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Group systematic desensitization and group insight therapies for test anxiety
BEHAVIORTHERAPY (1971) 2, 511-518
Group Systematic Desensitization and Group Insight Therapies for Test Anxiety 1 JAMES F. LOMONT~ AND LEWIS J. SHERMAN University o'f Missouri--St. Louis Changes in test anxiety in college students were compared among three groups: (1) those who received group-administered systematic desensitization, (2) those who received group insight therapy, and (3) a no-treatment control group. The, measures of tes~ anxiety included a questimmaire, course test grades, and performance on a laboratory reading test. There was no difference in anxiety reduction among the groups, despite the fact that all the systematic desensitization subjects completed their stimulus hierarchies at least twice. Also, there was no significant change of any group on any of the measures. A number of studies (Cohen, 1969; Donner & Guerney, 1969; Garlington & Cotler, 1968; Ihli & Garlington, 1969; Kondas, 1967; Suinn, 1968) have obtained evidence that systematic desensitization administered on a group basis is an effective means of reducing test anxiety in college students. However, these studies provide fairly consistent evidence for the efficacy of group desensitization only in terms of self-report measures of test anxiety. In terms of the only behavioral measure used more than once, vis., improvement in grade point average, the results are inconsistent. Two (Donner & Guerney, 1969; Johnson & Sechrest, 1968) out of five studies which compared desensitization, unconfounded, with a nontreatment control group and used grades as a dependent variable found a positive effect of desensitization. The other three studies (C0hen, 1969; E m e r y & Krumboltz, 1967; Garlington & Cotler, 1968) did not show any effect of desensitization on grades. Two more studies (Katahn, Strenger, & Cherry, 1966; Paul & Shannon, 1966) that combined group desensitization with counseling on study methods found grade improvement associated with desensitization. Several studies (Cohen, 1969; Emery & Krumboltz, 1967; Ihli & Garlington, 1969; Suinn, 1968) have further indicated that the greater therapist time economy of group than of indi1The authors express appreciation to the Office of Research Administration, University of Missouri-St. Louis, for providing financial support for this study. Requests for reprints should be sent to James F. Lomont, Psychology Department, University of Missouri-St. Louis, 800'1 Natural Bridge Road, St. Louis, Mo. 63121. 511
512
LO~ONT
AND
SHERidAN
vidual desensitization for test anxiety is not purchased at the price of lesser effectiveness. This evidence, then, suggests that group systematic desensitization may be a quite efficient method of coping with the common college student problem of test anxiety, but further investigation of its effects on course grades and other behavioral measures is required for solid establishment of its value. The present study was directed in part to this need. Evidence for the value of group systematic desensitization as a treatment for test anxiety is also deficient in regard to any clear indications of its superiority over traditional group counseling. In the only two studies (Crighton & Jehu, 1969; Doctor, Aponte, Burry, & Welch, 1970) that did compare group systematic desensitization with group counseling, neither treatment was clearly superior to the other. However, these comparisons are weakened by the fact that the studies lacked adequate no-treatment control groups. A second purpose, then, of the present study, was to make a comparison between group systematic desensitization and group counseling as treatments for test anxiety in college students. This study is unusual among investigations of systematic desensitization treatment of test anxiety in that it involved the following three different kinds of measures of test anxiety: (1) self report, (2) academic course grades, and (3) a laboratory reading test, in which opportunity for preparing for the test was controlled and special measures were taken to make the test stressful. METHOD
Subiects Six male and 19 female college students from introductory psychology at the University of Missouri-St. Louis constituted the subjects. These subjects were selected from the introductory psychology classes on the basis of meeting three criteria: (1) Exceeding certain cutoff scores on the debilitating and facilitating anxiety scales of the Alpert-Haber Test Anxiety Scale (Alpert & Haber, 1960) (DA and FA, respectively). More specifically, to be invited to participate in the study a student had to have obtained a score of at least 30 on DA (out of a possible 50) and a score no higher than 23 on FA (out of a possible 45). Of 396 students in the introductory psychology classes 119, or 30%, met this criterion; (2) Explicit indication on a standard form that the student felt he was "significantly bothered" by test anxiety; and (3) indication on the same form of willingness to participate in an investigation of test anxiety for pay at the rate of $1.50 an hour should he score above a certain level on the inventory just taken (the Alpert-Haber). Strictly speaking, in the respect that the subjects were paid rather than individuals voluntarily seeking help, this study is an analog study. The students were not told prior to the experiment that the study was going to be an investigation of methods for treating test anxiety, merely that their participation
TWO
THERAPIES
F O I l TEST A N X I E T Y
513
could involve as many as 10 sessions and 11 hr of their time. They were not told beforehand definitely how much time would be involved because they could b e assigned to either of the experimental groups or to the control group, the control group being seen only for testing before and after the therapy given to the experimental groups. There were initially nine subjects in each of the three groups. However, the systematic desensitization group later lost one male subject due to voluntary withdrawal, and the control group lost one male subject to the military draft.
Measures Four measures of test anxiety were used to assess the effects of the therapies received by the experimental groups. Three of these were administered within the 2 weeks prior to the beginning of the experimental therapies and the week after the termination of these treatments. Two of these three measures, DA and FA, have already been mentioned as criteria measures for subject selection. Two studies (Ihli & Garlington, 1969; Mitchell & Ingham, 1970) have found a decrease in DA in testanxious college students following systematic desensitization, and in one of these studies (Mitchell & Ingham, 1970) the decrease was greater than in an untreated control group, there being no control group in the other study. The latter study also found an increase in FA following desensitization, whereas no such change was found in the former study. A third measure was a sort of laboratory measure ( L M ) of test anxiety. In the first session of the experiment proper, all subjects, seen in groups of four to eight, were given LM. Intended as a simulation of an academic course test, this test has the advantage over a course test of better control of the testees' preparation for it. This control consisted of having the subjects prepare for the test in the laboratory by studying the items covered b y the test immediately before taking it. The items were three relatively easy passages that had been used for testing in a speed reading course, and the test itself consisted of three separate questionnaires on the three passages. The subjects were told to exchange their passages for the questionnaires when they were through with the reading, and they were allowed a maximum of 55 min to read the passages. To maximize the significance of the test, and hence its anxiety arousal to the subjects, they were told that it had been found to be a good predictor of future success in business and professional occupations. It was described as being better for predicting such success than other tests by virtue of indicating how well a person could gain information from reading in a limited amount of time. In addition, to enhance the significance of their performance all subjects were told that the test was being used in a research project investigating personality characteristics of students who did worse on this test than on the American College Entrance Examination ( A C E ) , which they had all taken. They were also told that students who did do worse on the test than on the ACE would be asked to serve as subjects in further testing, Presumably, the possibility of being singled out for further testing would lend importance to the subject's performance on the test and, consequently, make it more like a course test in its anxiety arousal. To set the stage for plausible readministration of the test after therapy h a d been completed with the experimental groups, the subjects were told that they would be asked to take the test again in several weeks so that more reliable scores, based on ~,vo administrations of the test, could be obtained.
8 9 8
n
34.75 ± 4 . 1 3 33.56 ± 2 , 8 8 35.63 ± 4.81 32,25 ± 8 . 1 7 33.33 ± 7 . 7 0 37.88 ± 4 . 4 2
12.88 ± 2.75 12.44 ± 4,16 10.86 ± 4 . 3 0
DA
14.88 ± 4.45 ° 12.89 ± 2.67 ° 9.71 ± 4.53 °
LM
" S D T = S y s t e m a t i c desensitization t h e r a p y . b I T = Insight therapy. c C = Control.
Pretherapy measures SDT a IT b Cc Posttherapy measures SDT IT C
Group
20.25 ± 3 . 2 8 20.00 ± 4 . 3 3 19.63 ± 4 . 0 6
19.63 ± 2 . 9 2 19.56 ± 2 . 6 0 19.25 ± 1.49
FA
Group means ± SD
59,13 ± 6,69 6 3 . 0 0 ± 10.51 68.00 ± 11.46
55.75 ± 6 . 2 7 57.33 + 14.28 64.75 ± 11.31
CT
19.00 ± 5.42 20.56 ± 4.88 22.88 ± 9 . 8 6
ACE
TABLE 1 Results ( G r o u p Means ± S D ) of P r e t h e r a p y and P o s t t h e r a p y M e a s u r e s and on A C E Social Science S t a n d a r d Score
P~
0
©
¢J(
TWO THERAPIES FOR TEST ANXIETY
515
The subject's score on LM was the number of his wrong answers to 45 questions on the reading passages. The final measure of test anxiety (CT, for course test) was the subject's performance on two of the actual examinations in his introductory psychology course. Although these tests lack the advantage of control over preparation that is afforded by LM, they have, by comparison with LM, the asset of being more clearly genuine instances of stressful test situations. The first course test was given 2 weeks after the two therapies began, and the second test, which was the final examination, was given approximately 2 weeks after the therapies ended. They were both multiple-choice tests.
Procedure The subjects were equally divided in random fashion among the two experimental groups and the control group. The three groups did not differ significantly on any of the pretherapy measures. Table 1 shows the means and SDs of the three groups on the three pretherapy measures. The two experimental groups were then seen separately as groups for eight weekly 50-rain sessions. The control group subjects were not seen during the time period spanned by these sessions. The group systematic desensitization was administered by a therapist ( J F L ) who had had 8 years of experience with individual systematic desensitization. In the first therapy session with the systematic desensitization ( D T ) group, the experimenter began by explaining the rationale of systematic desensitization as a treatment for test anxiety. He then instructed the subjects to make up test anxiety stimulus hierarchies individually as homework for the next session, explaining to them in detail how to do this. The rest of the session was spent training the subjects in deep muscle relaxation. The second session was begun with the experimenter reviewing the test anxiety stimulus hierarchies which the subjects had constructed. Only two of the hierarchies required any alteration, and their authors were advised as to how to make the needed changes. About half the session was then devoted to further practice of relaxation. The remainder of the session was spent in initiating the systematic desensitization procedure itself. In this procedure, all subjects together imagined their test anxiety stimulus hierarchies on signal from the experimenter. When the experimenter gave the signal for stimulus visualization, each subject imagined whatever item in his hierarchy he was then working on. The subject kept track of his progress in his hierarchy and ascertained what item he should be imagining at any given time by means of a sheet of paper bearing his hierarchy. For each stimulus visualization trial, as soon as a subject gained a visual image of the item he was working on, he signalled the experimenter by briefly raising his hand. Then he continued to imagine the same situation until he experienced the slightest degree of fear, tension, or anxiety, o r m failing this--until the experimenter said "relax." At whichever of these two events occurred first, he was to stop imagining the anxiety stimulus and visualize being in a pleasant, relaxing situation until the signal for the next anxiety stimulus was given. If, on a given stimulus visualization trial, a given subject did not experience any anxiety from the time he signaled image attainment to the experimenter's relaxation signal, he was to imagine the next higher item in his hierarchy on the next trial. The subject did not give any overt indication as to when he was moving from one hierarchy item to the next. By this procedure, the subject was to begin with the least disturbing item in his hierarchy and work his way up his hierarchy. If the subject finished his hierarchy before the termination of therapy, he was to
5]~6
LO3.IONT AND SHER~,IAN
begin the procedure over, starting again with the lowest item in his hierarchy. By the end of the therapy, all subjects had completed their hierarchies at least twice. The insight group met week]y for 1.5 hr over the 8 weeks of the study. The group was conducted by LJS who had had 15 years' experience with this therapeutic approach. Emphasis throughout the sessions was on expression of feelings and selfunderstanding. Members were permitted and encouraged to discuss any issues they wished within the group. Naturally enough, the early discussion focused on test anxiety specifically and school performance generally. Hovever, this discussion soon extended to an exploration of more general personal concerns such as feelings of loneliness and alienation, parental conflict, and identity crises. In no instance were any specific suggestions or recommendations concerning the management of test anxiety offered to the members. The restriction of each therapist to one treatment method might have confounded differences in therapists with differences between the therapies. However, this assignment of therapists to treatments did provide for the administration of each therapy by an experienced, enthusiast_'c practitioner of that therapy. Consequently, both treatments were given a better chance of showing themselves at their best than if they had been counterbalanced with respect to the thmapists. Within a week after both experimental groups had . -eived 8 weeks of therapy, all subjects, including the control group, were again administered the LM and DA and FA measures, LM being administered prior to DA and FA. Because of scheduling problems, the two experimental groups were tested separately at the times they had met for therapy. The control g"oup subjects were divided for testing between two other times. The p~sttreatment LM was administered by facult nbers other than the therapists for the experimental groups. This was done p~ qvoid the possibility that the administration of the test to the experimental s~, y their therapists would a]leviate their test anxiety. It was done also to .,'orroborate the instructions that the test was being given as part of research other than the investigation of test anxiety. RESULTS T a b l e 1 shows the pre- a n d p o s t t h e r a p y scores. T h e t h r e e groups w e r e c o m p a r e d on L M a n d C T b y analyses of covariance. This t y p e of analysis was u s e d to p r o v i d e statistical control of intelligence; t h e A C E social sc!enee a p t i t u d e score was t h e covariate. T h e d e p e n d e n t v a r i a b l e in one analysis was t h e L M score, e i t h e r pre- or postt r e a t m e n t , a n d in t h e o t h e r analysis t h e d e p e n d e n t v a r i a b l e was CT, e i t h e r p r e - or p o s t t r e a t m e n t . In b o t h analyses, t h e i n d e p e n d e n t v a r i a b l e s w e r e ( 1 ) t h e t w o kinds of t h e r a p y a n d ( 2 ) p r e - vs p o s t t h e r a p y . T h e r e was no significant effect in e i t h e r analysis. A n a l y s e s of v a r i a n c e w e r e perf o r m e d on D A a n d FA, t h e i n d e p e n d e n t v a r i a b s b e i n g t h e s a m e as in t h e analyses of covariance. T h e s e analyses also y i e l d e d no significant effect. F i n a l l y , s e p a r a t e t tests of t h e t w o g r o u p s ' c h a n g e s on e a c h dep e n d e n t v a r i a b l e d i d n o t show a significant e h a n v e in e i t h e r g r o u p on a n y of t h e measures.
TWO THERAPIES FOR TEST ANXIETY
517
DISCUSSION The results not only fail to indicate any difference in the effectiveness of the two therapies, they do not indicate any effectiveness of either treatment. In view of the evidence for reduction of test anxiety b y systematic desensitization in other studies, the total absence of such evidence in the present study is particularly surprising. There was not even a demonstrable effect of desensitization on DA, despite the decrease in DA with systematic desensitization in two other studies (Ihli & Garlington, 1969; Mitchell & Ingham, 1970) and the reducing effect of desensitization on test anxiety as measured by other inventories in still other studies ( D o n n e r & Guerney, 1969; Garlington & Cotler, 1968). If the subjects receiving desensitization had not been able to progress through their hierarchies, then this failure in hierarchy completion could have been held responsible for t})e ineffectiveness of desensitization in reducing test anxiety. However, in ,act all subjects did complete their hierarchies, and not just once, but twice. Consequently, according to any conceptualization of systematic desensitization commonly entertained by behavior therapists, anxiety reduction should have generalized from the imagined form
of the hierarchy s~: :11i to their real form. That this generalization did not occur sugges ',t the factors which can seriously affect the effleacy of systematic ~,:fzation are not presently fully understood. REFERENCES ALPEaT, R., & HA~En, lq. N. Anxiety in academic achievement situations. Journal of Abnormal and Social Psychology, 1960, 61, 207-215. COliN, R. The effects of group interaction and progressive hierarchy presentation on desensitization of test anxiety. Behaviour Research and Therapy, 1969, 7, 15-26. CRICHTON,J., & JEI-IV,D. Treatment of examination anxiety by systematic desensitization or psychotherapy in groups. Behaviour Research and Therapy, 1969, 7, 245-248. Doe-ton, R. M., A2ONTE, J., BtmaY, A., & WELCH, R. Group counseling versus behavior therapy in treatment of college underachievement. Behaviour Research and Therapy, 1970, 8~ 87-90. DONNEa, L., & GUERNEY,B. G., JR. Automated group desensitization for test anxiety. Behaviour Research and Therapy, 1969, 7, 1-14. EMERY, J. R., & KatrMBOLTZ,J. D. Standard vs. individualized herarchies in desensitization to reduce '~est anxiety. Journal of Consulting Psychology, 1967, 14, 204-209. GARLINCTOr¢, W. K., & COTLEn, S. B. Systematic desensitization of test anxiety. Behaviour Research a,7,d Therapy, 1968, 6, 247-256. IrILI, K. L., & GAnLINGTO,~,W. K. A comparison of groups vs. individual desensitization of test anxiet~ 3ehaviour Research and Therapy, 1969, 7, 207-210. JOI~NSON, S. M., & SEC EST, L. Comparison of desensitization and progressive re-
51~
LOlklONT AND SHERIkIAN
]axation in treating test anxiety. Jtmrnal of Coltstdling and Clinical Psychology, 1968, 280-286. KATAHN, M., S°rnENCER, & CrIE~a¥, N. Group counseling and behavior therapy with test anxious students. Journal of Consulting Psychology, 1966, 30, 544--549. KONDAS, O. Reduction of examination anxiety and 'stage-fright' by group desensitization and relaxation. Behaviour Research and Therapy, 1967, 5, 275-282. MITCrmLL, K. R., & INCHAM, R. J. The effects of general anxiety on group desensitization of test anxiety. Behaviour Research and Therapy, 1970, 8, 69-78. PAVL, G. L., & SHANNON, D. T. Treatment of anxiety through systematic desensitization in therapy groups. Journal of Abnormal and Social Psychology, 1966, 71, 124-135. SUINN, R. M. The desensitization of test anxiety by group and individual treatment. Behaviour Research and Therapy, 1968, 6, 385-387.
Group Systematic Desensitization and Group Insight Therapies for Test Anxiety 1 JAMES F. LOMONT~ AND LEWIS J. SHERMAN University o'f Missouri--St. Louis Changes in test anxiety in college students were compared among three groups: (1) those who received group-administered systematic desensitization, (2) those who received group insight therapy, and (3) a no-treatment control group. The, measures of tes~ anxiety included a questimmaire, course test grades, and performance on a laboratory reading test. There was no difference in anxiety reduction among the groups, despite the fact that all the systematic desensitization subjects completed their stimulus hierarchies at least twice. Also, there was no significant change of any group on any of the measures. A number of studies (Cohen, 1969; Donner & Guerney, 1969; Garlington & Cotler, 1968; Ihli & Garlington, 1969; Kondas, 1967; Suinn, 1968) have obtained evidence that systematic desensitization administered on a group basis is an effective means of reducing test anxiety in college students. However, these studies provide fairly consistent evidence for the efficacy of group desensitization only in terms of self-report measures of test anxiety. In terms of the only behavioral measure used more than once, vis., improvement in grade point average, the results are inconsistent. Two (Donner & Guerney, 1969; Johnson & Sechrest, 1968) out of five studies which compared desensitization, unconfounded, with a nontreatment control group and used grades as a dependent variable found a positive effect of desensitization. The other three studies (C0hen, 1969; E m e r y & Krumboltz, 1967; Garlington & Cotler, 1968) did not show any effect of desensitization on grades. Two more studies (Katahn, Strenger, & Cherry, 1966; Paul & Shannon, 1966) that combined group desensitization with counseling on study methods found grade improvement associated with desensitization. Several studies (Cohen, 1969; Emery & Krumboltz, 1967; Ihli & Garlington, 1969; Suinn, 1968) have further indicated that the greater therapist time economy of group than of indi1The authors express appreciation to the Office of Research Administration, University of Missouri-St. Louis, for providing financial support for this study. Requests for reprints should be sent to James F. Lomont, Psychology Department, University of Missouri-St. Louis, 800'1 Natural Bridge Road, St. Louis, Mo. 63121. 511
512
LO~ONT
AND
SHERidAN
vidual desensitization for test anxiety is not purchased at the price of lesser effectiveness. This evidence, then, suggests that group systematic desensitization may be a quite efficient method of coping with the common college student problem of test anxiety, but further investigation of its effects on course grades and other behavioral measures is required for solid establishment of its value. The present study was directed in part to this need. Evidence for the value of group systematic desensitization as a treatment for test anxiety is also deficient in regard to any clear indications of its superiority over traditional group counseling. In the only two studies (Crighton & Jehu, 1969; Doctor, Aponte, Burry, & Welch, 1970) that did compare group systematic desensitization with group counseling, neither treatment was clearly superior to the other. However, these comparisons are weakened by the fact that the studies lacked adequate no-treatment control groups. A second purpose, then, of the present study, was to make a comparison between group systematic desensitization and group counseling as treatments for test anxiety in college students. This study is unusual among investigations of systematic desensitization treatment of test anxiety in that it involved the following three different kinds of measures of test anxiety: (1) self report, (2) academic course grades, and (3) a laboratory reading test, in which opportunity for preparing for the test was controlled and special measures were taken to make the test stressful. METHOD
Subiects Six male and 19 female college students from introductory psychology at the University of Missouri-St. Louis constituted the subjects. These subjects were selected from the introductory psychology classes on the basis of meeting three criteria: (1) Exceeding certain cutoff scores on the debilitating and facilitating anxiety scales of the Alpert-Haber Test Anxiety Scale (Alpert & Haber, 1960) (DA and FA, respectively). More specifically, to be invited to participate in the study a student had to have obtained a score of at least 30 on DA (out of a possible 50) and a score no higher than 23 on FA (out of a possible 45). Of 396 students in the introductory psychology classes 119, or 30%, met this criterion; (2) Explicit indication on a standard form that the student felt he was "significantly bothered" by test anxiety; and (3) indication on the same form of willingness to participate in an investigation of test anxiety for pay at the rate of $1.50 an hour should he score above a certain level on the inventory just taken (the Alpert-Haber). Strictly speaking, in the respect that the subjects were paid rather than individuals voluntarily seeking help, this study is an analog study. The students were not told prior to the experiment that the study was going to be an investigation of methods for treating test anxiety, merely that their participation
TWO
THERAPIES
F O I l TEST A N X I E T Y
513
could involve as many as 10 sessions and 11 hr of their time. They were not told beforehand definitely how much time would be involved because they could b e assigned to either of the experimental groups or to the control group, the control group being seen only for testing before and after the therapy given to the experimental groups. There were initially nine subjects in each of the three groups. However, the systematic desensitization group later lost one male subject due to voluntary withdrawal, and the control group lost one male subject to the military draft.
Measures Four measures of test anxiety were used to assess the effects of the therapies received by the experimental groups. Three of these were administered within the 2 weeks prior to the beginning of the experimental therapies and the week after the termination of these treatments. Two of these three measures, DA and FA, have already been mentioned as criteria measures for subject selection. Two studies (Ihli & Garlington, 1969; Mitchell & Ingham, 1970) have found a decrease in DA in testanxious college students following systematic desensitization, and in one of these studies (Mitchell & Ingham, 1970) the decrease was greater than in an untreated control group, there being no control group in the other study. The latter study also found an increase in FA following desensitization, whereas no such change was found in the former study. A third measure was a sort of laboratory measure ( L M ) of test anxiety. In the first session of the experiment proper, all subjects, seen in groups of four to eight, were given LM. Intended as a simulation of an academic course test, this test has the advantage over a course test of better control of the testees' preparation for it. This control consisted of having the subjects prepare for the test in the laboratory by studying the items covered b y the test immediately before taking it. The items were three relatively easy passages that had been used for testing in a speed reading course, and the test itself consisted of three separate questionnaires on the three passages. The subjects were told to exchange their passages for the questionnaires when they were through with the reading, and they were allowed a maximum of 55 min to read the passages. To maximize the significance of the test, and hence its anxiety arousal to the subjects, they were told that it had been found to be a good predictor of future success in business and professional occupations. It was described as being better for predicting such success than other tests by virtue of indicating how well a person could gain information from reading in a limited amount of time. In addition, to enhance the significance of their performance all subjects were told that the test was being used in a research project investigating personality characteristics of students who did worse on this test than on the American College Entrance Examination ( A C E ) , which they had all taken. They were also told that students who did do worse on the test than on the ACE would be asked to serve as subjects in further testing, Presumably, the possibility of being singled out for further testing would lend importance to the subject's performance on the test and, consequently, make it more like a course test in its anxiety arousal. To set the stage for plausible readministration of the test after therapy h a d been completed with the experimental groups, the subjects were told that they would be asked to take the test again in several weeks so that more reliable scores, based on ~,vo administrations of the test, could be obtained.
8 9 8
n
34.75 ± 4 . 1 3 33.56 ± 2 , 8 8 35.63 ± 4.81 32,25 ± 8 . 1 7 33.33 ± 7 . 7 0 37.88 ± 4 . 4 2
12.88 ± 2.75 12.44 ± 4,16 10.86 ± 4 . 3 0
DA
14.88 ± 4.45 ° 12.89 ± 2.67 ° 9.71 ± 4.53 °
LM
" S D T = S y s t e m a t i c desensitization t h e r a p y . b I T = Insight therapy. c C = Control.
Pretherapy measures SDT a IT b Cc Posttherapy measures SDT IT C
Group
20.25 ± 3 . 2 8 20.00 ± 4 . 3 3 19.63 ± 4 . 0 6
19.63 ± 2 . 9 2 19.56 ± 2 . 6 0 19.25 ± 1.49
FA
Group means ± SD
59,13 ± 6,69 6 3 . 0 0 ± 10.51 68.00 ± 11.46
55.75 ± 6 . 2 7 57.33 + 14.28 64.75 ± 11.31
CT
19.00 ± 5.42 20.56 ± 4.88 22.88 ± 9 . 8 6
ACE
TABLE 1 Results ( G r o u p Means ± S D ) of P r e t h e r a p y and P o s t t h e r a p y M e a s u r e s and on A C E Social Science S t a n d a r d Score
P~
0
©
¢J(
TWO THERAPIES FOR TEST ANXIETY
515
The subject's score on LM was the number of his wrong answers to 45 questions on the reading passages. The final measure of test anxiety (CT, for course test) was the subject's performance on two of the actual examinations in his introductory psychology course. Although these tests lack the advantage of control over preparation that is afforded by LM, they have, by comparison with LM, the asset of being more clearly genuine instances of stressful test situations. The first course test was given 2 weeks after the two therapies began, and the second test, which was the final examination, was given approximately 2 weeks after the therapies ended. They were both multiple-choice tests.
Procedure The subjects were equally divided in random fashion among the two experimental groups and the control group. The three groups did not differ significantly on any of the pretherapy measures. Table 1 shows the means and SDs of the three groups on the three pretherapy measures. The two experimental groups were then seen separately as groups for eight weekly 50-rain sessions. The control group subjects were not seen during the time period spanned by these sessions. The group systematic desensitization was administered by a therapist ( J F L ) who had had 8 years of experience with individual systematic desensitization. In the first therapy session with the systematic desensitization ( D T ) group, the experimenter began by explaining the rationale of systematic desensitization as a treatment for test anxiety. He then instructed the subjects to make up test anxiety stimulus hierarchies individually as homework for the next session, explaining to them in detail how to do this. The rest of the session was spent training the subjects in deep muscle relaxation. The second session was begun with the experimenter reviewing the test anxiety stimulus hierarchies which the subjects had constructed. Only two of the hierarchies required any alteration, and their authors were advised as to how to make the needed changes. About half the session was then devoted to further practice of relaxation. The remainder of the session was spent in initiating the systematic desensitization procedure itself. In this procedure, all subjects together imagined their test anxiety stimulus hierarchies on signal from the experimenter. When the experimenter gave the signal for stimulus visualization, each subject imagined whatever item in his hierarchy he was then working on. The subject kept track of his progress in his hierarchy and ascertained what item he should be imagining at any given time by means of a sheet of paper bearing his hierarchy. For each stimulus visualization trial, as soon as a subject gained a visual image of the item he was working on, he signalled the experimenter by briefly raising his hand. Then he continued to imagine the same situation until he experienced the slightest degree of fear, tension, or anxiety, o r m failing this--until the experimenter said "relax." At whichever of these two events occurred first, he was to stop imagining the anxiety stimulus and visualize being in a pleasant, relaxing situation until the signal for the next anxiety stimulus was given. If, on a given stimulus visualization trial, a given subject did not experience any anxiety from the time he signaled image attainment to the experimenter's relaxation signal, he was to imagine the next higher item in his hierarchy on the next trial. The subject did not give any overt indication as to when he was moving from one hierarchy item to the next. By this procedure, the subject was to begin with the least disturbing item in his hierarchy and work his way up his hierarchy. If the subject finished his hierarchy before the termination of therapy, he was to
5]~6
LO3.IONT AND SHER~,IAN
begin the procedure over, starting again with the lowest item in his hierarchy. By the end of the therapy, all subjects had completed their hierarchies at least twice. The insight group met week]y for 1.5 hr over the 8 weeks of the study. The group was conducted by LJS who had had 15 years' experience with this therapeutic approach. Emphasis throughout the sessions was on expression of feelings and selfunderstanding. Members were permitted and encouraged to discuss any issues they wished within the group. Naturally enough, the early discussion focused on test anxiety specifically and school performance generally. Hovever, this discussion soon extended to an exploration of more general personal concerns such as feelings of loneliness and alienation, parental conflict, and identity crises. In no instance were any specific suggestions or recommendations concerning the management of test anxiety offered to the members. The restriction of each therapist to one treatment method might have confounded differences in therapists with differences between the therapies. However, this assignment of therapists to treatments did provide for the administration of each therapy by an experienced, enthusiast_'c practitioner of that therapy. Consequently, both treatments were given a better chance of showing themselves at their best than if they had been counterbalanced with respect to the thmapists. Within a week after both experimental groups had . -eived 8 weeks of therapy, all subjects, including the control group, were again administered the LM and DA and FA measures, LM being administered prior to DA and FA. Because of scheduling problems, the two experimental groups were tested separately at the times they had met for therapy. The control g"oup subjects were divided for testing between two other times. The p~sttreatment LM was administered by facult nbers other than the therapists for the experimental groups. This was done p~ qvoid the possibility that the administration of the test to the experimental s~, y their therapists would a]leviate their test anxiety. It was done also to .,'orroborate the instructions that the test was being given as part of research other than the investigation of test anxiety. RESULTS T a b l e 1 shows the pre- a n d p o s t t h e r a p y scores. T h e t h r e e groups w e r e c o m p a r e d on L M a n d C T b y analyses of covariance. This t y p e of analysis was u s e d to p r o v i d e statistical control of intelligence; t h e A C E social sc!enee a p t i t u d e score was t h e covariate. T h e d e p e n d e n t v a r i a b l e in one analysis was t h e L M score, e i t h e r pre- or postt r e a t m e n t , a n d in t h e o t h e r analysis t h e d e p e n d e n t v a r i a b l e was CT, e i t h e r p r e - or p o s t t r e a t m e n t . In b o t h analyses, t h e i n d e p e n d e n t v a r i a b l e s w e r e ( 1 ) t h e t w o kinds of t h e r a p y a n d ( 2 ) p r e - vs p o s t t h e r a p y . T h e r e was no significant effect in e i t h e r analysis. A n a l y s e s of v a r i a n c e w e r e perf o r m e d on D A a n d FA, t h e i n d e p e n d e n t v a r i a b s b e i n g t h e s a m e as in t h e analyses of covariance. T h e s e analyses also y i e l d e d no significant effect. F i n a l l y , s e p a r a t e t tests of t h e t w o g r o u p s ' c h a n g e s on e a c h dep e n d e n t v a r i a b l e d i d n o t show a significant e h a n v e in e i t h e r g r o u p on a n y of t h e measures.
TWO THERAPIES FOR TEST ANXIETY
517
DISCUSSION The results not only fail to indicate any difference in the effectiveness of the two therapies, they do not indicate any effectiveness of either treatment. In view of the evidence for reduction of test anxiety b y systematic desensitization in other studies, the total absence of such evidence in the present study is particularly surprising. There was not even a demonstrable effect of desensitization on DA, despite the decrease in DA with systematic desensitization in two other studies (Ihli & Garlington, 1969; Mitchell & Ingham, 1970) and the reducing effect of desensitization on test anxiety as measured by other inventories in still other studies ( D o n n e r & Guerney, 1969; Garlington & Cotler, 1968). If the subjects receiving desensitization had not been able to progress through their hierarchies, then this failure in hierarchy completion could have been held responsible for t})e ineffectiveness of desensitization in reducing test anxiety. However, in ,act all subjects did complete their hierarchies, and not just once, but twice. Consequently, according to any conceptualization of systematic desensitization commonly entertained by behavior therapists, anxiety reduction should have generalized from the imagined form
of the hierarchy s~: :11i to their real form. That this generalization did not occur sugges ',t the factors which can seriously affect the effleacy of systematic ~,:fzation are not presently fully understood. REFERENCES ALPEaT, R., & HA~En, lq. N. Anxiety in academic achievement situations. Journal of Abnormal and Social Psychology, 1960, 61, 207-215. COliN, R. The effects of group interaction and progressive hierarchy presentation on desensitization of test anxiety. Behaviour Research and Therapy, 1969, 7, 15-26. CRICHTON,J., & JEI-IV,D. Treatment of examination anxiety by systematic desensitization or psychotherapy in groups. Behaviour Research and Therapy, 1969, 7, 245-248. Doe-ton, R. M., A2ONTE, J., BtmaY, A., & WELCH, R. Group counseling versus behavior therapy in treatment of college underachievement. Behaviour Research and Therapy, 1970, 8~ 87-90. DONNEa, L., & GUERNEY,B. G., JR. Automated group desensitization for test anxiety. Behaviour Research and Therapy, 1969, 7, 1-14. EMERY, J. R., & KatrMBOLTZ,J. D. Standard vs. individualized herarchies in desensitization to reduce '~est anxiety. Journal of Consulting Psychology, 1967, 14, 204-209. GARLINCTOr¢, W. K., & COTLEn, S. B. Systematic desensitization of test anxiety. Behaviour Research a,7,d Therapy, 1968, 6, 247-256. IrILI, K. L., & GAnLINGTO,~,W. K. A comparison of groups vs. individual desensitization of test anxiet~ 3ehaviour Research and Therapy, 1969, 7, 207-210. JOI~NSON, S. M., & SEC EST, L. Comparison of desensitization and progressive re-
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]axation in treating test anxiety. Jtmrnal of Coltstdling and Clinical Psychology, 1968, 280-286. KATAHN, M., S°rnENCER, & CrIE~a¥, N. Group counseling and behavior therapy with test anxious students. Journal of Consulting Psychology, 1966, 30, 544--549. KONDAS, O. Reduction of examination anxiety and 'stage-fright' by group desensitization and relaxation. Behaviour Research and Therapy, 1967, 5, 275-282. MITCrmLL, K. R., & INCHAM, R. J. The effects of general anxiety on group desensitization of test anxiety. Behaviour Research and Therapy, 1970, 8, 69-78. PAVL, G. L., & SHANNON, D. T. Treatment of anxiety through systematic desensitization in therapy groups. Journal of Abnormal and Social Psychology, 1966, 71, 124-135. SUINN, R. M. The desensitization of test anxiety by group and individual treatment. Behaviour Research and Therapy, 1968, 6, 385-387.