Stress Management at Bain

Stress Management at Bain
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Agenda Introduction Recommended techniques for managing stress
Overcoming the triggers of performance decline How can Managers “manage” stress? How to screen for an anxiety disorder Key takeaways Additional resources on stress out Appendix: Stress surveys Stress_Management

Introduction This module provides general information only and is not intended as medical or psychological advice or treatment Any ideas, suggestions, and procedures described in this module are not intended as a substitute for consulting with a physician or mental health professional Self-motivated or self-help programs completed in isolation are not the preferred method for dealing with stress or stress-related disorders Better results are achieved when used in combination with a professional Medication is sometimes necessary for optimal results If you are concerned about your health or stress level, contact a medical or mental health professional immediately Stress_Management

Stress management is a key factor of job performance and satisfaction
Performance level Optimal performance zone High Low stress hinders job performance and satisfaction High stress hinders job performance and satisfaction Low Stress level High Source: Yerkes-Dobson curve; industry expert interviews Stress_Management

High-achieving individuals often perform better under elevated levels of stress
Performance level High achiever’s curve High General curve Low Stress level High Source: Yerkes-Dobson curve; industry expert interviews Stress_Management

Managing stress is a four-step process
Identify best techniques for stress management Use techniques to decrease the symptoms of stress Assess current situation Monitor progress Complete the surveys in the Appendix Stressful symptoms Stressful events Responses to stress Use key in Appendix to score and compare Summarize findings Use template on next slide Select best techniques to improve current response to stress Based on current stress symptoms Learn how to perform the technique Understand why various coping techniques can help you manage the symptoms of stress Assess progress after three months of implementing the coping techniques Complete the surveys in the Appendix again Compare results to the original summarized findings Stress_Management

Start by completing the surveys in the Appendix and summarize the scores here
Stress area Current score (totals from p.99) Current level (totals from p.99) Stress symptoms Top three stress symptoms ______________ Overall stress events Top three stressful events areas (highest points) ______________ Response to stress Stress_Management

Determine patterns among stress symptoms by placing them into groups (1 of 2)
Symptom group I felt little enthusiasm for doing my job I felt easily bored I felt tearful or angry I felt moody, irritable, or impatient over small inconveniences I felt physically, emotionally, or spiritually depleted I felt emotionally callous about the problems and needs of others I felt a sense of dissatisfaction, of something wrong or missing I felt helpless or “out of control” I wanted to withdraw from the constant demands on my time and energy I seemed to have more problems with relationships than usual I had more headaches, backaches, or tight muscles than usual I had stomach problems B A and C C A E F Stress_Management

Determine patterns among stress symptoms by placing them into groups (2 of 2)
Symptom group I had trouble falling asleep or slept too much I was less interested in sex than usual I procrastinated more than usual I was more forgetful than usual I had difficulty concentrating I was less decisive than usual I was not as efficient as usual The quality of my work declined My resistance to physical illness was lower Compared to usual, I was: Eating more or less Drinking more caffeine (e.g., coffee, tea, soda) Smoking more cigarettes Using more alcohol G and B A, B, and C A and B A, B, and D A, B, C and D A, B, C and F Stress_Management

Identify best coping techniques for symptom management
Best coping techniques for symptom group Symptom type* General symptom group Aerobic exercise Deep relaxation Abdominal breathing Refuting irrational beliefs A Feelings of fear, anxiety Feelings of powerlessness, lethargy, hopelessness, lack of enthusiasm, depression B Irritability, anger, frustration, resentment, hostility C D Worry, unwanted thoughts Indigestion, irritable bowel, ulcer, chronic constipation E Muscular tension, headaches, neck aches, backaches F G Insomnia, sleeping difficulty Note: Identified using checklist on previous slide Stress_Management

There are four main coping techniques to reduce the symptoms of stress
Aerobic exercise Refuting irrational beliefs Deep relaxation Abdominal breathing Stress_Management

Aerobic exercise is a powerful strategy for managing stress (1 of 2)
What is it? Why can it help you? One of the most powerful and effective methods for reducing and preventing stress and anxiety Natural outlet for your body when it is in a high mode of stress Reduced skeletal tension which is largely responsible for feelings of being tense or uptight More rapid metabolism of excess adrenaline and thyroxin in the bloodstream reducing feelings of stress and sense of impending threat Enhanced oxygenation of the blood and brain which increases alertness and concentration Increased production of endorphins which increase sense of well-being and relaxation Lowered pH of the blood which increases energy level Improved digestion and utilization of food Improved ability to sleep Stress_Management

Aerobic exercise is a powerful strategy for managing stress(2 of 2)
How to do it? How to optimize the effect of the technique? Ensure it is medically safe to start an exercise program See a physician if needed Understand any medical conditions to accommodate Know appropriate limits due to your current fitness level Choose a fitness program that matches your objectives Get started Approach exercise gradually (e.g., 10 minutes every other day for the first week and then add 5 minutes per week) Commit to a one month trial period as benefits may not be apparent immediately Quality/type Aerobic Intensity At least 10 minutes at target heart rate –> (.75) x (220 – your age) Frequency 4-5 times per week Duration 20-30 minutes per session Stress_Management

Deep relaxation is frequently used by sports psychologists with top athletes (1 of 3)
What is it? Why can it help you? The foundation for effectively managing stress and decreasing anxiety Enables you to achieve a very deep state of relaxation Is more powerful and long lasting than typical forms of relaxation Based on the principle that muscles can become deeply relaxed by first tensing them for a few seconds and then releasing them Offers a distinct physiological state that is directly opposed to and incompatible with the way bodies react during stress by Decreasing heart, respiration, and metabolic rate Decreasing blood pressure and oxygen consumption Decreasing skeletal muscle tension Empirical research shows that regular use of deep relaxation techniques achieves the following: Increases energy level and productivity Improves concentration and memory Reduces insomnia and fatigue Prevents and reduces headaches and ulcers Stress_Management

How to optimize the effect of the technique?
Deep relaxation is frequently used by sports psychologists with top athletes (2 of 3) How to do it? How to optimize the effect of the technique? Learn the technique Tense and release each major muscle group and then repeat specific areas as needed/desired When tensing a muscle group Hold the muscles for 7-10 seconds Hold the muscles vigorously (but without straining) Focus only on tensing the muscles in that group When releasing a muscle group Release abruptly then Enjoy the relaxation for at least 20 seconds before moving on to the next muscle group (do not rush through the exercise) Quality/type Deep Intensity Relaxed Frequency 4-5 times per week Duration 15-20 minutes per session Stress_Management

Deep relaxation: specific exercises (3 of 3)
Hands: make a fist (in each hands) Biceps: “make a muscle” (in each arm) Triceps: extend arms out straight and lock elbows Forehead: raise eyebrows as far as possible Eyes: tightly close eyelids Jaw: open mouth as wide as possible Neck: gently pull neck as if trying to touch head to back Shoulders: raise shoulders up towards ears Shoulder blades: push shoulder blades towards each other Chest: take in a very deep breath Stomach: suck your stomach in Lower back: arch back upwards Buttocks: pull buttocks together Thighs: squeeze thighs all the way down to knees Calves: pull toes towards self Feet: curl toes Stress_Management

Abdominal breathing significantly reduces tension and stress (1 of 2)
What is it? Why can it help you? Breathing directly reflects and impacts the level of tension in the body When tense, people breathe more rapidly and shallowly (from the chest) When relaxed, people breathe more slowly and deeply (from the abdomen) Increases oxygenation to the brain and the musculature system Improves concentration Stimulates the parasympathetic nervous system Counteracts the sympathetic nervous system (the system which produces sense of heightened arousal and stress) Promotes a sense of calmness Stress_Management

Abdominal breathing significantly reduces tension and stress (2 of 2)
How to do it? How to optimize the effect of the technique? Learn the technique Place one hand on abdomen exactly beneath rib cage Inhale through your nose slowly (count to four) and deeply Pause for a moment (count to two) Exhale through your mouth or nose slowly (count to four) and deeply If doing the technique correctly Your hand will rise and Your chest will move only slightly as abdomen expands Strive to complete three sets of 10 breaths Quality/type Deep and regular Intensity Relaxed Frequency 5-7 times per week Duration 5 minutes per session Stress_Management

Refuting irrational beliefs targets the emotional underpinnings of stress (1 of 2)
What is it? Why can it help you? Identifying and systematically challenging the beliefs underlying the emotional response to stress Thoughts and beliefs underlying feelings of stress and anxiety are often irrational Usually feels like the truth or reality, but it is often not the truth What individuals believe about a situation strongly influences how individuals feel about it It is possible to change the way an individual feels about a situation by refuting the beliefs causing the emotion Stress_Management

Refuting irrational beliefs targets the emotional underpinnings of stress (2 of 2)
How to do it? Learn the technique Identify the belief underlying the emotion Ask self series of challenging questions Examples of questions often used to refute irrational beliefs What is the evidence for this belief? Is it always true? When has it been true in the past? What is the probability of this being true? If this were true, what is the very worst that could happen? What are the chances of that happening? Why would it be so bad? How would you respond if it did happen? Are you looking at the whole picture? Are you being fully objective? Stress_Management

Certain factors can exacerbate stress and trigger performance decline
High tendency to ignore signs of stress High need for approval High need for control High tendency towards perfectionism Factors that can trigger performance decline Stress_Management

High tendency to ignore signs of stress High need for approval Factors that can trigger performance decline Stress_Management

Overview of high need for approval
Characteristics of factor Impact of factor on stress levels People with a high need for approval are almost always looking for external validation from other people In trying to be generally pleasing, people with a high need for approval may accommodate themselves so well to others’ expectations that they ignore their own needs and feelings Creates a strong feeling of being unacceptable/ unworthy when performance declines Makes it to difficult to push back on others’ demands/expectations when needed Promotes frustration, resentment, and insecurity Stress_Management

Downside of high need of approval
Often generates a strong feeling of being unacceptable/unworthy “At work, I feel like I can never show any weakness or ask for help. If people knew how how much help I need, they would think I don’t belong here.”-AC “I often feel like I don’t belong here and work really hard to prove to myself that it isn’t true.”-Consultant Often leads to difficulty in saying “no” to others’ demands and expectations “It takes a lot of confidence to push back on the client and your manager, even when you know you need to.”-Consultant “Sometimes I think the partners feel they need to give clients the moon and then push the team to deliver.”-Manager Can result in withheld frustration and resentment “I’m tired of giving everything I’ve got. At this point, I don’t even care about the perks that come in the SAC year. The way I see it, it is too little too late.”-AC Stress_Management

Recommendations: dealing with a high need for approval
Develop a realistic view of others’ approval Be objective with criticism Learn to prioritize your own needs alongside those of others Stress_Management

How to develop realistic view of others’ approval
Current view Recommended view Believing others’ approval affects your self-worth “No matter what I do, I just can’t please my manager. I am becoming so insecure.”-Consultant Letting go of the belief that your self worth is determined by others’ approval Believe in and respect yourself Know that what other people think has little to do with who you actually are Believing if someone doesn’t act positively towards you (e.g., is hostile, brusque, condescending), it is because you did something wrong “It’s the way our manager interacts with us. I always feel like the work we produce is no good.”-Consultant Overcoming the belief that others’ negative interactions with you are your fault People often express negative feelings and viewpoints that have little to do with the people around them, but, instead, are due to their own problems, frustrations, and/or fatigue Believing everyone should like you “It just kills me that my consultant doesn’t like me. He treats me like nothing more than his employee.”-AC Letting go of belief that everyone should like you There will always be people who do not like you no matter what you do The process by which people are attracted/repelled is often irrational Stress_Management

How to be objective with criticism
Take action and keep perspective Determine validity Ask for details Evaluate source Does she/he know enough about you, the subject matter, and your skills to make a reasonable assessment? Does the person have a bias making objectivity impossible? Is this person speaking emotionally or rationally? Don’t accept blanket statements such as, “This was unacceptable” or “You did a lousy job on that” Ask for clarity on the specific behaviors/ issues/instances involved Ask the person’s point of view about what actions you can take to improve Objectively examine the message to ferret out the truth to it Your actions may have been perceived differently than you intended You may need to change your actions to overcome current perceptions Map out a plan of actions to improve Remember the criticism reflects just a few of your behaviors and does not represent your entire being Remember that character and strength arises from overcoming challenges Is this person qualified to criticize you? What exactly is being criticized? Does the criticism have merit? How can I use the criticism to improve? Stress_Management

How to determine if you need to improve your ability to prioritize your needs
Check each of the following statements that generally characterizes your beliefs If someone important to me expects me to do something, I should do it I should not be irritable or unpleasant I shouldn’t do anything to make others angry at me I should keep people important to me happy It’s usually my fault if someone I care about is upset with me My self-esteem comes from helping others solve their problems I tend to overextend myself in taking care of others If necessary, I’ll put my own needs aside in order to preserve my relationship with my significant other Giving is the most important way I have to feel good about myself Fear of someone else’s anger has a lot of influence on what I say or do If you checked three of more of the statements, you will benefit by improving your ability to prioritize you needs alongside those of others Stress_Management

How to improve the prioritization of your needs
Focus on giving at least equal time to your own needs alongside the needs of others “I exercise every morning. This is my time and I am quite adamant about it. I can’t give effectively to others without taking this time for myself.”-Manager Learn to set limits on how much you do or how much you will tolerate “Unless there is an absolute emergency, I do not work weekends.” -Consultant Learn to push back and say, “no” when appropriate “I have no problem pushing back on the client for the team’s sake. Even just asking for a day delay on a presentation helps. You would be surprised at how flexible and understanding clients are and what a difference this makes to the team.”-Manager Stress_Management

High tendency towards perfectionism Factors that can trigger performance decline Stress_Management

Overview of high tendency towards perfectionism
Characteristics of factor Impact of factor on stress levels Perfectionists tend to have unrealistically high expectations about oneself, others, and life When outcomes fall short of expectations, perfectionists are highly disappointed and/or critical Tend to be over concerned with small flaws and mistakes in oneself or accomplishments Focus on what is wrong and discount or ignore what is right Pushes individuals forward out of anxiety and fear rather than from healthy pursuit of excellence Increases concern over small flaws and mistakes amplifying anxiety and increasing likelihood of making further errors Promotes low self-esteem Stress_Management

Downside of high tendency towards perfectionism
Common cause of low self-esteem Criticism of every effort convinces perfectionist that nothing is ever good enough Failure to see positives inhibits building of self-confidence Increases anxiety The more perfectionist an individual is, the more likely she or he is to experience anxiety The more anxiety a perfectionist feels, the more likely performance and happiness suffers Can drive a perfectionist to chronic stress, exhaustion, and burnout Constant, high, self-driven performance pressure is exhausting Inability to take a step back and enjoy life prevents individual from rejuvenation Stress_Management

Recommendations: dealing with a high tendency towards perfectionism
Distinguish between perfectionism and a healthy pursuit of excellence Improve current self-view Overcome perfectionist thought patterns Overcome perfectionist perceptions Stress_Management

Healthy pursuit of excellence
There is a difference between perfectionism and a healthy pursuit of excellence Perfectionism Healthy pursuit of excellence Motivated by fear of failure or by a strong sense of duty Strives to be the best Accomplishments (no matter how great) never seem to satisfy or do not satisfy for long Feels self-esteem and love/acceptance from others must be earned Terrified by failure Believes that inability to reach a certain goal means she or he is a failure Believes sharing vulnerable emotions such as insecurity, anger, sadness is not appropriate and makes a person seem weak Motivated by enthusiasm and find process of learning/attaining exhilarating Strives to do his/her best Efforts give a strong sense of satisfaction and accomplishment (even if they are not that great) Enjoys sense of unconditional self-esteem and know that others will accept/love them just as they are Not afraid to fail (even though find it disappointing) Views failure as part of the learning process and see it as an opportunity to grow Not afraid to share vulnerable emotions with others, believes it makes people seem human and facilitates closeness Stress_Management

How to overcome perfectionist self-view
Current self-view Recommended self-view Believing your worth is determined by your achievements “I don’t think I could feel good about myself if I don’t get a good (consensus) review.” –Consultant Letting go of the belief your worth is determined by your achievements and accomplishments “I know the things about myself that matter and nothing a manager can say will change this. -AC Tending to deny self pleasure and fun to pursue external goals “When we have a tight deadline, I stop exercising, spending time with friends. I think all my waking hours should be spent delivering for my manager.” –AC Making sure life is balanced, even when significant external goals appear to conflict “I rarely ever work on weekends and expect my team to take them off as well”–Manager Tending to focus on achievements rather than process “I know the skills and experience I’m gaining are valuable, but honestly all I really want is to do well here and that means getting promoted.”-Consultant Focus and value the process rather than the achievements “I tend not to worry so much about outcome. My approach is to focus on my skills and so I tend to play to my weaknesses. -Manager Stress_Management

How to overcome perfectionist thoughts
Current thoughts Recommended thoughts Thoughts characterized by “shoulds” and “musts” “I should be able to do these blank slides right the first time”-AC Thoughts characterized by self acceptance “I try to do the best I can and not worry about what I think I should do.” -AC Thoughts characterized by “all or nothing” or “black and white” perspective “I can’t do a tight storyline at all. I start with blanks and panic because I know I’ll never get it right.”-Consultant Thoughts characterized by “exceptions” or “shades of gray” perspective “I tend to break things down into small steps and know that eventually I’ll accomplish it all.”-Consultant Thoughts characterized by “overgeneralizations” “My manager criticizes practically everything I do. I go home feeling really badly about myself. It makes me question how smart and capable I am.”-Consultant Thoughts characterized by “exceptions” “When I do poorly at something here, I remind myself that it just means that I did poorly on that task alone…It’s important to keep it in perspective.”-AC Stress_Management

How to overcome perfectionist perceptions
Current perceptions Recommended perceptions Tend to magnify the importance of small errors and discount or ignore positives “Our credibility is shot with the client when we present decks with typos in it.”-Manager “I didn’t learn one valuable thing in my last case.”-AC Put errors in perspective and remember to take into account positives in performance “I try not to call out the small errors that I see like spelling mistakes- even when they are just killing me. I try to save my criticism for areas that will have the most impact.”-Manager Tend to work on goals that are unrealistic “I want to have complete ownership on my workstream by the time I hit the 6 month mark.”-AC “This may not be realistic, but I really do want my manager to review my deck and not find anything wrong with it.”-Consultant Tend to work on goals that are realistic “I set small goals for myself each day so that I can see the progress I’m making.”-AC “I talk with my advisor and team manager about my goals to make sure they’re realistic. I also talk with other people in my class to see what they’re shooting for.”-AC Stress_Management

High need for control Factors that can trigger performance decline Stress_Management

Overview of high need for control
Characteristics of factor Impact of factor on stress levels People who have a high need for control feel very uncomfortable with unpredictable future events People with a high need for control have a constant vigilance that all bases are covered and have difficulty letting go and trusting that the process will lead to an acceptable outcome Creates constant vigilance that all bases are covered preventing best use of available resources Increased concern over ambiguity and unpredictability of performance outcome heightens anxiety/fear and negatively impacts performance Promotes frustration and anger Stress_Management

Downside of high need for control
Future events are generally unpredictable, creating unnecessary stress and anxiety for those uncomfortable with the unknown Focusing on the unknown prevents allocating essential resources to the here and now Having constant vigilance that all bases are covered is not the best uses of available resources Not strategic: allocates resources inefficiently to areas with little impact Emotionally rather than rationally driven: based out of fear rather than logic Stress_Management

Recommendations: dealing with high need for control
Increase acceptance of the unpredictable Cultivate patience Trust that most problems eventually work out to an acceptable conclusion Stress_Management

How to increase acceptance of the unpredictable
Accept as inevitable that you will face many meaningful changes in your life that you are unable to predict or control You can learn to deal with uncertainty now or struggle with it throughout your life There is not one benefit to worrying about things you have no control over; allocate these resources to areas you can impact Accept that very few of us ever feel truly prepared to cope with the big changes that face us It is natural to feel overwhelmed and scared People often find that their response to an outcome is less emotional than anticipated Learn to tolerate ambiguity It is a fact of life and (ironically) is predictable Focus on the fact that the outcome will eventually be known and that when it is you will take steps to deal with it If you still cannot tolerate the unknown Imagine the best-case and worst-case scenarios Assign probabilities to each outcome happening Reality test probabilities to ensure they are not emotion driven (people have a natural tendency to increase the probability of an aversive outcome occurring) Map out ways you will cope with each scenario Stress_Management

How to cultivate patience
People with a high need for control tend to want to have life’s problems solved immediately Not realistic expectations Conflicts with the nature of complex problems (e.g., the ones that stress us the most) Complex problems Tend to require a great deal of time to solve Have many moments of ambiguity Have many interconnected variables where one component cannot be solved until another components is known Stress_Management

How to trust the problems will eventually work out
To trust that problems will eventually work out means that you recognize and accept You will eventually find a solution If you cannot find or impact the solution, you will be able to accept it Look back over your life and inventory of your strengths and coping abilities Thinking through all that you have overcome to get where you are today Acknowledge the skills and fortitude required to get there Recognize that those same resources will get you through most anything you face Note how your strengths and coping abilities have helped you in the past and can continue to generalize to new situations Recognize that just as you developed and gained strengths and coping skills in the past, you will gain new ones as life continues to provide unexpected twists and turns Learn to view the unexpected as a chance to either strengthen current coping abilities or a chance to grow and develop new ones Stress_Management

High tendency to ignore signs of stress Factors that can trigger performance decline Stress_Management

Overview of high tendency to ignore signs of stress
Characteristics of factor Impact of factor on stress levels People who ignore signs of stress tend to “live in their own heads” or take an analytical approach to life and tend to ignore how they feel psychologically and physically People who ignore signs of stress tend to continue to push themselves without taking time to rejuvenate until they reach the point of exhaustion, burnout, or illness Delays response to warning signs of stress hindering ability to prevent stress from accumulating to unhealthy levels Chronic, cumulative stress promotes the possibility of experiencing stress-related mental disorders and physical ailments Stress_Management

Downside of tendency to ignore signs of stress
By not responding to the warning signs of stress and slowing down, an individual significantly increases the likelihood of experiencing chronic, cumulative stress Chronic, cumulative stress taxes the neuroendocrine regulatory system and increases possibility of experiencing Stress-related mental disorders (e.g., Generalized Anxiety Disorder, Panic Attacks, Depression) Stress-related physical disorders (e.g., hypertension, ulcers, headaches) Aversive stress-related physical symptoms (e.g., constant fatigue, nervous stomach, tight muscles, cold hands) Stress_Management

Recommendations: dealing with a tendency to ignore signs of stress
Periodically measure your number of stress symptoms Use the survey in the Appendix Decide not to ignore your stress symptoms, but instead face and overcome them using the techniques presented in this module Stress_Management

Summary of recommendations for dealing with stress
High need for approval High tendency towards perfectionism High need for control High tendency to ignore signs of stress Develop a realistic view of others’ approval Be objective with criticism Learn to prioritize your own needs alongside those of others Distinguish between perfectionism and a healthy pursuit of excellence Improve current self-view Overcome perfectionist thought patterns Overcome perfectionist perceptions Increase acceptance of the unpredictable Cultivate patience Trust that most problems eventually work out to an acceptable conclusion Periodically measure your number of stress symptoms use the survey in the Appendix Decide not to ignore your stress symptoms, but instead face and overcome them using the techniques presented in this module Stress_Management

Managers can help the team mitigate the factors exacerbating stress
Managers can help address all of the factors leading to stress High need for approval High tendency towards perfectionism High need for control High tendency to ignore signs of stress Emphasize belief in the team’s inherent worth Provide clear, frequent feedback Take time to give encouragement and celebrate successes Remind the team of the value their team is providing Help the team keep job demands and expectations in perspective Be open about and comfortable with own mistake with the team Focus on the value and process of skill development Create a collaborative and less hierarchical environment Have individual meetings with team members at start of case to establish shared expectations Always keep team up to date on work plan changes, and client’s and partner’s perspective Model personal management to own stress Frequently check with team about stress levels and stress management Use positive coping techniques with the team Encourage team members to pursue positive coping techniques Stress_Management

Managers can help minimize impact of high need for approval in teams
Emphasize belief in team’s inherent worth Provide clear, frequent feedback Take time to give encouragement and celebrate successes Remind team of the value their work is providing “More than anything, I trust in the inherent intelligence of my team members.” “I treat my team members as colleagues and the atmosphere on my team is collaborative.” “Having confidence in the team. Is one of the most essential things a manager needs to do on a case.” “I know how much ACs and Consultants want our approval, want to know how their doing. So, I make sure I provide lots of feedback even when I’m dead tired.” “Managers always think they’re giving enough feedback, but believe me, most need to at least double it. The few managers that give feedback frequently are the ones everyone wants to work with.” “I make sure the partner leaves a team voic immediately after a big client meeting so that the absent team members can hear the excitement and celebration in the partners voice after a good client meeting.” “I also try to leave personal voic s to highlight the specific accomplishments of each team member.” “I go out of my way to make sure each team member knows the value they are providing.” “Whenever I discuss a team members workstream, I relate every task in terms of the value its bringing the client.” “My manager is terrific about letting me know how valuable my contributions are. It is great having my manager point it out to me.”-AC Stress_Management

Managers can help minimize impact of perfectionism in teams
Help team keep job demands and expectations in perspective Be open about and comfortable with own mistakes with team Focus on the value and process of skill development “One of the most important things a manager can do for the team is to keep this job in perspective. We’re not dealing with life and death situations here.” “I am quite frank with my team regarding how important our work is and I believe it is usually not nearly as big a deal as the team thinks it is. Some managers may think this de-motivates the team, but I find that it takes the pressure off them and helps them perform their best.” “I’m pretty honest about the mistakes I make with the team. I used to worry that the team would lose respect for me if I did this or would let their own standards slip, but I found instead that the opposite happened.” “I try to use humor with my team when talking about a mistake I’ve made. I want them to know that these things happen, that we don’t need to take ourselves so seriously and that the most important thing is to deal with the mistake openly and directly.” “When I give negative feedback to a team member, I emphasize that this is a terrific opportunity for growth and learning. I want them to leave my office feeling accepted and motivated/ capable of improving in this area.” “When a team member falls short of expectations on something, I try to emphasize the value in these set backs and how they are good opportunities to learn. I work hard to ensure that they don’t view the shortcoming as a failure.” Stress_Management

Managers can help minimize impact of need for control in teams
Create a collaborative and less hierarchical environment Have individual meetings with team members at start of case to establish shared expectations Always keep team up to date on work plan changes, client’s and partner’s perspective “I think we’re all doing essentially the same job, but just doing it on a different scale. This attitude helps make the team environment more collaborative.” “If you don’t give intellectual ownership to every team member and make the process collaborative, you’re going to have ‘Sunday night dread’ where your team isn’t excited to come to work Monday morning.” “I find having individual meetings with each team member to talk about what I expect and what they expect is essential. I try to reduce as much fear of the unknown as possible and work to make them feel empowered in dealing with me.” “I always make sure to talk about expectations with each team member at the start of the case. I cover work style, skill plan, personal style; both mine and theirs.” “I make a point to keep team members up to date about what the client and partner wants. This helps them anticipate and adjust to the changing needs and expectations of the case. I also find it helps reduce the stress level on the team as they feel ‘in the know’” “When I sense that we might be changing directions, I give the team as much heads up notice as possible. There is nothing worse than feeling like something has been sprung on you that you didn’t anticipate.” Stress_Management

Managers can help minimize impact of tendency to ignore signs of stress
Model personal management to own stress Frequently check in with team about stress levels and stress management Use positive coping techniques with team Encourage team members to pursue positive coping techniques “I make a point of letting my team know that I take the weekends off and that I expect for them to do the same.” “I often remind the team that I exercise in the mornings to handle stress.” “My team knows I frequently take off in the middle of the day for a quick jog.” “Even when I get good case team scores, I will ask the team about how manageable they’re finding the hours and whether there is anything we can do to improve.” “If I see someone on the team pull long hours, I make a point to swing by their desks and ask if they’re finding it manageable and whether the work load needs to come down.” “After a particularly grueling week, our manager called each person on the team and asked them if they had anything imperative to do with the client on Monday and when we each said, ‘no’, he told us we should take that day off and have fun. We absolutely loved it and felt like he really got how hard we had been working.”-SAC “If I learn about something a team member does to handle stress in a positive way, I try to encourage it. For instance, I had an AC who loved taking a weekly dance class and I made sure she left each week in time to attend it.” “I’ll sometimes tell a team member to get outside and take a 20 minute walk. This really seems to help them and I think they appreciate it.” Stress_Management

Screening tests overview
The screening tests presented here are not intended to provide a diagnosis for clinical disorders However, the screening tests may help identify anxiety symptoms and determine whether a further evaluation by a medical or mental health professional is necessary As with any other illness, you should see your doctor if you think you might have symptoms of an anxiety disorder Stress_Management

Anxiety disorders sometimes arise from increased stress
Approximately 1 in 15 individuals suffer from an anxiety disorder Anxiety disorders may develop from a complex set of risk factors, including genetics, brain chemistry, personality, and stressful life events Anxiety disorders are highly treatable with therapy, medication, or both Stress_Management

There are six types of anxiety disorder
Generalized Anxiety Disorder Obsessive-Compulsive Disorder Panic Disorder and Agoraphobia Anxiety disorders Post-Traumatic Stress Disorder Specific Phobias Social Anxiety Disorder Stress_Management

Overview of Generalized Anxiety Disorder
Generalized Anxiety Disorder (GAD) GAD is characterized by excessive, unrealistic worry that lasts six months or more In adults, the anxiety may focus on issues such as health, money, or career In addition to chronic worry, GAD symptoms include trembling, muscular aches, insomnia, abdominal upsets, dizziness, and irritability Stress_Management

Self-screen for Generalized Anxiety Disorder
Do you feel quite anxious much of the time but do not have distinct panic attacks, do not have phobias, and do not have specific obsessions or compulsions? Yes___ No___ Scoring key 2. Have you been prone to excessive worry for at least six months? If you answered “yes” to questions #1-3, you may have Generalized Anxiety Disorder If you answered “yes” to question #1, but “no” to questions #2-3, you are experiencing significant anxiety, but it may not be severe enough to qualify for an anxiety disorder Yes___ No___ 3. Has your anxiety and worry been associated with at least three of the following? Yes___ No___ Restlessness or feeling keyed up or on edge Being easily fatigued Difficulty concentrating or mind going blank Irritability Muscle tension Sleep disturbance (difficulty falling asleep, staying asleep, or restless unsatisfying sleep) Stress_Management

Overview of Panic Disorder and Agoraphobia
Individuals suffer severe attacks of panic, which may make them feel like they are having a heart attack or are going crazy for no apparent reason Symptoms include heart palpitations, chest pain or discomfort, sweating, trembling, tingling sensations, feeling of choking, fear of dying, fear of losing control, and feelings of unreality Panic disorder often occurs with agoraphobia, in which people are afraid of having a panic attack in a place from which escape would be difficult, so they avoid these places Stress_Management

Self-screen for Panic Disorder and Agoraphobia
Do you have spontaneous anxiety attacks that come out of the blue? (only answer “yes” if you do not have any specific phobias) Yes___ No___ 2. Have you had at least one such attack in the last month? Yes___ No___ 3. If you had an anxiety attack in the last month, did you worry about having another one? Or did you worry about the implications of your attack for your mental or physical health? Yes___ No___ 4. In your worst experiences of anxiety, did you have more than three of the following symptoms? Yes___ No___ Scoring key Shortness of breath or smothering sensation Dizziness or unsteady feeling Heart palpitations or rapid heartbeat Trembling or shaking Sweating Choking Nausea or abdominal distress Feelings of being detached or out of touch with your body Numbness or tingling sensations Flushes or chills Chest pain or discomfort Fear of dying Fear of going crazy or doing something out of control If your answers were “yes” to questions #1-4, you may have Panic Disorder If your answer was “yes” to #1, but “no” to #4, you may have Limited Symptoms Panic Attacks If you answered “yes” to #5, you may have Agoraphobia 5. Does fear of having panic attacks cause to avoid certain situations? Yes___ No___ Stress_Management

Overview of Post-Traumatic Stress Disorder
Post-Traumatic Stress Disorder (PTSD) PTSD can follow an exposure to a traumatic event such as a sexual or physical assault, witnessing a death, the unexpected death of a loved one, or natural disaster There are three main symptoms associated with PTSD “Reliving" of the traumatic event - such as flashbacks and nightmares Avoidance behaviors - such as avoiding places related to the trauma and emotional numbing (detachment from others) Physiological arousal - such difficulty sleeping, irritability or poor concentration. Stress_Management

Self-screen for Post Traumatic Stress Disorder (1 of 2)
Have you experienced or witnessed a life-threatening event that caused intense fear, helplessness or horror? Do you re-experience the event in at least one of the following ways? Repeated, distressing memories and/or dreams? Acting or feeling as if the event were happening again (flashbacks or a sense of reliving it)? Intense physical and/or emotional distress when you are exposed to things that remind you of the event? Yes___ No___ Yes___ No___ Do you avoid reminders of the event and feel numb, compared to the way you felt before, in at least three of the following ways? Avoiding thoughts, feelings, or conversations about it? Avoiding activities, places, or people who remind you of it? Blanking on important parts of it? Losing interest in significant activities of you life? Feeling detached from other people? Feeling your range of emotions is restricted? Sensing that your future has shrunk (for example, you don't expect to have a career, marriage, children, or a normal life span)? Yes___ No___ Stress_Management

Self-screen for Post Traumatic Stress Disorder (2 of 2)
Are you troubled by at least two of the following? Problems sleeping? Irritability or outbursts of anger? Problems concentrating? Feeling "on guard"? An exaggerated startle response? Yes___ No___ If you answered “yes” to questions #1-#4, you may have Post Traumatic Stress Disorder Scoring key Stress_Management

Overview of Social Anxiety Disorder
Social Anxiety Disorder (SAD) SAD, or Social Phobia, is characterized by extreme anxiety about being judged by others or behaving in a way that might cause embarrassment or ridicule This intense anxiety may lead to avoidance behavior Physical symptoms associated with this disorder include heart palpitations, faintness, blushing and profuse sweating Stress_Management

Self-screen for Social Anxiety Disorder
1. Do you avoid certain situations because you are afraid of being negatively evaluated or embarrassed by other people? Yes___ No___ 2. If you answered “yes” to #1, please check the following situations that you avoid Sitting in any kind of group Giving a talk or presentation to others Parties and social functions Using public restrooms Eating in front of others Writing in front of others Dating Any situation where you might say something foolish Other ______________ Scoring key If your answer was “yes” to questions #1, you may have Social Phobia Your answers to question #2 provide insight into the extent and type of Social Phobia you may be experiencing Stress_Management

Overview of Specific Phobias
People with specific phobias suffer from an intense fear reaction to a specific object or situation (e.g., spiders, heights) The level of fear is usually inappropriate to the situation and is recognized by the sufferer as being irrational This inordinate fear can lead to the avoidance of common, everyday situations Stress_Management

Self-screen for Specific Phobia
Do you fear and avoid any one (or more than one) of the following? Insects or animals (e.g., spiders, bees, snakes, rats, bats, or dogs) Heights Driving Tunnels Bridges Elevators Airplanes (flying) Doctors or dentists Thunder or lightening Water Blood Injections or medical procedures Illness such as heart attacks or cancer Darkness Other _____ 2. Do you have high levels of anxiety usually only when you have to face one of these situations? Scoring key If you checked one or more items in question #1 and answered “yes” to question #2, you may have a Specific Phobia Yes___ No___ Stress_Management

Overview of Obsessive-Compulsive Disorder
Individuals are plagued by persistent, recurring thoughts (obsessions) that reflect exaggerated anxiety or fears Typical obsessions include worry about being contaminated or fears of behaving improperly or acting violently Obsessions may lead an individual to perform a ritual or a routine (compulsion) to relieve the anxiety caused by the obsession Examples of compulsions: washing hands, repeating phrases, hoarding Stress_Management

Self-screen for Obsessive-Compulsive Disorder
Do you have reoccurring, intrusive thoughts of any of the following? Yes___ No___ Hurting or harming someone close to you Being contaminated with dirt or a toxic substance Fearing you forgot to lock your door or turn off an appliance An unpleasant fantasy of catastrophe Other ___________ 2. Do you perform any of the following ritualistic acts to relieve anxiety or irrational fears? Yes___ No___ Scoring key Washing your hands Checking and re-checking things Counting Other ___________ If you answered “yes” to questions #1, but “no” to #2, you may have Obsessive-Compulsive Disorder with Obsessions only If you answered “yes” to question #1 and 2, you may have Obsessive-Compulsive Disorder with Obsessions and Compulsions Stress_Management

Key takeaways The ability to deal with stress and stress-related symptoms is a key driver of individual performance and achievement in any professional environment This tools and techniques for assessing and tackling stress discussed in this module can be effective in reducing the worst effects of stress Learn about them and use them! This module, however, is not intended as a substitute for medical or psychological advice or treatment Seek help from a medical professional if you have any concerns about these issues Stress_Management

Recommended reading for stress and stress related problems and issues (1 of 2)
Anger Management When Anger Hurts: Quieting the Storm Within (McKay, Rogers & McKay, 1989) Assertiveness Training Don’t Say Yes When You Want to Say No (Fensterheim & Baer, 1975) Deep Breathing The Breathing Book (Farhi, 1996) Deep Relaxation Techniques New Directions in Progressive Relaxation Training: A Guidebook for Helping Professional (Bernstein, Borkovec, & Hazlett-Stevens, 2000) Drinking How to Control Your Drinking: A Practical Guide to Responsible Drinking Generalized Anxiety Disorder The Worry Control Workbook (Copeland, 1998) Overcoming Generalized Anxiety Disorder (White, 1998) Mastery of Your Anxiety and Worry (Barlow & Craske, 1992) Panic Disorder and/or Agoraphobia Mastery of Your Anxiety and Panic (Barlow & Craske, 2000) An End to Panic (Zeurcher-White, 1998) Triumph Over Fear (Ross, 1994) Stress_Management

Recommended reading for stress and stress related problems and issues (2 of 2)
Post Traumatic Stress Disorder Coping with Trauma: A Guide to Self-Understanding (Allen, 1999) PTSD: The Victim’s Guide to Healing and Recovery (Flannery, 1995) Specific Phobia Mastery of Your Specific Phobia (Barlow & Craske, 1995) Overcoming Specific Phobia (Bourne, 1998) Social Anxiety (and Social Confidence) The Shyness and Social Phobia Workbook (Martin and Swinson, 2000) Managing Social Anxiety: A Cognitive Behavioral Approach (Hope, Heimberg, Juster, & Turk, 2000) Time Management Time Tactics of Very Successful People (Griessman, 1994) Balancing Acts: Juggling Life, Love, Work, Family, and Recreation (Stautberg & Worthing, 1992) Obsessive Compulsive Disorder The OCD Workbook (Hyman and Pedrick, 1999) Stress_Management

Frequently asked questions about cognitive therapy (1 of 2)
Who should consider cognitive therapy? Anyone who wants to experience significant improvement in symptoms of stress Anyone who wants to perform better under heightened levels of stress Anyone who wants to overcome vulnerability factors to stress Anyone who thinks they may have an anxiety disorder What is cognitive therapy? One of the few forms of psychotherapy that has been scientifically tested and found to be effective in over three hundred clinical trials for many different disorders Focused on the present Problem-solving and results oriented Practical and collaborative How many sessions will I need? Decision is made cooperatively between therapist and patient Therapist usually has a rough idea after one or two sessions regarding how long it might take to reach the goals set in first session Cognitive therapists are often a good choice for tackling stress-related problems Stress_Management

Frequently asked questions about cognitive therapy (2 of 2)
How will I know if the therapy is working? Therapist will have you complete objective tests to track progress towards goals How long will it take before I feel better? Expect to notice a decrease in symptoms within three to four weeks of therapy (if you have completed sessions and assignments) Expect scores on objective tests begin to drop within several weeks How can I find a certified cognitive therapist? Visit the Academy of Cognitive Therapy (ACT) website for referrals across the world: Call The Academy of Cognitive Therapy for referrals across the world at: Cognitive therapists are often a good choice for tackling stress-related problems Stress_Management

Three surveys can help assess the overall levels of stress in our work
Stress assessment surveys Stress symptoms survey Stressful events survey Stressful responses surveys Stress_Management

Stress assessment surveys Stress symptoms survey Stress_Management

Stress symptoms survey (1 of 2)
Evaluate each statement in terms of how often it was true for you in the past six months Never Occasion-ally Some-times Freq-uently Almost always I felt little enthusiasm for doing my job I felt easily bored I felt tearful or angry I felt moody, irritable, or impatient over small inconveniences I felt physically, emotionally, or spiritually depleted I felt emotionally callous about the problems and needs of others I felt a sense of dissatisfaction, of something wrong or missing I felt helpless or “out of control” I wanted to withdraw from the constant demands on my time and energy I seemed to have more problems with relationships than usual I had more headaches, backaches, or tight muscles than usual Stress_Management

Stress symptoms survey (2 of 2)
Evaluate each statement in terms of how often it was true for you in the past six months Never Occasion-ally Some-times Freq-uently Almost always I had stomach problems I had trouble falling asleep or slept too much I was less interested in sex than usual I procrastinated more than usual I was more forgetful than usual I had difficulty concentrating I was less decisive than usual I was not as efficient as usual The quality of my work declined My resistance to physical illness was lower Compared to usual, I was: Eating more or less Drinking more caffeine (e.g., coffee, tea, soda) Smoking more cigarettes Using more alcohol Stress_Management

Stress symptoms scoring key
Write in your score and range Add up your total score by summing the points you circled on slides #86 and #87 Find your relative range (low,medium, high) by comparing your score to those of other individuals in similar jobs Low scores are <20 points Medium scores are points High scores are >40 points Stress_Management

Stress assessment surveys Stressful events survey Stress_Management

Stressful events survey (1 of 4)
Evaluate each statement in terms of how often it was true for you in the past six months Work over-load Never Occasion-ally Some-times Freq-uently Almost always I had unrealistic/tight deadlines I took on new responsibilities without letting go of old ones The size of my workload interfered with how well I did it My job interfered with personal commitments I worked on my own time (e.g., evenings after 8pm, weekends) Work under-load I had too little to do I felt overqualified for the work I did My work was not challenging Most of my work was routine I could have handled more responsibility than what I was given Value of work My work was poorly recognized or appreciated The person I reported to was overly critical of my work I received little positive encouragement My ideas and opinions were not valued I felt unaccepted by my team Stress_Management

Evaluate each statement in terms of how often it was true for you in the past six months Never Occasion-ally Some-times Freq-uently Almost always Merit basis of work I felt little relationship between how I performed and how I was rated I sensed that popularity and politics were more important than performance It was unclear what the person I report to thought of my performance I did not know what I was doing well and what I should do better There was little relationship between how I performed and the feedback I received Control of work I did not feel I could push back on the client or my manager/partner when I needed to I had little influence on the decisions that affected me I did not have anyone in authority I could get help from without adverse consequences My opinions regarding my work plan were not really considered My opinions regarding staffing were not really considered Career progress I felt pessimistic about the number of opportunities for advancement/promotion I felt hindered from progressing in my career more quickly I worried my performance was not as good as my peers I worried my performance was not good enough to stay here another year I worried my performance trajectory was not steep enough to stay here another year Stress_Management

Evaluate each statement in terms of how often it was true for you in the past six months Difficult people Never Occasion-ally Some-times Freq-uently Almost always People I worked with had outbursts of anger People I worked with were hostile, sarcastic, or condescending People I worked with were stubborn or argumentative People I worked with were critical or judgmental People I worked with did not know how to motivate me Conflict I could not get what I needed in order to get my job done efficiently There were disagreements with my team or client map(s) I felt caught in the middle with team members or client map(s) I was expected to satisfy conflicting needs among people at work I was expected to satisfy conflicting needs between work and home life Isolation I experienced little meaning in my work I did not have the support I needed/wanted from my colleagues I felt alone/isolated I did not feel I could ask for help/show weakness with anyone at work My values seemed different from my colleagues Stress_Management

Evaluate each statement in terms of how often it was true for you in the past six months Never Occasion-ally Some-times Freq-uently Almost always Environment I experienced traffic/flight delays in getting where I needed to go My workspace environment made it difficult to concentrate on my work My workspace environment lacked the privacy needed to do my work My workspace environment lacked enough space to do my work I had too little or too much contact with people than what I usually like Information My supervisor was not clear about my desired output I did not understand the criteria used to evaluate my performance I was unsure about my roles/responsibilities on my team I did not have enough information from team members to complete tasks optimally I did not have enough information from the client to complete tasks optimally Stress_Management

Stressful events scoring key (1 of 2)
Find your total stressful events score by Entering the subtotals for each stressful events category on the next slide by summating across the points you circled on slides #90-93 Adding up the subtotals entered on the next slide Find your total stressful events range (low,medium, high) by comparing your total score to the scores of other individuals in similar jobs presented on the next slide Stress_Management

Stressful events scoring key (2 of 2)
Write in your score Write in your range Work over-load Work under-load Value of work Merit basis of work Control of work Career progress Conflict Isolation Environment Information Find your relative range (low,medium, high) by comparing your score to those of other individuals in similar jobs Low scores are <40 points Medium scores are points High scores are >80 points Your total score Stress_Management

Stress assessment surveys Stressful responses survey Stress_Management

Stressful responses survey (1 of 2)
Evaluate each statement in terms of how often it was true for you in the past six months Never Almost always Freq-uently Occasion-ally Some-times I ignored how I felt and worked harder I sought out friends for conversation and support I ignored the problem until it went away I engaged in some sort of physical exercise I found that I took my frustrations out on those around me I used relaxation techniques or self-hypnosis I smoked or ate to make myself feel better I identified my source of stress and worked to change it I withdrew emotionally and went through the motions of my day I found a way to change my outlook on the problem I slept more than I really needed to Stress_Management

Stressful responses survey (2 of 2)
Evaluate each statement in terms of how often it was true for you in the past six months Never Almost always Freq-uently Occasion-ally Some-times I reminded myself to focus on the process of what I was doing and not the end result I told myself I should be able to figure it out I took some time off and really got away from my working life I bought something to make myself feel better I joked with friends and used humor to put my problem in perspective I drank alcohol to relax I got involved in an activity that makes me unwind and have fun I took medicine to relax or sleep better I prayed, meditated or enhanced my spiritual life I reminded myself that I am only as good as my last result I focused on things I could control and accepted things I couldn’t Stress_Management

Stressful responses scoring key
Scoring key steps Write in your scores/ranges Add up responses to odd numbered statements on slide #97 and #98 (negative coping responses) Add up responses to even numbered statements on slide #97 and #98 (positive coping responses) Add together odd and even numbered statements taking into account negative and positive signs of total values (this is your total coping score) Find your coping range (low, medium, high) by comparing your score to scores of other individuals in similar jobs Low scores are <-5 points Medium scores are –5 to 0 points High scores are >0 points Stress_Management

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