Stress Management Copy

Stress can exacerbate psychosis and may also lead to relapse. The family also experiences high levels of stress and will benefit greatly from learning how to manage their stress. In order to effectively manage stress, a variety of strategies are needed.

Model for Stress Management

View a schematic of the stress management model here

Other factors such as social support, personal resources, and general stress tolerance will affect how a person perceives and copes with stress.

Stress management involves first ensuring that an individual is able to recognize the events and situation that are currently (or are likely to be) stressful as well as to signs and symptoms that indicate the experience of stress.

Stress management techniques can target:

1. The stressors
   1. Reduction of responsibilities (such as work, school, etc.):
      • when the number or degree of stressors exceeds the ability to cope.
      • must be done with forethought to avoid increasing stress (e.g., fired or assigned failing grades in courses).
   2. Reducing daily hassles through:
      • time management
      • organizational skills
      • memory aids
   3. Problem solving – structured problem solving involves six steps:
      1. Identify the problem clearly (and break it down into smaller components if necessary).
      2. Brainstorm (list all possible solutions).
      3. Evaluate possible solutions (list advantages and disadvantages of each).
      4. Select one solution (the one that is more favourable when advantages and disadvantages were compared and the one that the individual has the resources to carry out – time, money, skills, etc.).
      5. Develop a plan to carry out the solution (break the plan into small concrete steps, set timelines for completion of steps, think ahead about likely difficulties and how they can be dealt with).
      6. Carry out the plan and review progress (evaluate the progress at each step, revise the plan as necessary, continue until the problem is solved).
2. The person’s appraisal
   1. Appraisals are often done automatically and may be magnified or even irrational.
   2. Teach individuals to identify and challenge negative thinking patterns.
3. The method of coping
   1. Assess clients’ current and past coping styles.
   2. Discussions with the client about the successes and limitations of their coping efforts in particular situations can prompt the initiation of a variety of strategies.
   3. Teach multiple strategies for coping including relaxation, exercise, breathing techniques, simple distraction, examining and rectifying situations in daily life, learning how to appraise internal states, and accessing available resources.
4. Physiological and behavioural effects.
   1. Reduction of physiological arousal is a fundamental approach and includes relaxation, distraction, recreation, massage, hot baths, exercise etc. Behavioural responses to stress include avoidance as well as maladaptive actions and individuals may need guidance in recognizing and changing these maladaptive behaviours.

Individualized stress management should be provided to both the client and family.

Families will benefit from having an explanation of the stressors they are likely to encounter by caring for their family member with psychosis, normalizing their emotional reactions, and having healthy ways of coping.

The following video is 10:06 minutes long. (Our apologies, we have had technical difficulties with the video – for now, you may review the transcript). You will likely find it helpful to take notes during the video. Click HERE for a transcription of the interview.

Additional Reading (all located in the carepath)

On the care pathway page, please review the handouts and worksheets on:

• stress management
• problem solving
• family coping

Activity One: Stress Management Strategies

Think about the strategies you most often use for stress management with your clients. Which strategies work best in which situations? Are there are any new stress management strategies that you would like to try with any of your clients/families?