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A multimodal behavioral approach to performance anxiety
Author(s) -
Lazarus Arnold A.,
Abramovitz Arnold
Publication year - 2004
Publication title -
journal of clinical psychology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.124
H-Index - 119
eISSN - 1097-4679
pISSN - 0021-9762
DOI - 10.1002/jclp.20041
Subject(s) - psychology , systematic desensitization , anxiety , cognition , psychotherapist , cognitive restructuring , desensitization (medicine) , psychological intervention , interpersonal communication , affect (linguistics) , cognitive psychology , social psychology , psychiatry , communication , biochemistry , chemistry , receptor
Cognitive‐behavior therapy (CBT) stresses a trimodal assessment framework (affect, behavior, and cognition [ABC]), whereas the multimodal approach assesses seven discrete but interactive components—behavior, affect, sensation, imagery, cognition, interpersonal relationships, and drugs/biological factors (BASIC I.D.). Only complex or recalcitrant cases call for the entire seven‐pronged range of multimodal interventions. Various case illustrations are offered as examples of how a clinician might proceed when confronted with problems that fall under the general heading of performance anxiety. The main example is of a violinist in a symphony orchestra whose career was in serious jeopardy because of his extreme fear of performing in public. He responded very well to a focused but elaborate desensitization procedure. The hierarchy that was eventually constructed contained many dimensions and subhierarchies featuring interlocking elements that evoked his anxiety. In addition to imaginal systematic desensitization, sessions were devoted to his actual performance in the clinical setting. As a homework assignment, he found it helpful to listen to a long‐playing record of an actual rehearsal and to play along with the world‐renowned orchestra and conductor. The subsequent disclosure by the client of an important sexual problem was dealt with concomitantly by using a fairly conventional counseling procedure. Therapy required 20 sessions over a 3‐month period. © 2004 Wiley Periodicals, Inc. J Clin Psychol/In Session.