Focussing on the exam

I'm sure you're all focussing now on the exam & end of semester clinical assessment. There is still one task to complete.

Multi-disciplinary stress management

As of 10pm on Sunday, no-one has worked on the case study which Judy prepared for you to help you to understand multi-disciplinary stress management. Can you please jump in there now, and answer the questions which she has posed.

Regarding the exam

You could be assessed on anything that we've covered so far. Remember that the exam will be composed of some questions on theories and some case studies that you will be expected to apply your learning to. You should be ensuring that you understand all of the theory that we've covered, and you should be practicing applying this theory to the case studies which will be provided to you through the Intermediate massage blog.

Multi-disciplinary stress management

This week your focus in stress management will be learning about how to work in conjunction with psychological health professionals to help your clients achieve their stress management goals.

Tasks this week

The week will start with an elluminate session on Monday at 11am. In this session Judy will introduce the ideas that you will be working with over the following week.

You will then be directed to apply these ideas to some work over the week.

Multi-disciplinary stress management

Hopefully you now have some level of understanding of how emotions can become stored in the body, how they can be released through massage, and how to deal with this when it happens. Unfortunately my attempt to video the mid-block tutorial wasn't successful (I think I need a tutorial on video camera use or something). In the mid-block tutorial we talked about these things, and clarified them. I've had a request to cover this again, and I'd be happy to run an elluminate or face-to-face tutorial at some stage over the next couple of weeks on this topic if it's required by more people.

Over the next two weeks the topic is multi-disciplinary stress management.

Judy Buckingham is going to talk with you about how counsellors and psychotherapists work with stress so that you can get a better idea about when it's a good idea to refer to a psychological health professional. Details to follow.

Week 14 - Emotional release pt. 2

Last week we had a look at how emotions may become lodged in the body, this week we'll consider what you should do if your client has an emotional release while you're working with them.

It's good to see there's been some work done on Feelings and their physical expression. Please continue to work on this. I have not been able to find any quality information on this, so what we're doing here is creating a resource which all of us can use in the future. It's good to realise that there is not a correct answer here. Different people are likely to experience emotions somewhat differently.

Hopefully you've completed the exercise in Box 6.2 from the second reading for last week, and you now have some level of self-awareness around how you are likely to cope with clients who present with different types of emotions. If you haven't please make this a priority for the week ahead.

Tasks for the week

Complete reading Emotional release from The psychology of the body, Greene & Goodrich-Dunn. I emailed you the files for this last week.

Mid-block tutorial - In the mid-block tutorial this week we'll talk about dealing with emotional release.

More reading - Sometime early this week I'll email you some reading material relating to the psycho-social management of stress. This is to give you an idea of some of the methods which counsellors and psychotherapists use, and will inform next week's work.

Week 13 - Emotional release pt. 1

Over the next two weeks in Stress management we'll be exploring emotional release. You'll find out how emotions become stored in the body, how these emotions can be released by massage and bodywork, and how to deal with an emotional release.

Tasks for this week

Please continue the email discussion around relaxation methods

I notice that no-one has yet contributed to the Google document- Feelings and their physical expression. Please take the time to notice how your body responds to emotions through this week and next week, and record your findings in this document.

You have two readings from the week. These will be emailed to you.

1. Emotional responses & Tissue memory from Outcome-based massage (2nd ed), Andrade & Clifford
   
2. Emotional release (p 1-7) from The psychology of the body, Greene & Goodrich-Dunn

After reading through these documents, please take some time to complete the exercise in the second reading which is in Box 6.2 - Exploring how you respond to client's emotions and behaviours. The purpose of this exercise is to prepare you for a client's emotional release.

Week 12 - Bodymind

This week in Stress management we'll be considering the body-mind concept.


Assessment
Remember that your clinical assessments are coming up this term. When scheduling assessment times, I've decided that letting you choose your own time is not going to work, so I've scheduled you all a time to sit this assessment. Please make sure that you have a look at the clinic schedule to see when you are on.

Also, your case study is coming up. Make sure that you're applying the stress management process in your work with clients so that you'll have enough clinical experiences to write about.


Tasks for the week

Continuing from our exploration of meditation, please

• Read this article on the place of meditation & sprituality in medicine.
• Watch this video - Jill Bolte, neuroscientist - My stroke of insight.
• Join in the discussion on the use of meditation and other relaxation techniques in massage practice

Read these articles on body-mind

• Mapping body into motion - Keith Grant
• Bodymaps part 1 & part 2

Real-world observation

• Over the next three weeks note how your body responds to different emotions, and record this here.
  

Week 8 - Hanna's reflexes & stretching

In this, the final week before the end of term, we're going to have another look at Hanna's neuromuscular reflexes, and consider the use of stretching and meditation in a stress management programme.

Tasks for the week

• Continue to use a stress log to record any stressful experiences and your reaction to them.
  
• I will send you an article on Monday which describes in some detail the three primary neuromuscular reflexes which have been described by Thomas Hanna. My email will relate his ideas to stress theory
• Read the resource on the use of stretching as a stress management modality.
• Design a stretching programme for one of your clients based on your assessment of them either this week or a past client.
• Have a look around on the web. Can you find any good high quality sources of video resources for stretching? Let the class know about them through the email group.
• If you haven't already done so, have a look at the meditation resource.

Stress management modalities

You should by now be a competent practitioner of breath retraining, and progressive muscle relaxation. If you haven't yet had a practice run of instructing someone else in these techniques, then get onto it as soon as possible.

It's recommended that you download and run through the meditation recording several times at least this week.

Lifestyle modification

This week we're going to have a look at Lifestyle modification in some depth.

Review of Case Study 1
Thanks to those who contributed to the case study exercise. A good level of understanding was shown by the parties involved. Have a look at my feedback on your work at the bottom of the document.

Tasks for the week

• Read through the page outlining Lifestyle modification
• Over the next week, keep a stress log (described on the Lifestyle modification page) to identify stressors in your life and your reaction to them.
  
• The assessment aspect of the stress management process has been updated to include assessment of the breathing pattern and rhythm. Make sure you review this process, taking note of the expansion.

Stress management exercises
You should be continuing to practice progressive muscle relaxation. If you've practiced it about 10 times by now, then you'll be ready to move on to instruction of clients.

The next stress management exercise which I want to introduce is meditation. I haven't quite recorded the meditation yet, but hope to get onto this sometime this week.

Assessment

• Case Study: You could start working with your clients anytime from now on really.

Developing a healthcare programme

We're now into looking at the treatment phase of developing a healthcare programme.

Have a look at the treatment phase of the stress management process. Later in the week we will apply it to a case study.

Also have a look at this partially completed resource - Stress management modalities. This will become a useful resource, so tag it for future reference.

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.
   

Introduction to Stress Management

Welcome to the first day of Stress Management.

The previous post contains all the information that you might need to know regarding learning outcomes, etc.

Here’s an indicative timeline for the course. Please note that this timeline may be subject to change.

You will notice that this course is composed of three strands

• Stress theory
• Stress management
• Stress management applications

In the Stress theory strand you will learn about stress, what causes it, what effects it has on the physiology of the body, and other related matters.

In the Stress management strand you will learn about techniques for assessing stress, and designing healthcare programmes for the effective management of client stress.

In the Stress management applications strand you will learn and practice relaxation techniques that may be applied in the management of stress.

Your assessment will be composed of three assessment tasks. This assessment is in the process of being moderated and will be released to you once this process has been completed.

1. Case Study – this will be the most significant piece of work, and will detail your work with two clients
2. Clinical assessment – Observation of your communication of stress management exercises with your clients. Students who have no clinical time this semester may submit video evidence to complete the requirements for this assessment.
3. Theoretical exam (at the end of the semester).

This week’s tasks

This week your tasks are to

1. Think of three times when you were under a lot of stress in your life. Try to choose times that are at least a year apart, and in which the factors leading to the stress were different. Record what happened and what about the situation caused you to become stressed in a file which is stored on your computer. You will be directed to refer to these events a number of times through the course, so make sure that you put the file somewhere that you can find it, and name it something that will be a good trigger for your memory. When you are directed to refer to these events they will be called “Your stress journal”.
   
   
2. Read through Introduction to Stress Theory.
   
   
3. Consider how the ideas of General Adaptation Syndrome and the Human Performance Curve relate to each of the events that you have recorded in your stress journal, and record your reflections in this journal.
   
   
4. Read through Individual factors in the Stress response
   
   
5. How would you rate yourself against each of these factors? Record your individual profile in a file on your computer. How does this individual profile relate to the events in your stress journal? Record your reflections in this journal.
   
   
6. Causes of Stress: Elluminate session – Friday 12:30 – 1:30pm
   This link will take you to a recording of the session.
   There is a section in the middle of the recording in which nothing much happens in elluminate, so you might want to skip over this section of the recording.
   

Remember that the course email group serves as a channel for classroom discussion, so if you have any queries about any of the material please text/speak up. J

Stress Management starting 22/7/08

This is the blog for the Otago Polytechnic Stress Management course.

Aims

This course aims to equip students with the applied understanding of stress and stress management methods that they need in order to create stress management programmes which support client wellness.

Pre-requisites

• OPTM1 Study Skills

Co-requisites

• OPTM13 Bioscience 2

Learning Outcomes

At the successful completion of this course, students will be able to:

1. Demonstrate an understanding of stress theory
2. Demonstrate an understanding of the multi-disciplinary nature of stress management
3. Assess the causes of a client’s stress, and their current level of stress
4. Guide clients in the use of relaxation techniques including diaphragmatic breathing and progressive muscle relaxation.
5. Create a stress management programme for their client that takes into account their client’s lifestyle, symptoms, and any contraindications to stress management exercises.

Content

• Stress theory
• Approaches to stress management
• Stress assessment techniques
• Stress management exercises including diaphragmatic breathing and progressive muscle relaxation
• Stress management programme creation and supervision