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Reduction of musical performance anxiety by attentional training and behaviour rehearsal : an exploration… Kendrick, Margaret Joan 1979

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cop • 1 REDUCTION OF MUSICAL PERFORMANCE ANXIETY BY ATTENTIONAL TRAINING AND BEHAVIOUR REHEARSAL: AN EXPLORATION OF COGNITIVE MEDIATIONAL PROCESSES by MARGARET JOAN KENDRICK B.A., University of B r i t i s h Columbia, 1971 M.A., University of B r i t i s h Columbia, 1975 A DISSERTATION SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF DOCTOR OF PHILOSOPHY i n THE FACULTY OF GRADUATE STUDIES (Department of Psychology) We accept t h i s dissertation as conforming to the required standard THE UNIVERSITY OF BRITISH COLUMBIA A p r i l , 1979 (g) Margaret Joan Kendrick, 1979 I n p r e s e n t i n g t h i s t h e s i s i n p a r t i a l f u l f i l m e n t o f t h e r e q u i r e m e n t s f o r a n a d v a n c e d d e g r e e a t t h e U n i v e r s i t y o f B r i t i s h C o l u m b i a , I a g r e e t h a t t h e L i b r a r y s h a l l m a k e i t f r e e l y a v a i l a b l e f o r r e f e r e n c e a n d s t u d y . I f u r t h e r a g r e e t h a t p e r m i s s i o n f o r e x t e n s i v e c o p y i n g o f t h i s t h e s i s f o r s c h o l a r l y p u r p o s e s m a y b e g r a n t e d b y t h e H e a d o f my D e p a r t m e n t o r b y h i s r e p r e s e n t a t i v e s . I t i s u n d e r s t o o d t h a t c o p y i n g o r p u b l i c a t i o n o f t h i s t h e s i s f o r f i n a n c i a l g a i n s h a l l n o t b e a l l o w e d w i t h o u t my w r i t t e n p e r m i s s i o n . D e p a r t m e n t o f . T h e U n i v e r s i t y o f B r i t i s h C o l u m b i a 2 0 7 5 W e s b r o o k P l a c e V a n c o u v e r , C a n a d a V 6 T 1W5 oatP k p e v l j i i . Abstract The present study evaluates attentional t r a i n i n g and behaviour rehearsal i n treating musical performance anxiety and i n modifying s e l f - t a l k and perceptions of s e l f - e f f i c a c y . Pianists who experienced extreme anxiety in. performing situations were randomly assigned to the following conditions: ( l ) attentional t r a i n i n g (n = 19), (2) behaviour rehearsal (n = 16), (3) waiting l i s t control (n = 1 8 ) . Three therapy sessions were conducted over a three-week period with subjects i n the f i r s t two conditions meeting i n small groups for one and one-half to two hours. Subjects i n the attentional t r a i n i n g program were taught to become aware of t h e i r negative thoughts ' before, during, and after t h e i r performances and to substitute these negative thoughts with positive task-relevant self-statements. Cognitive r e c a l l from videotaped performances and cognitive-modeling slide-tape sequences f a c i l i t a t e d t h i s process. Subjects i n the behaviour rehearsal program were given a rationale for the effectiveness of repeated performance before a small supportive audience i n reducing performance anxiety. Both treatments required performances during therapy sessions and i n home assignments. A multivariate analysis of covariance revealed no difference among the three groups at post-treatment on self-report, behavioural, or physiological measures. At a five-week follow-up, however, attentional t r a i n i n g and behaviour rehearsal were more effective than the waiting l i s t control condition i n reducing v i s u a l signs of anxiety and improving the quality of playing. Attentional t r a i n i n g was superior to behaviour rehearsal i n reducing v i s u a l signs of anxiety. i i i . Two scales were developed to measure the cognitive mediational variables of self-talk and self-efficacy. At follow-up, both treatments were superior to no treatment i n increasing positive and decreasing negative thinking surrounding performances. Attentional training was superior to the other two conditions i n enhancing expectations of personal efficacy. Behaviour rehearsal did not surpass the attentional training treatment on any of the six dependent measures, at follow-up. These findings were discussed i n relation to previous research on attentional training and behaviour rehearsal, and to the cognitive mediational processes common to both therapies. Issues such as modeling effects, expectancy effects, follow-up, home assignments, subject att r i t i o n , and implications for the musical community were also discussed. i v . Table of Contents Page Abstract i i Table of Contents i v L i s t of Tables v i i L i s t of Appendices v i i i Acknowledgements x OVERVIEW 1 REVIEW OF THE LITERATURE 6 Performance Anxiety 6 — Musical Performance Anxiety 7 ~~ Treatment Approaches to Performance Anxiety 10 The Cognitive Perspective 10 Se l f - i n s t r u c t i o n a l t r a i n i n g 11 Attentional t r a i n i n g 13 Behaviour Rehearsal 18 Cognitive Mediational Variables Influencing Performance Anxiety . . 24 Se l f - t a l k 24 Expectations of Personal Efficacy 27 The Measurement of Performance Anxiety 29 Cognitive, Behavioural, and Physiological Components of Anxiety 29 Self-report, Behavioural, and Physiological Measures of Performance Anxiety i n the Present Study 30 STATEMENT OF THE PROBLEM 33 THE DEVELOPMENT OF A SCALE TO MEASURE SELF-TALK 35 Method ., 35 Results. 36 Discussion* . . • 38 V. THE DEVELOPMENT OF A SCALE TO. MEASURE EXPECTATIONS OF PERSONAL EFFICACY 39 Method 39 Results 41 Discussion ... 41 A COMPARATIVE EVALUATION. OF ATTENTIONAL TRAINING AND BEHAVIOUR . REHEARSAL IN TREATING. MUSICAL PERFORMANCE ANXIETY 43 Method 43 Subjects 43 Experimental Room 43 Experimenters and Therapist . 44 Self-report Measures 44 Behavioural Measures 46 Physiological Measures 47 Apparatus and Equipment 48 Procedure 49 Selection of subjects 49 Administration of pre- and post-treatment assessment sessions . 51 Follow-up assessment 52 Administration of Attentional Training and Behaviour Rehearsal Treatments 53 Attentional t r a i n i n g 53 Behaviour rehearsal 56 Post-study Workshops for Control Subjects 57 Results 58 Pre-measures 58 Practice Time and Number of Performances, between Pre- and Post-treatment Assessments 63 Characteristics of the Follow-up Performance 64 Expectations of Treatment Effectiveness for Attentional Training and Behaviour Rehearsal Groups 64 Inter-rater R e l i a b i l i t i e s . 65 Treatment Outcome 67 Post-study Workshop for Behaviour Rehearsal and Waiting L i s t Control Groups 69 Relationships Among Dependent Variables 69 v i . Predictor Variables 71 Relationship of Improvement on the Dependent Measures to C l a s s i f i c a t i o n and Process Variables . . . 74 Discussion ^5 Modeling Effects 81 Expectancy Effects 83 Follow-up 84 Post-study Workshop 85 Home Assignments 85 Measures 86 Interrelationships among Indices . . . 89 Subject A t t r i t i o n 90 Implications for the Musical Community . 91 Footnotes 93 Reference Notes 94 References 95 Appendices 103 v i i . L i s t of Tables Page Table 1 Means, Standard Deviations, and F Values for Demographic and other C l a s s i f i c a t i o n Variables . . . 59 Table 2 Means and Standard Deviations of Outcome Measures . . . 61 Table 3 Inter-Rater R e l i a b i l i t i e s i n Percentages 66 Table 4 Analyses of Covariance Summary Tables 68 Table 5 Interrelationships among Dependent Measures at Pre-Treatment 70 Table 6 Interrelationships among Dependent Measures at Follow-up 72 Table 7 Post-Treatment Measures as Predictors of Outcome . . . . 73 v i i i . L i s t of Appendices Page APPENDIX A Consensual V a l i d i t y Test on the Performance Anxiety Self-Statement Scale (Form l ) 103 APPENDIX B Item Analysis Test on the Performance Anxiety Self-Statement Scale (Form 2) 113 APPENDIX C Fifteen Items from the Report of Confidence as a Performer 122 APPENDIX D Threat Value of Magnitude Items from the Expectations of Personal Efficacy Scale . . . . . . 123 APPENDIX E Threat Value of Generalization Items from the Expectations of Personal Efficacy Scale 125 APPENDIX F Subject Selection C r i t e r i o n 127 APPENDIX G Expectations of Treatment Effectiveness 128 APPENDIX H Expectations of Personal Efficacy Scale 129 APPENDIX I Performance Anxiety Self-Statement Scale ( F i n a l Form) 131 APPENDIX J Instructions f o r Performance Error Tabulation . . . . 135 APPENDIX K Performance Error Tabulation Sheet . . . . 136 APPENDIX L Consensual V a l i d i t y Test on Visual Signs of Performance Anxiety i n Pianists 137 APPENDIX M Timed Behavioural Checklist for Piano Performance . . 138 APPENDIX N Letter to Piano Teachers 139 APPENDIX 0 Telephone Screening Procedure . . . 141 APPENDIX P Consent Form H 3 APPENDIX Q Pre-Treatment Practice and Performance Information and Instruction Sheet . . . . . 144 APPENDIX R Post-Treatment Practice and Performance Information Sheet 145 APPENDIX S Follow-Up Performance Instructions for Attentional Training Subjects 146 i x . Page APPENDIX T Follow-Up Performance Instructions f o r Behaviour Rehearsal and V/aiting L i s t Control Subjects 147 APPENDIX U Information on Follow-Up Performance 148 APPENDIX V Significant Other Ratings of Visual Signs of Anxiety and Quality of Playing during Follow-Up Performance 149 APPENDIX W Therapist Manual for Attentional Training Sessions 150 APPENDIX X Therapist Manual for Behaviour Rehearsal Sessions 170 APPENDIX Y Therapist Manual for Attentional Training Workshop 176 APPENDIX Z Post-Workshop Follow-Up Instructions for Behaviour Rehearsal and Waiting L i s t Control. Subjects 177 APPENDIX AA Anticipated Effects of Success and Failure Models on the Performance of Observers 178 X. Acknowledgements Many people contributed to the successful.completion of t h i s study. I would f i r s t l i k e to mention those who served as members of the super-visory committee: Dr. Park Davidson (Chairman), Dr.. Ken Craig, Dr. David Lawson, Dr. Bob Knox, and Dr. Susan Butt-Finn. Dr. Dale Reubart was music consultant for the study. I would also l i k e to mention those who assisted i n carrying out the research. Outstanding were the contributions of Denise Bjerring and Judy Shotton who rated the audiotapes and served as models i n the s l i d e -tape sequences, Bob and Isobel Harrison, who rated the videotapes, and Elaine Smith who helped to administer the two assessment sessions. Denella Sing and Vance Hoy also helped by serving as models i n the s l i d e -tape sequences. Mrs. Helen S i l v e s t e r provided her studio for the performance assessments, and Trudy and Greg Morse, Mrs. E. Long, and Mrs. P. Wilson provided homes for the therapy sessions. In addition to the pianists i n the main study, there were many other musicians who assisted i n the development of the two scales and contributed ideas at various stages along the way. Ruth A l l a n p a t i e n t l y and s k i l l f u l l y typed the manuscript. Dr. Jan Nordin played a major role at every stage of the dissertation. In addition to.encouragement and moral support throughout, he photographed the modeling sequences, operated the polygraph and.video equipment, and did a l l the computer analyses. I would l i k e to express my deep appreciation to a l l these people for t h e i r time and help. This dissertation i s dedicated to my mother and to the memory of my father. 1. OVERVIEW In recent years behavioural theory, research, and practice have been extended to include "private events" - that i s , what we think, imagine, and f e e l . The cognitive behaviour modifier conceptualizes problematic behaviours as the result of faul t y patterns of thought (Wilson, 1978). There has been a burgeoning development of cognitive therapeutic techniques for a variety of problematic behaviours. These cognitive strategies attempt to modify maladaptive behaviours by changing the images and/or self-statements which the c l i e n t emits p r i o r to, duringand/or following overt behaviour. The cognitive trend i s ref l e c t e d i n the publication of a journal, Cognitive Therapy and Research, and a number of recent books devoted e n t i r e l y to the. topic (e.g., Beck, 1976; Foreyt and Rathjen, 1978; Meichenbaum, 1977). Although much enthusiasm has. been generated for t h i s trend i n behaviour therapy, there i s as yet l i t t l e evidence to demonstrate that i t i s superior to a more t r a d i t i o n a l behaviour therapy approach. An analysis by Ledwidge (1978) of controlled studies comparing the effectiveness of cognitive therapy techniques with t r a d i t i o n a l behaviour therapy procedures, revealed that neither was superior. Ledwidge's review prompted a deluge of accusations but also thoughtful consideration of some important issues. Ledwidge was c r i t i c i z e d for his assumptions about the nature of cognitive behaviour modification (Mahoney and Kazdin, i n press), his assumptions about the nature of behaviour therapy (Locke, i n press), and his "selective reporting" and "misrepresentation" of some of the studies (Meichenbaum, i n press). In addition, Meichenbaum questioned the usefulness of a comparative 2. evaluation of behaviour therapy versus cognitive behaviour therapy when differences among s p e c i f i c therapies, subjects, and outcome measures are ignored. There seemed to be general agreement, however, that a l l therapies are to some extent both cognitive and behavioural. As Mahoney and Kazdin pointed out, the behaviour therapist r e l i e s heavily on verbal communication during treatment and the cognitive behaviour therapist r e l i e s on behavioural performances as a primary means of challenging maladaptive b e l i e f s . This makes d e f i n i t e d i s t i n c t i o n s between the two approaches somewhat arbitrary. There was also agreement on the importance of empirical research i n evaluating treatment effectiveness. In responding to Ledwidge's position that cognitions are not behaviours and therefore cannot be made the object of proper s c i e n t i f i c study, Locke stressed the need to continue the development of methods to measure cognitions more accurately, rather than to abandon t h i s search prematurely. There was p a r t i c u l a r l y strong agreement on the need for more research with c l i n i c a l populations. The fact that two different approaches appear to be equally effective i n changing behaviour raises the question of what i t i s that accounts for t h e i r effectiveness. I t may be that instead of focusing our e f f o r t s on whether cognitive or behavioural techniques are superior, we should look for the factor or factors i n both which account for t h e i r effectiveness. An attempt has been made (e.g., Bandura, 1977) to i d e n t i f y a single cognitive mediational process which could account, for the e f f i c a c y of a variety of therapeutic techniques from widely d i f f e r i n g schools of psychology. Bandura postulated that psychological procedures achieve changes i n defensive behaviour by a l t e r i n g perceptions of s e l f - e f f i c a c y . 3. An efficacy expectation i s the conviction that one can successfully execute the behaviour required to produce certain outcomes. Such expectations influence choice of a c t i v i t i e s and the i n t e n s i t y and persistance of e f f o r t at those a c t i v i t i e s . From Bandura's viewpoint, i t may be that a cognitive and a t r a d i t i o n a l behavioural approach are successful because they both.raise c l i e n t s ' expectations of personal efficacy. Meichenbaum (1977) also theorized about mechanisms of change involved i n a l l therapeutic procedures. He proposed that behaviour change occurs through a sequence of processes involving the interaction of inner speech, cognitive structures, and behaviour. Although each therapy approach might focus primarily on only one of these three mechanisms, a l l three are viewed as being important i n change. Meichenbaum has developed techniques based on his assumption that a l t e r a t i o n of s e l f - t a l k i s the most direct form of therapeutic intervention. From Meichenbaum's viewpoint, i t may be that a cognitive and a t r a d i t i o n a l behavioural approach are successful because they both at some point a l t e r s e l f - t a l k . This search for a single mediational. process underlying therapeutic change has necessitated the development of new tools to measure such cognitive processes as perceptions of s e l f - e f f i c a c y and s e l f - t a l k . Bandura, Adams, and Smith (1977) have recently developed an instrument s p e c i f i c a l l y for the measurement of s e l f - e f f i c a c y i n snake phobic c l i e n t s . Other scales for use with other populations are needed i n order to extend the findings of Bandura et a l . S i m i l a r l y , the direct assessment of s e l f - t a l k i s also new. U n t i l recently, changes i n in t e r n a l speech were not assessed but were assumed to accompany changes i n overt behaviour. Scales have been developed to assess positive and negative A. thoughts r e l a t i n g to assert!veness (Schwartz and Gottman, 1976), c r e a t i v i t y (Henshaw, 1977), and test anxiety (Sarason, 1978). Further research on different samples i s obviously needed to validate the relationship of negative thinking to behavioural d e f i c i t . In comparing the effects of therapies i n terms of t h e i r common mediational processes, a suitable and challenging target population should be chosen. Since previous studies involving college undergraduates may be li m i t e d i n . t h e i r g e n e r a l i z a b i l i t y , i t is"particularly.important to study non-student populations, more s p e c i f i c a l l y , c l i e n t s who are sel f - r e f e r r e d f o r a problem which i s functionally related to t h e i r day-to-day l i v e s (Kazdin, 1-978). In recent years there has been an increased interest i n modifying anxiety i n a wide variety of evaluative situations (such as written exams, speeches, a t h l e t i c s , and musical performances). To the extent that a musical performance i s unique in.that i t incorporates elements of each of the others, i t may represent a particular, challenge to the researcher and therapist. Musical performance.anxiety i s also an inter e s t i n g problem to study because a t r a d i t i o n a l behavioural technique i s widely used i n the musical community as a way of treating i t . Behaviour rehearsal or repeated performance before an audience i s used by many musicians, both amateur and professional, as a way of coping with anxiety about upcoming performances. In fa c t , quite apart from the comparison ^ i t could afford with a cognitive-behavioural technique, thet . t-. widespread use of behaviour rehearsal for musical performance anxiety alone would, appear to warrant an investigation of i t s effectiveness. In taking a cognitive therapy approach, attentional t r a i n i n g would seem to be a useful strategy for reducing performance anxiety i n 5. musicians. This i s indicated by the c r i t i c a l importance of complete control of attention i n performing on a musical instrument, and by s i m i l a r i t i e s of musical performance with test anxiety,'for which attentional t r a i n i n g has been effective (Sarason, 1975a, 1978; Wine, 1971). There are, however, several important differences, notably the fine motor s k i l l involved i n playing an instrument, and i t has been suggested that an approach which does not involve relaxation t r a i n i n g may not be effective i n treating anxiety when a fine motor s k i l l i s involved (Wardle, 1975). Attentional t r a i n i n g , however, has not been evaluated with such a problem. In order to maximize maintenance of therapeutic change, the attentional t r a i n i n g should be cast i n a self-management framework. Although i t i s premature to draw conclusions as to the effectiveness of self-management procedures, t h e i r use has been recommended by Kazdin (1975) as one way of enhancing response maintenance over time and across settings. The comparison of behaviour rehearsal with self-management attentional t r a i n i n g , allows an interesting comparison between what musicians and what psychologists are currently recommending as the most e f f i c i e n t way to reduce performance anxiety and maintain improvement. More importantly, the design chosen i n the present study allows an investigation of the r e l a t i v e effectiveness of the attentional t r a i n i n g and behaviour rehearsal treatments, and of the. cognitive mediational processes common to both. REVIEW OF THE LITERATURE Performance Anxiety 6. In one of the most widely-known and highly regarded experiments i n psychotherapy research, Gordon Paul (1966) set a precedent with his position that performance anxiety was a legitimate problem for psychological intervention. The importance of treating such problem behaviours can be argued from a preventive point.of view. By increasing the competence of. individuals to deal with problems they encounter i n t h e i r everyday l i v e s , t h e i r behavioural repertoires can be strengthened to withstand stresses which might otherwise lead to more serious disruptions and expen-sive, .and- at aime-consuming therapeutic interventions (Iscoe, 1974; Sanford, 1968; Zax and Specter, 1974). I t should not, however., be assumed that anxiety w i l l always affect performance i n a negative way. Lomas (1937) found that public speakers who reported severe performance anxiety gave speeches judged least satisfactory, those who reported moderate performance anxiety gave speeches judged superior, and those who reported l i t t l e or- no •_. ~ performance :.anxiety. gave-speeches judged mediocre. The objective then would be the development of effective methods of reducing anxiety to the l e v e l necessary f o r optimal performance. Since Paul's study, a number of other investigators have focused t h e i r attentions on anxiety reduction i n a variety of performance situations. Attempts have been made to modify performance anxiety i n public speakers (e.g., Casas, 1975; Fremauw and Harmatz, 1975; Meichenbaum, Gilmore, and Fedoravicius, 1971), students taking written exams (e.g., Finger and Galassi, 1977; Holroyd, 1976: Meichenbaum, 1972; Sarason, 1972a, 1973, 1975b, 1978; Wine, 1970), performing athletes 7. (e.g., Suinn, 1972), and performing musicians (e.g., Appel, 1976; Goldstein, 1975; James, G r i f f i t h , Pearson, and Newbury, 1977; Lund, 1972; Wardle, 1975). Musical Performance Anxiety Some degree of musical performance anxiety i s experienced.by"most musicians, both amateur and professional, during t h e i r musical careers. In the present investigation i t i s defined as a tra n s i t o r y subjective, behavioural, and physiological response to a s p e c i f i c stress s i t u a t i o n , that of piano solo performance before an audience. That i t i s worthy of investigation i s evidenced by the following statement: The need to develop several effective methods of reducing high degrees of performance anxiety i s evident. Failure to overcome the performance anxiety problem may contribute to i n e f f i c i e n t use of acquired musical s k i l l s and negative performing experiences, s u f f i c i e n t l y negative to discourage students from further study of music. There i s a dearth of experimentation i n the f i e l d of musical performance and performance anxiety, and considerable need exists for more well-controlled studies (Appel, 1976, p. 14). Reduction of performance anxiety i n a musical sight-reading s i t u a t i o n with an audience, has been reported by both Lund (1972) and Wardle (1975). Systematic desensitization, relaxation t r a i n i n g , and "insight therapy" treatments a l l s i g n i f i c a n t l y diminished self-reported anxiety and performance errors r e l a t i v e to a no-contact control group, although t h e i r effects on physiological measures were not evaluated (Lund, 1972). Wardle used systematic desensitization, and relaxation t r a i n i n g (combined with supportive discussion) as therapeutic techniques f o r two different groups. He s i g n i f i c a n t l y reduced performance anxiety i n both t r a i n i n g groups r e l a t i v e to a no-contact control as measured by reduced heart rates and reduced observable signs of anxiety. There was no difference 8. among groups on number of errors and overall quality of playing. Wardle concluded that relaxation t r a i n i n g i s essential i n reducing anxiety when motor a c t i v i t i e s are involved. He did not, however, investigate effects on self-report of anxiety, or the effectiveness of relaxation t r a i n i n g alone, as i t was combined with an. emotive hierarchy i n one group and supportive discussion i n the other. In a more refined study, Appel (1976) compared systematic desensiti-zation focusing on control of the physiological.anxiety response, music analysis focusing on more complete i n t e l l e c t u a l mastery of the material, and an assessment control.. The systematic desensitization group showed the greatest improvements on physiological, self-report, and performance measures. Only performance errors were s i g n i f i c a n t l y reduced by the music analysis group. Control subjects showed the least improvement. Goldstein (1975) evaluated the effectiveness of a cognitive approach, Systematic Rational Restructuring (Goldfried, Decenteceo, and Weinberg, 1974), in.reducing performance anxiety i n p i a n i s t s . In.a comparison with systematic desensitization, neither treatment resulted i n changes which were s t a t i s t i c a l l y different from placebo and waiting l i s t controls. James, G r i f f i t h , Pearson, and Newbury (1977) investigated the effects of oxprenolol versus a placebo on performance anxiety i n s t r i n g players. S i g n i f i c a n t improvements from oxprenolol were found i n q u a l i t y of performance, self-report of anxiety, and pulse rate immediately before performance. The investigators j u s t i f i e d the use. of a drug to treat "normal" subjects under acute emotional stress, by pointing out that informal surveys among musicians, suggested that alcohol and sedatives were already widely used regularly on a long-term basis to cope with the adverse effects of performance anxiety. Drugs were therefore not being introduced where none was previously used. In addition, the investigators 9. suggested that the need for the drug would probably lessen with time. The potential side effects of oxprenolol (Wade and Reynolds, 1977, pp. 1 3 2 2 - 1 3 2 3 ) together with the possible development of psychological dependence on the drug argue against i t s use. Thus the popular trend of taking a p i l l as the f i r s t way of coping with a problem i s of great concern. Psychological therapies therefore would ce r t a i n l y be preferrable to the use of drugs i f the former are equally effective i n reducing perfor-mance anxiety. 10. Treatment Approaches to Performance Anxiety The Cognitive Perspective Much of the recent interest and research i n cognitive behaviour therapy i s based upon Ellis's.(1962) emphasis on the c l i e n t ' s i r r a t i o n a l b e l i e f s and the s e l f - t a l k aspect of anxiety. In his Rational Emotive Therapy, E l l i s d i f f e r e n t i a t e d the fear of a r e a l environmental danger from anxiety, which he claimed i s caused by a person's i r r a t i o n a l fear of an imagined stimulus. E l l i s further assumed that a person's i r r a t i o n a l labeling of a si t u a t i o n and his s e l f - t a l k are responsible for maintaining anxiety. Beck (1970) agreed with E l l i s ' s explanation of anxiety and suggested that a c l i e n t ' s b e l i e f s are important i n determining behaviour and. should be viewed as appropriate targets for analysis and change i n cognitive behaviour therapy. Bergin (1970), however, c r i t i c i z e d cognitive mediational theorists because of a lack of empirical data to support t h e i r contentions. In addition, Bergin asserted that i t i s frequently a change i n behaviour that leads to a change i n cognitions rather than the reverse (as Beck presented i t ) . Thus although s e l f - t a l k was seen as important, i t s precise role had not been established. Although Bergin (1970) did not f i n d the evidence for the efficacy of cognitive behaviour therapy to be adequate, the research i n t h i s area i n the l a s t .10 years has considerably changed the status of the cognitive approach to problem behaviours. Mahoney and Arnkoff (1978) reviewed the studies on the cognitive learning therapies and concluded that after a r e l a t i v e l y slow s t a r t , the cognitive restructuring, coping s k i l l s , and problem-solving therapies are gathering growing support i n 11. c l i n i c a l outcome research. Two cognitive restructuring therapies emerging from E l l i s ' s work have been developed, and appear to have some empirical support. Systematic Rational Restructuring (Goldfried, Decenteceo,• and Weinberg, 1974) places Rational Emotive Therapy into a systematic program which attempts to make c l i e n t s aware of t h e i r maladaptive self-statements and to change t h e i r behaviour through persuasion, encouragement, and education i n the form of r a t i o n a l analyses. The research on the ef f e c t i v e -ness of Systematic Rational Restructuring i s s t i l l at.a preliminary stage. The results so far have been equivocal with some studies demonstrating i t s superiority over other techniques (e.g., Goldfried, Linehan, and Smith, 1978) while others show i t leads only to minimal changes (Casas, 1975; Goldstein, 1975). Although Self-Instructional Training (Meichenbaum, 1974) also aims to make c l i e n t s aware of t h e i r negative thoughts, there i s an important difference between the two approaches. The goal of Systematic Rational Restructuring i s broader - to help the c l i e n t get r i d of i r r a t i o n a l concerns and worries and place each si t u a t i o n into a more r e a l i s t i c perspective. The goal of Self - I n s t r u c t i o n a l Training i s more sp e c i f i c - to substitute self-oriented i n t e r f e r i n g responses with task-focused ones. Mahoney and Arnkoff (1978) pointed out that: Although the major emphasis of Rational Emotive Therapy i s the destruction of maladaptive b e l i e f s £and the same can be said of i t s behavioural counterpart Systematic Rational Restructuring], s e l f - i n s t r u c t i o n a l t r a i n i n g supplants t h i s with a constructive phase of s k i l l s development (p. 705). Se l f - i n s t r u c t i o n a l t r a i n i n g . Although the role of "private monologues" i n emotional experience and performance regulation has been recognized 12. for many years, i t i s only recently that verbal s e l f - i n s t r u c t i o n has become a topic of experimental interest. Some of the most extensive and c l i n i c a l l y impressive work i n t h i s area has come from Don Meichenbaum and his colleagues. Meichenbaum (1974) presented an integration of the cognitive and s t r i c t l y behavioural approaches to therapy that has a wide range of c l i n i c a l applications. Rather than looking at s p e c i f i c verbal-izations as targets for change, as a r a d i c a l behaviourist might, Meichenbaum suggested thinking s t y l e as a target for behavioural intervention. In his Self-Instructional Training, self-management and cognitive-behavioural approaches are combined i n a treatment designed to modify maladaptive behaviours through changing the way people t a l k to themselves. Clients are taught to become aware of t h e i r negative thoughts and to substitute them with positive self-statements. Independent r e p l i c a t i o n s , refinements, and extensions to a variety.of problems and populations corroborate a growing confidence i n the eff i c a c y of t h i s strategy (Meichenbaum, 1977). Several recent reviews (Meichenbaum, 1977, Note 1, Note 2, Note 3) reveal an increasing number of studies on Se l f - I n s t r u c t i o n a l Training with both adults and children experiencing a wide variety of problematic behaviours. Although most of the experimental a c t i v i t y has been confined to treatment outcome studies, more recently investigators have begun to "dismantle" Self-Instructional Training i n order to i s o l a t e . i t s c r i t i c a l components (e.g., Bowman, 1977; Novaco, 1975). One serious problem i n the research and c l i n i c a l application of treatment "packages" (such as Se l f - I n s t r u c t i o n a l Training), has been that each investigator or therapist has his or her own p a r t i c u l a r idea as to what components are involved and how much emphasis should be placed on each. This makes comparisons across studies very complicated. 13. In order to f a c i l i t a t e replications and comparisons of r e s u l t s , i t i s important that the components of programs and t h e i r r e l a t i v e emphases be c l e a r l y specified. The a v a i l a b i l i t y of treatment manuals i s important i n t h i s respect. The Se l f - I n s t r u c t i o n a l Training program as Meichenbaum (Note 4) conceived i t , incorporates progressive muscle relaxation as an i n t e g r a l part of treatment. I t appears, however, that S e l f - I n s t r u c t i o n a l Training can be effective without the relaxation component, at least for some problem behaviours. An example i s the attentional t r a i n i n g approach for c l i e n t s with test anxiety. Attentional t r a i n i n g . Much of the current research on performance anxiety has focused on the task-irrelevant ideation that highly test-anxious individuals experience i n evaluative situations. When performance i s being evaluated, high-anxious persons spend much of t h e i r time, (a) worrying about t h e i r performance and about how well others are doing, (b) ruminating over alternative answers, (c) being preoccupied with such things.as feelings of inadequacy, an t i c i p a t i o n of punishment, loss of status and self-esteem, and heightened somatic and autonomic reactions (Handler and Watson, 1966; Marlett and Watson, 1968). Following the early work of Mandler and S.B. Sarason (1952), Irwin Sarason (i960, 1972a, 1975a) and J e r i Wine (1971) suggested that the highly anxious i n d i v i d u a l divides attention between s e l f - and task-relevant variables, whereas the mildly anxious in d i v i d u a l focuses attention more f u l l y on the task. This hypothesis was consistent with abundant evidence that the high test-anxious person i s more self-preoccupied and self-deprecating than a person with low test anxiety (Sarason, I960; Wine, 1971). In addition, research demonstrated that these self-focusing tendencies 14. were activated by the testing s i t u a t i o n (Ganzer, 1968; Mandler and Watson, 1966; Marlett and Vfatson, 1968; Neale and Katahm, 1968). The d e b i l i t a t i n g effects of worry on performance on written tests have been documented by Liebert and Morris (1967), Spiegler, Morris, and Liebert (1968), Doctor and Altman. (1969), and Morris and Liebert (1970). The importance of autonomic arousal i n test anxiety has also been investigated. Liebert and Morris (1967) suggested that test anxiety i s composed of two major components, worry and emotionality. The worry component was described as cognitive concern over performance; emotionality as the autonomic arousal aspect of anxiety. In comparative studies, several investigators found that the emotionality component was less l i k e l y to interfere with the performance of high test-anxious persons than worry which required more of the individual's attention (Doctor and Altman, 1969; Morris and Liebert, 1969, 1970). In a review of the research, Wine (1971) found that autonomic arousal appeared to bear no consistent relationship to performance on i n t e l l e c t u a l or cognitive tasks, while worry was consistently and negatively related to performance. Wine concluded that worry, a d i s t r a c t i n g cognitive a c t i v i t y , i s more d e b i l i t a t i n g of task performance than arousal. Doctor and Altman (1969) reported that autonomic a c t i v i t y was less l i k e l y than worry to require attention, 'except at high levels where physiological r e a c t i v i t y might be d i s t r a c t i v e and annoying" (p. 364). I f worry Is a more Important factor i n test anxiety than autonomic arousal, attentional t r a i n i n g would appear to be the most appropriate treatment. In a l l e v i a t i n g test anxiety both Wine (1970) and Sarason (1972a, 1975a) suggested that i t might be s u f f i c i e n t to substitute task-relevant responses for the s e l f - o r i e n t i n g ones by means of 15. straightforward attention-directing instructions. This hypothesis was tested and.corroborated by Wine (1970) and Sarason (1972a, 1978). Wine found that attentional t r a i n i n g combined with relaxation t r a i n i n g resulted i n general improvement i n performance on i n t e l l i g e n c e tests and i n self-reported test anxiety, but no more so than did attentional t r a i n i n g alone. Sarason (1978) reported that test-anxious subjects' performance on an anagram task was s i g n i f i c a n t l y improved by advising subjects to be f l e x i b l e i n t h e i r approach and suggesting strategies for completing the task. This led to adaptive coping behaviour because i t reduced self-preoccupying thoughts that interfered with ongoing a c t i v i t i e s and because i t provided dir e c t i o n i n approaching a challenging s i t u a t i o n . Sarason (1973? 1975b) also documented the effectiveness of a coping model who verbalizes cognitive strategies, i n reducing anxiety i n high test-anxious individuals.. In the f i r s t study he demonstrated that a model's enunciation of general principles and suggestions for approaching a task helped high- but not low-anxious subjects. In the second study he found that observing a model who admitted to test anxiety but described ways of coping with i t , resulted i n s i g n i f i c a n t l y greater anxiety reduction than exposure to a model who only admitted to test anxiety, and to a model who did not s e l f - d i s c l o s e . These, findings suggested the value of incorporating a cognitive coping model into the attentional trai n i n g program. This discussion has been based on studies involving test-anxious c l i e n t s . I t may not be legitimate, however, to draw similar, conclusions when the target population i s performance-anxious musicians."'" Otto Deri (1972) made a case that the performing musician faces the s t i f f e s t t e s t . He stated that written examinations, a t h l e t i c endeavours and public 16. addresses do not make as many demands on the in d i v i d u a l as a musical performance. According to Deri, the musician must be i n absolute control of motor co-ordination involving the fin e s t muscle action, has to trust memory, and at the same time f e e l and project the music with authority and conviction. There are several important factors then, which distinguish musical performance from other types of performance anxiety. One essential difference between a musical performance and a written test s i t u a t i o n i s that i n the l a t t e r , a temporary lapse of concentration or overwhelming feelings of anxiety can occur and be followed by se l f - i n s t r u c t i o n s to cope through attention focusing or relaxation. In playing a musical instrument, concentration lapses and overwhelming feelings of anxiety are not "allowed." I f these do occur they are immediately and often d r a s t i c a l l y reflected i n the performance. In. contrast, i f the t e s t -anxious student can cope with intruding anxious thoughts and feelings, the examiner w i l l never know they have occurred. A difference between speech and musical performance situations i s that i t i s much easier to "ad l i b " i n speaking than i t i s to improvise musically, because i n the.latter ease a set piece of music well-known to at least some members of the audience i s performed. Perhaps the most c r i t i c a l difference between test and speech anxiety on the one hand and musical performance anxiety on the other, i s the complex motor s k i l l involved,In playing a musical instrument. Because musical performance involves a complex motor s k i l l , the suggestion that autonomic arousal i s less l i k e l y to inter f e r e with performance than worry or cognitive concern (Wine, 1971.) may be r e s t r i c t e d to test and speech situations. The evidence for Wine's conclusion comes from performance on " i n t e l l e c t u a l or cognitive tasks" and not on tasks which also involve 17. a complex motor s k i l l . Given the necessity of . good- ' control of motor co-ordination i n playing an instrument, i t may be that an approach involving muscle relaxation would be more effective i n reducing the anxiety associated with performing i n p u b l i c . I t i s not possible to ascertain however from the l i m i t e d number of studies on musical performance anxiety (Goldstein, 1975; Lund, 1972; Wardle, 1975), whether an approach which does not include relaxation tra i n i n g could be effective i n reducing anxiety as assessed by self-report, behavioural, and physiological indices. Lund and Wardle did not, evaluate changes i n a l l three response systems and Goldstein found no s i g n i f i c a n t differences among groups on any of the measures. Appel (1976), however, showed that a cognitive-type approach (music analysis) could be as effective as systematic desensitization i n reducing performance errors. In deciding whether attentional t r a i n i n g i s an appropriate treatment for performance anxiety i n musicians, i t i s necessary f i r s t to investigate whether high-anxious performers are more self-preoccupied and s e l f -deprecating than low-anxious performers. Meichenbaum (Note 2) cautioned that we often provide.therapy regimens without f u l l y exploring the nature of our c l i e n t s ' d e f i c i t s . I f musical performance anxiety i s associated with self-preoccupied and self-deprecating thinking, then an attentional t r a i n i n g approach would seem to be an appropriate method of treatment. In summary, although not yet evaluated, attentional t r a i n i n g would appear to be a useful technique for reducing performance anxiety i n musicians. This was suggested by i t s s i m i l a r i t y i n part to test anxiety for which attentional t r a i n i n g had been e f f e c t i v e , and by the c r i t i c a l importance of complete control of attention i n performing on a musical instrument. The effic a c y of a cognitive approach when a complex motor 18. s k i l l i s involved warranted further investigation. Behaviour Rehearsal Behaviour rehearsal i s based on the p r i n c i p l e of e x t i n c t i o n , which refers to the' reduction i n frequency of a behaviour as a function of occurrences that are nonreinforced (Woodworth and Schlosberg, 1954). In performance anxiety terms, t h i s means that performing without negative consequences w i l l lead to a reduction i n the anxiety associated with performing that p a r t i c u l a r behaviour. Studies of the effectiveness of behaviour rehearsal i n reducing anxiety suggest that i t i s an important component of treatment programs such as participant modeling (Bandura, 1971) and assertiveness t r a i n i n g (McFall and Twentyman, 1973), but that used alone i t i s not as e f f e c t i v e as other techniques (Bellack, and Hersen, 1977; Paul, 1966). Bellack and Hersen found that mere practice i n the absence of instructions or coaching was i n e f f e c t i v e i n bringing about improvements i n assertive behaviour i n c l i n i c a l populations. In a study of the modification of speech anxiety, Paul found that subjects who presented s i x speeches over the course of f i v e months without further intervention, reported e s s e n t i a l l y no change i n performance anxiety as measured by se l f - r e p o r t , behavioural, and physiological indices.. Paul concluded that distributed practice i n public speaking served only to reinforce and maintain anxiety previously attendant on the speaking si t u a t i o n . From these studies i t appears that repeatedly rehearsing a p a r t i c u l a r behaviour i s not s u f f i c i e n t i n i t s e l f to reduce the anxiety associated with i t . Other studies have suggested that repeated performance actually results i n a deterioration of the problematic behaviour. In reducing performance anxiety i n brass players, Wardle (1975) found that a repeated assessment 19. control group showed increased heart rates and more observable signs of anxiety. Of nine performance-anxious pianists i n a s i m i l a r control group, Appel (1976) reported that s i x showed no change or an increase i n heart rate, f i v e showed no change or an increase i n self-reported anxiety, and f i v e evidenced a deterioration i n performance. Both studies, however, involved only two performances so they do not represent a f a i r test of the value of repeated performance. In contrast to t h i s , two studies have appeared i n the l i t e r a t u r e which attest to the value of behaviour rehearsal i n reducing speech anxiety. Sanders (1967) found that speech anxiety was reduced as a result of repeated performance before an audience. He concluded that anxiety can be reduced through exposure to the feared situations, i f no adverse effects accompany the consequent anxiety arousal. Sanders suggested that anxiety i s reduced in . role.playing as the make-believe quality reduces perception of threat by the c l i e n t . Johnson, Tyler, Thompson, and Jones (1971) found that systematic desensitization and repeated practice were equally effective i n reducing speech anxiety i n junior high students and were superior to a no-contact control condition. More recently the value of behaviour rehearsal i n affecting change has been re-examined. The current popularity of cognitive methods has been accompanied by attempts to evaluate whether they are more effec t i v e than t r a d i t i o n a l behavioural therapies. Kazdin (1977) reviewed the l i t e r a t u r e on covert conditioning techniques versus overt behavioural rehearsal and concluded that overt presentation of stimul i and overt c l i e n t performance lead to greater therapeutic change than do imagery-based treatments. This i s consistent with Bandura's view that performance-based treatments are superior to other types of therapy (1969, 1971, 1977). From t h i s review of the available l i t e r a t u r e , i t appears that 20. the benefits or l i m i t a t i o n s of behaviour rehearsal i n reducing perfor-mance anxiety have not been thoroughly assessed. Despite the uncertain status of behaviour rehearsal as f a r as psychologists are concerned, the musical community continues to place great import on the value of repeated performance before an audience. A number of well-known teachers and musicians - such as Artur Rubinstein (McNabb, 1951) - have recommended that simply performing often i n front of others i s the key to the performance-anxiety problem. They advise musicians to do the very thing they fear - to play i n public as often as possible, even though at f i r s t i t may be d i f f i c u l t because of high levels of anxiety. Some writers are almost f a n a t i c a l i n t h e i r b e l i e f that repeated-performance i s the solution to stage-fright. Don M i l s (1972) advised musicians to "never shy away from an opportunity to perform" (p. 33). Ralph Lewando (1968) said "Ask to perform for clubs, p a r t i e s , meetings. Offer your music to the Lions, the Elks, the Moose, bridge and bingo groups" (p. 64). The endorsement of behaviour rehearsal by so many musicians (many of whom are eminent i n t h e i r p a r t i c u l a r f i e l d s ) suggests that i t must have been associated with some degree of success i n reducing performance anxiety. I t may be useful then for psychologists to have a closer look at the way i n which behaviour rehearsal has been conceptualized and carried out i n the musical community. Perhaps the effectiveness of behaviour rehearsal d i f f e r s as a function of the nature of the problem, c l i e n t , and therapist or investigator employing i t . One factor which may be c r i t i c a l i n determining whether repeated performance can be of benefit i n reducing performance anxiety, i s the nature of the anticipated and/or actual response from the audience. Weiss and M i l l e r (1971) argued that evaluation apprehension i s evoked 21. only when negative outcomes are anticipated by the performer. Paul (1966) suggested that continued practice i n public speaking with positive reinforcement from the audience would probably lead to a reduction i n anxiety. Support for the.importance of "audience" reaction comes from the assertiveness t r a i n i n g l i t e r a t u r e . The reinforcement of improvement i s an essential ingredient of.behaviour rehearsal as employed i n assertiveness t r a i n i n g (Rimm and Masters, 1974). These authors noted that feedback, when necessary, i s presented i n a "decidedly nonpunitive manner" (p. 93). A second factor, related to the f i r s t , which may influence the effectiveness of behaviour rehearsal i s the threat-value of the audience. An audience which the in d i v i d u a l perceives as threatening may not be as effective i n reducing anxiety as an audience which i s perceived as non-threatening or f r i e n d l y and supportive. Support for t h i s comes from Davidson and Kelley (1973) who corroborated the hypothesis that when audiences are perceived as a "safety s i g n a l , " c l i e n t s ' a b i l i t y to cope with stress i s f a c i l i t a t e d . Perhaps the threat-value of the audience would decrease i f performance-anxious individuals believed that the audience members could i d e n t i f y with t h e i r problem. A t h i r d factor which may influence the effectiveness of behaviour rehearsal i s the use of a hierarchy of anxiety-producing situations as part of treatment. Assertiveness..training programs usually make use of such a hierarchy. Clients are f i r s t required to interact with an empathetic therapist. Then others are included i n role-playing situations, and f i n a l l y the c l i e n t i s asked to t r y the newly-acquired s k i l l s on a prospective employer, g i r l f r i e n d , or foe. Grossberg (1965) used a hierarchy i n treating a single case of public-speaking anxiety. He asked his c l i e n t to face progressively larger audiences and deliver 22. longer and longer speeches and.reported s i g n i f i c a n t improvement - from i n a b i l i t y to perform a one-minute speech to completing s i x required speeches. A fourth factor which undoubtedly affects the benefits derived from behaviour rehearsal i s perceived successes or f a i l u r e s i n the f i r s t few attempts. This factor, unlike the previous.three, i s under much less therapist control. I f a performer experiences f a i l u r e ( i . e . , i n a b i l i t y to control anxiety re s u l t i n g i n a poor performance) on the f i r s t few performances, i t i s l i k e l y that behaviour rehearsal w i l l f a i l to be effective for that indivi.'dual. I f , however,, a performer experiences success, s/he w i l l gain a feeling of. mastery (Bandura, 1977) and f o r that in d i v i d u a l the treatment may be ef f e c t i v e . I t i s surprising that researchers, have not addressed themselves to the value of these four factors i n determining the effectiveness of behaviour rehearsal therapy. Given the variety of ways that behaviour rehearsal could be conceptualized i t i s not surprising, however, that much confusion exists as to the value of the technique i t s e l f . I t seems that a behaviour rehearsal, "package" using a non-threatening audience, positive feedback, hi e r a r c h i c a l presentation of anxiety-producing situations, and minimization of perceived f a i l u r e by subjects has not yet been evaluated. I t i s interesting that behaviour rehearsal as i t i s conceptualized by the musical community incorporates these four factors. Many music teachers arrange informal afternoon or evening "get-togethers" to aid t h e i r students i n preparing f o r r e c i t a l s , competitions, and exams. Anxious students perform for other anxious students. Even very experienced musicians arrange p r e - r e c i t a l gatherings of friends to "tr y out" a program. Typically the feedback from the audience i s positive 23. or at least encouraging. Gradually audience size i s increased and the actual performance s i t u a t i o n more closely approximated. And f i n a l l y , care i s taken to prevent performers from viewing d i f f i c u l t i e s as an indication of f a i l u r e . In summary, although experimental evidence for the effectiveness of behaviour rehearsal i s equivocal, the musical community continues to place great import on i t s use. A number of c r i t i c a l features of behaviour rehearsal as i t i s employed by musicians, suggested that a further investigation of i t s effectiveness was warranted. 24. Cognitive Mediational Variables Influencing Performance Anxiety Self-Talk Meichenbaum's annual newsletter on cognitive behaviour modification (Note 1, Note 2, Note 3) and other publications (e.g., Meichenbaum, 1977) attest to the plethora of investigations since 1969 of the Sel f - I n s t r u c t i o n a l Training technique. The effectiveness of the .complete S e l f - I n s t r u c t i o n a l Training "package," and more recently i t s components, has been examined for a wide variety of problematic.behaviours i n both children and adults. In almost a l l of these studies, changes i n c l i e n t s ' s e l f - t a l k has been assumed to account for demonstrated changes i n verbal, motor, and/or physiological behaviour.. I t i s an unwarranted assumption, however, that changes i n behaviour are necessarily caused by changes i n s e l f - t a l k , or that no changes i n behaviour are associated with no change i n the individual's i n t e r n a l dialogue. An ind i v i d u a l may change cognitive s t y l e with the change not immediately reflected i n the observable behaviour. On the other hand, i f changes i n behaviour result i n a change i n cognitive s t y l e , i t i s possible that a change i n behaviour i s not immediately reflected i n changes i n the individual's s e l f - t a l k . I t seems important, then, to gather s p e c i f i c information about c l i e n t s ' thoughts rather than to make assumptions about these thoughts from the observable behaviour. I t i s only recently, however, that investigators have turned t h e i r attention to the s e l f - t a l k i t s e l f . Schwartz and Gottman (1976) developed an assertiveness questionnaire to assess individuals' thoughts and feelings following a role-playing s i t u a t i o n . Subjects responded to 34 items - 17 positive self-statements which would make i t easier to refuse an unreasonable request, and 17 negative s e l f -25. statements which would make i t harder to refuse. Subjects indicated on a scale from one. to f i v e how frequently these self-statements character-ized t h e i r thoughts during the preceding assertive situations. Schwartz and Gottman used t h i s questionnaire to determine the role of cognitive factors i n the behavioural d e f i c i t of unassertive individuals. They found that moderate- and high-assertive subjects had s i g n i f i c a n t l y more positive than negative self-statements., whereas low-assertive subjects did not d i f f e r i n t h e i r numbers of positive and negative self-statements. Since that.time, other investigators have used Schwartz and Gottman's approach to develop s i m i l a r scales for other target behaviours. Sarason (1978) developed a scale designed to assess the thought.processes of high test-anxious subjects. His Cognitive Interference Questionnaire consisted of 11 items representing 11 negative thoughts which a person could have while taking a written test. Sarason found that high test-anxious subjects, unlike low and middle test-anxious subjects, were preoccupied with how poorly they were doing, how other people were far i n g , and what the examiner would think. S i m i l a r l y Henshaw (1977) constructed • a questionnaire to examine the cognitive processes of subjects engaged i n c r e a t i v i t y t e s t s . Scores on t h i s scale correlated well with creative performance, were r e l i a b l e over time, and related to an external c r i t e r i a of creative performance (Meichenbaum, 1977). While lauding the development of these questionnaires, Meichenbaum (Note 3) cautioned that " i t i s impossible to determine i f the reported thoughts represent post hoc r a t i o n a l i z a t i o n s of performance and/or i f they r e f l e c t actual thought sequences the subjects experienced.during actual performance" (p. 18). Bruch (Note 5) attempted to overcome th i s problem by administering a cognitive self-report scale at several interrupted points during a laboratory anagram task. One wonders about the reactive effects of such 26. a procedure on performance at the task i . e . , the assessment i t s e l f would probably change the behaviour which followed i t . In addition, such interrupted assessments are not r e a l l y appropriate i n tasks such as piano performance because they would t o t a l l y disrupt the mood and flow of the music for the performer. I t i s anticipated that most musicians would refuse to undergo such a procedure. A refinement of such cognitive scales which are administered following the performance, would to some extent overcome the problem raised by Meichenbaum. The establishment of before, during, and after subscales would require subjects to caref u l l y consider t h e i r thoughts at each of these time periods separately. Thus a negative set re s u l t i n g from a poor performance would be less l i k e l y to generalize over a l l the answers than i n questionnaires which do not make t h i s d i s t i n c t i o n . In addition, t h i s segmentation could also provide information on whether a subject who performed poorly would s t i l l report positive thoughts which occurred before the performance began. While "attempting to search for further solutions to the problems incurred with retrospective reporting, i t i s worthwhile to continue to gather the kind of information which these post-performance questionnaires provide. As i n Schwartz and Gottman's (1976) approach, i t can be used to examine differences i n cognitive style between individuals who are low and high on any given variable. In other words, i t i s a useful t o o l for a task analysis of the role of cognitive factors i n a behavioural d e f i c i t . Secondly, scales which examine in t e r n a l dialogues can be used to assess changes i n self-statements as a result of various types of therapeutic intervention. This has not yet been attempted. 27. Expectations of Personal Efficacy Bandura (1977) postulated that psychological procedures achieve changes i n behaviour by a l t e r i n g perceptions of s e l f - e f f i c a c y . Perceived s e l f - e f f i c a c y influences choice of a c t i v i t i e s and the i n t e n s i t y and persistance of e f f o r t at those a c t i v i t i e s . Bandura distinguished among several dimensions of effi c a c y expecta-tions. The f i r s t of these was magnitude. Expectancies may vary from being able to carry out only simple tasks, to mastering very d i f f i c u l t ones. Efficacy expectations also d i f f e r i n generality. Expectancies may vary from engaging i n only a l i m i t e d number of tasks, to anticipating success at a wide variety of tasks and situations. The strength of expectancies also varies. The stronger the expectations, the greater the l i k e l i h o o d of perseverance, at a task despite dissuading experiences. According to Bandura, expectations of. personal eff i c a c y are gathered from four main sources of information: performance accomplishments, vicarious experience, verbal persuasion, and emotional arousal. Bandura hypothesized that the most i n f l u e n t i a l of these would be performance accomplishments because of i t s basis i n experiences of personal mastery. According to Bandura (1977), independent performance enhances efficacy expectations by (a) creating exposure to former threats which provides participants with evidence that they are no longer aversively aroused by what they previously feared, (b) providing an opportunity to perfect coping s k i l l s , (c) producing success experiences which reinforce expecta-tions of s e l f - e f f i c a c y . Bandura expected that vicarious experience, verbal persuasion, and emotional arousal would also influence eff i c a c y expectations, although to a lesser degree. In order to test his hypothesis, Bandura et a l . (1977) designed an experiment to examine the r e l a t i v e powers of performance accomplishments 28. and vicarious experience, i n r a i s i n g expectations of personal ef f i c a c y , and to investigate whether greater expectations of s e l f - e f f i c a c y were related to improvements i n behaviour. Thirty-three snake-phobic subjects were divided into three groups: participant modeling, modeling alone, and no treatment. The magnitude, generality, and strength of effi c a c y expectations as w e l l as approach behaviour and fear arousal were measured before and after treatment. The mastery-based treatment produced higher, stronger, and more generalized expectations of personal effi c a c y than the treatment re l y i n g on vicarious experience alone. In addition, the hypothesized relationship between s e l f - e f f i c a c y and behaviour change was confirmed. In both t h i s study and a second one (Bandura, 1977), the predictive superiority of efficacy expectations over past performance was demonstrated. Perceived s e l f - e f f i c a c y was a better predictor of behaviour toward f a m i l i a r and unfamiliar threats than was past performance. 29. The Measurement of Performance Anxiety Cognitive, Behavioural, and Physiological Components of Anxiety There has been abundant evidence to support the independence of the cognitive, behavioural, and physiological components of anxiety (Bergin and Suinn, 1975). Several investigators have reported that systematic desensitization results i n modified behaviour but no accompanying s i g n i f i -cant decrease i n self-reports of fear and anxiety (Davison, 1968; Lang and Lazovik, 1963; Lang, Lazovik, and Reynolds, 1965; Paul, 1966). Johnson and Sechrest (1968) i n a study involving test-anxious students, indicated that verbal behaviour of reporting oneself as anxious i s not dealt with d i r e c t l y by desensitization procedures. I t has also been reported that a person's cognitive appraisal of a s i t u a t i o n and self-report of anxiety can be altered without changing the physiological indications of anxiety (Leitenberg, Agras, Butz, and Wincze, 1971; Morris and Liebert, 1969). On the basis of t h i s research one might wonder whether s p e c i f i c types of treatment are effective i n changing only s p e c i f i c components of anxiety responses. Perhaps cognitive behaviour modification a l t e r s behavioural and self-report measures of anxiety but not physiological indices. Perhaps relaxation t r a i n i n g i s effective i n reducing physiological arousal but not self-reported anxiety. There have been data, however, which indicate that the three components of anxiety can be affected by the same treatment. The operating factor may be that, as Gambrill (1977) has noted, events i n one system may act as cues for reactions i n other systems. Folkins, Lawson, Opton, and Lazarus (1968) and Musante and Anker (1974-) have shown that treatments aimed at a l t e r i n g the cognitive appraisal of fear and anxiety also a l t e r 30. physiological responses such as skin resistence and heart rate. And conversely, relaxation t r a i n i n g can a l t e r not only physiological but self-report and behavioural measures as well (e.g., Goldfried and T r i e r , 1974). Although self-report, behavioural, and physiological responses can a l l be affected by a single treatment, there i s frequently an uneven pattern of change across the three systems e.g., behavioural change may occur before reductions i n physiological or cognitive stress (Lick and Katkin, 1976). The need for a multimodal approach to assessment i s thus evident. Self-report, Behavioural, and Physiological Measures  of Performance Anxiety i n the Present Study In the present study measures were selected to represent a l l three response systems. There were two self-report of anxiety scales - the State Anxiety Inventory (Spielberger, Gorsuch,. and Lushene, 1970) and the Subjective Stress Scale (Neufeld and Davidson, 1972) - i n addition to the Performance Anxiety Self-Statement Scale and the Expectations of Personal E f f i c a c y Scale developed for use i n t h i s study. Two behavioural measures were obtained. The f i r s t was a performance error count. From her data, Appel (1976) concluded that error count "appears to be the most sensitive indicator of performance anxiety i n p i a n i s t s " (p. 14). This observation was i n accord with the findings of Brozek and Taylor (1954) that motor performance was affected more negatively under stress than sensory or i n t e l l e c t u a l functioning. Wardle (1975) found a close relationship between error count and a subjective evaluation of quality by judges. Appel (1976) advised that s p e c i f i c and comprehensive error counts be used for most accurate results i n future studies of musical performance anxiety. 31. The second behavioural measure was a timed checklist of observable indications of performance anxiety ( v i s u a l signs). This measure had been employed as an anxiety indicant by Paul (1966) with speech-anxious c l i e n t s , by Wardle (1975) with performance-anxious brass players, and by Goldstein (1975) with performance-anxious p i a n i s t s . Although Paul and Wardle found s i g n i f i c a n t differences between treatment groups and a no-treatment control on observable behaviour, Goldstein found no such differences on observable signs of musical performance anxiety or on any of the other dependent measures. Thus the meaningfulness of using v i s u a l signs as an indication of performance anxiety i n pi a n i s t s i s not.clearly established In the l i t e r a t u r e . As the three response systems are r e l a t i v e l y independent, the usefulness of v i s u a l signs could not necessarily be assessed by an investigation of i t s relationship to physiological and self-report.data. However i f v i s u a l signs were compared to a second behavioural measure such as performance error count, i t s v a l i d i t y might be assessed. In order to assess changes i n physiological responses to performance stress, a measure of heart rate was obtained. Mathews (1971) reported that the most consistently s i g n i f i c a n t effects have, been observed using skin resistence or cardiovascular responses, p a r t i c u l a r l y heart rate. I t i s recognized that additional physiological measures would be desirable (Lick and Katkin, 1976), however, t h i s was surpassed by a concern with minimal interference from measurement devices during the actual performance. These seven measures were obtained p r i o r to treatment and following treatment, and four of them (the self-report measures) were obtained at a five-week In vivo follow-up. Behavioural ratings by s i g n i f i c a n t others were also gathered at follow-up. The necessity of follow-up assessment was highlighted by Jeffrey (1974) who reported, after 32. reviewing the l i t e r a t u r e , that when follow-up assessments were done, they often revealed a relapse to pre-intervention l e v e l s . A d d i t i o n a l l y , McFall and Twentyman (1973) recommended that follow-ups be done outside the laboratory. They noted that although behavioural assessment of treatment.effects i n the laboratory i s now common, few studies have demonstrated the existence of treatment effects outside the experimental context. 33. STATEMENT OF' THE: PROBLEM' The present research, had two major, aims: ( l ) to compare the r e l a t i v e effectiveness of attentional t r a i n i n g and behaviour rehearsal i n reducing musical performance anxiety and (2) to investigate whether these treatments would modify the cognitive mediational variables of s e l f - t a l k and expectations of personal efficacy. This second goal necessitated the development of two scales to measure these cognitions. The c r i t i c a l role of attention i n piano performance and s i m i l a r i t i e s between musical performance anxiety and test anxiety, suggested that attentional t r a i n i n g (with a behaviour rehearsal component) would be the most effective way to modify performance anxiety i n musicians. While behaviour rehearsal had. been an important component of many therapeutic programs, there was l i t t l e evidence to show that i t could.-.be effective on i t s own. I t would be expected that a cognitive treatment designed to a l t e r s e l f - t a l k would be more effective than behaviour rehearsal i n actually a l t e r i n g s e l f - t a l k . However, Meichenbaum (1977) postulated that a variety of treatments can a l t e r s e l f - t a l k and that t h i s i s a necessary aspect, at some point, of a l l therapy. I t was possible then that behaviour rehearsal alone may a l t e r s e l f - t a l k to some degree. With regard to the second cognitive variable, Bandura et a l . (1977) concluded that behaviourally-based treatments are superior to other types of therapy i n modifying expectations of personal efficacy. Since both treatments i n the present study contained a behaviour rehearsal component, interest lay i n whether the cognitive component was s u f f i c i e n t l y important to raise s e l f - e f f i c a c y beyond the l e v e l reached with behaviour rehearsal alone. 3 4 . The following hypotheses were advanced i n the present study: 1. Pianists who report themselves as highly anxious about performing have more negative and fewer positive thoughts surrounding a performance than pianists who. report themselves as only mildly anxious. 2. Both attentional. t r a i n i n g and behaviour rehearsal are more effective than a "no-treatment" control i n reducing performance anxiety i n p i a n i s t s as measured by self-report, behavioural, and physiological indices. 3 . Attentional training, i s more effective than behaviour rehearsal i n reducing performance anxiety i n pianists as measured by self-report, behavioural, and physiological indices. 4 . Attentional t r a i n i n g can resu l t i n changes i n a l l three response modalities. I t can reduce self-reported anxiety, increase behavioural competence, and decrease physiological indices of anxiety. 5. Attentional tra i n i n g i s more effective than behaviour rehearsal i n increasing positive.and decreasing negative thoughts surrounding a musical performance. In addition to these hypotheses, a number of questions could be answered from the available data: 1. Was there any difference between attentional t r a i n i n g and behaviour rehearsal i n r a i s i n g expectations of personal efficacy? 2. Were more successful performances during the program associated with, higher expectations of personal efficacy at i t s close? 3 . Were higher expectations of treatment effectiveness associated with a more successful response to treatment? 4 . Were more assignments completed by subjects i n the attentional t r a i n i n g group or by subjects i n the behaviour rehearsal group? Was completion of home assignments related to therapeutic outcome? 35. THE DEVELOPMENT OF A SCALE TO MEASURE SELF-TALK The Performance Anxiety Self-Statement Scale was developed to assess p i a n i s t s ' positive and negative thoughts or self-statements before, during, and after a musical performance. Method Subjects Three groups of subjects were employed i n t h i s study. Subjects i n group one were s i x pianists known to the author, ranging i n age from 14 to 51 (M = 30.50) and i n competence from a grade s i x student- to- a' " prpfessipna.l_musician and teacher. There were fiv e females and one male. Subjects i n group two were 34 musicians (31 of them p i a n i s t s ) from the Music Department at the University of B r i t i s h Columbia. They ranged i n age from 17 to 55 (M = 26.00, SD = 10.11), and there were 23 females and 11 males. Subjects i n group three were 101 pianists from music departments at two u n i v e r s i t i e s , two music schools, and one high school. They ranged i n age from 11 to 53 (M = 20.12, SD = 8.52), and there were 80 females and 21 males. For the construct v a l i d i t y measure some subjects were added to th i s group from the main study. Concurrent v a l i d i t y and t e s t -retest r e l i a b i l i t y were determined using subjects from the main study. Procedure The scale was developed as follows. In order to establish content v a l i d i t y , s i x pianists (group one) created a pool of 92 items - thoughts which they f e l t a piani s t could have before, during, and after a performance. 36. These 92 items (see Appendix A) were consensually validated on an independent sample of 34- musicians (group two). Items were rated as "more he l p f u l or more in t e r f e r i n g and as occurring before, during, or after a performance. Items which were not rated, by 80% of the subjects as c l e a r l y positive or negative (6, 7, or 1, 2 on a seven-point scale) i n terms of helping or i n t e r f e r i n g with piano performance, were discarded. This procedure eliminated 22 items. The 70 remaining items (see Appendix B) were administered to an independent sample of 101 pianists (group three). Items were rated as to how frequently they occurred with reference to a s p e c i f i c performance and whether before, during, or after the performance. An item analysis was then performed. According to Magnusson (1967), an item analysis i s necessary to choose items which contribute maximally to the r e l i a b i l i t y and v a l i d i t y of a scale. The item analysis revealed, each item's correlation with the t o t a l score. From t h i s l i s t the 16 positive and 16 negative items with the highest correlations to the t o t a l score were selected to comprise the f i n a l scale. The time-period ratings were combined with those from the previous test.and 80% agreement was required to designate an item i n the before, during, and/or after category. Tests of v a l i d i t y and r e l i a b i l i t y . o n the scale were then performed. Results Thirty-two items - 16 positive and 16 negative - comprised the f i n a l scale. Correlation coefficients i n the item analysis ranged from .65 to .38. In the f i n a l scale there were 16 before-, 25 during-, and 18 after-performance items, with some items occurring i n more than one category. Thus each of these subscales was large enough to be analyzed 37. separately. In obtaining a measure of concurrent v a l i d i t y , the t o t a l scale scores were correlated with four external c r i t e r i a i n the main study. The Performance Anxiety Self-Statement Scale (higher score = more positive thoughts) was inversely related to the State Anxiety Inventory ( r = -.4-0, p <. .01, one-tailed test) and the Subjective Stress Scale ( r = -.4-8, p<. .001, one-tailed t e s t ) , and to performance error count ( r = -.34, p <• .01, one-tailed test)~, -but .was^notj-related to heart rate. Subjects scoring, i n the top and bottom thirds (n = 75) on a 15-item anxiety scale (from the Report, of Confidence as a Performer, Appel, 1974 - see Appendix C) were included, i n an analysis to assess the construct v a l i d i t y of the self-statement scale. Two one-way between groups analyses of variance revealed a s i g n i f i c a n t difference between high-anxious and low-anxious subjects on.self-statements surrounding a musical performance. High-anxious subjects reported more negative thoughts, F ( l , 73) = 16.13, p<.0"001, and fewer positive thoughts, F ( l , 73) = 42.45, p < .0001, than low-anxious subjects. Two further analyses showed that low-anxious subjects had more positive than negative thoughts, F ( l , 35) = 32.00, p<i .0001, whereas high-anxious subjects did not d i f f e r i n t h e i r numbers of positive and negative thoughts, F ( l , 36)<C 1, p > .05. While test-retest r e l i a b i l i t y was not expected to be high because scales were completed with reference to different performances, i t was assessed using pre- and post-scores from subjects i n the main study who did not receive treatment (n = 18). The correlation of t o t a l scores was .56. A measure of the i n t e r n a l consistency of the scale was also obtained. A coeffi c i e n t alpha was computed ( r = .92).. 38. Discussion Although the focus of the present research was not the development of the Performance Anxiety Self-Statement Scale, i t was deemed necessary to devise a scale with good v a l i d i t y and r e l i a b i l i t y because of i t s importance i n assessing a cognitive mediational process of interest i n the main study. An item analysis, consensual, concurrent, and construct v a l i d i t y , and test-retest r e l i a b i l i t y and i n t e r n a l consistency were assessed. The results suggested that the scale was v a l i d and r e l i a b l e enough to be used i n further studies. The results of the construct v a l i d i t y test also provided support for attentional t r a i n i n g as an appropriate treatment for musical performance anxiety. I t was clear.from the results that high-anxious pi a n i s t s had more negative thoughts and fewer positive thoughts than low-anxious pi a n i s t s . In addition, low-anxious pianists had more positive than negative thoughts, whereas high-anxious pianists did not d i f f e r i n t h e i r numbers of positive and negative thoughts. This l a t t e r finding was interesting as i t p a r a l l e l e d the findings of Schwartz and Gottman (1976) that moderate- and high-assertive subjects had s i g n i f i c a n t l y more positive than negative self-statements,. whereas low-assertive subjects did not d i f f e r i n t h e i r numbers of positive and negative self-statements. I t appears that "an in t e r n a l dialogue of conflict.and negative self-statements" (Meichenbaum, Note 3) characterize individuals who are highly anxious i n interpersonal situations and musical performances. These results with musical performance anxiety are consistent with the research on test anxiety which has shown that the high t e s t -anxious person i s more self-preoccupied and self-deprecating than a person with low test anxiety (Sarason, I960; Wine, 1971). 39. THE DEVELOPMENT OF A SCALE TO MEASURE EXPECTATIONS OF PERSONAL EFFICACY The Expectations of Personal Efficacy Scale was developed to evaluate pi a n i s t s ' expectations as to t h e i r a b i l i t y to carry out a variety of performance tasks with anxiety under control. The magnitude, generality, and strength of expectations were of intere s t . Method Subjects Two groups of subjects were employed i n t h i s study. Subjects i n group one were 60 musicians from the Music Department at the University of B r i t i s h Columbia. Demographic information was. not gathered; however, the majority of subjects were between the ages of 17 and 22 and there were more females than males. Subjects i n group two were f i v e p i a n i s t s ranging i n age from 14 to 51 (M = 27.8). There were three females and two males. Concurrent v a l i d i t y and test-retest r e l i a b i l i t y were determined using subjects from the main study. Procedure In the present study, the scale Bandura et a l . (1977) used to measure effic a c y expectations i n snake phobics was modified for use with musical performance, anxiety. The scale, l i k e Bandura's, was to be comprised of three categories of items: magnitude, generality, and strength of expectations. 40. In developing a magnitude of expectations subscale, f i v e performance situations of varying degrees of threat were i d e n t i f i e d . Threat value was based on information collected informally from musicians, who reported that membership and size of the audience and consequences of the performance determined the degree of threat of a p a r t i c u l a r performance s i t u a t i o n . In order to obtain consensual v a l i d i t y on the rank order'of threat value, these f i v e performance situations (see Appendix D) were presented i n 10 possible pair-wise comparisons to 60 musicians (group one). Subjects were asked to select the si t u a t i o n which was "more threatening" (that i s , which would make them f e e l more anxious) from each pai r . The magnitude subscale also provided a measure of " s i t u a t i o n a l generalization" of expectations i . e . , whether expectations generalize to each of the fi v e different situations. In.developing a generalization, of expectations over tasks subscale, f i v e different performance tasks were i d e n t i f i e d . In t h i s subscale i t was the actual task rather than the si t u a t i o n which varied. Again, a l l possible pair-wise comparisons were presented; t h i s time to a small sample of f i v e pianists (see Appendix E). This was done to determine the magnitude of threat of the items i n t h i s subscale. Strength of expectations was set on a seven-point scale from "completely certain" to "very uncertain." Subjects were asked to rate how certain they were, that they could engage i n the .10 performance situations with t h e i r anxiety under control. Unlike Bandura's snake phobics, most of whom would not touch a snake, many musicians have engaged i n most or a l l of the 10 tasks a l b e i t with extreme levels of anxiety. I t was decided therefore, to obtain expectations of being able to perform the various tasks with "anxiety under control," rather than expectationsiof being able to perform the tasks. 41. Results The consensual v a l i d i t y of rank order of threat of the fi v e magnitude situations presented i n 10 pair-wise comparisonswas determined using percentage of agreement for each of the 10 pairs followed by a rank ordering of the items. Agreement ranged from 82% to 100%. An attempt was made to assess the consensual v a l i d i t y of rank order of threat of the fi v e generalization tasks, presented again i n 10 pair-wise comparisons. A small survey suggested that i t was not possible to equate the tasks i n terms of the magnitude of efficacy expectations. I t might be noted parenthetically that Bandura et a l . (1977) made no mention of' an attempt to investigate or equate the magnitude of threat of the items i n t h e i r generalization subscale. In obtaining a measure of concurrent v a l i d i t y , the t o t a l scale scores were correlated with four external c r i t e r i a i n the main study. The Expectations of Personal Efficacy Scale (high score = higher expectations) was inversely related to the State Anxiety Inventory ( r = -.41, P <^ .01, one-tailed t e s t ) and the Subjective Stress Scale ( r = -.33, p < .01, one-tailed t e s t ) , but was not related to performance error count or to heart rate. The test-retest r e l i a b i l i t y of the scale was assessed using pre-and post-scores.from subjects.in the,main study who did not receive treatment (n = 18). The correlation of t o t a l scores was .88. . Discussion As i n the previous study, the focus of the present research was 42. not the development of a scale - i n t h i s case the Expectations of Personal Efficacy Scale. Since the scale was to play an important part i n the main study, however, an attempt was made to make i t a v a l i d and r e l i a b l e instrument, although not to the extent of the previous scale. The results of the v a l i d i t y and r e l i a b i l i t y investigations, and a comparison with Bandura's work, suggested that the scale was v a l i d and r e l i a b l e enough to be used i n future studies. 43. A COMPARATIVE EVALUATION OF ATTENTIONAL TRAINING AND BEHAVIOUR-- • REHEARSAL IN TREATING MUSICAL PERFORMANCE ANXIETY This study constitutes the main body of the research. I t was an attempt to compare the effectiveness of two treatments for reducing musical performance anxiety, using the two previously described scales to investigate the cognitive mediational processes operating i n both therapies. Method Subjects Subjects were 53 pian i s t s ranging i n age.from 12 to 53 (M = 18.83, SD - 7.61). There were 48 females and f i v e males, which i s representative of the female/male r a t i o studying piano for t h i s age group (Reubart, Note 6). Grade levels ranged from three to 12 (M = 8.06, SD = 2.18). Two c r i t e r i a were applied to select subjects from a larger pool of pianists who reported that they experienced extreme anxiety i n a performing situation.. Subjects had to be i d e n t i f i e d by t h e i r teachers as having extreme performance anxiety, and were required to have a score of f i v e or higher on 15 items from the Report of Confidence as a Performer (Appel, 1974) (See Appendix F). Only three volunteers for the program were rejected because they did not meet the selection c r i t e r i a . Subjects were randomly assigned to one of three groups: attentional t r a i n i n g , behaviour rehearsal, and waiting l i s t control. Experimental Room The two performance assessments were conducted i n a studio i n the 44. Music Building at the University of B r i t i s h Columbia. A l l subjects performed on a six-foot Grotrian Steinweg grand piano. The room also contained the videotape recording equipment, an audio tape recorder, an FM telemetry receiver, and a polygraph. A drape from c e i l i n g to f l o o r concealed the polygraph from subjects when they were seated at the piano. Experimenters and Therapist The two performance assessment sessions were conducted by three experimenters: two females (one the author) and one male. The author was the therapist for both treatment groups, attentional t r a i n i n g and behaviour rehearsal, and for the afternoon workshops which constituted treatment for the control subjects. The therapist had an M.A. i n c l i n i c a l psychology and s i x months of supervised c l i n i c a l experience immediately prior to.the start of the. study. She had also studied piano over 20 years and held an A.R.C.T. (Associateship of the Royal Conservatory of Music i n Toronto) i n piano performance. Expectation of treatment effectiveness was assessed after each tr a i n i n g session in. both treatment conditions (see Appendix G). This permitted an evaluation of group differences p o t e n t i a l l y r e s u l t i n g from therapist bias. In.addition to evaluating expectancy differences between treatment groups, these assessments also provided feedback to the therapist as to how well each session had been received by subjects. Self-r.eport Measures In addition to the 15 True-False items which were used to screen subjects for the study, four self^report instruments were administered, 45. three before and one following each of the two performances. The State Anxiety Inventory (Spielberger, Gorsuch, and Lushene, 1970) was administered to subjects about 10 minutes p r i o r to t h e i r entering the studio for both performances. This scale i s designed to assess the l e v e l of state ( s i t u a t i o n a l ) anxiety on the basis of subjects' self-reports. Twenty items require subjects to report on a four-point scale the i n t e n s i t y of t h e i r anxiety at the time the form i s completed. A revised form of the Subjective Stress Scale (Neufeld and Davidson, 1972) was administered to subjects after they entered the studio and immediately before they approached the piano for both performances. This scale consists of 14 adjectives scaled for connotation of stress by university undergraduates. (The o r i g i n a l instrument, Kerle and Bialek, Note 7, had been scaled by Thurstone methods on a m i l i t a r y sample. ) Subjects are required to indicate which word from the l i s t best describes how they f e e l at the time the form i s completed. The Expectations of Personal Effi c a c y Scale for musicians (Kendrick, 1978) (see Appendix H) was administered to subjects p r i o r to t h e i r entering the studio for both performances. This scale assesses p i a n i s t s ' expectations of being able to complete a number of tasks r e l a t i n g to musical performance with anxiety under control. The magnitude, strength, and generality of expectations are evaluated. The Performance Anxiety Self-Statement Scale (Kendrick, 1978) (see Appendix I) was administered to subjects immediately a f t e r they had performed and l e f t the studio for both performances. This scale i s designed to assess p i a n i s t s ' positive and negative thoughts before, during, and after a performance. 46. Behavioural Measures Two behavioural measures of anxiety were obtained for each subject. The f i r s t was a performance error count of each performance. The performances were scored by two p i a n i s t s , both of whom held university degrees i n music and A.R.C.T.s i n piano performance. They worked independently (at different times) from copies of the music score and audiotape recordings of the performances, and were b l i n d with respect to subjects' group membership and order of the performances. Half of the performances, i n each group were presented i n t h e i r correct order (pre-post); the other half were presented i n reverse. Error types were c l a s s i f i e d as those i n p i t c h , omission, rhythm, tempo, dynamics, and touch.(see Appendix J for definitions, of each term). The raters listened to each complete performance three times. The f i r s t time through, they simply made a pencil mark on the score when they heard a mistake of any type. During the second hearing they i d e n t i f i e d the type of error. The third, hearing provided a chance to check over t h e i r work. The errors on the score were counted and recorded on an error tabulation sheet (see Appendix K). The two performances of each subject (pre-post) were presented consecutively i n order to allow a direct comparison of overall quality to be made. Each performance was rated on a 10-point scale from "an extremely poor, unsatisfying performance" to "an excellent, enjoyable performance." The second behavioural measure was a timed checklist of observable indications of performance anxiety. The items were derived as follows. Forty possible behaviours representing f i v e categories (feet and legs, body, arms and hands, face,, and vocalizations) were acquired from a checklist of observable anxiety-indicating behaviours for brass players 47. (Wardle, 1975) and from additional suggestions from four p i a n i s t s . This l i s t was administered to 33 musicians with instructions to select those which.they f e l t were indications of performance anxiety i n p i a n i s t s , which could he observed by someone other than the pianist him/herself (see Appendix L). The behaviours were then rank-ordered within each category and the., f i r s t two i n each were selected for the f i n a l checklist. This procedure resulted i n 10 behaviours: knees tremble, l i f t s shoulders, s t i f f back and neck, hands: tremble, s t i f f arms, face deadpan, moistens l i p s , foot trembles on pedal, counts, and whispers to s e l f . The l a t t e r three behaviours were omitted because they could not be seen c l e a r l y on videotape. An i n t e r v a l recording method was used to assess these seven observable signs of performance anxiety. Two raters (both musicians) worked inde-pendently from video recordings of the performances (without sound) and were b l i n d with respect to subjects', group membership and order of the performances. Half of.the. performances i n each group were presented i n t h e i r correct order (pre-post); the other ha l f were presented i n reverse. Raters scored the target responses as having occurred or not occurred i n each of three 20-second i n t e r v a l s : one immediately following the f i r s t note of the performance, one i n the middle, and.one immediately before the f i n a l note was played (see Appendix M). In addition, each performance was rated on a 10-point scale from "completely relaxed" to "extremely tense" and on a 10-point scale from "thorough enjoyment" to "extreme distress" with "indifference" as the mid-point. Physiological Measure In order to assess changes i n subjects' physiological responses 48. to performance stress, a measure of heart rate was obtained. Use of a telemetry technique provided a continuous recording of heart rate before, during, and after the performances. Seven 10-second samples of heart rate were selected from each performance at the following times: 10 seconds a f t e r the transmitter was attached, immediately before the f i r s t note was played, immediately after the f i r s t note, i n the middle of the performance, immediately before the f i n a l note was played, and two immediately following the performance. The tachometer output for the beat-to-beat.interval was averaged for a l l beats occurring wholly or. p a r t i a l l y within each 10-second i n t e r v a l . Apparatus and Equipment A Sony-matic portable camera, videocorder with one-half inch V-30H tapes, and a Sony power supply unit were used to record subjects' performances. Tapes were played back on a Sony CVM 115 17-inch portable television, set during the treatment sessions. A 21-inch set was used for r a t i n g purposes. A Sony TC 630 stereophonic audio tape recorder was used to obtain a good quality sound for rating purposes and to back up the videocorder i n case of mechanical f a i l u r e . Ampex 291 one-quarter inch tapes were used. Heart rate data were collected v i a a telemetry technique. The subjects' skin was f i r s t abraded with Redux paste. Two Beckman one-half inch.Ag/AgCl electrodes were then attached at the base of the subject's neck and the lower l e f t r i b cage, using Beckman electrolyte paste. An EKG telemetric system transmitter sent the signal to an FM radio serving as the receiver. Output was provided to a 7P4A tachograph 49. preamplifier on a Grass model 7 polygraph. Colour slides for the four cognitive-modeling sequences were taken with a Nikomat camera using Kodachrome I I and Ektachrome f i l m . The audio track was f i r s t recorded onto an Ampex 291 one-quarter inch tape and then rerecorded onto a Telex cassette tape for use with the Singer Caramate I I SP projector. Procedure Selection of subjects. One hundred-eighty l e t t e r s were mailed to teachers of piano i n the Greater Vancouver area, asking for r e f e r r a l s of students who experienced extreme anxiety when performing (see Appendix N). In response, about 60 persons phoned expressing interest i n the program. A telephone screening procedure was used (see Appendix 6). Subjects were verbally administered 15 of the 30 True-False items from the Report of Confidence as a Performer (Appel, 1974). Those subjects with scores of f i v e or higher were t o l d the program would be appropriate for t h e i r type of anxiety. Subjects were then t o l d they would be required to perform twice before a videocamera and two experimenters on the weekends of March 4th and A p r i l 8th. Subjects who could not make commitments for those two occasions were not selected for the study. Those subjects who could attend were t o l d to choose a piece of music, three to fi v e minutes i n length, which they had mastered i n a non-performing si t u a t i o n . The piece did not have to be memorized. Subjects were asked which nights of the week they could attend sessions, and were t o l d there would be some choice as to time and location of the sessions. F i n a l l y , subjects were t o l d they would be call e d again to arrange a def i n i t e time for t h e i r performances and to confirm the 50. day and location of the treatment sessions. Fifty-three p i a n i s t s were selected for p a r t i c i p a t i o n i n the study. There were 19 i n the attentional t r a i n i n g group, 16 i n the behaviour rehearsal group, and 18 i n the waiting l i s t control group. Several weeks l a t e r , subjects were contacted again and assigned a time for t h e i r two performances and a day and location for t h e i r treatment sessions. Waiting l i s t control subjects were t o l d that t h e i r program would take the form of an afternoon workshop at the end of A p r i l . They were also given some choice as to location and time. Only two or three of these subjects questioned coming for two performances before the workshop. They were t o l d that the experimenter was interested i n seeing how they performed a second time when the s i t u a t i o n was more f a m i l i a r , and when they had played the piano before. In the week before the f i r s t performance, a l l subjects were phoned and reminded of the time for t h e i r scheduled performance, and were asked to arrive 15 minutes early. They were also, asked to bring a photocopy of t h e i r music with them and to mark on the copy any deliberate changes they were making i n tempo or dynamics. Subjects were then reminded that the performance would be videotaped and were t o l d that a measure of heart rate would also be obtained. This l a t t e r procedure was described i n an informal and non-threatening manner: I'm going to attach two small p l a s t i c discs - one at the base of your neck and one on your lower r i b s . You w i l l have a t i n y box taped on to your l e f t shoulder over your clothes. I t ' s so l i g h t you won't even notice i t ' s there. Please wear a two-piece o u t f i t so i t w i l l be easier to attach the discs. In the session(s) y o u ' l l have a chance to look at your heartrate. I think you w i l l f i n d t h i s quite interesting. None of the subjects expressed any concern at t h i s time about the procedure. 51. Administration of.pre- and post-treatment assessment sessions. Performances were scheduled at 10-minute in t e r v a l s s t a r t i n g at 9:00 a.m. and f i n i s h i n g at 6:45 p.m. This scheduling minimized waiting periods for subjects and experimenters and the procedure operated smoothly. Forty-six subjects were seen on Saturday, f i v e on Sunday, and two on Monday. When subjects arrived at the studio, they were greeted outside by experimenter 1. They f i r s t read and signed a consent.form (see Appendix P) and then the two electrodes were attached. Subjects wore these electrodes for about 10 to 15 minutes before they entered the studio, i n order to allow habituation to th i s apparatus. Subjects recorded how long they had studied the test piece and how many times they had performed i t . They then read the pra c t i s i n g and performing r e s t r i c t i o n s for the following six-week period and were reminded to make any changes i n the photocopy of t h e i r music before bringing i t i n to the studio (see Appendix Q). The State Anxiety Inventory and Expectations of Personal Effic a c y Scale were then completed. These were administered to subjects i n a balanced order to control for possible carryover effects. Subjects were greeted at the door of the studio by experimenter 2 and were asked to be seated. Their photocopied music was taken and the transmitter and cushioning material were then securely attached with masking tape. The polygraphic recording was i n i t i a t e d and the Subjective Stress Scale was then administered. Subjects were t o l d to proceed to the piano and to.announce t h e i r names and the t i t l e s of t h e i r pieces and then to begin whenever they were ready. Experimenter 3 started the video equipment and audio recorder as each subject approached the piano bench. Experimenter 2 marked on the polygraph recording paper the beginning and end of the piece. 52. At the conclusion of the performance subjects were handed a reminder s l i p for the time and location of t h e i r sessions and t h e i r second performance. Subjects were asked i f they were aware of the transmitter while they were playing. Only two subjects mentioned that they were, but i t did not appear to have bothered them to any extent. Subjects were accompanied out the door while the recording of t h e i r heartrate continued. The transmitter was then disconnected. The next subject was waiting with electrodes attached (two sets were used) and was accompanied into the studio by experimenter 2. For the second performance assessment, subjects were again phoned during the previous week. They were reminded of the time (same as before with two or three exceptions) f o r t h e i r performances and were again reminded to wear a two-piece o u t f i t to f a c i l i t a t e the attachment of the electrodes. The procedure was i d e n t i c a l to that of the f i r s t performance assessment with two exceptions. Before entering the studio, subjects recorded how many minutes per day (on the average) they had practised the test piece and how often they had performed t h i s and other pieces i n the time since t h e i r f i r s t performance s i x weeks previously (see Appendix R). Follow-up assessment. Before leaving, subjects were given an envelope containing instructions and materials necessary to complete the follow-up assessment. Subjects were asked to perform the test piece(s) and to complete the four enclosed questionnaires i n the same manner as they did f o r the two i n i t i a l performance assessments. (see Appendices S and T for inst r u c t i o n s ) . In addition, they were required to give some information about the performance s i t u a t i o n and to rate t h e i r anxiety and the quality of t h e i r performance on scales from 1 to 10 (see Appendix U). 53. In order to.have an additional rati n g by someone other than the performer him/herself, subjects were asked to s o l i c i t ratings from members of t h e i r audience who had heard them play frequently i n recent months. This provided an evaluation of v i s u a l signs of anxiety and quality of performance by someone who was f a m i l i a r with subjects' performance behaviour and thus i n a position to assess any changes since the program had begun (see Appendix V). Subjects i n the attentional t r a i n i n g group were asked to mail back the information i n the addressed and stamped envelope provided; subjects i n the other two groups were t o l d to bring t h e i r envelopes when they came to the workshops. Administration of Attentional Training and Behaviour Rehearsal Treatments Attentional.training. Subjects were divided into two small groups which met on two evenings i n two different locations over the course of three consecutive weeks. There were 10 subjects i n one group and nine i n the other. Each of the three sessions lasted from one and one-half to two hours. Treatment was modeled after Meichenbaum's (Note 4) S e l f - I n s t r u c t i o n a l Training program for test anxiety, with the relaxation t r a i n i n g component omitted. Subjects were f i r s t taught to become aware of t h e i r negative and task-irrelevant thoughts during piano performance. They viewed videotapes of t h e i r performances ( i n the assessment session) and were asked to r e c a l l t h e i r thoughts, many of which were negative. In addition, s p e c i f i c examples of negative thinking were drawn from t h e i r answers on the Performance Anxiety Self-Statement Scale. This phase was followed by the presentation of a ..treatment rationale which related, negative thinking to performance anxiety and poor performance, 54. which i n turn increased negative thinking. I t was suggested that the best place to intervene i n t h i s "vicious c i r c l e " was at the point of negative thinking. Challenging negative thoughts and substituting with positive ones was recommended. Four types of positive self-statements (comforting, task-focused, technique-oriented, and rewarding) were then described. A slide-tape cognitive-modeling sequence of a pian i s t performing for a group of friends was then shown and discussed. A coping model was portrayed i . e . , the model encountered problems, expressed feelings of anxiety, and then demonstrated how to deal with those feelings and improve performance. A handout describing a home assignment to perform for family members was then distributed. Group members were asked to rate anxiety l e v e l and quality of t h e i r performances and to record positive and negative thoughts. They were also asked to make a l i s t of at least f i v e positive thoughts which they found hel p f u l i n reducing t h e i r anxiety about performing. The second session began with a review of the rationale and discussion of the home assignment. Two slide-tape cognitive-modeling sequences of pia n i s t s i n examination and competition situations, were then, shown. Again coping rather than mastery models were portrayed. Anxieties s p e c i f i c to these two types of performances were discussed. In the l a s t part of the session, subjects were required to perform a piece of music and verbalize aloud t h e i r thoughts before and after they played. Thoughts during the performance were shared after subjects had finished playing. In order to make them more comfortable with t h i s perhaps unusual task, the therapist modeled, the behaviour beforehand. Unchallenged . negative thoughts were discussed and challenged by group members. A handout describing a home assignment to perform for a small group was then distributed. Again members were asked to rate anxiety l e v e l and perfor-mance quality and to record positive and negative thoughts. Changes on these 55. from the f i r s t assignment were also rated. In addition, subjects were asked each day .to play a piece of music, pretending they were performing for someone. They were to verbalize t h e i r thoughts out loud, challenging negative thoughts and replacing them with positive task-focused ones. The t h i r d session began with a review of the rationale and discussion of the home assignment. Subjects were then given four-inch by six-inch cards with l i s t s of positive self-statements which the therapist had copied from t h e i r home assignments. Subjects were asked to add to the l i s t positive thoughts which they found especially helpful i n overcoming anxiety and focusing attention on the task. A cognitive-modeling sequence of a pianis t i n solo r e c i t a l was then shown and discussed. Again a coping model was used. During the second half of the session subjects performed two pieces of music, t h i s time sharing t h e i r thoughts after the performance was over. F i n a l l y , subjects were asked to close t h e i r eyes and follow the therapist through an imaginary sequence describing a musical competition. They were to place themselves i n the pos i t i o n described by the therapist. At set points the therapist said "I could f e e l my anxiety increasing but I said to myself . . . " and then asked i n d i v i d u a l members of the group to complete the thought out loud. The home assignment was simi l a r to the one following session two with one exception. Subjects were asked to take themselves through two imaginary sequences (an exam and a r e c i t a l ) and to actually perform as part of the sequence. This was suggested as a good way to practise coping with performance anxiety i n a variety of situations and settings with-out actually being there. A more detailed outline of the three treatment sessions i s presented i n Appendix W. In order to ensure standardization of treatment, the 56. therapist followed t h i s outline very closely. A l l the material i n the outline was presented and additional comments were made when appropriate to reinforce the central themes. Missed sessions were made up i n d i v i d u a l l y or i n small groups p r i o r to the next group session. Behaviour rehearsal. Subjects were divided into two small groups which met during an afternoon and an evening i n two different locations over three consecutive weeks. There were eight subjects i n each group. Sessions lasted from one and one-half to two hours. The f i r s t session began with a general discussion of performance anxiety. Subjects were asked how long, how much, and i n what situations they had experienced performance anxiety. They shared anxiety-inducing moments i n front of an audience and ways i n which they had attempted to cope with anxiety i n the past. Several suggestions were made by the therapist as to how performance anxiety i s acquired. This discussion was es s e n t i a l l y " f i l l e r material" to raise the c r e d i b i l i t y of the program and to match time with the attentional t r a i n i n g program. This was followed by the presentation of a treatment rationale for undergoing repeated practice before an audience as the way to reduce performance anxiety. Subjects were t o l d that they had learned to be anxious and so they could relearn how not to be anxious by having positive performing experiences i n front of a small understanding group. Support for repeated rehearsal came from quotes by well-known musicians such as Artur Rubinstein, and by eminent authors i n the musicology f i e l d . In addition, the popular idea that "the more you do i t the easier i t gets" lent credence to the rationale. Subjects were then asked to play a piece of music i n front of the group. The therapist modeled t h i s behaviour beforehand. Response, from the therapist and group members was positive or at least encouraging, 57. and. the general atmosphere was f r i e n d l y and supportive. A home assignment to perform for family members was then distributed. Subjects were asked to rate t h e i r anxiety and the quality of t h e i r perfor-mances. Sessions two and three were very si m i l a r to session one. At the beginning of each session the rationale and home assignments were reviewed. Improvements i n anxiety l e v e l and qua l i t y of playing from previous sessions were noted by the therapist and group members. At the end of each session a similar home assignment was given with encouragement to enlarge audience size and include non-family members among those l i s t e n i n g . A more detailed outline of the three behaviour rehearsal sessions i s presented i n Appendix X. Again, the therapist followed the outline closely, although additional comments were made when appropriate to reinforce the central theme. Missed sessions were made up i n small groups. Post-study Workshops for Control Subjects Two workshops i n two different locations were held fo r the behaviour rehearsal subjects. A workshop was also held for the waiting l i s t control subjects. Of 34 subjects e l i g i b l e to attend, 30 came. The material from the three attentional t r a i n i n g sessions was condensed into one four-hour period. A detailed outline of the workshops i s presented i n Appendix Y. Subjects In the workshops were given a second follow-up assignment, i d e n t i c a l to the f i r s t , to take home and return by mail three weeks l a t e r (see Appendix Z for ins t r u c t i o n s ) . This second follow-up allowed a pre- post-workshop comparison to be made. 58. Results Analyses to evaluate the adequacy of random assignment of subjects to groups are presented f i r s t . These include comparability of groups on demographic and other c l a s s i f i c a t i o n variables, on self-report, behavioural, and physiological pre-measures, and on process variables. Inter-rater r e l i a b i l i t i e s of the behavioural ratings are followed by a description of the major analyses i n the study: an evaluation of the d i f f e r e n t i a l effectiveness of the three experimental conditions at post-treatment and follow-up. A b r i e f subsidiary evaluation of a post-study workshop i s followed by correl a t i o n a l analyses which assess interrelationships among demographic, process, and dependent measures. Pre-measures In order to assess the comparability of the attentional t r a i n i n g , behaviour . . rehearsal, and waiting l i s t control groups p r i o r to intervention, analyses were performed on important demographic and other c l a s s i f i c a t i o n variables and on self-report, behavioural, and physiological pre-measures. One-way between groups analyses of variance (ANOVA) were computed on age, l e v e l of proficiency (grade), reported i n i t i a l l e v e l of performance anxiety, length of test piece, and number of months of preparation and number of performances of the test piece. This conservative approach to the data analysis indicated no s i g n i f i c a n t differences among the three experimental conditions on these variables. Means, standard deviations, F values, and pr o b a b i l i t y levels are presented i n Table 1. There was z also no difference on use/non-use of musical score, X (6) = 8.84, p > .05. Measures Age Grade Anxiety l e v e l Length of piece i n seconds Months of preparation of test piece Number of performances of test piece Table 1 Means, Standard Deviations, and F Values for Demographic and other C l a s s i f i c a t i o n Variables AT (n = 19) M 16.74 7.79 8.89 3.95 1.00 SD 4.95 2.51 3.16 198.21 124.73 2.99 1.49 BR (n = 16) M SD 18.81 7.56 10.44 145.19 5.19 .50 10.13 1.90 2.39 67.12 3.04 .63 WLC (n = 18) M 21.06 8.78 9.56 134.72 6.44 .50 SD 7.32 2.05 2.96 66.70 5.96 .79 1.49 >;05 1.54 >.05 1.25 2.52 >.05 >.05 1.59 >.05 1.35 >.05 AT = attentional t r a i n i n g , BR = behaviour rehearsal, and WLC = waiting l i s t control. 60. Kaplan and Litrownlk (1977) recommended multivariate s t a t i s t i c s when several outcome measures are employed, i n order to reduce the probability of making a Type I error. The BMDX69 computer program (Le, 1972, University of B r i t i s h Columbia) was employed i n the present study.to perform the multivariate analyses of variance. This required the random deletion of two. subjects from each of the attentional t r a i n i n g and waiting l i s t control groups. (One subject for whom post-treatment data were not available, was also dropped from the main analyses). A one-way between groups multivariate analysis of variance (MANOVA) was performed on s i x pre-measures which were to be used i n the evaluation of treatment effectiveness. Means and standard deviations of pre-treatment dependent measures are presented i n Table 2. The obtained F value was s i g n i f i c a n t , approximate F (12, 80) = 2.3.7, p < -01 in d i c a t i n g pre-treatment differences on some variables among experimental conditions. In order to i d e n t i f y the variables contributing to t h i s significance, s i x univariate analyses of variance were computed with three of them reaching or approaching significance: expectations of personal efficacy, F (2, 45) = 4-39, p .02, performance error count, F (2, 45) = 2.00, p <-l .15, and heart rate, F (2, 45) = 2.45, p<: .10. In order to adopt a conservative approach i n future analyses, these three variables were used as covariates. P r i o r to intervention the group as a whole had a mean score of 51.42 (SD = 12.24) on the State Anxiety Inventory. This i s higher than the average scores reported by Spielberger, Gorsuch, and Lushene (1970) for a group of general medical and surgical patients (42.38), a group of psychiatric patients (47.74), and a group of young prisoners (45.96). As a group,. subjects obtained a mean score of 2.60 (SD = 1.38) on the Subjective Stress Scale administered p r i o r to intervention. The word most closely associated with t h i s value i s "unsafe.1" The Table 2 Means and Standard Deviations of Outcome Measures AT (n = 16) BR (n = 16) WLC (n = 16) Measures M SD M SD M SD STAI Pre Post Follow-up 49.56 38.38 34.69 10.22 8.88 8.75 49.69 41.63 39.00 14.25 11.81 10.20 52.88 43.44 45.19 11.75 11.87 13.53 SSS Pre Post Follow-up 2.27 1.18 .92 1.36 1.09 .81 2.97 1.44 1.52 1.35 1.35 1.06 2.46 2.09 2.34 1.52 1.44 1.50 PASSS Pre Post Follow-up 200.94 255.63 265.69 64.70 50.99 43.92 203.00 228.50 241.88 49.41 60.58 58.77 193.13 215.19 184.63 63.95 46.85 64.74 EPES Pre Post Follow-up 34.50 40.50 44.88 9. 9. 39 71 7.90 28.56 34.50 35.44 10.49 9.76 9. 51 24.31 27.19 29.88 9.40 12.19 9.59 PEC Pre Post Follow-up 11.37 9.37 69 20 8.62 8.64 5.02 5.29 7.60 7.51 4.60 4.58 HRM Pre Post Follow-up 117.54 109.42 21.12 15.62 109.26 102.75 15.48 14.32 123.93 118.41 19.40 16.25 (continued on the next page) Measures AT ( n = l 6 ) BR (n = 16) WLC (n = 16) M SD M SD M SD IVSA Pre - - _ Post - - -Follow-up 2.38 .62 1.38 .96 .06 1.53 IQP Pre Post - - _ Follow-up 1.94 1.00 1.56 1.15 - .19 1.72 cl AT = attentional t r a i n i n g , BR = behaviour rehearsal, and WLC = waiting l i s t control, STAI = State Anxiety Inventory, SSS = Subjective Stress Scale, PASSS = Performance Anxiety Self-Statement Scale ( t o t a l score), EPES = Expectations of Personal Efficacy Scale ( t o t a l score), PEC = performance error count, HRM = mean heart rate, IVSA = improvement i n visua l signs of anxiety, IQP = improvement i n quality of playing. 63. average score obtained i s s l i g h t l y belov? that reported for subjects who were exposed to slides of homicide victims (Neufeld and Davidson, 1974). The group as a whole had a mean heart rate of 116.13 beats per minute (SD = 20.63) averaged across the seven time samples. This compares to a mean heart rate of 85 beats per minute for normals undergoing a series of e l e c t r i c shocks (Craig and Prkachin, 1978). Appel (1974) found mean pulse rates of 82.60 beats per minute for pianists immediately p r i o r to performance. This compares to 114-44 beats per minute (SD = 18.31) before playing for subjects i n the present study. The mean number of performance errors before treatment for a l l subjects was 9.73 (SD = 5.98). On the Expectations of Personal Efficacy Scale and Performance Anxiety Self-Statement Scale, mean scores were 29.49 (SD = 9.89) and 196.85 (SD = 58.93) respectively for the whole group p r i o r to treatment. On these scales, possible scores ranged from zero to 60 and zero to 354 respectively, with higher scores in d i c a t i n g higher expectations and more positive thinking. Practice Time and Number of Performances between Pre- and  Post-treatment Assessments There were no s i g n i f i c a n t differences among the three experimental groups on amount of practice time on the test piece, F (2, 49) = 1.01, p > .05, but there were on number of performances of the test piece, F (2, 49) = 4.93, p < -01, and number of performances of other pieces, F (2, 49) = 75.44, V< .001. A Newman-Keuls Test applied to the data showed that the attentional t r a i n i n g and behaviour rehearsal groups had s i g n i f i c a n t l y more performances of the test piece than the waiting l i s t 64. control subjects, (p < .05) but did not d i f f e r s i g n i f i c a n t l y from each other. The behaviour rehearsal group had s i g n i f i c a n t l y more performances of other pieces than the attentional t r a i n i n g group (p*£ .05) which had s i g n i f i c a n t l y more than the waiting l i s t control group (p .05). Characteristics of the Follow-up Performance One-way analyses of variance showed no s i g n i f i c a n t differences among the three experimental groups on the following characteristics of the follow-up performance: number of days after the post-treatment assessment, F (2, 45) = 2.82, p > .05, and audience s i z e , F (2, 45) = < 1, p > .05). A chi square analysis, *X(2) = 1.60, p "> .05 also revealed no s i g n i f i c a n t difference on degree of threat. The follow-up performance took place an average of 20 days following the post-treatment performance and there was an average of 19 members i n the audience. The follow-up performance was viewed as more threatening than the post-treatment performance by 62.5% of the subjects, and less threatening, by 37.5$ of the subjects. One s i g n i f i c a n t difference occurred on use/non-use of musical score x during the follow-up performance,X (4) = 10.86, p ^  .05. More behaviour rehearsal subjects used the score than did attentional t r a i n i n g and waiting l i s t control subjects. Expectations of Treatment Effectiveness for Attentional Training and  Behaviour: . Rehearsal Groups Six one-way between groups analyses of variance were computed on expectations of treatment effectiveness on a seven-point scale, as measured by three questions after each of three treatment sessions. 65. Scores were collapsed across time and across questions f o r the two sets of analyses. The three questions were: 1. How l o g i c a l does t h i s type of program seem to you? 2. How confident are you that t h i s program w i l l tie successful i n eliminating your fear of performing? 3. How confident would you he i n recommending t h i s program to a friend who was extremely anxious about performing? Mean values for each of the three questions for both groups collapsed across time were 17.09 (SD = 1.07), 14 . 2 6 (SD = 1.67), and 16.87 (SD = 1.42) respectively. Mean values for each of the three times collapsed across questions were 15.52 (SD = 1.38), 15.83 (SD = 1.41), and 16.00 (SD = 2.11) respectively. No s i g n i f i c a n t differences between the attentional t r a i n i n g and behaviour rehearsal groups were found on any questions at any of the three times. Inter-rater R e l i a b i l i t i e s Inter-rater r e l i a b i l i t i e s were calculated for the attentional t r a i n i n g , behaviour rehearsal, and waiting l i s t control groups separately at pre- and post-treatment. This resulted i n s i x r e l i a b i l i t y measures for each of the f i v e rated variables: performance error count, o v e r a l l quality, v i s u a l signs of anxiety, o v e r a l l anxiety, and apparent enjoyment during the performance. Observer agreement was computed by dividing the smaller t o t a l by the larger one and multiplying;; by 100 to form a percentage. Kazdin and Straw (1976) reported that convention dictates agreement should f a l l Table 3 Inter-rater R e l i a b i l i t i e s i n Percentages Variable Group Pre-treatment Post-treatment Performance error AT 87.3 90.2 count BR 88.0 92.3 WLC 94.2 95.2 Quality of playing AT 95.4 94.5 BR 92.3 96.0 WLC 95.0 99.2 Visual signs of AT 82.1 81.6 anxiety BR 84.0 96.9 WLC 97.6 85.2 Overall anxiety AT 83.1 78.1 BR 63.3 67.5 WLC 76.8 74.3 Enjoyment AT 85.0 88.7 BR 80.2 89.7 WLC 76.5 90.1 AT = attentional training, BR = behaviour rehearsal, WLC = waiting l i s t control. between 80% and 100%. Inter-rater r e l i a b i l i t i e s f o r the present study-are presented i n Table 3. On the two variables of primary i n t e r e s t , performance error count and v i s u a l signs of anxiety, agreements ea s i l y reached an acceptable l e v e l . On other variables of only minor interest they were less impressive. Treatment Outcome In order to evaluate d i f f e r e n t i a l treatment effects, two one-way between-groups multivariate analyses of covariance (MANCOVA) were performed separately on s i x post and s i x follow-up measures, with pre-treatment expectations of personal ef f i c a c y , performance error count, and heart rate as. covariates. As performance error count and heart rate measures were not taken at follow-up, two other measures were used instead: behavioural ratings by s i g n i f i c a n t others of v i s u a l signs of anxiety, and quality of playing. At follow-up, only pre-treatment expectations of personal efficacy was used as a covariate. Means and standard deviations of post- and follow-up-outcome measures are presented i n Table 2. • The re s u l t i n g F value for the post-measures was not s i g n i f i c a n t , approximate F (12, 74) = < 1, p > .05; however, the F value for the follow-up measures was s i g n i f i c a n t , approximate F.(l2, 78) = 3-05, p <.01. This indicated that the experimental conditions did not produce s i g n i f i c a n t l y different outcomes at the post-treatment assessment, although they did f i v e weeks after the termination of treatment. Six univariate analyses of covariance were then computed on the s i x follow-up measures with pre-treatment expectations of personal effi c a c y as a covariate. With the exception of the State Anxiety Inventory and the Subjective Stress Scale, a l l measures were s i g n i f i c a n t . Table 4 Analyses of Covariance Summary Tables Measure Source sum of squares d.f. mean squares F P STAI covariate 695.67 1 695.67 6.43 -c .05 groups 294.60 2 147.30 1.36 > .05 explained 1587.05 . 3 529.02 4.89 <.01 residual 4758.18 44 108.14 SSS covariate 5.75 1 5.75 4.58 ^.05 groups 7.62 2 3.81 3.04 >.05 explained 22.03 3 7.34 5.86 <.01 residual 55.17 44 1.25 PASSS covariate 754.83 1 754-83 .23 >.05 groups 43032.10 2 21516.05 6.63 <T.01 explained 56305.38 3 18768.46 5.78 <.01 residual 142859.44 44 3246.81 EPES covariate 1167.77 1 1167.77 20.51 <.001 groups 649.59 2 324.80 5.70 < .01 explained 3007.81 3 1002.60 17.61 < .001 residual 2505.65 44 56.95 IVSA covariate • 03 1 .03 .03 >.05 groups 37.09 2 18.54 15.00 <^ .001 explained 43.07 3 14.36 11.61 <.001 residual 54-41 44 1.24 IQP covariate 1.58 1 1.58 .89 > .05 groups 30.64 2 15.32 8.67 < .001 explained 42.75 3 14.25 8.07 <.001 residual 77.73 44 1.77 a STAI = State Anxiety Inventory, SSS = Subjective Stress Scale, PASSS = Performance Anxiety Self-Statement Scale ( t o t a l score), EPES = Expectations of Personal Efficacy Scale ( t o t a l score), IVSA = improvement i n vi s u a l signs of anxiety, IQP = improvement i n quality of playing. 69. Refer to Table 4 for a summary of these analyses. In order to determine the nature of the differences among the three groups, Newman-Keuls Tests for i n d i v i d u a l comparisons were computed. These, revealed that on the Performance Anxiety Self-Statement Scale and on the quality of playing rating, the attentional t r a i n i n g and behaviour rehearsal groups were superior to the waiting l i s t control group (p«< .05) although they did not d i f f e r s i g n i f i c a n t l y from each other. On the Expectations of Personal Efficacy Scale, attentional t r a i n i n g was superior to behaviour rehearsal and waiting l i s t control conditions (p-< .05) with no s i g n i f i c a n t difference occurring between the l a t t e r two. On the.visual signs of anxiety r a t i n g , the attentional t r a i n i n g , behaviour rehearsal, and waiting l i s t control groups differed s i g n i f i c a n t l y from each other i n that order of efficacy ( p < .05). Post-study Workshop for Behaviour Rehearsal and. Waiting L i s t  Control Groups Six one-way within-subjects analyses of variance were computed to evaluate the effect.of a b r i e f attentional t r a i n i n g program on the s i x outcome measures assessed at follow-up. Behaviour rehearsal and waiting l i s t control groups were combined, resulting i n a sample of 20 subjects. Only one variable, rating of v i s u a l signs of anxiety, was s i g n i f i c a n t l y modified, F ( l , 18) - 9.54, £ < .01. Relationships Among Dependent Variables Pearson correlation coefficients were calculated to investigate relationships among the dependent variables at pre-treatment. These are presented i n Table 5. Table 5 Interrelationships among Dependent Measures at Pre-treatment (n = 4-8) STAI SSS PASSS EPES PEC HRM STAI SSS PASSS EPES PEC HRM 1.00*** .52*** - .40** - .41** - .14 .17 .52*** 1.00*** - . 4 8 * * * - .33** .00 . 2 8 * - .40** - . 4 8 * * * 1.00*** - . 3 4 * * - .08 - .41** - .33** .57*** 1.00*** - .01 .02 - .14 .00 - .34** - .01 r . o o * * * - .28 .17 .28* - .08 .02 - .28 1.00*** a STAI = State Anxiety Inventory, SSS Anxiety Self-Statement Scale ( t o t a l E fficacy Scale ( t o t a l score), PEC = = Subjective Stress Scale, PASSS = Performance score), EPES = Expectations of Personal performance error count, HRM = mean.heart rate. * p < .05, one-tailed test ** p < .01, one-tailed test *** p < .001, one-tailed test 71. Predictably, the before, during, and after subscales of the Performance Anxiety Self-Statement Scale were highly i n t e r r e l a t e d . Before was correlated with during ( r = .74-, p <• .001) and with after ( r = .77, p <.001),.and during was correlated with after ( r = .91, p < .001). The pre-treatment rating of v i s u a l signs of anxiety was not related to the other behavioural measure, performance error count (r_ = .08, p •*>•,.05), or to self-reported anxiety or heart rate. I t was, however, inversely related to the Performance Anxiety Self-Statement Scale (r_ = - . 3 6 , p < .01, one-tailed t e s t ) . Pearson, correlation coefficients were also calculated to investigate relationships among the dependent variables at follow-up. These are presented i n Table 6 . Ratings of. improvement i n v i s u a l signs of anxiety and quality of playing at follow-up were correlated ( r = .78, p < .001). Predictor Variables Pearson correlation c o e f f i c i e n t s were calculated to investigate which measures at post-treatment were good predictors of f i n a l outcome. These are presented i n Table 7. Of p a r t i c u l a r interest was the predictive power of the two cognitive mediational variables, s e l f - t a l k and s e l f - e f f i c a c y , i n predicting future behaviour. Expectations of personal e f f i c a c y at post-treatment was p o s i t i v e l y correlated to improvements at follow-up i n v i s u a l signs of anxiety (2? = . 3 4 , p<.0l) and quality of playing ( r = .29, p < .05). Positive thinking at post-treatment was associated with greater improvement i n v i s u a l signs of anxiety ( r = .25, p <C.05) but was not s i g n i f i c a n t l y related to quality of playing. Table 6 Interrelationships among Dependent Measures at Follow-up (n = 48) STAI SSS PASSS EPES IVSA IQP STAI 1.00*** .68*** - .61*** - . 5 3 * * * - .52*** - . 4 4 * * * SSS .68*** 1.00*** - .58*** - .64*** _ . 5 7 * * * - .42*** PASSS - .61*** - .58*** 1.00*** .48*** .68*** .52*** EPES _ . 5 3 * * * - .64*** .48*** 1.00*** .45*** .42*** IVSA - .52*** - .57*** .68*** .45*** 1.00*** .78*** IQP - . 4 4 * * * - . 4 2 * * * .52*** .42*** .78*** 1.00*** STAI = State Anxiety Inventory, SSS = Subjective Stress Scale, PASSS = Performance Anxiety Self-Statement Scale ( t o t a l score), EPES = Expectations of Personal Effic a c y Scale ( t o t a l score), IVSA = improvement i n visua l signs of anxiety, IQP = improvement, i n quality of playing. * p <C.05, one-tailed test ** p <c .01, one-tailed test *** p<.001, one-tailed test Table 7 Post-treatment Measures as Predictors of Outcome (n = 48) Follow-up STAI SSS PASSS EPES IVSA IQP 3t-treatment STAI .77*** . 5 4 * * * - .30* - .38** - .33** - .26* SSS .51*** .51*** - .39** - .36** - .44*** ' - .40** PASSS _ .53*** - .25* .56*** .31* .25* .15 EPES - . 5 9 * * * - .58*** .36** .81*** .34** .29* PEC. .07 - .29 .09 .08 .35 .24 .12 .12 - .28* - .07 - .22 - .15-STAI = State Anxiety Inventory, SSS = Subjective Stress Scale, PASSS - Performance Anxiety Self-Statement Scale ( t o t a l score), EPES = Expectations of Personal Effica c y Scale ( t o t a l score), PEC = performance error count, HRM = mean heart rate, IVSA = improvement i n v i s u a l signs of anxiety, IQP = improvement i n quality of playing. * p <.05, one-tailed test ** p<C.01, one-tailed t e s t *** p < .001, one-tailed test Although performance error count at post-treatment was not related to either of the behavioural measures at follow-up, v i s u a l signs of anxiety at post-treatment was inversely related to improvement i n v i s u a l signs of anxiety at follow-up ( r = -.40, p<C.001, one-tailed t e s t ) . Relationship of Improvement, on the Dependent Measures to C l a s s i f i c a t i o n and Process Variables Correlation coefficients were calculated to assess the relationship of c l a s s i f i c a t i o n and process variables to improvement on the s i x dependent measures. In order to avoid the problems incurred with pre/ post "change scores" (Glass and Stanley, 1970), residual gain scores were employed and part correlations computed. Age, grade, i n i t i a l level.of reported anxiety, and amount of piano practice and number of performances were correlated with change on the s i x dependent measures. Age was negatively related to improvement i n positive thinking ( r = -.35, p<£ .05, two-tailed t e s t ) and p o s i t i v e l y related to an increase i n state anxiety ( r = .36, p < .05, two-tailed t e s t ) . These findings, however, must be viewed with caution as they represent only a small proportion of the correlations calculated and the others were generally low. Subjects' view on treatment effectiveness, t h e i r anxiety levels and quality of playing during therapy sessions and home assignments, and the number of completed home assignments were generally not related to improvement i n therapy. 75. Discussion The results of t h i s study indicate that although differences among the experimental conditions had begun to occur at post-treatment, these differences were not s i g n i f i c a n t u n t i l a follow-up assessment f i v e weeks after the termination of treatment. On four of the s i x outcome measures at follow-up, the attentional t r a i n i n g treatment was superior to a waiting l i s t control condition. Attentional t r a i n i n g was more effective than no treatment i n reducing v i s u a l signs of anxiety and i n improving the quality of playing. I t also had greater impact on the cognitive mediational variables of s e l f - t a l k and s e l f - e f f i c a c y . At follow-up, subjects i n the attentional t r a i n i n g group had more positive and fewer negative thoughts and higher perceptions of s e l f - e f f i c a c y than subjects who were awaiting treatment. On three of the s i x outcome measures at follow-up, the behaviour rehearsal treatment was more effective than the waiting l i s t control condition. Behaviour rehearsal was superior i n reducing v i s u a l signs of anxiety, and i n improving quality of playing and s e l f - t a l k . Attentional t r a i n i n g was superior to behaviour rehearsal i n reducing v i s u a l signs of anxiety and enhancing expectations of personal efficacy. In summary then, subjects i n the cognitive modification treatment manifested s i g n i f i c a n t l y greater improvement r e l a t i v e to waiting l i s t control subjects; although i n comparison with behaviour rehearsal, attentional t r a i n i n g was less impressive. On two of- the four indices, behaviour rehearsal was as effective as attentional t r a i n i n g i n producing change. These results p a r t i a l l y corroborated the second and t h i r d hypotheses of the superiority of attentional t r a i n i n g over behaviour rehearsal, and of both these treatments over a waiting l i s t control. 76. The superiority of attentional t r a i n i n g over behaviour rehearsal on some measures at follow-up corroborated Goldfried, Linehan, and Smith's (1978) conclusion that active.attempts to cope with anxiety by means of cognitive reappraisal add to anxiety reduction associated with extinction or habituation and f a c i l i t a t e generalization. After a review of the l i t e r a t u r e , Beck and Mahoney (1979) concluded, more generally that the combination of cognitive and behavioural techniques may be more effective than behavioural techniques alone. The results of the present study contradict Wardle's (1975) conclusion as they indicate that relaxation tra i n i n g i s not necessary to reduce performance anxiety, even when a fine motor s k i l l i s involved. The results are consistent with "'Wine's (1970) and Sarason's (1972a, 1975a) position on test anxiety that treatment should involve substitution of task-relevant responses for se l f - o r i e n t i n g ones, and rehearsal of the behaviour. As may have been expected both treatments, r e l a t i v e to the waiting l i s t control condition, resulted i n s i g n i f i c a n t changes on the two behavioural measures of anxiety at follow-up. A common component of the two therapies was rehearsal before a small supportive audience. This t r a d i t i o n a l behavioural technique was aimed at changing behaviour and i t did help the performers to control body tension (e.g., s t i f f arms, shaking arms and legs) and to improve the quality of t h e i r playing. More surprising perhaps was the efficacy of both attentional t r a i n i n g and behaviour rehearsal i n increasing positive and decreasing negative thinking about performing. Thus the hypothesis of the superiority of attentional t r a i n i n g on t h i s measure was not corroborated. One would have anticipated that a cognitive modification treatment designed s p e c i f i c a l l y to a l t e r s e l f - t a l k , would be superior to one which focused 77. e n t i r e l y on changing behaviour. This unexpected outcome may be accounted for by Meichenbaum's (1977) theory of behaviour change that apparently diverse therapies can be equally effective because they a l l at some point a l t e r c l i e n t s ' s e l f - t a l k . Also related to t h i s may be Wilson's (1978) obser-vation that directly-produced behaviour change may be the most effec t i v e means of a l t e r i n g the cognitive mechanisms that mediate subsequent performance. Bandura et a l . (1977) found that a performance-based treatment produced higher, stronger, and more generalized expectations of personal efficacy than a treatment which r e l i e d on vicarious experience alone. Mahoney and Kazdin ( i n press) remarked on the "almost comic irony" that behavioural procedures may be among the most, powerful methods for activating cognitive, processes such as expectations of s e l f - e f f i c a c y . In the present study, the attentional t r a i n i n g treatment was s i g n i f i c a n t l y superior to behaviour rehearsal and to no treatment i n increasing efficacy expectations. Although behaviour rehearsal subjects surpassed waiting l i s t control subjects on t h i s measure, the difference was not s i g n i f i c a n t . Results.from the present study therefore do not support the importance of a performance-based treatment alone i n increasing s e l f -efficacy. They indicate instead that supplementing a s t r i c t l y behavioural technique with a cognitive approach leads to s i g n i f i c a n t l y greater improvement i n s e l f - e f f i c a c y than the behavioural technique alone. This i s an aspect which Bandura (1977) has not yet examined but which he predicted would occur. After a review of the l i t e r a t u r e , Mahoney and Kazdin ( i n press) concluded that cognitively-dictated "mastery experiences" appear to enhance the effectiveness of behaviour rehearsal, and participant modeling techniques, and more generally that cognitive parameters may enhance either the predictive v a l i d i t y or therapeutic power of t r a d i t i o n a l behavioural procedures. Meichenbaum and Cameron (1974), for example, 78. found increased effectiveness when systematic desensitization was supple-mented with s e l f - i n s t r u c t i o n a l t r a i n i n g methods. In the present study, the effectiveness of the attentional t r a i n i n g therapy i n enhancing s e l f - e f f i c a c y may be explained by i t s focus on assuring c l i e n t s that they could gain mastery or control over t h e i r anxiety and as a result improve t h e i r playing i n a variety of performance situations. On the whole, the philosophy was "You can do i t . You can reduce your.anxiety and improve your playing." In addition, although both treatments r e l i e d on verbal persuasion, vicarious experience, and performance accomplishments to some extent (Bandura, 1977) attentional t r a i n i n g made greater use of the former two methods. And f i n a l l y , subjects i n the attentional t r a i n i n g group were taught a coping s k i l l which they could use when experiencing anxiety i n a performing si t u a t i o n . As Bandura (1977)noted, "having a serviceable coping s k i l l at one's disposal undoubtedly contributes to one's sense of personal efficacy", (p. 196). It i s unfortunate that the often-debated question as to order of cognitive-behavioural change could not be answered by the present data. I t was not possible to ascertain i f subjects observed an improvement i n t h e i r playing, and subsequently changed what they said to themselves and increased t h e i r efficacy expectations; or i f they changed t h e i r s e l f - t a l k and s e l f - e f f i c a c y which led to an improvement i n performance. Had the cognitions changed at post-treatment with behaviours also changing at follow-up (or vice versa), t h i s question may have.been answered. However, neither cognitions nor behaviour changed at post-treatment and both changed at follow-up. An evaluation part-way between the two assessments may have revealed the order of change. I t may be of course that the two change simultaneously. Mahoney (1977) has argued for a "causal c i r c u l a r i t y " or an "interactive determinism" between cognitions and actions. 79. The r e l a t i v e l y good showing of behaviour rehearsal was unexpected given the negative findings of several studies examining the effectiveness of repeated rehearsal alone i n reducing performance anxiety (e.g., Paul, 1966). A c r i t i c a l factor which may have accounted for t h i s difference i n outcome may be the way i n which the audience was perceived by the performers.. Davidson and K e l l y (1973) corroborated the hypothesis that when audiences are perceived as a "safety signal," c l i e n t s ' a b i l i t y to cope with stress i s f a c i l i t a t e d . Related to this i s Weiss and M i l l e r ' s (1971) view that evaluation apprehension i s evoked only when negative outcomes are anticipated by the performer. Geen's (1977) findings indicated that test-anxious subjects who expected that the outcome of an evaluation would be of benefit to them, showed less anxiety than subjects who were just t o l d they were being evaluated and subjects who were t o l d nothing. The l a t t e r two conditions are comparable to Paul's (1966) control group i n which speech-anxious subjects performed before an audience which made no response - positive or negative. I t may be that i n order for extinction to take place, both anticipation of, and actual occurrence of, positive consequences are important. This bears further investigation. I t seems very plausible that i n the behaviour rehearsal sessions i n the present study, the group members were perceived as a "safety sign a l " or as being of potential benefit to the performer. Although perception of the audience was not assessed, anecdotal evidence and therapist opinion provide some support for t h i s view. A l e t t e r from one of the group members, following treatment, best exemplifies t h i s group attitude. She wrote: " I t was just l i k e Weight-Watchers with each of us cheering the others on." 80. Related to t h i s are reports by Johnson et a l . (1971) i n a study which demonstrated that systematic desensitization and repeated practice were equally effective i n reducing speech anxiety. These authors reported that i n the practice group, subjects were i n i t i a l l y reluctant to speak before the others and were even reluctant to attend the sessions. The therapist found that i f he l e f t the group members alone to "chat" for a few minutes, the subjects were more w i l l i n g . t o attend sessions and to give speeches before the others. The group sessions were described as "informal," with therapist and subjects t a l k i n g casually about giving speeches and problems of anxiety. The authors expressed surprise at the outcome of the study but acknowledged that i t offered support for an approach which was commonly used by classroom teachers as a way of reducing speech anxiety. This study by Johnson et a l . p a r a l l e l s to some extent the design and outcome i n the present study. In both investigations a technique developed and recommended by psychologists, was found to be si m i l a r i n effectiveness to a technique i n common.use by teachers involved with the students. In addition, I t was f e l t i n both studies that a casual atmosphere which permitted interaction among group members f a c i l i t a t e d the behaviour rehearsal, therapy. The diminished structure and extra time i n the behaviour rehearsal sessions i n the present study, allowed f o r greater interchange among group members. They had more time to get to know each other and the atmosphere was f r i e n d l y and relaxed. In attentional t r a i n i n g , the sessions were, highly structured and time was short resulting i n much less casual interaction among group members and a more formal atmosphere. An increase i n the number of attentional t r a i n i n g sessions, allowing more time for casual interchange among group members, may increase perceptions of the audience as a "safety 81. signal." Future studies should include the assessment of performers' perceptions of the audience, as t h i s may be a c r i t i c a l factor i n the effectiveness of anxiety-reduction treatments when evaluative situations are involved. Modeling Effects The effect i n therapy sessions of group members' performance on the in d i v i d u a l performer was not assessed i n the present study. The p o s s i b i l i t y was acknowledged, however, that i f some systematic modeling influence were operating,.it might enhance the more effective treatment and/or detract from the less effective one. I f subjects i n the attentional t r a i n i n g group were improving t h e i r performing s k i l l s to a greater degree than those i n the behaviour rehearsal group, for example, there might be even more improvement among the former subjects as a resu l t of observation of more competent models. Modeling ef f e c t s , however, may d i f f e r from one type of problematic behaviour to another. For example, successful and unsuccessful models may have a different effect on small-animal phobics than on individuals i n performing situations. I t was decided therefore to gather information about possible modeling effects on performing musicians. A survey was taken of musicians' expectations as to how a "success" and a " f a i l u r e " model would affect t h e i r own performance•(see Appendix AA). An independent sample of 50 musicians was asked what effect i f any, a poor performance by a s o l o i s t playing immediately before them would have on t h e i r own performance. Fifteen subjects said i t would cause them to play better, 18 said i t would cause them to play worse, and 17 said i t would have no effect on t h e i r performance. When asked about the effect of an excellent performance by a s o l o i s t ahead of them, 20 said i t would 82. cause them to play better, 14- worse, and 16 said i t would have no effect on t h e i r playing. Although the results were generally i n the expected dir e c t i o n , the large variation among responses suggested that a number of different factors might be operating. Of interest i n t h i s regard was some subjects' sense of "competition" with the model i . e . , that a " f a i l u r e " model would make them play better because they gained confidence that they could give a superior performance, and that a "success" model would make them perform more poorly because they f e l t they could never match that performance. This l a t t e r view i s si m i l a r to the rationale for the use of coping rather than mastery models. It does not appear from t h i s survey that systematic modeling effects are operating when musicians observe other musicians perform. The usual favourable effects of a "success" model and-adverse effects of a " f a i l u r e " model (Bandura, 1971) may not always hold among performing musicians. In addition, a sense of competition with the model may be a factor i n reversing the usual modeling effects for some subjects. Although t h i s survey r e f l e c t s expected rather than actual performance, the results are inter e s t i n g and the area of modeling effects i n the competitive world of musicians, dancers, actors, and athletes warrants further investigation. Sarason (1972a, b) has investigated the effects of success and f a i l u r e models on test-anxious subjects. He found that when a person observes f a i l u r e in. another, subsequent performance depends on the l e v e l of anxiety. The high-anxious observer performed at a r e l a t i v e l y low l e v e l whereas the low-anxious observer performed we l l . Sarason suggested that for the l a t t e r group, f a i l u r e i n another person may re s u l t i n heightened attention, motivation, and e f f o r t . I t may also have been possible that these low-anxious subjects, l i k e some of the musicians 83. i n the survey, gained even more confidence from a f a i l u r e model because they f e l t they could give a superior performance and wanted to demonstrate t h i s to the examiner. In future studies of modeling effects among musicians, the l e v e l of anxiety of observers should be assessed as t h i s may be-important i n determining the effects of modeling on subsequent performance. Expectancy Effects The importance of monitoring the c r e d i b i l i t y of placebo conditions i n outcome research was stressed by Borkovec and Nau (1972) and Mahoney (1978). Although behaviour rehearsal was not considered as a placebo control i n the present study, i t served as a control for expec-tations of therapeutic outcome and p a r t i c i p a t i o n i n a study. As with most placebo conditions, behaviour rehearsal was c l e a r l y less complex than the cognitive modification treatment and therefore l i k e l y to be perceived as less effective. Every e f f o r t was made to present the behaviour rehearsal therapy i n a manner which would lead to equivalent expectancies of treatment effectiveness to those of the attentional t r a i n i n g treatment. The data reveal that t h i s goal was achieved. The superiority of the cognitive treatment therefore cannot be attributed to higher expectations of treatment effectiveness by subjects. This kind of conclusion cannot be drawn i n studies i n which expectancy factors have been ignored. Future research should employ post-session questionnaires of the type used i n the present study as t h e i r use consumes very l i t t l e time and provides important information. In addition to assessing expectancy factors, such questionnaires can help toward c o n t r o l l i n g experimenter bias, a problem which Mahoney (1978) 84. has noted i s often ignored and i s p a r t i c u l a r l y d i f f i c u l t to control. I f researchers and therapists know that expectations of treatment effectiveness w i l l be assessed, they may. be. more l i k e l y to make the presentations of treatments equally credible,.rather than favouring one which supports the experimental hypothesis. Follow-up The question of whether improvements i n behaviour i n the laboratory generalize to the "re a l world" has plagued therapy, outcome research for many years. Evidence suggests that generalization does not automatically occur (e.g., Rosen, Glasgow, and Barrerg, 1977) but should be programmed (Baer, Wolf, and Risley, 1968), and assessed. (Mahoney, 1978). McFall and Twentyman (1973) followed t h i s recommendation i n t h e i r use of i n vivo follow-ups as a way of assessing i f generalization across time and settings occurred. They devised a set of ingenious telephone follow-up assessments i n which experimental confederates c a l l e d c l i e n t s i n assertive-ness t r a i n i n g programs and made a variety of unreasonable requests. The suggestion of i n vivo follow-ups was taken up i n the present research with subjects being asked to mail i n s e l f - and s i g n i f i c a n t other-evaluations of levels . .. of anxiety and quality of playing associated with a performance i n the community. For these performances subjects used music f e s t i v a l s , competitions, auditions, exams, and spring r e c i t a l s . Those subjects not involved i n these performances set-up t h e i r own r e c i t a l s . Some teachers arranged special r e c i t a l s and i n v i t e d family members and friends. With a lowering of anxiety and improved quality of playing occurring.in follow-up performances such as these, one could f e e l more confident that the results of therapy extended to situations i n 85. which pia n i s t s most commonly perform (Kazdin, 1978). This was, after a l l , the ultimate goal of the treatment program. In addition to evaluating transfer of therapeutic effects across settings, follow-ups are also recommended to evaluate maintenance of effects across time. The follow-up assessment i n the present study was important, not because i t evaluated maintenance of therapeutic ef f e c t s , but because i t i d e n t i f i e d d i f f e r e n t i a l improvement which was not yet sig n i f i c a n t at post-treatment. I t would have been worthwhile to do a three- or six-month follow-up assessment to evaluate whether the trend of improvement over time continued for both groups. For p r a c t i c a l reasons, t h i s was not carried out i n the present study. Post-study Workshop Results of an analysis assessing pre/post changes suggested that a four-hour attentional t r a i n i n g workshop;.was only minimally effective i n treating performance anxiety i n p i a n i s t s . Of s i x variables only one, vis u a l signs of anxiety, was s i g n i f i c a n t l y modified. Although the same material i n condensed form was presented as i n the three-session attentional therapy, the l a t t e r format was a more effective way of designing the program. I t i s probable that the week between sessions, the additional performances, and the home assignments contributed to the greater e f f e c t i v e -ness of the three-session program, although the r e l a t i v e importance of these components was not assessed. Home Assignments The incl u s i o n of written home assignments i n both treatment programs was designed to transfer some of the r e s p o n s i b i l i t y for change from 86. therapist to c l i e n t . This procedure also resulted i n a reduction of therapist time which i s desirable from a cost-benefit perspective. Ninety-five percent of assignments i n the attentional t r a i n i n g group and seventy-five percent of assignments i n the behaviour rehearsal group were completed. Bowman (1977) recommended that future research should more system-a t i c a l l y c o l l e c t information on c l i e n t s ' application of treatment techniques. The use of home assignments enabled the present investigator to respond i n part to t h i s recommendation. Subjects' f u l f i l l m e n t of homework exercises (including positive and negative thoughts for attentional t r a i n i n g subjects) were recorded and i n t h i s way subjects' compliance with suggestions i n therapy could to some extent be assessed. Number of completed home assignments and anxiety l e v e l and quality of playing during home assignments were, not related to therapeutic outcome. However, the fact that only three sessions of. therapy could res u l t i n s i g n i f i c a n t improvements at follow-up, suggested that the home assignments may have played an important role i n supplementing the sessions with the therapist. In order to assess s p e c i f i c a l l y the value of home assignments i n a therapeutic program, future research should evaluate treatment programs with and without the addition of home assignments. Measures Although i n the predicted direction, the State Anxiety Inventory and Subjective Stress Scale did not discriminate s i g n i f i c a n t l y among the three groups at post-treatment or at follow-up. A further evaluation of self-reported anxiety at a l a t e r time may have revealed a s i g n i f i c a n t difference. Lick and Katkin (1976) noted that several studies have demonstrated that c l i e n t s may make behavioural changes before evidencing 87. reductions i n cognitive distress. R e l i a b i l i t y and v a l i d i t y tests of the Performance Anxiety Self-Statement Scale and the Expectations of Personal E f f i c a c y Scale, indicated that they can j u s t i f i a b l y be used i n future research. As they are sp e c i f i c to pianists i n performance situations, transformations would have to be made for use with other populations. Such transformations usually necessitate alterations i n format. This was the case i n adopting Bandura's scale for snake phobics for.anxious musicians. The magnitude sub-scale, which i n Bandura's scale consisted largely of expectations about making closer approaches to a snake, was changed to expectations about performing i n increasingly threatening situations. I t was simply not meaningful to ask pianists about expectations of being able to approach a piano! In addition,, as many subjects had engaged i n one or several of the tasks i n the magnitude scale, a l b e i t with extreme anxiety, i t was deemed important to have them rate t h e i r expectations of being able to engage i n tasks with t h e i r anxiety under control. Revisions of the scale for other types of target behaviours may necessitate alterations of other aspects of the scale. One of the advantages of the use of such scales to assess cognitions, i s that i t may be possible to determine whether a change i n cognitions i s followed by a change i n behaviour or vice versa, or whether they both change concurrently. Unfortunately, there were not a s u f f i c i e n t number of assessments i n the present study t o make th i s kind of evaluation. The d i v i s i o n of the Performance Anxiety Self-Statement Scale into three time periods coincides with Sarason and Stoops's (1978) recommendation of obtaining measures of cognitive interference at several points during a performance. These, authors expressed a p a r t i c u l a r interest i n cognitive a c t i v i t y during waiting periods and noted the process of incubation 88. (Breznitz, 1971) by which the stress value ef a stimulus or si t u a t i o n i s enhanced during a waiting period. In order to obtain a more v a l i d measure of cognitions during t h i s waiting period, the before subscale could be administered to subjects immediately p r i o r to playing as i t would eliminate a tendency for post-performance r a t i o n a l i z a t i o n (Meichenbaum, Note 2). The rating of v i s u a l signs of anxiety from the videotape was not related to a second behavioural measure, a rating of performance qu a l i t y (performance error count), or to self-reports of anxiety. At follow-up, however, the ratings by s i g n i f i c a n t others of v i s u a l signs of anxiety were related to ratings of the quality of playing and to self-reported anxiety. This discrepancy may have been caused by the d i f f i c u l t y of seeing some of the more subtle behaviours on the t e l e v i s i o n screen (e.g., shaking arms, shaking legs). These behaviours, which had been observed on some performers and noted during the actual performance, did not appear on the videotape. This suggested that although the videotaped performances were valuable during therapy sessions for "cognitive r e c a l l , " they were less useful for rating purposes. Future studies of performance anxiety should employ observers at the time of the performance i f v i s u a l signs of anxiety are to be rated most accurately. In contrast, the sound quality of the audiotapes from which performance error counts were taken was excellent and subtle errors i n notes, rhythm, and dynamics were e a s i l y detected. The use of audiotaped perfor-mances i s superior to i n vivo ratings as the tapes can be reviewed several times enabling a more accurate count of errors. A telemetry technique was employed i n the present study to obtain a continuous recording of heart rate before, during, and after the performance. Although the equipment i s expensive, t h i s i s a vastly 89. superior method to the commonly-used practice of taking pulse rate immediately p r i o r to the performance. A "pounding heart" was one of the major complaints of subjects both i n the assessment and treatment sessions. This concurred with an elevated heart rate (M = 116.13) as assessed by the telemetry system during the pre-treatment performance. Heart rate was not altered ' ... ... by either of the two treatments at post-treatment. Thus the hypothesis that attentional t r a i n i n g can resul t i n changes i n a l l three response modalities was not supported. At the follow-up performances,-it'was not possible to- -.^  obtain a measure of heart rate using telemetry equipment, as had been done i n the previous two assessments. Thus conclusive evidence on the effica c y of the two treatments i n reducing physiological arousal i s not available. Future researchers employing such, follow-ups could ask subjects to do a self-evaluation of heart rate (pulse rate p r i o r to and following performance); however, the r e a c t i v i t y of such a measure would make i t s value questionable. In addition, as many of these performances have important implications f o r subjects (e.g., exams and auditions) self-assessment requests should be kept to a minimum. Interrelationships among Indices At pre-treatment, the behavioural and physiological measures were not correlated with each other or with self-report of state anxiety. Heart rate was moderately related to a subjective report of stress immediately prior to playing; however, the l a t t e r measure was not related to performance error count. At follow-up, both behavioural measures were related to self-reports of state anxiety and subjective stress. 90. In summary, no clear patterning of relationships among self-report, behav-i o u r a l , and physiological measures can be discerned from these data, and the discrepancy between pre-treatment and follow-up correlations cannot be unambiguously interpreted. In terms of predicting behavioural response to treatment, expectations of personal efficacy at post-treatment were p o s i t i v e l y correlated with improvement i n v i s u a l signs of anxiety and quality of playing at follow-up. Positive s e l f - t a l k at post-treatment was associated with a reduction i n v i s u a l signs of anxiety but not to improved performance at follow-up. The best predictor of improvement i n behaviour . was subjects' report of subjective stress immediately p r i o r to playing. Subject A t t r i t i o n Several factors may account for the zero a t t r i t i o n rate i n the present study. Treatment sessions were offered i n four different locations i n the Greater Vancouver area. This meant that subjects did not have to t r a v e l far each week to attend the program. Frequent contact was made by phone with subjects to remind them of the assessment and therapy sessions. When subjects were not able to attend a therapy session, i t was made up within the following week with the therapist driving to a location convenient f o r subjects. The largest drop-out rate often occurs i n waiting l i s t control groups, which i s understandable i n view of the fact that these subjects are usually promised therapy at some unspecified future time. In the present study, waiting l i s t control subjects were given a time and location for t h e i r therapy session. The fact that 30 of 34 subjects attended the post-study workshops attests to maintenance of interest i n the program by control subjects. 91. In some studies, an incentive to attend sessions i s provided by offering a reward for completing treatment (e.g., money) or punishment for dropping out' (e.g., no refund of deposit). The l a t t e r was recommended by Goldstein (Note 8) who encountered a sizable drop-out rate i n his program for performance-anxious musicians (1975). In the present study no such incentives were used - with the exception perhaps of refreshments which were served at the end of each therapy session. Continued telephone contact was f e l t to be \a?:' major factor i n preventing subjects from leaving the program. I t i s useful to know that a few evenings on the telephone could be a c r i t i c a l factor i n reducing subject a t t r i t i o n . Implications for the Musical Community .Up to t h i s point, the discussion has primarily focused on implications of the present study for psychologists engaging i n future research. The results also have implications for the musical community. The popular use of behaviour rehearsal as a method of reducing performance anxiety gains some support from the present data. Behaviour rehearsal was more effective than no treatment i n reducing v i s u a l signs of anxiety, improving the quality of playing, and increasing positive thinking about performing. Music teachers can be advised that t h e i r student rehearsal gatherings before important performances are probably r e s u l t i n g i n some benefit to t h e i r students, provided that a positive perception of audience members i s fostered. I f time were allowed for the students to converse among themselves, t a l k about t h e i r anxiety, and share personal experiences, t h i s perception would more l i k e l y be promoted. In the present study many subjects expressed r e l i e f to know that others shared s i m i l a r feelings. 92. They had believed they were the only ones who suffered from d e b i l i t a t i n g anxiety about performing. With regard to more experienced performers, even they, can be assured that gathering some friends together to rehearse a program may be a useful way of aiding anxiety reduction. The addition of attentional t r a i n i n g , however, would add even more to such rehearsals. Several teachers who participated i n the present program reported using the attentional t r a i n i n g ideas on an informal basis with t h e i r students. I t would be possible.to develop a. structured "package" for teachers with, a manual and the four cognitive-modeling slide-tape sequences. The e f f i c a c y of non-professionals i n carrying out a wide variety of treatments (Karlsruher, 1974) suggests that therapists,,- with extensive backgrounds i n psychology are not required for the effective administration of many treatments. The effectiveness of music teachers i n using an attentional t r a i n i n g program, such as that i n the present study, remains to be evaluated. I t i s f e l t , however, that t h i s i s the way we should proceed i n disseminating the attentional t r a i n i n g program. Aside from obvious cost-benefit advantages, i t would be easier to teach musib teachers what they need to know about attentional t r a i n i n g than to teach psychologists what they would need to know about music. 93. Footnotes 1. I t should also be noted that i t i s not legitimate to make.generalizations from research using subjects with small-animal or other types of non-evaluative phobias. In these cases the in d i v i d u a l i s simply asked to complete a required task such as touching a snake, crossing a bridge, or f l y i n g i n a plane. Success depends on completing the task, and ongoing quality of performance i s not a factor. A person could report being t e r r i f i e d but i f s/he completes the task then behavioural change has been achieved. In performance anxiety, p a r t i -c u l a r l y musical performance anxiety, improving the quality of the performance i s essential i n order to report behavioural change. A second l i m i t a t i o n of generalizing from small-animal research was noted by Kazdin (1978). He reported that fears of small animals i n college students t y p i c a l l y habituate more quickly i n response to anxiety-provoking situations and are more influenced by suggestion than are fears i n s o c i a l situations such as heterosexual and speech anxiety. 9 4 . Reference Notes 1. Meichenbaum, D. Cognitive-behavior modification newsletter. Unpublished manuscript, University of Waterloo, 1975. 2. Meichenbaum, D. Cognitive-behavior, modification newsletter. Unpublished manuscript, University of Waterloo, 1976. 3. Meichenbaum, D. Cognitive-behavior modification newsletter. Unpublished manuscript, University of Waterloo, 1977. 4. Meichenbaum, D. Therapist manual for cognitive behavior modification. Unpublished manuscript, University of Waterloo, 1973. 5. Bruch, M. Type of cognitive modeling, observers' imitation of  modeled strategies, and modification of test anxiety. 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Four experiments on the r e l a t i v e contributions of rehearsal, modeling, and coaching to assertion t r a i n i n g . Journal of Abnormal Psychology, 1973, 81, 199-218. 100. McNabb, G. Get r i d of your stage f r i g h t . Etude, 1951, 69, pp. 11; 56. Meichenbaum, D. Cognitive modification of test anxious college students. Journal of Consulting and C l i n i c a l Psychology, 1972, 39, 370-380. Meichenbaum., D. Cognitive behavior modification. Morristown, N.J..: General Learning Press, 1974-. Meichenbaum, D. Cognitive-behavior modification. New York: Plenum Press, 1977. Meichenbaum, D. Cognitive behavior modification: The need for a f a i r e r assessment. Cognitive Therapy and Research, i n press. Meichenbaum, D., and Cameron, R. The c l i n i c a l potential of modifying what c l i e n t s say to themselves. In M.J. Mahoney and C.E. Thoresen (Eds.), Self-control: Power to the person. Monterey, C a l i f . : Brooks/Cole, 1974. Meichenbaum, D., Gilmore, J.B., and Fedoravicius, A. Group insight versus group desensitization i n treating speech anxiety. Journal  of Consulting and C l i n i c a l Psychology, 1971, 36, 410-421. M i l l s , D. Pre-fright t r a i n i n g . The American Music Teacher, 1972, 21, PP. 33; 44. Morris, L.W., and Liebert, R.M. The effects of anxiety on timed and untimed i n t e l l i g e n c e t e s t s . Journal of Consulting and C l i n i c a l  Psychology, 1969, 33, 240-244. Morris, L.W., and Liebert, R.M. Relationship of cognitive and emotional components of test anxiety to physiological arousal and academic performance. Journal of Consulting and C l i n i c a l Psychology, 1970, 35, 332-337. ' Musante, G., and Anker, J. Cognitive, physiological and motor effects of systematic desensitization on complex stimulus generalization. Behavior Therapy, 1974, 5_, 365-380. Neale, J.M., and Katahn, M. Anxiety choice and stimulus uncertainty. Journal of Personality, 1968, 36, 235-245. Neufeld, R.W.J., and Davidson, P.O. 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Journal of Personality  and S o c i a l Psychology, 1973, 28, 58-61. Sarason, I.G. Anxiety and self-preoccupation. In I.G. Sarason and CD. Spielberger (Eds. ), Stress and anxiety (Vol. 2). Washington: Hemisphere, 1975. (a) Sarason, I.G. Test anxiety and the s e l f - d i s c l o s i n g coping model. • Journal of Consulting and C l i n i c a l Psychology, 1975, 4v3, 148-153- (h) Sarason,. I.G. The Test-Anxiety Scale: Cbncept and research. In CD. Spielberger and I.G. Sarason (Eds.), Stress and anxiety (Vol. 5). Washington: Hemisphere, 1978. Sarason, I.G., and Stoops, R. Test anxiety and the passage of time. Journal of Consulting and C l i n i c a l Psychology, 1978, 46, 102-109. 102. Schwartz, R., and. Gottman, J. Toward a task analysis of assertive behavior. Journal of Consulting and C l i n i c a l Psychology, 1976, 44, 910-920. Spiegler, M.D., Morris, L.W., and Liebert, R.M. Cognitive and emotional components of test anxiety: Temporal factors. Psychological  Reports, 1968, 22, 451-456. Spielberger, CD., Gorsuch, R.L., :.and Lushene, R.E. Manual for the  State-Trait Anxiety Inventory. Palo A l t o , C a l i f . : Consulting Psychologists Press, 1970. Suinn, R.M. Behavior rehearsal t r a i n i n g for s k i racers. Behavior Therapy, 1972, 3, 519-520. Wade, A., and Reynolds, J.E.F. (Eds.). Martindale:. The., extra pharmacopoeia. London: Pharmaceutical Press, 1977. Wardle, A. Behavior modification by reciprocal i n h i b i t i o n of instrumental music performance anxiety. In C.K. Madsen, R.D. Greer, and CH. Madsen, J r . (Eds. ), Research i n music behavior: Modifying music  behavior i n the classroom. New York: Teachers College Press, 1975. Weiss, R.F., and M i l l e r , F. The drive theory of s o c i a l f a c i l i t a t i o n . ^ Psychological Review, 1971, 78, 44-57. Wilson, G.T. Cognitive behavior therapy: Paradigm s h i f t or passing phase? In J.P. Foreyt and D.P. Rathjen (Eds. ), Cognitive behavior  therapy. New York: Plenum Press, 1978. Wine, J. Investigations of an attentional interpretation of test anxiety. Unpublished doctoral dissertation, University of Waterloo, 1970. Wine, J. Test anxiety and dire c t i o n of attention. Psychological  B u l l e t i n , 1971, 76, 92-104. Woodworth, R.S., and Schlosberg, H. Experimental psychology. New York: Holt, 1954. Zax, M. , and Specter, G.A. An introduction to community psychology. New York: Wiley and Sons, 1974. 103. APPENDIX A Consensual V a l i d i t y Test on the Performance Anxiety Self-Statement Scale (Form l ) I am a Ph.D. student i n c l i n i c a l psychology at the University of B.C., and am undertaking a research project to evaluate a number of techniques.for reducing performance anxiety i n musicians. Part of my study i s concerned with assessing the thoughts people have before, during, and after they perform i n front of an audience. I am asking you as a musician to give me your opinions as to whether the thoughts which appear on the following pages would, cause a p i a n i s t to give a better or poorer performance. Take for example the thought: "I was a f r a i d that I would make a. l o t of mistakesV" Do you think t h i s thought would cause a pian i s t to give a better or worse musical performance? For each thought or statement please choose a point along a seven-point scale which expresses your opinion. For example: I was a f r a i d that I would make a l o t of mistakes. a ) l 2 3 4 - 5 6 7 I f you f e e l that having t h i s thought would i n general be extremely  helpful to a performing p i a n i s t , c i r c l e 7. I f you f e e l that the thought would seriously interfere with a performance, c i r c l e 1. I f your opinion l i e s between these two extremes, select a point along the scale which accurately r e f l e c t s your view. You w i l l f i n d that some of the thoughts could only occur after the performance i s finished. In t h i s case, base your decision on whether that thought would help or hinder future performances. F i n a l l y , I would l i k e you to decide whether each thought would be most l i k e l y to occur before (before the f i r s t note i s played), during, or after a performance. For example: I was worrying about the reactions of the audience, b) before during after C i r c l e your answer. I f you f e e l that t h i s thought would be equally l i k e l y to occur before as a f t e r , then you may c i r c l e both "before" and "after:'" In summary, please rate each thought according to the a) scale, and indicate on the b) scale when the thought would be most l i k e l y to occur. Thank you for your help. GENERAL INFORMATION SHEET age sex number of years of piano experience Toronto or Western Board grade completed and/or number of years i n a college or university music program What musical instruments do you play and how long have you played them? 105. seriously-i n t e r f e r i n g extremely helpful 1. I was thinking about the music I was going to play - i t s mood, tempo, and feel i n g . 2. I was a f r a i d that I wouldn't play as well as I knew I could. 3 . I was thinking that I wasn't incompetent or a a f a i l u r e just because I didn't play w e l l . , 4. I decided that I'd never again play i n front of other people. 5. I f e l t that the people i n the audience enjoyed my playing. 6. My fingers f e l t paralyzed - I couldn't make them move. 8. I was thinking that everyone was expecting me to have a memory lapse and now I'd done just that. 9. I was thinking that t h i s was i t - there was no second chance i f I messed i t up. 10. I f e l t i t was my unlucky day. 11. I was reminding myself to focus on the present s i t u a t i o n and not allow my mind to wander onto other things. 7. I was just concerned with playing the notes a correctly ; and not having any memory lapses. , 1 2 3 4 5 6 7 before during a f t e r • 1 2 3 4' 5. 6 7 before during a f t e r 1 2 3 4 5 6 7 before during a f t e r 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during a f t e r 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 106. 3 4 5 . 6 seriously i n t e r f e r i n g extremely helpful 12. I was concerned that the other performers would play much better than I would. 1 3 . The piano f e l t strange - I wished I were playing on my own piano. 14-. I remembered that a problem l i k e t h i s had happened before and I'd mastered i t . 15. I was reminding myself not to think about my anxiety but about what I was there to do. 16. I was thinking I didn't play as wel l as I would have l i k e d to. 17. I was concentrating on a l l the things I'd been prac t i s i n g - the right tempo, touch, and dynamics. 18. I was thinking about how disappointed my rela t i v e s or my teacher would be about the way I'd played. 19. 1 I was thinking i t wasn't as bad as I'd expected. 20. I was wondering whether I could make i t to the end without forgetting. 21. I was wondering what people would think of me i f I made a mistake or forgot. 22. I was thinking that I could hardly wait t i l l i t was over. 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during a f t e r 1 2 3 4 5 6 7 before during a f t e r 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during a f t e r 107. 4 6 seriously i n t e r f e r i n g extremely help f u l 23. I was thinking that the whole thing was a complete disaster. 24-. I f e l t that the people i n the audience v.: weren't that c r i t i c a l and they'd probably enjoyed my playing even though I made mistakes. 25. I f e l t that I'd t r i e d to communicate something to the audience and wasn't just concerned with playing correctly. 26. I was thinking that i t wasn't the end of the world. 27. I was worried about disappointing my r e l a t i v e s or my teacher. 28. My stomach f e l t as i f i t were " t i e d i n knots." 29. I was glad that I was able to control my anxiety. 30. I was concentrating on playing the music with feeling and on communicating that feeling to the audience. 31. I knew that my mistakes were only a small part of the whole performance. 32. I was reminding myself to take deep breaths through my mouth. 33- I was feeling happy. 34. I was thinking that I had t r i e d my best and that even to get up and play i n front of others was an achievement In i t s e l f . 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during a f t e r 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 108. 7 seriously interfering. extremely helpful 35. I was thinking, that worrying about making mistakes wouldn't help anything. 36. I was not thinking of the past or too far ahead, but was focusing on what I was playing at the moment. 37. I was sure that I wasn't playing as w e l l as the other performers. 38. I was thinking that I was i n control and could meet t h i s challenge. 39- I couldn't believe that I was making mistakes a i n front of a l l . those people. I was so ^ embarrassed and was wondering what people thought of me. 40. I was aware that I was running out of breath, a b 41. I f e l t I was playing well. 42. I l o s t interest in.what I was doing. 43. I was disturbed by restless or noisy members of the audience. 44. I f e l t as i f everything were unreal - as i f I were i n a dream. 45. I had a feeling that I wasn't going to play w e l l . 46. I f e l t the audience was disinterested or h o s t i l e towards me. 1 2 3 4 5 6 7 before during a f t e r 1 2 3 4 5 6. 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during a f t e r 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during a f t e r 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during a f t e r 109. 3 4 7 seriously-i n t e r f e r i n g extremely-helpf u l 47. I f e l t that I had been i n control of things throughout the performance. 48. I was thinking that the audience seldom notices mistakes. 49. I was feel i n g as i f I'd l i k e to get up and walk o f f the stage. 50. I knew that my re l a t i v e s and teacher would understand so I didn't have to be ashamed i n front of them. 51. I was thinking that I was crazy to be up there i n front of a l l those people. I was wishing I hadn't come. 52. I was thinking that I'd had memory lapses before and i t would probably happen again. 53. I was r e c a l l i n g a place i n the music where I could st a r t again after a memory lapse. 54. I was glad the ordeal was over. 55. I f e l t i t was my lucky day. 56. I f e l t I had l e t myself down. 57. I was a f r a i d I wouldn't be able to get through the d i f f i c u l t parts I'd had trouble with before. 58. I knew I could play better the next time. a b a b a b a b a b a b a b a b a b a b a b a b 1 2 ..3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 ' 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before -during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during a f t e r 1 2 3 4 5 6 7 before during after 110. 1 2 3 4 5 6 7. seriously -extremely i n t e r f e r i n g h e l p f u l 59. I was remembering to breathe deeply. 60. I was reasoning that I was well prepared, my fingers were i n good shape, and that I was going to do the best I could. 61. I f e l t that probably no-one was l i s t e n i n g . 62. I was wondering what the people i n the audience were thinking of me for making so many mistakes. 63. I wished t h i s performance were taking place at another time. 64. I was forgetting past mistakes and tr y i n g to concentrate on what I was playing at the moment. 65. I was thinking that the people i n the audience weren't as c r i t i c a l as I was, but were just there to enjoy the performance. 66. I was thinking that no performance i s perfect so i f I made one or two mistakes i t didn't r e a l l y matter. 67. I f e l t the audience was receptive to my performance. 68. I was r e a l l y enjoying myself - thinking I was glad to have the chance to share t h i s music with, the audience. 69. I f e l t incompetent. 70. I was sure that none of the other performers would play so badly. 1 2 3 4 5 6 7 before during a f t e r 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 111. 1 2 3 4 5 6 7 seriously extremely i n t e r f e r i n g helpful 71. I was confident I would play well. 72. I was wondering i f people were enjoying my playing or i f they were bored. 73. I was panicking and feeling completely out of control. 74. I f e l t l i k e a complete f a i l u r e . 75. 76. I knew that I could overcome my d i f f i c u l t i e s a and continue on with the music. , I re a l i z e d that I was star t i n g to f e e l sick. 77. I was a f r a i d of some external mishap over which I had no.control - l i k e a s t r i n g breaking i n the piano. 78. I was just relieved that I hadn't had any memory lapses. 79. I was thinking that the other performers were playing better than I had. 80. I was aware that my heart was pounding faster and faster.. 81. I was ashamed of myself and didn't want to face anyone. 82. I was uncertain whether I could maintain the q u a l i t y of the performance. 83. I was aware.that I f e l t relaxed and comfortable. a b a b a b a b a b a b a b a b 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4.5 6 7 before during after 1 2 3 4 5 6 7 before during a f t e r 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 112. 3 4 7 seriously-i n t e r f e r i n g extremely-helpful 84. I was feel i n g pleased with the way. I'd played. 85. I was hoping that I wouldn't have to go through that again too soon. 86. I was wondering.if people l i k e d what I was wearing. 87. I was concerned that no-one l i k e d what I was playing. 88. I was thinking how much I l i k e d the piece of music I had chosen to play and I was looking forward to sharing i t with the audience. 89. I was remembering that other people make mistakes t o o - t h a t I wasn't the only one. 90. I was reminding myself that I was able to control the situ a t i o n and not f a l l apart. 91. I noticed that my mind was sta r t i n g to wander and I wasn't able to control i t . 92. I r e a l l y enjoyed, performing and was kind of sorry i t was over. a b a b a b a b a b a b a b a b a b 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 1 2 3 4 5 6 7 before during after 113. APPENDIX B Item Analysis Test on the Performance Anxiety Self-Statement Scale (Form 2) I am a Ph.D. student i n c l i n i c a l psychology at the University of B.C. I am planning to undertake a research project which would evaluate a number of techniques for reducing performance anxiety i n musicians. As part of my study I am assessing the thoughts pianists have before, during, and after they perform i n front of an audience. I t i s obvious that people think a variety of things during the course of a musical performance. I believe that these thoughts may have an important effect on how a person performs. On the following pages are a number of thoughts which you may have had before, during, or after a musical performance. I would l i k e you to think back to your most recent solo performance. Read each item c a r e f u l l y and decide when and how frequently you were thinking that p a r t i c u l a r thought during that performance. For Example: I was a f r a i d I was going to make a l o t of mistakes. before during a f t e r ( ) ( ) ( ) Please follow these instructions very c a r e f u l l y : 1. F i r s t read the statement. 2. Then c i r c l e whether the thought occurred before, during, or after the performance. I f you can't decide on one time period alone, you may choose more than one. 3. Next decide on how frequently the thought occurred during each of the periods of time, and provide that information by entering one o f the numbers from the following scale: 0 1 2 3 4 5 6 never almost continuously I f the thought did not occur to you at any time, place zeros i n a l l three parentheses as follows: I was a f r a i d I was going to make a l o t of mistakes. before during after ( o ) ( o ) ( o ) The following example provides an i l l u s t r a t i o n . o f a thought that occurred quite frequently both before and during a performance, but more frequently during. I t did not occur after. I noticed that my knees were shaking. (before) (during) after ( 4 ) ( 5 ) ( 0 ) Please t r y to answer as accurately as possible. Don't answer the way you f e e l you should, but the way you actually believe to be the case. This information i s completely confidential and w i l l not be made known to anyone except myself. Thank you for your help. GENERAL INFORMATION SHEET age sex number of years of piano experience Toronto or Western Board grade completed and/or number of years i n a college or university music program What musical instruments do you play and how long have you played them? 116. 6 never almost continuously 1. I was thinking about the music I was going to play - i t s mood, tempo, and feeling. before ( ) during ( ) aft e r ( ) 2. I was thinking that I wasn't incompetent or a f a i l u r e just because I didn't play well. before ( ) during ( ) after ( ) 3. I decided that I'd never again play i n front of other people. before ( ) during ( ) after ( ) A. I f e l t that the people i n the audience enjoyed my playing. before ( ) during ( j aft e r ( ) 5. My fingers f e l t paralyzed - I couldn't make them move. before ( ) during ( ) aft e r ( ) 6. I was thinking that t h i s was i t - there was no second chance i f I messed i t up. before ( ) during ( ) after ( ) 7. I was thinking that everyone was expecting me to have a memory lapse and now I'd done just that. before ( ) during ( ) after ( ) 8. I remembered that a problem l i k e t h i s had happened before and I'd mastered i t . before ( ) during ( ) after ( ) 9. I f e l t i t was my unlucky day. before ( ) during ( ) after ( ) 10. I was remembering to focus on the present s i t u a t i o n and not allow my mind to wander onto other things. before ( ) durin g ( ) after ( ) 11. I was concerned that the other performers would play much better than I would. before ( ) during ( ) after ( ) 12. The piano f e l t strange - I wished I were playing on my own piano. before ( ) during ( ) after ( ) 117. 4 6 never almost continuously 13. I was reminding myself not to think about my anxiety but about what I was there to do. before during after ( ) ( ) ( ) 14. I was concentrating on a l l the things I'd been pra c t i s i n g - t h e right tempo, touch, and dynamics. before during after ( ) ( ) ( ) 15. I was thinking about how disappointed my re l a t i v e s or my teacher would be about the way I'd played. before during after ( ) ( ) ( ) 16. I was wondering whether I could make i t to the end without forgetting. before during a f t e r ( ) ( ) ( ) 17. I was f e e l i n g happy. before during after ( ) ( ) ( ) 18. I was wondering what.people would think of me . i f I made amistake or forgot. before during after ( ) ( ) ( ) 19. I was thinking that I could hardly wait t i l l i t was over. before during after ( ) ( ) ( ) 20. I was thinking that the whole thing was a complete disaster. before during a f t e r ( ) ( ) ( ) 21. I f e l t that I'd t r i e d to communicate something to the audience and wasn't just concerned with playing correctly. before during after ( ) ( ) ( ) 22. I was thinking that i t wasn't the end of the world. before during after ( ) ( ) ( ) 23. I was worried about disappointing my re l a t i v e s before during after or my teacher. ( ) ( ) ( ) 24. My stomach f e l t as i f i t were " t i e d i n knots;.'" before during a f t e r ( ) ( ) ( ) 118. 0 1 never almost continuously 25. I was glad that I was able to control my anxiety. before during after ( ) ( ) ( ) 26. I was trying, to play the music with feeling and communicate that fe e l i n g to the audience. before during a f t e r ( ) ( ) ( ) 27. I l o s t interest i n what I was doing. before during • a fter ( ) ( ) ( ) 28. I knew that my mistakes were only a small part of the. whole performance. before during after ( ) ( ) ( ) 29. I was thinking that I had t r i e d my best and that even to get up and play i n front of others was an achievement i n i t s e l f . before during after ( ) ( ) ( ) 30. I was aware that I was running out of breath. before during after ( ) ( ) ( ) 31. I was thinking that, worrying about making mistakes wouldn't help anything. before during after ( ) ( ) ( 32. I was not thinking of the past or too f a r ahead, but was focusing on what I was playing at the moment. before during after ( ) ( ) ( ) 33. I was sure that I wasn't playing as w e l l as the other performers. before during after ( ) ( ) ( ) 34-. I was thinking that I was i n control and could meet t h i s challenge. before . during after ( ) ( ) ( ) 35. I couldn't believe that I was making mistakes i n front of all.those people. I was so embarrassed and was wondering what people thought of me. before during after ( ) ( ) ( ) 36. I f e l t I was playing well. before during after ( ) ( ) ( ) 119. 0 1 never 5 6 almost continuously 37. I was disturbed by restless or noisy members of the audience. before during after ( ) ( ) ' ( j 38. I f e l t as i f everything were unreal - as i f I were i n a dream. before during after ( ) ( ) ( ) 39. I had a feeling that I wasn't going to play w e l l . before during after ( ) ( ) ( ) 4-0. I f e l t that I had been i n control of things throughout the performance. before ' during after ( ) ( ) ( ) 41. I was fe e l i n g as i f I'd l i k e to get up and walk o f f the stage. before during a f t e r ( ) ( ) ( ) 42. I was thinking that I'd had memory lapses . before and i t would probably happen again. before during after ( ) ( ) ( ) 43- I f e l t . i t was my lucky day. before during after ( ) ( ) ( ) 44. I was thinking that I was crazy to be up there i n front of a l l those people. I was wishing I hadn't come. before during after ( ) ( ) ( ) 45. After having a memory lapse, I was r e c a l l i n g a place i n the music where I could st a r t again. before during after ( ) ( ) ( ) 46. I f e l t I had l e t myself down. before during after ( ) ( ) ( ) 47. I knew I could play better the next time. before during after ( ) ( ) ( ) 48. I was a f r a i d I wouldn't be able to get through the d i f f i c u l t parts I'd had trouble with before. before during after ( ) ( ) ( ) 120. 0 . 1 2 3 4 5 6 never almost continuously 49. I was remembering to breathe deeply. before during after. ( ) ( ) ( ) 50. I was reasoning that I was well prepared, my fingers were i n good shape, and that I was going to do the best I could. before. during a f t e r ( ) ( ) ( ) 51. I wished t h i s performance were taking place at.another time. before during after ( ) ( ) ( ) 52. I was forgetting past mistakes and tr y i n g to concentrate on what I was playing at the moment. before during a f t e r ( ) ( ) ( ) 53. I was thinking that the people i n the audience weren't as c r i t i c a l as I was, but were just there to enjoy the performance. before during after ( ) ( ) ( ) 54. I f e l t incompetent. before during after ( ) ( ) ( ) 55. I was confident I would play well. before during a f t e r ( ) ( ) ( ) 56. I was thinking that no performance i s perfect so i f I made one or two mistakes i t didn't r e a l l y matter. before during after ( ) ( ) ( ) 57. I f e l t l i k e a complete f a i l u r e . before during after ( ) ( ) ( ) 58. I was r e a l l y enjoying myself - thinking I was glad to have the chance to share t h i s music with the audience. before during after ( ) ( ) ( ) 59. I was sure that none of the other performers would play so badly. before during after ( ) ( ) ( ) 60. I was panicking and feel i n g completely out of control. before during after ( ) ( ) ( ) 121. 0 1 2 3 4 never almost continuously 61. I knew' that I could overcome my d i f f i c u l t i e s and continue on with the music. before during a f t e r ( ) ( ) ( ) 62. I rea l i z e d that I was s t a r t i n g to f e e l sick. before during after ( ) ( ) ( ) 63. I was aware that,my heart was pounding faster and faster. before during a f t e r ( ) ( ) ( ) 64. I was ashamed of myself and didn't want to face anyone. before during after ( ) ( ) ( ) 65. I was aware that I f e l t relaxed and comfortable. before during after ( ) ( ) ( ) 66. I was fee l i n g pleased with the way I'd played. before during after ( ) ( ) ( ) 67. I was concerned that no-one l i k e d what I was playing. before during after ( ) ( ) ( ) 68. I was thinking how much I l i k e d the piece of music I had chosen to play and I was looking forward to sharing i t with the audience. before during after ( ) ( ) ( ) 69. I noticed that my mind was st a r t i n g to wander and I wasn't able to control i t . before during after ( ) ( ) ( ) 70. I r e a l l y enjoyed performing and was kind of sorry i t was over. before during after ( ) ( ) ( ) 122. APPENDIX C Fifteen Items from the Report of Confidence as a Performer (from Appel, 1974) I'd l i k e to ask you some s p e c i f i c questions which w i l l give me some information about your confidence as. a performer. Read each . statement and then.circle whether i t i s true or false for you. 1. I look forward to. an opportunity to perform i n public. T F 2. My legs tremble when I reach f o r the pedal. T F 3. I am i n constant fear of forgetting the music. T F 4. At the conclusion of a performance I f e e l that I have had a pleasant experience. T F 5. My thoughts become jumbled and confused when I perform before an audience. • T F 6. Although I am nervous just before getting up, I soon forget my fears and enjoy the experience. T F 7. I f e e l that I am i n complete possession of myself while performing. T F 8. I prefer to have the notes on the piano i n case I forget the music. T F 9. I f e e l relaxed and comfortable while performing. T F 10. I always avoid playing solos i n public i f possible. T F 11. I enjoy preparing for a solo performance. T F 12. My hands f e e l cold and weak before performing. T F 13. I perspire and tremble just before performing. T F 14. I am f e a r f u l and tense a l l the while I am performing before an audience. T F 15. At the conclusion of my performance I f e e l that I would l i k e to continue performing. T F 123. APPENDIX D Threat Value of Magnitude Items from the Expectations of Personal.Efficacy Scale Please select from each p a i r of performances the one which i s more threatening (that i s , which makes you more anxious). Place a check beside i t . You should make ten checks i n t o t a l . 1. playing your favourite piece of music for family members playing three pieces i n an exam with one examiner present 2. playing a single piece i n competition for a scholarship i n a music f e s t i v a l playing a piece of music f o r a small group of friends 3. performing f i v e pieces of music for memory i n a one-person r e c i t a l to a f u l l house. This r e c i t a l i s to be reviewed i n the l o c a l newspapers. playing your favourite piece of music for family members 4. playing three pieces i n an exam with one examiner present performing f i v e pieces of music for memory i n a one-person " r e c i t a l to a f u l l house. This r e c i t a l i s to be reviewed i n the l o c a l newspapers. 5. playing your favourite piece of music for family members playing a single piece i n competition for a scholarship i n a music f e s t i v a l 6. playing a piece of music for a small group of friends playing your favourite piece of music for family members 124. 7. playing a piece of music f o r a small group of friends playing three pieces i n an exam with one examiner present 8. playing a single piece i n competition.for a scholarship i n ~ a music f e s t i v a l performing f i v e pieces'of music for memory i n a one-person ~ r e c i t a l . t o a f u l l house. This r e c i t a l i s to be reviewed i n the l o c a l newspapers. 9. playing three pieces i n an exam with one examiner present playing a single piece i n competition for a scholarship i n a music f e s t i v a l 10. performing f i v e pieces of music for memory i n a one-person r e c i t a l to a f u l l house. This r e c i t a l i s to be reviewed i n the l o c a l newspapers. playing a piece of music for a small group of friends APPENDIX E Threat Value of Generalization Items from the Expectations of Personal Efficacy Scale Please select from each pa i r of performances the one which i s more threatening (that i s , which makes you more anxious). Place a check beside i t . You should make ten checks i n t o t a l . 1. sightreading a piece of music playing i n a piano duet 2. playing i n a chambre group of three - v i o l i n , c e l l o , and yourself at the piano playing music from a different period ( f o r example, Baroque, Romantic, Modern, etc.) 3. accompanying a small choir of twenty members playing i n a piano duet 4.. playing music from a different period ( f o r example, Baroque, Romantic, Modern, etc.) sightreading a piece of music 5. accompanying a small choir of twenty members playing i n a chambre group of three - v i o l i n , c e l l o , and yourself at the piano 6. playing i n a piano duet playing music from a different period, (for example, Baroque, Romantic, Modern, etc.) sightreading a piece of music accompanying a small choir of twenty members playing i n a chamibre group of three - v i o l i n , c e l l o and yourself at the piano sightreading a piece of music playing music from a different period ( f o r example, Baroque, Romantic, Modern, etc. ) accompanying a small choir of twenty members playing i n a piano duet playing i n a chambre group of three - v i o l i n , c e l l o and yourself at the piano 127. APPENDIX F Subject Selection C r i t e r i o n (from Report of Confidence as a Performer, Appel, 1974-) I'd l i k e to ask you some sp e c i f i c questions which w i l l give me some information about your confidence as a performer. I w i l l read a statement and you t e l l me whether i t i s true or false for you. 1. I look forward to an opportunity to perform i n public. T F 2. My legs tremble when I reach f o r the pedal. , T F 3. I am i n constant fear of forgetting the music. T F .1 4-. At the conclusion of a performance I f e e l that I have had a pleasant experience. T F 5. My thoughts become jumbled and confused when I perform before an audience. T F 6. Although I am nervous just before getting up, I soon forget my fears and enjoy the experience. T F 7. I f e e l that I am i n complete possession of myself while performing. T F 8. I prefer to have the notes on the piano i n case I forget the music. T F 9. I f e e l relaxed and comfortable while performing. T F 10. I always avoid playing solos i n public i f possible. T F 11. I enjoy preparing for a solo performance. T F 12. My hands f e e l cold and weak before performing. T F 13. I perspire and tremble just before performing. T F 14. I am f e a r f u l and tense a l l the while I am performing before an audience. T F 15. At the conclusion of my performance I f e e l that I would l i k e to continue performing. T F APPENDIX G Expectations of Treatment Effectiveness (from Goldstein, 1975) Please respond to these questions by c i r c l i n g the number which indicates your attitude at t h i s time: 1. How l o g i c a l does t h i s type of program seem to you? not at a l l 0 1 2 3 4 5 6 very much so 2. How confident are you that t h i s program w i l l be successful i n eliminating your fear of performing? not at a l l 0 1 2 3 4 5 6 very much so 3. How confident would you be in'recommending t h i s program to a frie n d who was extremely anxious about performing? not at a l l 0 1 2 3 4 5 6 very much so 129. APPENDIX H Expectations of Personal E f f i c a c y Scale Name Date PART A How c e r t a i n are you th a t you could now perform the f o l l o w i n g tasks w i t h your an x i e t y under c o n t r o l ? For each t a s k , please c i r c l e the appropriate number: (1) p l a y i n g your f a v o u r i t e p i e c e f o r f a m i l y members very 0 1 2 3 4 - 5 6 completely c e r t a i n u n c e r t a i n * J (2) p l a y i n g a piece of music f o r a s m a l l group o f f r i e n d s very 0 1 2 3 4 5 6 completely c e r t a i n u n c e r t a i n * J (3) p l a y i n g three pieces i n an exam w i t h one examiner present very 0 1 2 3 4 5 6 completely c e r t a i n u n c e r t a i n (4) p l a y i n g a s i n g l e piece of music i n competition f o r a s c h o l a r s h i p i n a music f e s t i v a l v e r y , . 0 1 2 3 4 5 6 completely c e r t a i n u n c e r t a i n (5) performing f i v e pieces of music f o r memory i n a one-person r e c i t a l t o a f u l l house. This r e c i t a l i s t o be reviewed i n the l o c a l newspapers. very 0 1 2 3 4 5 6 completely c e r t a i n u n c e r t a i n PART B How c e r t a i n are you th a t you could now perform the f o l l o w i n g -tasks before an audience w i t h your an x i e t y under c o n t r o l ? On the f i r s t f o u r t a s k s , assume you have learned the music. For each t a s k , please c i r c l e the appropriate number: (1) p l a y i n g i n a piano duet y . 0 1 2 3 4 5 6 completely c e r t a i n u n c e r t a i n 130. (2) accompanying a small choir of twenty members very uncertain 0 1 2 3 4 - 5 6 completely certain (3) playing i n a chamber group of three - v i o l i n , c e l l o , and yourself at the piano v e r y x . 0 1 2 3 4 5 6 completely certain uncertain (4) playing a piece of music from a different period ( f o r example, Baroque, Romantic, Modern, etc. ) from that which you have chosen to play today. v e r y x . 0 1 2 3 4 5 6 completely certain uncertain (5) sightreading a piece of music very 0 . 1 2 3 4 5 6 completely certain uncertain * J 131. APPENDIX I . Performance Anxiety Self-Statement Scale ( F i n a l Form) Name Date On the following pages are a number of thoughts which you may have had before, during, or after the performance you just gave. Read each item c a r e f u l l y and decide how frequently you were thinking that p a r t i c u l a r thought. For Example: I was a f r a i d I was going to make a l o t of mistakes. Please follow these instructions very c a r e f u l l y : 1. F i r s t read the statement. 2. Next decide on how frequently the thought occurred during each of the periods of time, and provide that information by entering one of the numbers from the following scale: 0 1 2 3 4 5 6 never almost continuously I f the thought did not occur to you at any time, place zeros i n a l l the parentheses as follows: I was a f r a i d I was going to make a l o t of mistakes. before ( 0 ) The following example provides an i l l u s t r a t i o n of a thought that occurred quite frequently both before and during a performance, but more frequently during. I t did not occur after. I noticed that my knees were shaking. before during after U ) ( 5 ) ( 0 ) Please t r y to answer as accurately as possible. before during ( ) ( ) during ( 0 ) 132. never almost continuously I was reasoning that I was wel l prepared, my fingers were i n good shape, and that I was going to do the best I could. I was confident I would play w e l l . before ( ) before ( ) I l o s t interest i n what I was doing. before ( ) I had a feeling that I wasn't going to play w e l l . before during ( ) ( ) I was thinking that I could hardly wait t i l l i t was over. before during ( ) ( ) I was thinking about the music I was going to play - i t s mood, tempo and feeli n g . before during ( ) ( ) I was thinking that I was crazy to be up there i n front of those people. I was wishing I hadn't come. before during ( ) ( ) I was panicking and feeling completely out of control. before during ( ) ( ) I wished t h i s performance were taking place at another time. before during ( ) ( ) 10. I was thinking that I was i n control and could meet t h i s challenge. before during ( ) ( ) 11. I was not thinking of the past or too far ahead, but was focusing on what I was playing at the moment. during ( ) 12. I f e l t as i f everything were unreal - as i f I were i n a dream. during ( ) 133. 0 1 2 3 4 5 6 never almost continuously 13. I was feel i n g as i f I'd l i k e to get up and leave. during ( ) 14. I f e l t I was playing well. during ( ) 15. I was r e a l l y enjoying myself - thinking I was glad to have the chance to share t h i s music with those l i s t e n i n g . before during after ( ) ( ) ( ) 16. I was aware that I f e l t relaxed and comfortable. before during after ( ) ( ) ( ) 17. I was worried about disappointing my relat i v e s or my teacher. before during after ( ) ( ) ( ) 18. I was feeling happy. before during a f t e r ( ) ( ) ( ) 19. I was thinking how much I l i k e d the piece of music I had chosen to play. before during after ( * ) • ( ) ( ) 20. I was concerned that the other performers would play much better than I. before during after ( ) ( ) ( ) 21. I f e l t that I had been i n control of things throughout the performance. during after ( ) ( ) 22. I was thinking that the whole thing was a complete disaster. ' during after ( ) ( ) 23. I f e l t that I never again wanted to play i n front of other people. during after ( ) ( ) 24. I knew that my mistakes were only a small part of the whole performance. 25. I f e l t l i k e a complete f a i l u r e . during ( ) during ( ) after ( ) aft e r ( ) 134. 0 1 never almost continuously 26. I couldn't believe that I was making mistakes i n front of those people. I was so embarrassed and was wondering what people would think of me. 27. I f e l t that I'd t r i e d to communicate something and wasn't just concerned with playing correctly. 28. I f e l t that the people i n the audience enjoyed my playing. during after ( ) ( ) during after ( V ( ) during after ( ) ( ) 29. I f e l t I had l e t myself down. after ( ) 30. I was feeling pleased with the way I'd played. after ( ) 31. I was ashamed of myself and didn't want to face anyone. after ( ) 32. I r e a l l y enjoyed performing and was kind of sorry i t was over. after ( ) APPENDIX J Instructions for Performance Error Tabulation (from Appel, 1974) Please l i s t e n to each performance three times while following the score. Mark type of error on score as you hear i t . Count number of errors from the score and record them on the error tabulation sheet. Definitions of error types follow: P = p i t c h error - wrong note, wrong inversion of chord, blurred note. 0 = omission error - note or chord l e f t out. R = rhythm error - incorrect time value of note or r e s t , unco-ordinated attack (both hands not together). T = tempo error - unsteadiness of tempo (mark an error for every two measures), unusual speed of passage, inconsistent speeds. D = dynamics error - lack or misinterpretation of indicated ( i n score) dynamics, or accents. TO = touch error - lack of indicated staccato, legato, or phrasing. 136. APPENDIX K Performance Error Tabulation Sheet Subject's Name Rater Date 1. pi t c h errors t o t a l 2. omission errors t o t a l 3- rhythm errors t o t a l 4. tempo errors t o t a l 5. dynamics errors . t o t a l 6. touch errors t o t a l GRAND TOTAL Overall Quality of Performance an extremely poor, an excellent, unsatisfying performance. 1 2 3 4 5 6 7 8 9 10 enjoyable performance 137. APPENDIX L Consensual V a l i d i t y Test on Visual Signs of Performance Anxiety i n Pianists I am interested i n your opinions as a musician on whether the following items are observable indications of performance anxiety i n p i a n i s t s . I would l i k e you to check those items which you f e e l are indications of performance anxiety which can be observed by someone other than the pianist him/herself. Feel free to add to the l i s t s any observable behaviours which I have omitted. feet and legs: knees tremble taps toe or foot foot trembles on pedal paces back and forth before playing shuffles up to piano walks slowly to piano body: moves bench back and forth excessively before playing sways body breathes heavily l i f t s shoulders crouches over piano s t i f f back and neck arms and hands: clenches hands wipes hands on towel fi d d l e s with hands clutches bench hands tremble l i f t s hands abruptly to keyboard extraneous arm or hand movement touches face adjusts clothes puts hands through hair s t i f f arms deadpan pale blushes moistens l i p s swallows clears throat perspires moves head winks blinks rapidly hums whistles counts whispers to s e l f groans grunts face: vocalizations: 138. APPENDIX M Timed Behavioural Checklist for Piano Performance Subject's Name Rater Date . . BEHAVIOUR TIME PERIOD. 1 2 3 sum 1. face deadpan 2. moistens l i p s 3. l i f t s shoulders 4. s t i f f back and neck 5. hands tremble - 6. s t i f f arms 7. knees tremble completely 1 2 3 4 5 6 7 8 9 10 extremely relaxed tense extreme distress 1 2 3 4 5 6 7 8 9 10 thorough ^ enjoyment indifference 139. APPENDIX N Letter to Piano Teachers Dear I am a psychologist and have studied piano for over 20 years. In March I w i l l be offering a free program for pianists who are suffering from performance anxiety which prevents them from demonstrating t h e i r s k i l l s and musicianship, and makes the performing experience unpleasant f o r them. As a piano teacher, I'm sure you are aware that t h i s i s a common d i f f i c u l t y among many music students. The program i s directed toward pianists who play w e l l at home or f o r t h e i r teachers, but i n performance situations tend to play at a l e v e l below t h e i r own standard. I am not attempting to reduce anxiety completely, as that would result i n a d u l l l i f e l e s s performance. I am concerned with reducing i t to the point where i t i s under control and enhances rather than interferes with the performance. The behavioural sciences have successfully demonstrated ways of reducing anxiety i n other areas, f o r example, with test and speech anxiety. I believe that these same techniques could prove effe c t i v e i n reducing musical performance anxiety. In designing the program, I have had input from, p i a n i s t s of a l l ages and l e v e l s . I hope t h i s has resulted i n a program which w i l l meet the i n d i v i d u a l needs of the participants. The program consists of three 1 and 1/2 hour evening sessions over the course of three weeks, starting the week of March 6th - 10th. Participants may choose the night which they would l i k e to attend. In order to assess the benefits of the program, participants w i l l be asked for a pre-program and post-program performance of a single piece of music. This should require no more than 15 minutes at each of those two times. This program could be offered at several convenient s i t e s within Greater Vancouver, subject to geographical response. There has been considerable interest shown by several teachers at music schools i n the lower mainland, and by the Board of the Registered Music Teachers? Association. I have agreed, therefore, a f t e r the program i s over, to discuss i t at the music schools and at a meeting of the R.M.T.A. In addition, I w i l l make the i n s t r u c t i o n a l material available so that you may use i t with your students. I f you have any students ages 14- and older who could benefit from t h i s program, please discuss i t with them and c a l l me, or ask them to c a l l me at 224-1219. I w i l l be home most evenings from 7 - 1 1 p.m. After February 14th, I can be reached at that number during days as w e l l . MO. I f you would l i k e further information do not hesitate to c a l l me. Thank you for'your int e r e s t . Sincerely, Margaret Kendrick H i . APPENDIX 0 Telephone Screening Procedure 1. name 2. age 3. telephone number 4. address 5. number of years of piano study 6. l e v e l or grade 7. can attend sessions Monday _, Wednesday , or Thursday evenings 1 or Sunday afternoon 8. can attend pre-performance (March 4) post-performance ( A p r i l 8) 9. Now I'd l i k e to ask you some sp e c i f i c questions which w i l l give me some information about your confidence as a performer. I w i l l read a statement and you t e l l me whether i t i s true or false for you. 1. I look forward to an opportunity to perform T F i n public. 2. My legs tremble when I reach for the pedal. T F 3. I am i n constant fear of forgetting the music. T F 4. At the conclusion of a performance I f e e l that I have had a pleasant experience. T F 5. My thoughts become jumbled and confused when I perform before an audience. T F 6. Although I am nervous just before getting up, I soon forget my fears and enjoy the experience. T F 7. I f e e l that I am i n complete possession of myself while performing. T F 8. I prefer to have the notes on the piano i n case I forget the music. T F 9. I f e e l relaxed and comfortable while performing. T F 10. I always avoid playing solos i n public i f possible. T F 142. 11. I enjoy preparing for a solo performance. T F 12. My hands f e e l cold and weak before performing. T F 13. I perspire and tremble just before performing. T F 14. I am f e a r f u l and tense a l l the while I am performing before an audience. T F 15. At the conclusion of my performance I f e e l that I would l i k e to continue performing. T F 143. APPENDIX P Consent Form I have been informed about the requirements of p a r t i c i p a t i n g i n t h i s program for reducing my musical performance anxiety. I have made a commitment to attend the two performances (today and on A p r i l 8th or 9th) and a l l additional sessions. I am aware that my two performances w i l l be video-taped and that a measure of my heart rate w i l l be taken. I know that t h i s and a l l other information gathered from me i n the course of the program i s confidential. I t w i l l be used to assess the benefits of the program and, with my permission, the tapes w i l l be shown during the group session when I am present. I f f o r some reason I wish to terminate my p a r t i c i p a t i o n i n the program, I know that I am free to do so. Signature Date 144. APPENDIX Q Pre-treatment Practice and Performance Information and Instruction Sheet a) How long have you been studying t h i s piece of music? b) How many times have you performed t h i s piece of music? c ) Between now and the beginning of A p r i l when you return f o r your second performance, t r y to r e s t r i c t your pra c t i c i n g of t h i s piece to no more than 15 minutes a day. In addition, i f possible do not perform t h i s piece of music again u n t i l you return i n A p r i l . Please bring the copy of your music i n to the studio with you. I f you play anything d i f f e r e n t l y from the way i t i s written, (for example, different tempo, expression, e t c . ) , be sure to make those changes on the copy. APPENDIX R Post-treatment Practice and Performance Information Sheet Estimate the average amount of time spent per day prac t i s i n g t h i s piece (or these pieces) of music since March 4-th/5th. How often have you performed t h i s piece (or these pieces) of music before an audience since March 4-th/5th? I f you have performed, describe the circumstances ( f e s t i v a l , r e c i t a l , for friends, etc. ). How often have you performed other pieces of music before an audience since March 4 t h / 5 t h ? I f you have performed other pieces, describe the circumstances. 146. APPENDIX S Follow-up Performance Instructions for Attentional Training Subjects There i s one f i n a l stage of p a r t i c i p a t i o n i n t h i s program for reducing your musical performance anxiety. I am interested i n knowing what benefits the program has for you. a month a f t e r the sessions have finished. I would l i k e you to perform the same piece or pieces of music which you played for the video-tape. Some of you w i l l be p a r t i c i p a t i n g i n music f e s t i v a l s or r e c i t a l s over the next few weeks. I f so, you may use the piece or pieces you are planning to play for those occasions. For those of you who aren't, I'd l i k e you to arrange a small " r e c i t a l " i n the same way as you did i n the home assignments e a r l i e r . Have at least s i x people there to hear you play (more i f you can!). Perhaps several of you who know each other could get together and arrange something. About 10 minutes before you play (or just before you leave home for the performance i f i t ' s more convenient), complete the f i r s t two questionnaires (#1 and #2). Just before you are about to play, pick one word from the t h i r d questionnaire (#3) which describes how you are f e e l i n g at that moment. And within a short time after you've finished (preferably within one or two hours), complete the fourth questionnaire (#4) describing the thoughts you had while you were performing. In addition, rate your l e v e l of anxiety and the quality of your performance i n the same way you've been doing e a r l i e r i n the sessions and home assignments (#5). As you can see, I'm asking you f o r a "do-it-yourself assessment" of the thoughts and feelings you have when you perform i n public. In addition to t h i s , I'd l i k e you to ask a member of your audience (someone who has heard you play often i f possible - teacher, parent, f r i e n d , etc. ) to rate changes i n l e v e l of anxiety and quality of your performance on the paper provided for t h i s (#6). Use the back of one of the pages for any comments you might have about the program. Positive and negative self-statements are both h e l p f u l ! I f you have any questions, don't hesitate to c a l l me at 224-1219. Please mail a l l t h i s information back to me i n the addressed and stamped envelope, by A p r i l 30th. Thank you for p a r t i c i p a t i n g i n the program. I enjoyed the sessions we had together and hope that they have been and w i l l continue to be helpful i n reducing your performance anxiety. 147. . APPENDIX T Follow-up Performance Instructions f o r Behaviour-.'. Rehearsal and Waiting L i s t Control Subjects There i s something I'd l i k e you to do before you come to the workshop on A p r i l 29th or 30th. I would l i k e you to perform the same piece or pieces of music which you played for the video-tape. Some of you w i l l be p a r t i c i p a t i n g i n music f e s t i v a l s or r e c i t a l s over.the next few weeks. I f so, you may use the piece or pieces you are planning to play for those occasions. For those of you who aren't, I'd l i k e you to arrange a small "recital!.'" Have at least s i x people there to hear you play (more i f you can! ). Perhaps several of you who know each other could get together and arrange something. About 10 minutes before you play (or just before you leave home for the performance i f i t ' s more convenient), complete the f i r s t two questionnaires (#1 and #2). Just before you are about to play, pick one word from the t h i r d questionnaire (#3) which describes how you are feel i n g at that moment. And within a short time after you've finished (preferably within one or two hours), complete the fourth questionnaire (#4) describing the thoughts you had while you were performing. In addition, rate your l e v e l of anxiety and the quality of your performance (#5). As you can see, I'm asking you for a "do-it-yourself assessment" of the thoughts and feelings you have when you perform i n public. In addition to t h i s , I'd l i k e you to ask a member of your audience (someone who has heard you play often i f possible - teacher, parent, f r i e n d , etc. ) to rate changes i n l e v e l of anxiety and qua l i t y of your performance on the paper provide for t h i s (#6). I f you have any questions, don't hesitate to c a l l me at 224-1219. Please put a l l t h i s information i n the envelope provided, and bring i t with you when you come to the workshop. I'm looking forward to seeing you then. APPENDIX U Information on Follow-up Performance Name date of performance piece or pieces of music Did you play from memory? or with music? Describe the circumstances i n which you performed ( f e s t i v a l , r e c i t a l , for friends, etc.). How many people were i n your audience ( i f large, estimate)? A few months ago would you have considered t h i s to be a more  threatening or less threatening performance s i t u a t i o n than playing for a videotape with two people i n the room? Please check your answer: a) more threatening than videotape b) less threatening than videotape Please c i r c l e the number which best describes your: a) o v e r a l l l e v e l of anxiety completely 1 2 3 4 - 5 6 7 8 9 10 extremely "relaxed tense b) quality of performance worst you've best you've ever played 1 2 3 4 5 6 7 8 9 10 ever played t h i s piece(s) ' t h i s piece(s) H 9 . APPENDIX V Si g n i f i c a n t Other Ratings of Visual Signs of Anxiety and Quality of Playing during Follow-up Performance Name I would l i k e you to rate the change over the l a s t two months i n 's l e v e l of anxiety and the q u a l i t y of his or her playing. Use v i s u a l signs to help you arrive at a l e v e l of anxiety (e.g., shaking arms, shaking knees, s t i f f arms, tense shoulders, etc. ). Use accuracy i n notes, tempo, dynamics, rhythm, etc. and communication of mood and f e e l i n g to arrive at a rati n g of quality. C i r c l e the number which best describes the change i n : a) v i s u a l signs of anxiety much more tense -3 -1 0 +1 +2 +3 much more relaxed b) quality of performance much worse -2 +1 +2 +3 much better (0 = no difference) Please place t h i s sheet i n the envelope provided, seal, and give i t to . Thank you for your help. 150. APPENDIX W Therapist Manual for Attentional Training Sessions Session One 1. attendance 2. introduction of therapist as a psychologist and also a p i a n i s t 3. introduction of group members 4. discussion of performance anxiety: a) How long have you experienced performance anxiety? When did i t f i r s t become a problem for you? b) How much does your anxiety interfere with your playing (sometimes/ every time, able to continue/have to stop)? c) What situations are most anxiety-arousing for you? d) How do you know when you're anxious? I f I were, l i s t e n i n g to you how would I know you were anxious? 5. cognitive r e c a l l : I'm going to ask you to think back to the performance you gave• • i n front of the videocamera. I'm going to show you the videotapes of your performances and ask you to share the thoughts and feelings you were experiencing. Therapist shows videotaped performances (from pre-treatment assessment) and asks: What were you thinking here? What were you t e l l i n g yourself or saying to yourself here? Did you f i n d that your thoughts took the form of things you were saying to yourself? 6. presentation of treatment rationale: In l i s t e n i n g - t o you t a l k about your performance anxiety and i n reading over the questionnaires which you completed after your performance (pre-treatment assessment)} I notice that a l o t of you have d i f f i c u l t y focusing on the task before you - i . e . , on playing the music. Somehow your attention seems to wander away from the music to something else l i k e *• 151. I wonder what people w i l l think of me i f I make mistakes. I'm sure I'm playing worse than anyone else. My gosh my knees are shaking. I'm a f a i l u r e . Your thoughts, or the things you are saying to yourselves i n your heads, seem to get i n the way of what you are there to do - which i s of course to play the music as b e a u t i f u l l y as you can. Is that right? I'm going to c a l l these thoughts or things we say to ourselves i n our heads, our self-statements. We now know that there i s a strong relationship between what people are thinking and how anxious they f e e l . The anxiety you experience when.you are performing i s caused by the kinds of thoughts you have. I f you expect to do poorly, e.g.,."I know I ' l l have a memory lapse" or i f you start to wonder about what people are thinking of you e.g., "They'll think I'm t e r r i b l e " then your attention i s taken away from the music and focused onto something else. These negative thoughts raise your anxiety and affect the way you are playing. I t ' s a vicious c i r c l e . (Therapist draws on blackboard): negative thoughts anxiety ; problems with your playing Does t h i s make sense? During our three sessions together we w i l l explore and share the thoughts and feelings we have as we are performing. F i r s t of a l l you w i l l t r y to become aware of the negative things you are saying to yourselves. The recognition that you are i n fact doing t h i s i s the f i r s t step forward i n changing. Second, you w i l l learn to challenge your negative thoughts, and t h i r d , learn to replace them with positive self-statements. In short, you w i l l learn how to gain control over your thinking and not allow i t to take over and lead you to a state of anxiety. We are not helpless victims of our thinking.' The positive self-statements can be of several different types: 152. a) they can be comforting self-statements: e.g., "I'm w e l l prepared for t h i s performance so there's no reason, for me to be worried." More examples? b) they can be task-focused self-statements: e.g., "Don't worry about that d i f f i c u l t part on the next page. Concentrate on what you're doing right now." More examples? c ) they can be technique-oriented self-statements: e.g., "Now what did my teacher t e l l me to do at t h i s point? Oh yes, I'm supposed to play very s o f t l y and gradually increase the tone." Or "I'm supposed to play from my shoulders here." More examples? d) they can be rewarding self-statements: e.g., "I f e e l pleased with the.way I played - and I'm glad I was able to control my anxiety." More examples? Over time you w i l l gradually f i n d that you w i l l have more positive self-statements and fewer negative ones. Don't expect, however, that you w i l l always be able to have only positive thoughts. We know that mildly anxious people do not think only positive thoughts. The difference, however, i s that they are able to challenge the negative thoughts they do have and replace them with positive self-statements. Very anxious people don't do t h i s a l l that w e l l . Are there any questions? 7. d i s t r i b u t i o n of S e l f - I n s t r u c t i o n a l Training handouts (see Page 155) 8. modeling slide-tape presentation and discussion: The p i a n i s t i n the following slides i s Judy. She was together with some friends at a party one evening, and a couple of them asked her to play the piano. I'm sure a l l of.you have been i n that same situa t i o n . A few weeks ago I asked Judy i f she would go back and r e - l i v e that experience as i t happened and share with us her thoughts and feelings i n the same way that you did with the videotapes e a r l i e r . Note the kinds of anxieties which she has and the way i n which she copes with them. Pay p a r t i c u l a r attention to the negative things she says to herself and the way i n which she challenges them and i s able to replace the negative, thoughts with positive self-statements. Therapist shows slide-tape sequence. 153. Questions: a) How many of you f i n d you are anxious performing i n front of friends or family? b) What kinds of anxieties are special to that situation? c) What positive self-statements could you make to overcome those negative thoughts? Therapist gives an example from her own personal experience: I often worry that my friends expect to hear a popular piece l i k e something by Elton John or the Beatles or Fleetwood Mac, and instead they hear Bach or Beethoven. I f e e l anxious that they w i l l be bored. What could I say to myself to overcome that anxiety? d) A problem which I think many of us fear when we perform was demonstrated here - the memory lapse. What do you do when you have a memory lapse - are you able to get back on the track again, forget about i t , and concentrate on doing your best for the rest of the piece? Or do you l e t -it devastate you and make you f e e l l i k e a f a i l u r e and make you play poorly for the rest of the piece? e) How did Judy cope with i t ? What positive statements could you say to yourself to help you cope with a memory lapse? f ) Do any of you remember what Judy said to herself after she had finished playing? Why do you think that i s important? What could you say i f you played well? What could you say i f you didn't play as wel l as you would have liked? 9. homework assignment: There are a couple of things I'd l i k e you to do before you come back next week. I'd l i k e you to perform a piece of music for some family members. Have at least two people l i s t e n i n g to you and make i t l i k e a performance. Play something other than the piece which you played for the videotape. You can use your music i f you l i k e . 154. After you've finished, I'd l i k e you to rate your anxiety from 1 (completely relaxed) to 10 (extremely anxious). Also, rate the quality of your performance from 1 (the worse you've ever played that piece) to 10 (the best you've ever played that piece). In addition, I'd l i k e you to write down the negative and positive thoughts which you had during that performance. The second thing I'd l i k e you to do i s l i s t at least f i v e positive thoughts or self-statements which you f e e l would be helpful to you i n overcoming your performance anxiety. Be sure to;include at least one 'before,' one 'during,' and one 'after' self-statement. These sheets w i l l summarize these instructions for you and you can write the information on the sheets and bring, them back next week. 10. questions on expectancy: The.last thing I'd l i k e you to do today i s answer three questions which I ' l l pass out to you now. 11. closing 12. re fre shments SELF-INSTRUCTIONAL TRAINING HANDOUT fe e l anxious about a performance: Explore what you are saying to yourself. You w i l l probably f i n d i t ' s something negative. NOTE: Your anxiety i s not a bad sign, but a cue to star t the coping process which you have learned. STEP 2 Challenge those negative thoughts or self-statements. STEP 3 Replace the negative thoughts or self-statements with positive self-statements: a) comforting or reassuring b) task-focused - focus your attention on playing the music and not on the audience, a d i f f i c u l t spot two pages ahead, etc. c) technique-oriented - concentrate on the touch, expression, and a l l the other things you have been pract i s i n g d) rewarding - say something good to yourself after you have played ( i f you did w e l l and even i f you didn't do as well as you would have l i k e d ) I f you STEP 1 156. HOME ASSIGNMENT #1 Name PART A 1. date of performance 2. piece of music 3. Did you play from memory? or with music? 4. How many people were listening? 5. Please c i r c l e the number which best describes your: a) o v e r a l l l e v e l of anxiety completely 1 2 3 4 5 6 7 8 9 10 extremely relaxed tense b) quality of performance worst you've 1 2 3 4 5 6 7 8 9 10 best you've ever played ever played >. Please l i s t . a l l the negative thoughts or self-statements you had. 7. Please l i s t a l l the positive self-statements you made. PART B Please l i s t at least f i v e positive self-statements which you f e e l would be helpf u l to you i n overcoming your p a r t i c u l a r performance anxieties. Be sure to include i n your l i s t at least one comforting, one task-focused, one technique-oriented, and one rewarding thought. Also, remember to include thoughts for before, during, and after performing. 157. Session Two 1. attendance 2. b r i e f restatement of rationale 3. discussion of homework assignment: a) How many of you found you were saying some negative things to yourselves? What kinds of things were you saying? b) Did you notice a relationship between what you were saying to yourself and how you were feeling? c) Were you able to challenge those negative thoughts and replace them with p o s i t i v e task-oriented self-statements? d) Turn now to the second part of the assignment. .I'd l i k e to hear some of the positive self-statements you came up with. What self-statements did you think would be helpful before you are about to play? - during your performance? - after i t ' s over? -4. modeling slide-tape presentation and discussion: A. The pianis t i n the following slides i s Denise. Just before Christmas, Denise was playing for an exam at university. I think most of you have taken Toronto Conservatory or Western Board exams. I asked Denise i f she would go back and r e - l i v e that experience as i t happened, and share her thoughts and feelings with us i n the same way that Judy did i n the slides l a s t week. I asked Denise to play just one of the three pieces she played - a Bach Toccata i n C Minor. Note the kinds of anxieties which she has and the way i n which she copes with them. Pay p a r t i c u l a r attention to the negative things she says to herself and the way i n which she challenges them and replaces them with positive task-oriented self-statements. Therapist shows slide-tape sequence. Questions: a) How many of you f i n d you are anxious when you play i n an exam? b) What kinds of anxieties are special to the exam situation? 158. c) What positive self-statements could you make to overcome those negative thoughts? Therapist gives an example from her own personal experience. When I was taking exams I worried that my teacher and my parents would be disappointed i n me i f I didn't do wel l . Do any of you ever have that feeling? What could I have said to myself to overcome that worry? d) What techniques did Denise use to overcome her anxieties? What positive things did she say to herself? e) What did Denise say to herself after she had finished performing? Remember l a s t week we decided i t was important to say something positive after a performance because what we say to ourselves influences how we w i l l f e e l the next time we play. B. The model i n the next slides i s Denella. Last year Denella was competing for a scholarship i n a music.festival i n Burnaby. I imagine that a l o t of you have participated i n some of the music f e s t i v a l s throughout the c i t y . I asked Denella I f she would go back and r e - l i v e that experience as i t happened and share with us her thoughts and feelings. She i s playing the same piece of music.as she did i n the f e s t i v a l - two Spanish dances from a. suite by Ginastera. Note the kinds of anxieties which she has and the way i n which she copes with them. Pay par t i c u l a r attention to the negative things she says to herself, the way she challenges these, and the way she replaces them with positive task-oriented self-statements. Therapist shows slide-tape sequence. Questions: a) How many of you fi n d that a music f e s t i v a l s i t u a t i o n makes you very anxious? b) What kinds of anxieties are special to that s i t u a t i o n (compe-t i t i o n , audience, etc. )? c) What positive self-statements could you make to overcome those negative thoughts? Therapist gives an example from her own personal experience: When I played i n f e s t i v a l s I sometimes looked at the trophy on ..the adjudicators' desk and thought about how much I would l i k e to win i t . During my performance, i f I made a few mistakes I would think about losing that trophy. Now that's an example of a task-irrelevant thought. What could I have said to myself to push that thought out of my head and get back on the task? d) Did you notice the positive kinds of things Denella was saying to herself while she was playing? What did she say after she had finished? rehearsal: Okay now for t h i s part of the session I'm going to ask you to . play a piece or part of a piece of music and use the technique we've been t a l k i n g about. I w i l l go f i r s t and show you what I mean. Today we're going to think our thoughts out loud. As I am thinking a positive or negative thought I w i l l share i t with you. Notice how I challenge my negative thoughts, push them aside, and replace them with positive self-statements. Therapist models: approaching piano: "I'm sure t h e y ' l l think t h i s piece i s too simple for .me to be playing . . . What am I thinking l i k e that f o r i I t ' s a lovely l i t t l e piece and I enjoy playing i t . s i t t i n g at piano: "I f e e l nervous . . . Now just relax . . . Think of the f i r s t phrase of the music. Sing i t i n your head." playing: "Here comes that fast part. My fingers sometimes get tangled up . . . Stop worrying and thinking ahead and just play. Make i t sing." after f i n i s h i n g : "I was able to control my anxiety and I f e e l good about that. I actually enjoyed playing." It ' s kind of d i f f i c u l t to play and t a l k at the same time so save those thoughts and share them with us afterwards. Also, rate your anxiety and quality of playing on scales from 1 to 10 as you did i n your home assignment. Each group member performs. homework assignment: Before you come back next week there's something I'd l i k e you to do. Each day when you practise I'd l i k e you to take one of your pieces and pretend that you're about to perform i t for someone. 160. You could even sightread a piece i f you want to. Go through i t just the way we did today, verbalizing your thoughts out loud. Try to focus on positive thoughts. I f you do have negative ones, challenge them and replace them with positive thoughts. I f mum or dad or brothers and s i s t e r s comment on the fact that you're t a l k i n g to yourself, tell.them that research shows that people who t a l k to themselves p o s i t i v e l y when they're performing a task do better on that, task and f e e l less anxious than people who don't t a l k to themselves! One time during the week I'd l i k e you to.do the same as you did l a s t week. Perform a piece for family members or friends. Try to increase the number of people i n your audience and make i t l i k e a. performance. After you've finished, rate the qua l i t y of your performance and the l e v e l of your anxiety. Write down your positive thoughts. Also write any negative thoughts which you had, the way you challenged them, and the positive thoughts which replaced them. Therapist hands out sheets. Each day place a check i f you have done the verbalizing aloud exercise. Please respond accurately as i t w i l l be most helpful i f you do. I f you don't practise the piano every day or i f you forget to do the exercise one day, leave the square blank. 7. questions on expectancy 8. closing 9. refreshments 161. HOME ASSIGNMENT #2 Name PART A 1. date of performance 2. piece of music 3. Did you play from memory? or with music? ' 4. How many people were listening? 5. Please c i r c l e the number which best describes your: a) o v e r a l l l e v e l of anxiety completely 1 2 3 4 5 6 7 8 9 10 extremely relaxed tense b) quality of performance worst you've 1 2 3 4 5 6 7 8 9 10 best you've ever played ever played 6. Please l i s t a l l the negative thoughts or self-statements you had. 7. Please l i s t a l l the positive self-statements you made. 8. Has there been a change since l a s t week: Yes No a) Has your anxiety decreased? b) Has the qua l i t y of your playing improved? c) Do you have fewer negative thoughts or self-statements? d) Do you have more positive s e l f -statements? PART B Each day when you practise, take one of your pieces and pretend that you are about to perform i t . You can even sightread a piece Home Assignment #2 Page 2 i f you want to. Go through i t just the way we did i n the session, thinking your thoughts out loud. I f you have negative thoughts or self-statements, challenge them and replace them with positive self-statements. Place a check after each day that you complete the think aloud exercise. Please respond accurately as i t w i l l be most helpful i f you do. I f you don't practise the piano every day, or i f you don't do the exercise one or two days, leave the square(s) blank. Monday _____ Tuesday Wednesday Thursday Friday Saturday 163. Session Three 1. attendance 2. b r i e f restatement of rationale 3. discussion of homework assignment: a) How many of you rated yourselves as less anxious than l a s t week? b) How many of you rated the quality of your performance higher that l a s t week? c) Did you have more positive thoughts than l a s t week? Did you f i n d you could challenge your negative thoughts? d) How did the verbal!zing-aloud exercise go? 4. modeling slide-tape presentation and discussion: The p i a n i s t i n the slides which you're going to see tonight i s Vancev: ' Vance i s a teacher and concert p i a n i s t . I asked him to share the kinds of.thoughts and feelings which he has while giving a r e c i t a l , because often we think that people who have reached that l e v e l never have any performance anxiety at a l l . This i s not the case. Notice, however, that Vance's anxieties are not focused on himself and what people w i l l think of him,, but whether he w i l l be able to play the music i n a way that w i l l communicate something to the audience. As I mentioned e a r l i e r , a certain amount of anxiety i s necessary to give excitement and l i f e to a performance. I f there were no anxiety at a l l i t would be d u l l and l i f e l e s s . I think Vance has just the right amount of performance anxiety. Therapist shows slide-tape sequence. Questions: a) What kinds of anxieties are special to a r e c i t a l situation? You're not being given a mark, you're not competing against anyone, why would you s t i l l f e e l anxious? Why have people i n the audience come to hear you play? b) Did you notice how Vance was almost completely focused on the music and how he was playing i t ? Did you notice what he said just before starting? Just after finishing? 164. c) You may remember that when he came on stage he searched f o r his mother's face. That was very comforting for him. Some of you may l i k e to locate a f a m i l i a r face i n the audience. Others of you may prefer not to look at the faces but instead to look at the back wa l l . rehearsal: Now I'd l i k e each of you to play two pieces of music and do the same as l a s t week only t h i s time say your thoughts s i l e n t l y to yourself. Again t r y to focus on positive task-oriented thoughts. I f you have negative thoughts challenge them and replace them with positive self-statements. After you f i n i s h playing share with us how successful you've been at controlling your thoughts. And again I'd l i k e you to rate your anxiety and quality of playing on scales from 1 to 10. music f e s t i v a l imagination sequence: For the next part of the session I'd l i k e you to activate your imaginations. Do you think you can do that? I'm going to describe a scene to you. Each time I come to a negative self-statement I w i l l pause and I'd l i k e you to challenge i t and replace i t with a positive coping statement. Now close your eyes and relax. Imagine that you are p a r t i c i p a t i n g i n a music f e s t i v a l . You arrive at the h a l l where you're going to play and while standing at the door you can hear someone playing the piano inside. You show your competitor's card to the woman at the desk and s l i p inside as the audience i s applauding the p i a n i s t who i s just leaving the stage. You walk slowly down to the front and take a seat right at the a i s l e . You notice from your program that there i s one more person to perform before i t ' s your turn. The next performer i s walking up to the stage. She s i t s at the piano and.waits for a signal from the adjudicator to begin. She starts to play. I t ' s a piece which i s much more d i f f i c u l t than the one you have chosen to play. And she plays b e a u t i f u l l y -her technique i s flawless and she plays musically too. You are wondering how you w i l l measure up to her - you are thinking you couldn't possibly beat her but then you say to yourself . She i s finished playing and returns to the audience. You get up and ascend the f i v e s t a i r s to the stage. The l i g h t i s so bright and everything feels strange. You s i t down at the bench and move i t into a p o s i t i o n which feels comfortable for you. You look out towards the audience. It ' s f a i r l y dark, you can't see much, but towards the back of 165. the h a l l you see the adjudicator s i t t i n g at a long table. He seems to be reading something - then looks up. You hear the b e l l and know you must begin. Yoy wonder i f you can remember the f i r s t note but you say to yourself ' . You begin to play. You're fee l i n g kind of shakey and are just hoping y o u ' l l get to the end without messing i t up but then you say to yourself _ ^ . You're remembering the louds and softs, the parts to play staccato and the parts to play smoothly, and you're concentrating on the be a u t i f u l phrasing. You're doing so we l l you wonder i f you can keep i t up but you say to yourself . You f i n d you are actually enjoying playing. You come to the closing notes. You stand up. The audience i s applauding. You f e e l good inside and you say to yourself . This exercise has two purposes: a) I t helps you to challenge negative anxiety-arousing thoughts. b) I t shows you that you can practise dealing with anxiety i n a variety of situations and settings simply by using your imagination. How many of you were able to imagine the scene v i v i d l y ? 7. homework assignment: I'd l i k e you to do something between now and the time you come back • for the post-program performance. Again, one time during the week do the same., thing which you've been doing over the past two weeks. Perform a piece of music increasing your audience, size from l a s t week. Rate the qu a l i t y of your performance and the l e v e l of your anxiety. And write down the accompanying thoughts. The second thing I'd l i k e you to do i s imagine you are i n an examination sit u a t i o n . Do t h i s the same way i n which I have, done i t today. Start from before you enter the room and go through u n t i l the time you leave. Be aware of the things you are saying to yourself. Try to focus on positive task-oriented thoughts. When they're negative, challenge them and change them. Next do the same thing i n a r e c i t a l s i t u a t i o n where you are one of three performers on the program. There's a difference between what we did today and what I'd l i k e you to do at home. I'd l i k e you to incorporate actual playing into your imagined sequence. Start by s i t t i n g on the sofa with your eyes closed and bring the scenes into your mind. Then as you're imagining yourself getting up to approach the piano actually get up and go to the piano and play, t r y -' -..ing'tokeep i n mind a l l the time that you are not i n your l i v i n g -room at home but f i r s t i n an exam and second i n a r e c i t a l . 166. 8. questions on expectancy 9. closing 10. refreshments 167. HOME ASSIGNMENT #3 Name PART A 1. date of performance 2. piece of music 3. Did you play from memory? or with music? 4. How many people were listening? 5. Please c i r c l e the number which best describes your: a) o v e r a l l l e v e l of anxiety completely 1 2 3 4 5 6 7 8 9 10 extremely relaxed tense b ) q uality of performance worst you've 1 2 3 4 5 6 7 8 9 10 best you've ever played ever played 6. Please l i s t a l l the negative thoughts or self-statements you had. 7. Please l i s t a l l the positive self-statements you made. 8. Has there been a change since l a s t week: Yes No a) Has your anxiety decreased? b) . Has the quality of your playing improved? c) Do you have fewer negative thoughts or self-statements? d) Do you have more positive s e l f -statements? 168. Home Assignment #3 Page 2 PART B 1. a) How v i v i d l y were you able to imagine the examination scene? not 1 2 3 4 5 6 7 8 9 10 very v i v i d l y -at a l l I almost f e l t as i f ! were there b) Please c i r c l e the number which best describes your ov e r a l l l e v e l of anxiety. completely 1 2 3 4 5 6 7 8 9 10 extremely relaxed tense c) Please c i r c l e the number which best describes the quality of your performance. worst you've best you've ever played 1 2 3 4 5 6 7 8 9 10 ever played d) Please l i s t a l l the negative thoughts or self-statements you had. e) Please l i s t a l l the positive self-statements you made. 2. a) How v i v i d l y were you able to imagine the r e c i t a l scene with yourself as one of three performers on the program? not 1 2 3 4 5 6 7 8 9 10 very v i v i d l y -at a l l I almost f e l t as i f I were there b) Please c i r c l e the number which best describes your o v e r a l l l e v e l of anxiety. completely 1 2 3 4 5 6 7 8 9 10 extremely relaxed tense c) Please c i r c l e the number which best describes the qua l i t y of your performance. worst you've best you've ever, played 1 2 3 4 5 6 7 8 9 10 ever played Home Assignment #3 Page 3 d) Please l i s t a l l the negative thoughts or self-statements you had. e) Please l i s t a l l the positive self-statements you made. 170. APPENDIX X Therapist Manual for Behaviour Rehearsal Sessions Session One 1. attendance 2. introduction of therapist as a psychologist and also a pi a n i s t 3. introduction of group members discussion of performance anxiety: a) How long have you experienced performance anxiety? When did i t f i r s t become a problem for you? b) How much does your anxiety interfere with your playing (sometimes/ every time, able to continue/have to stop)? c) What situations are most anxiety-arousing for you? d) How do you know when you're anxious? I f I were l i s t e n i n g to you how would I know you were anxious? 5. discussion of ways i n which performance anxiety can develop: In l i s t e n i n g to you t a l k , I notice that many of you have not always been anxious while performing at the piano. Performance anxiety can develop for a number of different reasons: a) You may have had one or more bad experiences performing. Perhaps you had a memory lapse i n a r e c i t a l and were t e r r i b l y embarrassed, or perhaps you were extremely nervous i n an exam and didn't play.nearly as well as you could at home. Perhaps you were playing for some friends and f e l t they were bored by the piece you had chosen to play. Negative experiences l i k e these tend to make us less eager to perform and much more nervous and less self-confident when we do perform. Have any of you had experiences l i k e these? Therapist gives an example from her own personal experience. b) Performance anxiety may also develop after seeing, other people perform who are very anxious and make a l o t of mistakes. c) Your anxieties about performing may also be a result of anxieties which you have i n other areas of your l i f e . I f you have a poor self-image i . e . , a low opinion of yourself In general, then 171. you may expect that you won't do w e l l , that y o u ' l l probably have a memory lapse, or that you won't be able to control your anxiety. d) Do any of you have additional ideas as to how your anxiety about performing may have developed? In any case i t seems that many of us have learned to be anxious while performing. Knowing why we are anxious doesn't necessarily help us to change how we f e e l . I t only helps i n that i f we have learned to be anxious, we should be able to rel'earn how not to be anxious! 6. presentation of treatment rationale: A number of well-known teachers and musicians - Artur Rubinstein for one - have recommended that simply playing i n front of others i s the key to reducing performance anxiety. They advise you to make yourself do the very thing you fear. - play i n public as much as possible, even though at f i r s t i t may be d i f f i c u l t because of your anxiety. Each time i t w i l l get a l i t t l e easier. Does t h i s make sense to you? One good idea i s to start with an audience of one - a family member or friend. You will.make mistakes. Afterwards r e c a l l where, how, and why the mistakes, happened and work to strengthen those d i f f i c u l t spots. For the second performance get an audience of two. Continue to repeat your performances, each time adding one more to your audience. Gradually you will.concentrate more on playing the music and less on the fact that you are s i t t i n g i n front of an audience. The program i n which you are p a r t i c i p a t i n g i s divided into two parts. The f i r s t part takes place over the next three weeks. During these three sessions I am going to ask each of you to play a piece of music i n front of the rest of us. A l l of you share the same concerns about performing so'together we form a sympathetic and understanding audience. Don't worry i f you don't perform your best at f i r s t . By continuing to perform i n a comfortable atmosphere, without c r i t i c i s m from those l i s t e n i n g to you, you w i l l r e a l i z e that performing i s not such a f r i g h t f u l experience after a l l and your anxiety w i l l lessen. 172. In the second part of the program we w i l l meet together during an afternoon f o r a workshop. I w i l l show you the videotapes and heart rates from your performances and y o u ' l l have a chance to see how much you have improved as a result of the sessions we've had together. rehearsal: Now I'd l i k e each of you to play for the rest of us. After you've finished rate your anxiety from 1 (completely relaxed) to 10 (extremely anxious). Also rate the quality of your performance from 1 (the worst you've ever played t h i s piece) to 10 (the best you've ever played i t ) . Over the next few weeks you should be able to see changes i n these ratings as a resul t of an increase i n your number of performances i n supportive situations. I ' l l go f i r s t . Therapist performs and each group member performs. homework assignment: There i s something I'd l i k e you to do before you come back next week. I'd l i k e you to perform a piece of music for some family members. Have at least two people l i s t e n i n g to you and make i t l i k e a performance. Play something other than the piece which you played for the videotape. You can use your music i f you l i k e . After you f i n i s h I'd l i k e you to rate your anxiety and the quality of your playing i n the same way that you did today/tonight. questions on expectancy: The l a s t thing I'd l i k e you to do today i s answer three questions which I ' l l pass out to you now. closing refreshments Home Assignment following A l l Three Behaviour Rehearsal Sessions Name- ' . 1. date of performance 2. piece of music 3. Did you play from memory? or with music? ______ 4. How many people were listening? . 5. Please c i r c l e the number which best describes your: a) o v e r a l l l e v e l of anxiety completely 1 2 3 4 - 5 6 7 8 9 10 extremely relaxed tense b) quality of performance worst you've 1 2 3 4 5 6 7 8 9 10 best you've ever played ever played 174. Session Two 1. attendance 2. b r i e f restatement of rationale 3. discussion of homework assignment: a) What kind of audiences did you manage to gather? b) How did your ratings of anxiety and quality of performance compare with the ones i n our session l a s t week? c) Did you make a note of the places where you had d i f f i c u l t y or f e l t insecure so you could work on those parts? 4. rehearsal: Again today/tonight I'd l i k e each of you to play f o r us. After you've finished, rate your anxiety (1-10) and rate the quality of your performance (1-10). Each group member performs. 5. homework assignment: Your assignment for t h i s week i s the same as before. Perform' a piece of music for family members or friends. Try to increase the number of people i n your audience from l a s t week and make i t l i k e a performance. Again, don't use the piece which you played for the videotape. You can use your music i f you l i k e . After you've finished, rate your anxiety and the quality of your performance i n the same way that you did. today/tonight. Look to see what changes have taken place since l a s t week. 6. questions on expectancy 7. closing 8. refreshments 175. Session Three 1. attendance 2. b r i e f restatement of rationale 3. discussion of homework assignment: a) How did your ratings of anxiety and qua l i t y of performance compare with the ones i n your home assignment l a s t week? Was your audience larger? b) Did you make a note of the places where you had d i f f i c u l t y or f e l t insecure so you could work on those parts? 4. rehearsal: Again today I'd l i k e each of you to play for us. After you've finished, rate your anxiety (1-10) and rate the quality of your performance (1-10). Each group member performs. 5. homework assignment: Your assignment for t h i s week i s the same as before. Perform a piece of music f o r family members or friends. Try to increase the number of people i n your audience from l a s t week and make i t l i k e a performance. Again, don't use the piece which you played for the videotape. You can use your music i f you l i k e . 6. questions on expectancy 7. closing 8. refreshments 176. APPENDIX Y Therapist Manual, for Attentional Training Workshop 1. attendance 2. introduction of therapist as a psychologist and also a p i a n i s t 3. introduction of group members 4. cognitive r e c a l l : I am going to ask you to think back to the f i r s t , performance you gave i n front of the video camera. I'm going to show you the video-tapes of your performances and ask you to share the thoughts and feelings you were experiencing. Therapist shows videotaped performances and asks: What were you thinking here? What were you t e l l i n g yourself or saying to yourself here? Did you f i n d that your thoughts took the. form of things you were saying to yourself? 5. presentation of treatment rationale: (same as i n Attentional Training - s e s s i o n one) 6. d i s t r i b u t i o n of S e l f - I n s t r u c t i o n a l Training handouts 7. modeling slide-tape presentations and discussions: (same as i n Attentional Training - sessions one and two) a) p i a n i s t playing for a group of friends b) p i a n i s t performing i n an exam 8. short break for refreshments 9. rehearsal: Therapist models performing and sharing thoughts out loud. Group members also perform, verbalizing t h e i r thoughts. Audience helps performer to challenge negative thoughts (same as i n Attentional Training - session two). 10. music f e s t i v a l imagination sequence: (same as i n Attentional Training - session three) 11. questions on expectancy 12. closing 177. APPENDIX Z Post-workshop Follow-up Instructions for Behaviour- Rehearsal and Waiting L i s t Control Subjects There i s one f i n a l stage of p a r t i c i p a t i o n i n t h i s program. I am interested i n knowing how b e n e f i c i a l the workshop i s i n reducing your musical performance anxiety. I would l i k e you to arrange a second performance, following the same procedures as you.did previously (of. course the place and audience may be d i f f e r e n t ) . Perform the same piece or pieces as you did for that performance - i n most cases, t h i s w i l l be the same as for the video-tape. Some of you w i l l be p a r t i c i p a t i n g i n music f e s t i v a l s or r e c i t a l s over the next few weeks. I f so, you may use the piece or pieces you are planning to play for those occasions. For those of you who aren't, arrange a small " r e c i t a l " of your own. Have at least s i x people there to hear you play (more i f you can!). Perhaps several of you who know each other could get together and arrange something. About 10 minutes before you play (or just before you leave home for the performance i f i t ' s more convenient), complete the f i r s t two questionnaires (#1 and #2). Just before you are about to play, pick one word from the t h i r d questionnaire (#3) which describes how you are fe e l i n g at that moment. And within a short time after you've finished (preferably within one or two hours), complete the fourth questionnaire (#4-) describing the thoughts you had while you were performing. In addition, rate your l e v e l of anxiety and the qua l i t y of your performance i n the same way as you did before (#5). Again, I'm asking you for a "do-it-yourself assessment" of the thoughts and feelings you have when you perform i n public. In addition to t h i s , I'd l i k e you to ask a member of your audience (someone who has heard you play often i f possible - teacher, parent, f r i e n d , etc.) to rate changes i n l e v e l of anxiety and quality of your performance on the paper provided for t h i s (#6). I f possible, choose the same person who did t h i s before. Use the back of one of the pages for any comments you might have about the program. Positive and negative self-statements are both h e l p f u l ! I f you have any questions, don't hesitate to c a l l me at 224-1219. Please mail a l l t h i s information back to me i n the addressed and stamped envelope, by May 22nd. Thank you for your p a r t i c i p a t i o n . I enjoyed the time we spent together and hope that the program has been and w i l l continue to be helpful i n reducing your performance anxiety. APPENDIX AA Anticipated Effects of Success and Failure Models on the Performance of Observers Please place a check beside the answer which applies to you. You should make two checks i n t o t a l . A. Imagine you are waiting to perform. The performer ahead of you i s playing accurately and with r e a l musicianship. Do you f e e l t h i s would: a) cause you to play better? b) cause you to play worse? c) have no effect on your performance? B. Again imagine that you are about to give a performance of piece of music. As you are waiting your turn, the performer ahead of you starts to make a l o t of mistakes, and then has a memory lapse. Do you f e e l t h i s would: a) cause you to play better? b) cause you to play worse? c) have no effect on your performance? 

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