Coping with stress

Types of Coping.

According to Folkman and Lazarus coping can be either Problem focused - dealing with the stressor Emotion focused - dealing with the emotions associated with the stressor.

Problem focused Taking control - changing the relationship between self and source of stress Evaluating pros and cons - different options for dealing with stressor Suppressing competing activities - avoiding/putting off things that need to be done.

Emotion focused Denial - refusing to accept what's happening Focusing and venting emotions - crying/anger Wishful thinking - dwelling on what might have been.

Some methods such as social support can be both problem and emotion focused. In reality people often use a variety of methods, if the situation seems controllable then a problem-focused method will be used and vice versa.  In some cases if the stressor seems to be a major threat people often react with an emotion-focused method and then when the shock has subsided they develop a problem focused strategy.

Cognitive Behavioural Therapy.

Psychological method - How we perceive and think about the stressors we encounter

Alter faulty thinking.

Overview. Therapist and client identify faulty cognitions Therapist tries to show the thoughts aren't true sets goals to think in more positive ways mainly focuses on present Encouraged to keep a diary for patterns of feelings and actions.

Stress Inoculation Therapy.According to Meichenbaum 1976 this technique aims to train people to cope more effectively with stressful situations, it has three stages: Conceptualisation - exploring in which stressful situations are thought of, eg with negative self statements "I can't handle this." Skill acquisition and rehearsal - attempts to replace negative self-statements with positive coping statements, learnt and practised. Application and follow through - guided through progressively threatening situations that have been rehearsed in roleplay in actual producing situations.

SIT is more effective than other psychological treatments, Meichenbaum 1976 compared SIT patients with systematic desensitisation patients for examination of anxiety in students. Patients in the SIT group reported improvement in their anxiety, showing the treatment is effective.

The main advantage is that it inoculates against future stressors by giving skills and confidence to cope, eg how to deal with fear in general not fear of a certain concept. These skills are transferable so the patient can cope independently in the long term, meaning the treatment is life lasting.

It 

It requires a lot of time and can be seen as over complicated, therefore possibly only suitable for a certain type of patient, one who is dedicated and determined to stick to the techniques and progression of the treatment.  This limits how useful and suitable the treatment is.

Increasing Hardiness - Kobasa.

Control - hardly individuals see themselves in charge Commitment - Tackle problems head on Challenge - See change as a challenge rather than a threat.

According to Kobasa hardiness can be increased in the following ways: Focusing - recognise symptoms of stress, eg increase in heart rate. Reliving stressful situations - asked to think about recent stressful situations they've overcome and to consider better ways to cope for the future. Self-Improvement - emphasises that challenges can be coped with rather than problems we give in to.

Hardiness training targets both perception and coping, therefore reducing the gay between demands and abilities, eliminating the feeling of unable to handle situations aka stress, when this skill is acquired this will be able to be used for future stressful situations to the patient feels more equipped to handle the situation, making the treatment's effect life long.

Rea

Real world application - Judkins (2006) found that nurse managers who took part in hardiness training programmes increased their levels of hardiness. It also had a positive impact on staff turnover levels. This shows that Kobasa's research is useful in the workplace to improve staff wellbeing.

As 

As with other psychological treatments it takes a lot of time, commitment and money. It will not be available to everyone, only those who are dedicated and determined to stick to the training plan, this limits the treatments suitability.

Concepts may be too complex, eg a lack of hardiness might be just another label for negativity, it could be argued that its just as effective to relax and think positively. 

Beta Blockers and Bio-feedback.

Physiological methods - changing the way the body responds.

Beta-blockers slow down activity in the sympathetic branch of the autonomic nervous system by reducing levels of adrenaline and noradrenaline.  They bind to receptors on the cells of the heart and other parts of the body usually stimulated when we are aroused by stress. This results in a reduced heart rate and lower blood pressure etc. It is difficult to feel stressed when your body isn't responding in that way, so the mind feels like anxious and calmer.

Beta-blockers can improve performance, Lockwood studied 2000 musicians in major US orchestras. 27% had taken beta-blockers and felt better about their performances. Beta-blockers appear to lower stress levels and help performance and lower anxious emotions.

Quick and easy to take the drug and get a instant result of feeling less stressed, this treatment is quicker than psychological methods such as stress inoculation therapy and hardiness training which is a progressive treatment that takes more time.

Drugs have side effects such as dizziness and tiredness or even blurred vision and a change in sex drive. Withdrawal symptoms can also appear such as anxiety, siezures, tremours and headaches. Benzodiazepines can be addictive, generally limited to 4 weeks dosage, which will lead to other health problems after a completed course of treatment. However bio-feedback has no side effects, its just relaxation techniques that are voluntary and not invasive.

Drugs are easy to prescribe and use than bio-feedback, easy to prescribe and use. Bio-feedback needs specialist equipment and expert supervision, some argue that the benefits of bio-feedback could be gained from relaxation techniques and so this is an unnecessary expense

Bio-feedback gives people information about internal physical processes of things the wouldn't usually be aware of, Patient is attached to a machine that monitors body rates and muscle tension and gives feedback They are taught how to control these processes and their symptoms through breathing control, meditation ect. Relaxation acts as a reward and encourages patient to repeat Patient learns how to use the techniques in real-life scenarios.

Attanasio found that bio-feedback helped teenagers and children with stress related disorders to gain control over the symptoms of migraines, they also showed increased enthusiasm.

Bradley compared patients on bio-feedback with non patients for muscle contraction headaches and found significant improvements were found in the treatment group. Showing bio-feedback can be effective treatment.

B

Both treatments only cure symptoms related to stress rather than the underlaying causes for the stress. Drugs only help with symptoms and only as long as they're being taken. bio-feedback also aims to reduce symptoms but by using relaxation techniques to control them. By using relaxation techniques the patient does however have long lasting benefits of being able to feel more in control of the situation.

Psychological method - How we perceive and think about the stressors we encounter

Types

CBT

hARDYNESS tRAINING

bETA bLOCKERS