Category: Allied Health Options
What is it?
Stress Management (SM) is a set of techniques used to help an individual cope more effectively with difficult situations in order to stimulate relaxation and improve coping skills. SM may include any psychological treatment delivered individually that predominantly use non-trauma focused cognitive, behavioural or cognitive-behavioural techniques such as relaxation exercises, role playing, guided self-talk, assertiveness training, cognitive restructuring, thought stopping, time management, and use of social support.
How does it work?
In PTSD, a client is not able to forget the traumatic event and their memory of the experience keeps returning which ultimately becomes a further source of stress. This memory is then avoided in an attempt to control anxiety or fear. In SM, the goal of the treatment is to reduce the anxiety associated with the stressful event/s, override the anxiety related thoughts and physical symptoms with a relaxation response and more logical thinking, and then teach alternative coping responses to replace avoidance and other non-productive attempts at coping.
Is it effective?
Results from two recent reviews have demonstrated that SM is better than waitlist/usual care in reducing symptoms of PTSD. Limited evidence also shows that SM is superior to other forms of non-trauma focused therapy.
Whilst there is some evidence to support effectiveness of this intervention, more clinical trials are required to confidently say that SM is an effective treatment for PTSD.
Are there any disadvantages?
Whilst it is not very common, side effects consist of symptom worsening which can occur during treatment.
Where do you get it?
Stress management techniques can only be administered by a registered mental health professional.
What are the evidence limitations?
Some studies included in the review had individuals with traumatic stress symptoms who were diagnosed using different criteria from DSM-IV. Therefore interpreting this evidence should be undertaken with caution.
In light of the current evidence, SM may be considered in the treatment of clients with PTSD.
Basco, MR, Glickman, M, Weatherford, P, et al. 2000, ‘Cognitive-behavioural therapy for anxiety disorders: why and how it works’, Bulletin of the Menninger Clinic, vol. 64, no. 3A, pp. A52-A70.
Bisson, J & Andrew, M 2007, ‘Psychological treatment of post traumatic stress disorder (PTSD)’, Cochrane Database of Systematic Reviews, Issue 3 Art. No.: CD003388. DOI: 10.1002/14651858.CD003388.pub3.
Bisson, J, Ehlers, A, Matthews, Richards, D & Turner, S 2007, ‘Psychological treatments for chronic post traumatic stress disorder’, British Journal of Psychiatry, vol. 190, pp. 97-104.