Modelling and participant modelling

1. Introduction

Version followed: Bandura's participant modeling (first called "live modeling with guided participation", Bandura, Blanchard & Ritter 1969), as specified in Bandura (1977, Psychological Review) and the induction-aid and self-directed-mastery studies (Bandura, Jeffery & Wright 1974; Bandura, Jeffery & Gajdos 1975). Bandura's later name for the same approach, "guided mastery" (Bandura 1997; S. L. Williams 1990), is used where it adds procedures. Symbolic (film/video) and covert (imagined) modelling are included as the observational components of the family. [source: Bandura 1977; Pressbooks chapter 13.3]

Modelling therapy is a family of procedures from social learning (later social cognitive) theory. It is not one manualised therapy. In modelling, the client watches a model (live, filmed or imagined) deal with a feared or difficult situation without harm, or perform a skill well. In participant modelling, the therapist demonstrates and then helps the client do the activities themselves. The therapist uses "response induction aids" (supports such as joint performance, protective equipment and graded steps) so the client succeeds despite fear. The therapist then withdraws the aids and arranges a period of self-directed mastery. [source: Bandura 1977 pp. 196–197; Bandura, Jeffery & Wright 1974]

How change happens. In Bandura's account, the main driver is perceived self-efficacy: the person's belief that they can carry out the actions a situation requires. Performance accomplishments are the strongest source of efficacy information. Bandura calls successful performance the "primary vehicle of psychological change" (1977, p. 196). Vicarious experience is weaker but still useful. Here, observers learn from a model that the feared consequences do not occur (vicarious extinction) and see which approach behaviours to use. Verbal persuasion and lowered arousal add to these. The therapist's task is to arrange mastery experiences the client can attribute to their own capability. Fear reduction is expected to follow from those experiences rather than to come first. [source: Bandura 1977 pp. 195–200; Pressbooks 13.3]

2. Framework

Modelling and participant modelling have no officially fixed session protocol. The research protocols had a consistent structure, set out below. Session counts are those of the research protocols; there is no clinical norm. [source: Bandura 1977; Bandura, Jeffery & Wright 1974; Bandura, Jeffery & Gajdos 1975]

Phase 0: Assessment and target setting

Goal: define the target behaviour, build a graded series of tasks, and measure baseline performance and self-efficacy.
Format: interview plus a behavioural approach test, in which the client attempts each task in order and stops where they cannot go on. Bandura's snake studies used an 18-task graded series. Before each test, clients privately marked which tasks they expected to manage and rated their confidence for each task. [source: Bandura 1977 pp. 205–206]
Move on when the target, the hierarchy and the baseline ceiling are known.

Phase 1: Modelling (observation)

Goal: show that the feared activities are safe, and show exactly how to do them.
Format: the therapist demonstrates each step live, usually starting just below the client's ceiling. Film or video models are an alternative or a preparation (symbolic modelling). [source: Bandura 1977 p. 196; Pressbooks 13.3]
In the participant modelling protocols this phase is brief and runs straight into Phase 2. With symbolic modelling used alone, it is the whole treatment.

Phase 2: Guided participation with induction aids

Goal: get the client performing each task successfully, step by step, with as many aids as needed.
Format: the client performs the tasks the therapist has just modelled. The therapist uses joint performance, graded subtasks, graded time, protective aids and graded threat. The research sessions were individual and in vivo, and continued until the client performed the terminal task (in the snake studies, letting the snake crawl in the lap). [source: Bandura 1977 pp. 196, 205; Pressbooks 13.3]
Typical length: the snake-phobia treatments were brief, a few hours in total rather than many weekly sessions. [uncertain: the exact durations in Bandura, Blanchard & Ritter 1969 and Bandura et al. 1974]
Move on when the client completes a task with aids, and again when they complete it with fewer aids. The aim is the terminal task.

Phase 3: Fading of aids

Goal: show the client that success comes from their own ability, not from the supports.
The therapist withdraws aids one at a time (steps out of joint performance, removes protective items, increases the time and threat level) until the client copes unaided. [source: Bandura 1977 pp. 196–197, 201]

Phase 4: Self-directed mastery

Goal: consolidate and generalise.
Format: the client practises alone, at first with the same threat and then with varied ones. In Bandura, Jeffery & Gajdos (1975), a brief period of independent practice after participant modelling gave broader change, more fear reduction and stronger self-competence than participant modelling alone. Practice with the familiar threat worked better than practice with varied threats. Bandura (1977) recommends extended self-directed practice under progressively harder conditions after treatment. [source: Bandura, Jeffery & Gajdos 1975 abstract; Bandura 1977 p. 202]
End criterion: the client performs the target tasks independently, in varied conditions, with self-efficacy ratings that match the performance.

Re-test and cycle (microanalytic version). In Bandura's microanalytic studies, treatment targeted only the block of tasks the client had failed. After each cycle the client was re-tested on the next block, and this was repeated until the terminal performance was reached. [source: Bandura 1977 p. 211] Clinically this means: treat, test, then treat the next failed block.

Formats. Individual is the main format in the primary studies. Group delivery (peer models, a single therapist modelling for several clients) and symbolic modelling in groups or for children are documented in the wider literature. A guided mastery group programme for agoraphobia was run in an inpatient setting (Hoffart 1995: a six-week group programme). [source: Pressbooks 13.3; Hoffart 1995 abstract]

3. Guiding principles

[source: Bandura 1977 unless marked]

Performance is the primary vehicle; talk is secondary. Spend session time on doing, not discussing.
Arrange success; do not just encourage it. Persuasion without arranged success can lead to failure that discredits the therapist (p. 198). Pair encouragement with an aid that makes success likely.
Use whatever aids it takes, then remove them. A wide range of aids speeds progress, and too few aids slows it (Bandura, Jeffery & Wright 1974). Choose the aid that gets this step done today, and plan its removal.
More aids is not always better. In the 1974 study, a moderate number of aids matched a high number and sometimes generalised better. Use enough to succeed, not the maximum available.
Success must be attributed to the self. Success credited to external aids raises self-efficacy less (p. 201). Fade aids and point out the client's own contribution.
Authenticate success through independent performance. Unaided performance in varied conditions removes the client's doubt that it only worked because the therapist was there (pp. 201–202). Always end with self-directed trials.
Graduate the challenge. Graded tasks, time and threat keep each step within reach. Keep the next step one the client rates as just attainable.
Coping models over mastery models; similar models; multiple models; clear outcomes. Models who overcome difficulty through effort, are similar to the observer, are varied, and are shown with clearly safe outcomes produce stronger vicarious effects (p. 197). Pick or describe models accordingly.
Measure self-efficacy at the task level, not globally. Efficacy judgments predicted performance task by task (p. 206). Ask about the next specific task before each attempt.
Arousal is information, not a stop signal. Clients read high arousal as a sign they cannot cope (p. 198). Reframe it, and let success bring arousal down rather than waiting for calm first.
Safe in fact, threatening subjectively. Treatment works by persistence in activities that are threatening but objectively safe (abstract). Only use tasks that are genuinely safe. [synthesis: implication for task selection]
Generalisation has to be built in. Add self-directed practice and varied situations after aided success (Bandura, Jeffery & Gajdos 1975). Never stop at the session-room success.
Pace is collaborative. [synthesis] Each step is proposed, not imposed. The client can always stop, and the therapist responds by adding aids, not by pushing.

4. Intervention inventory

The inventory has four groups: A, assessment and preparation; B, observational (modelling) procedures; C, participant modelling and its response induction aids; D, consolidation. All example wording is illustrative unless quoted. [source: as tagged per item]

A1. Graded task hierarchy and behavioural approach test

Purpose / when: At the start and between treatment blocks. The test sets the baseline, defines the steps, and shows where treatment should begin. [source: Bandura 1977 pp. 205, 211]
Steps: (1) Agree on a terminal target, a concrete performance the client wants to manage. (2) With the client, list 10–20 graded actions from easy to terminal. Bandura's snake series ran from approaching the snake to letting it crawl in the lap. [source: Bandura 1977 p. 205] (3) Make sure each step is objectively safe and repeatable in session. (4) Ask the client to attempt the steps in order, stopping whenever they choose. (5) Record the highest step done and any partial attempts. (6) After treatment blocks, re-test the next block up. [source: p. 211]
Example language (illustrative): "We'll go up this list one step at a time. Do each one only if you're willing. You can stop at any point, and stopping tells us where to start."
Watch for: Hierarchies that jump too far between steps; the remedy is to add sub-steps. Watch also for steps that are not genuinely safe. The test is working if it produces a clear ceiling and a usable next step.

A2. Microanalytic self-efficacy assessment

Purpose / when: Before the first test, after each block, and at the end. It predicts the step at which the client will stop, and it tracks change in the mechanism of change. [source: Bandura 1977 pp. 194, 205–206]
Steps: (1) Show the client each task description. (2) Ask privately which tasks they judge they can do now. This is level (magnitude). (3) For each task, ask how confident they are, on a 0–100 scale in 10-point steps. This is strength. (4) Ask the same about a related but different situation, for example a different animal, place or audience. This is generality. (5) Compare the ratings with the actual performance. [source: Bandura 1977 pp. 194, 205–206] This is a method, not a published questionnaire. Write the task list for your client.
Example language (illustrative): "Before you try anything: for each of these, how sure are you right now that you could do it, from 0 to 100?"
Watch for: Ratings much higher than performance, which suggests social desirability. Repeat the instruction that ratings are private. Also watch for low ratings after a success, which suggests the client is discounting it (see D3). It is working when efficacy rises step by step and predicts the next attempt.

A3. Rationale and consent

Purpose / when: Before any modelling or exposure. [synthesis: Bandura's rationale; consent and safety steps are standard exposure practice]
Steps: (1) Explain the model: watching, then doing with help, then doing alone. Confidence is built by doing. (2) State that the client controls pace and can stop at any time. (3) Agree a stop signal. (4) Describe the aids that will be offered. (5) Screen for contraindications and safety issues (see section 5). (6) Get explicit agreement for in vivo work, including any work outside the office.
Example language (illustrative): "Most people's fear goes down after they've done the thing, not before. My job is to make each step doable. I'll show you first, do it with you, and give you whatever help you need. Then we'll take the help away bit by bit."
Watch for: Agreement given only to please the therapist. Check by asking what the client expects to happen.

B1. Live modelling

Purpose / when: To show the client that the feared activity is safe and to demonstrate exactly how to do it. Use at the start of each new step, and as the first induction aid. [source: Bandura 1977 p. 196, listing "preliminary modeling"; Pressbooks 13.3]
Steps: (1) Position the client where they can watch comfortably, which may be at a distance. (2) Perform the next step calmly and slowly. (3) Narrate what you are doing and that nothing bad is happening. (4) Make the outcome visible, for example the snake moving harmlessly or the shop assistant responding normally. (5) Repeat the step if the client wants. (6) Invite the client to try the same step (see C).
Example language (illustrative): "Watch my hand. I'm resting it near its head. It's just moving its tongue to sense the air. Nothing's happening. I'll do that once more."
Watch for: Displays of bravado, which work against the coping-model principle. Make sure the client is actually watching rather than averting their gaze. It is working when the client's distress falls while watching, and when they can predict what will happen next.

B2. Graduated modelling (modelling a sequence)

Purpose / when: To present the hierarchy as a series of modelled steps of increasing threat, so the client never sees more than they can tolerate. [source: Bandura 1977 p. 196; Pressbooks 13.3]
Steps: Model step 1 and wait until the client is settled. Move to step 2, and continue up the hierarchy. Pause or step back whenever the client becomes very distressed.
Example language (illustrative): "That was step three. Before I do four, how are you doing?"
Watch for: Jumping ahead of what the client can tolerate. It is working when the client stays engaged throughout.

B3. Symbolic modelling (film or video)

Purpose / when: When live models are impractical, to prepare clients before in vivo work, or for groups and children (for example, preparation for medical procedures). Symbolic modelling alone was less effective than participant modelling: 33% versus 92% reached the terminal task in Bandura, Blanchard & Ritter (1969). It is better used as a first stage. [source: Pressbooks 13.3]
Steps: (1) Choose or make a recording that shows graded approach, coping models, models similar to the client, several models, and clearly safe outcomes. [source: Bandura 1977 p. 197] (2) Let the client watch in segments. (3) In the 1969 study, clients controlled the viewing and could stop and replay scenes while using relaxation. [uncertain: from the primary study] (4) Discuss what the models did and what happened. (5) Move to live practice.
Example language (illustrative): "Pause whenever you want. If a scene feels too much, go back to the last one until it feels okay."
Watch for: The client discounting the film ("that's just a film") as a special case. Bandura notes that clients dismiss success seen under special conditions (1977 p. 200). Follow with performance. It is working when efficacy ratings for the shown tasks rise.

B4. Model selection: coping, similar, multiple, clear outcome

Purpose / when: Each time you choose who the model is or how you model. [source: Bandura 1977 p. 197]
Steps: (1) Model or show people who start hesitant and overcome difficulty by effort, rather than performing with ease. (2) Match the model to the client on relevant features, for example age, gender, or a history of the same fear. (3) Use several varied models where possible, such as peers, group members or videos. (4) Make the consequences of the model's behaviour clear and positive.
Example language (illustrative): "I'm going to show you how I'd do it if I were a bit nervous: slowly, with a pause, then going ahead anyway."
Watch for: The client saying "that's easy for you". If so, switch to a coping demonstration, a peer model, or a recording of someone like the client.

B5. Covert modelling (imagined model)

Purpose / when: When the situation cannot be staged, or to rehearse before in vivo attempts. Proposed by Cautela (1971) and developed by Kazdin. [source: Uhlemann & Koehn 1989 p. 373, citing Cautela 1971 and Kazdin 1976, 1982]
Steps: (1) Check imagery: have the client imagine a neutral scene and question them about its detail. [source: Uhlemann & Koehn 1989 p. 375] (2) Write brief scenes, each with a setting, the challenge, the model's adaptive response and a favourable consequence. Reinforcing the model improves effects. [source: ibid. pp. 373, 375–376, citing Kazdin 1976] (3) Read each scene. The client imagines it with eyes closed, then holds it silently for about 15–40 seconds (the range used in the research). [source: ibid. p. 373] (4) Use several scenes per session and repeat them. (5) The model may be another person or the client themselves (covert self-modelling). [source: ibid. p. 375] (6) Follow with overt rehearsal or in vivo practice. Emmelkamp notes that covert procedures work best when they are situation-specific and that real-stimulus practice matters. [source: Emmelkamp 1982 via coachsci page]
Example language (illustrative): "Picture someone a bit like you standing in the queue at the checkout. They notice their heart speeding up, take a breath, and stay. The cashier smiles and they pay. Hold that picture for a few seconds."
Watch for: Poor imagery or scenes that drift to catastrophe. Shorten the scenes and add concrete detail. Count it as working when the client reports clear images and rising efficacy for the imagined task.

B6. Self-modelling (video self-modelling)

Purpose / when: To show the client a recording of themselves performing the target behaviour successfully, often edited to remove errors or aids. It is listed among video modelling formats and is used especially with children and autism. [source: Pressbooks 13.3] [uncertain: procedural detail comes from the secondary literature (Dowrick)]
Steps: (1) Record the client performing the behaviour, with aids or prompts if needed. (2) Edit out the prompts and failures so that only competent performance remains. (3) The client watches the clip repeatedly before practice.
Example language (illustrative): "This is you, last week, doing it on your own. Watch how you handled the pause."
Watch for: Consent and privacy around recordings. Watch also for clients who distrust the editing. Check that it is working by whether in vivo performance improves after viewing.

C1. Guided participation: the core cycle

Purpose / when: The central procedure of participant modelling. Use it for every step after it has been modelled. [source: Bandura 1977 pp. 196, 205; Pressbooks 13.3]
Steps: (1) Model the step (B1). (2) Ask for an efficacy rating for the client doing it now (A2). (3) Invite the client to do it with whichever aid makes success likely (C2–C9). (4) Stay physically close and coach briefly while they do it. (5) Repeat the step until it is done smoothly. (6) Remove one aid and repeat (D1). (7) Move to the next step once it is done with minimal aid. (8) If the client cannot do a step, do not wait it out. Add an aid or insert an easier sub-step.
Example language (illustrative): "You've seen me do it. Want to do it with my hand next to yours this time? … Good. Again, and this time I'll keep my hand a little further back."
Watch for: Stalling for long periods at one step; the answer is a new aid or a smaller step, not more talk. It is working when the client completes steps, efficacy ratings rise after each success, and the next step is reached within the session.

C2. Graduated subtasks

Purpose / when: When a step is too large. Break it into smaller parts. [source: Bandura 1977 p. 196, "graduated tasks"; Donohue 2005, graduated tasks and proximal goals]
Steps: Identify the smallest version the client will attempt, for example touching with one fingertip before resting a whole hand. Do that, then add the next increment, sequenced from highest to lowest efficacy. Set a near-term goal for each subtask so each success prepares the next.
Example language (illustrative): "Let's make it smaller: just one finger, for one second."
Watch for: Subtasks the client finds trivial, which can feel patronising. Keep them just at the edge of what feels possible.

C3. Graduated time intervals

Purpose / when: When the client can start the action but cannot sustain it. [source: Bandura 1977 p. 196, "enactment over graduated temporal intervals"]
Steps: Do the action briefly, for example a few seconds in the lift or one sentence to the group. Repeat, extending the duration in steps the client agrees to.
Example language (illustrative): "Five seconds, then step out. Next time we'll try ten."
Watch for: Escape before the agreed interval. Shorten the interval rather than repeating failure.

C4. Joint performance with the therapist

Purpose / when: When the client cannot attempt the step alone. The therapist's presence and shared action lower the threat and raise willingness. [source: Bandura 1977 p. 196; Donohue 2005]
Steps: Do the action together. In the snake studies, for example, the client placed hands on the therapist's hands as the therapist held the snake, or the two held it together. [uncertain: hand-over-hand detail recalled from Bandura, Blanchard & Ritter 1969] For agoraphobia, walk side by side, then a few paces apart, then out of sight. Gradually reduce your share of the action.
Example language (illustrative): "Put your hand on top of mine. I'm holding it; you're just feeling what I feel."
Watch for: Over-reliance on the therapist; fade early (D1). Respect touch boundaries: always ask before any physical contact and offer alternatives.

C5. Protective aids

Purpose / when: To reduce the likelihood of feared outcomes for early attempts. [source: Bandura 1977 p. 196, "protective aids"]
Steps: Offer a protective item or arrangement for first attempts. Examples: gloves when handling the animal, a seat by the exit, a phone kept on, a short planned route. The gloves example is from the snake studies. [uncertain: protective gloves recalled from Bandura et al. 1969/1974] Then plan its removal.
Example language (illustrative): "Use the gloves the first few times. Once that's easy, we'll try one bare hand."
Watch for: Aids that turn into safety behaviours the client will not give up. The client should know from the start that each aid is temporary.

C6. Graduated threat severity

Purpose / when: To begin with a less threatening version of the feared object or situation. [source: Bandura 1977 p. 196, "varying the severity of the threat"]
Steps: Use a smaller or less active animal, a quieter shop, a friendly audience, or a lower floor. Then step the severity up as performance consolidates.
Example language (illustrative): "We'll start with the quiet supermarket on a weekday morning, then work up to a Saturday."
Watch for: Stopping at the easy version. The terminal target should be the client's real-life situation.

C7. Physical guidance and mechanical support

Purpose / when: In skill-like tasks or with children, where the client needs physical support to perform. [source: Donohue 2005: holding a bicycle seat and gradually lightening the hold]
Steps: Give a physical support that keeps the client from failing. Lighten it gradually, then remove it.
Example language (illustrative): "I've got the back of the seat. Tell me when you want me to loosen my grip."
Watch for: Consent to touch, and the client's understanding of how much support you are giving (see D3).

C8. Targeting the problematic subtask and graduated settings

Purpose / when: When one element of a task undermines confidence in the whole of it (for example, the moment the lift doors close). Also used to transfer gains across settings. [source: Donohue 2005]
Steps: Identify the hardest component and practise it in isolation with aids until it is mastered. Re-embed it in the whole task. Practise the same task in settings ranked by difficulty, such as different shops, lifts or roads.
Example language (illustrative): "What's the hardest moment in all of this? … Let's practise just that moment ten times."
Watch for: Avoidance of the hard component disguised as completing the whole task.

C9. Reducing defensive manoeuvres and building flexible performance (guided mastery)

Purpose / when: After the client can perform the task, to remove the self-protective ways of doing it (gripping, rushing, holding the breath, staying near exits, eyes averted) and build proficient, flexible performance. Guided mastery adds this to stimulus exposure. [source: Donohue 2005, aid withdrawn as performance becomes proficient and flexible] [uncertain: the detailed account in Williams 1990 "beyond stimulus exposure"]
Steps: (1) Observe how the client does the task. (2) Name one defensive habit. (3) Model the task without it. (4) Ask the client to do it the same way, with an aid if needed. (5) Add variations, for example a different speed, place, or time of day.
Example language (illustrative): "You're doing it. Now let's try it with your hands loose by your side and walking at a normal pace."
Watch for: Habits the client is not aware of. Point them out matter-of-factly. It is working when the client performs relaxed, varied versions.

C10. Verbal persuasion and coaching tied to performance

Purpose / when: Throughout, but only as an adjunct to an arranged success. [source: Bandura 1977 p. 198; Donohue 2005: encouraging objective thinking, praising effort, teaching coping skills]
Steps: Before an attempt, give a short, specific prediction that the client can do it with this aid. During the attempt, give brief, calm, factual commentary. Afterwards, give specific praise for effort and for what the client did, and correct any catastrophic predictions against what happened.
Example language (illustrative): "You predicted it would bite. What actually happened?"
Watch for: Over-persuasion ahead of failure, which discredits you (p. 198). Talking too much during the performance.

C11. Calibrating the number of aids

Purpose / when: When choosing how much support to give overall. [source: Bandura, Jeffery & Wright 1974 abstract]
Steps: Have a wide repertoire of aids available. Use enough to get rapid success, but aim for a moderate number. A moderate number matched a high number and sometimes generalised better. Then switch to self-directed practice.
Example language (illustrative): n/a (a therapist decision).
Watch for: Too few aids, which slows progress and lowers outcomes. Too many aids, which can leave the client attributing success to them.

D1. Fading (withdrawal of aids)

Purpose / when: As soon as a step is done reliably with an aid. [source: Bandura 1977 pp. 196–197]
Steps: Remove one aid at a time: protective item, then joint performance, then shortened time, then reduced threat. Repeat the step after each removal. If performance breaks down, return briefly to the last level and fade in smaller increments.
Example language (illustrative): "You did that with me holding the other end. This time I'll stand back here and watch."
Watch for: Fading that is too fast and produces failure, or too slow and creates dependence. Aim for the client to notice the change and succeed anyway.

D2. Self-directed mastery

Purpose / when: After aided success. Independent practice authenticates the success and generalises it. [source: Bandura, Jeffery & Gajdos 1975 abstract; Bandura 1977 pp. 196–197, 201–202]
Steps: (1) Ask the client to repeat the mastered task alone, with you out of the room or out of sight. (2) Begin with the same, familiar threat; this gave more fear reduction and stronger efficacy than varied threats in the 1975 study. (3) Then extend to varied situations and harder versions. (4) Agree between-session practice: a specific task, frequency and context, and recording. (5) Review the practice next session and add an efficacy rating.
Example language (illustrative): "I'm going to step outside for ten minutes. Do it as many times as you like, any way you like. I'll come back and you tell me what you found."
Watch for: The client doing practice only with a companion, or skipping it. It is working when the client reports doing the task alone, and efficacy holds or rises.

D3. Authenticating success and self-attribution

Purpose / when: After each success, and especially when the client discounts it. [source: Bandura 1977 pp. 200–202]
Steps: (1) Ask what made the success possible. (2) If the client credits luck, the therapist or the aid, point to what they themselves did. (3) Arrange a repeat with less aid to test their explanation. (4) Highlight progress over time, including setbacks that were overcome; Bandura notes these can raise efficacy more than a flat run of easy success (p. 201). (5) Vary the conditions so the client cannot dismiss the success as only working in the clinic.
Example language (illustrative): "You think it was because I was there. Let's find out. Do it while I'm out of the room."
Watch for: Efficacy ratings that stay low after repeated success. This is a sign of discounting, not lack of progress.

5. Handling problems

The primary sources address problems mainly through two moves: adding or changing induction aids, and securing self-attribution of success. Most of the specific responses below are therefore [synthesis] built on those principles, and are tagged.

Safety, contraindications and consent (do before any in vivo work) [synthesis: standard exposure practice; not set out in the opened Bandura sources]

Use only objectively safe stimuli and tasks: non-venomous, handled animals; legal and safe driving conditions; and so on. The method relies on threats that are frightening to the client but objectively low-risk (Bandura 1977, abstract).
Screen for medical conditions in which strong arousal or exertion is risky (for example, cardiac or respiratory conditions, or pregnancy with complications). Obtain medical clearance where in doubt.
For blood-injection-injury fears, check for a history of fainting. Use seated or lying positions and consider adding applied tension (a separate technique).
Postpone or modify in vivo work during acute psychosis, intoxication, an active suicidal crisis, or severe dissociation. Assess risk using standard practice first.
Get explicit consent for each new type of task, for any physical contact (C4, C7), for leaving the office, and for any video recording (B6). Agree a stop signal and honour it every time.
Never use deception, surprise or forced exposure. Pace is set with the client.

Client freezes or refuses a step [source: Bandura 1977 p. 196; Bandura, Jeffery & Wright 1974] Do not argue or wait it out. Add an aid (joint performance, a protective aid, a shorter time, a lower threat) or split the step. Re-model it. Ask: "What would make this doable right now?" (illustrative).

Stuck on a plateau across sessions [synthesis] Re-test with the behavioural test and microanalysis (A1–A2). Look for one problematic subtask (C8), hidden defensive manoeuvres (C9), or success being credited to the aids (D3). Check that the next step is not too big. Bandura's microanalytic sequencing targets only the failed block (1977 p. 211).

Overwhelm or panic during a task [synthesis] Step back to the last mastered step, and remain present and calm. Give brief factual commentary. Lengthen the time on the easier step until the client is able to proceed again, then return to the original step with an added aid. End the session on a success, not on escape. Do not use flooding-style persistence; the method relies on manageable, graded success.

Client attributes success to the therapist or the aids ("I could only do it because you were there") [source: Bandura 1977 pp. 201–202] Fade the aids sooner. Introduce solo trials (D2), and test the client's attribution directly (D3).

Client discounts modelled evidence ("it's different for you") [source: Bandura 1977 pp. 197, 200] Switch to a coping-style demonstration, a peer or similar model, or several models. Move quickly from observation to the client's own performance.

Non-adherence to self-directed practice [synthesis] Make the homework the exact task last mastered in session, with the familiar threat (Bandura, Jeffery & Gajdos 1975). Set a precise time and place, and plan for obstacles. If the client cannot practise alone, schedule a companion-assisted version as an explicit, temporary aid with a planned fade. Review the practice first thing next session.

Safety behaviours persist after treatment [synthesis; see C9] Name each one, model the task without it, and fade it like any other aid.

Rupture (client feels pushed or embarrassed) [synthesis] Acknowledge it directly. Go back to client-set pace and re-state the stop rule. Ask which step felt too big, and offer more aid. Apologise for pressure if it was applied. Check any touch-based aid for consent again.

Poor imagery in covert modelling [synthesis; Uhlemann & Koehn 1989 for the imagery check] Use shorter scenes with more sensory detail, or audio recordings. Switch to live or video models if imagery stays weak.

Generalisation failure (fine in clinic, not at home) [source: Bandura 1977 pp. 200–202; Bandura, Jeffery & Gajdos 1975] Move practice into the real settings, graded by difficulty (C8). Vary conditions, and add independent practice.

Children and groups [synthesis] Use peers of similar age as coping models, short video segments and concrete praise. In groups, let members who have just mastered a step model it for others. They make good similar, coping models (Bandura 1977 p. 197).

Relapse [synthesis] Return to the hierarchy at the level that now fails, with brief aided participation and then a quick fade. Bandura notes that extended self-directed practice under progressively harder conditions after treatment protects against relapse (1977 p. 202).

Fear is not the only barrier (skill deficit) [synthesis] Where the client lacks the skill, for example in social or assertive behaviour, use modelling plus rehearsal and feedback, as in skills training (Pressbooks 13.3). Do this before participant modelling.

Sources

Sources:

Further reading (not drawn on) [uncertain where relied on]:

Bandura, A. (1969). Principles of Behavior Modification. Holt, Rinehart & Winston.
Bandura, A., Blanchard, E. B., & Ritter, B. (1969). Relative efficacy of desensitization and modeling approaches for inducing behavioral, affective, and attitudinal changes. Journal of Personality and Social Psychology, 13, 173–199.
Bandura, A. (1976). Effecting change through participant modeling. In J. D. Krumboltz & C. E. Thoresen (Eds.), Counseling Methods. Holt, Rinehart & Winston.
Rosenthal, T. L., & Bandura, A. (1978). Psychological modeling: Theory and practice. In S. L. Garfield & A. E. Bergin (Eds.), Handbook of Psychotherapy and Behavior Change (2nd ed.). Wiley.
Bandura, A. (1997). Self-Efficacy: The Exercise of Control. Freeman.
Williams, S. L. (1990). Guided mastery treatment of agoraphobia: Beyond stimulus exposure. Progress in Behavior Modification, 26.
Cautela, J. R. (1971). Covert modeling. Paper presented at the Association for Advancement of Behavior Therapy, Washington, DC. Kazdin, A. E. (1976, 1982), covert modelling studies (as cited in Uhlemann & Koehn 1989).

Further reading (not drawn on): PubMed and PMC, Europe PMC and several archive.org and repository pages, the uky.edu Bandura archive, and Google Books. Procedural details marked [uncertain] are not checked against those primary texts.

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