An activity based training module for developing coping skills- My research

             I have recently submitted my research report in the area of Health Psychology, particularly enhancing stress coping skills among college students. I have developed an activity-based module to enhance students stress coping skills.

          In order to prevent stress related problems it is necessary to improve the competencies of students, making them more able to cope with whatever difficulties life might bring. Some of the competencies that seem to relate to stress coping skills are 1) anticipate or detect potential stressors and identifying functional, dysfunctional coping; 2) taking responsibility for one’s behaviour and its outcome; 3) building satisfying relationship with others; 4) develop effective cognitive problem solving and decision making skills. According to proactive coping theory the individual is seen as striving for improvement, is capable of making things happen. Resource management is an important facet of proactive coping in that students can acknowledge and utilize information, advice, practical assistance and emotional support from others. Those students who are unskilled in these areas might experience and avoid stress. Training of these skills makes the students more competent and coping efficiency is maximized.

          The first phase of training helps the students reconceptualize the nature of their stress and coping. This phase focuses on the reappraisal of the events using cognitive strategies to endure unavoidable everyday stressors. Students can be thought to take a non-catastrophizing, and viewing as a challenge rather than threat perspective when faced with stress. Thus, the replacement of unproductive thoughts and actions with coping strategies are important sets of skills. In the next phase, the students learn to use specific modified ways of coping skills. Contemplation about a variety of possible alternatives by comparing their possible outcome and its effectiveness, which include brainstorming, analyzing problems and resources, and generating hypothetical plan of action carried out in this phase. Role playing techniques used to promote smooth execution of the newly learned coping skills. The final phase involves the application of coping skills in a systematic way to every day stressful events. The generalization and maintenance of coping skills are encouraged by helping the students in each session. Throughout training, students are involved as a collaborator in developing, implementing and evaluating the variety of coping skills.

          Figure -1 depicts some of the major components in the stress coping programme. This model somewhat simplified and provide a framework for understanding the components of enhancing proactive coping skills and self-efficacy.

Figure -1 Schematic diagram of the programme

         

The 3'A' model 

Aware

Assume responsibility and

Act

          This training was conducted throughout the weekdays over a month. During each session, students were given relevant handout and worksheet to practice.  Handout provides a tangible resource for them to consult between session and especially after training is completed. Worksheet helps the students gain insight into their own levels of stress and coping. This programme is based on primary prevention principle as they are aimed towards masses of students.

General Overview of the Sessions

          The group members may bring up issues related to their   day-to-day events such as upcoming exam, interview, projects, relationship problems or mastering a new task, recent failure and disappointment. Each session will introduce some new concepts, which include an exercise to be completed. The content of the session are as follows (Annexure -4, and 5),

1. Knowledge – theoretical input

2. Skills – teach specific skills

3. Practice – Role-play/ worksheets

4. Feedback and discussion

          Although organization of the sessions must be structured, participants’ real life problem should not be ignored. Otherwise, they may view programme as irrelevant to their present needs. Participants bring their real life issues to their role-play and practice exercises. Role-play is a critical part of this programme and hence more time is allocated to it. Active participation, modeling and practice with corrective feedback are the most effective ways to modify and build self-efficacy and create long lasting behaviour change. Each session participants will be given relevant handouts. To encourage the participants to workout practice exercises outside the session, the researcher may announce some attractive gifts for the participants who fill the worksheet properly.  At the end of each session, instruction regarding the practice exercises and instruction regarding the next session will be given.

METHODS TO ENHANCE COPING SKILLS

1. Stress Inoculation Training (SIT)                   

The goal of stress inoculation training is to teach people to identify and anticipate stress-provoking situations, and defuse potential stress by rehearsing thoughts and actions to be implemented in actual stressful situations. This rehearsal of newly learned skills equips the individual to deal more effectively with a wide range of situations that have been potentially be stressful. SIT include, (1) Teaching clients the role of cognitions and emotions in stress and stress management. (2) Training them in fundamental problem-solving skills such as problem definition, anticipation of consequences and evaluation of feedback. (3) Providing instruction in and rehearsal of coping strategies such as relaxation, communication skills, social support building, attention focusing, and positive self-evaluation.     (4) Gradually increasing behavioural assignments to strengthen newly acquired coping skills. The specific coping skills may include emotional self-regulation, self-soothing and acceptance, relaxation training, self-instructional training, cognitive restructuring, problem-solving, interpersonal communication skills training, attention diversion procedures, using social support systems and fostering meaning-related activities. (5) The final phase of application and follow through provides opportunities for the clients to apply the variety of coping skills across increasing levels of stressors.

2. Cognitive-Behavioral Therapy (CBT)

Cognitive therapy assumes that people can develop automatic erroneous thought patterns and beliefs of which they are unaware and that they consequently think and behave in ways that are irrational. Cognitive-behavioral therapy is a major component of stress management programs and of interventions for acute and chronic traumatic stress disorder. Many people who have a chronic illness or psychological problem see themselves as incapable of changing their situation. CBT directly challenges people to alter the way they think about themselves, the way they behave, and the way they deal with problems and their illnesses. Therapy and homework are designed to heighten the awareness of behaviors, feelings, and thoughts associated with specific stressors, situations, or conditions. Then, the person is encouraged to evaluate the pros and cons of his or her attitudes and beliefs regarding the stressor and to offer positive interpretations or cognitive reappraisals of situations with the intention of challenging the negative thought pattern. The person, therefore, learns to actively seek new ways of perceiving or appraising situations that are less damaging to their psychological and physical well-being.

3. Mindfulness-Based Therapies

The goals of mindfulness-based therapies are to teach people how to manage everyday stress and pain and take responsibility for their well-being. Mindfulness involves moment-by-moment awareness of what a person is experiencing, such as paying close attention to breathing, noises, sensations in the body, inner feelings and thoughts, and our reactions to specific situations. Mindful awareness involves meditation exercises and is often coupled with stretching to help attain a mindful state. The person observes the moment-by-moment sensations, cognitions, and emotions without judging whether they are bad or good, important or trivial, or sick or healthy (nonjudgmental observation). The person is encouraged to recognize and accept his or her limits and body, as opposed to pushing and pulling at his or her physical and psychological limits. The goal is for the person to experience a new relationship with the mental or physical condition instead of doing the same old catastrophizing, avoiding, or other maladaptive coping strategy. Mindfulness-based approaches have been applied to various physical and emotional problems and have received empirical support.

Stress research updates

1. Short-Term Stress Enhances Anti-Tumor Activity

Researchers at the Stanford University School of Medicine have shown that, at least in laboratory mice, bouts of relatively short-term stress can boost the immune system and protect against one type of cancer. Furthermore, the beneficial effects of this occasional angst seem to last for weeks after the stressful situation has ended.short-lived stress may enhance anti-tumor activity. But chronic stress has the opposite effect taxing the immune system and increasing susceptibility to disease.

more details of the study please follow the link below

http://www.sciencedaily.com/releases/2009/09/090921134650.htm

2. Partner Relationship As A Buffer Against Stress

"The relationship reduces the negative effects of this kind of stress on our health. But poor relationships will amplify the negative effects,"

The body needs to recover

After having been exposed to stress, the body must recover and recharge itself. If there is no opportunity to recover because the work doesn't allow for breaks and lunches, the body's reserves are emptied, and poor health ensues. The same principle applies when a person takes work home, frequently works overtime or has recurring quarrels and problems in his or her relationship.

The effects of the sometimes small but recurring stress situations of everyday life sneak up on a person, who at first does not even notice them. The person under stress adapts and tries to accommodate the demands and changes he or she face, until one day, there is such a great imbalance, that massive efforts are needed just to manage everyday life.

"The risk is that we don't realize things are not right until we get to that point. Our work and required social interactions demand much too much of us. Our relationship is strained to the breaking point, and we've used the last drop of the energy reserves we once had." According to Ann-Christine Andersson Arntén, not taking time to recover can lead to impaired physical and mental health and cognitive and concentration problems, which reduce performance and problem-solving ability.

more details of the study please follow the link below

  http://www.sciencedaily.com/releases/2009/06/090623090711.htm