Behavior therapy focuses on changing current behavior, goal setting, and self- management skills. Behavior therapy is an action therapy, unlike verbal therapies such as client-centered and psychoanalysis. Homework assignments are often part of therapy that may include rehearsing coping skills, recording behaviors, or identifying trigger behaviors. Four common characteristics of behavior therapy defined by Spiegler are: individualized therapy, stepwise progression, treatment packages, and brevity . Treatment is tailored to each client’s personal issues, progresses from simple to more complex tasks, often combines more than one behavioral therapy procedure, and is relatively short in duration (Spiegler, 2010).
It is essential for counselors to build a strong therapeutic relationship with the client, this enables the counselor to establish trust and he is able to identify the behaviors the client wishes to change. The counselor can then establish goals for the client and determine which techniques would apply best to the client’s situation. One technique that will be discussed in detail is Stress Inoculation Training (SIT). This therapy combines behavioral and cognitive techniques to prepare the client in advance to handle stressful events. Stress inoculation has three phases: the initial conceptualization phase, skills acquisition and rehearsal phase, and application and follow through phase. First the client is educated about the source of stress and how it may be effecting their physiological and psychological wellbeing. Coping skills such as relaxation techniques are discussed. Lastly, clients are exposed to real or simulated situations to practice the learned coping skills. Stress Inoculation Training has been used in the treatment of military combat, medical illness, PTSD, preparation for surgery, and occupational stress. In Stress Inoculation Training, the therapist helps the client identify cues for their anxiety and fear. Clients are also taught breathing and relaxation skills to help them manage their anxiety. By combining behavioral techniques with cognitive techniques, therapists are able to provide a more comprehensive treatment plan.
A study of 60 male athletes who were undergoing arthroscopic knee surgery were randomly assigned to either treatment (SIT and physical therapy) or control conditions (physical therapy only). Participants in the treatment group completed a pain scale assessment rating their current pain level and an anxiety inventory questionnaire that they filled out using a rating scale prior to surgery. Stress Inoculation procedures included providing participants with an understanding of their cognitive and emotional responses to surgery, becoming aware and monitoring indicators of pain, and applying relaxation techniques. Participants were also taught positive coping statements. Participants were instructed to rehearse these strategies several times a day and use them when they recognized discomfort. Results showed that participants had reduced self-reported anxiety and pain during the rehabilitation process. The findings also indicated stress inoculation training reduced the amount of time to return athletes to a criterion level of physical functioning (Ross & Berger, 1996).
Another study assigned forty multiple sclerosis patients in either a stress inoculation training group (SIT) or in their current available care group. The SIT treatment included cognitive-behavioral psychotherapy paired with relaxation exercises. The SIT group participated in six sessions that included daily self-monitoring of stressors, feedback to enhance self-monitoring, identifying stress cues, and relaxation imagery. The current available care group was provided with their usual clinic services. Results showed that the SIT group was less depressed, anxious, and distressed than the available care group. Coping was facilitated by developing increased ability to control psychological symptoms and by altering the process that was generally used to cope. Patients utilized more problem-focused coping strategies.
In the previous studies SIT has been shown to help clients gain confidence in their ability to cope with anxiety, fear, and pain.
The main goal of behavior therapy is to replace undesirable behaviors with desirable ones. The success of behavior therapy lies in the individual. In order to successfully deal with emotional distress, one must first realize that certain behaviors can be controlled. Perception has a great deal to do with the way that one feels and acts which can effect one’s interpretation and behaviors.
Many times behavior therapy is paired with to change the way a person feels about and reacts to a situation. This combination helps a person gain a better understanding of the relationship between their thoughts, feelings, and actions. A key principle in behavior therapy is to be aware of your negative thinking (cognitive) and to not allow those thoughts to control your plans or actions. By using a behavioral-cognitive plan, clients will receive a more inclusive treatment experience.
Cognitive behavioral therapy, in the form of stress inoculation training, is successful in reducing stress. Clinical studies have shown that even brief treatments of six sessions reduce anxiety, fear, and pain. Clients are taught to identify their emotions, thoughts, and behaviors, build skills to cope with those reactions, and apply those skills to their daily situations. Stress inoculation training continues to be used to treat mental disorders and disease.
References
Foley, F., & Bedell, J. (1987). Efficacy of stress-inoculation training in coping with multiple
sclerosis. Journal of Consulting and Clinical Psychology. 55(6). 919-922.
Meichenbaum, D. (1996). Stress inoculation training for coping with stressors. The Clinical
Psychologist, 49, 4-7.
Ross, M., & Berger, S. (1996). Effects of stress inoculation training on athletes. Journal of
Consulting and Clinical Psychology, 64(2), 406-410.
Sharf, R. S. (2011). Theories of psychotherapy & counseling, concepts and cases. (5ed.).
Belmont, CA: Brooks/Cole Pub Co.
Spiegler, M. D., & Guevremont, D. C. (2009). Contemporary behavior therapy. Belmont,
CA: Wadsworth Pub Co.