WEek 6 - Assessment

This week in Stress management, we're going to complete the study of assessment methods for Stress management. Next week we will consider the application of assessment findings in the development of a healthcare programme for stress management.

Tasks for the week

Complete the learning modules

• Neuromuscular effects of stress
• Approaches to stress assessment
• The stress management process - The process that we considered earlier is extended to incorporate what we have covered so far in the course. You will notice that the treatment phase is blank - we'll extend this next week.
  

Assessment

We are a little behind the schedule laid out at the start of the course. According to this schedule you should have started work with the first client for your case study. Realistically you can't really do this until we've covered the material for next week. No need to worry, there's still plenty of time for you to complete the assessment, but you should start canvassing the people you think would be suitable candidates so that you're ready to start the assessment next week or the week after next.

The stress management process module (above) contains a link to the stress monitor that we finalised in the mid-block tutorial. You are free to use this stress monitor if you like, or to use one which suits your preferences more.

Week 5 - Assessment

This week we're supposed to be getting into looking at Assessment for stress in some more detail, however there has not been enough time put into development of the Stress monitor instrument.

This is a fundamental element of the course, and it needs your attention.

Please read through the emails which are titled
Stress management - building the stress monitor
and continue the discussion.

We will also dedicate some time to this issue during the mid-block tutorial this Thursday.

If we make enough progress towards development of the stress monitor, we will move onto looking at Assessment in more detail, and/or the effects of stress on muscular tension.

Week 4 - Breathing | Massage

This week in Stress management, we'll have a look at breathing, and how this relates to the stress response. We'll also have a look at how massage may be modified to suit different stages of the stress response.

Weekly tasks

• Read through the breathing physiology learning unit.
  
  
• Read through the massage for stress management learning unit.
  
  
• Try another relaxation technique progressive muscle relaxation. This is another one which is required for your assessment. Remember that before you can use a technique with clients you need to experience it yourself. With PMR you should probably use it most days for about 2 weeks before you are familiar enough with the process to use it with clients.
  WARNING: If you have muscle pain, then make sure that you don't tense the muscle up enough to increase the pain. Also if you suffer from hypertension or any other cardiovascular illness please contact David (021 2800 253) before trying out this technique.
  

Assessment for Stress

Identify client goals

Is stress management what your client wants/needs?

(assuming that it is)

Establish a baseline measure of stress level (e.g. stress monitor)

Identify stressors

• Identified areas on the stress monitor may give some clues
  
  
• Start with a general question – e.g. “so what’s causing your stress?”, and follow their answers. This open-questioning approach allows your client to talk about the stressors which they are comfortable sharing with you at this time.
  
  
• Observe their body language – are they comfortable with your line of questioning?
  Respect their emotional boundaries.
  
  
• More information may come out during the massage, or in future sessions as your client becomes more comfortable with you.
  
  
• Always bear in mind your professional boundaries. Stress is strongly related to emotions and psychology. Often when we've had some kind of personal experience, we feel that we are able to give advice to our friends on matters similar to our experiential learning. This is not appropriate in a clinical space you are in a position of authority, and the client is paying for a professional service. We are not qualified to provide advice on emotional/ psychological matters, and should therefore be careful to avoid doing so & refer to others when this is required.

Record keeping

Because the information which is discussed in a stress assessment process may be very personal in nature, you need to be careful when recording the details in your records. Bear in mind that your client, and other people they authorise (most likely another healthcare practitioner), may read your records at some point in the future. Try to avoid names, and any details which are likely to identify the parties involved.

Week 3 - Stress physiology

This week in stress management we'll be focussing on stress physiology.

Last week we discussed and developed a subjective assessment protocol for stress

Tasks for the week

1. Read about stress physiology and make diagrams to illustrate at least three of the following
   
   • The layers and functions of the triune brain
   • The physiological initiation of the fight or flight response
   • Short-term effects of stress
   • Chronic effects of stress
   
   
2. We will discuss how these elements of stress physiology may be used within the stress monitor instrument.
   
   
3. Breath retraining - try teaching breath retaining to 2-3 people this week preferably friends and family. Next week you can start to use it with clients in a stress management context.
   
   
4. Later in the week we will discuss how massage application can be modified depending on the stage of the stress response.
   

Week 2 - The stress management process

In week 2 of stress management (week 32 on the Otago Polytech calender) we'll be looking at the stress management process, and you will be introduced to your first relaxation technique - breath retraining.

Tasks for the week

1. Continue on working on Causes of stress. It's looking at present as if there have been contributions from perhaps a quarter to a third of the class. We'll be using content from this document as the basis of our discussions later in this week, so if you haven't contributed yet, please do so. Try being a bit creative with the words that you search for, or using different search engines, otherwise you'll probably come across the same information that previous people have. If everyone spends an hour or so looking into this, we should end up with a fairly comprehensive document. Some work needs to be done on consolidating some of the information that's there (particularly in the Work-related section). Remember to reference your contributions & try to avoid low-quality sources of information.
   
   
2. Read through Introduction to the stress management process. This really is an introduction. We will come back to much of the material in greater depth later in the course.
   
   
3. Stress management application 1: Breath retraining
   The stress response is associated with upper chest breathing. One way to short-circuit the stress response is to breathe from the diaphragm. The handy thing about breath retraining is that due to it's simplicity you can use it at any stage you become aware that you are experiencing stress.
   
   In accordance with relaxation training theory, you must first gain experience with using this technique yourself before you are able to apply it with clients. Click on the above link & select download, then save it to your computer. Make sure you know where you have saved it so that you can use it in the future. Put aside 5-10 minutes each day over the next week to sit down & practice this technique. Also try to notice if you are becoming stressed at any stage, and try to breathe from your diaphragm if you are.
   
   
4. On Wednesday, I'll begin an email-based discussion around subjective assessment for stress and stress-related condtions. This discussion will continue until the end of the week. Make sure you're regularly checking your emails & participating.