Guided Mastery

Description of the Strategy

Guided mastery is a therapeutic method of assisting clients in raising their self-efficacy (i.e., perception that a task can be accomplished) so they are motivated to attempt, and subsequently accomplish, progressively more difficult tasks that are involved in the implementation of behavioral therapies. As proficiency and flexibility of performance are accomplished, therapeutic assistance is gradually withdrawn. For instance, exposure to progressively greater anxiety-provoking situations is the treatment of choice for individuals who evidence problems associated with anxiety disorders (e.g., panic disorder with agoraphobia). In the utilization of guided mastery, a therapist might encourage and assist the individual in accomplishing a situation that is associated with a low degree of anxiety (e.g., walking in the shopping center with a friend) prior to attempting a situation that evokes slightly more anxiety (e.g., walking in the shopping center without a friend). In the latter situation, the therapist would conduct various cognitive-behavioral strategies to increase the individual's self-efficacy during the exposure trials (e.g., encourage objective thinking, praise effort, teach relevant coping skills).

There are several strategies involved in guided mastery, including performing tasks jointly, modeling, overcoming problematic subtasks, graduating tasks, setting proximal goals, graduating the treatment setting, and giving physical and mechanical support. Performing tasks jointly is important when attempting to improve self-efficacy, because people often feel more capable when a trusted companion is present. Indeed, in performing tasks jointly, clients feel confident that assurance and assistance are available; thus, they will attempt greater accomplishments. Another technique to improve self-efficacy is to model successful accomplishment of therapeutic tasks, verbally describing behavior or showing a video of behavior in order to give concrete guidance relevant to the execution of the behavior. Modeling is especially useful when attempting to eliminate defensive behaviors or awkward performance and may also be used jointly with other techniques. A small aspect of an activity that is troubling may significantly lower self-efficacy for the entire activity, thus restricting efforts to attempt the respective task. Therefore, focusing on overcoming problematic subtasks can be a powerful technique in guiding the client to mastery.

Another alternative is to graduate tasks so that they become progressively more difficult. In this strategy, the client first attempts a strategy for which self-efficacy is relatively high, and upon accomplishing this task feels more prepared to accomplish the next task, and so on. The latter strategy is enhanced by setting proximal goals. In this method, a goal is set for each task involved in the hierarchy of tasks to be accomplished. Thus, accomplishment of each goal provides a feeling of accomplishment and preparedness for the upcoming task of greater perceived difficulty. Graduating treatment settings involves attempting related tasks in settings that are perceived to be increasingly more difficult. Thus, the client improves self-efficacy through the generalization process. Physical or mechanical support might include manually guiding an individual in the accomplishment of a task (e.g., holding the bicycle seat while a child first learns to ride). As with the other methods of guided mastery, assistance would be gradually withdrawn (e.g., holding the bicycle seat with less support as the child's riding improves).

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