Monday, 18 May 2015

STRESS - Managing stress - What methods are available to help us manage the stress we experience?

SOCIAL APPROACH - Managing stress 

Many forms of dysfunctional behaviour are treated in group therapy and support sessions, such as alcoholism, drug addiction and anger management. Some stress management also emphasises the need for social support in coping with stressful situations.

Cohen and Willis argue that there are four types of social support (all of which we need):

1. Instrumental support; practical support such as help with taking care of loved ones or help with getting to where you need to be.

2. Informational support; advice on what to do and how to cope with different situations.

3. Esteem support; emotional support from friends, colleagues, loved ones and others which makes you feel valued, loved and respected.


4. Social companionship; general interaction with others for its own sake rather than functional relationships such as at work.

Waxler-Morrison: How social relationships influence women's survival rates with breast cancer.

Sample: 133 Canadian women under the age of 55 who had been diagnosed with breast cancer.



Method and procedure: Quasi-experiment: women with breast cancer and used the social network support and those who didn't. Data was taken from medical records as well as self-report methods (largely questionnaires but also some interviews).

Results:The findings suggested six aspects of social support were most closely associated with cancer survival:

1. Marital status (married women who survived tended to report supportive husbands)
2. Support from friends
3. Contact with friends
4. Employment (employed women found this important in coping with cancer as it was a source of information and social support).
5. Social network
6. Total support

Conclusions: A strong social support system was concluded to reduce the stress associated with life-threatening but not necessarily terminal illnesses such as breast cancer, and thus make survival more likely. Though, obviously the most important factor in survival is the diagnosis of the cancer (i.e. how developed the cancer is).


COGNITIVE APPROACH - Managing stress 

According to the cognitive approach, stress is the result of faulty thinking and poor perceptions. However, you will be glad to hear that behaviour these errors in thinking can be improved or cured via cognitive restructuring. This is known as cognitive behavioural therapy (CBT).

One form of CBT specifically targeted at coping with stress is Stress Inoculation Therapy (or SIT). It was developed by Meichenbaum, and has three stages which aim to help clients to replace "self-defeating thoughts" which cause stress with more positive ones, which can help to reduce the effect of potential stressors, and thus reduce the overall stress response.

Meichenbaum - baum sounds like bum, you SIT on your bum. Miss Smiths top tip for remembering this study ;)



The three stages of SIT are:

1. Education - the client and therapist work together to identify the nature of stress, and the therapist educates the client on the general effects of stress to help them understand what stress is and how it can be overcome.
2. Skills acquisition - the therapist helps to train the client in relevant skills which will aid them to cope with and reduce their stress. This often includes monitoring their own internal dialogue and reassuring themselves that things are okay if not everything goes to plan.
3. Application - the patient has to apply their skills to real-life situations, and the therapist helps them with this.

Meichenbaum: comparing SIT to systematic desensitisation and a control group in reducing test anxiety (a major cause of stress)



Sample: The study consisted of 21 students aged 17 to 25, who had responded to an advert asking for participants in a study on anxiety that is experienced when taking tests/exams.

Method: It was a field experiment, where the IV was the type of therapy the participant received (none, SIT or systematic desensitisation), and the DV was levels of anxiety, which was measured through self-reports, and their performance on  a test measured by the score they achieved in an IQ test. These measures were carried out before and after the therapy.

Procedure: It was a matched pairs design where they were matched on anxiety levels. There were three conditions:

  • Group 1 received eight therapy sessions of SIT where they were taught to identify stress, learn how to reduce thoughts which increased their stress, monitoring their internal dialogue, etc. 
  • Group 2 received the same number of sessions but were given the behavioural therapy of systematic desensitisation
  • Group 3 were put on a waiting list. 
Results: 

Both therapy groups had improved results on their anxiety levels, but Group 1 (SIT group) performed better in test conditions and had reduced anxiety levels than both other groups.

Conclusion: SIT helped to reduce the stress people felt during test situations and enabled them to perform better.

BEHAVIOURAL APPROACH - Managing stress

The behaviourist approach to psychology assumes that we are all born as a blank slate, and we learn all of our behaviour. It's a very reductionist approach as it is purely on the nurture side of the nature-nurture debate, the situational side of the situational-dispositional debate, and deterministic on the freewill-determinism debate.

It essentially works on the basis of three concepts: classical conditioning (learning via association), operant-conditioning (learning via punishment and reinforcement) and social learning theory (learning via imitation and interaction with others).In terms of stress management, the behaviourist approach takes the view that as behaviour is learned, you can be taught to manage stress through the same processes.

Biofeedback is not a treatment. Rather, biofeedback training is an educational process for learning specialised body skills. Learning to recognize physiological responses and alter them is not unlike learning how to play the piano or tennis - it requires practice. Through practice, we become familiar with our own unique physiological patterns and responses to stress, and learn to control them rather than having them control us.

By giving audible feedback on the state of the body it is assumed that we would be more likely to repeat the method of reducing stress. This is the method used by Budzynski's research on patients with tension headaches. These headaches are thought to be caused by sustained contraction of the scalp and neck muscles. Which is associated with stress, therefore by relaxing the muscles (reducing the stress response), the headaches should be reduced.



Budzynski - Conducted a study on the role of biofeedback in reducing stress management. 

Method: It was a field experiment. Data was collected using muscle tension measurements (EMG). Patients were also given a psychometric test for depression (MMPI) and asked to complete questionnaires on their headaches.

Sample: 18 volunteers who had responded to an advert asking for people with tension headaches.

Procedure: Participants were split into 3 conditions:

  • Group 1 were taught relaxation techniques during two weekly sessions for eight weeks, during which they had their muscle tension measured by an EMG machine (genuine measure). They were informed about the biofeedback in terms of clicks, (more clicks = more tension) and encouraged to relax.
  • Group 2 had the same relaxation training received biofeedback clicks that did not represent their true muscle tension. This was to see if this technique could be successful when used as a placebo treatment. This means that the patients believe they are receiving the treatment, but they actually aren't. 
  • Group 3 were not trained in the relaxation techniques nor taught about the biofeedback and so acted as a control group. 
Results: 
The study showed that Group 1 had the lowest muscle tension, lowest levels of hysteria and depression and the fewest tension headaches by the end of the study. 

In addition, a follow up study 18 months (not all original participants took part) showed that 3 participants reported VERY low head ache activity, and one participant reported SOME reduction in headaches. 

Conclusion: Biofeedback combined with relaxation techniques help to significantly reduce stress-related illness.



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