a i l y f o r 1 0 w e e k s , i n 50 s e s s i o n s of 30
minutesf duration,
Use of s e l f - i n s t r u c t i o n a l
t r a i n i n g was e v a l u a t e d by r a t i n g t a p e s of e a c h c h i l d ' s
v e r b a l i z a t i o n w h i l e s o l v i n g problems.
A l l children learned t h e
s e l f - i n s t r u c t i o n a l t r a i n i n g sequence t o 100% c r i t e r i o n .
The
Treatment
Research
Self-instructional
Like
convincing.
i n improving s p q c i f i c academic b e h a v i o r s .
Taken t o g e t h e r ,
&'
s e l f - i n s t r u c t i o n a l t r a i n i n g h a s been s u p p o r t e d a s a n e f f e c t i v e
t r e a t m e n t f o r a v a r i e t y o f problems.
Skr~~a=Xn~~u~a~inn,Tr~i~i~!g~Sk~~i~s
One g e n e r a l e f f e c t i v e n e s s s t u d y a p p l i e d s t r e s s - i n o c u l a t i o n
t r a i n i n g t o a n g e r management i n a b u s i v e p a r e n t s .
Momellini and
Katz ( 1 9 8 3 ) i n v e s t i g a t e d t h e e f f e c t i v e n e s s o f s t r e s s - i n o c u l a t i o n
t r a i n i n g i n reducing abusive p a r e n t s
The s t r e s s - i n o c u l a t i o n t r a i n i n g p r o c e d u r e , a s
Subjects
They l e a r n e d c o g n i t i v e c o p i n g s k i l l s , e.g.,
replacing
a n g e r - p r o d u c i n g t h o u g h t s w i t h m o r e - a p p r o p r i a t e c o g n i t i o n s and
self-statements.
Relaxation, self-reinforcement,
and
+-/
s e l f - i n s t r u c t i o n s were t a u g h t a s c o p i n g , s e l f - c o n t r o l s k i l l s .
p r o b l e m - s o l v i n g a p p r o a c h was i n c o r g a r a t e d t o p r o v i d e a l t e r ~ a t i v e
.+.'
C-
responses t o anger-arousing s i t u a t i o n s .
P a r e n t s developed anger
h i e r a r c h i e s from a n g e r - p r o d u c i n g s i t u a t i o n s t h a t t h e y found
particularly difficult,
S u b j e c t s p r a c t i c e d applying coping
skills a s t h e y r o l e - p l a y e d t h e s e s c e n e s from t h e i r h i e r a r c h i e s .
- ,Tcained o b s d e r s r a t e d
and p o s i t i v e p a r e n t and c h i l d
b e h a v i o r s d u r i n g in-home o b s e r v a t i o n s ,
depen&ent
measures,
Sollow-up o c c u r r e d a t d i f f e r e n t times,
YJ
On t h e a n g e r s c a l e , s c o r e s were reduced
31 % and 43%.
C b i f d r e n * ~aversive behaviors a l s o
e f f e c t i v e n e s s of s t r e s s - i n 6 c u l a t i o n ' t r a i n i n g was s u p p o r t e d by
I
'
experiment,
As
p a r q i t s decreased t h e i r a t t e n t i o n t o c h i l d r e n ' s
I n s p i t e of t h i s p o t e n t i a l l y p r o v o c a t i v e r e s p o n s e ,
The r e s u l t s of t h i s g e n e r a l e f f e c t i v e n e s s s t u d y applying
s t r e s s - i n o c u l a t i o n t r a i n i n g t o anger management w a s e n c o u r a g i n g ,
One s t u d y c a n n o t produce a c o m p e l l i n g body
of d a t a , b u t i t d o e s
The s e l f - i n s f r u c t i o n a l t r a i n i n g s t u d i e s r e v i e w e d p o i n t
toward t h e g e n e r a l e f f e c t i v e n e s s o f t h i s t r a i n i n g p r o c e d u r e .
i;;
/ .:
i m p u l s i v e , j h y p e r a c t i v e , and d i s t r a c t i b l e c h i l d r e n ; a g g r e s s i v e
$
c h i l d r e n ; !ow-achieving
s c h o o l c h i l d r e n ; and s c h i z o p h r e n i c s .
In
I .
, subjects
in the self-instructional
(1971) s e l f - i n s t r u c t i o n a l t r a i n i n g
p a r a d i g m , and r e s u l t s g e n e r a l l y s u p p o r t e d t h o s e o f Meichenbaun
and Goodman.
( 1 9 8 3 ) s t u d y p r o v i d e d some
-D
s u p p o r t f o r s t r e s s - i n o c u l a t i o n t r a i n i n g as a n e f f e c t i v e t r e a t m e n t
for a n g e r management.
I n summary, t h e s t u d i e s reviewed .
d e m o n s t r a t e d t h e general e f f e c t i v e n e s s of s e l f - i n s t r u c t i o n a l
5
t r a i n i n g and p o t e n t i a l e f f e c t i v e n e s s o f s t r e s s - i n o c u l a t i o n
training
Frequent1
t h e a u t h o r s recommended f u r t h e r r e s e a r c h
t o d e t e r m i n e t h e c o n t r i b u t i o n s o f p a r t i c u l a r components o f t h e s e
procedures.
Dismantling s t u d i e s , which a d d r e s s t h i s q u e s t i o n ,
a r e d i s c u s s e d i n t h e n e x t section.
?-
QismPfling-Sfudiea
To be included i n t h i s s e c t i o n , s t u d i e s had t o b e c o n c e r n e d
i'
s e l f - i n s t r u c t i o n a l t r a i n i n g t o t h e o v e r a l l e f f e c t i v e n e s s of
b,
s e l f - i n s t r u c t i o n a l t r a i n i n g p e r se.
S t u d i e s reviewed have
i n c l u d e d b o t h modeling and o v e r t t o c o v e r t r e h e a r s a l o f
Meichenbaum
self-instructional training.
Genshaft and H i r t i n v e s t i g a t e d t h e
e f f e c t s of d i f f e r e n t model c h a r a c t e r i s t i c s on t h e e f f i c a c y o f
self-instructional training.
ulsive
.y,-,
Both s t u d i e s used i
primaryr
~ e ~ e n ' d e nmeasures
t
f o r both
Arrangement s u b t e s t o f t h e WISC-R
(Wechsler, 1 9 7 4 ) .
Heichenbaum
The 60 c h i l d r e n i n t h e Genshaft
f 1) b l a c k model-black
s u b j e c t , ( 3 ) w h i t e model-black
s u b j e c t , ( 2 ) b l a c k model-white
s u b j e c t , ( 4 ) w h i t e model-white
3 and
self-instructional training.
In modeling with
'
Three of
These r e s u l t s
A *dele
.'
A m d e Z x race
<-/
/'
These r c s u f t e
self-instructional training,
self-instructions,
behavior change.
training paradigm.
Wilcox, 1980)
separately.
no-treatment control,
&If--i-
modeling c o n d i t i o n w i t h s p e c i f i c s t r a t e g i e s c o n s i s t e d of t h e same
modeling component as is t h e self-instructions% t r a i n i n g w i t h
s p e c i f i c s t r a t e g i e s but d i d n o t c o n t a i n a r e h e a r s a l component#
t h e c h i l d o n l y responded by p o i n t i n g o r s a y i n g ' Y e s m or e#o.m The
a s s e s s m e n t c o n t r o l c o n d i t i o n p r o v i d e d no s e l f - i n s t r u c t i o n a l
t r a i n i n g ; t h e c h i l d was a s k e d o n l y t o look a t t h e material.
The
T r a i n i n g took p l a c e on f o u r c o n s e c u t i v e days i n
materials.
On t h e l e s s o n posttests, c h i l d r e n i n t h e
s e l f - i n s t r u c t i o n a l t r a i n i n g c o n d i t i o-n s made r e l i a b l y f e v e r e r r o r s
-- -
--
--
arid increased l a t e n c y s c o r e s t h a n c h i l d r e n i n t h e o t h e r
conditions,
The s p e c i- f i c s t r a t e g y affected o n l y l a t e n c y s c o r e s .
s
P o s t hoc c o n p a r i s o n e r e v e a l e d t h a t t h e s e l f - i r b t r u c t i o n a l
incrc&lng
model&
l a t e n c y t h a n a11 o t h e r c o n d i t i o n s and t h a t t h e
\
i
c o n d i t i o n w i t h s p e c i f i c ~ t r s t e g i e swas r e l i a b l y mor
e f f e c t i v e t h a n the two c o n t r o l c o n d i t i o n s .
T h e r e were no
of s e l f - i n s t r u c t i o n a l t r a i n i n g w i t h s p e c i f i c s t r a t e g i e s o v e r the,
other conditions,
self-verbalizations,
'
The
self-fngtruction~ without
self-reinforcement.
posttests only.
sane tasks, presented in the same sequence, and with the same
nuIlber of trials.
(Epetein
&
overt, covert, or
In the
In the
High
Mean
procedure.
trained.
Dependent measures
&
Wilcox, 1979)
Posterirori
Analysis of
nodeling
Bender's
impulsive children.
sel :instructional
training.
Fry's
experimental conditions.
as experimental conditions.
criteria,were described:
Three
.L
Meiche
(See
&
All but
Emelkamp,
-h
,Hide,
McCann , C a l d w e l l , and
, 1977; and
Wickert , 1981.
Many s t u d i e s d i d n o t i n c l u d e an h - y i y p a p p l i c a t i o n p h a s e a s
d e f i n e d by Meichenbaum ( l 9 7 7 a ) --i .e.,
exposure t o g r a d u a l l y
S t u d i e s which l a c k e d an io-yjyp
&
&
&
&
Lawrence,
Shumate, 1981) o r
included
s t r e s s - i n o c u l a t i o n t r a i n i n g t r e a t m e n t components (Cooley
&
Frernouw,
&
McCordick,
&
A n d r a s i k , 1978; Kaplan,
Valerio
&
Stone, 1982).
i~
The r e s e a r c h e r s i n v e s t i g a t e d c o n t r i b u t i o n s of
components i n t h e r e h e a r s a l and a p p l i c a t i o n p h a s e s .
This s e c t i o n
d i s c u s s e s components i n t h e e d u c a t i o n a l phase i n f r e q u e n t l y
- b e c a u s e t h e r e s e a r c h d i d n o t examine l h e m d i r e c t l y .
The l a c k
r e s e a r c h i n t o t h e e d u c a t i o n p h a s e is i n t r i g u i n g , and t h e
i m p l i c a t i o n s of t h i s w i l l be examined.
/
The m a j o r i t y of s t u d i e s i n v e s t i g a t e d components i n t h e
r e h e a r s a l phase:
&
Worthington h S h u m t e , 1 9 8 1 ) ; and ( 2 ) a c o m b i n a t i o n of b e h a v i o r a l
4
and c o g n i t i v e c o p i n g s t r a t e g i e s ( A l t m a i e r e t a l . ,
&
1 9 7 6 : Hendonca
&
&
A n d r a s i k , 1978; Meichenbaum e t a l . ,
4
'
1981; V a l e r i o h S t o n e , 1 9 8 2 ) .
a p p l i c a t i o n phase:
F i v e s t u d i e s examined t h e i n - y i y p
Emmelkamp e t a l .
(1982). Backett et a l .
a l . (1981).
1982; Cooley.&
T h i s r e v i e w of s t r e s s - i n o c u l a t i o n d i s m a n t l i n g
Examination of t h e r e s e a r c h p e r t a i n i n g t o t h e
i o n component c o m p l e t e s t h i s rev'iew of s t r e s s - i n o c u l a t i o n
appY
t r a i n i n g dismantling s t u d i e s .
Q g ~ i k i u e - s fraf g g i f : ~ - ~ J p m .The s t u d i e s i n t h i s s e g t i o n
f o c u s e d on c o p i n g s e l f - s t a t e m e n t s ,
strategies
a l o n e and w i t h o t h e r
' c o n t r i b u t i o n s of d i f f e r e n t t y p e s of c o p i n g s e l f - s t a t e m e n t s .
' .
Worthington and
--
artdfP
_
I
anxiety.
treatment:
.,
Stress-inoculation training,
Training components
Problem-solving self-statements
Waiting list
was
Stress-inoculation training
'
Only
No
conditions.
Experimental
f l l extinction, f 2 )
P r m u n d e ~ g ~ a d w t tstudents
e
w i t h h i g h 8 c 0 r ~ san
- ..
Apprekension ( M C i e s k e y ,
a random block
procedure,
exercises.
In t h e coping treatment,
e u D 2 e c t s l e a r n e d and r e h e a r s e d p o s i t i v e c o p i n g s e l f - s t a t e m e n t s ;
r e h e a r s e d t h e m b e f o r e , d u r i n g , and f o l l o w i n g speaking e x e r c i s e s .
to
reduce anxiety.
assessments,
B e h a v i o r a l and s e l f - r e p o r t
dependent
meaglures vere
used,
number of v e r b a l i z a t i o n s
containing
a t l e a s t t h r e e words i n c l u d i n g a s u b j e c t a n d p r e d i c a t e f P r e q L ) ;
a n d r e s p o n s e l e n g t h , - t h e p o i n t a t which o n e s u b j e c t b e g a n
speaking u n t i l a n o t h e r p e r s o n r e s p o n d e d .
s u b y e c t t e n s i o n , r e l e v a n c e , and verbosity.
Reliable
f o r a l l c o ~ u n i c a t i o nHleasnres.
f-test c o m p a r i s o n s r e v e a l e d reliable S i f f e r e n c e s b e t w e e n c o p i n g
and w a i t i n g l i s t c o n d i t i o n s a n d b e t w e e n combined a n d e x t i n c t i o n ,
At
Individually, 5 0 % of subjects in
treataent, and the coping treatment was more effective than any
training.
The
The
elr rack
viewed as a m u S t i s t a q e process.
were:
conf r e n t i n g a
Self-reinforcement
could f o l l o w
T r a i n i n g t m k place in
treatment c o m b i n a t i o n s .
Dependent aeasurcs were d u r a t i o n i n m i n u t e s of tolerance of
Results
i s i a q e r y x educational c o n d i t i o n i n t e r a c t i o n was o b s e r v e d ;
treatments,
t h e a d d i t i o n of t h e e d u c a t i o n a l component produced no r c l i + b l e
iaprovewnt.
under l y i n g , n e g a t i v e c o q n i t i o n s m o t be t r e a t e d be
o r e coping
p r o v i d e e v i d e n c e f o r t h e efficacy of coping' s e l f - a t a t c l c n t s ,
it
d i d i n d i c a t e t h a t t h e e d a c a t f o n a l component is an important
T h i s s t u d y supported s t r e e s - i n o c u l a t i o n
r e s e a r c h e r s c a l l e d f o r f u r t h e r s t g g i e s t o examine
training as an
The
actively t h e
two s t u d i e s of coqnitivc s t r a t e g i e s , a f o n e
1 9 7 8 ) provided
evidence t h a t coping s e l f - s t a t e m e n t s c o n t r i b u t e d t o t r e a t m e n t
e f f i c a c y in s t+r e s s - i n o c u l a t i o n . t r a i n g ,
provided evidence
These s t u d i e s a l s o
c o n t r i b n t i o n s mdc by an e d u c a t i o n a l
co~iponentt o t r e a t m e n t efficacy.
n o r t h i n g t o n and S h u m t e (1981)
t a i l e d t o demonstrate c o n t r i b u t i o n s of coping k i f - s t u t e a c n t s .
anronq t h e s t r e s s - i n o c u l a t i o n t r a i n i n g
these s t u d i e s , coping"sse1f-statement
dismantling research.
In
t r e a t m e n t s were combined
w i t h o t h e r c o g n i t i v e and b e h a v i o r a l s t r a t e g i e s .
The f i r s t s e t of
. ~ i r o d oand
Roehf
Hultiple cognitive
Horan ( 1 9 8 1 ) .
a l . (1976),
t h e e f f e c t i v e n e s s of coping s e l f - s t a t e m e n t s ,
response.
a c q u i s i t i o n , and s t r e s s - i n o c u l a t i o n t r a i n i n g t r e a t m e n t s f o r
dating s k i l l s and a s s e r t j v e n e s s t r a i n i n g , r e s p e c t i v e l y .
.Glues e t
a l . s e l e c t e d 6 1 male u n d e r g r a d u a t e v o l u n t e e r s and a s s i g n e d t h e m
randomly t o one o f s i x c o n d i t i o n s .
r e s p o n s e a c q u i s i t i o n and c o p i n g s e l f - e t a t e l a t n t t r e a t m e n t s .
The
11 t r a i n i n g s i t u a t i o n s .
c o n s i s t e d of modeled s e l f - s t a t e m e n t s d e n o n s t r a t i n g a p p r o p r i a t e
coping w i t h each s i t u a t i o n f o l l o w e d by r e i n f o r c e m e n t .
S t r e s s - i n o c u l a t i o n t r a i n i n g conbined t h e s e tro t r e a t m e n t s .
In
of two more t r a i n i n g e x a q l e s .
The s i x t h c o n d i t i o n was a w u i t i n g
T r a i n i n g took p l a c e i n f o u r o r f i v e 1-hour
list control.
s e s s i o n s , depending upon t h e c o n d i t i o n .
(Gaass, Gottman,
questionnpire.
&
The b e h a v i o r a l a s s e s s m e n t c o n t a i n & 2 4 s o c i a l
s i t u a t i s n y s u b j e c t r e s p o n s e s t o each w e r e r a t e d ,
la
bn t h e
men's s o c i a l b e h a v i o r w i t h women.
T h e s i x groups were s i m i l a r on a l l dependent measurea p r i o r
to treatacnt.
On t h e b e h a v i o r a l w a s u r e , t r e a t e d men inproved
relative t o controls.
On t r a i n e d s i t u a t i o n e , response
by c o p i n g s u b j e c t s men i n t h e coping s e l f - s t a t e m e n t
On u n t r a i n e d s i t u a t i o n . ,
o n l y coping
shoved r e l i a b l e improvement.
condition
i n t h e coping c o n d i t i o n
On t h e t e l e p h o n e c a l l , t h e men i n
Assertive
A combined treatment
I
self-statements.
MI
change,
No
moat measures.
At
Improvement was
This study
--
flying.
Hovaco
(1)
Women in
to prmztice p s t t i v e self-statements In
Stress-inoculation training
Women in
The
A-
ate in an experiment
4
were not aware, however, that the
landing
- on return to Ottawa would be manipulated to appear as if
-,
Self-talk
;t'
this stpy,coping self-statements increased anxiety prior
In
to and
1 9 1 3 f , matched o~
\
sex d anri&g
B#-8,
am3 assigned to
The
rela~at~ion
treatment trained subjects in a variety of relaxation
B
stills.
Training
-.
physiological measures.
Z
At a 5-week follsw-up,
@E
~ e s u l t swere interpreted
'
test anxiety.
Altmaier et al. (1982) matched treatments to client sympkoms
of anxiety.
conditions.
postassessments.
over 3 weeks.
Dependent .easurcs were self-reports3 speyhes, and''q
thoudht-listing proccd&e.
experienced anxiety s h t o r e .
strategies.
--
--
- ---
Treatments were:
(1) self-instructions,
attention control,
potentially anger-arousing,
Subjects in
This research
supported stress-inoculation
and
coping self-ataterent
components for anger control.
-
--
s t r a t e g i c ~ , S c h l i c h t e r and Horan's
Bath B a c k e t t
c o n t r i b u t i o n s of m l t i p l e c o g n i t i v e s t r a t e g i e s with r e l a x a t i o n i n
treatments designed t o reduce p a i n ,
S c h l i c h t e r and Roran (1981) s t u d i e d s t r e s s - i n o c u l a t i o n
training as a treatment f o r anger i n i n s t i t t z t i o s a l i r e d
--
- -
or
no-treatment c o n d i t i o n s ,
v t e k s in 1-hour' s e s s i o n s .
Stress-inoculation t r a i n i n g includedr
The * t r e a t u n t
On
- -
self-report
- -
Observation. from
--
--
--
- -
- -
- - - -
conditions.
additional treatments:
(Sf relaxation
(4) relaxation
+ coping self-atatemento;
cognitive strategieat
( 6 ) cognitfve 8trategTfes
strategies
training).
+ cognitive
no-trtrrtwnt control.
&
in
Wall,
---
self-repert of dfscalfort,
before treatment.
tolerance.
F&
with
ID6 r e l i a b h r e s u l t 8 f o r coping
f ~tek-#te
tto -t-
tftflB
T h i s experiment
.L
8,
f o r tension headaches,
Subjects
In the c o g n f t i w
and fantasy.
'*
124
I n s t r e u - i n o c u b t i u n training, r e ~ i u c i o am.
In
--
--
--
--
over 5
weeks.
wa+wat--f-.Ihutfmnh
I ---
--
Beadacbe data
Bo reliable changes
I n i t i a l l y , the
jFcopfag e k i l l e fn the
-
--
--
a b s ~ c eof training.
s-
- -
mtcrrrts
c-n
contributed to treatment o e t c o m ,
Sduclltioa and
All of thaue
anB uelf-instructions,
--
---
five conditionst
Desensitization
relaxation,
postas8edsments.
'
'
k
<>
d i f f i c u l t y i n d i n g decisions.
On t h e
problts-salving measure,
condition improved
i ~ r o w
rore than t h e no-treatment c o n t r o l groap.
The#@ r e s u l t s
Desensitization
conditions a l s o c o n t r i b u t e d
-
t o s p e c i f i c tre
I n t h e i r study of c o g h i t i v e , behavioral, and stre88-
The c o g n i t i v e
coping
self-statements, s e l f - L m t r u c t i o n u , and i m g e r y r e b e a r s a l .
The
S t
In addition,
procedures.
Only t h e
R e s u l t s were i n t e r p r e t e d a s support f o r t h e
Volunteers, u n i v e r s i t y s t u d e n t s and c o m i t y
.-
(.
desensitization,
i n s i g h t m ), s t r e s s - i n e m l a t i o n t r a i n i n g , and
discussion c o n t r o l ,
four treatments,
D e s e n s i t i z a t i o n included t r a i n i n g i n
-
atnd
imagery
The
The
ncasures.
treatment,
for the
cwWAcms= a - r
streaa-imcU&ha
conditions
On the cognitive
At 3 - w n t h follow-ap, perfarrance of
i
were reliably lower than at preteat.
Desensitization and
Post
received a
-\
cognitive or st tess-fnocalafQon
c o q n e n t s to trea
Ium) *
~~~ of-cop*
Studies
&
&
Roehl, 1978).
Studies of
&
&
Horan, 1981)
Stuqies
19761, but in
96
>
components, t e a c h i n g t h e r o l e of c o g n i t i o n s and s e l f - m o n i t o r i n g ,
and a p p l i c a t i o n comeponents also c o n t r i b u t e d t o t r e a t m e n t
outcomes.
." The r o l e of
coping
s e l f - s t a t e m e n t s remained u n c l e a r .
XLY&i!QY~RRlf~~kfPII,8h,8dA~.
Ffve s t u d i e s manipulated an
application t a s k .
i n v e s t i g a t e d t h e e f f e c t s of r e p e a t e d exposure t o a s t r e s s o r on
b o t h t r a i n i n g and a p p l i c a t i o n tasks.
Emelkamp e t a l , (1978)
used a c r o s s o v e r d e s i g n t o r e s e a r c h - t h e r e l a t i v e e f f i c a c y of a
prolonged exposure. t r e a t m e n t and a c o g n i t i v e s t r a t e g i e s
treatment; w
','
w these t y ~
conUtFORs weze U n e B as a s i n g l e
L
c o n d i t i o n , produced by t h e c r o s s o v e r d e s i g n , a s t r e s s - i n o c u $ a t i o n
t r a i n i n g - l i k e t r e a t r a e n t emerged.
d i r e c t l y researched t h e . e f f i c a c y of s t r e s s - i r i o c u l a t i o n t r a i n i n g .
al.
investigated contributions
a p p l i c a t i o n s t o a c o g n i t i v e - b e h a v i o r package.
Horan e t a l . (1977) i n v e s t i g a t e d f o u r t r e a t m e n t s f o r pain:
(11 n o n s p e c i f i c , ( 2 ) coping s t r a t e g i e s , ( 3 ) exposure, and ( 4 7
-
combined treatments-jects
one of t h e f o u r t r e a t m e n t s o r a no-treatment c o n t r o l .
I.
An
A ~ombined~condition
m d i k i o n , subjacks were.%&&
coping st;ategies
task.
In this
r"
'
r e l a r , and use
hg&ter
fllersky
&
&
~ h m 1932)
,
and the p;essure
Residual gain
I.
The
n were
In all conditions,
d
let
al. (1977).
Unlike the
Wonen in the
condition.
>
a trend
sir-eposnre coAftiorts.
The instructional
Q
in their
Thyer et al. (1981) varied the I D , J T ~ ~coraponcnt
study of test anxiety.
desensitization hierarchy.
Students i n t h e
amid t a p e s of d f e t r a c t i n g n o i s e s .
d i s t r a c t i o n - c o p i n g c o n d i t i o n were t r a i n e d t o a p p l y coping
s t r a t e g i e s a c t i v e l y ; 'as p a r t of t h e a p p l i c a t i o n component,
t h e r a p i s t s modeled s e l f - i n s t r u c t i o n s t h a t focused a t t e n t i o n on
t e s t relevant tasks.
over 6 weeks,
There were no r e l i a b l e d i f f e r e n c e s
between groups p r i o r t o t r e a t m e n t ,
R e s u l t s demonstrated r e l i a b l e
Manual d e x t e r i t y a l s o w a s iarpraved,
1Qo
to
reliable
The a u t h o r s s p e c u l a t e d t h a t t h e
designed i n s u c h a way t h a t c o n t r i b u t i o n s m d e by t h e
distraction-&-&Q
compunest cuuld b e i d e n t i f i d .
a s s e s s c o g n i t i v e t r a i n i n g w i t h 20 h o s p i t a l i z e d agoraphobics
assigned randomly t o t r e a t m e n t s .
Treatments were c o g n i t i v e
A c o e i n e d t r e a t m e n t , produced
by t h e c r o s s o v e r , a p p r o x i r a t e d s t r e s s - i n o c u l a t i o n t r a i n i n g ,
The
self-statements.
m k E a m uf-cvpphrg-
f o r t h e f o u r s t a g e s of d e a l i n g w i t h a s t r e t m o r ,
In prolonged
T r a i n i n g f o r each s e p a r a t e t r e a t m e a t took
, eub j e t
md observer
. S u b j e c t s were a s s e s s e d b e f o r e , a t c r o s s o v e r , a f t e r
t r a i n i n g , and 1 month l a t e r .
=
No r e l i a b l e d i f f e r e n c e s on any of
S u b j e c t s i n t h e combined t r e a t m e n t ( f o l l o w i n g
Comparisons of
i n c o r p o r a t ing c o g n i t i v e t r a i n i n g i n t o ~ , ~ L Ht rQa i n i n g .
They
9/
Such a r o u s a l may b e q u i t e
--
cognitiv+<3atcgies,
~ftfpp.expoeure,
and s t r e s s - i n o c u l a t i o n t r a i n i n g .
The tp
t r c a t a e n t r a t i o n a l e e x p l a i n e d t h e i n f l u e n c e o f c o g n i t i o n s on
avoidance behavior.
treatment:
(1) t e a c h i n g t h e r o l e o f c o g n i t i o n s , ( 2 ) t e a c h i n g
self-monitoring,
( 3 ) developing coping s e l f - e t a t e a e n t s ,
(4)
teaching s e l f - i n s t r u c t i o n s i n p r e p a r a t i o n f o r a s t r e s s o r , and ( 5 )
The
S u b j e c t s in t h i 8 c o n d i t i o n
-&Q
exposure.
Training
A t posttest, aabfecta
r e l i a b l e ImprovS~~SBt03
o v t r w h t l n i n g a a j o r i t y of raaaruree.
Subjects i n t h e s t r e s s - i n o c a l a t i o n t r a i n i n g c o n d i t i o n
At 811-month
The cognitive
avoidance scales.
phobic scales.
The z s g n i k i n n treaknenf
treatment,
(I
\
Hackctt
s i t u a t i o n in
The
c o n t r i b u t i o n s of s t r e a r - i n o c u l a t i o n t r a i n i n g , coping procedures,
*
remained unclear.
QPEIYE~PP.
The s t r e s s - i n o c u l a t i o n t r a i n i n g s t u d i e s
reviewed in t h i s d i s l r a n t l f n g s e c t i o n d i d n o t provide r e a u l t s that
led t o e a s i l y s u a r a r i r e d concla8ions as d i d t h e
Nevertheless, o b s e r v a t i o n s
of (1) --*in_
wrt
, and
p r o p o r t i o n s of
c u r t t r i b u t i o n s of i n d i v i d u a l c o q o n e n t s t o s t r e m - i n o c u l a t i o n
training.
A ~ j o r f t yof the dismntlfng s t u d i e s focus&
-
on trainingp
* -
a l . , 19743; Eh'Tplkarp
c-ng
1981) examined
application of
skills.
Understanding
thc
entire
implemented in part.
Experi-ental treat~nt8generallywere laare effective than-control conditions.
were
stress-inoculation training.
a1
treatments.
s- y
. -
or m t r W @ ~ eerfective
C
ECC
rCI
OOC
YYY
em.
Kf
**a
rCT
:::
CC
C
01
0
..
YO
a*
KX
I..
+.N
.- I
==;
-09
: z 3
:. .:.
Y,:
..:
5s
urn
--
ma
.u
1 1
I).
0s
I I
I
I
c
E
9
+
r
r g
-I
C40
02u
"MU*
39u
u
kc
- Z F
gs7.";
M I
w -YO
rY
w u sL
.
&
&
1982; Mendonca
&
Stone, 1982)
infrequently.
&
&
stress-inoculation training.
'
~ J & Q
--!
---
Superior effective
Table 2
in s t r e & - ~ n o c u l a t i o n Training D
Ingredients.
ntling
Studies
ACT I V e
c o p i n g strateglrn
1=2>3=4>5poetteat
1=2>3>4,5 follow-up
1-2-3-4 flying
1 ,3>2,4 unexpected
l=2=3>4 follorup
1,3,4>2,5>6 trained
2,5>1-,3,4,6 phone
1=2=3'=4>6 follw-ap
1=2>3 uelf-report
1>3 role-play
I
I
1
I
I
I
1>2 role-play
3,2>1,4 p o s i t i v e s-e
114,5,7>2,3r6,8
on tolerance
2=6>3
by r e s e a r c h e r s .
Less t h a n h a l f o f t h e s t u d i e s i d e n t i f i e d ' a c t i v e
i n g r e d i e n t s m i n s t r e s s - i n m u l a t i o n t r a i n i n g , and t h e y f r e q u e n t l y
n o t e d t h a t f u r t h e r r e s e a r c h was needed t o t e a s e o u t t h e
c o n t r i b u t i o n s of components t o s t r e s s - i n o c u l a t i o n t r a i n i n g .
The
i n g r e d i e n t * s i x times, and s e l f - i n s t r u c t i o n s , b e h a v i o r a l
coping s t r a t e g i e s , s e l f - m o n i t o r i n g , and
~ Q - J T ~ Y aQp p l i c a t i o n
r e l e v a n t o b s e r v a t i o n s were made.
three
Horan e t - a l . (1977) i d e n t i f i e d
H a c k e t t e t a l . (1979)
h y p o t h e s i z e d t h a t modeling of c o p i n g s k i l l s i n t h e * a p p l i c a t i o n
.-,
component enhanced t r e a t m e n t g e n e r a l i z a t i o n .
On t h e o t h e r hand,
s t r e s s - r e d u c e d environment.
A n a l y s i s of component f r e q u e n c i e s may i l l u m i n a t e
component c o n t r i b u t i o n s t o t r e a t m e n t outcomes.
t r a i n i n g component a c r o s s t h e reviewed s t u d i e s .
F i g u r e 3 shows
/ 1
4:
&
I
I 1, 4 ,
&
I 1,
1
4., &
1 1, 4
I
&
Teaching the
of C o g n i t i v e
6: Teaching
of C o g n i t i v e
5: Teaching
of C o g n i t i v e
2: Teaching
of CogniM-ve
1
21
21
I
I
18
- , - - - - - - - - - = I I = = P = = = = = = = = = = P I = = = = = = =
===================z*T--"-------
Figure 3 ,
I
I
33
Frequencies o components-in e f f e c t i v e t r e a t m e n t s .
A
F i g u r e 3 demonstrates t h a t c o g n i t i v e s t r a t e g i e s were
implemented f r e q u e n t l y i n combinations.
I n Component 4 ,
This c o r e configuration
an e f f e c t i v e t r e a t m e n t .
t r e a t m e n t s r e v e a l e d t h a t t h e c o g n i t i v e s t r a t e g i e s component was
These d a t a s t r o n g l y s u g g e s t
T a b l e 3 summarizes
i n f o r m a t i o n a b o u t t h e p r e s e n c e o r a b s e n c e o f components i n
e f f e c t i v e and i n e f f e c t i v e t r e a t m e n t s .
Questionable
--
Their r a t i o s for
and 44:12,
t h e i r implementation r a t i o s i n , e f f e c t i v e vs
t r e a t m e n t s was 37:9 and 4 4 : 6 ,
respectively.
respectively, and
. ineffective
These components
',
These d a t a
efficacy
Table 3
f Coaaponents
Contributions of t h e self-fnstrnctions,
self-monitoring,
These t h r e e
and
25:31,
r e s p e c t i v e l y , and implementation r a t i o s in e f f e c t i v e
and 30:5,
respectively.
determining f a c t o r s i n t r e a t m e n t e f f i c a c y .
I t was n o t p o s s i b f e t o draw c o n c l u s i o n s about t h e
c o n t r i b u t i o n s of problea-solving and
j,n-xix~ a p p l i c a t i o n
'
C o n t r i b u t i o n s made by t h e s e
m a t be investigated f u r t h e r .
I n summary, c o n t r i b u t i o n s of components in
-
r o l e of c o g n i t i o n s c o n t r i b u t e d t o t h e e f f i c a c y of
stress-inoculation training,
However, t h i s h y p o t h e s i s needs t o
a d d r e s s t h e r e l a t i v e l y h i g h frequency of t h e l a t t e r component i n
i n e f f e c t i v e treatments.
Contributions o f s e l f - h s t r u c t % o n s ,
befrxvhr a-s,
&
sic I
c-
clear.
mrtf
--
---
pevertheless,
- -
- -
g and
#f
The
&
--s
e
E
-l
Although
t
-3
'
Self-instructions, behavior
,- -
"l
118
--
~~-IY;,-E~-bdllbta[8IS,QP-SBLP=I~~Q~-TBbZ~EoG
C
~S%&4S=I'PPCnUEJQL7WZIZH4k--~-LL
f u n c t i o n a l a n a l y s i s of
This chpater c
self-instruction
e s s - i n o c u l a t i o n t r a i n i n g by
I
Tlisse s t u d i e s e r a p i n e
f o c u s i n g on comparative outcome s t u d i e p .
t h e e f f i c a c y of t r e a t m e n t s i n c o r p o r a t i n g s e l f - i n s t r u c t i o n a , l
t r e a t m e n t outcomes of t h e s e experimental c o n d i t i o n s t o t h o s e of
.<
o t h e r t r e a t m e n t s c o m n l y - used i n a p a r t i c u l a r s i t u a t i o n .
~ ~ = I P B ~ Z U G ~ ~ Q D B L , T X ~ ~ D ~ ~ ~ B - S ~ Y ~ ~ ~
T h i s s e c t ion examines comparative outcome s t u d i e s i n which
t h e e f f i c a c y of s e l f - i n s t r u c t i o n a l t r a i n i n g is compared -hat
gf, o t b e r t r e a t m e n t s .
..
These c o g n i t i v e t a s k s
d i s c u s s e d i n terms of t r e a t m e n t c o n d i t i o n s :
self-instructional
&
White,
c o n t i n g e n c i e s compared t o o t h e r t r e a t m e n t s (Arnold
&
Forehand,
&
upa an,
1 9 8 1 ) ~and
.
'\
lnr
Collins
&
Kendall
&
Greenberg, 1981)
&
Henker, 1977; Y e l p ,
&
&
Hirt,
&
~ , - E Q D ~ x Q ~ , ~ ~ M ~~n~y d
= es r.and White (1979) tested the
assessment control.
A contingency awareness
i_f
Trained
These results,
&
Finch,
t r a i n i n g i n t h e following s t u d i e s :
1981.
K e n d a l l and Zupan
combined w i t h r e s p o n s e c o s t i n i n d i v i d u a l a n d g r o u p t r e a t m e n t s t o
each o t h e r and t o a n o n s p e c i f i c c o n t r o l t r e a t m e n t .
Yellin et a l .
(1981) compared s e l f - i n s t r u c t i o n a l t r a i n i n g w i t h r e s p o n s e c o s t
(This s t u d y w i l l be
discussed w i t h s t u d i e s comparing s e l f - i n s t r u c t i o n a l t r a i n i n g t o
medical t r e a t m e n t s .)
Arnold and Forehand f f 9 7 8 ) i n v e s t i g a t e d p ~ e s c W l e r 's
s e l f - c o n t r o l using s e l f - i n s t r u c t i o n a l t r a i n i n g , response c o s t
c o n t i n g e n c y , combined s e l 5 - i n s t r u c t i o n a l t r a i n i n g w i t h r e s p o n s e
c o s t c o n t i n g e n c y , aad c o n t r o l c o n d i t i o n s .
Self-instructional
follow-up:
c h i l d r e n v e r e g i v e n p e n n i e s and t o l d t h a t t h e y would
C h i l d r e n i n t h e combined
c o n d i t i o n , s e l f - i n s t r u c t i o n a l t r a i n i n g with response c o s t
c o n t i n g e n c y , were .+ained
following t h e s e l f - i n s t r u c t i o n a l
The c o n t r o l c o n d i t i o n i n v o l v e d modeling,
S u b j e c t s were s e l e c t e d by s c o r e s on t h e Kansas
P
R e f l e c t i o n - I m p u l s i v i t y S c a l e f o r P r e s c h o o l e r s [KRISP] (Wright,
1973).
Treatment a s s i g n m e n t s were d e s i g n e d t o e q u a t e a g e , s e x ,
A n a l y s i s of KRISP d a t a r e v e a l e d a s t a t i s t i c a l l y
On t h e c l a s s r o o m measure,
These r e s u l t s d e m o n s t r a t e d a n a b i l i t y of
The r e s e a r c h e r s s u g g e s t e d t h a t r e d u c t i o n o f
e r r o r s a c r o s s a l l t r e a t m e n t s m y have r e s u l t e d from i n s t r u c t i o n s ,
p r a c t i c e , and f e e d b a c k ,
treatment conditions.
K e n d a l l and Zupan (1981) compared two t r e a t m e n t s having
s e l f - i n s t r u c t i o n a l t r a i n i n g with'response c o s t contingency
The
treatment.
had become more like kheix peers that had not been r e f e r r e d ,
At 2
months, t e a c h e r r a t i n g s demonstrated t h a t s t a t i s t i c a l l y r e l i a b l e
improvement had been maintained independent of t r e a t m e n t
conditions.
between groups.
l a t e n c y s c o r e s were no l o n g e r s t a t i s t i c a l l y r e l i a b l e , b u t e r r o r
s c o r e s r e v e a l e d maintenance of improvement.
Decreased l a t e n c y
On a r o l e - t a k i n g t a s k
(Chandler, 1 9 7 3 ) , c h i l d r e n i n t h e c o g n i t i v e c o n d i t i o n
demonstrated r e l i a b l y g r e a t e r ipfprovement a t follow-up t h a n d i d
c h i l d r e n i n t h e c o n t r o l group.
i n t e r e s t , and f o l l o w i n g d i r e c t i o n s c o r r e l a t e d p o s i t i v e l y w i t h
t h e s e p e r f o r m c e measures.
Xendall (1982) followed-up 23 (77%) c h i l d r e n from t h e
previous study.
T h i s s l ~ l l e rgroup w a s n o t r e l i a b l y d i f f e r e n t
Dependent measures
follow-up assessment.
Teacher r a t i n g s i n d i c a t e d t h a t c h i l d r e n i n
A SeIf--conkrol Elating S c a l e
{Kendall
&
Wilcor,
1979) r e v e a l e d r e l i q b l e d i f f e r e n c e s between c h i l d r e n t r a i n e d
i n d i v i d u a l l y i n t h e cognitive-behavior c o n d i t i o n and t h o s e i n t h e
nonspecific treatment condition.
group,
-
The
Performance measures r e v e a l e d t h a t
Interview d a t a indicated
These r e s u l t s
demonstrated maintenance of t r e a t r ~ t e n te f f e c t s u s i n g a
cognitive-behavior approach.
he
i n d i v i d u a l a p p l i c a t i o n of t h i s
a.
methylphenidate--treataents
children,
Yellin et al. (1981) compared two groups of boys, five
per group, referred to psychiatric or psychological services for
hyperactivity.
Hedical procedures
was ~ o n ~ i n u e ~ t h r o ~ h
Dependent
&
Wilcox, 1979).
Analysis of
between groups.
a l t e r n a t i v e t o medical t r e a t m e n t f o r h y p e r a c t i v e c h i l d r e n .
Bugental e t a l . (1977, 1978) i n v e s t i g a t e d t h e e x t e n t t o
which h y p e r a c t i v e c h i l d r e n ' s c a u s a l a t t r i b u t i o n s a r e r e l a t e d t o
d i f f e r e n t i a l t ~ e a t n t e n te f f e c t i v e n e s s .
Medicated c h i l d r e n were
s e l e c t e d f i r s t ; t h e n h y p e r a c t i v e c h i l d r e n were selected u s i n g
Conners' Teacher R a t i n g S c a l e (1969).
randomly t o two t r e a t m e n t s :
C h i l d r e n were a s s i g n e d
a self-instructional training
T r a i n i n g took p l a c e t w i c e weekly i n
Children
A n a l y s i s of c o v a r i a n c e was used t o
On t h e P o r t e u s Maze, c h i l d r e n i n t h e c o g n i t i v e
S c o r e s of
c h i l d r e n i n t h e s o c i a l reinforcement c o n d i t i o n r e v e a l e d a t r e n d
toward improvement f o r t h o s e c h i l d r e n who had low l o c u s of
c o n t r o l and/or werq m d i c a t e d .
S t a t i s t i c a l l y r e l i a b l e main
e f f e c t s f o r b d i c a t i o n and a medication x t r e a t m e n t i n t e r a c t i o n
i n d i c a t e d t h a t a s u p e r i o r t r e a t m e n t f o r t h e nonmedicated c h i l d r e n
was s e l f - i n s t r u c t i o n a l t r a i n i n g , while a s u p e r i o t t r e a t m e n t f o r
medicated c h i l d r e n was social reinforcen#nt.
TBe,re was no
r e l i a b l e d i f f e r e n c e i n s h o r t term g a i n s between t r e a t m e n t s .
d i f f e r e n c e s were observed i n t e a c h e r r a t i n g s .
No
Because
Using Be same
Children i n t h e
s e l f - i n s t r u c t i o n a l t r a i n i n g c o n d i t i o n e v a l u a t e d t h e i r performance
t o be due t o t h e i r own e f f o r t s more f r e q u e n t l y t h a n d i d c h i l d r e n
in t h e s o c i a l r ~ e i n f o r c e ~ nc ot n d i t i o n .
t r e n d toward
S t a t i s t i c a l l y r e l i a b l e treatment e f f e c t s
were observed on t e a c h e r r a t i n g s ,
C h i l d r e n in t h e s o c i a l
Social
,Interestingly,
In other studies,
&
Thirty-two
educable m e n t a l l y - r e t a r d e d c h i l d r e n , mean c h r o n o l o g i c a l a g e of
11.1 y e a r s and mean IQ of 63.2' (Peabody P i c t u r e Vocabulary T e s t ,
m n n , 1 9 6 5 ) , were s e l e c t e d on a b i l i t y t o match-to-salaple,
They
children i n
b u t r e c e i v e d no s e l f - i n s t r u ~ " t f o n a 1t r a i n i n g .
Following each
kept e q u i v a l e n t a c r o s s groups,
Tbe c o n t r o l group r e c e i v e d
T r a i n i n g took p l a c e i n
t h r e e 20-minute s e s s i o n s .
Dependent measures were match-to-sample
(Ragan, 1 9 6 5 ) .
form.
Ip"
Thirty-six
Conditions were
.
i
self-instructional training, induced rehearsal procedure, and
'*
practice control.
k l 3 e w e c r c k w a a itwaa-taand
&?
~ e ~ e t ions
i t were pr duced audibly.
Each.
In the practice-
way to
On
Nonproducers in
Data on
These results
The
cognitive performance
math tutoring,
Self-instructional
&
&
Strickland, 1973).
The
On performance measures,.all
,
Thirty
The
-In
Direct training
'+"
postassessments
Data
Comparison of
.-b
generalization measures.
Analysis of children's
P
However,
self-instruction into a single word, which, on occasion, was notcoordinated with the motor response it was supposed to guide.
They also
'
Arnold and
Although
*dies
,":
'f
Sfrsas=Lnn~ula~i~n-Tr~iniag~Sf~dies
S t u d i e s i n t h i s s e c t i o n compare t r e a t m e n t outcomes of
s t r e s s - i n o c u l a t i o n t r a i n i n g t o t h e outcomes of
c o g n i t i v e - b e h a v i o r a l and o t h e r t r e a t m e n t s .
Although none o f
t h e s e s t u d i e s i n c l u d e d a named s t r e s s - i n o c u l a t i o n t r a i n i n g
t r e a t m e n t , a l l o f t h e reviewed s t u d i e s c o n t a i n e d t r e a t m e n t
components of s t r e s s - i n o c u l a t i o n t r a i n i n g .
Studies containing
c o g n i t i v e - b e h a v i o r a l t r e a t m e n t s s i m i l a r t o o r based on
s t r e s s - i n o c u l a t i o n t r a i n i n g components a r e c o n s i d e r e d , f o r t h e
p u r p o s e s o f t h i s r e v i e w , t o b e examples of s t r e s s - i n o c u l a t i o n
S t d e s s - i n o c u l a t i o n t r a i n i n g was employed
t r a i n i n g research.
i n i t i a l l y t o t r e a t p h o b i a s (Meichenbaum
&
camera,#, 1972a; 1 9 7 4 ) ,
The broad
a p p l i c a b i l i t y of t h i s t r a i n i n g p r o c e d u r e is i l l u s t r a t e d by t h e
d i v e r s i t y of s t u d i e s c a v e r e d h e r e .
The s t u d i e s reviewed i n t h i s
s e c t i o n i n v e s t i g a t e d t h e e f f i c a c y of s t r e s s - i n o c u l a t i o n t r a i n i n g
t r e a t m e n t s f o r p h o b i a s (Meichenbaum and Cameron, 1972a, 1 9 7 4 ) ;
t e s t a n x i e t y ( G o l d f r i e d , Linehan,
Leal, B a x t e r , H a r t i n ,
anxiety ( P r e m u w
&
&
Z i t t e r , 1978; Weissberg, 1 9 7 7 ) ; n o n a s s e r t i v e
&
&
Glaros,
Stress-inoculation
t r a i n i n g g e n e r a l l y h a s a t t e m p t e d t o change b e h a v i o r by r e d u c i n g
o r e l i m i n a t i n g m a l a d a p t i v e t h o u g h t s and b e h a v i o r s .
Meichenbaum's
s t u d y on c r e a t i v i t y ( 1 9 7 5 a ) , on t h e o t h e r hand, used
stress-inoculation t r a i n i n g t o increase c r e a t i v e behaviors.
This
expe; iment s u g g e s t e d t h a t s t r e s s b - i n o c u l a ti o n t r a i n i n g c a n b e
e f f e c t i v e i n e i t h e r i n c r e a s i n g o r d e c r e a s i n g t a r g e t t h o u g h t s and
behaviors.
S t r e s s - i n o c u l a t i o n t r a i n i n g t r e a t m e n t s c a n b e used t o
i n c r e a s e e x i s t i n g b e h a v i o r s , t o t r a i n new o n e s , o r t o d e c r e a s e
xmladaptive ones.
C l i n i c a l p o p u l a t i o n s , s u b j e c t s who e x h i b i t e d
The u s e of c l i n i c a l p o p u l a t i o n s i n c o m p a r a t i v e
important consideration i n s e l e c t i n g a t h e r a p e u t i c i n t e r v e n t i o n .
lleichenbaum and Cameron
( l972a)
e f f i c a c y of s t r e s s - i n o c u l a t i o n t r a i n i n g f o r
Uale v o l u n t e e r s were s c r e e n e d f o r c l i n i c a l p h o b i a s t o b o t h rats
and snakes; men vhose a c t i v i t i e s were c u r t a i l e d because o f these
central./
t r e a t m e n t components, a l l o f t h e coaponents s p e c i f i e d by
lleichenbaum (1977a), except s e l f - i n s t r u c t i o 6 s r
about t h e r o l e of t h o u g h t s on behavior;
(1) l e a r n i n g
'
( 2 ) s e l f -monitoring f o r
s e l f - s t a t e m e n t s t o u s e a t each s t a g e of t h e phobic r e a c t i o n 1 ( 5 )
r e l a x i n g by a l t e r n a t i v e l y t i g h t e n i n g and r e l a x i n g muscles 'and b y .
deep b r e a t h i n g ; f 6 f r e b e a r s i n g newZy-Zearned self-statements
A
strategies
t o a nonphobic a t r e s s o r , i n t h i s c a s e , u n p r e d i c t a b l e
L
e l e c t r i c shock.
S e l f - i n s t r u c t i o n a l t r a i n i n g included t h e same
f i r s t f i v e components; m e n , i n t h i s c o n d i t i o n d i d n o t apply t h e i r = .
c o p i n g ' s k i l l s t o a s t r e s s f u l e x p e r i e n c e nor d i d they p r a c t i c e
-
them using s e l f - i n s t r u c t i o n a l t r a i n i n g .
Systematic
Men i n t h e c o n t r o l c o n d i t i o n r e c e i v e d
o n l y pre- and p o s t a s s e s s m e n t s .
*re
t o snakes.
The dependent measure w a s an approach t o each of t h e phobic
g e n e r a l is a t i o n .
S e l f - i n s t r u c t i o n a l t r a i n i n g w a s also an
effective treatment,
The
stress-inoculation training.
- --- -
--
Stress-inoculation training
m
c
a
n
t
r
a
l
Students were
Training t o o k
group of 10 p e e r s t u d e n t s , selected by
Data
students.
S t u d e n t s were a s s e s s e d on s e l f - r e p o r t measures, performance
The A l p c r t and h e r (1960)
. c a s u r e s , and g r a d e p o i n t average.
test a n x i e t y q u e s t i o n n a i r e provided s c a l e s f o r d e b i l i t a t i n g
a n x i e t y and f a c i l i t a t i n g a n x i e t y ,
s t u d e n t s d u r i n g analogue t e s t i n g s i t u a t i o n s ,
-- - -- - - -
Analogue t e s t i n g
a digit
8-01
T e s t of P r o g r e s s i v e Hatrices (1956).
f u r t h e r perforlrance measure.
and p o s t t r e a t m e n t asseasotents.
d i f f e r e n t p r i o r t o t r e a t m e n t and t h a t t r e a t m e n t outcomes d i d n o t
-*i-:
Qutcoaes f o r s t r e s s - i n o c u l a t i o n t r a i n i n g ,
Both
In addition, students
r e c e i v i n g s t r e s s - i n o c u l a t i o n t r a i n i n g outperformed o t h e r s t u d e n t s
on t h e measure o f g r a a e p o i n t average.
On self-report measures,
both t r e a t m e n t s d e m n s t r a t e d s t a t i s t i c a l l y reliable r e d u c t i o n i n
d e b i l i t a t i n g a n x i e t y , and improvement was maintained a t follow-up
1 nonth l a t e r .
S t u d e n t s i n s t r e s s - i n o c u l a t i o n t r a i n i n g showed
s t a t i s t i c a l l y r e l i a b l e increases i n f a c i l i t a t i n g dnxiety.
Mefchenbaum hypothesized t h a t t h e s t r e s s - i n o c u l a t i o n t r a i n i n g
-
Students i n t h e stress-inoculation
peers a t p o s t t r e a t m e n t ,
Holroyd (1976) a l s o r e s e a r c h e d t h e comparative outcome o'f
several treatments f o r test anxiety.
H i s work was s i m i l a r t o
S t u d e n t s were a s s i g n e d randomly t o
Treatments included
(1)
The
stress-inoculate
Group interactions in
point arerage.
The
The author
rather than test anxiety and ebosc whose test anxiety was related
stress~inoculationtraining, systematic,
Stress-inoculation
The
(1976)
Students in tbe
&
Alexander,
The
E ~ E W ~were
~ S
&
Lushene, 1970).
Q
n
the
The autho~s
measure; 90%
This finding'i
anxiety.
In
Cop-ing
The prolonged
'
anxiety.
No
On the anxiety
On measures of
training were
-,
students.
ollowing
i
randomly t o a , t r e a t m e n t .
T r a i n i n g took p l a c e i n three v e e k l y
The d i r e c t t r e a t m e n t
Ro t h e r a p i s t was p r e s e n t i n t h e
vicarious conditions,
The
Two of
measured g e n e r a l anxiety.
Postassessment followed t r e a t m e n t by 1
>
ti-;
s t u d e n t s i n the c o n t r o l c o n d i t i o n demonstrated r e l i a b l y
Although t h e r e were no $
'
s t a t i s t i c a l l y r e l i a b l e r e s u l t s from s e l f - r e p o r t measures, s
measures o f g e n e r a l a n x i e t y approached s t a t i s t i c a l r e l i a b i l i t y .
This t r e n d , which f a v o r e d t h e d i r e c t s t r e s s - i n o c u l a t i o n t r a i n i n g
c o n d i t i o n , w a s n o t m a i n t a i n e d a t follow-up.
On
behavioral
measures, d i r e c t s t r e s s - i n o c u l a t i o n t r i i n i n g and d i r e c t
d e s e n s i t i z a t i o n t r e a t n w n t s demonstrated s t a t i s t i c a l l y reliable
decreases in observable a n x i e t y during a speech p r e s e n t a t i o n ,
In
comparison t o c o n t r o l s , treated s t u d e n t s d e w n s t r a t e d r e l i a b l e
r e d u c t i o n s i n speech a n d ' g e n e r a l a n x i e t y ,
These r e s u l t s p r o v i d e d
some support f o r s t r e s s - i n o c u l a t i o n t r a i n i n g as a t r e a t m e n t f o r
and g e n e r a l anxiety and f o r the e f f i c a c y o f +
r e d u c i n g speech
direct q8wt v i k a r i o u s t r e a t m e n t s ,
P o ~ t t e s tt r e n d s s u g g e s t e d t h a t
s t r e s s - i n o c u l a t i o n t r a i n i n g - m y be more e f f e c t i v e t h a n
Prom a p o o l o f u n d e r g r a d u a t e
&
F r i e n d , 1969) and
a s s i g n e d randomly . t o a c o n d i t i o n ,
C o n d i t i o n s wereg
stills
t r a i n i n g , s t r e s s - i n o c u l a t i o n t r a i n i n g , d i s c u s s i o n p l a c e b o , and
Thus t h e r e were eight gr
r a i t i n g list c o n t r o l .
conditione x
tk a n x i e t y l e v e l s .
The
' d i s c u s s i o n s of i n t e r p e r s o n a l t o p i c s as t h e c o n t e n t o f t r e a t s e n t .
S t u d e n t s in t h e waiting l i s t c o n d i t i o n r e c e i v e d the-same pre- and
p o e t t e s t s as t h e o t h e r s t u d e n t s b u t were t o l d t h e y would have t o
wait f o r t r e a t m e n t .
s e s s i o n s , held weekly.
*,'
%
---
--
--
The a t t r i t i o n .
r a t e of s t u d e n t s r i s u l t e d i n r e l i a b l e group d i f f e r e n c e s p r i o r ' t o
J
On a
fhPEK 6f
t r a b i n g groups
H ! k e k t % t e W & m e & -
i q r o v e a e n t over s t u d e n t s i n t h e c o n t r o l group.
On
r a t i n g s of
e,
overall anxiety v b i h making a speech, students in the
skills-training and stpsfloculat
On the
group,
instr-nts,
in
The experiment-
The results
mis
The
efficient treatment.
A subjects x treatment
Thorpe /I9751 =d
--
&
Lillesand, 1971).
Scores
Students vere
"i
assigned to treataents using a random procedure ~ ~ B g t r a i n eby
d
score range, sex, and scheduling restrictions.
Carmdy recruited
,--
wsre
~ agslgnea randomly to treatments.
ZEFl t 153 u a ~ s i m
---
--
--
The treatments,
Stress-inoculation
of positive self-state&nts,
The therapist
situstion.
In
response,
t h e i r nursassertBn~beha viof=,
- - -
---
21
Behavioral measures r e r e
4
5-point scale.
Subject
Alcsertive
were dsge&
assertion
On a generalization naaeure,
- - -
--
- - -- -
159
--
situations for which training had not been given, the performance
of students in stress-inoculation training and rodeling-rehearsal
conditions wae superior to that of control students.
A similar
students
These results
---
----
-- - - --
condition.
Carmody's (1978) research on nonassertive behavior compared
the relative efficacy of rational-emotive therapy, behavior
condition.
rehearsal.
behavior.
overt, assertive behaviors were Bodeled; subjecte were coached inperforming these babavfors and then practiced them.
Cckgnitiwe
'
In
90-minute sessions.
Dependent measures included eelf-report measures of
assertiveness and '&cia1
-- - -
Data were
-cram
each other.
=l=-m+w
+cams-
aeasure, consisting of
J
-=--w.
vr2
reliable main effects for time but not for treatments were
161
,
i
observed.
They compared
Biofeedback relaxation
r-
Training' took
s t r e s s - i n o c u l a t i o n ' t r a i n i n g c o n d i t i o n s had r e l i a b l e r e d u c t i o n s i n
headache a c t i v i t y : t h i s improvement was nraintained a t a 15-week
a.
folloto-up.
separcate
The d a t a demonstrated t h a t t h e s u p e r i o r i t y of
K:\
r e p o r t e d headache imprgvelent a t p o s t t r e a t m t a n d , c o n t i n u e d t o
i q r o v e following the end of t r e e r a n t .
-86
Subjects i n .the
of improvement,
S u b j e c t s i n both t r e a t m e n t s reporthd r e l i a b l y
b i o f eedbaek subjects o u t p e r f o r 6 u b j e c t s i n e t r e a a - i n o c u l d t i o n
Stress-inoculation t r a i n i n g w a s
i d e n t i f i e d a s an e f f e c t i v e t r e a t m e n t f o r t e n s i o n headache.
'
These
overweight but weighed less than 260 pounds, were selected and
assigned at random to conditions.
The stress-inoculation
Stress-inoculation training
training procedures.
(Correspondence
At a 7-week
t t r r aft r r i x r g
m&
'u
c,
aJ
EI
0,
JJ
W
6,
r-i
0,
-4
JJ
-4
-*B
V
01
C
.r(
31
4J.
-4
r-i
rl
c o d i n e f a n t a s y and r e a l i t y .
treatment.
consist-d
Groups were e q u i v a l e n t p r i o r t o
On p e r f o r m a ~ c emeasures, d a t a r e v e a l e d h i g h l y
s t a t i s t i c a l l y r e l i d b l e group d i f f e r e n c e s
i!
Students i n t h e stress-inoculd@on
t r a i n i n g c o n d i t i o n performed
-2-
cc@isistently h i g h e r on a l l c r e a t i v b t y tests.
Students in the
?'
S t u d e n t s i n t h e stresh=,Jnoculation
training condition
Welsh Revised A r t S c a l e ( 1 9 5 9 ) , w h i l e t h e s t u d e n t s i n t h e
f o c u s i n g c o n d i t i o n performed r e l i a b l y b e t t e r on t h i s s c a l e t h a n
did students i n the control condition.
Three o f t h e s e l f - r e p o r t
The
4
'
Heichenbaum s u g g e s t e d t h a t s t u d e n t s i n t h e f o c u s i n g c o n d i t i o n
\
felt.more creative.
Data r e v e a l e d , however, t h a t o n l y s t u d e n t s
in stress-inoculation training,condition
changed hot@ t h e i r
and performance.
S ; n a ~ l u g i ~ n .I n t h e c o m p a r a t i v e outcome s t u d i e s reviewed i n
this s e c t i o n , s t r e s s - i n o c u l a t i o n t r a i n i n g h a s been d e m o n s t r a t e d
t o b e an e f f e c t i v e t r e a t m e n t f o r a v a r i e t y o f problems.
S t r e s s - i n o c u l a t i o n t r a i n i n g was more e f f e c t i v e t h a n o t h e r
t r e a t m e n t s for' t e s t a n x i e t y ( G o l d f r i e d e t h l . ,
1978; ~ e i c h e n b a u m ,
1 9 7 2 a ) ; speech a n x i e t y {Weissberg, 1 9 7 7 ) ; n o n a s s e r t i v e b e h a v i o r
frenouv
&
-.
In a variety of problem
These
C@G~UB~Q~~,,~QP~OPI;B~~YS~~~EQ~-~~U~~~@
-
Studies
The
,.
self-instructional trai&ing
1 '
o t h e r treatmnts.
t r a i n i n g h d stress-inoculation t r a i n i n g can
e f f e c t i v e l y implemented.
GBiHTEE, SL ,EG?BCLQSZI;PP
I n drawing c o n c l u s i o n s t o t h i s paper, s t r u c t u r a l ,
f u n c t i o n a l , and t b c ~ r ~ e t i c ac ol n s i d e r a t i o n s h a v e been c u l l e d f r o m
precedincy' c e a p t t r s
u n d e r s t h d i n g s of s e l f - i n s t r u c t i o n a l
stress-inoculation
t h e end of t h e f i r s t c h a p t e r :
and s t r e s s - i n o c u l a t i o n
procedures?
t r a i n i n g and
In answering t h i s question, s t r u c t u r a l
considerat ions a r e d b c u s s c d f i r s t , f o l l o w e d by f u n c t i o n a l
considerations.
v i e r of i l c f c h e n b a u m i a t h e o r y of c o g n i t i v e - b e h a v i o r
change.
After
r e l a t i n g t h e f i n d i n g s of this paper t o t h e q u e s t i o n t h a t
i n i t i a t e d i t r t h i s c h s p t 3 ~will c o ~ c l u d eby examfning t h e
imp1 icat i o n s of these f i n d i n g s
S9~r~,~f,S~nrsfrrr~f~Cm~fde~~i~08
~ o t hs e l f - i n a t r u c t i o n a l t r a i n i n g and s t r e s s - i n o c b l a t i o n
C1
t r a i n i n q were d e v e l o p e d t o h e l p c l i e n t s c h a n g e o v e r t and
c o q n i t i v e b e h a v i o r s , in' p a r t i c u l a r , t h i n k i n g processes.
S e l f - i n s t r u c t i o n a l t r a i n i n g w k s used i n i t i a l l y t o h e l p i m p u l s i v e
w
c h i l d r e n i n c r e a s e p e r f o r m a n c e on t a s k s t h a t r e q u i r e t h o u g h t f u l ,
c a r e f u l , and systelsat fc c u q n f t ive processing.
Self-instructional
behaviors, including:
problem d e f i n i t i o n , a t t e n t i o n f o c u e i n g ,
r e s p o n s e guidance, s e l f - r e i n f o r c e m e n t , s e l f - e v a l u a t i o n , c o p i n g
s k i l l s f o r e r r o r s o r f a l f u r e - , and e r r o r - c o r r e c t i n g
procedures.
s e r i e s of p r a c t i c e t r i a l s , d u r i n g which a c l i e n t / s t u d e n t r e p e a t s
a modeled set of s e l f - i n s t r u c t i o n s ,
m es from e x p l i c i t g u i d a n c e
by a t h e r a p i s t t o i n t e r n a l , c o v e r t s e l f - g u i d a n c e by t h e c l i e n t ,
! S e l f - i n s t r u c t i o n a l t r a i n i n g is a t r a i n i n g p r o c e d u r e t h a t assists
a c l i e n t / s t u d e n t i n p e r f o r m i n g a task more e f f e c t i v e l y .
S e l f - i n s t r u c t i o n a l t r a i n i n g has two components:
a cognitive
s e l f - i n s t r u c t i o n s b u i l t upon a problem-solving
procedure and.a
- --
These components f o c u s on l e a r n i n g p r o c e a s e a .
The
s e l f - i n s t r u c t i o n s t o b e - l e a r n e d v a r y a c r o s s s i t u a t i o n s and
tasks r e q u i r e s i m i l a r c o g n i t i v e p r o c e e s i n g .
performance,
~~,
* v,
M
a& Eef*
I n sulpmary, s e l f - i n s t r u c t i o n a l t r a r n i n g is a
In c o n t r a s t , s t r e s s - i n o c u l a t i o n t r a i n i n g grew out o f
a t t e m p t s t o g e n e r a l i z e t r e a t m e n t effects.
Ueichenbaum and
C a ~ r o nI19741 s e r e f i d i p i t o u s l y d i s c o v e r e d t h e power o f c o p i n g
s e l f - s t a t e m e n t s t o g e n e r a l i z e b e h a v i o r s acroos d i f f e r e n t
Training goal8 of t h i s
other'noxious s i t u a t i o n s .
The purpone of t h i s t r a i n i n g
W48
to
spectrum of s i t u a t i o n s .
St r e s s - i n o c u l a t i o n t r a i n i n g , as c o n c e p t u a l i z e d by
Heichenbaum, is a seven-coPponent t r a i n i n g p r o c e d u r e .
The f i r s t
feelings, and b e h a v i o r s .
variety af cop*
skills:
a k i U t cognitive
coping s k i l l s and s t r a t e g i e s , i n c l u d i n g s e l f - s t a t e - n t s ,
self - i n s t r u c t i o n s ,
particularly relaxation.
skill^,
newly-learned skills to
situations using
self-instructional training.
Stress-inoculation training components focus both on
. learn'ing
According
at three levels:
..
final component.
specific tasks.
-
Self-instructional
"Ynitive processes i h a t
behaviors.
Similarities are evident
T w n c n t s of
--
Three stress-ineculation
In addition to differential
rehearaal of self-instructions,
--
S t r e s s - i n o c u l a t i o n t r a i n i n g t e a c h e s c l i e n t s t o implement a
v a r i e t y 0.f c o p i n g s k i l l s and s e l f - i n s t r u c t i o n s .
Overall,
s t r e s s - i n o c u l a t i o n t r a i n i n g is s t r u c t u r a l l y more complex t h a n
self-instructional
t r a i n i n g a n d , i n t h e a p p l i c a t i o n component,
uses s e l f - i n a t r u c t i o n a 3 t r a i n i n g as a l e a r n i n g p r o c e d u r e t~
increase p r o f i c i e n t coping.
Gt
S tress-inoculat ion t r a i n i n g ,
a m l t icomponent t r a i n i n g
p r o c e s s e s common t o s e l f - i n s t r u c t i o n a l
training.
S t r e s s - i n o c u l a t i o n t r a i n i n g i n c l u d e s modeling and r e h e a r s a l
p r o c e d u r e s and a d d s a p p l i c a t i o n t r a i n i n g p r o c e s s e s .
self - i n s t r u c t i o n a l " t r a i n i n g providee o n l y coping
s e l f - i n s t r u c t i o n s for h a n d l i n g d i f f i c u l t e i t u a k i o n e , w h i l e
s t r e 5 s - i n o c u l a t i o n t r e i n i n g o f f e r s many c o p i n g s k i l l s ,
Although
foreshadowed in s e l f - l n e t r u c t f o n a l t r a i n i n g , s t r e s s - i n o c u l a t i o n
t r a i n i n g f o r m a l l y i n t r o d u c e s and teaches t h e m .
Coping s k i l l s and
a p p l i c a t i o n components a r e i n c l u d e d t o i n c r e a s e t r e a t m e n t
q e n c r a l i r a t i o n t o a v b r i e t y o f s i t u a t i o n s f o r w t ~ i c ht r a i n i n g h a s
not been given,
s e l f - i n s t r u c t i o n a l t r a i n i n g and s t r e s s - i n o c u l u t ~ o n t r a i n i n g may
be o b s e r v e d i n t r e a t m e n t g o a l s and i n the n u d e r , c o n t e n t , a n d
c o m p l e x i t y of component e l e m e n t s ,
S i m i l a r i t i e s a r e found i n
--
-4
$I
+,
U
r-i
.r)
!
a
5
C
r-i
4
U
0
1
aQI
QI
0,
I
U
C
r4
0,
LC
3
bl
0
0
a
k
0,
U
U
t-i
T b e dismantling
iw,shpittg,
pr-t
d g&hg)
-y
be h p ~ & w &c ~ ~ k s f t f t f k b
~ 3f s
training demonstrated superior efficacy in four cases, Self-instructional training was equally as effective a8 another
treatment in t w o studies and elightly"lessB-effective than a
direct instruction treatment in anqther study ( ~ o b i net al.,
19751.
'
The
as
y-
e;
training
treatments,
Self-instructional
response
'
, children *s scores
-*
improved
&
&
Shemberg,
closely-related methodological
Robin et al,
children.
&
Hirt, 1980).
----1
In sulllary,
1
--
r e s u l t 8 of t h e s t u d i e s in s e l f - i n s t r u c t i o n a l
trainin3j-%ehmtrated t h a t t h i s is an e f f e c t i v e t r a i n i n g
expanded and i n d i v i d u a l i r e d ,
%a
c h i l b t e n , adeleecents, and a d u l t s c b i r o p h r t n i c s i n a v a r i e t y of
. self-control,
i n t e t ~ r s o n a land
~ c o g n i t i v e problem are-
Unlike s e l f - i n s t r u c t i o n a l train*,
t h e r e was only one
general e f f e c t i v e n e s skstudy in thelstreds-inaculation t r a i n i n g
e f f e c t i v e n e s s of stresu-inoculation t r a i n i n g ,
The c o l p a r a t i v e
iI
I
i n d i ~ aion,
t
fram dismantling or collparat i v e outcome s t u d i e s , of
studies,
Dismtlw experirveta
8 t r e u - h o c a l a t i o n training
PI-
rrhrcr
-elf
- - - - -
sttee#-inoculation training.
Became of i n c ~ g l e t e
hypotheses.
--
--
There
-fnaculation
---effee-ofstrmm
t raining: self-monitoring
answered.
> of
In order t o asuess Hticbenb8nrBsconceptualization
seven corponents.
- - -
<
of s o m codponents on o t h e r corponcnts,
S t r e s s - i n o c u l a t i o n t r a i n i n g t r e a t m e n t s in t h e comparative
t h e r e s n l t a of o t h e r t r e a t m e n t s .
The s u c c e s s f u l r e s u l t s of t h e
--
--
- ---
s t r e n g t h e n s t h e promise of t h i n t r a i n i n g p r o c a h l r e .
Out o f t b e
- -
another t r e a t m e n t . Examination of
-- -
w
-
s t u d e n t . t h a n d i d t h e d e u e n s i t i r a t i o n t r e a t m e n t which appeared by
.
t h e e f f i c a c y of s t r e s s - i n o c u l a t i o n t r a i n i n g ,
Stres8-inoculation
. ~ r i ~ ~ m - t r a i n itreatment.
nq
me autbora
uu~eattec~
that
- -
gemeralitation.
This examination
~ 0 m p B m t BVhf Ch
Treatment8 impaleranting
--
>
--
Tba a b i l i t y of a
--
ilia not
ft
trafnfnq
I t will be important to
o&co#rs.
by ilcichenbaum, is also. a8 ~
--
~ (Xn
l pram)
u
has suggeatd,
Borsvtr, they
--
?be dilrrmtllng
%,e
s t r e s s - i n o c u l a t i o n t r a i n i n g r e s e a r c h d i d n o t demonstrut.
whether
e f f e c t i v e treatment.
I n s p e c t i o n .of e f f e c t i v e t r s a t m t s s i m i l a r
N o t o n l y is f a r t h e r d i s ~ a n t l f n gresearch of
t r a i n i n g treatments.
--
- - -
--
Self-instructional training t r e a t m t s
B
often incorporated' o t h e r techniques i n t o the b a a i c t r a i n i n g
procedure o u t l i n e d by I4eichenbaum.
r'
Other m o d i f i c a t i o n s of s e l f - i n s t r u c t i o n a l
- --
*self-instructional (training1
Hsichonbaum / f 977d
treatments.
<
self-in&oct
Be suggested that'
These amodifications
-
blurred the differences that had been drawn between these two
-
treatments.
--
--
p ~ .103-4)
procedures.
tho tm
H i s d e w r i p t i o n of an expanded t r e a t m e n t i n
s e l f - i n s t r u c t i o n a l t r a i n i n g included (1) t e a c h i n g t h e r o l e of
c o q n i t i o n s , ( 2 ) problea-salving
s t r a t e g i e s and coping o e l f - e t a t e m n t s ,
(5) behavioral s t r a t a g i e s ,
cmpment.
Orrw an
(4) self-instructions,
and
I t also h i n t e d a t a s e l f - m n i t o r i n g
fL1-yJm- a p p r i c a ~ t o n ~ c o ~ n ew mX a b M t .
Functional
S t r e s s - i n o c u l a t i o n t r a i n i n g was more o f t e n a s u p e r i o r t r e a t m e n t
- -
--
training.
However, i n t h o s e s t u d i e s i n which s t r e s s - i n o c u l a t i o n
-
--
(Dankel
&
&
.-
a or m i e t y : or ~
Fepalses.
&
~ ,~ ~ 3 ,z z r d e 8 ~
-
the L J T
application
~ ~ Qcomponent of stress-inoculation training
In stress-inoculation
stress-inoculation training
was not a superior treatment,
t
superior treatments employed skills training.
cases, atrese-
&kiWt s
If, in t h e m
k-3s
-iff=
experimntal work.
effective cognitive-hhavior
change treatment:
(1) Mification
Meicbenham
---
By training clients to
Both
By
The educational
and self--
ZbeL-se
+
a
%
and &oping s k i l l s
-
+-'
r e p l a c e former n w a t i v e o r a b s e n t s e l f - s t a t & e n t s
self-instructions.
and
/
i
I n s e l f - i n s t r u c t i o n a l t r a i n i n g , changes i n
I n stress-inuculatfon t r a i f i i n g , changes i n i n t e r n a l
d i a l o g u e f o c u s on r e p l a c i n g n e g a t i v e i n n e r d i a l o g u e w i t h
p o s i t i v e , p r o d u c t i v e s e l f - s t a t e m e n t s and s e l f - i n s t r u c t i o n s .
new s e l f - r e g u l a t o r y i n t e r n a l d i a l o g u e r e p l a c e s p r e v i o u s d i
that i n t e r f e r e d with o r p r e v e n t e d d e s i r e d b e h a v i o r ,
Becauae
e been
p r e v i o u s l y i n f l u e n c e d t h e c o n t e n t of i n n e r d i a f ~ ~ uhave
modified o r e l i m i n a t e d , a new i n n e r d i a l o g u e is more l i k e l y t o be
maintained,
The f i n a l phase i n Heichenbaum's t h e o r y of
cognitive-behavior change is n a s t e r y of new s k i l l s by s y s t e m a t i c
a p p l i c a t d o n a c r o s s a v a r i e t y of s t r e s s f u l s i t u a t i o n s .
-In
s e l f - i n s t r u c t i o n a l t r a i n i n g , t h i s mastery l e a r n i n g is
accomplished through p r e s e n t a t i o n of p r o g r e s s i v e l y laore demanding
tasks,
c o n t e n t v a r i e s a c r o s s s e n s o r i m o t o r , c o g n i t i v e , and s o c i a l
mdalities , In s t r e s s - i s o e a l a t i o n t r a i n i n g , an &,SIJyg
S e l f - i n s t r u c t i o n a l t r a i n i n g is included i n t h e
Maintenance and
g e n e r a l i z a t i o n o f t r e a t m e n t .were-hypothesized outcolws of
cognitive-behavior change.
Changes i n u n d e r l y i n g c o g n i t i ~ e
. p r o c e s s e s a f f e c t s e l f - r e g u l a t o r y i n n e r d i a l o g u e which i n t u r n
i n f l u e n c e s b e h a v i o r s and c o g n i t i o n s .
Meichenbaum nraintained t h a t
dialogue.
S t r e s s - i n o c u l a t i o n t r a i n i n g was designed t o f a c i l i t a t e
maintenance and g e n e r a l i z a t i o n e f f e c t s .
The f u n c t i o n a l a n a l y s e s
of s t r e s s - i n o c u l a t i o n t r a i n i n g , and, t o a l e s s e r d e g r e e , of
s e l f - i n s t r u c t i o n a l t r a i n i n g p r o v i d e evidence t h a t t h e s e
procedures do produce t r e a t m e n t e f f e c t s . t h a t a r e maintained up t o
a year f o l l o w i n g t r e a t m e n t and t h a t f r e q u e n t l y g e n e r a l i z e t o
other situations.
I n summary, t h e s t r u c t u r a l and f u n c t i o n a l a n a l y s e s of
s e l f - i n s t r u c t i o n a l t r a i n i n g and s t r e s s - i n o c u l a t i o n t r a i n i n g
\
--
In addition, the
iP
based 06-structural
&
Cameron, 1974)
This l a c k of
Some researcher8
1 .
The
There seem to be
techniques.
> .
Finally,
(Because there
\*
i
clearer understanding and commonly-agreed upon definitions of
cognitive, behavioral, and cognitive-behavioral treatments qre of
considerable importance.)
Dismantling and
Researchers need to
similar studies,
Once a subset of cognitive-behavioral treatments is
established, it may be possible to differentiate between
self-instructional training and stress-inoculation training, as
described by Heichenbaum (1977a). Comparative outcome studies
can compare, on one hand, the treatments derived from
stress-inoculation training and self-instructional training and,
o f s e l f - i n s t r u c t i o n a l t r a i n i n g and s t r e s s - i n o c u l a t i o n t r a i n i n g i n
t r e a t i n g anxiety-based probl&ts
problems.
and i n t r e a t i n g s k i l l d e f i c i t
f ~ ~ t f t
This
r e s e a r c h w i l l need to i n v e s t i g a t e s t r e s s - i n o c u l a C i o n t r a i n i n g as
d e s c r i b e d by Heicbenbaum (1977al and, perhaps, g e n e r i c
stress-inoculation training.
Dismantling s t u d i e s i n v e s t i g a t i n g
e s s e n t i a l f o r treatesent e f f i c a c y b u t a l s o whether o r n o t
s t r e s s - i n o c u l a t i o n t r a i n i n g as d e s c r i b e d by Heichenbaum is a
v i a b l e and s e p a r a t e paradigm from o t h e r t r e a t m e n t s s i m i l a r t o
/
stress-inoqulation training.
195
/-
and a p p l i c a t i o n conponents i n
s t r e s s - i n o c u l a t i o n t r a i n i n g were n o t c l e a r .
-
Meichtnbaum (1977a)
s t a t e d t h a t an ip-j&~ a p p l i c a t i o n component i n c l u d e d s t r e s s f u l ,
painful, o r unpleasant experiences i n yhicb c l i e n t s practiced
newly-learned
coping s k i l l s .
This d e s c r i p t i o n s u g g e s t s t h a t
--
a p p i l c a t i o n e x e r c i s e s s h o u l d have d i f f e r e n t c o n t e n t a n d ' d i f f e r e n t
components.
Ueichenbaum i n c l u d e d u n p r e d i c t a b l e e l e c t r i c s h o c k ,
c o l d p r e s s o r t e s t , imaginary s t r e s s , s t r e s s - i n d u c i n g f i l m , and
f a i l u r e and embarrassment s i t u a t i o n s a s s u i t a b l e a p p l i c a t i o n
e x p e r i e n c e s (1977a, p. 1 5 6 ) . Recently,.Meichenbaum and Cameron
(In press)
, included
These
F u t u r e r e s e a r c h wi 11 need t o
'
procedures.
Then,
The*
cognitive~ehaviormodification.
Structural
cognitive-behavior modification,
- -
ingredientsm in
t h e ~ et r e a t m e n t s .
On t h e basis of t h e a n a l y s e s reported h e r e i n ,
cognitive-behavior m d i f i c a t i o n ,
cognitive-behavior m o d i f i c a t i o n t r e a t m e n t .
References
Gardner, E.,
&
Karlsen, B, b f ~ x d
P;lasnaafis,Bafhr#ti~~2shf;~~-a~M~f;l~iw-~P
U-rSjpg,
Bender, R.
N e w Pork:
- -
Brm,
-R.
---
----
C a w , B.,
'
- m ~n , rm,
~ xm
, --.
Carmdy, T. R a t i o n a l - e m t i v e , s e l f - i n s t r u c t i o n a l ,
a s s e r t i o n t r a i n i n g s F a c i l i t a t i n g maintenance.
Theramr-md-E-sb,
1978, 2 ( 3 ) , 241-253,
and b e h a v i o r a l
JIpqgiffm
J , , & HcGbie, A.
A c o ~ a r a t i v es t u d y o f d i s o r d e r e d
attentfen 4n &Mzupkeitf-a.
m, 487-SO6.
--m-i
*2,
L P O ~
Cpggi&i~~Tb~trlpp~@
Uimeapolis:.
American
Guidance S e r i e s , 1965.*
-.
Problem s o l v i n g and b e h a v i o r
&*Goldfr i d , II.
m o d i f i c a t i o n . J ~ i m w L, ~
& fB Q I ; ~ ~ s Y E ~ ~,~1971,
w Y 28,
107-126,
D tZ u r i l l a , T.,
E s m e l k a ~ ( ~P.,
,
& Hessch, P.
Cognition and exposure i n v i v o i n t h e
t r e a t s e n t o f agoraphobiat Short-term and delayed e f f e c t s .
t
~
2 ??-at=
~
. ,
rcu,
'4
Pfavell, J.,
mfu
W.,
& Xitter, R.
A comparison of s k i l l s training and
c o g n i t i v e r e s t r u c t u r i n g - r e l a x a t i o n f o r t&e t r e a t m e n t of speech
a n x i e t y . ~ ~ J p ~ , ~ l978,3,
~ ~ O p 248-259.
y ,
Fremouw,
Geer , J
. The development
o f a scale t o measure f e a r .
45-53. '
BeaerrrrLarrd.~berapr,196% 3,
m i p i :
~l~gf
Girodo, H,,
&
978-989,
--
Hi=,
&
Horan, J.
E. h Brown,
e.
S t r e s s i n o c u l a t i o n f o r pain:
A stm&m3 strimn*
What's
Kagan, J.
e-w-al
17-24,
fagan, J., Rosman, B., Day, D., Albert, J., & Phillips* W.
Inforwtion processing in the child: Significance of analytic
and reflective attitudes. ~ ~ ~ E ~ Q ~ Q ~ ~ - H Q B P1964,
Q E B Q ~ B ,
B(1, Whole mmber 5781,
Is it t h e c o g n i t i v e o r
Kaplan, R., HcCordick, S, , br T w i t c h e l l , M.
t h e b e h a v i o r a l colnponent v h i c h makes c o g n i t ive-behavior
medication e f f e c t i v e i n t e x t a n x i e t y ? J ~ u x ~ a l - ~ f - C ~ U a ~ ~ l i a g
E s y ~ b a l a g y , 1979, 25(5) 371-377.
B~Pr
ccwLi*-
m o d i f i c a t i o n and systematic.desensitization w i t h t e a t a n x i o u s
high s c h o o l s t u d e n t s . ~ L ~ ~ ~ ~ Q ~ ~ ~ P U D E 1981,
~ ~ ~ D ~ ~
~ S ~ ~ P , B ~ ~ , B P B ~ Y S ~ S ~ Q ~ ~ ~ Z Q ~ L ~
P
EBoston:
~ ~ ~Houghton
Q ~ .Miff lin, 1953.
~ ~ p m a l -- G~ ~fn a u l f i ~ g ~ P s y 1964,
~ b ~ l28
~ ~, ~87-90
McCroskey, J;
Measures of comunication-bound anxiety,
# I Q D Q ~ & P P ~1970,
&~
12, 269-277.
@eecb
/'
f---
Meichenba m, D.
stuae
8-.
fa)
PIeichenbaum, D. T h e r a p i s t raanual f o t c o g n i t i v e - b e h a v $ o r
m o d i f i c a t i o n . Unpublished manuscript, U n i v e r s i t y o f Waterloo,
1972 ( b )
C i t e d i n K . Bolroyd, C o g n i t i o n and d e s e n s i t i z a t i o n
i n t h e group treatment of test a n x i e t y , J ~ p x ~ a l - ~ f - G ~ ~ ~ u l k i n q
nnd-!Xiu~~a1,Paycbaln9r,1 9 7 6 , 4 4 M ) t 991-1001.
Heichenbaum, D. S e l f - i n s t r u c t i o n a l s t r a t e g y t r a i n i n g : A
c o g n i t i v e p r o s t h e s i s f o r t h e a g e d . B ~ m n , Q e y g l ~ p p ! e ~ f1974,
t
12,
273-280.
Meichenbaua, D .
Enhancing c r e a t i v i t -y by
m o d i f y i n g what s u b i e c t s
s a y to t h e m s e l v e s . B ~ ) ~ ~ ~ E ~ Q - E ~ ~ G P L ~ Q ~ P ~ - P B & ~ B ~I E ~ ~ J Q u X D Q ~
1 9 7 5 , 12(2), 129-145. ( a )
A s e l f - i n s t r u c t i o n a l approach t o s t r e s s
bleichenbaum, D .
management: A p r o p o s a l f o r s t r e s s i n o c u l a t i o n t r a i n i n g . I n I .
S a r a s o n & C. S p i e L b e r g e r (Eds ,) , S f ~ g ~ 8 , a ~ d - B n a i g f y(Vol. 2 ) ,
rlew York: W i l e y , 1 9 7 5 . (b)
Xeichenbaum, D, S e l f - i n s t r u c t i o n a l methods.
G o l d s t e i n (Eds.1, B ~ ~ Q ~ ~ ~ , E ~ P
b g f b ~ d ~ .New York: Pergamon P r e s s , I n c . ,
I n F, K a n f e r and A .
Q ~ ~ , C ~ B ~ ~ ~ ~ ~ ~
1975. ( c )
Yeichenbaum, D .
T h e o r e t i c a l and t r e a t m e n t i m p l i c a t i o n s o f
d e v e l o p m e n t a l r e s e a r c h on v e r b a l c o n t r o l o f b e h a v i o r , G a n ~ d i m
E ~ r ~ h a l a s i ~ a l , B e ~ 1i9~7u5~, 16, 22-27 , (dl.
Meichenbaun, D , T e a c h i n g c h i l d r e n s e l f - c o n t r o l ,
I n B e ~ a h e ya n d
A , Kazd i n ( Eds 1 , P ~ Y ~ S ~ S - ~ Q - ~ ~ ~ U ~ E P ~ - G ~ ~ ~ ~ - E S Y E ~
New York: Plenum P r e s s , 1 9 7 7 . (b)
H e i c h e n b a u n , D . , & B u r l a n d , S.
nodif ication with children.
426-433.
Cognitive behavior
S G ~ P P ~ , E S Y E ~ Q ~ Q ~ Y ,I P 1~9~7B9 S
, ~4 ,
-Xe i ~ k e s b a u m , D r
C ~ s n i f i ~ ~ = B g b a ~ f ~ r , B ~ d f f i ~ ~ f f ~ n i - & ~ L 1 1 f ~N e0w~ 0 f f ~ 2
Training schizophrenics t o t a l k t o
Meichenbaum, D., & Cameron, R.
themselves: A means o f d e v e l o p i n g a t t e n t i o n a l c o n t r o l s .
./
& ~ P Y ~ Q L , T ~ ~ I B P 1973,
Y,
4 , 515-5340
Meichenbaum, D , , & Cameron, R.
The c l i n i c a l p o t e n t i a l of
modifying what clients say t o t h e m s e l v e s * E ~ s b Q f b g ~ a ~ y ~
T b ~ a r r ~ - P ~ & ~ ~ r s b , a n d -,E1974,
r ~ c f i11
~ ~( 2 ) , 103-117.
Meichenbaum, D . , & Cameron, R. S t r e s s - i n o c u l a t i o n t r a i n i n g :
Toward a g e n e r a l paradigm f o r t r a i n i n g c o p i n g s k i l l s . I n D m
Meichenbaurn and M. Jaremko (Ede.1, S ~ L ~ ~ ~ , P L ~ Y ~ D ~ ~ Q I ~
u s a ~ g g ~ g ~ New
f . York: Plenum P r e s s , i n p r e s s .
Meichenbaum, D . , Gilmore, J. , h F e d o r a v i c i u s , A . Group i n s i g h t
v e r s u s group d e s e n s i t i z a t i o n i n t r e a t i n g s p e e c h a n x i e t y .
J n ~ r a a l - ~ f , ~ a u n & ~ l i n ~ ~ E 1975,
& ~ b ~21,
L ~339-347.
gy~
Meichenbaum', D m , & Goodman, 3. T r a i n i n g i m p u l s i v e c h i l d r e n t o
t a l k t o t h e m s e l v e s : A means o f developing, s e l f - c o n t r o l .
J Q U ~ ~ ~ ~ , Q ~ , & Q Q ~ W ~ 1971,
- ~ ~ Y
12,
E ~115-126.
Q ~ Q ~ Y ,
Meichenbaum, D . , & Novaco, R. S t r e s s i n o c u l a t i o n : A p r e v e n t a t i v e
approach. I n I . S a r a s o n and C . S p i e l b e r g e r (Eds .) , S f ~ ; e g g , ~ ~ d
& s i g f y (Vol 5 ) . New York: Wiley, 1978.
Meichenbaum, D . , & Turk, D . The c o g n i t i v e - b e h a v i o r a l management
of a n x i e t y , a n g e r and p a i n .
I n P. Davidson (Ed.) The
& b a ~ i ~ r a l , Y o n a ~ ~ ~ ~ n f c ~ ~ f ~ & x i ~ New
f y ~
York: Bruner Mazel, 1976.
~ Q ~ ~
Melzack, R.,
&
Wall, P .
P a i n mechanisms:
A new t h e o r y .
S~im~a,
Mulac, A,,
Shernan, A.
N o w i c k i , S , & S t r i c k l a n d , B, A l o c u s of c o n t r o l scale. f o r
children
WIDIZ-Q~
- c Q D B Y I ~ ~ ~ ~ - ~ ~ ~ c ~ ~ ~ ~ c I L - E B 1973,
Y G ~ Q ~ Q ~ Y ,
u , 148-154.
Y-
Raven, J
Guide-f ~ , Q S i a g - P ~ ~ g z f : & s Li ~; ~e C~ M~ o U
f ~ d o n ,England :
El. E. Lewis P r e s s , 1956.
Raven, J. ~ P ~ P P ~ ~ _ P ~ ; ~ ~ x ~ B S ~ Y NBe w~ York:
B ~ ~ ~ ~ S ; P ; ~
P s y c h o l ~ g i c a lC o r p o r a t i o n , 1965.
Robin, A * , Armel, S., & O I L e a r y , K . The e f f e c t s of
s e l f - i n s t r u c t i o n on w r i t i n g d e f i c i e n c i e s
&bpyipx-Tb~xqpy,
1975, 6, 178-187.
.Sarason, I.
T e s t a n x i e t y and c o g n i t i v e modeling.
Ef;~aanaUU-mP-Sa~aL.P&rshalns~,
1973, 28,
&unal,~f
58-61
S c h l i c h t e r , K . , & Horan, J, E f f e c t s o f s t r e s s i n o c u l a t i o n on t h e
a n g e r and a g g r e s s i o n management s k i l l s o f i n 8 t i t u t i o n a l i z e d
j u v e n i l e d e l i n q u e n t s . ~ f f W b ~ z ~ ~ y - ~ d - ~ e ~ f1981,
: ~ L ; G b t
5 4 4 ) , 359-365.
Snyder, J.,
Spielberger, C.,
Gorsuch, R.,
Lushene, R.
y,
The-Sfafg=T~aif
~ i ~ & - Z n x ~ n k ~ r u ~ - - L S T B f f -Palo
~8f~
~alif
C o n s u l t i n g P s y c h o l o g i s t s P r e s s , 1970.
h
.:
Sutton-Smith, B e , L Rosenberg, B, A s c a l e t o i d e n t i f y i m p u l s i v e
b e h a v i o r i n c h i l d r e n . J Q U X D ~ ~ - Q ~ , G C D ~ ~ ~ E , P S Y E1 ~
9 5Q9~, Q9~5Y, ~
211-216.
Thorpe, G , D e s e n s i t i z a t i o n , b e h a v i o r r e h e a r s a l ,
s e l f - i n s t r u c t i o n a l t r a i n i n g and p l a c e b o ef'fects on
a s s e r t i v e - r e f u s a l beha'vior.
~~QQ~PD-JQU~D
M n l ~ s i ~ - U n d i f k ~ f i1975,
P n ~ I , 30-44.
~~-Q~~B~~OY
Turk, D. A s k i l l s - t r a i n i n g a p p r o a c h f o r the c o n t r o l o f
e x p e r i m e n t a l l y - i n d u c e d p a i n . Unpublished d o c t o r a l
d i s s e r t a t i o n , U n i v e r s i t y of Waterloo, 1975, C i t e d i n D.
Heichenbaum. C W R ~ ~ ~ Y ~ = B S ~ ~ Y ~ Q I - B Q ~ ~
B ~ Q L Q B E ~ N,e w York: Plenurh P r e s s , 1977 ( a ) ; and i n D. Turk.
A p p l i c a t i o n of c o p i n g - s k i l l s t o t h e t r e a t m e n t of p a i n .
I n I ./Sarason 6 C, S p i e l b e r g e r (Ed8.) , S~EBS~,~PP,BO&~ ( V o l e
5) / N e w York: Wiley, 1 9 7 8 ,
~ ~ E P
v a l e r i o , B . , & S t o n e , G. E f f e c t s o f b e h a v i o r a l , c o g n i t i v e , and
c o d i n e d t r e a t m e n t f o r a s s e r t i o n as a f u n c t i o n of d i f f e r e n t i a l
~f
QSYI 1982 1 29 ( 2 ) ,
def i c its. & ~ m o l , ,En~nssJia~J!s~~b~f
158-168.
Vyqotsky , L.
Thpggbg,gpQ,&~gyagft.
H e i s s b e r g , H. A comparison o f d i r e c t and v i c a r i o u s t r e a t m e n t s of
s p e e c h anxiety: D e s e n s i t i z a t i o n , d e s e n s i t i z a t i o n w i t b c o p i n g
1977,
imagery, and c o g n i t i v e m o d i f i c a t i o n , Bebasrf~x-Tb~x~gy,
4 , 606-620.
Whitmn; T . , & J o h n s t o n , H, Teaching a d d i t i o n and s u b t r a c t i o n
v i t h regrouping t o educable mentally r e t a r d e d c h i l d r e n r A
group s e l f - i n s t r u c t i o n a l t r a i n i n g program. Bebasri~~-Z'bs~~pp.
1983, J4, 127-143.
W i l l i a m s , D,, L Akamatsu, T. C o g n i t i v e s e l f - g u i d a n c e t , r a i n i n g
with j u v e n i l e d e l i n q u e n t s : Applicabf l i t y and g e n e r a l i z a t i o n .
~ L L L X Z , T ~ X ~ Q L & B P , P ~ ~,L1378,
: B L E2~(31 , 285-288.