THE PREVENTIVE USE OF ANXIETY MANAGEMENT TRAINING FOR HOTLINE VOLUNTEERS (JOB-RELATED STRESS, BURNOUT, SUPPORT SYSTEMS, COPING-SKILLS TRAINING)

Anxiety Management Training (AMT) is a coping-skills training program by which people are taught how to manage their anxiety by conditioning competing responses (muscle relaxation, visualization) to the anxiety response itself. Since the treatment is not dependent on the external cues for anxiety, it has been an effective treatment for a wide range of anxieties and, theoretically, should generalize to prevent future anxiety. Virtually no studies have examined AMT's preventive effects. This study examined the effects of AMT when given over 4 weeks to a group of people before they underwent a stressful experience of extended duration. AMT was given to a group of students working on a university-based crisis intervention hotline, at the very beginning of their hotline training and telephone work. The effects of AMT in minimizing job stress and reducing levels of self-reported state anxiety specific to stressful hotline situations and in decreasing trait anxiety were studied. Additionally, performance measures (grades) and staff ratings of hotliners' anxiety during training and on shift were obtained. AMT's effects were compared to a credible attention placebo group and to a no-treatment control group. Treatment effects were minimal: AMT and placebo group subjects both showed reductions in state anxiety sooner in the semester and scored lower on the Depersonalization subscale of the Maslach Burnout Inventory than did control group subjects. Students in general, regardless of group, showed consistent reductions on behavioral and self-report indicators of anxiety (intensity and interference of anxious symptoms and trait anxiety). Students in general also improved their hotline performance. The influence of treatment and placebo factors was examined to account for the similar changes noted in the AMT and placebo groups. The changes that occurred for all three hotline groups were explored in light of Bandura's self-efficacy theory and Meichenbaum's stress inoculation model as they might relate to the hotline experience itself. The role of support systems in reducing anxiety was also addressed.