Wednesday, January 19, 2011

Stress counseling

The serenity prayer: God, grant me the serenity to accept the things I can not change, the courage to change the things I can, and the wisdom to know the difference.
Research in the area of stress and coping indicates that the manner in which a person responds to stress is greatly influenced by longstanding personality traits. Many of the stress management programs teach participants only one such as relaxation etc. or few strategies, and skills. These programs are incomplete may be little beneficial because it may not suites to the individuals need. Stress counseling is an in depth, unique and dynamic process through which a professional assist another person to use his or her resources to handle effectively on the negative consequences of stress. At the same time, make the person to understand the positive consequences of stress.
Why we need stress counseling
1. Lack of awareness
Many people are not aware of their own thinking, feeling and behaviour. They simply exist with an easy feelings and problems.
2. Lack of self-responsibility
Many people remain in a dependency situation, they wait passively, they are not striving for independence or self-sufficiency.
3. Lack of skills
The person may know what the situation is but because the person responds emotionally, this knowledge does not help to change behaviour.
4. Loss of contact
People withdraw from the environment when they are stressful including significant others.
5. Lack of feedback
When they are emotional they become confused which lead to wrong decision or in decision.
In stress counseling, a qualified experienced professional explores many different details of the person, the individual’s backgrounds, needs, circumstances, strength and weakness, the hope for the future and so on. They see the person as a unique individual and the complete intervention is tailored to serve that one person.
Stress counseling is not
-giving information, although information may be given
-interviewing, although interview may be involved
-listening, although listening is present
-giving advice, suggestion and recommendations
Major goal of stress counseling is
Facilitating behaviour change
Enhancing coping skills
Promoting problem solving and decision making
Improving relationships
Facilitating personal development / effectiveness
One to one professional help ultimately has been found valuable in assisting people to modify their stressful life style and enhancing personal effectiveness.

Thursday, October 28, 2010

Psychological health and stress

Its not stress that kills us, it is our reaction to it. - Hans Selye 
When we react to stressors, a wide variety of cognitive and emotional responses can occur. Examples of cognitive responses are concentration problems, indecision, forgetfulness, and sensitivity to criticism, self-critical thoughts, and rigid attitudes. Examples of emotional responses are nervousness, tension, irritability and anger. Stress contributes not only physical ill health but also psychological ill health. Taking care of our psychological health is very important. We need to learn how to preserve and promote psychological health to cope more effectively with our stressful life situations.

Psychological health is dependent on the fit between the entire configuration of a person's characteristics and potentials with those of the environments in which the person functions, such as family, job, school, church, and recreation.   Psychological health is about doing things that give you a sense of enjoyment and achievement, holding helpful and balanced attitudes toward life, and building satisfying relationships.

A theoretical model of psychological health encompasses 6 distinct dimensions
1.     Autonomy,
2.     Environmental Mastery,
3.     Personal Growth,
4.     Positive Relations with Others,
5.     Purpose in Life,
6.     Self-Acceptance

Psychological health includes
1. Emotional health
Learning the skills needed to handle emotional problems will give you a foundation of psychological health. Everyone, including people who are emotionally healthy, has problems. Emotionally healthy people are able to adjust to and solve problems, and in doing so they help others as well as themselves to get satisfaction out of life. Mood is central to psychological health, and disturbances in mood are related to subsequent psychological maladjustment.
2. Spiritual health
Learn to love. Cultivate the skill of loving each other and ourselves.
3. Social health
People are able to coexist peacefully in communities with opportunities for advancement.

Psychological health produce varied outcomes including
(a) Reduced stress, strain, anxiety, absenteeism, turnover intentions, and turnover;
(b) Improved physical health, psychological health, emotional stability, adjustment, goal-setting behavior, coping, adaptation, attitudes toward learning, and vocational choice; and
(c) Increased creativity, motivation, performance, occupational success, commitment, tenure, satisfaction, and morale.

Positive psychology: psychological health
Positive psychology expands our view of psychological health beyond the absence of symptoms and disorders, and provides hope that a healthy, fulfilled, and productive life is possible for all.

Primary enhancement of psychological health suggests that our relationships are crucial for life satisfaction. Indeed, for most people, interpersonal relationships with lovers, family, and good friends provide the most powerful sources of well-being and life satisfaction. Beyond the relationship with one's mate, primary enhancement satisfactions also can come from other relationships, such as family and friends. Arranging living circumstances to be within close physical proximity to kin also can produce the social supports that are so crucial.

Secondary enhancement of psychological health enables people to maximize their pleasures by building on their preexisting positive mental health. Peak psychological moments often involve important human connections, such as the birth of child, a wedding, the graduation of a loved one, or perhaps the passionate and companionate love of one's mate. There are psychological group experiences the purpose of which is to help people to achieve the extreme pleasures of in-depth relating with others.

Rational emotive behavioural theory: criteria of psychological health 

Rational emotive behavioural theory also puts forward a number of criteria of psychological health. These include the following:

1. Self-interest: Sensible and emotionally healthy people tend to be primarily interested in themselves and to put their own interests at least a little above the interests of others. They sacrifice themselves to some degree for those for whom they care but not overwhelmingly or completely.

2. Social interest: Social interest is usually rational and self-helping because most people choose to live and enjoy themselves in a social group or community. If they do not act morally, protect the rights of others, and abet social survival, it is unlikely that they will create the kind of world in which they themselves can live comfortably and happily.

3. Self-direction: Healthy people tend mainly to assume responsibility for their own lives while simultaneously preferring to cooperate with others. They do not need or demand considerable support or succoring from others, though they may prefer and work for this.

4. High frustration tolerance: Rational individuals give both themselves and others the right to be wrong. Even when they intensely dislike their own and others' behavior, they refrain from damning themselves or others, as persons, for unacceptable or obnoxious behavior. They are capable of changing the changeable and accepting those they cannot, and having the wisdom to know the difference between the two.

5. Flexibility: Healthy and mature individuals tend to be flexible in their thinking, open to change, and unbigoted and pluralistic in their view of other people. They do not make rigid, invariant rules for themselves and others.

6. Acceptance of uncertainty: Healthy men and women tend to acknowledge and accept the idea that we seem to live in a world of probability and chance where absolute certainties do not and probably never will exist. They realize that it is often fascinating and exciting and definitely not horrible to live in this kind of probabilistic and uncertain world. They enjoy a good degree of order but do not demands to know exactly what dies future will bring or what will happen to them.

7. Commitment to creative pursuits: Most people tend to be headier and happier when they are vitally absorbed in something outside themselves and preferably have at least one powerful creative interest, as well as some major human involvement, that they structure a good part of their life around it.

8. Scientific thinking: Non-disturbed individuals tend to be more objective, realistic, and scientific than more disturbed ones. They are able to feel deeply and act concertedly, but they tend to regulate their emotions and actions by reflecting on them and evaluating their consequences in terms of the extent to which they lead to the attainment of short-term and long-term goals.

9. Self-acceptance: Healthy people are usually glad to be alive and accept themselves just because they are alive and have some capacity to enjoy themselves. They refuse to measure their intrinsic worth by their extrinsic achievements or by what others think of them. They try to avoid rating themselves-- their totality or their being. They attempt to enjoy rather than to prove themselves

10. Risk-taking: Emotionally healthy people tend to take a fair amount of risk and to try to do what they want to do, even when there is a good chance that they may fail. They tend to be adventurous but not foolhardy.
11. Long-range hedonism: Well-adjusted people tend to seek both the pleasures of the moment and those of the future and do not often court future pain for present gain. They are hedonistic, that is, happiness-seeking and pain avoidant, but they assume that they will probably live for quite a few years and that they had therefore better think of both today and tomorrow and not be obsessed with immediate gratification.

12. Non-utopianism: Healthy people accept the fact that Utopias are probably unachievable and that they are never likely to get everything they want and to avoid all pain. They refuse to strive unrealistically for total joy, happiness, or perfection or for total lack of anxiety, depression, self-downing, and hostility.

13. Self-responsibility for own emotional disturbance: Healthy individuals tend to accept a great deal of responsibility for their own disturbance rather than defensively blame others or social conditions for their self-defeating thoughts, feelings, and behaviors.
  
Creating and reinforcing psychological health is the goal in successfully living a balanced lifestyle. Learn to preserve and promote psychological health!.

Friday, July 30, 2010

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.