Stress can have a harmful impact on both physical and mental health. Assisting young people to identify causes of stress in their lives is an important part of self-care, as it helps them to understand that their life does not have to be so intense and that they have some agency over changing the issues affecting them.
“If you don't like something, change it. If you can't change it, change your attitude.” - Maya Angelou
“If a problem is fixable, if a situation is such that you can do something about it, then there is no need to worry. If it's not fixable, then there is no help in worrying. There is no benefit in worrying whatsoever.” - Dalai Lama XIV
It may be necessary to take an ‘outside/inside’ approach; using problem-solving to systematically approach external situation and problems in order to reduce stress, while at the same time engaging with the young persons thoughts and feelings to enable them to gain more control over how they respond to external situations. Specialist counselling (e.g. psychologist) may be necessary to assist the young person to change their cognitive or emotional responses to stressful situations.
Education
Whilst stress may be a normal part of life, chronic or persistent stress can negatively impact the mental and physical health of the individual (Davis et al., 2008). It may be useful for a young person to understand that to actively address the stressors in their lives can have a beneficial result on their overall health in both the short and long terms.
Practice
A starting point for assisting a young person to reduce stress is to develop motivation and goals. It may be useful to ask the person to rate their overall stress level on a scale of 1 – 10, or perhaps use this more comprehensive checklist of stress-related symptoms which has a column to record levels after stress-reduction techniques have been tried.
Using the Coping with Stress questionnaire (see links) may be a way to identify the helpful and less-helpful ways the young person already utilises to manage stress. This may elicit information about strengths and resources that can form part of the plan (even numbered items), and identify area where new coping strategies may be beneficial (odd numbered items).
For identifying and responding to problems which may be the cause of stress both CBT and Solutions Focused approach offer systematic processes and techniques which can be utilised by practitioners with young people. Where the stress is arising from interpersonal relationships, the approaches to communication and assertiveness in CBT and DBT could form part of a ‘resource development’ approach to addressing stressors.
B4. Solutions – eliciting, affirming & reinforcing
This strengths-based approach looks for experiences and resources the young person already has and can draw from to address stressors.
C3. Problem-solving and coping skills training
This range of practical elements from CBT guides the problem-solving process in a systematic way. These steps are described and there is a problem-solving worksheet that can be printed and used in collaboration
G6. Interpersonal effectiveness
These interpersonal skills in DBT may be useful where interpersonal conflict is a primary source of stress in their lives.
C2. Assertiveness and communication skills
From CBT these elements are a alternative set of ideas to consider when relationship issues are a major cause of stress.
Where a young person has a pervasively negative or distorted world-view, it may be necessary to seek further assessment and specialist treatment. However, within the therapeutic relationship between a practitioner and a young person, it is possible to provide information about how thoughts can be biased in a way that can cause stress and how they can use CBT skills to reduce the impact of stress, for example, through using evidence to dispute unhelpful thinking.
C4iii. Identify unhelpful thinking styles
This CBT element is supported with printable tools to assist the young person to understand the concept of thinking styles.
C4iv. Use evidence to dispute unhelpful thinking
This idea encourages the young person to ‘think about their thinking’ and take time to analyse the thoughts that are causing stress in their lives.
Thought Defusion is another way to conceptualise the idea of taking space from thoughts and ‘thinking about your thinking’. This ACT approach may be appealing to young people who enjoy metaphors and visual thinking.
Finally, it may be helpful for the young person to have some simple skills to apply in times of stress to potentially prevent escalation. These can be taught and practiced with the practitioner, and then reviewed for effectiveness.
This CBT element provides some of the most basic and practical stress-reduction skills that can be applied almost anywhere, for example, Grounding and Controlled Breathing.
M. Davis, E. Eshelman, & M. McKay. (2008). The Relaxation & Stress Reduction Workbook. Oakland: New Harbinger.
