Support, Recovery & Coping With Stress

1. Support, Recovery & Coping With Stress Dr. Paul Carré School of Social Sciences Bangor University

2. The point of this talk… • To combine several perspectives on coping, support and recovery; • To identify how internal and external variables affect emotional wellbeing and related social behaviours; • To generate some thoughts on how to meet diverse and complex needs.

3. Points of ReferenceAcademic and Applied Settings • Doctoral research on British Army Soldiers Under Training • Residential Support Work with Looked After Children • KESS II Research Project on community engagement with supporting diverse needs • Part of a previous evaluation project on Recovery & Rehabilitation Services in North Wales; • Some theoretical perspectives on rationality, emotions and adaptation, recovery.

4. Self-actualization • needs • Need to realize one’s • deepest creative • and productive potential Meeting Human Needs • Esteem needs • Need for self-esteem, self-respect and • appreciation from others • Social needs • Need to socialize with other people, need for relationships based on emotions, need for friendships • Safety needs • Need for physical and psychological safety and stability • Physiological needs • Primary needs; water, food and a home Maslow, A. (1954), Motivation and Personality, London, Harper & Row.

5. “The mind is its own place, and in itself, Can make a heaven of hell, a hell of heaven”

6. Trained Soldier ADSC Civilian Initial Medical Examination Phase 1 Training CMS (SE) 14 weeks Attestation & Enlistment Unit Welfare Office Chain of Command Welfare Issues Fail Key Tests Soldier Preconditioning Course Injury Medical Deferral Discharge As Of Right Unfit For Army Service Medical Discharge Gold Platoon (Physical Rehabilitation) Juno Platoon (Remedial Training)

7. Institutional life: coping and response • Cognitive-rational-emotional • behaviours and attitudes • Weberian duality – authority and rationality • Person-environment relationship • Stressors • Appraisal and response mechanisms • Adaptational encounters & adjustment • Internal-external dialectic resulting in relational meaning • Authority • Rational/legal • Traditional • Charismatic • (Weber, 1968). • Rationality • Purposive • Value-based • Affective • Traditional • (Weber, 1968). 1. What does the individual feel, need or want? (Internal variables); 2. How is the environment affecting the individual? (External variables).

8. Environmental demands • (Social Context) • Stressors (Responsibilities, Fears, External Agents) • Social interaction • Events • (Personal and Collective) • Appraisals (Reflective Learning) • Perceptions • of stress (Usually negative but can provide opportunities for growth) • Affective • (Relational Decision-making) • Behavioural (Conditional or Value-led) • Biological • (Instinctive) • Subjective evaluation of situation stressfulness • Environmental experiences • Stress responses The Environmental Stress Process, using definitions and components from Cohen et al (1997).

10. Is the person-environment relationship healthy, beneficial and maturational for the individual, or is it harmful, regressive or stressful? It is important, if we are to consider the prevalence of stress in the environment and its effects on the person to make the distinction among three kinds of stress: “Harm refers to psychological damage that had already been done - e.g., an irrevocable loss. Threat is the anticipation of harm that has not yet taken place but may be imminent. Challenge results from difficult demands that we feel confident about overcoming by effectively mobilizing and deploying our coping resources” Lazarus, R, (1993), From Psychological Stress to the Emotions: A History of Changing Outlooks, Annual Review of Psychology, 1993. 44:1-21.

11. Characteristic of the Person • Characteristic of the Environment • Job Decision Latitude • Environmental Uncertainty & Rate of Change • Social Support Systems & Relationships • Generalized • Expectancies of Control • Tolerance for Ambiguity • Self-Reliance • The Control • Dimension • The Uncertainty Dimension • The Interpersonal Dimension An Isomorphic framework for stress (Quick et al, 2001, p.148).

12. Moods, emotions, moderation of stress and readjustment • Stress is presumed to have a negative impact on emotional wellbeing; • This, in turn, affects mood and other socio-emotional characteristics, such as self-esteem, confidence, trust, gregariousness and motivation; • Mood itself must be distinguished from an emotional trait – a dispositional characteristic of a person (Lazarus, 1991) • Also needs to be distinguished from acute emotions – a temporal or contextual state of response to an event or social interaction; • However, moods are neither established permanently nor irreversibly; they may act as drivers of subsequent acute emotional behaviour, but they may equally be generated by experiences and associated emotional responses.

13. Moods “have to do with the larger background of one’s life” Moods “refer to the larger, pervasive, existential issues of one’s life” Acute emotions “refer to an immediate piece of business”

14. Moods, emotions, moderation of stress and readjustment • So, we can define both moods and acute emotions as formative psychosocial responses • They are responses to stressors • But also to generic encounters and influences • Therefore, it follows that individuals seek to moderate the effects of these stressors for two primary reasons; 1. To return to a familiar, functional emotional status quo, or 2. To use the experience of appraisal and coping to acquire more effective techniques of doing so in future stressful situations.

16. Stress, crisis and opportunities for growth. • The two most common types of crisis experienced by people are: • Situational crisis – events or experiences that create stress and require effective appraisal and coping responses to avoid distress or harm; • Maturationalcrisis – stress experienced by individuals as they move from one formative stage of development to another. Maturational crises are considered to provide opportunities for learning and growth. • Caplan (1989) notes that during the period of upset in a crisis a person is more susceptible to being influenced by others than at any other time of relative psychological equilibrium.

17. Therapeutic Crisis Intervention • How am I feeling? • What does the individual feel, need or want? • How is the environment affecting the individual? • What is my response? • Emotions • Emotions and Motivation • Stressors • Adaptation Cornell University (2001), Therapeutic Crisis Intervention: A Crisis Prevention and Management System Student Handbook, Ithaca, NY, College of Human Ecology, 5th edition.

18. Key elements in successful social and emotional readjustment • Competence – internalized knowledge, mechanisms and emotional agency • Social support – externalized emotional support and pastoral care ∴Competence + Social support = Recovery “An external mechanism that protects individuals against the damage that might be caused by environmental stressors” (Caplan, 1989) Bellman et al (2003) note that social support is one of the few variables that reliably covaries with gender

19. What is Recovery? • Recovery is based on mutually agreed goals which arise from a collaborative assessment of strengths and needs; • It is an individualapproach, enabled by positive and helpful relationshipsbetween individuals and staff members across a wide variety of agencies; • “An idea, a movement, a philosophy, a set of values, policyand doctrine for change” (Turner, 2002a, in Hall et al, 2008); • A measurable end state, with illness or disability in remission or overcome; • An ongoing process that aims to achieve life goalsdespite continuing symptoms or disabilities (Corrigan & Phelan, 2004); • The recovery model shifts expertise and decision-making away from professionals and establishes the primacy of the person;

20. A whole person-whole lifeapproach • Hope and optimism; • Autonomy, • Consumer participation • Self-determination • The intra-personal domain; • The service provision agenda; • The social domain; • Power and control; • Getting better. • Social skills training • Cognitive-behavioural therapy • Case management • Psychosocial rehabilitation • Supported employment • Risk and responsibility • The importance of a satisfactory sense of personal identity; • Coping with symptoms;

21. Thank you! Questions?