Post on 06-Mar-2018
Developing Explana.ons the ‘vulnerability -‐ stress’ model (a<er: Zubin & Spring 1977)
Zubin & Spring (1977: 110) suggest that: ‘…as long as the stress induced by challenging events stays below the threshold of vulnerability, the individual… remains well within the limits of normality. When the stress exceeds the threshold, the person is likely to develop a psychopathological episode of some sort… when the stress abates and sinks below the vulnerability threshold, the episode ends.’
John Butler 2014
1. iden.fy examples of stressors & vulnerabili.es
2. iden.fy some posi.ve coping methods / protec.ve factors
3. relate this to the stress vulnerability model and provide an explana.on to the service-‐user and family members
4. op.on: use an analogy to aid explana0on 5. create a sketch with the service-‐user & family, which you can
then give to them – this becomes a ra0onale for ac0on
using the stress vulnerability model
John Butler 2014
voices
anxiety
not geVng enough sleep
debts
exam pressures
lack of support
using an analogy: the stress bucket (based upon: Brabban & Turkington 2002)
signs & symptoms = overflowing
water
vulnerability factors =
the size & strength of the bucket
stress factors
(stress = the level of
water in the bucket)
coping strategies = hole(s) in the
bucket to let out water (lower stress)
John Butler 2014
voices worsen shou.ng
out
sleep problems
anxiety
arguments with brother & sister
mother’s death
being bullied / in.midated
more vulnerable = a shallower bucket
signs & symptoms
vulnerability factors = family history; sensi.ve; solitary
stress factors
a more vulnerable person = a smaller / shallower bucket
John Butler 2014
draw your own stress bucket
signs & symptoms = overflowing
water
write in your stress factors
(stress = the level of
water in the bucket)
Id coping strategies = hole(s) in the bucket
John Butler 2014
value of using the SV model the ‘vulnerability -‐ stress’ model (a<er: Zubin & Spring 1977)
the model generally makes sense to service-‐users and carers and can lead to a common understanding leading to clearer plans and interven.on – a plausible model that assists engagement
the model integrates biological, psychological and social factors
psychosis is viewed as episodic and related to stress
represents a way in which mental health status at a par.cular point in .me may be regarded as a con.nuum applicable to all people (Hayes 2012)
it acknowledges a person’s threshold for coping
John Butler 2014
value of using the SV model the ‘vulnerability -‐ stress’ model (a<er: Zubin & Spring 1977)
offers a framework to build on strengths and increase capacity in managing stress
encourages early detec.on & management
focus upon enhancing coping, minimising less useful ways of coping, and developing protec.ve buffers against stress
encourages hope and op.mism
promotes a reduc.on in the poten.al of relapse
John Butler 2014
Key References Birchwood. M., Hallec, S. & Jackson, C. (1988) Schizophrenia: an integrated
approach to research and treatment. Harlow, Essex: Longman Group UK Ltd. Brabban, A. & Turkington, D. (2002) The Search for Meaning: detec.ng
congruence between life events, underlying schema and psycho.c symptoms. In A.P. Morrison (Ed) A Casebook of Cogni0ve Therapy for Psychosis (Chap 5, p59-‐75). New York: Brunner-‐Routledge
Nuechterlein, K. & Dawson, M. (1984) A Heuris.c Vulnerability / Stress Model of Schizophrenic Episodes. Schizophrenia Bulle0n 10: 300-‐312
Zubin, J. & Spring, B. (1977) Vulnerability: A new view of schizophrenia. Journal of Abnormal Psychology 86: 103-‐126
John Butler 2014