Page 47 - JSOM Winter 2021

SUPPLEMENTARY MATERIALS
Phase III (Adaptation / Exposure) Session 8: Adaptation Lab
Application and Follow Through Education: Effective graduated exposure training strategies: ratio-
Trainees are provided opportunities to practice skill sets cultivated in nale, activity selection, and sequencing. Effective training techniques
Phases 1 and 2 adaptively. Trainees receive more comprehensive train- (integration of physiologic and cognitive self-monitoring applica-
ing, learning effective strategies from graduated exposure training tions) and learning strategies (optimizing training plans with SUDS
focusing on rationale, and learning effective self-training techniques measurement system). Awareness and approach techniques (SMART
(activity selection, sequencing, repetition, hierarchical training plan de- goal setting).
sign). SUDS is used to generate and monitor training plans. Trainees Adaptives: Interactive simulations with partially worked-out exam-
apply goal-setting strategies, training activity selection, and sequencing ples leveraging Catalytics, while demonstrating graduated exposure
techniques weekly. practices and SUDS in building effective real-world training plans.
Trainees participate in “lab” to build initial training plan (hierarchy)
Biomechanical Awareness/Control skills from Phase I are integrated elements.
into self-monitoring practices during graduated exposure training to en-
hance stress tolerance and emotion regulation capacity, self-efficacy, and Session 9: Guided Imagery and Mental Rehearsal
confidence in skills application. Education: Application of techniques to enhance relaxation practice
(Guided Imagery) and approach to graduated exposure activities
Mental Agility/Mental Flexibility skills from Phase II are integrated and
applied to analyze patterns, countermeasure performance degrading (Mental Rehearsal).
thoughts and beliefs, install gains and more effective, performance en- Adaptive: In-vivo training follow-up and weekly item selection, strat-
hancing thoughts. egizing/troubleshooting, interactive demonstrations using trainee-
Key strategies are reviewed and monitored with a deliberate focus on generated examples. Guided Imagery demonstration and Mental Re-
self-attribution of successes, cultivation of self-efficacy, and strengthen- hearsal build.
ing cues to implement all skills adaptively in real-life situations. Mainte- • Applied DBR and PMR with HRV biofeedback using Guided Im-
nance skills/plans are formulated in the last two sessions; gold-standard agery and Mental Rehearsal.
trauma-focused treatments (Cognitive Processing Therapy/Prolonged Session 10: Behavioral Coping, Communication, and Assertiveness
Exposure [CPT/PE]) are introduced as an extension of Phase III, as a Education: Self-evaluation, progress monitoring, and individual
means of further enhancing skill sets and recovery. needs analysis. Applied installation techniques for performance mon-
Overarching Goal: Support application of skills adaptively and effec- itoring and reinforcement. Styles of communication and assertiveness
tively; ensure acquisition of skills necessary for real-world application. techniques.
Transition to trauma-focused treatment as appropriate. Application: In-Vivo training follow-up and weekly item selection,
strategizing/troubleshooting, interactive demonstrations using trainee-
Objectives: Adaptive Real-World Skill Application generated examples. Applied Mental Rehearsal with DBR and PMR
• Practice Phase I and Phase II Skill Sets with HRV biofeedback.
• Plan, practice, and evaluate self in structured, graduated exposure
practice while performing skills in avoided and valued activities, en- Session 11: SIT Maintenance + Momentum
hance performance/stress tolerance Training: Skills review, collaborative discussion, and installation of
• Actively prepare for self-maintenance or transition to trauma-focused progress. Identification of goals and maintenance needs, including
treatment (CPT/PE) as needed. ongoing trauma-focused treatment (PE/CPT rationale, elements) and
relationship to SIT goals/strategies.
Application: Complete progress/self-care assessment and mainte-
nance plans.

Stress Inoculation Training: A Performance Training Protocol, Part 1 | 45