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.