Guided Mastery Treatment of Phobias

Guided mastery treatment (Williams, 1990) is a performance-based approach to phobia therapy derived from social cognitive theory (Bandura, 1986, 1988; Cervone & Williams, 1992) and its component self-efficacy theory (Bandura, 1988, in press; Williams, 1996). It is applicable to a broad range of specific and generalized phobias in both children and adults. In the self-efficacy analysis, phobic disability and distress result from people having lost their sense of self-efficacy, or confidence, that they can deal effectively with phobia-related activities or objects. Because people are most convinced that they can manage an activity by their own success at doing so, guided mastery treatment stresses overt performance mastery. The therapist's role is to promote performance successes by bringing to bear various techniques to enable clients to tackle scary tasks, and to execute them proficiently. Treatment is a collaboration between therapist and client in which the goal is to keep in motion a reciprocal interaction between increases in self-efficacy and greater performance successes, eventuating in mastery. This approach differs in important ways from phobia treatment conceived in terms of stimulus exposure and anxiety extinction (see Williams, 1990). >