Managing and Coping with Stress - Stress Inoculation Therapy (SIT)

Question 1

Stress Inoculation Therapy (SIT)
What is it?

Answer 1

Meichenbaum (1985) proposed SIT as a form of cognitive therapy to help manage stress.

SIT involves changing the way that a person thinks about stressors.

He believed that positive thinking leads to changes in attitudes and feelings, reducing the stress response and enabling the individual to cope better.

Question 2

Phase 1 – Conceptualisation

Answer 2

The main cognitive element.

It’s a collaborative process between the therapist and client – the therapist investigates the client’s sources of stress through interviews with the client

The client is encouraged to relive stressful situations and to analyse the features of that situation, identifying what was particularly stressful about it, how they coped and why that coping strategy may not have been successful.

The client is taught to view perceived threats as problems to be solved and to break down global stressors into specific components that can be coped with. This enables the client to think differently about (i.e. reconceptualise) their problem.
Disputing….therapist encourages client to challenge their beliefs…’where is the evidence for…’

Question 3

Phase 2 – Skills acquisition (and rehearsal)

Answer 3

Clients are then taught specific and non-specific coping strategies, which the client will initially practice with the therapist and then rehearse in real life situations.

The client may be taught skills such as:
Positive thinking,
Relaxation,
Social skills such as body posture,
Eye contact and conversational give-and-take,
Making effective use of social support systems, and time management.
Clients may be taught to use self-statements e.g. ‘You can develop a plan to deal with it’; ‘Relax, you’re in control. Take a deep breath’; ‘It wasn’t as bad as you expected’.

The skills taught are both cognitive (because they encourage the client to think in a different way) and behavioural (because they involve learning new, more adaptive behaviours).

Skills are rehearsed using imagery, modelling and role playing.

Question 4

Phase 3 - Application (and follow through)

Answer 4

Clients are given opportunities to apply the newly learnt coping skills in different situations, which become increasingly stressful.

It is particularly important for clients to be taught to anticipate situations where it may be difficult to apply the skills and rehearse coping responses.

Clients may even be asked to help train others.

Booster sessions (follow-through) are offered later on.

Question 5

Holcomb (1986):
procedure

Answer 5

Assigned 26 psychiatric patients with severe stress and anxiety disorders to:a) SITb) SIT and drug treatmentc) Drug treatment

Question 6

Holcomb (1986):
findings

Answer 6

They found that SIT was superior to drugs in reducing symptoms of anxiety, depression and distress
A 3 year follow-up showed that the SIT group required fewer admissions for psychiatric problems than others- this suggests that drug therapy may actually hinder recovery

Question 7

SIT - Evaluation

Answer 7

Effectiveness – Meichenbaum (1996) claims that SIT has been shown to be successful with acute (e.g. public speaking) and chronic stressors (e.g. medical illness); and can inoculate against future stressful situations, unlike systematic desensitisation.

Deals with the causes, as well as the symptoms: now and in the future

Time consuming and requires high motivation

Unnecessarily complex – It might be just as beneficial to learn to think/talk more positively and relax more.