Symptoms
People experiencing the signs and symptoms of stress and stress-related conditions are likely to seek treatment first from their primary care practitioner. Clients may indicate that they are feeling stressed out, overwhelmed, overworked or exhausted. Some may describe unpleasant bodily symptoms or emotions, while others may deny feeling stressed and insist on addressing a physical condition that seems to have no identifiable origin (Hambly & Muir, 1997). Regardless of the specific symptoms, stressed clients typically describe a combination of symptoms listed below:
Assessment
Good dialogue between clients and practitioners is the starting point for obtaining a comprehensive picture of clients' current difficulties. Listen to clients' stories, which may detail challenging situations, missed opportunities, experiences, behaviours and emotions, as well as what clients would like to do about their difficulties.
Gain a better understanding of clients' problems by paying attention to:
- non-verbal behaviours which can modify the meaning of what is being said (e.g., facial expression, tone of voice, eye contact, bodily postures and movements)
- social context, which often provides a wider context for clients' problems (e.g., culture, personality,interpersonal style, ethnicity, key life experiences, education, economic status andother individual differences).
Primary care practitioners should empathically communicate their understanding of clients' stress. This empathic response should accurately identify the emotions expressed and the experiences and behaviours that caused them; for example,
"You feel disappointed because you expected your promotion to lead to more opportunities for advancement and it seems as though you've hit a dead end."
It is also important to listen for clients' personal strengths, in addition to their problems. Despite their apparent vulnerabilities, all clients have strengths that can be tapped to help reduce their stress levels. These strengths will be especially important in executing the treatment plan (Egan, 2002).
Treatment
Stress management techniques are an underrated complement or alternative to medication for stress and stress-related disease. Working with clients to reduce their stress levels can relieve many medical and mental health problems. For example, relaxation methods may benefit people with high blood pressure and anxiety disorders. Although no single stressreduction intervention is always successful, a combination of approaches is generally most effective (Sutton, 2007).
Interventions aimed at reducing stress have four main objectives:
- removing or changing the source of stress,
- altering reactions to a stressful event,
- reducing the bodily impact of stress
- improving coping capabilities.
Depending on clients' resources, personal strengths and personality, some of these strategies may be more viable than others. For example, clients with very hectic schedules may be reluctant to take 20 minutes to document and challenge stress-inducing thoughts during the day, but they may be willing to test and evaluate the effectiveness of alternative statements when stress arises in everyday activities. A good stress management plan should be tailored to clients' needs.
Approaches to treatment
- Psychoeducation
- Relaxation techniques
- Cognitive exercies (reframing, problem solving, scheduling worry time)