1. Stress HEALTH & CLINICAL PSYCHOLOGY a. Causes of Stress b. Measuring Stress c. Stress Management G543

2. Think about the following scenarios – what would you recommend to these people? Seb is applying for a demanding University course and he is also the Head Boy at his school. Alongside this, his Mum works late hours and he has to cook dinner for his little sister. Sometimes he feels overwhelmed by it all. Isla is an A&E doctor. She works under extreme pressure, and very long hours. Sometimes she sees distressing things. She’d like to find a way to manage the stress she is under better. John has been unwell for a while and is finding it difficult to manage his work and family commitments, coupled with the anxiety he experiences as a result of his illness. Sometimes he just wants to talk.

3. Managing Stress How many ways do you know about already? MANAGING STRESS

4. Managing Stress The Theories/Studies Cognitive: SIT (Michenbaum 1975) Behavioural: Biofeedback. (Budzynski 1973) Social: social support (Waxler-Morrison 2006)

5. Approaches The social, behavioural and cognitive approaches all view the physiological symptoms of stress as caused by different aspects: Cognitive – Faulty thoughts Behavioural – Associations or consequences Social – People around you

6. Meichenbaum SIT Cognitive Stress inoculation therapy What does inoculation mean?

7. Background Meichenbaum’s assumption is that stress is caused by the faulty processing of information. Therefore, stress inoculation therapy assumes that some people find situations stressful because they think about them in catastrophising ways The aim of the therapy is to train people to cope more effectively with stressful situations.

8. Background: Stress Inoculation Therapy, SIT, has 3 stages: Cognitive preparation; Therapist and client identify the sources of stress. Encouraged to keep a diary of stressful events so the therapist can challenge some of the client’s appraisals of stressful situations if they seem exaggerated. Skill acquisition and rehearsal; Training the individual to cope with their stress using different techniques for different stressors. I.e relaxation techniques. Application and follow through; Therapist guides the client through progressively more stressful situations.

9. Aim To compare effectiveness of standard behavioural methods with cognitive techniques. Cognitive methods aimed to enable people to identify their stressors and change their mental processes when under stress. What would a behavioural therapy concentrate on?

10. Methodology Field experiment Participants put into three groups; SIT, standard desensitisation, control. Tested using anxiety questionnaires and grade averages before and after treatment. Single Blind study- people assessing did not know which condition they had been in. Matched pairs design with gender controls and a random allocation to a group.

11. Procedure 21 students aged 17-25 responded to an advert about treatment of test anxiety. The SIT group received 8 therapy sessions giving them insight into their thoughts. They were then given some positive statements to say and progressive relaxation training whilst imagining stressful situations. The systematic desensitisation group was also given 8 therapy sessions with only progressive relaxation training whilst imagining stressful situations. The control group were told that they were on a waiting list for treatment.

12. Results Performance in tests from the SIT group improved the most in comparison to the other two groups. Both therapy groups improved more in comparison to the control group. Participants in the SIT groups showed more reported improvement in their anxiety levels, although both therapy groups showed an improvement over the control group.

13. Conclusions SIT is an effective way of reducing anxiety in students who are prone to anxiety in test situations and more effective than simply behavioural techniques when a cognitive component is added.

14. Activity In pairs: Devise a story/scenario outlining an example of SIT You can write or draw this

15. Evaluation

17. Exam Focus For now, let’s focus on what makes a good ten mark answer. Please read the sample answers and mark using the mark scheme. NB:

18. Homework FOR NEXT LESSON: RESEARCH: Using the internet (you may like to have a go at using Google Scholar): What is biofeedback? Research evidence that biofeedback is an effective method of stress management

19. Plenary Based on your evaluation of the study, and of your knowledge of the technique, what do you think are the overall strengths and weaknesses of this particular method of stress management? Please complete your exit pass.