Chapter 35: Stress Inoculation Training

How is the technique implemented?

Stress inoculation training (SIT) is based on the principle that exposure to mild stressors will eventually build tolerance for more severe issues that a client may face.  This technique is tailored for each individual and does not necessarily entail the same thing for all clients and often times collaborates with other techniques for a comprehensive treatment.  In addition the technique takes a lot of time (8-15 sessions). SIT general follows the following three steps: 1) Conceptualization 2) Skill acquisition and rehearsal and lastly 3) Application and Follow-Through.  Essentially, this means that the client will frame the issue, reveal triggers, learn how to handle them, spend time with the counselor practicing the technique and then apply it to real life and follow up with the counselor.

What type of situation can the technique be applied to?

The wonderful thing about SIT is that it can used for almost any problem that involves a trigger.  The technique would be most beneficial for dealing with things such a drug addiction but it can also be used for relationship issues or really anything that has an identifiable stressor.

What is your opinion of the technique?

I like the SIT technique because it helps a client learn how to deal with their issue slowly rather than evoking heavy amounts of the stressor like most exposure and response techniques.  Another factor about this technique that I find to be beneficial is that, while it is a CBT approach, there are plenty of opportunities for the client to express how these stressors make them feel.

Chapter 34: Systematic Desensitization

How is the technique implemented?

Systematic desensitization is a form of exposure and response therapy that can be used to help a clients build a response to negative thoughts.  By evoking negative past cognitions, this technique sets the stage for a client to react appropriately.  Repeated exposure to a stressful event or thought gives the client a chance to develop an appropriate response while minimizing the damages of those thought since they are occurring so frequently.  The process of desensitization generally occurs in three stages.  The first stage requires that the client becomes proficient in some sort of relaxation (see aforementioned deep breathing technique).  Second, the client and counselor work together to create and anxiety hierarchy.  And lastly, provoking negative stimuli and working towards developing a positive coping mechanism.

What type of situation can the technique be applied to?

Desensitization is primarily used with trauma victims such as rape victims or soldiers coming back from war.  The technique can be used for lighter issues such as phobias as well to help minimize the fears of particular situations.

What is your opinion of the technique?

This technique when employed correctly can help eliminate many of the unpleasant traumas of PTSD and related issues.  For this, I think that this technique can be incredibly beneficial (especially for things like phobias that are generally of a lower magnitude).  That being said, I think it can be incredibly dangerous to continuously expose an individual to a traumatic or difficult occasion as it may just worsen the situation.

Chapter 32: Deep Breathing

How is the technique implemented?

Deep breathing is a technique that has proven to be very beneficial in relaxation.  Deep breathing exercises are typically conducted in five steps processes.  The counselor should have the client do the following five things:

1) Breathe through the nose and out the mouth

2) In between deep breaths, breathe normally.

3) This exercise should be done while laying on one's back unless the client is more comfortable sitting.

4) If yawning is necessary the client should do so as it puts the body at equilibrium

5) Note differences in breathing.

The purpose of this technique is for the client to use their breathing as a strategy for relaxation to escape from their issues.

What type of situation can the technique be applied to?

The main use for deep breathing is to relieve or release stress.  However, deep breathing can be used in a multitude of situations to help the individual change their cognitions.  For example, deep breathing can be used when a client begins to have negative thoughts or is placed in a position that they feel uncomfortable.  Deep breathing can also be used before a client knows they are entering a stressful situation (tests, public speaking, public performance, etc.)

What is your opinion of the technique?

I think deep breathing is a good way to minimize the stress of an individual who comes the counselor in extreme panic.  That being said, I think that deep breathing is simply a complementary skill because it does not provide any education or coping strategies for future issues.  

Chapter 31: Bibliotherapy

How is the technique implemented?

Bibliotherapy is essentially the implementation of books and readings as therapy for a student.  The intent of this practice is to educate the client on a condition so that they can understand it throughout therapy.  There are four stages to implementing this technique.  First it is important to identify the needs of the client.  Second, finding literature that is appropriate and will be beneficial to helping the client with their issue.  In addition, literature needs to be appropriate with the clients reading abilities. Next, the client reads the material.  And lastly, the client and the counselor review the literature together so that they can confirm the value and meaning of the literature as it pertains to the clients struggles.

What type of situation can the technique be applied to?

This type of therapy has a wide array of uses and can be used to help any client who is unaware of what may be causing their issues.  Bibliotherapy can either educate the client on the counseling theory they will be participating in or it could be simply education on a condition or status the client assumes (mental illnesses, LGBQTA, physical illness, etc.).

What is your opinion of the technique?

Personally I find this therapy to be beneficial as a complement to other therapy.  Using bibliotherapy allows the reader/client to gain insight or education on their situation which will help them in therapy and may even make them a more willing participant in therapy.

Chapter 29: Overcorrection

How is the technique implemented?

Overcorrection is a technique that is used to eliminate maladaptive behavior and then provide the client with education.  Just like many techniques in the behavioral realm, the first step is to identify the target behavior.  Once the behavior is witnessed the counselor should tell the client to stop.  Then the counselor should guide the client through restitution and have the client undergo positive practice for a set number of repetitions. The purpose of this is so that the student can immediately recognize the behaviors that are inappropriate and is faced with consequences that will ultimately alter their decisions in the future.  For instance if the client misbehaves, the counselor will make them correct their action and then undo it and redo it a set number of times to overcorrect the action.

What type of situation can the technique be applied to?

Overcorrection can be used most effectively to eliminate bad habits.  In addition, it can be used to help a client recognize the consequences of their actions and the effort it may take someone else to correct them.  Once the student recognizes the extra effort they are forcing someone else to make, they realize why it may be important for them to behave appropriately.

What is your opinion of the technique?

Just as many behavioral techniques I find this one to be limited in scope.  It seems like a practice that would be most effective in an elementary school setting where students may do things carelessly and this technique would prevent and educate them on why that behavior is unacceptable.

Chapter 26: Extinction

How is the technique implemented?

Extinction is a technique that relies on the punishment or removal of a reinforcement for a behavior.  This technique is generally used to provide consequences for engaging in a behavior seen as inappropriate.  The first step of extinction is to make sure that extinction is appropriate considering the behavior.  If an increase in the behavior would be intolerable, this is not an appropriate technique.  Next, identify the reinforcers of the behavior.  Third, develop a method of removing those reinforcers, if this cannot be done this technique will not work.  Lastly, it is important to identify a new target behavior.

What type of situation can the technique be applied to?

One of the biggest issues with this technique that it has a limited scope of usability.  The technique can really only be implemented in a situation where the behavior requires a response and that response is eliminated.  An example of this would be tantrum behaviors.  If you eliminate the environmental and personal responses to a tantrum, the client is less likely to engage in that behavior.

What is your opinion of the technique?

I do not like this technique.  I feel as thought it is limited in applicability and there are better ways to handle a situation.  The dangerous part of the technique is that it may initially create an increase in behavior as the client will try to receive the reinforcers it previously received by increasing the behavior.

Chapter 25: Behavioral Contract

How is the technique implemented?

Behavioral contracts provide an opportunity for two or more individuals to create a contract of what behaviors they find beneficial in an attempt to eliminate the negative behaviors.  These contracts can seek to achieve a target behavior for one or both parties involved in the contract in order to ensure that progress is being made and noticed.  The first step in implementing a contract is to identify the target behavior.  These contracts typically also include how the client will feel when they have achieved a successful performance at participating in the target behavior.

What type of situation can the technique be applied to?

This technique can be applied to a widespread group of issues but the one that stands out the most is a scenario where there are incongruent beliefs regarding a behavior between two parties.  A contract can be formed to create a target behavior that both parties feel is appropriate.  Using this technique in this manner is a terrific way of developing compromise and the expectations of one another.

What is your opinion of the technique?

I see this technique as a very good way for a counselor to help individuals involved in a relationship to see the other side of an argument and try to develop a middle ground.  Overall, the technique is something that could help a client modify their behavior so that they appease others.  On that note, there is danger in using this technique because sometimes the presentation of a contract could be seen as an ultimatum or pressure one end of the contract forcing resistance or client behavior that is forced or not genuine.

Chapter 23: Behavior Chart

How is the technique implemented?

The behavior chart is a technique that allows the client to note their behaviors throughout the day and then evaluate them to see there progress in dealing with an issue.  The chart can monitor interventions or serves as one itself.  The first step in creating a behavior chart is to define the target behaviors to reform.  Next, develop a rating system that allows the client to identify either magnitude or frequency of behavior.  Then create the chart by developing a monitoring strategy and the goals for using the chart.  Lastly, create consequences for positive or behavior behaviors.  This includes things such as small rewards or punishments for the progress or lack thereof that is being made.

What type of situation can the technique be applied to?

The best situation to use something like a behavior chart would when a dealing with strong compulsions or issues with self-control.  By creating a chart the client is responsible for giving consequences to themselves for their behaviors which serves as a great motivator.  A behavior chart however, is not limited to just this type of use.  A behavior chart can be used any time a client strives to seek change in their behaviors.

What is your opinion of the technique?

The behavior chart is a great idea for anyone and almost any behavioral situation.  It's usefulness is not limited to just certain behaviors, it can be utilized to modify any behavior.  That being said, one weakness of this technique is that it is only useful when dealing with a client who seeks behavioral reform and offers little help cognitively. 

Chapter 20: Thought Stopping

How is the technique implemented?

Thought stopping technique is a classic example of cognitive-behavioral therapy.  The counselor helps the client to develop mechanisms to prevent or interrupt unwanted thoughts that may be inhibiting the client.  Thought stopping is generally implemented in a four step process.  The first step is to identify the thoughts that the client wants to eliminate or interrupt.  Second, the client is asked to imagine a scenario where the thought may occur.  Next, the client and counselor both attempt to identify situations where the thought is occurring and call "Stop" to interrupt the thought.  And the final step is to substitute in a new thought for the old thought.

What type of situation can the technique be applied to?

The thought stopping technique can be (but not optimally) for a variety of situations.  However, it specializes in dealing with things like obsessions and addictions.  The entire premise of the technique is to prevent cognition of certain aspects of an individuals life which would be inhibiting to getting to real issues in other situations.

What is your opinion of the technique?

Personally I see this technique as only having one purpose and that is to aid with the elimination of obsessions and addictions.  Otherwise, I believe that this technique prevents insight which is the opposite of what a counselor should aim to do in session.

Chapter 19: Reframing

How is the technique implemented?

Reframing is a technique that is implemented by taking a problematic situation and presenting it in a new way so that the client can gain a new perspective on the situation.  The most well known method of implementing this technique is to use three a step model.  First the counselor must effectively listen to the client to gain an understand of the problematic situation.  Second, after the counselor understands the issue they must begin to formulate a bridge between the client's point of view to a new way of handling the problem.  Finally, the counselor must reinforce the bridge that they have created by assuring themselves that this new way of looking at a problem has stuck with the client.  This may occur through a homework assignment that forces the client to view the issue in the new way.

What type of situation can the technique be applied to?

This technique can be applied most appropriately to a client who is suffering from self-defeating behavior or irrational beliefs.  In addition, if the issue is a persistent issue that the client may have given up on due to their inability to overcome it, this technique can be used to help the client seek new solutions to the problematic situation.

What is your opinion of the technique?

I like this technique in situations where the client is struggling to overcome issues that are clearly only problematic because of the manner in which the client is approaching them.  The counselor can use this technique most effectively when helping dispel negativity about a situation.  Overall, its an excellent technique because in most cases a problem can either be solved or at least understood to the fullest by approaching it from different perspectives.