Stress inoculation training incorporates several of the specific therapies already described. This procedure was developed by Meichenbaum. Stress inoculation training is analogous to being inoculated against disease. That is, it prepares patients to deal with stress-inducing events by teaching them to use coping skills at low levels of the stressful situation and then gradually to cope with more and more stressful situations. Stress inoculation training involves three phases: conceptualization, skills acquisition and rehearsal, and application and follow-through.
In the conceptualization phase of stress inoculation training, patients are given an adaptive way of viewing and understanding their negative reactions to stressful events. In the skills-acquisition and rehearsal phase, patients learn coping skills appropriate to the type of stress they are experiencing. With interpersonal anxiety, a patient might develop skills that would make the feared situation less threatening (for example, learning to initiate and maintain conversations). The patient might also learn deep muscle relaxation to lessen tension. In cases of anger, patients learn to view potential provocations as problems that require a solution rather than as threats that require an attack. Patients are also taught to rehearse alternative strategies for solving the problem at hand.
The application and follow-through phase of stress inoculation training involves the patients practicing and applying the coping skills. Initially, patients are exposed to low levels of stressful situations in imagery. They practice applying their coping skills to handle the stressful events, and they overtly role-play dealing with stressful events. Next, patients are given homework assignments that involve gradual exposure to actual stressful events in his or her everyday life. Stress inoculation training has been effectively applied to many types of problems. It has been used to help people cope with anger, anxiety, fear, pain, and health-related problems (for example, cancer and hypertension). It appears to be suitable for all age levels.
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