Self-management therapy and SORKC analysis

1. Introduction

Version followed: Kanfer, Reinecker & Schmelzer, Selbstmanagement-Therapie: Ein Lehrbuch für die klinische Praxis, 4th revised edition (Springer, 2006). The 5th edition (2011/2012) keeps the same 7-phase structure and chapter plan. The SORKC behaviour analysis follows the standard German behaviour-therapy convention (Kanfer & Saslow; Kanfer & Phillips), which the textbook's Phase 3 uses as its situational analysis. [source: 4th-ed. front matter and table of contents; Springer 5th-ed. book page]

Self-management therapy (SMT) is a general process framework for individual cognitive-behavioural therapy, not a single technique or a disorder-specific protocol. The authors call it an attitude plus a systematic process model. It is not a new school, not self-treatment and not a time-management method. [source: 4th-ed. preface; de.wikipedia "Selbstmanagement-Therapie"]

Core idea of change. Behaviour is treated as a system with three classes of variables: alpha (external, environmental), beta (internal, self-generated: thoughts, plans, self-regulation) and gamma (biological). Therapy works mainly through the beta system. The therapist acts as a temporary "change assistant" (Änderungsassistent) and catalyst who teaches the client to regulate their own behaviour. Self-regulation follows a three-step loop: self-monitoring → self-evaluation against a standard → self-reinforcement or self-correction. Self-control is the special case where a short-term payoff (e.g., a drink now) conflicts with a larger delayed payoff. The aim is Hilfe zur Selbsthilfe (help towards self-help): the client ends therapy able to solve new problems without professional help. [source: 4th-ed. preface and ToC §2.1–2.2; Backenstrass 2007 handout; hubbs.schule unit citing Kanfer et al. 2012]

2. Framework

The authors present the 7-phase model as an idealised orientation map for a single case. Phases overlap and the therapist loops back when new information appears (e.g., from Phase 5 back to Phase 3). It is not a fixed session-by-session protocol. [source: 4th-ed. ToC Teil II, "Rolle von Orientierungsmodellen"; Backenstrass 2007]

Format. Individual outpatient therapy with typical behaviour-therapy session lengths (around 50 minutes). Sessions are usually weekly at first, then spaced out in Phase 7. The textbook supplies a short session-protocol form and a therapist self-evaluation form. [source: ToC Anhang D–F] The total number of sessions is not fixed by the sources. In German statutory practice SMT is delivered inside short-term (up to 24 sessions) or long-term behaviour-therapy contingents. [uncertain: session counts; the figures below are synthesis]

[source: phase titles and tasks from 4th-ed. ToC and Backenstrass 2007; Springer 5th-ed. chapter abstract for Phase 3]

Diagnostic principles that run through all phases (textbook §3.3): individual problem analysis rather than diagnosis alone; a functional view; close link between assessment and intervention; assessment as an ongoing process; an active role for the client; economy of information gathering; hypothesis-led, results-oriented optimising. [source: 4th-ed. ToC §3.3]

3. Guiding principles

From the textbook (paraphrased; source as tagged):

• Help towards self-help. Every step should leave the client more able to manage alone. Ask "what does the client learn to do here?" [source: 4th-ed. preface]
• Therapist as change assistant, not expert-healer. You structure and teach; the client decides and does. Avoid both the medical-expert stance and passive waiting. [source: 4th-ed. preface]
• Transparency. Explain the rationale for every step and share the functional model. No hidden techniques. [source: 4th-ed. preface; buffl Phase 2 cards]
• Voluntariness and client control. No "therapy against the client's will". The client chooses goals; you can question them but do not impose them. [source: 4th-ed. preface; buffl Phase 2 cards]
• Self-set goals. Goals the client generates motivate more than assigned ones, so work from their values (ZWK). [source: buffl Phase 2 cards; ToC Teil III §4]
• Small steps and early success. Pick steps the client will very likely manage, to build self-efficacy. [source: Backenstrass 2007, Phase 5 heuristics]
• "Good reasons". Assume even problematic behaviour has subjectively good reasons. Find its function before trying to remove it. [source: 4th-ed. preface]
• Functional, systemic view. Analyse alpha, beta and gamma variables and the client's wider context, not only symptoms. [source: ToC §2.1, Phase 3]
• Scientist-practitioner. Treat formulations as hypotheses, test them with data from the client's life, and revise. [source: ToC §2.8, §3.3]
• Pluralism with limits. Respect the client's values while keeping effectiveness and ethics (no egoism licence). [source: 4th-ed. preface]
• Time-limited and goal-directed. Plan your own redundancy from the start. [source: 4th-ed. preface]

Phase 5 selection heuristics [source: Backenstrass 2007 handout, from Kanfer et al. 1996]: finish the work of earlier phases first; prefer the least aversive effective method; use minimal intervention; work in small steps; create positive learning experiences; consider the client's acceptance; weigh cost against benefit.

Six basic rules for the self-management approach (textbook Teil III §1.1). The ToC names them without listing them. Commonly taught as: think in behaviour terms; think in solutions; think positively (strengths); think in small steps; think flexibly; think future-oriented. [uncertain]

Kanfer's 11 "laws" of therapy (textbook ch. 7), paraphrased [source: de.wikipedia list; chapter title confirmed in 4th-ed. ToC]:

1. Never ask clients to act against their own interests. In practice: check every task against the client's goals.
2. Look to the future, seek concrete solutions and build on strengths. In practice: spend more time on "what next" than on "why".
3. Do not play God by taking over responsibility for the client's life. In practice: the client makes the decisions.
4. Build a new route before you remove an old support. In practice: no stopping a coping behaviour until an alternative exists.
5. The client is always right. In practice: the client's view is the valid data to work with, even when you see it differently.
6. Without a concrete picture of the problem behaviour you do not know what the issue is. In practice: always ask for a recent specific episode.
7. You can only work with clients who are present. In practice: work with the person in the room, not absent partners or parents.
8. Aim for small weekly gains, not distant utopias. In practice: set one concrete step each session.
9. Human information-processing capacity is limited. In practice: one or two key messages per session, written down.
10. If you work harder in session than the client, something is wrong. In practice: hand tasks back.
11. Be generous with praise for progress. In practice: notice and name every step taken.

4. Intervention inventory

The textbook names the interventions below in its table of contents (phase tasks, Teil III §3 "basic self-management skills" and §4 ZWK). The authors' own step lists are not drawn on. All step sequences below are therefore an operationalisation of the named procedure, built from the phase structure, the Backenstrass (2007) teaching handout (which summarises Kanfer et al. 1996 and Fliegel et al. 1998) and general behaviour-therapy practice. They are tagged [synthesis] where they go beyond what a source states. All example language is illustrative. [source: 4th-ed. ToC; Backenstrass 2007]

A. Process and assessment interventions

4.1 Role structuring and building the therapeutic alliance (Phase 1)

• Purpose / when: First sessions, and again whenever the client slips into a passive "fix me" role. Sets up the collaborative change-assistant relationship the whole model depends on. [source: ToC Phase 1 "Rollenstrukturierung", "Beziehungsaufbau"]
• Steps [synthesis]:
  1. Ask what the client expects from therapy and from you; note expectations of being cured, advised or simply listened to.
  2. Explain the model briefly: you bring methods and structure; they bring knowledge of their life, decisions and most of the work between sessions.
  3. Agree practical frame: frequency, length, cancellations, homework as a normal part, how progress will be checked.
  4. Use warm, accurate listening and summarise their view before adding yours, so the client feels understood.
  5. Ask for feedback at the end of the session (what helped, what was unclear) and use the session-evaluation form if you use it.
• Example language (illustrative): "I'll bring methods and a structure. You're the expert on your life, and you'll decide what we work on. Most of the change will happen between our sessions, in your everyday life."
• Watch for: Expectations of a passive cure, deference or testing of the therapist. Working signs: the client starts bringing their own observations and suggestions, and attends reliably.

4.2 Problem-related information gathering and screening (Phase 1)

• Purpose / when: First overview of complaints, expectations, risk and context, to find first candidate targets. Keep it economical; depth comes in Phase 3. [source: ToC Phase 1 "Screening von Beschwerden und Erwartungen"; §3.3 "Ökonomie der Informationssammlung"]
• Steps [synthesis]:
  1. List current complaints in the client's words; ask for one recent concrete example of each.
  2. Screen risk (suicidality, violence, safeguarding) using your service's standard risk assessment, plus substance use and medical conditions needing referral.
  3. Note life areas affected, prior treatment and what has already been tried.
  4. Note strengths and resources (assets) alongside problems.
  5. Draft a provisional problem list and read it back to the client for correction.
• Example language (illustrative): "Let's make a first list of what's troubling you. For each one, tell me about the last time it happened, as if I were watching a film."
• Watch for: Over-collecting (long histories without focus) or premature diagnosis. Working signs: a short, client-endorsed problem list with concrete examples.

4.3 Motivation analysis and building change motivation (Phase 2)

• Purpose / when: Before detailed analysis, and whenever motivation drops. The textbook uses the motivating conditions built into the approach, reduces demoralisation and resignation, and analyses motivation before deliberately building change motivation. [source: ToC Phase 2 §2.1; 5th-ed. ToC via Lehmanns]
• Steps [synthesis, organised around the textbook headings]:
  1. Use the motivating conditions of SMT: stress the client's control, self-set goals, transparency, voluntariness and small steps. [source: buffl Phase 2 cards]
  2. Reduce demoralisation: acknowledge failed attempts, reframe them as information about conditions rather than character, and point to one area where some control already exists.
  3. Motivation analysis: for the problem behaviour, list short- and long-term advantages and disadvantages, for the client and for important others. Identify what the client would lose by changing.
  4. Link to values: ask what the change would make possible that matters to them (bridge to ZWK, 4.9).
  5. Build change motivation deliberately: agree a very small first step with high success probability. Ask the client to imagine and describe concretely the desired future state.
• Example language (illustrative): "You've tried hard before and it didn't hold. That tells us something about the conditions, not about you. What would be the smallest change that would still feel worth doing?"
• Watch for: Ambivalence presented as agreement, and change wanted mainly to please others. Working signs: the client argues for change in their own words and completes a first small step.

4.4 Deciding "change or accept?" and provisional choice of change areas (Phase 2)

• Purpose / when: When several problems compete, or when some conditions cannot be changed (chronic illness, others' behaviour). [source: ToC Phase 2 "Ändern vs. Akzeptieren?", "vorläufige Auswahl von Änderungsbereichen"]
• Steps [synthesis]:
  1. Lay out the problem list and sort each item: changeable by the client, partly changeable, not changeable.
  2. For unchangeable items, define acceptance or coping targets instead of change targets.
  3. Choose one to three provisional areas using these criteria: importance to the client, likelihood of early success, centrality (does change here help other problems?), and urgency or risk.
  4. Mark the choice as provisional and to be revised after the behaviour analysis.
• Example language (illustrative): "Some of these are in your hands, some only partly, and some not at all. Let's start where a change is both possible and important to you."
• Watch for: Starting with the hardest or least controllable area. Working sign: a short, agreed list of starting areas.

4.5 Situational behaviour analysis: SORKC (Phase 3, macro to micro)

• Purpose / when: To find the conditions that trigger and maintain a problem behaviour in concrete situations. This is the core of the functional analysis. [source: Springer 5th-ed. ch. 16 abstract; de.wikipedia "SORKC-Modell"]
• Components [source: de.wikipedia "SORKC-Modell"]:
  • S (stimulus/situation): external or internal triggers; discriminative cues signalling that a consequence is available.
  • O (organism): biological and learning-history preconditions, e.g., illness, medication effects, temperament, enduring beliefs or thinking style.
  • R (response) on four levels: cognitive, emotional, physiological and motor.
  • K (contingency): how regularly the consequence follows the response, e.g., every time or intermittently.
  • C (consequence): C+ = something pleasant added (positive reinforcement); C– = something unpleasant added (punishment); C+/ (crossed C+) = something pleasant removed (indirect punishment); C–/ (crossed C–) = something unpleasant removed (negative reinforcement). Always separate short-term from long-term consequences.
• Origin: Lindsley added K to the S–R–C operant scheme; Kanfer and Saslow added O. Wikipedia dates this to 1969; other textbooks cite Kanfer & Phillips (1970). [uncertain: dating differs between secondary sources] Kanfer meant the formula as a working hypothesis, not a rigid template. [source: de.wikipedia "SORKC-Modell"]
• Steps [synthesis]:
  1. Choose one recent, typical episode of the target behaviour (macro: problem area → micro: one situation).
  2. Walk through it in slow motion: where, when, who present, what happened just before (S).
  3. Ask what went through their mind, what they felt, what their body did, and what they did (R on four levels).
  4. Ask what happened immediately afterwards, then hours or days later, and how it felt (C, short and long term). Code each consequence as C+, C–, C+/ or C–/.
  5. Ask how reliably this consequence follows (K).
  6. Add relevant O variables (sleep, illness, substances, enduring beliefs, learning history).
  7. Repeat with two or three other episodes, including one where the problem did not occur, to identify discriminating conditions.
  8. Draw it with the client on paper, left to right, and agree on the maintaining loop (typically short-term relief or reward versus long-term costs).
  9. Mark possible levers at each point: change S (stimulus control), O (e.g., sleep, medical review), R (skills, self-instruction, relaxation), C/K (self-reinforcement, contracts, enlisting others).
• Example language (illustrative): "Let's slow down last Tuesday evening. Where were you just before you started drinking? … And what did you notice right after the first glass? … And the next morning?"
• Watch for: Generalities instead of an episode (keep returning to "last time"); missing long-term consequences; ignoring negative reinforcement (relief) as the maintaining factor. Working signs: the client can predict when the behaviour will occur and explain why it persists.

4.6 Contextual behaviour analysis (Phase 3, micro to macro)

• Purpose / when: After the situational analyses. Moves from single situations to the client's higher-level plans, rules and system conditions (relationships, work, culture), to understand why the pattern makes sense in their life and what change would cost. [source: ToC Phase 3 §3.3 "Regeln, Pläne, Systembedingungen"; Anhang C]
• Steps [synthesis]:
  1. Across several SORKC episodes, look for recurring rules (e.g., "never show weakness") and plans or needs the behaviour serves (control, belonging, avoiding criticism).
  2. Map system conditions: who reacts to the problem, who benefits or loses if it changes, what work, family or cultural norms apply.
  3. Ask for the functions the problem has for others and for the client's self-image.
  4. Note obstacles to change and resources in the wider system.
• Example language (illustrative): "In every one of these situations you seem to follow a rule, something like 'I must never let anyone down.' Does that sound right? Where did you learn it?"
• Watch for: Losing focus in history-taking. Working sign: the client sees how the pattern fits into larger goals and relationships.

4.7 Kanfer and Saslow's areas of behavioural analysis (macro analysis)

• Purpose / when: As a checklist to make sure the macro picture is complete, either before or alongside 4.5–4.6. This comes from Kanfer and Saslow's 1965 scheme, an ancestor of the textbook's analysis. [source: primarycarenotebook functional-analysis outline; uncertain: original Kanfer & Saslow paper]
• Areas: (1) initial analysis of the problem situation: behavioural excesses, deficits and assets; (2) clarification of the problem situation: who and what maintains it and what would change if it were solved; (3) motivational analysis: what reinforces and punishes this person; (4) developmental analysis: biological, social and behavioural history; (5) analysis of self-control: where and how the client already regulates themselves, and past change attempts; (6) analysis of social relationships; (7) analysis of the social, cultural and physical environment and its norms.
• Steps [synthesis]: Work through the areas across one or two sessions plus questionnaires or diaries. Record each briefly, and flag the areas that suggest levers or obstacles.
• Watch for: Over-long assessment; use the economy principle. Working sign: no major surprise context emerges later.

4.8 Functional condition model (Phase 3 integration)

• Purpose / when: End of Phase 3. Combines the situational and contextual analyses into a provisional explanatory model that guides goals and methods. [source: ToC Phase 3 §3.4 "vorläufiges funktionales Bedingungsmodell"]
• Steps [synthesis]:
  1. Summarise predisposing (O, history), triggering (S) and maintaining (C/K, rules, system) conditions on one page.
  2. Present it to the client as a hypothesis; ask what fits and what is missing.
  3. Derive two to four testable predictions (e.g., "the urge will be higher on evenings alone") and check them with self-monitoring.
  4. Mark change points and link each to candidate methods.
• Example language (illustrative): "Here's our best guess at how this works. Tell me where it's wrong. Then let's test it with your notes over the next two weeks."
• Watch for: A model that is the therapist's alone. Working sign: the client explains the model in their own words and uses it to predict their own behaviour.

4.9 Goal and value clarification (ZWK; Phase 2 start, Phase 4 core, Teil III §4)

• Purpose / when: To find self-chosen, value-based goals that motivate change and give direction. Especially useful for clients who are demoralised, unclear what they want, or pursuing goals set by others. The textbook describes a structured procedure with a production phase, an evaluation phase and integration into everyday life. [source: ToC Teil III §4; Lehmanns ToC]
• Steps [synthesis built on the three named stages]:
  1. Preparation: explain that this is about what they want for their life, not what they should want.
  2. Production phase: generate without judging. Ask for wishes, aims and values across life areas (work or education, relationships, health, leisure, personal growth). Use prompts like an imagined good future some years ahead, or what they would like people to say about them.
  3. Evaluation phase: sort the list. Which items are truly theirs? Which conflict? Which are central? Rank them, check for conflicts between short-term wants and long-term values, and translate the top items into concrete, observable goals.
  4. Integration into everyday life: for each chosen goal, plan the first concrete step this week and build in reminders (diary, cue cards).
• Example language (illustrative): "Imagine it's three years from now and things have gone well. Describe an ordinary Tuesday. Who's there, what are you doing, what's different?"
• Watch for: Socially desirable answers; goals that are only the absence of symptoms ("not anxious"). Ask what they would do instead. Working signs: goals in the client's own words that create visible energy.

4.10 Agreeing therapeutic goals and joint goal analysis (Phase 4)

• Purpose / when: After the functional model. Turns wishes into explicit, shared therapeutic goals with sub-goals and success indicators. [source: ToC Phase 4: Klärung, gemeinsame Zielanalyse, Konsens]
• Steps [synthesis, plus GAS from buffl cards]:
  1. Restate the top goals from ZWK and link each to the functional model.
  2. Joint goal analysis: check each goal for conflicts with other goals or people, side effects on the system, whether it is within the client's control, and whether it is realistic.
  3. Break it into a hierarchy: long-term goal → intermediate goals → this month's sub-goal.
  4. Operationalise: what would be seen or counted when the goal is reached; consider Goal Attainment Scaling (graded outcome levels from much worse to much better than expected, with a time frame). [source: buffl Phase 2 cards]
  5. Write down the agreed goals and both sign or date them, if the client wishes.
• Example language (illustrative): "How would you or someone close to you notice, concretely, that you'd reached this? What would be a realistic first sign within a month?"
• Watch for: Therapist-owned goals or vague goals. Working sign: a written list the client refers to unprompted.

4.11 Intervention analysis and method selection (Phase 5)

• Purpose / when: Choosing methods from the clinical "knowledge store" for each change point in the model. [source: ToC Phase 5; Backenstrass 2007]
• Steps [heuristics from Backenstrass 2007; ordering is synthesis]:
  1. Check that earlier phases are sufficiently complete (motivation, model, goals).
  2. List candidate methods per lever (S, O, R, K/C, rules or system), including disorder-specific programmes where indicated.
  3. For each, weigh: expected effectiveness, aversiveness, effort and cost, client acceptance, and fit with self-management (does it build the client's own skills?).
  4. Choose the least aversive effective option and minimal intervention, starting with steps likely to succeed.
  5. Explain the rationale; agree on a trial period and success criteria; plan how the client will practise.
• Example language (illustrative): "Here are two ways we could tackle the evenings. The first is easier to start but slower; the second is harder but quicker. Which fits you better right now?"
• Watch for: Technique-hopping without a model; methods the client finds unacceptable. Working sign: the client can say why a method was chosen.

B. Self-management skills and therapeutic tools (Phase 5)

The textbook lists these basic self-management skills: self-monitoring, self-instruction, goal clarification and goal setting, self-reinforcement, and self-control. It lists these therapeutic tools: teaching self-regulation skills, changing the environment, therapeutic tasks and homework, role-play, contracts, handling unexpected situations, relaxation exercises (and fitness), and developing the capacity for enjoyment. [source: 4th-ed. ToC Teil III §3; Lehmanns ToC; de.wikipedia]

4.12 Self-monitoring (Selbstbeobachtung)

• Purpose / when: The first step of the self-regulation loop and of most self-control programmes. It supplies data for the SORKC analysis and evaluation, and often changes behaviour by itself (reactivity). Used widely: eating, smoking, alcohol, work behaviour, tics, depression, compulsions, social anxiety. Caution with persistent intrusive or obsessive thoughts, because monitoring can increase their frequency. [source: Backenstrass 2007, citing Fliegel et al. 1998; Reinecker 2000]
• Steps [synthesis]:
  1. Define the target precisely (what counts as one instance) together with the client.
  2. Choose the format: tally counter, diary card, app, or short ABC/SORKC columns (situation, thoughts or feelings, behaviour, consequence, rating).
  3. Record immediately after the behaviour, not at the end of the day; tie recording to a cue.
  4. Start small (one behaviour, one week); practise filling in one entry in session.
  5. Review every entry in the next session, praise the effort, and extract patterns together.
• Example language (illustrative): "This week, every time you notice the urge, jot down where you are, what was going through your mind, and what you did. Just a few words. We're collecting data, not grading you."
• Watch for: Retrospective filling-in; shame about "bad" entries; increased rumination. Working signs: complete records, and the client spotting patterns themselves.

4.13 Self-evaluation and standard setting

• Purpose / when: The second step of the loop: comparing observed behaviour with a standard. Needed when the client's standards are unclear, too harsh (perfectionism, depression) or too lax. [source: Backenstrass 2007; hubbs.schule unit, after Kanfer et al. 2012]
• Steps [synthesis]:
  1. Ask what standard the client currently uses and where it comes from (own values, others' norms).
  2. Agree an explicit, attainable criterion for this week's sub-goal (e.g., three of seven days).
  3. Have the client rate their monitored behaviour against the criterion, not against the ideal.
  4. Discuss gaps neutrally as information for planning.
• Example language (illustrative): "What would count as a good enough week, given where you're starting from? Let's write that down as the yardstick, instead of 'perfect'."
• Watch for: All-or-nothing judgement; a standard that keeps rising after success. Working sign: the client judges progress fairly and adjusts the next step accordingly.

4.14 Self-reinforcement (and self-punishment)

• Purpose / when: The third step: the client supplies consequences contingent on meeting the standard. Most useful for increasing behaviour where natural or social reinforcement is delayed or unreliable. Possibly not indicated where self-reinforcement is already high. Self-punishment is listed in the sources, but positive self-reinforcement is generally preferred. [source: Backenstrass 2007; de.wikipedia]
• Steps [synthesis]:
  1. Build a reward menu: small, available, genuinely pleasant activities or items, plus self-praise statements.
  2. Specify the contingency: which reward follows exactly which achievement, and when (as soon as possible).
  3. Agree that the reward is withheld if the criterion is not met, without self-criticism.
  4. Review honesty and timing; adjust rewards that lose value.
• Example language (illustrative): "When you've done the 20 minutes of paperwork, you get the coffee on the balcony, but only then. And say to yourself something like 'Done, well handled.'"
• Watch for: Taking rewards without meeting the criterion; harsh self-punishment in depressed or self-critical clients (avoid). Working sign: the target behaviour increases and the client keeps the system going.

4.15 Self-instruction

• Purpose / when: Replaces unhelpful self-talk with guiding statements before, during and after demanding situations. Indicated for impulsivity, performance anxiety, poor concentration, passivity, and preparing for stressful events. Uses Meichenbaum's procedure, which the self-management literature incorporates. [source: Backenstrass 2007]
• Steps [source: Backenstrass 2007; wording synthesis]:
  1. Identify current self-statements in the problem situation through dialogue or monitoring.
  2. Develop alternative instructions with the client, for each stage: preparing and orienting; coping in the situation; encouragement when arousal rises; evaluation and self-praise afterwards.
  3. Rehearse: therapist models aloud, client says them aloud, then whispers, then thinks them.
  4. Apply them in graded real situations; write them on a card.
• Example language (illustrative): "Before: 'One step at a time; I know what to do first.' During: 'Breathe, slow down, back to the next point.' After: 'I got through it; that's progress.'"
• Watch for: Empty positive slogans the client doesn't believe; use task-focused and realistic wording. Working sign: the client uses their own phrases spontaneously.

4.16 Self-control training (resisting temptation and "heroic" behaviour)

• Purpose / when: For conflicts where a short-term positive outcome competes with a larger delayed one. Resisting temptation means not doing a highly probable rewarding behaviour (e.g., declining a cigarette). Heroic behaviour means doing an unpleasant behaviour for a later gain (e.g., a dental check without pain). Relevant to addictions, eating problems, anxiety avoidance, work behaviour and health behaviour. [source: Backenstrass 2007]
• Steps [synthesis]:
  1. Use the SORKC model to map the conflict: short-term consequence of the problem behaviour versus long-term consequences of the alternative.
  2. Help the client commit in advance, when no temptation is present (decision made "cold").
  3. Combine techniques: stimulus control to reduce temptation (4.17); self-instruction at the decision point (4.15); an alternative incompatible behaviour; immediate self-reinforcement for the controlled response (4.14); contracts (4.20).
  4. Rehearse high-risk moments in imagination or role-play.
  5. Debrief each lapse as data (where did the chain break?).
• Example language (illustrative): "The moment of the decision is the hardest place to win. Let's plan what you'll do two steps earlier, when it's still easy."
• Watch for: Willpower framing that blames the client. Working sign: longer intervals or fewer episodes, and the client describing early interruption points.

4.17 Stimulus control and changing the environment

• Purpose / when: Rearranging cues so the desired behaviour becomes more likely and the problem behaviour less likely. Very widely used: addiction, sleep, work or study problems, compulsions, anxiety, relationship conflicts. [source: Backenstrass 2007; ToC "Veränderung der Umgebung"]
• Steps [synthesis]:
  1. From the SORKC analysis, list the S-cues for the problem behaviour and for the target behaviour.
  2. Reduce access to problem cues (remove, hide, make effortful), e.g., not keeping alcohol at home, phone in another room while working.
  3. Narrow the cues for the target behaviour: a fixed place and time used only for that activity.
  4. Add prompts for the target behaviour (notes, alarms, prepared materials).
  5. Enlist others' help where the client agrees (household rules).
• Example language (illustrative): "Rather than fighting the urge every evening, let's make it harder to start. What would need to be different in the kitchen?"
• Watch for: Rigid avoidance that shrinks life (in anxiety, stimulus control must not become safety behaviour). Working sign: fewer urges or episodes in the modified setting.

4.18 Therapeutic tasks and homework

• Purpose / when: The main vehicle of change in SMT. Learning should happen in the client's life, and the client should do more work than the therapist. [source: ToC Teil III §3.3; Kanfer law 10 via de.wikipedia]
• Steps [synthesis]:
  1. Derive each task from the session's work and the agreed goals.
  2. Make it specific (what, when, where, how often, how recorded) and small enough to succeed.
  3. Have the client restate it and rate their confidence (if below about 7/10, shrink it).
  4. Anticipate obstacles and plan responses.
  5. Write it down; review it first thing in the next session; reinforce any attempt; analyse non-completion functionally.
• Example language (illustrative): "On a scale of 0 to 10, how sure are you that you'll do this? … A 5? Then let's cut it down until it's an 8."
• Watch for: Tasks set by you alone; forgetting to review (which teaches the client homework doesn't matter). Working sign: completion rates rise and the client starts proposing tasks.

4.19 Role-play

• Purpose / when: Practising new behaviour (e.g., refusing, asking, expressing feelings) and exploring situations in a safe setting before real-life use. [source: ToC Teil III §3.4]
• Steps [synthesis]:
  1. Choose a concrete upcoming situation; set the scene (who, where, what's said).
  2. Let the client play themselves as they usually would; therapist plays the other person.
  3. Give specific feedback, starting with what worked; agree one or two changes.
  4. Model the alternative if helpful; swap roles to show the other perspective.
  5. Replay until the client is reasonably confident; plan the real-life trial as homework.
• Example language (illustrative): "I'll be your boss. Show me how you'd usually start this conversation. We'll then try one change at a time."
• Watch for: Embarrassment (start with low-stakes scenes); over-correcting. Working sign: smoother performance and real-life attempts.

4.20 Contracts (Kontrakte)

• Purpose / when: Making agreements explicit: between client and therapist, client and others, or with themselves. They structure commitment, specify contingencies and support self-control. Used in addiction, couples work, child and adolescent work, and as part of safety planning in suicidality. [source: Backenstrass 2007, citing Kanfer et al. 1996 pp. 422–424; ToC "Kontrakte schließen"]
• Steps [synthesis: typical behavioural-contract components; Kanfer's own list]:
  1. Specify the target behaviour concretely and how it will be observed and recorded.
  2. Set the criterion and time frame.
  3. Define the positive consequence for meeting it (and, if agreed, a mild loss for not meeting it; avoid harsh penalties).
  4. Agree who checks and when progress is reviewed.
  5. Write it down in the client's words; both sign; set a review date and renegotiate rather than abandon it.
• Example language (illustrative): "Let's put what we agreed on paper so it's clear to both of us: what you'll do, how we'll know, and what happens when you manage it."
• Watch for: Contracts imposed by others; criteria set too high. A no-suicide contract does not replace risk assessment and a collaborative safety plan. Working sign: the contract is met or renegotiated rather than ignored.

4.21 Handling unexpected situations

• Purpose / when: The textbook lists this as a tool. It prepares clients for events outside the plan and treats in-session surprises as material. [source: ToC Teil III §3.6; steps are synthesis]
• Steps [synthesis]:
  1. When a crisis or surprise is brought into the session, first deal with urgency and safety.
  2. Then apply the problem-solving steps (4.24) to it, modelling the self-management process.
  3. Look ahead: list foreseeable disruptions (holidays, illness, conflict) and plan responses.
• Example language (illustrative): "This came out of nowhere. Let's use exactly the same steps we've been practising and see how they hold up."
• Watch for: Every session becoming crisis-driven; agree how much session time crises may take.

4.22 Relaxation exercises and physical fitness

• Purpose / when: Reducing general arousal and tension, providing an alternative response to stress cues, and improving wellbeing. Often progressive muscle relaxation or breathing-based methods. [source: ToC Teil III §3.7 "Entspannungsübungen und körperliche Fitness"; method choice is synthesis]
• Steps [synthesis]:
  1. Explain the rationale (arousal as part of R in the SORKC).
  2. Teach one method in session (e.g., progressive muscle relaxation: tense and release muscle groups in sequence; or slow breathing).
  3. Daily practice in calm conditions first, recorded; then shorter forms and use in mild stress.
  4. For fitness, agree enjoyable, regular activity at a level that suits the client's health. Set no fixed targets; consult a physician where indicated.
• Example language (illustrative): "Relaxation is a skill like any other. It works best in a crisis once you've practised it when things are calm."
• Watch for: Relaxation-induced anxiety (slow down, eyes open, shorter units); use as avoidance in anxiety disorders. Working sign: lower tension ratings and spontaneous use.

4.23 Developing the capacity for enjoyment (Genussfähigkeit)

• Purpose / when: Building pleasure and positive experience as a resource and a natural reinforcer. Especially useful in depression, burnout and clients who are strongly duty-driven. [source: ToC Teil III §3.8; method detail uncertain]
• Steps [synthesis]:
  1. Collect small pleasant activities and sensory experiences the client has enjoyed or would like to try.
  2. Plan them deliberately into the week, small and frequent.
  3. Practise attentive enjoyment: slow down, focus on one sense, notice details, without multitasking or judging.
  4. Record and rate pleasure; discuss what interferes (guilt, "not earned" rules) and link these to the rules from 4.6.
• Example language (illustrative): "This week, plan two small things just because they're pleasant, not because they're useful. Then notice what goes on inside you while you do them."
• Watch for: Enjoyment turned into another duty; guilt. Working sign: more pleasant activities and higher pleasure ratings.

4.24 Problem-solving training

• Purpose / when: Teaching a general method for new problems, which serves the SMT aim of independent problem handling. The textbook frames therapy itself as problem solving. The procedure below follows D'Zurilla and Goldfried (1971) as summarised in the handout. Requires that the client can, with help, make problems concrete; not suitable in severe acute disorder. [source: ToC §2.3; Backenstrass 2007]
• Steps [source: Backenstrass 2007]:
  1. Define the problem and goal: choose one, split into sub-problems, and describe the current and desired state concretely.
  2. Generate many solutions without evaluating them.
  3. Evaluate the solutions: pros and cons weighted by importance; short- and long-term consequences, for self and others.
  4. Decide on the option with the best balance.
  5. Plan implementation: steps, obstacles, rehearsal (role-play or imagery), and a written plan.
  6. Review: next session, reinforce attempts and analyse what happened.
• Example language (illustrative): "For the next five minutes, let's list every possible way to handle this, even silly ones. We'll judge them afterwards."
• Watch for: Premature evaluation; solving the problem for the client. If the client solves problems in their head but not in real life, combine with skills or exposure work. Working sign: the client uses the steps on a new problem without prompting.

C. Evaluation and ending

4.25 Therapy-accompanying evaluation (Phase 6)

• Purpose / when: Continuously throughout Phase 5. Checks whether the methods are working and why, and models the self-evaluation the client must later do alone. The textbook distinguishes ongoing process assessment, pre/post evaluation and goal-dependent evaluation in practice. [source: ToC Phase 6; Backenstrass 2007]
• Steps [synthesis]:
  1. At intake, choose a few measures linked to the goals: self-monitoring counts, ratings, Goal Attainment Scaling levels, and standard questionnaires as used in your service.
  2. Review the data briefly each session (graph it if possible) and ask the client to interpret it first.
  3. If progress stalls for two to three weeks, go back: is the model wrong (Phase 3), are the goals wrong (Phase 4), or is the method wrong or not being carried out (Phase 5)?
  4. Repeat the pre-measures at the end and at follow-up.
• Example language (illustrative): "Here's your curve for the last six weeks. What do you make of it before I say anything?"
• Watch for: Measuring without using the data. Working sign: decisions are visibly based on the data, and the client reads their own curves.

4.26 Stabilisation, transfer, relapse prevention and ending (Phase 7)

• Purpose / when: Once the main goals are largely reached. The aims are to make gains durable and general, to deal with remaining targets, to teach self-management as a process the client can reuse, to prevent relapse, to end contact and give final feedback, and to arrange follow-up. [source: ToC Phase 7]
• Steps [synthesis]:
  1. Transfer: practise the skills in new settings and situations; reduce therapist prompts; the client plans their own tasks.
  2. Remaining targets: the client runs the analysis-goal-method cycle on a secondary problem with minimal help, as a test of self-management.
  3. Self-management as a process: together, write a one-page summary: "my model, my warning signs, what helps, my steps when a problem appears."
  4. Relapse prevention: identify high-risk situations; distinguish a lapse from a relapse; rehearse the first steps after a lapse; plan reinforcement for maintenance.
  5. Fading: space out sessions (e.g., two-weekly, then monthly); review the summary in each.
  6. Ending: exchange feedback on the process; agree when and how the client can return; set a follow-up appointment.
• Example language (illustrative): "A slip isn't a return to square one. If it happens, what are the first two things on your own plan?"
• Watch for: Dependency (the client says they can't cope without you); abrupt endings. Working signs: the client handles new difficulties between spaced sessions, and gains hold at follow-up.

4.27 Further self-control techniques listed in teaching material

The Backenstrass (2007) course handout, drawing on Fliegel et al. (1998) and Reinecker (2000), groups these with self-management methods. Whether and how the Kanfer textbook presents them is unknown. [uncertain]

• Thought stopping: for repetitive unwanted thoughts. The client brings the thought to mind and signals; the therapist says "Stop" out loud; the client switches to a prepared alternative thought; practice moves to a silent self-given stop. The handout notes the theory is unclear and the evidence weak and inconsistent. [synthesis: in OCD and worry, prefer exposure-based or acceptance-based approaches, because suppression can maintain the thoughts]
• Covert conditioning / covert sensitisation (Cautela): learning in imagination; the client imagines the problem situation paired with aversive or alternative imagery under therapist guidance. Requires adequate imagery ability. [source: Backenstrass 2007] Use only with clear consent and a careful rationale, avoiding degrading content. [synthesis]

5. Handling problems

The textbook has a chapter on difficult therapy situations: problems arising within the therapy, resistance phenomena, and specific problem situations. It also has a chapter on the therapist as a person (self-reflection, supervision, reducing judgement errors). [source: 4th-ed. ToC Teil III §5–6] The responses below are synthesis from SMT principles unless tagged otherwise.

Low motivation or "stuck" before change starts. [synthesis] Return to Phase 2. Re-do the motivation analysis, especially what the problem behaviour still gives the client (C+ and C–/ consequences) and what change would cost. Check whose goal it is. Shrink the step until success is very likely (law 8). Consider whether "accept" fits better than "change" (4.4).

Resistance. [synthesis grounded in principles] In SMT terms, resistance is usually information: the therapist has moved ahead of the client's goals, model or capacity, or change threatens something the client values (the "good reasons" principle). Responses:

• Name it neutrally and ask what doesn't fit.
• Check transparency (did you explain why?).
• Return choice explicitly (voluntariness).
• Check that you are not working harder than the client (law 10).
• Look for system conditions (4.6) that punish change, such as a partner who loses influence.
• Example (illustrative): "I've been pushing this idea and it doesn't seem to fit for you. Help me understand what I'm missing."

Non-adherence to homework or monitoring. [synthesis] Treat it functionally with a mini-SORKC of the non-completion: when they intended to do it, what got in the way, what happened afterwards. Typical fixes:

• smaller tasks and confidence ratings (4.18);
• cues tied to existing routines;
• simpler recording formats;
• reviewing every task without fail;
• self-reinforcement for completion;
• checking whether the task was really the client's choice. Never reprimand; it punishes disclosure.

Overwhelm (too many problems, too much information, crises). [synthesis] Apply law 9: one or two key points per session, written down. Prioritise using the change-area criteria (4.4). Set a crisis-time agenda rule. Address acute risk with standard risk assessment and a collaborative safety plan, including lethal-means counselling (safe storage or removal) where relevant. Temporarily increase structure and therapist activity, then hand it back.

Alliance ruptures. [synthesis] These often follow perceived pressure, misunderstanding or feeling judged by data. Raise the rupture openly. Take your share of responsibility. Return to role structuring (4.1). Ask for session feedback routinely so ruptures surface early. Bring repeated ruptures to supervision (textbook ch. 6 recommends supervision and self-reflection).

Modality-specific difficulties:

• Analysis paralysis: endless behaviour analysis without intervention. Use the economy principle: a "good enough" model is a hypothesis to test in Phase 5. [source: ToC §3.3; synthesis]
• Generic SORKC: the client describes "always" rather than episodes. Insist on the most recent concrete instance (law 6). [synthesis]
• Self-monitoring worsens symptoms (rumination, obsessions, body checking in eating disorders): switch to less frequent or event-based recording, record behaviour rather than thoughts, or stop. [source: Backenstrass 2007 caution; synthesis]
• Self-reinforcement erodes (rewards taken anyway or lose value): move the reinforcement to others (contract with a partner) or to natural consequences; refresh the reward menu. [synthesis]
• Overly harsh standards: perfectionistic or depressed clients set impossible criteria and punish themselves. Make standards explicit and graded (4.13); ban self-punishment. [synthesis]
• Goals imposed by others (court, employer, family): keep law 1 and voluntariness; find a goal the client does own (e.g., "getting them off my back") and work from that. [synthesis]
• Clients with limited self-regulation capacity (severe acute disorder, cognitive impairment): the problem-solving procedure requires active participation. Increase external structure, use more environmental and stimulus control, involve carers with consent, and treat acute disorder first. [source: Backenstrass 2007 indication note; synthesis]
• Dependency at the end: begin fading early; have the client lead sessions; set an explicit end date; offer booster sessions rather than open-ended contact (law 4: build the route before removing support). [synthesis]
• Therapist pitfalls: playing "God", premature advice, technique-hopping. Use the self-evaluation and supervision forms in the appendix and regular supervision. [source: ToC Anhang D, F; law 3]

Sources

Sources:

• Kanfer, Reinecker & Schmelzer, Selbstmanagement-Therapie, 4th ed. 2006: front matter and table of contents (e-bookshelf reading sample)
• Selbstmanagement-Therapie, table of contents (visuallibrary)
• Selbstmanagement-Therapie, 5th ed., table of contents (Lehmanns)
• Springer: Selbstmanagement-Therapie, 1st ed. 1991 book page
• Springer: Selbstmanagement-Therapie, 5th ed. 2012 book page
• Springer: "Situative Verhaltensanalyse: Von der Makro- zur Mikro-Ebene", chapter abstract
• Google Books: Selbstmanagement-Therapie, 5th ed.
• Backenstrass, Selbstkontrolle und Problemlösen 1 (Universitätsklinikum Heidelberg course handout, 2007)
• Wikipedia (de): Selbstmanagement-Therapie
• Wikipedia (de): SORKC-Modell
• Self-management teaching unit based on Kanfer et al. 2012 (hubbs.schule)
• Flashcards on Phase 2 and Phase 5 of the self-management model (buffl)
• Functional analysis for behavioural therapy (Primary Care Notebook)
• Kanfer & Schmelzer, Wegweiser Verhaltenstherapie, 2nd ed.: sample (lesejury)

Further reading (not drawn on):

• Kanfer, F. H., Reinecker, H., & Schmelzer, D. (2006). Selbstmanagement-Therapie: Ein Lehrbuch für die klinische Praxis (4th ed.). Springer. (Also 1991, 1996, 2000; 5th ed. 2012.)
• Kanfer, F. H., & Schefft, B. K. (1988). Guiding the process of therapeutic change. Research Press.
• Kanfer, F. H., & Saslow, G. (1965). Behavioral analysis: An alternative to diagnostic classification. Archives of General Psychiatry, 12, 529–538.
• Kanfer, F. H., & Phillips, J. S. (1970). Learning foundations of behavior therapy. Wiley.
• Kanfer, F. H., & Goldstein, A. P. (Eds.) (1975/1980/1991). Helping people change: A textbook of methods. Pergamon. (Kanfer's "Self-management methods" chapter; archive.org copy access-restricted.)
• Kanfer, F. H., & Schmelzer, D. (2005). Wegweiser Verhaltenstherapie (2nd ed.). Springer.
• Fliegel, S., Groeger, W. M., Künzel, R., Schulte, D., & Sorgatz, H. (1998). Verhaltenstherapeutische Standardmethoden. Beltz PVU.
• Reinecker, H. (2000). Selbstmanagement. In J. Margraf (Ed.), Lehrbuch der Verhaltenstherapie, Bd. 1 (2nd ed., pp. 525–540). Springer.
• D'Zurilla, T. J., & Goldfried, M. R. (1971). Problem solving and behavior modification. Journal of Abnormal Psychology, 78, 107–126.

Further reading (not drawn on): the textbook's body text (Springer chapters, Google Books and archive.org Helping People Change copies).