Managing Stress

Managing Stress

1. COGNITIVE

   • Ellis (1977)
     • Rational Emotive Therapy
       • Irrational thinking
         • Awfulising
           • Can't-stand-itus
             • Musterbating
       • Cognitive Restructuring
         • A - Activating Experience (cause of upset) B - Beliefs and thoughts (response to the upset) C - Consequences (results of irrational thought)  D - Disputing (irrational thought logically examined) E - Effect (restructuring beliefs to be rational)  
       • Meta analysis
         • by Engels
           • effective therapies score 0.8+
             • RET scored 1.62
   • lack of information
     • misperceptions
       • irrational beliefs
   • demand is a threat to wellbeing
     • don't have the resources to meet demand
       • STRESS <-

2. BEHAVIOURAL

   • McGrath (1990)
     • Systematic Desensitisation
       • Facing the fear
         • 1) construct a hierarchy of feared situations 2) train the patient in relaxation techniques; deep breathing, muscle relaxation, and visualisation 3) introduce patient to each situation, from least feared to most feared.
       • Lucy
         • 9 year old girl, under average IQ, fear of sudden loud noises. Not depressed or anxious. 10 therapy sessions Parental consent&nbsp;
         • 1) Hierarchy
           • balloons
           • party poppers
           • cap guns
         • 2) Training
           • visualisation
             • at home on bed with toys
           • deep breathing
         • 3) Confrontation
           • Had a 'fear thermometer' Could measure fear from 1 to 10&nbsp;
           • introduced to balloons
             • First session: didn't want balloon burst at end of corridor Fifth session: Lucy could pop a balloon herself&nbsp;
             • 7/10 to 3/10
           • introduced to party poppers
             • Beginning: didn't allow them in consulting room End: Lucy could use a popper if therapist held it.&nbsp;
             • 9/10 to 3/10
           • introduced to cap guns
             • Agreed to have one fired in consulting room
             • 8/10 to 5/10
   • Classical conditioning
     • Fear (stress) learnt by associating a situation with an unpleasant event
       • desensitisation: pairing feared situation with something neutral or pleasant

3. SOCIAL

   • Waxler-Morrison (1993)
     • how social relationships affect a woman's reaction to breast cancer and her survival
       • 133 women with breast cancer
         • All under 55 (pre-menopausal) Vancouver, Canada Confirmed cancer&nbsp;
         • -> QUASI <-
     • Questionnaires, interviews, medical records
       • Checked medical files for cancer diagnosis JUNE 1980 Checked survival and recurrence JANUARY 1985&nbsp;
       • responsibilites
       • support network
       • marital status
       • home life
     • MORE support = BETTER survival
       • factors affecting survival; marital status, support and contact from friends,&nbsp; total support, social network, employment&nbsp;
       • survival also dependent on cancer stage
   • Stroebe (2000)
     • Emotional support (empathy, care, love)
     • Instrumental support (direct help, taking responsibilty)
     • Informational support (routes to helpful knowledge)
     • Appraisal support (self-evaluation)

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