Self management therapy
The self-management therapy is a method of behavioral therapy , founded by Frederick Kanfer , Hans Reinecker and Dieter Schmelzer. The aim of therapy is to improve the patient's self-management . As a rule, the therapy is focused on a specific problem area of the patient (e.g. alcohol disease and its consequences).
The term self-management therapy (hereinafter SM-T) is often misunderstood by assuming that it is self-directed therapy (as self-treatment) with which one can improve one's self-management (e.g. one's time management ).
In an SM-T
- the therapist guides the client to better self-control and
- motivates and enables him with his guidance to deal with certain problems as actively, independently, independently and efficiently as possible
He usually does this (often in a gradual process) until the patient can do without external professional help.
Definition of self-management
König and Kleinmann (2006) understand self-management to be “all efforts by a person to influence their own behavior in a targeted manner”. For the authors, this is a working definition that can be applied above all to jobs with great leeway; that is, for activities that are not constantly influenced by a superior. Freelance workers (e.g. graphic artists or self-employed) need efficient self-management more than others,
- because they do not have a manager who imposes a daily structure on them, and / or
- because their work output is difficult to measure quantitatively and / or qualitatively (often such workers, even at the end of the day, hardly know how productive and efficient their work was, and they underestimate or overestimate it).
Manz (1986, quoted from König & Kleinmann, 2006) describes self-management as a set of behavioral and cognitive strategies that help individuals
- structure their environment,
- To build or maintain self motivation and
- Facilitate behavior that is appropriate to achieve performance standards.
Everyone practices self-management, but not everyone is a successful self-manager: there is also dysfunctional self-management (Karoly, 1993, quoted from Frayne & Geringer, 2000).
Since self-management is a trainable skill , one can improve one's self-management skills through learning processes .
Basic philosophical and practical assumptions
Long-term overarching goals of therapy are autonomy and self-regulation , as it is assumed that the human striving for self-determination, personal responsibility, self-regulation and independence are goals that are aimed at in the context of SM therapy. It is based on an active role of the human being, within the framework of which work is carried out on maximizing personal freedom, and also on a holistic conception of the person model with a fundamental pluralism of values, views and lifestyles, with room for development individual goals and ideas about life that can change dynamically. In principle, this ability can be learned and is not innate.
In practical terms, this means trying to maximize the patient's freedom of choice and personal responsibility, and to adhere to the principle of minimal intervention. The therapist does not tell the patient what problems or therapy goals could be, but develops them together with him.
Basics
The perspective behind this is closely linked to approaches from social learning theory , self-control and self-regulation and cognitive behavioral therapy or with the names Albert Bandura , Frederick Kanfer or Donald Meichenbaum . Even Hans Reinecker is an important representative of the therapeutic approach. In his 1995 German edition of the Kanfer book Self- Management Therapy (SM-T), he also described exactly what constitutes the more specifically understood meaning of the term in the Kanfer sense. He emphasizes that it is primarily about a certain understanding of the entire diagnostic- therapeutic process, which consists less in the application of certain self-regulation methods, but rather contains a general therapist attitude and a 7-phase process model for the systematic implementation of changes in practice. The SM-T has a special treatment philosophy, a special image of man , its own basic theoretical assumptions and its own reference to findings from basic psychological research , which result in its own practical implementation.
Self-management therapy is not a guide to egoism or reckless self-assertion, no behavior change by any other name in humanistic disguise and has nothing to do with "management" or economic and business life. It is not a panacea, not a new therapy school, does not mean irresponsibility for either the therapist or the client, has fixed boundaries and is neither open nor neutral for everything.
Therapy is understood to mean the implementation of a systematic change process that starts with the patient's problems, analyzes their respective conditions, tries to clarify therapy goals and, in the further course, is based on these, thereby controlling itself based on the results that occur, and for so long until a certain degree of target achievement (e.g. the subjective optimum) is achieved.
The patient always has a high degree of self-responsibility, process orientation, goal and motivation clarification, until in the end - also through the structured instructions for self-control - he can live again without therapeutic support.
Self-management skills are e.g. B. Self -observation, self-instruction, goal clarification and setting, self-reinforcement, self- control .
Self-management strategies can be learned in psychotherapy or independently with the help of self-help manuals and advice books. The prerequisites for this are 1. the recognition of deficits and 2. the willingness to work on oneself. Are important
- a specific goal
- a realistic goal
- a goal that the person concerned can control himself
- a reward for achieving goals.
Outside of self-management therapy, the term self-management describes the management of oneself or one's own actions. In this context, the term stands for example for personal time management (including setting priorities , planning and effective action) in relation to personal life planning in private and professional life.
The cognitive-behavioral approach to self-management
The first self-management approach was developed based on considerations of learning theory: the cognitive-behavioral approach (e.g. Cautela, 1969; Mahoney, 1972, quoted from König & Kleinmann, 2006). The basic assumption of the theory is that behavior that leads to something positive occurs more frequently (positive reinforcement), while behavior that leads to something negative declines (punishment).
Behavior can also be influenced by stimuli. Certain behavior only occurs when certain stimuli associated with the behavior are present. According to the ABC scheme (from English: A for “antecendents” (cue), B for “behavior” and C for “consequences”), certain consequences are also associated with behavior. According to the behavioral approach, people themselves can change the probability of exhibiting a certain behavior (Mahoney, 1972, quoted from König & Kleinmann, 2006). They can reinforce themselves, punish themselves, or exercise stimulus control (trying to prevent stimuli associated with negative behavior from occurring).
Self-efficacy (Bandura, 1977, quoted from König & Kleinmann, 2006), a central component of the cognitive-behavioral self-management approach, was cited as a cognitive component of the approach . Self-efficacy: One expects / expects to be able to perform a certain behavior.
The 7-phase model of self-management therapy
For the course of a therapy Kanfer suggests a procedure in seven phases:
- Entry phase - creation of favorable initial conditions
- Development of motivation for change and (preliminary) selection of change areas
- Behavior analysis : problem description and search for sustaining conditions
- Clarify and agree on therapeutic goals
- Planning, selection and implementation of special methods (as a means to the goal)
- Evaluation of progress
- End phase - optimization of success and completion of counseling / therapy
The 11 Laws of Self Management Therapy
Kanfer gives eleven instructions for the therapist, which from his point of view promote the success of the therapy:
- Never ask clients to act against their own interests.
- Work future-oriented, look for concrete solutions and focus on the strengths of clients.
- Do not play the "good Lord" by taking responsibility for clients' lives.
- Do not saw off the branch that clients are sitting on until you have helped them build a ladder to descend.
- Clients are always right.
- Before you have a specific problematic behavior in mind, you don't know what it is actually about.
- You can only work with clients who are present.
- Aim for small, feasible progress from week to week and beware of utopian long-term goals.
- Remember that human information processing capacity is limited.
- If you work harder than your clients in the counseling / therapy session, you are doing something wrong.
- Do not spare with appreciation for clients' progress.
SMART rule of goal setting
In the management area, the SMART rule has been able to prevail with regard to goal setting (Gächter, 2007). The SMART rule was first outlined by Drucker (1956) in his book on Management by Objectives (MBO). According to Drucker (1956), the SMART method is used to check the validity of the objective. The SMART rule includes the following points:
- S pecific (as opposed to general)
- M edible (quantity / quality)
- A ttractive (rewarding / challenging)
- R ealistic (feasible under the given conditions)
- T erminiert (fixed in time)
Effect of goal setting
According to Locke and Latham (2002), goal setting influences performance through four mechanisms.
- Objectives have a directive function. They bring about attention control towards target-relevant activities. Activities that are irrelevant to the goal are pushed into the background. This purposefulness takes place both cognitively and at the behavioral level.
- Goal setting processes mobilize energy and the willingness to make an effort, i. H. Goals have an energizing (motivational) function. Higher goals lead to more effort than lower goals.
- Setting goals has a positive effect on endurance.
- Objectives also have an indirect effect on the activities themselves, in that they stimulate the acquisition and application of task-relevant knowledge and adequate work strategies (Wood & Locke, 1990, quoted in Locke & Latham, 2002).
Psychotherapy research
How effective is the psychotherapeutic process of self-management therapy?
In Grawe's meta-analysis on the effectiveness of psychotherapies , self-management therapy is assigned to problem-solving therapies ; In turn, the research group around Grawe certified this to have an extraordinarily favorable effect profile .
Differentiation from time management
A related area of self-management is time management, which seems to be particularly relevant for similar professions. In both the cognitive-behavioral approach of self-management and time management, it is suggested that people set goals and observe themselves (König & Kleinmann, 2006). However, there are also certain differences between the two terms. “Firstly, self-management is more often related to a single problem.” (König & Kleinmann, 2006, p. 341) In contrast, time management focuses more on a generally improved use of time. The setting of priorities plays a decisive role. Second, time management research is less theoretical than self-management research. "At the beginning of the research there was the observation that time management is ascribed an important role in many contexts and in many counselors, and the assumption that the use of time management techniques should be good for performance and good against stress." (König & Kleinmann, 2006, p. 341.) Questionnaires that record time management as a trait are the “Time Management Behavior Scale” (TMBS; Macan, 1994; Macan et al. 1990, quoted from König & Kleinmann 2006) and the “Time Management Questionnaire ”(TMQ; Britton & Tesser, 1991, quoted from König & Kleinmann, 2006). Among other things, trainings were evaluated with them.
See also
literature
- T. Baldwin: Effects of Alternative Modeling Strategies on Outcomes of Interpersonal Skill Training. In: Journal of Applied Psychology. 77 (2), 1992, pp. 147-154.
- Michael Borg-Laufs , H. Hungerige: Self- Management Therapy with Children: A Practical Guide . 2nd Edition. Klett-Cotta, Stuttgart 2010, ISBN 978-3-608-89104-1 .
- CA Frayne, JM Geringer: Self-management training for improving job performance: A field experiment involving salespeople. In: Journal of Applied Psychology. 85, 2000, pp. 361-372.
- FH Kanfer, H. Reinecker, D. Schmelzer: Self-management therapy: a textbook for clinical practice. 5., corr. and through Edition. Springer, Berlin / New York 2012, ISBN 978-3-642-19365-1 .
- CJ König, M. Kleinmann: Self-management. In: H. Schuler (Ed.): Textbook of Personal Psychology. 2., revised. and exp. Edition. Hogrefe, Göttingen et al. 2006, ISBN 3-8017-1934-0 , pp. 331-348.
- EA Locke, GP Latham: Building a practically useful theory of goal setting and task motivation: A 35-year odyssey. In: American Psychologist . 57, 2002, pp. 705-717.
- P. Sadowski: The mature drinker: self-management therapy for alcoholics. dgvt-Verlag, Tübingen 2007, ISBN 978-3-87159-066-5 . (Reading sample; Section 1.1 Self-Management Therapy)
- D. Schmelzer: "Help for self-help": The self-management approach as a framework for counseling and therapy. (PDF; 287 kB). In: Advice Current. 4/2000.
Web links
- Self-management therapy in the acceptance comparison of two patient groups (PDF; 149 kB) - a field report, (requested on March 22, 2010)
- Self-management therapy: interventions in inpatient rehabilitation for alcohol addiction . Dissertation, 2007 (Peter Sadowski, University of Greifswald)