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

1. Take a Deep Breath: Stress Reduction Techniques for Job Corps Staff and Students Milo Milburn, PhD Julie Luht, MPH

2. 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

3. Setting the Mood: Deep Breathing

4. Benefits of Deep Breathing According 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).

5. 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.

6. 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

7. 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

8. Adapted from: “ET Handbook, April 1984” Stressors Stress Filter Stress Adequate Coping Response Inadequate Coping Response Distress Management of Stress Failure to Cope Increasing Coping Resources Equilibrium Crisis and/or Symptoms No Crisis

9. 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”

10. 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

11. Progressive Relaxation

12. 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)

13. 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”

14. Guided Meditation/Imagery Sample available at: http://wholesomeresources.com/library/meditation-guided-imagery/

15. 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.

16. Exercise as a Stress Management Technique

17. 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

18. 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

19. Exercise and Test Performance

20. 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

21. How do you relax?

22. Resources

23. Inexpensive and Free Downloads

24. 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. • iRelaxGuided 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/