Download UNIT THREE - STRESS MANAGEMENT

AQA PSYCHOLOGY: PHYSIOLOGICAL PSYCHOLOGY
Unit of learning 3
Stress in everyday life
STRESS MANAGEMENT
LEARNING OBJECTIVES :
1.
2.
YOU WILL BE ABLE TO:
Outline and evaluate psychological methods of stress management including stress
inoculation therapy.
Outline and evaluate biological methods of stress management including drug therapy.
PSYCHOLOGICAL METHODS OF STRESS-MANAGEMENT
STRESS INOCULATION TRAINING (A TYPE OF COGNITIVE BEHAVIOURAL THERAPY)
CBT is based on the belief that the key influence on behaviour is how an individual thinks about
a situation. Cognitive therapy aims to change unwanted or maladaptive thoughts and beliefs.
Behaviourists believe that undesirable behaviours have been learned, therefore behavioural
therapy aims to reverse the learning process in order to produce a new set of more desirable
behaviours. CBT links the two models. Meichenbaum (1985) believed that although we cannot
(usually) change the causes of stress in our life, we can change the way that we think about
theses stressors e.g. I missed one deadline, the teacher thinks I’m a bad student and expects
me to fail, my parents are disappointed in me and I think I will probably fail if I go to university.
Stress Inoculation Therapy Is a type of CBT which was designed specifically to deal with
stress.
Meichenbaum proposed 3 main phases:
1. Conceptualisation the therapist and client establish a collaborative relationship. The
client is helped to understand the nature of their reactions to stressful situations. They will be
helped to reappraise these if they are over exaggerated. Clients are encouraged to view
perceived threats and provocations as problems-to-be-solved and to identify those aspects of
their situations and reactions that are potentially changeable and those aspects that are not
changeable.
2. Skills acquisition phase and rehearsal - coping skills are tailored specifically to the
stressors the client has to deal with (e.g. chronic illness, traumatic stress, surgery, sports
competition, military combat etc.). These include positive thinking, emotional self-regulation,
problem solving, relaxation, social skills, methods of attention and diversion, using social
support systems and time management. Clients may be taught to use statements e.g. ‘relax,
you’re in control’. The skills are both cognitive (thinking in a different way) and behavioural
(behaving in a more adaptive way). The skills are designed to meet the specific needs of the
individual.
3. Application and follow through – clients are given opportunities to apply the newly
learned coping skills in different situations which become increasingly stressful. This could
include visualising a situation, behavioural rehearsal or role playing. The client and therapist
monitor the success or failure of the therapy. The client is encouraged to learn from experience,
by reflecting on the success or failure of their new skills. If necessary, there will be opportunities
for further training and rehearsal.
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AQA PSYCHOLOGY: PHYSIOLOGICAL PSYCHOLOGY
Unit of learning 3
Stress in everyday life
STRESS MANAGEMENT
STRENGTHS OF Stress Inoculation Therapy
SIT can provide the individual with a toolkit for dealing with future stressful situations as well as
offering help with the current problems. It, therefore, provides a long-term solution which other
treatments, e.g. medication, may not.
SIT has been found to be effective. Sheehy and Horan (2004) examined the effects of SIT on
anxiety, stress and academic performance of first-year law students. Participants received four
weekly sessions of SIT each lasting 90 minutes. All participants displayed lower levels of
anxiety and stress over time. Many of them did better academically than expected.
SIT is a very flexible treatment which can range from simple problem-solving taking just 20 – 40
minutes of therapists’ time to a year of weekly or bi-weekly sessions. Either way, the end result
still relies on the person themselves to put the techniques into action within their daily lives and
enforce the change required. This could be a strength or weakness depending on the type of
client. If you use this in your evaluation you need to explain it fully.
WEAKNESSES OF SIT
Where the needs of the client are such that SIT requires a lot of time, it will only be appropriate
if the individual is very determined and highly motivated. Some individuals will not be able to
make the required effort to ensure its success.
SIT is quite a complex process with many aspects to it. However, it may be that the
effectiveness of SIT is due to particular elements of the training e.g. the relaxation or other
coping skills. If this is the case, it could be made much simpler without losing its effectiveness.
Compared with medication, SIT may take longer to make any difference to the client.
Remember to explain each evaluative point you make thoroughly. If asked for one
strength or one weakness, make sure that you stay focused on just one and elaborate it.
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AQA PSYCHOLOGY: PHYSIOLOGICAL PSYCHOLOGY
Unit of learning 3
Stress in everyday life
STRESS MANAGEMENT
PHYSIOLOGICAL METHODS OF STRESS-MANAGEMENT
DRUGS
Benzodiazepines (BZs)
BZ drugs act directly in the brain. They imitate the action of the neurotransmitter GABA (gammaaminobutyric acid) in the synapses.
This is a naturally occurring chemical which helps us to relax by opening channels on the receptor sites
for negatively charged chloride ions to enter the post synaptic neurons.
BZs also reduce any increased serotonin activity (which is a neurotransmitter that has an arousing
effect). This has the effect of reducing anxiety.
Beta-blockers (BBs)
Stress leads to the arousal of the sympathetic nervous system and this raises the blood pressure,
increases heart rate and levels of cortisol. These can lead to cardiovascular disorders and reduce the
effectiveness of the immune system.
BBs reduce the activity of adrenaline and noradrenaline which are part of the sympathomedullary
response to stress. BBs bind to receptors on the cells of the heart and other parts of the body which are
stimulated during arousal. The result is that the heart beats slower and with less force and blood vessels
do not contract so easily. This leads to a fall in blood pressure. The person feels calmer and less
anxious.
STRENGTHS OF DRUG TREATMENTS
Drugs can be effective.
Kahn et al. (1986) followed nearly 250 patients over 8 weeks and found that BZs were superior to
placebos.
BBs are effective in reducing anxiety in a variety of stressful situations e.g. among musicians and in
sports where accuracy is more important than physical stamina (e.g. snooker and golf).
One of the great benefits of using drugs for stress is that they require little effort compared with CBT and
work relatively quickly.
WEAKNESSES OF DRUG TREATMENTS
Recently, it has been recognised that BZs are addictive even in low doses. Withdrawal effects are
noticed when patients stop taking them. It is therefore recommended (Ashton, 1997) that they are taken
for a maximum of 4 weeks. Neither BZs nor BBs should be stopped suddenly once they are being
taken. Medical supervision is needed when coming off them.
BZs also have side effects such as increased aggressiveness and cognitive side effects such as
memory impairment.
BBs may also have side effects such as nausea and stomach cramps.
Drugs may be effective at treating the symptoms, but they do not tackle the cause of anxiety. This may
mean that symptoms may return when the drugs are stopped.
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