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Critical Issue:
Stress Management
How do you cope with stress?
• Brainstorm the ways you use to cope with
different stressful situations
Problem - focused Coping
Stress is treated as a problem to
be solved.
• Seeking social support – discussing a
problem helps make more sense of it, puts
problem in perspective.
• Taking control – e.g taking steps to deal
with debt, finding out about a disease, looking
for a new job.
Problem Focused Coping
• Evaluating the pros and cons of different ways
of dealing with the stress – e.g. planning a new
life after bereavement, choosing whether to have
• Suppressing competing activities – e.g.
avoiding the temptation to put off going to the
dentist because of work commitments
• Anticipatory coping – work out what triggers
stress, train ourselves to anticipate and deal with
it e.g working out your route to a new location,
anticipating possible roads to avoid e.t.c
Problem Focused Coping
These strategies are often achieved
through Psychological Therapies
• Cognitive Behavioural Therapy – CBT
Emotion – focused Coping
Avoidant methods, used when a person feels
is nothing that can be done to change the problem.
Treats the symptoms not the problem
1. Defence mechanisms – tend to be negative
• Denial – e.g going on as if nothing has
• Distancing/distraction – e.g just not thinking
about it
• Focusing on and venting emotions e.g crying,
anger, praying
• Wishful thinking – dwelling on what might have
been if this hadn’t happened
Emotion – focused Coping
2. Reappraisal/reinterpreting – taking
another look at the situation may change
the way you feel about it. A positive
3. Arousal reduction – heightened
reactions associated with stress are
reduced, so the person becomes less
stressed e.g meditation, relaxation,
exercise, biofeedback or drug therapy
Gender differences in coping
• Do you think males and females may cope
• Research has evidence that ...
• Males more likely to use Problem-focused
methods, whereas women use emotionfocused
Gender differences in coping
1. Socialisation theory – women taught to
show emotions openly, men taught to
approach stress in a more active way.
2. Role constraint theory – coping strategy
matches roles males and females occupy.
When males and females
have same role – used same
strategies to cope with stress
There is a very, very tall coconut tree,
and there are 4 animals passing by:
King Kong, Ape, Orangutan and Monkey
They have a competition to see who is
the fastest to get the banana. Who do
you guess will win?
Your answer will reflect your
personality. Try and answer within 30
Got your answer?
If your answer is ....
Orangutan = Dumb
Ape = Foolish
Monkey = Idiotic
King Kong = Stupid
Why ?????
A Coconut tree ........ doesn't have bananas!!
It's obvious you're stressed by your work.
Go home!
What is Stress Management?
The process by which an
individual attempts to cope with
(manage) stressful demands.
• Psychological – CBT (e.g Stress
Inoculation, Hardiness training and
• Physiological – Drug therapy,
Biofeedback, exercise
Psychological Methods
• Use techniques that help the person
cope with the situation itself rather
than just dealing with the symptoms.
• Patients find ways of changing or
avoiding stressful situations in the
• Or learn techniques to minimise
negative effects of stressful
Psychological Methods
Stress Inoculation Training (SIT)
Meichenbaum (1985) – cognitivebehavioural therapy – person can change way
they think about certain stressors.
Suggested client should develop a form of
coping before the problem arises – inoculate
yourself against the disease of stress like
vaccinations to prevent infectious diseases!
Use clients’ existing coping skills.
Evaluation of Research
• It works! –Meichenbaum
(1996) successful with
acute and chronic stress.
• Combines cognitive and
behavioural therapy –
powerful method of stress
• By gaining new skills gap
between demands and
coping resources narrows
– more confidence in
handling previously
stressful situations
• Time consuming and high
levels of motivation
needed –only suits a small
range of determined
individuals. Expensive.
• Difficult to change some
• Complex – may not need to
do all aspects of the
therapy – e.g. may be
sufficient to just talk
more positively and relax
Psychological Method 2:
Hardiness Training
Kobasa and Maddi (1977)
1.Focusing – client taught to spot signs of
stress (e.g. muscle tension, increased heart
rate, anxiety). Allows client to recognise
stressful situations and thus sources of
2.Reliving Stress Encounters – clients analyse
recent stressful situations in terms of how
easily they were resolved and how they might
have turned out better or worse. Gives client
insight into their current coping strategies
and how they might be better than they
Psychological Method 2:
Hardiness Training
Kobasa and Maddi (1977)
3. Self-improvement – The key to
hardiness is the belief that we can cope
with life’s challenges.
Client taught to focus on seeing
stressors as challenges and thus learn
to take control.
Control, commitment and challenge are
the basis of hardiness training.
Evaluation of Hardiness Training
• Deals with the problem
rather than the
symptoms – teaches
clients to manage all
stressors in their life.
• More adaptable and
effective than drugs
• Long-term
• Much of research
carried out on male
executives or soldiers in
US. Low ecological
• High control can be
stress inducing for
some people.
• Difficult to modify
learned habits.
• Does hardiness exist? –
is it just being in
Comparison of SIT and
Hardiness Training
Both treat the
problem not the
Both teach clients
skills to provide
lasting and varied
strategies to cope
with stress
Both teach clients
to view stress as a
problem to be
• Both require
lengthy training and
highly motivated
• The success of SIT
may be mainly due
to positive thinking
• The success of
hardiness training
may be due to
increased control
Physiological approaches to
stress management
These methods focus
on getting rid of the
emotions associated
with the stressful
situation, but the
situation may not be
They directly target
the stress- response
Anxiolytic* Drug Therapy
Benzodiazepines (BZ’s)
Librium, Valium, Halcion, Xanax
Short term relief of severe anxiety.
1.Enhance action of natural brain chemical, GABA.
2. GABA tells neurons to slow down or stop firing
– general quietening influence on brain.
3. Action of GABA is supported by BZ’s to
inhibit neuron activity even more
4. The brain’s output of excitatory
neurotransmitters (e.g serotonin) is reduced
and person feels calmer
Anxiolytic – anti-anxiety drugs, GABA – gamma-amino-butyric acid
Anxiolytic* Drug Therapy
Treat high blood pressure
1. Reduce activity of adrenaline and
noradrenaline, which are key agents in
sympathetic (ANS) arousal.
2. By blocking ANS arousal, beta-blockers slow
the heart beat, lessen the force with which
the heart contracts and reduces blood vessel
3. This results in a fall in blood pressure and
less stress on the heart.
Also given to sportsmen and women to reduce
arousal which can affect performance
Anxiolytic* Drug Therapy
1.What do you think are the
advantages and disadvantages of
using drug therapy to manage
2. Do these methods really manage
the stress? Explain.
• Selective Serotonin Reuptake Inhibitors
– e.g Prozac
• Prevent the recycling of Seratonin
• Leads to more Seratonin in the synapses
• Helps depression as people suffering this illness
have low levels of Seratonin.
Trivedi et al 2006 – 3000 depressed patients given
Citalopram. 47% halved their depression score.
BUT - Effectiveness did depend on type of
Evaluation of Drug Therapy
High efficacy (work on
range of anxiety disorders)
Kahn et al (1986) – BZs
superior to placebo
Work quickly to reduce
disabling effects of stress
related anxiety.
Low toxicity
Rai et al (2005) – Beta
Blockers increased survival
of patients with certain
serious heart problems.
Can be prescribed
immediately for acute
Easy to take
Addictive –BZs
psychological and physical
dependence can develop
within a few weeks – Ashton
1997 – BZs limited to 4
weeks use
Side effects – drowsiness,
dizziness, tiredness, dry mouth,
diarrhoea, changes in sex
drive/ability, seizures, severe
skin rash, irregular heartbeat
Can prevent normal
psychological adjustment –
treats the symptoms not
the problem
Person learns to exert voluntary control over
involuntary (autonomic) behaviours
Biofeedback involves 4 processes:
• Feedback – patient attached to machines
that give feedback about ANS activities –
heartbeat, blood pressure
• Relaxation – patient taught relaxation
techniques – reduces activity of sympathetic
nervous system and activates
parasympathetic NS – reduced heart rate,
blood pressure and symptoms related to
• Operant conditioning – relaxation leads to
target behaviour e.g. reduced heart rate,
which is rewarding.
• This will increase likelihood of same
behaviour being repeated. This learning
(conditioning) takes place without conscious
• The reward results in an unconscious
‘stamping in’ of the behaviour. (Like Pavlov’s
• Transfer – The patient transfers the
skills learned to everyday situations.
Evaluation of Biofeedback
No negative side
Provides patient
with long lasting
means of dealing
with stress
• Expensive –the cost
of equipment and
time needed
• Treating the
symptoms not the
problem – does not
treat the source of
3. Which is best Emotion-focused or
problem-focused methods?
Aim to remove
No side effects
Last longer
More expensive
Ppts need to be
motivated to stick with
Emotion focused
Control symptoms –
problem still there
Quick and effective
Relatively cheap
May have side effects
May cause addiction
Biofeedback – no
addiction or side
effects, more
expensive than drugs