Take a Deep Breath: Stress Reduction Techniques for Job Corps Staff and Students

Milo Milburn, PhDJulie Luht, MPH

Overview• A way to understand stress

• Benefits of stress-reduction techniques for staff and students

• Practice stress-reduction techniques including deep breathing, progressive relaxation (with visualization), and guided meditation

• Resources to incorporate techniques into HEALs and other components of center life

Setting the Mood: Deep Breathing

Benefits of Deep BreathingAccording to Davis, Eschelman & McKay (2008), “Breathing exercises have been found effective in reducing generalized anxiety disorders, panic attacks, agoraphobia, depression, irritability, muscle tension and fatigue” (p. 28).

What Percentage of Workers Suffer from Significant Distress?• “A recent study estimated the prevalence of

high psychological distress (likely mental disorder) at 4.5% and that of moderate distress (mental disorder possible) at 9.6% in a sample of 60,556 employees of large employers in the USA.”

Hilton, M.F., Whiteford, H.A., Sheridan, J.S., et al. The prevalence of psychological distress in employees and associated occupational risk factors. J Occup Environ Med 2008;50:746-757.

What Causes Work-Related Stress Disorders?• High job demands (strong evidence for everyone)

• Low job control (especially for men)

• Low co-worker support (especially for men; relationship is not clear for women)

• Emotional demands (some evidence for men; conflicting evidence for women)

• Lack of procedural justice (strong evidence for everyone)

• Low relational justice (strong evidence for everyone)

• Effort-reward imbalance (strong evidence for everyone)Nieuwenhuijsen, K., Bruinvels, D., & Frings-Dresen, M. Psychosocial work environment and stress-related

disorders, a systematic review Occup Med (Lond) (2010) 60(4): 277-286 doi:10.1093/occmed/kqq081

Things to know about managing stress• Up to a point, stress improves our functioning and promotes growth

• Too much for too long with too little “break” is how stress becomes a problem

• Stress can be managed from a variety of vantage points

Adapted from: “ET Handbook, April 1984”

Stressors

Stress Filter

StressAdequate

Coping Response

InadequateCoping

Response

Management of

Stress

Equilibrium

Distress

Failure to Cope

Crisis and/orSymptoms

No Crisis

IncreasingCoping

Resources

Stress can be managed by:• Controlling what we can of our environment

– List all the demands in our lives– Decide which ones can be eliminated or reduced

realistically– Learn to say “No” politely but firmly

• Evaluating and modifying my beliefs and thoughts where appropriate to do so– Catch my “have to’s” and “shoulds” and change them

to wishes, wants and preferences– Change “awfuls” to percentages of bad or to

“unfortunate”– “It is hard to take, but I can stand it.”– Praise or criticize the deed rather than label the doer– “Self-Instructional Training”

Stress can be managed by:• Giving and receiving support through

relationships

• Solving problems where you can– Define the problem– Brainstorm (creativity, not evaluation)– Evaluate and select– Implement– A win-win: either you have solved it, learned

something that will help solve it, or a percentage of each.

• The “stress” (i.e., the bodily and emotional reactivity itself) can be managed by the techniques that follow

Progressive Relaxation

Benefits of Progressive Relaxation“Excellent results have been found with progressive relaxation techniques for the treatment of muscular tension, anxiety, depression, fatigue, insomnia, neck and back pain, high blood pressure, mild phobias and stuttering” Davis, et al. (p. 42)

Types of Progressive Relaxation• Active tensing—create strong tension, then

release to notice difference in how relaxation feels

• Threshold—create just enough tension to notice there is tension before releasing it

• Passive—notice whatever tension is present naturally (and whatever relaxation) and relax further from there

• Our exercise worked with the “passive tension”

Guided Meditation/Imagery

Sample available at: http://wholesomeresources.com/library/meditation-guided-imagery/

Benefits of Visualization and Guided Imagery• Lower levels of anxiety, less anger, lower reparatory

rate (Iglesias, 2012)

• Lessons PTSD symptoms in returning active duty military; also decreases depression, increases quality of life, and decreases hostility (Jain, 2012)

• Reduce the severity of nausea and vomiting in chemotherapy patients (Karagozohlu, 2013)

• Increase focus in sports competition (Davis, et al., p. 66)

Jain, S. et al. (2012). Healing touch with guided imagery for PTSD in returning active duty military: a randomized control trial. Mil Med; 177(9): 1015-1021.Karagozoglu, S., Tekyasar, F., Yilmaz, F.A. (2013). Effects of music therapy and guided visual imagery on chemotherapy-induced anxiety and nausea-vomiting. Journal of Clinical Nursing. 22(102):39-50.Iglesias, SL., et al. (2012). Psychological and physiological response of students to different types of stress management programs. American Journal of Health Promotion. 26(6), e149-158.

Exercise as a Stress Management Technique

The Ultramarathon Man• “I run because if I didn’t, I’d be sluggish and

glum and spend too much time on the couch. I run to breathe the fresh air. I run to explore. I run to escape the ordinary. I run to savor the trip along the way. Life becomes a little more vibrant, a little more intense. I like that.” ― Dean Karnazes, Ultramarathon Man: Confessions of an All-Night Runner

Exercise• 20 minutes of exercise equivalent to a brisk walk

– That is, the pulse is slightly elevated, a light sweat develops, one breathes a little more deeply…

– Done daily or almost daily…– Will increase production of beta-endorphins…– Which will have one feeling better both emotionally and

physically

• Any exercise that is safe for you is good

• Any is better than none

• A little consistently beats a lot inconsistently

• Remember to consult your physician before embarking on a program of exercise

Exercise and Test Performance

Applying it to HEALS• Use techniques at end of group exercise

class

• Encourage students to take a walk before a test

• Integrate breathing and progressive relaxation techniques into classes

• Have a quiet space for students to practice these techniques

• Emphasize the benefits of any type of exercise

• Tie it into emotional eating

How do you relax?

Resources

Inexpensive and Free Downloads

References/Recommended Readings

• Davis, M., Eschelman, E., and McKay, M. (2008). The relaxation and stress management workbook (6th ed.). Oakland, CA: New Harbinger Publications.

• Hilton, M.F., Whiteford, H.A., Sheridan, J.S., et al. The prevalence of psychological distress in employees and associated occupational risk factors. J Occup Environ Med 2008;50:746-757.

• iRelax Guided Meditation: http://www.orangeorb.com/downloads/product-page.asp?id=1 (cheaper on iTunes)

• Yoga Nidra Lite: https://itunes.apple.com/us/app/deep-relaxation-yoga-nidra/id444707986?mt=8 (free)

• Guided imagery script: http://wholesomeresources.com/library/meditation-guided-imagery/