Meichenbaum

Cognitive:Stress inoculation therapy

Managing stress

Managing Stress

• How many ways do you know about already?

MANAGING STRESS

Managing Stress

• The Theories/Studies

• Cognitive: SIT (Meichenbaum 1975)

• Behavioural: Biofeedback. (Budzynski 1973)

• Social: social support (Waxler-Morrison 2006)

Cognitive behavioural technique

• What does this mean?

Approaches

• The social, behavioural and cognitive approaches all view the physiological symptoms of stress as caused by different aspects:

• Cognitive – Faulty thoughts

• Behavioural – Associations or consequences

• Social – People around you

Background:

• Meichenbaum’s assumption is that stress is caused by the faulty processing of information.

• Therefore, stress inoculation therapy assumes that some people find situations stressful because they think about them in catastrophising ways and so the aim of the therapy is to train people to cope more effectively with stressful situations.

• SIT• Psychotherapy method• Help patients prepare themselves in advance• Handle stressful situations with minimum upset

• Inoculation in SIT comes from the idea that the therapist is inoculating patients to become resistant to the effects of the stressor.

Background:

To analyse the effectiveness of their coping strategies

Teaches new coping strategies

Explain how SIT could be used in this situation

• 1. Conceptualisation

• 2. Skill acquisition

• 3. Application and follow through

Strengths • Possibility of long lasting

effects

• Effective if the stressor is specific e.g. Exams

• Can be generalised to new situations

• Improves – perceived control and locus of control

• Non invasive

Limitations

• Time consuming

• Financial cost- therapists are expensive

• High level of commitment needed

• Not effective with high levels of stress or generalised stress

Aim:

• To compare standard behaviour methods with cognitive ones which aimed to enable people to identify their stressors and change their mental processes when under stress.

Methodology:

• Field experiment

• Participants put into three groups; SIT, standard desensitisation, control.

• Tested using anxiety questionnaires and grade averages before and after treatment.

• Blind study- people assessing did not know which condition they had been in.

• Matched pairs design with gender controls and a random allocation to a group.

Procedure:

• 21 students aged 17-25 responded to an advert about treatment of test anxiety.

• The SIT group received 8 therapy sessions giving them insight into their thoughts before tests.

• They were then given some positive statements to say and relaxation techniques to use in test situations.

• The systematic desensitisation group was also given 8 therapy sessions with only progressive relaxation training whilst imagining stressful situations.

• The control group were told that they were on a waiting list for treatment.

Results:

• Performance in tests from the SIT group improved the most in comparison to the other two groups.

• Both therapy groups improved more in comparison to the control group.

• Participants in the SIT groups showed more reported improvement in their anxiety levels, although both therapy groups showed an improvement over the control group.

Conclusions:

• SIT is an effective way of reducing anxiety in students who are prone to anxiety in test situations and more effective than simply behavioural techniques when a cognitive component is added.

Issues:

• Generalisability• Only used students- can only generalise to this age bracket• Volunteers- all one type of personality

• Ecological validity• Was a field experiment- high ecological validity

• Usefulness• Can help with managing stress

• Ethics• Gained consent• Deception of control group- not really on the waiting list

• Replicability• Standardised procedure• Higher reliability

• Validity• A blind study- less bias• High internal validity

Debates:

• Determinism vs Free will• Free will to change your behaviours

• Reductionism vs Holism• Thought processes cause stress

• Cognitive approach bias

Describe one cognitive technique for managing stress. (10)

BudzynskiBehavioural:Biofeedback

Biofeedback- Behavioural

• Consequences of behaviour can lead to it being repeated or not (reinforcement)

• If pleasurable/rewarding we are more likely to repeat it

Background:

• Biofeedback is a means for gaining control of our body processes to increase relaxation, relieve pain and develop healthier and more comfy life patterns.

• Biofeedback gives us information about ourselves by the means of external instruments, for example thermometers.

• Biofeedback familiarises ourselves with the body processes and so can help us to learn to control them to relieve stress.

Electromyography

Electromyography (EMG) is a diagnostic procedure to assess the health of muscles and the nerve cells that control them (motor neurons). Motor neurons transmit electrical signals that cause muscles to contract. An EMG translates these signals into graphs, sounds or numerical values that a specialist interprets.

An electromyogram (EMG) measures the electrical activity of muscles at rest and during contraction.

Aim:

• To see if biofeedback was effective in reducing tension headaches or whether it is due to the placebo effect.

Methodology:

• Experimental method with participants trained in a lab.

• Data was collected using muscle tension measurements with an electromyography.

• Psychometric tests for depression.• Questionnaires on headaches.• Independent measures with participants

randomly assigned to 3 groups.

Procedure:

• 18 participants replied to a newspaper advert, 2 males and 16 females.

• Screened by telephone and then had psychological and medical examinations to ensure there were no other reasons for their headaches.

• Group A: Real biofeedback training with relaxation

• Group B: Biofeedback training but false feedback• Group C: Used as a control group• All groups kept a diary of their headaches for 2

weeks.

Results:

• After 3 months, group A’s muscle tension was significantly lower than the other two groups.

• Reported headaches in group A fell significantly compared to their baseline measurements, this did not happen in the other two groups.

Conclusions:

• Biofeedback is an effective way to reduce stress levels by reducing tension.

• It is therefore an effective way of reducing stress.

• Relaxation techniques are more effective than just being monitored but better with biofeedback as well.

Issues:

• Low ecological validity• In a lab• Biofeedback requires wiring up to machines

• Ethics• Had given informed consent

• Objectivity• Quantitative data through EMG and MMPI• Biological methods

• Usefulness• Shows an effective way of reducing stress

• Validity• High internal validity- used machines to measure muscle tension

• Generalisability• Biological measures tested- should be universal• Gender bias

• Reliability• Standardised• Machine based- can be repeated

Debates:

• Psychology as science• Used scientific equipment• Objective

• Reductionism vs holism• Reduced the causes of stress to muscle

tension

Waxler-Morrison

Social:Relationships and cancer survival

Background:

• A strong, social support network can be critical in helping individuals through stressful situations.

• It has been shown that cancer growth is amplified by stress and therefore by reducing this stress, there are positive outcomes on the cancer.

Aim:

• To look at how women’s social relationships influence her response to breast cancer and survival.

Methodology:

• A quasi experiment where women were already diagnosed with breast cancer.

• Used questionnaires and 18 interviews plus an examination of medical records.

• The women naturally fell into categories based on social support networks.

Procedure:

• 133 women all under 55 years old who were referred to a clinic in Vancouver after being diagnosed with breast cancer.

• Mailed questionnaires to gather information about their demography and existing social networks.

• Questions included education level, who they were responsible for- children- contact with friends and family and perceived support from others.

• Details of their diagnosis were taken from their medical records as were their survival and recurrence rates.

Results:

• 6 aspects of social networks were significantly linked with survival;

• Marital status• Support from friends• Contact with friends• Total support• Social networks• Employment

• Qualitative data showed that practical support, such as childcare, were the concrete sources of support.

Conclusions:

• Several characteristics of women's social networks are significantly linked with survival rates.

• So, the more social support networks, the higher the rate of survival in breast cancer patients.

Issues:

• Ecological validity• Quasi experiment so was naturally

occurring- no manipulation

• Demand characteristics• Questionnaires can lead to social

desirability- not wanting to seem unsupported

• Subjective• Questionnaires and not physical

measurements

Debates:

• Individual vs Situational• Your social support networks influence

survival

• Reductionism vs Holism• Usefulness

• How to reduce stress and therefore increase survival rates in women diagnosed with breast cancer.

Outline the social approach to managing stress. (10)