Psychological and physiological methods of stress management

1. Cognitive Behavioural Therapy
- Alters irrational thoughts and cognitive biases that are assumed to be the cause of the problem.

Meichenbaums stress inoculation training (SIT)

1. Conceptualisation: Identify sources of stress in live. Recall stressful encounters. Keep diary recording stressful experiences. 
2. Skills training rehearsal: Acquires specific skills to address situations.
   - People with social anxiety have poor non verbal communications e.g. eye contact. They will be shown how to improve this.
   - Relaxation to keep bodily arousal under control.
3. Application in the real world: .. Therapist will monitor progress/behaviour.

+/-:
First stages involve identifying sources of stress assessing how well you dealt with them. It is a CBT approach focusing on these elements;

• Stress exists when there is a gap between perceived demands and resources to cope.
  -The cognitive element of SIT is aimed at producing a realistic appraisal of demands while training relevant skills aimed at increasing resources to cope with demands 'problem faced coping'.
• Training in relaxation techniques gives clients control over any stressful situation. Can be emotion focused and reduces emotionally arousing effects of stress.

-Time, commitment, money ETC

Kobasa's Hardiness training (control commitment, challenge)

1. Focusing: Client focuses on physiological symptoms associated with stressful situations to help identify source of stress. +helps require new skills strategies for coping. 
2. Reconstructing stressful situations: Cognitive strategy, encourages clients towards realistic appraisal of life stress and how coped with.
3. Self improvement: Improve clients sense of self efficiency. Take on manageable sources of stress

+/-: targets appraisal sources of stress and through training the resources available for dealing with them.
- reduces gap between demand and coping resources.
- Client self efficient so can deal with future.
- time, commitment, money.

2. Physiological of methods of stress management

Drugs

• Benzodiazepines (librium, valium):
  - Anti anxiety drugs
  -Act in brain, increases action of neurotransmitter GABA (Which Reduces activity of other neurotransmitters in brain) this decreases adrenaline and seratonin to relax you.
  +/-: Bad side effects e.g. tiredness, impaired motor coordination.
  Can lead to physical dependence.
  Withdrawal symptoms e.g. raised heart rate, sleeping problems.
  Doesn't target source.
  Consent.
• Beta blockers:
  - Act on cardiovascular system of body rather than brain. (Heart)
  - Reduces activation of autonomic nervous system to reduce heart rate.
  +/-: No side effects
  Targets physiological stress response and lowers stress related arousal.
  Doesn't target source of stress ... targets physical symptoms.
  Not good for long term.

Alternative methods of stress management

Biofeedback

- Combines physiological and psychological techniques.
- One wired to machine to provide feedback e.g. heart rate.
- Then helped to develop techniques to reduce symptoms e.g. meditation.
+/-: Effective to control heart rate.

Masters (1987) 
-involves relaxation which is already a technique so may have no implication.

Progressive muscle relaxation meditation

- Muscle relaxation common component for CBT,.
Jacobson (1938)

- Muscles tense and relaxed in systematic fashion.
- When more familiar, the person can go into a state of relaxation state without going through the whole process.
+/-: Gives control
Meditation has similarities with muscle relaxation. Immediate effect of reducing bodily arousal.
Meditation works against bodily arousal associated with stress.

Physical exercise

- Chronic stress = energy reserves (glucose) and fatty acids build up in bloodstream contributing to atherosclerosis.
+/-: Not clear it reduces physiological reactivity to stressors.
- P.E reduces resting levels of heart rate and blood pressure so while stress increases they start from a lower level and shouldn't be harmful.

Throne (2000)- FIREFIGHTERS

- Found regular exercise reduces levels of stress in fire fighters.
- helps lift mood indirectly copes with stress.
- Increases self efficiency.
- Enkephalins are released during exercise and act on brain to improve mood.

Social support

• Emotional support: Social network provide reassurance. 
• Practical or instrumental support: e.g. lending money.
• Informational support: Support group, share experience and give advice. 
• General network support: Self belonging and social identity improves self esteem.

Uchino, Cacioppio and Kiecolt-Glaser (1992)

-Reviewed studies on social support on body's physiological processes.
Result: Across 28 studies. degrees of social support showed consistent relationships with reduced blood pressure.
Across 19, there was a significant association between level of social support and immune function.