Stress Evaluation and Intervention Proposal

Stress Management

Stress Evaluation and Intervention Proposal

Stress Management in Public Safety Organizations

Public safety organizations are one of the most important components of any society as they are responsible to provide support and assistance to the community in times of crisis. The employees of such organization however are always exposed to stressful situations and they need to be mentally and emotionally strong to take the challenge, deal with it and help other dependents out of it. This is of great concern for public administration authorities as constant exposure to stressful situations leads to development of some kind of psychological disorder among the employees. This paper aims at evaluating how stressful conditions can be identified, evaluated and intervened so as to provide a coping strategy to deal with a stressor. The paper evaluates various literature pieces that are available in the relevant field of study and also analyzes stress management models that are developed by various psychologists. The paper further evaluates the scope and limitations of those models and theories and then proposes relevant evaluation and intervention strategies in light of the theories.

Stress Evaluation and Intervention: A Theoretical Overview

Evaluating stress and developing interventions to prevent or decrease its psychological impact to the individual requires an understanding of the identified origin and processes affecting the onset and prevalence of stress in a person. To identify the origin, nature and dynamics of stress and its theoretical foundations must be identified and carefully evaluated. This will provide the researcher sufficient information to determine which theoretical concepts; models and frameworks would be most appropriate or illustrative of the research case that s/he would like to pursue. In this section, theoretical frameworks that will be reviewed are the primary models and concepts from which stress theory emerged: (1) Hans Selye's systemic stress theory; and (2) Richard Lazarus' psychological stress theory (also called Lazarus theory). Both theoretical frameworks have influenced contemporary stress research; however, each theory has its own merits and weaknesses. Selye's systemic stress theory is well-known for setting the foundations of stress theory development, thus providing a technical construct and process to a socio-psychological phenomenon commonly experienced by individuals. However, literature on the topic has yet to identify this phenomenon as psychological stress. Lazarus' take on stress as having a psychological dimension, however, revolutionized the way stress is conceptualized and operationalized in research studies. His focus on the 'filtering process' or appraisal of stress experienced from external factors distinguished and elevated Lazarus' theory from Selye's framework. Selye's concept of stress is framed from the "response pattern" identified as "General Adaptation Syndrome," or GAS (Krohne, 2002:2). Under the GAS framework, stress is said to undergo three (3) critical stages, namely: (1) alarm reaction, (2) stage of resistance, and (3) stage of exhaustion. At the first stage, alarm reaction, a response to external stimuli is communicated from the body to the brain, wherein a corresponding response will be developed. This is the onset of second stage, wherein the response would be that of resistance or defense to the external stimuli. Critical at this stage was Selye's recognition that "while resistance to the noxious stimulation increases, resistance to other kinds of stressors decreases at the same time" (ibid.). Thus, at the stage of exhaustion, the individual experiences stress, wherein resistance is further decreased and no longer becomes possible, at which point, according to Selye, "the organism dies" (ibid.).

In a new stress theoretical model by Ursin and Eriksen (2004), called the Cognitive Activation Theory of Stress (CATS), the authors adapted components from Selye's theoretical framework to posit that stress could actually lead to "illness and disease through established patho-physiological processes" (567). Ultimately, CATS demonstrates how illness and disease developing from stress, as illustrated similarly from Selye's framework. Unlike Selye's thesis, however, Ursin and Eriksen argued that illness and disease could possibly develop from stress, a popular relationship developed from research studies, but is not theoretically and empirically demonstrated in research studies.

Lazarus' theory of psychological stress, meanwhile, provided a different dimension to the concept of stress, positing that stress is more than just an action-reaction process between the individual and his/her external environment . For Lazarus, stress is a transactional relationship between the individual and his/her external environment: "psychological stress refers to a relationship with the environment that the person appraises as significant for his or her well being…" (Krohne, 2002:3). The process of appraisal is critical in Lazarus' psychological stress framework, as this is the differentiating factor between his and Selye's theories. Under the appraisal process, the individual undergoes two phases of appraisal processes: primary and secondary. Ultimately, these appraisal processes act as filters that help determine the individual identify what kind of stress an "episode" is: harm, threat, or challenge (4). Furthering his study on stress, Lazarus also determined that individuals develop coping mechanisms as their defense against an identified harm, threat or challenge.

Lazarus' psychological stress theory has been truly instrumental in developing stress research and is almost always incorporated in new theoretical frameworks about stress. Even Ursin and Eriksen's CATS theory adapts from both Selye and Lazarus, although CATS also puts heavy emphasis on the appraisal stage, reflecting Lazarus' influence in the CATS model.

Similarly, the Cybernetic Model of Stress in organizations demonstrate the role that appraisal plays in determining the kind of level of stress experienced by an employee/member of an organization. Under this model, the appraisal stage is further elaborated and contextualized in the organizational development context to ultimately determine the wellness of employees' well-being within an organization (Edwards, 1992:248).

To further understand the concepts stress evaluation and intervention, it is critical to uncover other perspectives, dimensions, concepts and measures surrounding it. Extant literature and research studies on these concepts have focused on different aspects, and this review of related literature will provide a 'quick scan' of the kind of studies and dimensions discovered, discussed and analyzed as far as stress evaluation and intervention are concerned.

.Psychological Stress Model

The Psychological Stress Model (PSM) presented in Lemyre's (2009) study was adapted as a classic model for stress research, following the flow of "first generation" stress models, which is in the form of Stimuli-Response or S-R linkage. This model looks at different critical components that causes and influences stress affect: stressor(s), coping strategies, social environment, appraisal, stress, and disorder. This linear stress model ultimately shows the linkage between stressors and stress, and determines how stress can actually lead to psychological disorders when it escalates and without intervention (p. 455).

Through the PSM, Lemyre posited that in an individual, 'more stressful life events lead to higher probability of developing an illness the following year' (p. 456). This hypothesis is then supported through the PSM, wherein each component is part of a critical path that ultimately determines the eventual development (or prevention) of stress into a psychological disorder.

Stressors were determined based on the following parameters that describe perceived threat or danger to the individual of an event: severity, mastery, and uncertainty. Using these 3 concepts, the author went developed linkage among these to help understand the nature of stressors in the PSM: stressors considered as highly severe contribute to lesser mastery of events by the individual, which eventually increases the level of uncertainty in him/her, and at this point, the individual now experiences stress based on this transition of threat created by stressor(s) (p. 457).

Further down into the model, stressors are either dealt with through coping strategies and/or the social environment. It is also possible that the individual would eventually become stressed once these stressors set in, and the PSM demonstrates these possible scenarios. That is, the individual can take four routes under this model when confronted with stressors: (i) develop coping strategies to combat these stressors, (ii) generate support from the social environment to deal with these stressors, (iii) generate support by developing coping strategies and turning to one's social network; and (iv) succumbing to stress immediately. The fourth route, in fact, makes it plausible for Lemyre's hypothesis to be proven correctly: indeed, in the event that the stressors lead directly to stress, it is not a remote possibility that the individual will also, almost immediately, succumb to psychological disorder as a result of this stress.

The model also addresses stress evaluation through the appraisal stage, which happens in two (2) stages: the first appraisal is the evaluation component of this stage, wherein the event is understood from the individual's point-of-view. The second appraisal, meanwhile, is the contemplation and development of an appropriate response to the stimulus experienced and upon the individual's analysis of the event and the effect of stressors in it. As explicated earlier, the success of this appraisal could be influenced by the individual's going through the route to developing coping strategies or turning to the social environment for support. However, the PSM also shows that despite effective appraisal, it is still possible that the appraisal conducted will result to stress and eventual development of a psychological disorder. Indeed, Markov's hypothesis holds true, wherein accumulates stressful life events will eventually lead to an illness in the following year.

In the following sections, understanding of the dimensions and measures related to stress evaluation and intervention will be contextualized through the PSM. Further into this proposed study, all dimensions and measures uncovered in the literature review will be assessed and eventually interpreted through this model. That is, for this proposed study, the working theoretical framework and model would be anchored on the basic components and routes illustrated in the Psychological Stress Model.

Stress Evaluation -- Dimensions and Measures. Review of literature on stress evaluation per se yielded different dimensions and measures that attempt to determine this concept quantitatively. Moeini (2008) dimensionalized stress evaluation in terms of self-efficacy, positing that perceived self-efficacy is an indication of one's susceptibility to stress. Moeini's study's hypothesis suggests general self-efficacy and mental health of the individual are the primary determinants of perceived stress by the individual. Further into the study, the author defined self-efficacy as it relates to psychological stress, and developed measures to quantitatively measure these determinants in the study.

In the study, the author found out that and established the inverse relationship between perceived stress and self-efficacy: as perceived stress levels increases, self-efficacy of the individual decreases or lowers (p. 262). Stress evaluation becomes a critical concept at this point, since the study demonstrates how one's self-perception could actually make the difference between succumbing to stress and psychological disorder or not. A perceived stress level, as established in the study, affects the individual's performance in life, and effects of perceived stress in one's self could be detrimental to the everyday functions, activities and interactions of the individual.

Another dimension explored that could influence stress evaluation is in the aspect of effective coping, as explicated in Caserta's (2009) study among the recently bereaved. While this study could explain stress intervention as well, the study is more relevant to the concept of stress evaluation as one of the key findings of the study is that stress among the recently bereaved was prevented through the following factors: experienced generosity, high self-esteem, and perceived support satisfaction (p. 768). These factors affecting the development of stress are considered by the author as coping strategies; however, when applied to the PSM, these factors become more relevant to the social environment and appraisal stage. Findings in this study demonstrated the way social environment functions contributed to the prevention of stress, particularly, how the individual perceives his/her social environment.

The study showed that a social environment conducive to the grieving individual -- that is, perceived generosity of people, strong social support received from his/her social network and high self-esteem resulting from these positive experiences -- lessens the possibility of the individual developing stress or a psychological illness resulting from the death of a loved one.

Stress evaluation, then, is a function of other factors that influence the escalation of the individual towards having a stressful or stress-free life. In both studies, specific factors were identified critical to the determent of stress in an individual: self-efficacy, perceived generosity, support satisfaction, and self-esteem. All these factors are also found at the critical path in the PSM, the stage between stressors and appraisal, since they contribute to the determination of one's response to stressors and susceptibility to experiencing psychological stress. Thus, the achievement of these factors ensures a clear path away from having a stressful life; however, PSM is designed in such a way that it proves that accumulated stress over time eventually results to the development of illness in the individual. This is a challenge that must be established or be given further consideration in the study. Specifically, the researcher will have to evaluate if this component of the PSM will still be retained or another component from another model be used to provide two alternative outcomes to the PSM, not only limiting the result to psychological disorder or illness.

Stress Intervention -- Dimensions and Measures. Stress intervention can still be placed in the PSM between the onset of stressors and appraisal stage, and can be found in either coping strategies or social environment, or both. Literature review on stress intervention showed that most interventions are coping mechanisms developed to either prevent stress or recognize it as an inevitable part of people's lives (Bianchi, 2004, p. 743).

Existing intervention programs to combat or prevent stress can be as highly structured as the 'general therapeutic model' used in the military. This stress intervention program deals with issues of and related to stress through specific techniques, namely: brevity (of the program), immediacy, centrality, expectancy, proximity, and simplicity. All of these dimensions pertain to the program and the individual, and as Potter's (2009) study illustrated, this program adopted by the military have proven to be effective, particularly among personnel deployed or assigned to highly stressful environments.

The general therapeutic model provides a good basis for stress intervention programs, as it consolidates important learning and critical components that intervention programs must essentially have (i.e., minimum basic requirements in an intervention program). In the proposed study, this type of intervention program will be evaluated thoroughly and will be applied in the course of the study's development of recommended intervention programs to be tested, re-modeled or re-programmed, and proposed as another stress intervention program alternative.

Literature Review and Discussion

Discussion

To understand, the effects of stress and the measures, which should be taken to avoid it, the way stress works needs to be understood. Stress is the particular issue in our life, which one has to deal with every single day. In some cases it can serve the purpose of motivation considering there is a constant realization to produce better, however excess of it can lead to many negative effects like sleep deprivation, downward graph in performance, and loss of appetite as well as sudden mood changes. Due to these reasons it has become extremely important for researchers and doctors to determine symptoms of stress visible in every individual that can have a potential exposure to a stressful situation.

For this purpose a literature search was conducted to discover the available information on stress education and evaluation in various aspects of life. The analysis was conducted using two studies. The first study is by Beck (2006) and their colleagues who conducted a survey among various medicine, nursing and pharmacy students. The questionnaire asked the participants to describe their perception about stress and its origins. The results of the study showed that nursing students were facing a greater amount of stress as compared to pharmacy students. Pharmacy students reported stress associated with the amount of class material they have to present. The second and third most common causes of stress emerged from the results of this research were studies and exams and grades respectively.

As there is limited research available on the topic of stress and its evaluation wa second study will also be considered, which was conducted for this case. This study was conducted by Ranelli and their colleagues (1993), this study aimed at discovering how many students and pharmacy, nursing and other social sciences use prescription and non-prescription drugs and supplements to cope with stress. Out of 692 students who participated in the study, 47% admitted that they had used supplements during the past two weeks. The major reasons found to be stress; improper diets and to boost energy. This is a brief account of the presence of stress around us based on two strong studies.

Throughout the twentieth and the twenty first century, stress models have always been used to describe understanding and definitions of stress and to help a great deal in understanding the inter-connectivity of the problem. Similar to Lazarus's and Lemyre's model on stress, there are other available models as well which confer, in some cases the same and in some cases provide a rational representation on stress.

For instance Canon's "fight or flight" model is considered one of the earliest models available on stress. It describes stress in the form of an internal conflict, explaining that once a person's mind is under stress the thinking process in some way gets distorted hence the only choice a person feels is left for the person under stress is to either escape stress or fight it. According to Cannon, stress is the response to various individual stressors that are most normally seen as physiological factors. Another model worth mentioning here is Selye's General Adaption Syndrome model that was designed in 1956. This model describes the process of stress in three stages; the first stage is "alarm," second is "resistance" and the third stage is "exhaustion." These three stages can be described in a condominium. For example, in the first stage stressful situation may arise as a result of any activity that a person may not be used to. The second stage is Resistance in which one tries to deal with and reduce the effects of stress in any way that he/she might come up with an attempt to reverse the effects of the first stage. In the third stage of exhaustion, the person reaches to a limit where he/she is unable to cope with, and is forced to quit sometime (Yoshiuchi.1998).

It is evident from research that situations and circumstances that cause stress in a person's life cause there certain changes to take place in it. Holmes and Rahe's (1967) has discussed this in 'Schedule of Recent Experiences' (SRE), this research provides a long list of possible stress related events which might put huge impact on one's life and cause their lives to undergo certain changes. These events include, jail time, pregnancy, death of a family member, and children moving out. Sometimes minor events can cause stress like "vacations" and "alteration in eating habits." Each of these events hold a score points that shows the impact and to what extent does it affect one's life, especially if it's under stress.

The Stress Appraisal Measure

Much of the available literature on the measurement of appraisal in the process of stress or stressful situations deals with the events of daily life or everyday problems that one comes across with. Lazarus's notes suggest that even though encounters do provide useful information regarding a person's life, it can also serve as a major compromise when it comes to cognitive relational theory. Hence the alternative focus should be on a person's environment and a particular event in their lives, which can be used as a transaction to analyze specific components which can be useful in the assessment and analysis of that particular event and hence further recommendations can be suggested based on the findings. This process is also called the primary and secondary appraisal.