Non-drug Therapies

• Stress Inoculation Therapy (SIT) is a ‘talking therapy’ and a form of cognitive behaviour therapy (CBT) that engages in cognitive restructuring of thoughts
• SIT prepares people to cope with stress in a similar way to an injection preparing a body’s defences against a virus or disease, but exposing them to a small ‘dose’ of it to protect them against greater levels later on
• SIT was developed by Meichenbaum (1985) and operates in three stages:
  • Conceptualisation: the client identifies and expresses their fears and is encouraged to re-live stressful situations, analysing them and how they attempted to deal with them
  • Skill acquisition and rehearsal: the client is taught how to relax, how to think differently about stressors and how to express their emotions as well as learning specific skills such as time management to reduce stress

• Application and follow-through: this is the ‘inoculation’ part of the training and clients work on transferring coping skills across increasingly demanding levels of stressors using role play and imagery and afterwards feeding back to the trainer

Learning how to express emotions is an important part of stress inoculation therapy.

• Biofeedback is based on operant conditioning and uses technology so an individual can see and hear the physiological reactions that occur when under stress 
• The individual is taught relaxation techniques and connected to machines measuring muscle tension (EMG), brain activity (EEG) and skin sweat (SCR)
• When increased muscle activity, brain activity and sweating is identified, visual and audio feedback is given
• The client learns how to use relaxation techniques when stressed
• The client is set targets, for instance reducing muscle tension, and the relaxation techniques combined with the instant audio-visual feedback help them reach their targets, reinforcing the behaviour 
• Relaxation techniques used while receiving biofeedback help to decrease heart rate

Relaxation and biofeedback helping to relieve stress

Research which investigates non-drug therapies

• Meichenbaum (2001) reported that SIT modelling films, wherein role models demonstrated coping skills, were used to successfully control anger and stress in alleged rape victims when preparing them for forensic examination
• Lemaire et al. (2011) in an experiment gave biofeedback therapy to doctors (a stressful occupation) for 28 days and found it reduced their stress levels in comparison to a control group

Evaluation of non-drug therapies

Strengths

• SIT inoculates against future as well as current stressful situations, as it is effective over long periods and people can continue after the therapy to practise and apply skills they have learned to any type of stressful situations they encounter
• SIT and biofeedback are not invasive and have no negative side effects or addictive qualities, giving them an advantage over drug therapies

Weaknesses

• SIT requires individual commitment and motivation over a long period and if a person is suffering from extreme stress this is not easy to achieve 
• Biofeedback involves expensive specialist equipment and supervision and the success may be more due to the relaxation techniques, in which case such expense is unnecessary

Link to Issues and Debates:

The research into non-drug therapies demonstrates that training helps people manage their stress responses by exercising free will, increasing their control over physical symptoms and increasing their motivation to succeed in combating their symptoms. The treatment is not deterministic and there are individual variations in the success rate, but generally results demonstrate that people have more control over physiological responses to stress than might have been expected.

Link to Approaches:

Biofeedback is based on operant conditioning and so is a learning approach. SIT involves modelling, which is based on social learning, but SIT also involves cognitive restructuring, which is part of the cognitive approach. SIT especially focuses on internal mental processes.