Vicarious and direct counterconditioning of test anxiety through individual and group desensitization

Bchav.

Res.

% Therapy.

1969,

Vol.

7. pp.

359 co 367.

Pcrgamon

Press.

Printed

in England

VICARIOUS AND DIRECT COUNTERCONDITIONING OF TEST ANXIETY THROUGH INDIVIDUAL AND GROUP DESENSITIZATION * JAY MANN and

TED LEE ROSENTHAL

University of Arizona

Summary-Vicarious and direct desensitization were compared for individual and group treatment of test anxiety. Fifty seventh-graders were assigned by stratified random sampling to the following treatment conditions: direct-individual; vicarious-individual; direct-group; group-observing-group; group-observingmodel. Twenty-one eighth-graders served as no-treatment controls. Upon completion of the experimental phase, al1 subjects were administered a measure of test anxiety and a reading test. As predicted, experimental subjects improved significantly, relative to controls, on both outcome measures: as further expected, the experimental variations did not produce significantly different outcomes among treatment conditions. Neither sex of subject nor assignment to alternative therapists qualified the findings. NUMEROUS researchers have studied the measurement and reduction of test anxiety (e.g. Mandier and Sarason, 1952; Sarason and Mandler, 1952; Sarason, Mandler and Craighilt, 1952). The problem appears to be widespread. Eysenck and Rachman (1965) estimate that 20 per cent of school children fear examinations, and many students with apparent scholastic ability perform poorly because of their anxiety (Alpert and Haber, 1960; Paul and Erikson, 1964). Emery and Krumboltz (1967) report the effects of test anxiety to include: inability to organize logical and coherent answers to essay questions; impairment of normal eating and sleeping patterns on the day preceding an examination; and the experience of “going blank” when facing a difficult mathematical problem. Further, it has been found that highly anxious students receive lower grades and sustain a higher rate of academic failure, than do nonanxious students of equivalent intelligence (Spielberger and Katzenmeyer, 1959; Spielberger, 1962). The high incidence of test anxiety (TA) and its debilitating effects on academic performance create a strong need for preventive and remedial programs in the schools. Such programs do not yet exist, in part because effective techniques for reducing TA have only recently been devised. Moreover, despite the evidence from current studies (Emery and Krumboltz, 1967; Katahn, Strenger and Cherry, 1966; Kondas, 1967; Paul and Shannon, 1966; Suinn, 1968) that variants of Wolpe’s (1958) systematic desensitization method can remove or reduce TA, procedures must be devised applying Wolpe’s technique * This paper was based on an M. A. thesis conducted by the first author with the guidance of the second author, and submitted to the Department of Psychology of the University of Arizona. The assistance of the other committee. members, Richard W. Coan and George W. Hohmann, is gratefully acknowledged. We wish to express appreciation to Charles F. Grubbs, Kathryn Gildon and Clarence 1. Logan of Tucson School District One, for their splendid cooperation with the execution of this research. We wish aho’to thank Susan Eissele, who assisted in the conduct of treatment, and Albert Bandura and S. I. Kachman, who provided editorial consultation.

359

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J.&Y 4!.-\NN

and

TED

LEE

ROSENTHAL

to larger SrOllpS if currsnt needs are to be met without considerable expansion of school staffs. This paper prsssnts s:idence that the principles of vicarious learning discussed by BJndura (1965, 1969) may be combined krith systematic desensitization for treating large numbers of test-anxious students effectively faith a limited expenditure of therapist time. In a review of the TA literature, lClann (1969) concluded that most investigators using methods &riced from insight therapies have reported marginal or conditional changes and that their rssults suggest a limited efficacy of insight-oriented methods for reducing T.4. in COntr3.jt. the OLltCO~~~jof desensitization studies v.ith both direct indiL-idual and group methods appeared highly encouraging. The52 findings led to the hypothesis that. by Ivhatever variant of des:nsitization. e\ptrimsntal subjects should display greater reduction of T.-\ than should untrrlated controls. Rectnc evid
?vIETHOD

School counselors referred each S after they had counseled him for reported TA on at least one occasion, Of 50 s,xperimental Ss, 27 lvere female and 23 male; all were 12-13 yr old and in szventh grade. Of 21 control Ss 12 were female and 9 male; all were 13-14 yr old and in eighth grade. The proportions of males and females did not differ significantly bztiveen experimental and control groups. Ss were students at the same junior high school in Tucson, Arizona. and Lvere predominantly from middle-class backgrounds. It \vas required that all students of a given grade level serve either as experimental or control Ss; this constraint was imposed to forestall parental criticism anticipated by school authorities had some members of a given class been randomly selected while others were by-passed. Depetdetlt

measures

Initial assessment was conducted nine weeks before the end of the spring semester, 1968 : (treatment was begun within one week thereafter). Two measures of TA were employed: a Test Anxiety Scale (TAS) almost identical with that used by Emery and Krumboltz (1967); the first form of the Gates-McGinnitie Readin, u Test (GM). The self-report TAS measure Leas modified only by replacing lower-frequency words, e.g. “anxious”, by higherfor use with younger Ss, and this modified version is frequency words, e.g. “nervous”, presented in the original report (Mann, 1969). On this measure, control group scores ranged from 23 to 68 with a mean of 48.5; the experimental Ss displayed more initial TA, with scores ranging from 23 to 91 2nd a mean of 53.9.* The GM provided a criterion worksample of test-taking that requires acquisition and retention of information under time X In order to partial out the elects of initial TAS differences between experimentals and upon TAS and G\f change, analyses of covariance were subsequently performed. These analyses that, with initial TAS differences controlled, no qualification of main results was required.

controls revealed

VICARIOUS

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pressure and, consequently, would be sensitive to the debilitating effects of anxiety. Furthermore, this test was available in presl~mably-equivalent alternate forms suitable for the age range of the Ss. On this measure, the oider controls initially displayed a mean of 39.7, higher than the experimental mean of 36.3.

Experimental Ss were ranked according to their initial TAS scores and were then assigned by stratified random sampling (to approximately equalize group means) to one of two subgroups in each of the following treatment conditions: (n) individual direct desensitization; (b) individual vicarious desensitization; (c) group direct desensitization; (d) vicarious group desensitization, observing direct desensitization of a group; (e) vicarious group desensitization, observing direct desensitization of a peer model. Peer models were provided by two students with TAS scores close to the mean, who had been referred for treatment and kvho were directly desensitized; since their treatment (conducted before five observers) was not comparable to that of the direct individual condition (conducted with one observer), these children were considered only as models, and their TA changes were not analyzed in the results. Within each of the five treatment conditions, half the Ss were randomly assigned to the first author for desensitization and the other haif to a female graduate student some 23 yr younger than he. Thus, if personal characteristics of the therapist play a prominent role in these treatment procedures, the differences in sex and age of the present therapists might plausibly create differential treatment outcomes. Procedure The precise jnstructions and technical details of procedure are provided in the original report (Mann, 1969). In individual conditions, one direct S observed by one vicarious S constituted a dyad; in group conditions, either five direct Ss or a model was observed by five vicarious Ss. Assignment to a dyad or group remained constant throughout treatment. In the vicarious groups observing models, the male therapist desensitized a female model, and the female therapist desensitized a male model. Vicarious Ss were so seated that they could see and hear the procedures administered to the direct Ss (or the model) and were encouraged to learn as much as they could. They were informed at the first session that the more carefully they attended the more they would learn and benefit; they were also advised and permitted to emulate direct Ss if they chose but were not otherwise instructed subsequently. The possibility of practice at home, between sessions, was mentioned to al/ Ss but was not required, urged, or monitored by the therapist. The same l&item TA hierarchy employed by Emery and Krumboltz (1967) was used throughout this study. In group conditions, completion of an item was geared to the slowest direct group member, who had to signal no tension on three successive triais before the next item was introduced. If any direct S signalled anxiety, the therapist would revert to the prior (completed) item before returning to the item that had evoked the tension response. Two sessions were devoted to relaxation training. The entire hierarchy was mastered by all direct Ss after from four to six treatment sessions. A minimum of three items and a maximum of five items were completed per treatment session. If Ss completed five items, the session was terminated; otherwise, sessions were of approximately 50 min duration. Two review sessions (numbers 7 and 8) recapitulated the topmost 12 hierarchy items at the rate

367

JAY SI.-~YY’ and

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LEE KOSENTH.AL

of six per treatment session. All direct Ss successfully completed the repeated presentation of these items. After the completion of treatment. the TAS and the second form of the GM were administered to all experimental Ss and to the control group. It should be noted that this assessment closely preceded the impending semester final-examinations at the school. RESULTS”’ It is of interest to first determine the pre- to post-treatment changes for the experimental and control groups separately. On the TAS measure, the pooled experimental Ss exhibited a highly significant decrease after treatment (mean change = - 16.1; r=7.26; p
levels reported

in this study

are based

on rwo-tailed

probability

estimates

VICARIOUS

AND DIRECT

COL~TERCONDITIONING

OF l-EST ANXIETY

363

initial TAS score was correlated with subsequent change on TAS and on GM; these coeficients proved signi~cant for both the TAS (r=@Sj; p<@OOtf and GM jr=@29; p < 05) measures. Consequently, analyses of covariance were performed adjusting change scores to compensate for the initial TAS differences. These analyses revested that. with initial TAS Ievel controlled, the experimental group continued to exhibit highly significant improvement, relative to the controls, both on the TAS variabie f F= 14.69 ; d.,/: = I /68 ; p < 0401 f, and on the GM variable (F=&97; d..f= l/68; p
Although desensjtization has been found to improve self-reported TA, this appears to be the first study showing significant improvement on a specific criterion measure of test-taking as well as on self-reports. Unlike Suinn’s (1948) untreated controls, whose TA scores decreased when retested on the same measure, here, control Ss displayed a slight increase in TA over time, possibly because of the approach of actual semester examinations at the time of reassessment. One may surmise that similar factors affected the GM changes and, in such case, the results would emphasize the apparent efficacy of treatment in counteracting the stress of impending final examinations. The possible roles of therapist attention and of expectation effects based on performing any activities in the guise of treatment have been studied by Paul (1966) and by Davison (1968). Both these writers found that actual * Inspection of the mean changes for the two group-vicarious treatments revealed greater apparent improvement on both variables for the ~~ou~b~rv~ng-~ou~ procedure. To rule out differences between these procedures, they were compared by one-way analysis of variance, which revealed no significant difl’erences on either dependent measure. Add~tjona~~y~ treatment-by-levels analyses were performed excluding the soup-ob~~~n~-rnode~ data, and comparing only the four other groups (which were symmetrical in numbers of vicarious Ss paired with direct S’s during treatment). These analyses also failed to approach significance. It should be noted that all experimental graups proved quite comparable on iniriui TAS level, with means that ranged only from 53.4 to 54.6.

364

JAY

MANN

and

TED LEE ROSENTHAL

-3iZECi --“ic**lo”s . ClO”P 3

,NDI”IO”AL

I

I I INITIAL

MEANS

ilNA1

MEAN.

FIG. I. TAS changes by experimental group.

41

INITIAL

MEANS

FIG. 2.

CM

FINAL

changes

MEANS

of experimental group.

desensitization far surpassed “attention-placebo”, “pseudo-desensitization”, or sheer exposure groups in treatment outcome. The faifure to find outcome differences between SS treated by quite diff’erent male and female therapists supports prior evidence (Paul and Shannon, 1966) that personal differences among trained therapists do not appear to greatly influence the results of systematic desensitization. Nor do personal differences between therapists appear to affect modeling outcomes. Bandura, Hanchard and Ritter (1968) report no significant differences between the results achieved by dissimilar male and female therapists with either desensitization or modeling.

VICARIOUS

AND

DIRECT

CO~~~RCO~~ITIONI~G

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That the vicarious groups improved no less than (and even tended to surpass) the direct groups in magnitude of improvement appeared striking and warrants further investigation. One might plausibly have expected direct treatment to be more effective for a number of reasons, including the following: Unlike vicarious Ss, who received almost no therapist attention, direct Ss were the focus of the therapist’s efforts. Unlike the vicarious Ss, who could only progress through the hierarchy at a pace geared to others, the techniques, e.g. item-presentation, were adjusted to observed and reported anxiety-level changes in direct Ss. One might well ask how vicarious Ss managed to improve as much as did direct Ss. Since direct Ss held their eyes shut during sessions, it does not seem very plausible that they were adversely influenced by peer scrutiny. Alternatively, if the desire to appear fearless before peers had distorted the direct Ss’ reports of anxiety, this should aIso have hampered outcome in the direct group treatment which did not. in fact, differ from the direct individual treatment. If one regards desensitization procedures as learning trials (Davison, 1968), and treats perception of progress through the hierarchy, and therapist attention and approval, as Berger (I 96 I), Craig (I 967), reinforcements, prior research provides a possible explanation. Hillix and Marx (1960), and Kanfer and hilarston (1963), all have found that Ss who observe in learning situations perform better than Ss who are directly reinforced for their own actions. Hillix and Marx (1960) suggest that this effect may result because participant errors or the necessary but additional activity of making decisions (e.g. reporting tension changes on item-trials when questioned by the therapist) may impede retention of correct responses. Since vicarious Ss observed the procedure without responding to questions or instructions froin the therapist, they might have encountered less interference than did direct Ss. An alternative, but not jncompatible, explanation could be based on l~otivated selfinstruction. One finds clinically that desensitization patients may modulate the rate of item-presentation or modify slightly the content of hierarchy or rest items to better approximate their idiosyncratic preferences and the subtle details of their milieux and experiences. The direct Ss were, relatively, constrained to follow the therapist’s rate of presentation and a uniform stimulus hierarchy. The vicarious Ss were freer to vary both rate and precise details of items. This flexibility could have conteracted the problematical advantages of the focused procedure given direct Ss. The behavior of vicarious 5% during sessions makes this conjecture at least plausible. A range of response was observed among vicarious Ss in the course of treatment. Some executed the ongoing procedures sporadically; others, although not required to copy, often imitated the procedures step-by-step, simultaneously with their direct counterparts. In any case, considerable further research is needed to control and to expiicate the effects of active rehearsal and covert self-instruction which were not explicitly manipulated for vicarious Ss in the present study. The practical importance of the faiIure to find significant outcome differences among experimental treatments requires emphasis. If group procedures yiefd results comparable to individual methods, and if vicarious techniques approximate the outcomes of direct techniques, the less costly methods are economically preferable. Thus, investment in therapeutic films, or closed-circuit television facilities in which large numbers of patients could benefit from observing the treatment of others, are clear\; implicit clinical applications which await subsequent con~rmation of the present results. Obviously, the limits upon group-size for multiple and vicarious treatment require further exploration and specification. Moreover, it is acknowledged that with larger-sample designs, variations of

366

JAY

WANN

and TED LEE ROSESTHAL

technique, or treatment of different complaints, theoretically important differences may be found among individual, group, vicarious, and direct procedures. For clinical purposes, however, the present results combined with the above-cited findings of 3andura and his associates, provide considerable evidence that the less costly methods may equal or surpass the more expensive procedures in pragmatic utility. In this regard, some anecdotal material reported by parents and students is of interest in amplifying the clinical resuits and suggesting directions foi future research. One mother reported that her asthmatic son was successfully inhibiting asthma attacks with the relaxation technique learned during the study. Other mothers claimed a variety of helpful uses for relaxation; these included reducing anxiety before a dental examination, before a piano recital, and before class recitations. Several children themselves volunteered that they felt generally less tense in classrooms or sociai situations. These observations appeared to further corroborate the usefulness of the treatments studied, and suggested that, in some cases, treatment-based effects were generalized to spheres of behavior not specifically countercondi~ioned. REFERENCES situations. J. abtror~n. sec. Psychol 66, 207-216. BANDURA A. (1965) Vicarious processes: A case of no-trial learning. in Advarlces in Experimental Social Psychology (edited by L. BERKOWITZ),Vol. 2, pp. l-55. Academic Press, New York. BAN~URAA. (1969) Principks o/‘Behar,ior Modifcorion. Holt, Rinehart & Winston, New York. BANDURA A., GRUSEC J. E. and MENLOVEF. L. (1967) Vicarious extinction of avoidance behavior. J. Person. sot. Psychol. 5, 16-23. RANC)URAA. and MENLOVE F. L. (1968) Factors determining vicarious extinction of avoidance behavior ALERT

R. and

through

HATER R. (1960) Anxiety in academic achievement

symbolic

modeling.

J. f’ersa~.

sot. Psycho/. 8, 99-10s.

HANDURAA., BLANCHARDE. D. and RITT~KB. J. (1968) The relative efficacy of desensitization and modeling approaches for inducing behavioral, affective, and attitudinal changes. Unpublished manuscript, Stanford University. BANDURAA. and ROSENTH;\LT. L. (1966) Vicarious classical conditioning as a function of arousal level. J. Person. SOC. F~ychol. 3, 54-62. BEKGEKS. M (1961) Incidental learning through vicarious reinforcement. Psychol. Rep. 9, 477491. CRAIG K. D. (1967) Vicarious reinforcement and non-instrumental punishment in observational learning. J. Person. sot. Psycho/. 7, 172-176.

D,\vrso~ G. C. (1968)

Systematic

desensitization

as a countercondirioning

process.

/. abnorjn. Psycho/.

73, 91-99.

and KRUMBOLTZJ. D. (1967) Standard versus individualized hierarchies in desensitization to reduce test anxiety. J. cowwe/. Psychol. 14, 234-209. EYSENCK H. J. and RACHMANS. (1965) T/je Causes and Cures of Xewosis. Routiedge & Regan Paul, London. HIL~~XW. A. and MARX M. H. (1960) Response strengthening by information and the effect on human learning. J. exp. Psychoi. 60, 97-102. HOVLANDC. 1. and PRITZKERH. A. (1957) Extent of opinion change as a function of amount of change advocated. 1. abaorttt. me. Psycho/. 54, 257-261. KANFERF. H. and MARSTONA. R. (1963) Human reinforcement: Vicarious and direct. J. exp. Psycho/. EVEKY J. R.

65, 292-296. K.AT.AHN M.,

STREXGERS. and CHERRY N. (1966) Group counseling and behavior therapy with test-anxious college students. J. consult. Psychol. 30, 544-549. KO?IDAS0. (1967) Reduction of examination anxiety and “stage-fright” by group desensitization and relaxation. Behav. Res. & Therapy 5, 275-281. MANDLER G. and SARA~~NS. B. (1952) A study of anxiety and learning. J. abnorm. sm. Psycho!. 47, 166-173.

(1969) A comparison of the effects of direct versus vicarious individuai and group desensitization of test-anxious students. Unpublished M.A. thesis, University of Arizona. PAUL G. (1966) Insight versus Desensitization in Psychotherapy. Stanford University Press, Stanford. J. Persona&y PAUL G. and ERI~CSENC.W. (1964) Effects of test anxiety on “real-life” examinations. XIANN J.

32,48M94.

‘v’ICARIOCS AND DIRECT

COLVIERCOSDlTIOSl~G

OF TEST ANXIETY

x37

PAUL G. and S~~A>XOND. T. (1966) Treatment of anxiety through sysrematic desensitization in therapy groups. f. abnorm. Psychoi. 71, 17-I-135. ROSENTHALT. L. (1964) clnxiery-proneness and susceptibilir) to social influence. (Doctoral dissertation, Stanford University) Ann Arbor, >lich.:Universi?y Xlicrotilms. No. 64-1645. ROSENTHALT. L. (1966) Anxiety-proneness and susceptibility to social influence. clrch. gzs. Ps~chol. 118, 15-33. SARAF,~NS. B. and MAXDLERG. (1952) Some correlaies of test anxiety. J. abnorm. sot. Ps~ckot. 47, SIO-817. SARXXINS. 3.. S~AIVDLER G. and CR..UCHILLP. 6. (1952) The effect of differential instructions on anxiety and learning. J. abnorm. sot. Ps&~oi. 47, 561-565. SPIELBERGER C. D. (1962) The effects of manifest anxiety on the academic achievement of college students. &fen. 17y.e. 66, 12W26. SPELBERGERC. D. and KATZEWEYER W. G. (1959) hlanifest anxiety, intelligence, and college grades. 3. consair.Prychol. 23, ‘78. SCINX R. hf. (1968) The desensitization of test-ansiety by group and indikiduai treatment. B&nv. Res. & Tkerapy

6, 3853S7.

WOLPEJ. (1958) Fs_vckorkerap_v b,v Reciprocal inkibirion. ZIMB~\RDO P. G. (1960) Invoivemen: and communication J. nhnorm.

sot. Ps.vchoi. 60, 8694.

Stanford University Press, Stanford. discrepancy as determinants ofopinion

conformity.