Stress vaccination training

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The stress inoculation training (Engl. Stress Inoculation Training) was developed by Donald Meichenbaum published in 1979, 1985 and is present in Germany since 1991. It is a method of coping with stressful situations . It is used to teach people strategies for coping with stress in current situations. The acquisition of the strategies is preventive , that is, the strategies for stress reduction are taught before the stressful event. Meichenbaum's cognitive-behavioral therapeutic approach is generally similar to that of Aaron T. Beck and Albert Ellis , but Meichenbaum focuses more on developing and training beneficial cognitions. The stress vaccination training was integrated into the therapy of anger by Novaco (1979).

Action

Three successive phases are described for the procedure:

Information phase

In the information phase, the client's problems are analyzed. A plausible model for the emergence of stress is created for the client. In addition, the structure of the therapy process is determined.

The aim of the information phase is to give the client a clear understanding of how stress reactions arise and how they are maintained, their fears, anger, problems, etc. At the beginning of the therapy there is psycho-education, at the end of which the patient should have understood the basic model that it is not the events themselves that cause stress, but the way in which the events are perceived. It is made clear to the clients that they perceive the events differently and can deal with them in such a way that they cause less stress.

The actual beginning of the stress vaccination training is a detailed problem analysis, during which it is recorded which thoughts of the person go through the head in critical and stressful situations. As a rule, the person's usual stress reactions are used so that the patient can vividly imagine a situation and empathize with the self-verbalizations that take place. It is important that the client is given a plausible model for the development of his stress reactions, whereby he should understand how his thoughts contribute to the build-up of stress and negative emotions. The aim of the information phase is to sensitize the client to cues from emerging fear or stress, so that he can recognize stressful situations and related behavioral reactions at an early stage and can react to them differently. The stress events are analyzed using the SORKC model .

Practice phase

In the practice phase, the client is taught several methods with which he can control emerging fear and stress reactions. In this phase, information is collected about problematic situations and the client's stress reactions, but also coping reactions, e.g. relaxation training (such as progressive muscle relaxation according to Edmund Jacobson ) are learned. Other strategies such as breath control, role play or thought stops can also be used. According to Meichenbaum, however, the cognitive coping mechanisms are particularly important.

The practice phase is divided into four, overlapping, steps:

  • Preparing for a stressor: serves as a guide and clarification of what to do. Examples: "Don't worry.", "Better think about what you can do."
  • Confrontation with the stressor: The client should remember what to do in the face of a stressful situation, e.g. B. expose yourself to the situation in small steps, relax, do not panic etc. Example: “You can handle the situation! Always one thing at a time. ”,“ Don't panic now! ”,“ Take a deep breath and relax! ”
  • Feeling overwhelmed: The emergency is anticipated and the impending panic presented. Example: "The fear cannot be switched off, but you can deal with it.", "The fear is bearable."
  • Self-reinforcement: Self-reinforcement is intended to stabilize the coping behavior in the person's behavioral repertoire. Example: "It worked.", "You did it.", "Great! You are making progress."

According to Meichenbaum, it is important to look for a formulation that is individually favorable for the client and not to stipulate rigid sentences. The development takes place together with the client u. a. by the model specification. The strategies learned are then practiced in an exemplary problem situation (e.g. in an imagined or artificially produced stress situation).

Application phase

In the application phase, the client tests the newly acquired coping skills in real and diverse stressful situations. The stressful situations are usually sought out in a “graded” manner and dealt with by the client using self-verbalization. The aim of the application phase is to teach the client a certain degree of flexibility in dealing with real problem situations. It is assumed that the client has learned coping reactions in the exercise phase, which exert a protective immunization for real stressful situations. For this reason, the procedure is called stress vaccination .

Areas of application

The stress vaccination training was originally developed to control stressful and stressful situations. In the meantime, however, it is also used in other areas, for example in behavioral medicine or for prevention within groups that are often exposed to severe stress, for example police officers or firefighters, or for health promotion.

According to Jungnitsch (1992), stress vaccination training can also be adapted for coping with pain attacks in the context of rheumatic diseases. There are several studies that prove its effectiveness in coping with stress, anxiety, and treating PTSD .

criticism

The term self-verbalization is used rather vaguely to denote a number of very different cognitive contents. There is also a conceptual ambiguity in his concept, since Meichenbaum uses the terms “self-verbalization”, “inner speaking”, “inner monologue”, “verbal coping behavior”, “cognitions” and “convictions” almost synonymously in various publications. In addition, in contrast to those of Aaron T. Beck or Albert Ellis , Meichenbaum does not provide a summarizing theoretical framework for his approach from which a more detailed specification of the therapy goals, e.g. B. in relation to appropriate self-verbalization, could be derived. Meichenbaum does not specify any criteria that characterize “dysfunctional” cognition. Furthermore, there are no empirical findings that support the evidence of stress vaccination training.

Individual evidence

  1. ↑ a b c Ulla Franken: Emotional Competence - A Basis for Health and Health Promotion. A scientific contribution to basic health care for people with psychogenic disorders and illnesses (dissertation 2004) . Books on Demand, Norderstedt 2010, ISBN 978-3-8370-3279-6 , pp. 295 ( limited preview in Google Book search).
  2. ↑ Michael Zaudig, Rolf Dieter Trautmann-Sponsel, Peter Joraschky, Rainer Rupprecht, Hans-Jürgen Möller, Henning Saß (eds.): Therapielexikon Psychiatrie, Psychosomatik, Psychotherapie . 2006, ISBN 3-540-30986-1 , pp. 753 ( limited preview in Google Book search).
  3. ^ Claas-Hinrich Lammers: Emotion-related psychotherapy: Basics, strategies and techniques . 2011, ISBN 978-3-7945-2787-8 , pp. 264 ( limited preview in Google Book search).
  4. ↑ Hansruedi Ambühl, Barbara Meier & Ulrike Willutzki: Understanding and treating social anxiety. A cognitive-behavioral approach . 3. Edition. Klett-cotta, Stuttgart 2006, ISBN 3-608-89025-4 , p. 132 ( limited preview in Google Book search).
  5. ↑ Georg Jungnitsch: Clinical Psychology . 2nd Edition. W. Kolhammer, Stuttgart 2009, ISBN 978-3-17-020054-8 , pp. 141 ( limited preview in Google Book search).
  6. ↑ RJ Boerner: Special therapy methods . In: Hans-Jürgen Möller (Ed.): Therapy of mental illnesses . 3. Edition. Georg Thieme, Stuttgart 2006, ISBN 3-13-117663-6 , p. 884 ( limited preview in Google Book Search).

literature

  • Meichenbaum, Donald (2003). Intervention in case of stress . Ed., Translated and with a supplementary chapter by Lothar Schattenburg. 2nd Edition. Bern: Huber
  • Reinecker, H. (1999), Textbook of Behavioral Therapy. Tübingen: DGVT publishing house
  • Wilken, B. (1998), Methods of Cognitive Restructuring. Stuttgart: Kohlhammer.