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Stress Audit 3
Stress Audit 3
Introduction
There are a number of ways in which stress management can be approached,
but the stress management process should always include assessment and
treatment. This learning module describes an assessment protocol which has
been designed for massage therapists. Some elements of the learning module
will be expanded later in the course.
Now let's try to get a better understanding of what stress is and how to
manage it. Stress is anything that puts demands upon our bodies and minds
to cope, adjust, change, or accommodate to the demand. Although stress can
come from an ongoing, routine, and chosen activity like long work hours or
a hurried work pace, it is often associated with an intense reaction to an
event in our lives which can be either pleasant or unpleasant. We often seek
out positive, stressful events such as roller coaster rides or white water
rafting or competitive sporting events. By the way, watching competitive
sporting events can even be stressful. On the other hand, any time we
perceive a threat to us either physically or psychologically, we respond in the
same way. This distress response has been labeled the "fight or flight
response". This response occurs when we perceive that the challenge facing
us is dangerous, difficult, painful, or unfair, and we are concerned that we
may not be able to cope with it successfully(Davis, Eshelman, and McKay,
2000).
Assessment
This assessment protocol includes the following stages
Medical screening
Identify client goals
Stress assessment
Identify need for referral if any
Identify level of training required
Identify client's level of commitment to change
Palpation
Asthma
Diabetes
Hypertension
Epilepsy
Psychiatric illness
Assessment
Through assessment you can determine two important questions
I'm sure that the need to identify your client's goals for treatment, and to
base what you do on these goals has been drummed into you by now. If your
cilent's goals are aligned with stress management, then it may be worthwhile
suggesting this to your client.
If you do this be sure to discuss your reasons for believing it would benefit
the client, and what it would mean if they did not use stress management
techniques.
One both you and your client have agreed to embark on a stress management
programme, you will need to run through an assessment process with them.
One important thing to do at the start of the process is to get a measure of
their current level of stress.
It's best if baseline assessment measures can be objective (e.g. joint range of
movement) rather than subjective ("rate pain on a scale of 1-10"). You don't
really want the measure to change depending on the mood of your client on
the day of assessment. It's fairly difficult to develop an objective measure of
stress for use in clinical practice. Stress-related research often uses blood
sampling of hormones such as cortisol which are related to the stress
response as an objective assessment measure, however this is not an
approach that you can commonly take in your practice. Another way to
attempt to measure someone's stress levels is to take a multi-factor approach.
Identifying stressors
Once you've gone through the medical screening process and have taken an
objective measure of your client's stress, the next stage in the assessment
process is to identify the major stressors in your client's life. The stress
monitor form will give you some information about how stress is affecting
your client which will give you some pointers about the kinds of stressors
which could be involved, but you will need to also question your client
about the kinds of factors which could be involved.
When developing your stress management plan, you should try to encourage
your client to reduce their exposure to factors which increase their stress and
increase exposure to any factors which reduce their stress.
Treatment
The treatment process includes four elements
Programme goals
Lifestyle modification (activities to increase/decrease)
Massage (frequency and focus)
Stress management exercises
Expected length of the programme
Monitor progress
The client's progress in the stress management programme should be
regularly monitored both through the use of the stress assessment
instrument, and through questioning the client about their adherence to the
stress management programme.