Workgroup 6: Stress and stress management

Stress influences functioning on different levels: cognitive, emotional and physical. These three levels of functioning all influence each other as well, causing a vicious cycle.

Stress management is an intervention which can break this vicious cycle, by influencing physical processes, giving more feelings of control, changing cognitions and reducing anxieties. During the workgroup three types of stress management are practiced by students, which have been prepared prior to the workgroup. Each student has prepared an intervention for their patient.

Progressive relaxation is about first tensing your muscles and then relaxing them.

Applied relaxation is based on progressive relaxation. However, this type of relaxation is only about relaxing your muscles. The goal is to teach the patient a new coping strategy (relaxing your muscles) and then having the patient being able to apply this new coping strategy in any (stressful) situation. It is also called release-only relaxation.

Mindfulness is a form of meditation, originating from Buddhism. It is about doing things with 100% focus and focusing on the very moment, instead of focusing on the past or the future. During mindfulness, the patient has to let go of bad thoughts and the patient must let thoughts come and go without judging those.

You start the stress management interview with an intro, in which you can ask how things have gone since last time you spoke, give a brief summary of last time you spoke, tell the patient what is going to happen today and you can answer any questions the patient has before you start.

During the interview it is important to sit in a comfortable position (both for you as for the patient), to have the patient close their eyes (unless they don’t feel comfortable to), for you to have a monotone voice and to speak calmly and to have breaks in-between what you have to say, so the patient can adjust.

When finishing up the interview, you ask how relaxed the patient is feeling and evaluate together. Give brief instructions for doing the relaxation at home and give a brief summary of what you have done today. Also answer any questions the patient has.