MANAGING STRESS: Cognitive Approach and SIT [Meichenbaum]

The cognitive approach works on the assumption that it is necessary to refer to internal mental processes such as thought, perception and language in order to understand and explain behaviour. 

It would thus view stress as the result of faulty thinking and poor perceptions, and as a form of dysfunctional and maladaptive behaviour which can be improved or cured via cognitive restructuring. This is the fundamental concept behind all forms of cognitive behavioural therapy (CBT).

One form of CBT specifically targeted at coping with stress is Stress Inoculation Therapy (or SIT). It was developed in the 1970s by Meichenbaum, and has three stages which aim to help clients to replace "self-defeating thoughts" which cause stress with more positive ones, which can help to reduce the effect of potential stressors, and thus reduce the overall stress response.

The three stages of SIT are:

1. Conceptualisation - the client and therapist work together to identify the nature of stress, and the therapist educates the client on the general effects of stress to help them understand what stress is and thus how it can be overcome

2. Skills acquisition - the therapist helps to train the client in relevant skills which will aid them to cope with and reduce their stress. This often includes monitoring their own internal dialogue and reassuring themselves that things are okay if not everything goes to plan.

3. Follow through/application - the patient has to apply their skills to real-life situations, and the therapist helps them with this. 

Study: Meichenbaum: comparing SIT to systematic desensitisation and a control group in reducing test anxiety (a major cause of stress)

The study consisted of 21 students aged 17 to 25, who had responded to an advert asking for participants in a study on test anxiety. It was a field experiment, where the IV was the type of therapy (if any) the participant received, and the DV was reduction in test anxiety, which was measured through the use of grade averages and self-reported measures. It was a matched pairs design with three conditions. Group 1 received eight therapy sessions where they were taught to identify stress, learn how to reduce thoughts which increased their stress, monitoring their internal dialogue, etc. Group 2 received the same number of sessions but were given the behavioural therapy of systematic desensitisation, whilst Group 3 were put on a waiting list. Both therapy groups had improved results, but Group 1 (SIT group) performed better in test conditions and had reduced anxiety levels than both other groups, and thus it was concluded that SIT helped to reduce the test-associated stress people felt and enabled them to perform better.