Describe what psychologists have discovered about the management of stress.

Mark scheme

Marking points from the official mark scheme (May/June 2018). The mark or mark type is shown in brackets.

1. Describe what psychologists have discovered about the management of stress. Management of stress, including the following: ∞ medical techniques (biochemical) ∞ psychological techniques: biofeedback (Budzynski et al., 1969) and imagery (Bridge, 1988) ∞ preventing stress (Meichenbaum, 1985) Medical techniques (biochemical) Antidepressants (SSRIs) such as fluoxetine (Prozac). Regulates serotonin (mood stabiliser) in the brain. Benzodiazepines (BZs) – Benzodiazepines act as a sedative which shows down the body’s functions. They work by increasing the effect of a brain chemical called GABA (gamma amino butyric acid). GABA reduces brain activity in the areas of the brain responsible for: rational thought, memory, emotions and essential functions, such as breathing. The main effects of benzodiazepines are: sedation, reduced anxiety and muscle relaxation. Psychological techniques: biofeedback (Budzynski et al., 1969) and imagery (Bridge, 1988) Biofeedback - A medical device monitors physical processes (such as heart rate, blood pressure, etc.) and immediate feedback is given to the patient. The patient can then learn to do relaxation to reduce the physical processes and therefore hope to reduce the experience of stress. Budzynski found this technique was effective in helping to reduce tension headaches. Imagery - Sensory awareness of various muscle groups while imagining a peaceful scene of their choice (as used by Bridge in their study of women with cancer). Imagining a peaceful or beautiful setting while doing relaxation exercises such as deep breathing and muscle relaxation. Bridge found that the patient’s mood when using imagery improved over the course of therapy (although symptoms did not improve). Preventing stress (Meichenbaum, 1985) Stress Inoculation therapy – a form of CBT. Three phases 1 Conceptualisation – discussing the nature of the problem with the therapist Taught about stressors and how they affect the body. 2 Skills acquisition and rehearsal – taught relaxation and problem solving techniques and practice in the session. 3 Application and follow through – the client practices between sessions and they discuss with the therapist how it is going and make alterations as necessary. Mark according to the levels of response descriptors in Table A. Other appropriate responses should also be credited.
2. Evaluate what psychologists have discovered about the management of stress, including a discussion about ethics. A range of issues could be used for evaluation here. These include: ∞ Named issue – ethics (can be of the management techniques and/or the ethics of the research). In all of the studies listed above (Budzynski and Bridge) there was a control group who did not receive any treatment. This could be considered unethical as the participants were not given the opportunity to find a way of management their stress levels. However, it did improve stress levels for the patients in the experimental conditions which improves the ethics of the study. In terms of the ethics of the treatments themselves – biochemical techniques (drug therapy) can be addictive for the patient whereas the psychological techniques do not involve any biochemical changes so are therefore more ethical. ∞ nature versus nurture debate with reference to the various management strategies and the theory on which they are based. Biochemical techniques are down to nature whereas the others involve some nature as they recognise the symptoms of stress are biological in nature but also suggest that the patient can learn (nurture) to relax and solve problems in a different way that produces less stress. ∞ comparisons of different management techniques – any issues can be used to make comparisons. Do not credit issues twice. ∞ Application of psychology to everyday life (with reference to management strategies) - all have been shown to be effective through the research. The studies are all done in the everyday life of the patients so they are looking at genuine (often long term as in the case of Bridge) reduction in experiences of stress. ∞ usefulness (effectiveness) of different management strategies – all have been shown to be effective via the research. Can evaluate the evidence with reference back to effectiveness. ∞ reductionist nature of the management strategies – biochemical and the most reductionist and the other treatments are less reductionist as they take into account both the biological as well as the psychological causes of stress. ∞ deterministic nature of the management techniques – all require some form of free will (even if it is just to take the medication). Biochemical is the most deterministic with the psychological treatments involving much more free will as the patient has to go away and practice the relaxation and problem solving techniques. ∞ appropriateness of management techniques (e.g. if there are side effects) - Biochemical can have side effects and the psychological therapies might be difficult for some patients as they involve talking to someone and being able to be reflective which some patients may find difficult. ∞ cost of management strategies biochemical is the least costly whereas the other therapies have some cost to the patient/health service. ∞ ethics of management techniques. – all are ethical as they require the permission of the patient to take part in or take the treatment in the case of biochemical. ∞ evidence to suggest management techniques work and an evaluation of this evidence with reference back to the management technique Mark according to the levels of response descriptors in Table B. Other appropriate responses should also be credited.