1. Therapeutic Response to Stressed and Anxious Clients
Chapter 5
Therapeutic Response to Stressed and Anxious Clients

2. Objectives Describe the impact of stress on the body
Identify the four levels of anxiety
Identify signs and symptoms of Eustress and distress for each age group
Identify 3 therapeutic responses for both types of stress for each age group
List a minimum of six ways to decrease stress

3. What is Stress? A nonspecific response to a stressor
Eustress or Distress
Bad versus positive influence, result
Intensity and duration
Cumulative effect

4. Stressors and Stress Stressors
Internal perceptions or external events
Causes autonomic nervous system to respond
Differences among men, women, children; responses to stress, stressors
Vital signs respond and change
Physiological changes to adapt
Hormonal changes for homeostasis

5. Four Stages of Stress Alarm Fight or Flight Exhaustion
Sounds a warning such as pain. Respond with suggestions for coping, such as breathing; distract and engage the client.
Fight or Flight
Sympathetic nervous system; pupils dilate, dry mouth, increase in heart rate and respirations. Do not take anger personally. Sympathize as client may not have a solution or coping mechanisms
Exhaustion
After fight or flight, the body tires, fatigue arises. Do not give verbal instructions, allow the client to rest, write out any instructions/education
Return to Normal
Parasympathetic system establishes body normalization. In a calm soft voice, encourage the client to express their feelings, use eye contact & active listening to help them cope with stress

6. Therapeutic Responses to Stress
Be honest with clients
Offer educational materials
Encourage emotional support
Be a teacher of medical information
Refer to community resources

7. Types of Anxiety: Mild Increases perceptions Helps body to
Think more clearly, more alert
Make wise decisions, judgments
Professional offers details, instructions, choices

8. Types of Anxiety: Moderate
Decreased perception
Focused on one challenge at a time
Decisions, judgments made when faced with stressor at that time
Still alert, able to think clearly
Physiological changes
Professionals focus on one detail, explain what is happening, speak calmly

9. Types of Anxiety: Severe
Inability to focus, indecisive
Inability to concentrate, make decisions
Physiological changes
Behavioral manifestations
Professionals give instructions to family, follow up

10. Types of Anxiety: Panic
Focused on escape
Ineffective communication, incoherent speech
Physiological, behavioral changes
Professionals wait until client is safe to leave

11. Age Groups and Stress INFANTS TODDLERS Totally dependent on others
Focused on eating, sleeping
Sleep becomes coping mechanism
Therapeutic response:
Educate how to meet infant physical needs
Seek community referrals
Require consistency, praise
If stressed as infant exhibits now
Therapeutic response
Modeling for parents
Talk at toddler level
Be honest about procedures, pain

12. Age Groups and Stress Cont’d
SCHOOL AGE
ADOLESCENTS
Stressful transition home to school
May regress to earlier behaviors
Therapeutic response
Prepare child well in advance
Don’t compare siblings, other children
Speak at their level
Be honest
Period of change; child yet adult
Social demands, peer pressure
Therapeutic response
Provide for modesty
Address how procedure affects activity or appearance

13. Age Groups and Stress Cont’d
ADULTS
ELDERLY
Variety of stressors
Empty nest/sandwich syndromes
Therapeutic response
Encourage friends, colleagues to share
Answer questions, educational materials
Encourage to talk about feelings
Retirement, illness, death, loss versus gain
Therapeutic response
Use full name, title
Encourage to talk about accomplishments
Foster self-esteem, dignity, sense of worth

14. Ways to Reduce Stress How can or do clients reduce stress? (p.113)
How do professionals help clients reduce their stress? (p. 115)
This project was funded at $3,000,000 (100% of its total cost) from a grant awarded under the Trade Adjustment Assistance Community College and Career Training Grants, as implemented by the U.S. Department of Labor’s Employment and Training Administration. Rogue Community College is an equal opportunity employer/program. Auxiliary aids and services, alternate form and language services are available to individuals with disabilities and limited English proficiency free of cost upon request.
This work is licensed under a Creative Commons Attribution 4.0 International License.