Stress Management

Stress management training aims to change environmental triggers to the stress response and/ or change inappropriate behavioral, physiological, or cognitive responses that occur in response to this event. High levels of muscular tension can be reduced through relaxation techniques; triggers can be identified and modified using problemsolving strategies; cognitive distortions can be identified and changed through cognitive techniques such as cognitive restructuring; and "stressed" behaviors can be changed through consideration and rehearsal of alternative behavioral responses.

Many stress management programs teach simple relaxation techniques to minimize high levels of arousal. More complex interventions try to change cognitive (and therefore emotional) reactions to environmental triggers. A few address factors that initiate the stress response. Given the idiosyncratic nature of both the stressors that individuals experience and the complexity of changing their cognitive response, such interventions are often led by stress management specialists, and are best targeted at individuals experiencing significant stress. Relaxation skills are learned through three phases: learning basic relaxation skills; monitoring tension in daily life; and using relaxation at times of stress. Two strategies for changing cognitions are used. Self-instruction training interrupts the flow of stress-provoking thoughts by replacing them with pre-rehearsed stress-reducing or "coping" thoughts. Cognitive restructuring involves identifying and challenging the accuracy of stressengendering thoughts. Basic interventions, particularly relaxation, can be taught by most healthcare professionals in a group context. The problem-focused or cognitive interventions can be taught by professionals familiar with the issues. However, where an individual reports high levels of stress, these may best be implemented by more specialist mental health professionals.

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