SIT (man and cop)

• Stress inoculation therapy (SIT)

  • SIT is a cognitive behaviour therapy
  • Meichenbaum and Cameron = identified phases of SIT (each focuses on practical steps to help the client)
  • Phases are not distinct or in order = they overlap with some going backwards before moving on
• SIT focuses on how we think about stress/cognitive appraisal

  • Cognitive appraisal = client learns to think differently, to see stressors as challenges to overcome
  • The client also learns to focus on aspects of a stressful situation that can be changed rather than aspects that can’t
• phase 1 = conceptualisation (to understand stressors)

  • Client and therapist work together to identify and understand stressors the client faces
  • Client learns about the nature of stress and its effects
  • There should be a warm and collaborative rapport between the therapist and client
  • Client retains responsibility for their progress and learns to attribute success to their own skills (internal locus of control)
• phase 2 = skills acquisition and rehearsal

  • Client learns skills to cope with stress (eg relaxation, social skills, communication, cognitive restructuring)
  • Major element of skills acquisition is learning to monitor and use self-talk
  • Client uses coping self-statements (‘you can do this!’) to replace anxious internal dialogue
  • Client plans in advance how to cope when stress occurs = how they can overcome it through skills they learn
• phase 3 = real-life application and follow-through

  • Therapist creates opportunities for client to try out skills in a safe environment
  • various techniques increase realism = eg role playing, virtual reality, mobile apps
  • Learned skills are gradually transferred to the real world through homework tasks for client to seek out moderately stressful situations and use their coping skills in everyday life (‘personal experiments’)
  • Relapse prevention is important = eg client learns to cognitively restructure setbacks as temporary learning opportunities, not permanent catastrophic failures
• duration of therapy

  • varies from client to client
  • Typically 9-12 sessions, one hour each week or over longer period
  • Also follow ups
• strength = research supporting its effectiveness

  • Saunders et al = meta-analysis found SIT reduced anxiety in performance situations (eg public speaking) and enhanced performance under stress (eg doing better in exams)
  • also found that SIT was just as effective for people experiencing extreme anxiety as for those with moderate or normal levels of anxiety
  • Suggests that SIT works for a wide range of people with anxiety and can help change behaviour in a positive direction
• limitation = SIT is a very demanding therapy

  • Clients must make big commitments of time and effort and be highly motivated
  • Training involves self-reflection and learning new skills
  • It is challenging to apply SIT techniques to everyday life = eg some people are less able to use coping self-statements when experiencing anxiety in a stressful situation
  • => the demands placed on clients and their experiences of failure mean that many do not continue the treatment
• counterpoint to SIT being a demanding therapy

  • SIT is very flexible with a variety of stress management techniques tailored to specific needs (eg people with learning difficulties) to encourage commitment/motivation
  • This flexibility means SIT can help clients manage almost any form of stress
• limitation = SIT is overcomplicated

  • SIT uses a lot of techniques but perhaps personal control is the one key feature that accounts for its success
  • Hansel-Dittman et al = found that SIT did not work with asylum seekers who could not exert control (they could have been deported at any time)
  • Suggests that control may be the vital element of SIT because the therapy does not work with people who have no opportunity to exert control
• extra evaluation = quick fix vs slow fix

  • SIT may be better to manage stress because it is a ‘slow fix’ = ‘future oriented’, longer-term benefits, clients learn techniques so they can cope when same stressful situations arise
  • BUT drugs may be preferable because they are a ‘quick fix’ for anxiety = no effort is required (taking a pill) and gives a ‘window’ to learn to cope
  • => drugs may be better because they help stressed clients reach a point where other stress management methods (eg SIT) could benefit them more