Post on 24-Dec-2015
Relieving Stress Relieving Stress Through Biofeedback Through Biofeedback
TrainingTrainingBarbara Morrell, Ph.D.Barbara Morrell, Ph.D.
Michael Maughan, Ed.D.Michael Maughan, Ed.D.Shannon Coetzee, B.S.Shannon Coetzee, B.S.
Grant GardnerGrant GardnerKarstin Slade, B.S.Karstin Slade, B.S.
Brigham Young UniversityBrigham Young UniversityProvo, UtahProvo, Utah
Presented at the AMCAP Spring ConventionPresented at the AMCAP Spring ConventionSalt Lake City, UtahSalt Lake City, Utah
March 29, 2007March 29, 2007
Brigham Young University Stress Brigham Young University Stress Management and Biofeedback LabManagement and Biofeedback Lab
In operation since 1976In operation since 1976
Integral part of the Counseling and Career Integral part of the Counseling and Career CenterCenter
Utilize EMG, Thermal, GSR, HRV & Utilize EMG, Thermal, GSR, HRV & Respiration modalitiesRespiration modalities
350 students seen in 900 sessions per year350 students seen in 900 sessions per year
Purpose of LabPurpose of Lab To Provide Stress Management/Biofeedback To Provide Stress Management/Biofeedback
training to help students:training to help students:
Better manage school and other stressorsBetter manage school and other stressors
Develop Skills to reduce unwanted tensionDevelop Skills to reduce unwanted tension
Lessen interference of stress/anxiety with Lessen interference of stress/anxiety with school performance & overall wellbeingschool performance & overall wellbeing
To Provide an Adjunct to PsychotherapyTo Provide an Adjunct to Psychotherapy
Lab PersonnelLab Personnel
1 Psychologist Lab Supervisor/Admin1 Psychologist Lab Supervisor/Admin
1 Psychologist doing tx (4 hours/week)1 Psychologist doing tx (4 hours/week)
1 Graduate Assistant Coordinator1 Graduate Assistant Coordinator
2-3 Undergraduate lab assistants2-3 Undergraduate lab assistants
Relaxation Skills TrainingRelaxation Skills Training
Body ScanBody Scan AutogenicsAutogenics Diaphragmatic BreathingDiaphragmatic Breathing Progressive Muscle RelaxationProgressive Muscle Relaxation MeditationMeditation VisualizationVisualization Self-HypnosisSelf-Hypnosis Performance RehearsalPerformance Rehearsal
Outreach PresentationsOutreach Presentations
Housing—On and Off campusHousing—On and Off campus
Campus classesCampus classes
Workshops offered in Counseling CenterWorkshops offered in Counseling Center
Stress Management Group in Counseling Stress Management Group in Counseling CenterCenter
Health FairsHealth Fairs
Purpose of Research Purpose of Research
To better understand the experience of To better understand the experience of stress of students referred to the labstress of students referred to the lab
To determine the effectiveness of To determine the effectiveness of biofeedback/relaxation trainingbiofeedback/relaxation training
To increase effectiveness of To increase effectiveness of biofeedback/relaxation trainingbiofeedback/relaxation training
Research QuestionsResearch Questions
What subjective level of stress do students What subjective level of stress do students report on the average?report on the average?
What are the major stress symptoms What are the major stress symptoms reported by students?reported by students?
What are students major stresses?What are students major stresses?
What are the major ways students cope What are the major ways students cope with stress?with stress?
Research QuestionsResearch Questions
How effective is biofeedback/stress How effective is biofeedback/stress management training?management training? Pre-/Post- changes in EMG Readings?Pre-/Post- changes in EMG Readings? Pre-/Post- change in Temp Readings?Pre-/Post- change in Temp Readings?
How do student self-reports of level of How do student self-reports of level of stress change pre- and post- session?stress change pre- and post- session?
Does practice between sessions improve Does practice between sessions improve effectiveness of training?effectiveness of training?
Subjective MeasuresSubjective Measures
Student rating of stress for past weekStudent rating of stress for past week Student beginning and ending BF session Student beginning and ending BF session
rating of stress levelrating of stress level Anonymous Student report of how useful, Anonymous Student report of how useful,
relaxing and effective the session wasrelaxing and effective the session was Student report of between-session practiceStudent report of between-session practice
Skill(s) practiced Skill(s) practiced FrequencyFrequency EffectivenessEffectiveness
Objective MeasuresObjective Measures
EMG and Temperature BF ReadingsEMG and Temperature BF Readings
Pre- and Post-treatment readings by Pre- and Post-treatment readings by sessionsession
Change in Post-treatment readings over Change in Post-treatment readings over several sessionsseveral sessions
Preliminary DataPreliminary Data
Data Collected from 09/2006 & 01/2007Data Collected from 09/2006 & 01/2007
Participants: N =158Participants: N =158
BF Sessions: N = 282BF Sessions: N = 282
Range: 1-13 sessionsRange: 1-13 sessions
Modal session #: 1 sessionModal session #: 1 session
Anonymous Satisfaction surveys: N = 177Anonymous Satisfaction surveys: N = 177
Referral Sources to LabReferral Sources to Lab
CounselorReferral
ClassAssignment
Self/Physician/Parent/Other
Percent of Lab Participants by Percent of Lab Participants by Class and GenderClass and Gender
0
5
10
15
20
25
30
Fresh Soph Junior Senior Grad0
10
20
30
40
50
60
70
Male Female
Top Stress Symptoms Endorsed by Top Stress Symptoms Endorsed by Students Referred to LabStudents Referred to Lab
Most Frequently Endorsed Stress Symptoms by Percentage
13%
12%
10%
9%9%
9%
9%
6%
4%
19%Feeling Overwhelmed
Feeling Anxious
Feeling Depressed
Muscle Tension/Pain
Sleep Problems
Headaches
Difficulty Concentrating
Excessive Worry
Fatigue
Others Combined
Top Stressors Endorsed by Top Stressors Endorsed by Students Referred to LabStudents Referred to Lab
Top Stressors by Percentage
15%
12%
11%
11%7%
6%
5%
5%
4%
24%
Homework
Classes/School
Tests
Too much to do
Opposite sex
Lack of sleep
Family
Lack of Money
Inadequacy/Inferiority
Others Combined
Top Coping Strategies EndorsedTop Coping Strategies Endorsed
Top Coping Techniques by Percentage
10%
9%
9%
8%
7%7%6%4%
4%
36%
Relaxation Techniques
Pray
Sleep
Talk to Friends
Ignore/Procrastinate
Talk to Family
Exercise
Relax
Endure
Others Combined
Preliminary ResultsPreliminary Results
Students anonymously reported on average Students anonymously reported on average that their BF sessions were:that their BF sessions were:
Not Informative Not Informative Very Informative Very Informative
0 1 2 3 4 5 6 7 8 0 1 2 3 4 5 6 7 8 99 10 10
Not Relaxing Not Relaxing Very Relaxing Very Relaxing
0 1 2 3 4 5 6 7 8 0 1 2 3 4 5 6 7 8 99 10 10
Not UsefulNot Useful Very Useful Very Useful
0 1 2 3 4 5 6 7 8 0 1 2 3 4 5 6 7 8 99 10 10
Results of Home PracticeResults of Home Practice
Average Usefulness rating of those Average Usefulness rating of those who practiced was who practiced was 6.64 out of 106.64 out of 10
(10 point scale: O = Least useful; 10 = useful)(10 point scale: O = Least useful; 10 = useful)
49% of students reported they 49% of students reported they practiced relaxation techniques practiced relaxation techniques during the previous weekduring the previous week
Self-Report Rating of Stress Self-Report Rating of Stress Pre-and Post-TreatmentPre-and Post-Treatment
Avg Change = 3.555 (10 point scale: 0 = not stressed; 10 = most stressed)Avg Change = 3.555 (10 point scale: 0 = not stressed; 10 = most stressed)
5.92
2.36
0
1
2
3
4
5
6
7
Pre Post
Pre- and Post- Frontal Pre- and Post- Frontal EMG RecordingsEMG Recordings
Ave Change = 2.285Ave Change = 2.285
4.873
2.588
0
1
2
3
4
5
6
Pre Post
EM
G (
mic
roV
olt
s)
Pre- and Post- Hand Temperature Pre- and Post- Hand Temperature RecordingsRecordings
Ave Change = -.573Ave Change = -.573
90.798
91.364
90.5
90.6
90.7
90.8
90.9
91
91.1
91.2
91.3
91.4
91.5
Pre Post
Te
mp
era
ture
(d
eg
ree
s F
)
Preliminary ConclusionsPreliminary Conclusions BF sessions are effective in reducing stress BF sessions are effective in reducing stress
level in the short run based on subjective data level in the short run based on subjective data and EMG/Temp readingsand EMG/Temp readings
Students overwhelmingly report BF sessions to Students overwhelmingly report BF sessions to be helpfulbe helpful
Only half of BF trainees are engaging in home Only half of BF trainees are engaging in home practice of relaxation techniquespractice of relaxation techniques
Those who practice relaxation techniques report Those who practice relaxation techniques report it to be usefulit to be useful
Future InvestigationFuture Investigation
Do Pre-Post EMG/Temp BF readings improve Do Pre-Post EMG/Temp BF readings improve significantly over multiple sessions?significantly over multiple sessions?
Do weekly and pre-session subjective ratings Do weekly and pre-session subjective ratings decrease significantly over multiple sessions?decrease significantly over multiple sessions?
Do Students who practice show significantly Do Students who practice show significantly greater improvement compared to those who greater improvement compared to those who don’t?don’t?
How do therapy clients compare to non-clients?How do therapy clients compare to non-clients?