1. Relieving Stress Through Biofeedback Training Barbara Morrell, Ph.D. Michael Maughan, Ed.D. Shannon Coetzee, B.S. Grant Gardner Karstin Slade, B.S. Brigham Young University Provo, Utah Presented at the AMCAP Spring Convention Salt Lake City, Utah March 29, 2007

2. Brigham Young University Stress Management and Biofeedback Lab  In operation since 1976  Integral part of the Counseling and Career Center  Utilize EMG, Thermal, GSR, HRV & Respiration modalities  350 students seen in 900 sessions per year

3. Purpose of Lab  To Provide Stress Management/Biofeedback training to help students: Better manage school and other stressors Better manage school and other stressors Develop Skills to reduce unwanted tension Develop Skills to reduce unwanted tension Lessen interference of stress/anxiety with school performance & overall wellbeing Lessen interference of stress/anxiety with school performance & overall wellbeing  To Provide an Adjunct to Psychotherapy

4. Lab Personnel  1 Psychologist Lab Supervisor/Admin  1 Psychologist doing tx (4 hours/week)  1 Graduate Assistant Coordinator  2-3 Undergraduate lab assistants

5. Relaxation Skills Training  Body Scan  Autogenics  Diaphragmatic Breathing  Progressive Muscle Relaxation  Meditation  Visualization  Self-Hypnosis  Performance Rehearsal

6. Outreach Presentations  Housing—On and Off campus  Campus classes  Workshops offered in Counseling Center  Stress Management Group in Counseling Center  Health Fairs

7. Purpose of Research  To better understand the experience of stress of students referred to the lab  To determine the effectiveness of biofeedback/relaxation training  To increase effectiveness of biofeedback/relaxation training

8. Research Questions  What subjective level of stress do students report on the average?  What are the major stress symptoms reported by students?  What are students major stresses?  What are the major ways students cope with stress?

9. Research Questions  How effective is biofeedback/stress management training? Pre-/Post- changes in EMG Readings? Pre-/Post- changes in EMG Readings? Pre-/Post- change in Temp Readings? Pre-/Post- change in Temp Readings?  How do student self-reports of level of stress change pre- and post- session?  Does practice between sessions improve effectiveness of training?

10. Subjective Measures  Student rating of stress for past week  Student beginning and ending BF session rating of stress level  Anonymous Student report of how useful, relaxing and effective the session was  Student report of between-session practice Skill(s) practiced Skill(s) practiced Frequency Frequency Effectiveness Effectiveness

11. Objective Measures  EMG and Temperature BF Readings Pre- and Post-treatment readings by session Pre- and Post-treatment readings by session Change in Post-treatment readings over several sessions Change in Post-treatment readings over several sessions

12. Preliminary Data Preliminary Data  Data Collected from 09/2006 & 01/2007  Participants: N =158  BF Sessions: N = 282  Range: 1-13 sessions  Modal session #: 1 session  Anonymous Satisfaction surveys: N = 177

13. Referral Sources to Lab

14. Percent of Lab Participants by Class and Gender

15. Top Stress Symptoms Endorsed by Students Referred to Lab

16. Top Stressors Endorsed by Students Referred to Lab

17. Top Coping Strategies Endorsed

18. Intake Form

20. Recording Form

21. Tracking Form

22. Preliminary Results Students anonymously reported on average that their BF sessions were: Not Informative Very Informative 0 1 2 3 4 5 6 7 8 9 10 0 1 2 3 4 5 6 7 8 9 10 Not Relaxing Very Relaxing 0 1 2 3 4 5 6 7 8 9 10 0 1 2 3 4 5 6 7 8 9 10 Not Useful Very Useful 0 1 2 3 4 5 6 7 8 9 10 0 1 2 3 4 5 6 7 8 9 10

23. Results of Home Practice  Average Usefulness rating of those who practiced was 6.64 out of 10 (10 point scale: O = Least useful; 10 = useful)  49% of students reported they practiced relaxation techniques during the previous week

24. Self-Report Rating of Stress Pre-and Post-Treatment Avg Change = 3.555 (10 point scale: 0 = not stressed; 10 = most stressed)

25. Pre- and Post- Frontal EMG Recordings Ave Change = 2.285

26. Pre- and Post- Hand Temperature Recordings Ave Change = -.573

27. Preliminary Conclusions  BF sessions are effective in reducing stress level in the short run based on subjective data and EMG/Temp readings  Students overwhelmingly report BF sessions to be helpful  Only half of BF trainees are engaging in home practice of relaxation techniques  Those who practice relaxation techniques report it to be useful

28. Future Investigation  Do Pre-Post EMG/Temp BF readings improve significantly over multiple sessions?  Do weekly and pre-session subjective ratings decrease significantly over multiple sessions?  Do Students who practice show significantly greater improvement compared to those who don’t?  How do therapy clients compare to non-clients?