Managing stress

Biofeedback is based on reducing unpleasant bodily symptoms of stress it involves:

• Wiring patient up to a biofeedback machine that gives patient feedback on bodily responses.
• This can be EEG (brain activity), heart rate, sweat (GSR) or muscle tension.
• Patient is taught relaxation techniques and the idea is once a patient is aware of bodily processes, the successful use of relaxation techniques will act as +ve reinforcement to lower responses.

Illustrated by Budzynski's study:

• See whether biofeedback is effective in reducing tension headaches. 18 P's used - volunteered
• 3 groups, A - biofeedback with relaxation training + EMG feedback. B - pseudofeedback. C - waiting list. (prior groups kept record of headaches rating them from 0-5 for baseline comp.)
• 16 training sessions, 2x a week for 8 weeks. A were taught relaxation and told that the clicks of the biofeedback machine reflected muscle tension - slower clicks, less tension. Also told to practice relaxation at home for 15-20 minutes. 
• Group A - sig. lower muscle tension than B, headaches had dropped significantly below baseline and less reported than B & C. Reduction in drug usage, insomnia, depression etc.

CBT - form of therapy that focuses on a patient's cognitive appraisal of the stressor.

• Gets patients to identify and be realistic about -ve thoughts that can cause stress.
• Cognitive - Encourage p's to consider alternatives to their negative thoughts & treat beliefs as hypotheses and examine their validity.
• Behavioural - Then experiments are set up to test their beliefs and targets set to incorporate new beliefs and act as positive reinforcement, building on successes.

Illustrated by Clark:

• Test the effectiveness of CBT treatment for panic disorder. with 42 patients w/ panic disorder.
• Random 3 groups; 1 - full CBT 12 1hr session. 2 - Brief CBT 5 1hr sessions. 3 - waiting list.
• Treatment : Cog - helping p's recognise symptoms of panic in themselves + looking at patients worst fears about sensations during attacks and finding less frightening explanations.
• Beh - explained how safety behaviours inhibited cog change and identified saftey behaviours. Experiments where p's were encouraged to drop safety behaviours.
• Assessed on a range of measures by an independent assessor.
• Experimental group did sig. better on all measures, no diff between brief and full CBT.

• The social approach to managing stress looks at reducing stress overall in everyday life.
• Involves the use of support groups to help reduce stress - some people can be reassured knowing others and going through the same thing.
• Assumes that those with strong social networks are less likely to suffer from stress-related illnesses and diseases.

Illustrated by Waxler-Morrison:

• Looked at how women's response to breast cancer is influenced by social relationships.
• 133 women in Vancouver all with diagnosis of breast cancer, interviewed, filled out questionnaire and medical records examined.
• Questionnaire asked about women's existing social networks, level of education, who they were responsible and contact with family and friends.
• Six aspects - marital status, support from friends, contact with friends, social network, employment. Practical help was important, spouses supportive, jobs important as a source of support and info.
• More social networks the better the survival rate assumes that social networks linked to stress and that reduced stress reduced impact of breast cancer.