Stress Management Group Proposal
Transcript of Stress Management Group Proposal
Running head: STRESS MANAGEMENT STUDENTS 1
Stress Management Group Proposal for Undergraduate & Graduate Students
Keith W. Sun
Regent University
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Stress Management Group Proposal for Undergraduate & Graduate Students
Purpose
This program is designed to function as a short-term therapeutic group environment for
students, both undergraduate- and graduate-level, to learn how to improve stress management.
During this process, students will become self-aware of personal factors that contribute to their
unhealthy levels of stress and/or inability to manage stress effectively.
Population
The group focuses on students at the undergraduate-level or graduate-level, including
both part-time and full-time students. These students may be attending community college,
vocational schools, or universities. The students will include both genders, male and female.
Students will have reached, at minimum, the age of 18 with no maximum age limit. Students
may join on a voluntary basis or be referred from counseling centers on their respective
campuses.
Rationale
Students encounter multiple stressors during their academic years that create challenges
not only to their academic success, but also to their mental health and their ability to cope well
with many dimensions of life, including relationships, spirituality, finances, family, and
vocation. A large proportion of students across the United States confess feeling overwhelmed
and having to endure stress on a regular basis (“1 in 5 undergrads is constantly stressed,” 2008).
The college years, especially, are a time of major adjustment to full adulthood with new
responsibilities and expectations. Given a stressful environment, students make themselves prone
to a variety of mental disorders including depression, anxiety, substance abuse, and eating
disorders (“Stress and the College Student,” n.d.). Common stressors include academic demands,
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financial pressures, decision-making, preparation for life after graduation, distance from home,
and personal identity development (“Stress and the College Student,” n.d.).
This population requires special consideration because of their lack of awareness of
mental health services and their potential precipitation of mental disorders. University students
who struggle with stress utilize counseling services at low rates, after many surveys have
indicated (“1 in 5 undergrads is constantly stressed,” 2008). This strongly indicates many
students whose stress demands remain harmful with inadequate treatment. Also, scientific
evidence strongly links chronic stress with higher risk for mental health problems in the future
(Sanders, 2014). By helping students manage stress to minimal levels, they will maintain
stronger states of mental and emotional health over the course of their lifetime.
Group approach is a much more viable form of treatment than individual for students on
the topic of stress management because of the solidary it provides as well as the possible stress
relief that may come from being surrounded by other students who want the same goal – good
stress management skills. Talking with supportive friends or peers can be extremely beneficial
and conducive to relaxation and greater coping ability (“Managing stress,” n.d.). Also, forming
healthy relationships is key to maintaining healthy stress levels (“Stress and the College
Student,” n.d.). In a group therapy environment, students experiment in initiating and building
healthy relationships while gaining confidence and efficacy in managing stress.
Theoretical Approach
The group leader will use primarily cognitive behavior therapy (CBT) approaches with
students for therapeutic outcomes. A positive and helpful attitude towards self and circumstances
demonstrates decreased stress levels (“Managing stress,” n.d.). Often, negative self-talk distorts a
student’s perception of a life circumstance, promoting a stress reaction (Scott, 2014). By
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addressing those irrational, negative beliefs about oneself and circumstances outside oneself,
students can quickly gain traction in reducing general stress. This CBT technique of positive
self-talk proves useful in many campus stress management groups (“Stress management,” 2007).
In addition, in a group setting that plans to meet for eight weeks at the most, cognitive behavior
therapy functions well as a quick, short-term approach that maximizes benefits and solves
problems (Scott, 2014). When combined with mindfulness and relaxation techniques, CBT
increases its effectiveness in helping stressed students.
Recruitment
Given the group’s target population of university-level students, the recruitment will
primarily take place in university settings. The group leader and assistant leaders will visit
multiple university housing areas to present on the benefits of the group to students, as well as
make presentations at the campus counseling center and for many student organizations who
share interest in promoting stress management for their members. Also, leaders will put up flyers
and posters on bulletin boards in academic buildings where there is high student traffic. Because
most universities have a student services department, the leaders will arrange meetings with
school counselors to discuss potential candidates who may benefit from such a group. In
addition, leaders will provide contact information and informational resources via flyers as well
at the student support services departments.
Outside of the university setting, group leaders also will post flyers at local cafes, public
libraries, and community mental health agencies. Students highly frequent these locales and are
likely to notice information promoting this stress management group.
Screening
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Interested students will fill in two assessment forms to determine level of stress and need
for this group. The first assessment form will be the Holmes-Rahe Stress Inventory (see
Appendix). This form seeks to ascertain what stressors are currently present in a student’s life
(Holmes-Rahe Stress Inventory, n.d.). Examples include death of a close family member, a major
change in financial state, and a change in residence. The second assessment form will be the
College Stress Test (see Appendix). This second form similarly determines what stressors are
present in a student’s life that fit the college lifestyle (College-Stress Test, n.d.). These two
assessments hope to help the group leader(s) to understand the main sources of stress for students
admitted into the group, and to narrow the focus for managing stress to those specific areas.
In addition to the screening forms, the group leader(s) will interview each potential
candidate individually. The interview will consist of informal questions that seek to get to know
the general issue with stress the student candidate is currently undergoing. Also, the interview
will provide an opportunity for the student to ask questions regarding the group, as well as for
him/her to sign a contract of commitment to the group, understanding its duration of time, its
expectations for confidentiality and active participation.
Exclusion criteria for students is as follows: below score of 150 on Holmes-Rahe Stress
Inventory, under 1300 for College Stress Test, and/or leader judgment for incompatibility with
group (e.g. inability to commit to full 8 weeks, unwillingness to abide by group policies, and
mental instability with possible suicidal ideation).
Structure
The group will take place on Thursday evenings from 5:00 PM to 6:30 PM for eight
consecutive weeks. The format for the group will be closed. Once screened, no new members
will join the group until a new group forms after the current one is completed. The size of the
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group will require a minimum of 6 members and not exceed a maximum of 10 members, not
including the group leader(s). Possibilities for the group will be a mental health agency
conference room or office, a church classroom, or a small university classroom, most central to
the current residences of students admitted into group.
Pre and Post Group Meetings
Pre-Group Meetings for group leaders will be scheduled for the preceding Wednesday
evening of each week that the group meets, at the same time of day, 5 PM, for at least an hour, at
the same location for group meetings. These Pre-Group Meetings serve the purpose of preparing
the group leader(s) with understanding of the lesson plan, as well as rehearsing the activities and
potential questions to ask students. In addition, the Pre-Group Meetings assist the group leader(s)
in determining specific leader roles during the group.
Post-Group Meetings for group leaders will be scheduled for Thursdays of each week
that the group meets, from 6:45 PM to 7:30 PM in the evenings. These Post-Group Meetings
serve to have the group leader(s) reflect on the work done during group, and on assessment of
each individual student’s status and progress. Topics for discussion include: areas for
improvement, affirmations, and possible revisions to group curriculum for future groups.
Goals
The group leader(s)’(s) goals for the group are reduction of stress symptoms, increased
self-awareness of students’ sources of stress, and development of stress management skills that
are lacking for each student in specific areas. The group leader will also require students to write
down their own goals as a personal statement to oneself with handwritten signature.
Ground Rules/Norms
1. Students will not talk when someone else is speaking.
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2. All discussion during group meeting will remain confidential, as signed on initial
contract. Confidentiality means students will not divulge names of other participants nor
details of information shared. Students may talk, in a general sense, about they have
learned about themselves.
3. Students will attend meetings on time, and if an emergency occurs, will notify the group
leader(s) at least 24 hours ahead of time.
4. Students are encouraged to speak openly and participate as actively in the discussion and
activities for maximum benefit from the group.
5. Group leaders are not here to solve students’ problems, but are here to empower students
to achieve individualized stress management goals. Group leaders are not experts and
also are learning to improve stress management skills as well.
6. Enjoy the experience, and students are encouraged to keep in contact with leaders and
fellow students throughout the week, and even after the group finish its eight-week
length.
Ethical Issues
Multiple ethical issues exist when the group leaders establish a stress management
therapy group. First, because these students are at least 18 years of age, the group does not
require parental permission for any participation from the students. As legal adults, the
participants are completely within their own rights to sign any contractual policy for the group
proposed. Second, as discussed in the Screening section previously, the group leader will screen
prospective members to make sure they are compatible with the goals of the group and will not
be an impediment to the work of the group process (American Counseling Association, 2014,
A.9.a.). By providing a minimum of criteria for participation in the group, the group leader
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maximizes the therapeutic benefits of the group for all students participating in its process. Third,
in a group counseling setting, confidentiality and informed consent are necessary topics of
discussion for group leaders with group participants. The group leader must explain the
boundaries of confidentiality for the group ahead of time, or by the end of the first session
(American Counseling Association, 2014, B.4.a.). As for informed consent, the group leader
expects to abide fully to federal and state laws in this area (ACA, 2014, B.5.a.). Students have
the right to access current leader notes on their individual file, as well as to expect privacy with
any discussion for group purposes only, unless an emergency situation precludes it (ACA, 2014,
B.7.a.). An emergency situation includes potential harm to oneself or others (ACA, 2014,
B.1.d.). For all other potential ethical dilemmas, the group leader shall refer to the most current
Code of Ethics by the American Counseling Association for guidance.
Multicultural Issues
In a stress management group, a main multicultural issue is the varied cultural
perspectives on expressing symptoms of stress. The issue of self-disclosure about the extent of
stress may differ from a person of one ethnic background to a person of another ethnic
background. The group leader will briefly discuss at the first meeting the need to respect
different cultures in the room and for participants to disclose in the most culturally appropriate
manner.
Recognizing that university settings are highly likely to be composed of many cultural
backgrounds amongst students, the group leader will seek to address each student’s
understanding of reacting to stress from their cultural background. The group leader may ask
each student to explain how people in his/her culture interpret the type of stress the student is
currently undergoing. In addition to ethnic differences, the group leader will also discuss
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international differences, given the scenario of the participation of international students studying
in the U.S. By being upfront about the cultural diversity in the group, student participants will be
more attuned and aware to potential misunderstandings of each other and will be better equipped
to understand themselves and each other.
Other multicultural issues will arise that cannot be foreseen in this proposal but group
leaders are bound to the most contemporary Code of Ethics of the American Counseling
Association and will need to have demonstrated a minimal degree of multicultural competence
before being eligible to lead the group.
Group Leadership
Group leaders must have training in school counseling and experience working with
students at the university level. This provides a threshold level of competence to be necessarily
effective for the therapeutic goals of the group. Characteristics of a qualified group leader
include: 1) empathy, 2) evidence of continued supervision by another counselor, 3) cultural
competence, 4) emotional stamina, and 5) evidence of self-care. The theoretical model for the
stress management group is a cognitive-behavioral approach; therefore, the group leader will
take on an active, directive role with the students as well as provide some psychoeducation on
stress management techniques and skills.
Risks and Benefits
A potential risk in a group setting is that participants will not get the full attention in
individual therapy for their stress concerns, and may perceive their needs as inadequately
addressed in an eight-week long period. Another risk inherent in the group process is the lack of
trust and group chemistry between participants, which may lead to minimal self-disclosure and
minimal therapeutic effect for everyone. A third risk is the chance of inappropriate therapeutic
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theory for certain participants. Not every participant in the group will be receptive and
responsive to the cognitive-behavioral approach. Some resistance can be expected.
Potential benefits include the supportive communal system of students in solidarity over
stress, breakthroughs in therapeutic hindrances through the presence and actions of others, the
equipping of students with applicable stress management skills beyond the academic world, and
the open realization and motivation of students to continue therapy if needed, after group
termination, on an individual basis. Primarily the benefits of the stress management group stem
from the communally supportive atmosphere inherent in its structure.
Evaluation
In order to determine the efficacy of the group, the group leader will disburse an
evaluation form (see Appendix) to group participants at the eighth and final meeting. The
evaluation will focus on a 1-5 scale rating of the group leaders, the effectiveness of presentation
of sessions, personal gain from the group, and comments for constructive feedback. “1” will
represent Poor and “5” will represent Excellent. The form will also include space for details
regarding personal therapeutic benefits from participants. Future group leaders may seek
permission from participants for anonymous disclosure of their success in the group for public
marketing purposes.
Group Sessions
1. Session One
a. Goal – Set group expectations. Introduce the concept and definition of stress, and the
need for stress management.
b. Potential problem – Discomfort with participant disclosure at the first meeting
c. Potential strength – Beginnings of development of trust between participants
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d. Discussion Topics – Definition of stress, definition of stress management
e. Activities/Techniques – Presentation of problem by all participants, Psychoeducation
2. Session Two
a. Goal – Identify sources of stress. Explore the effects of stress.
b. Potential problems – Multicultural differences in stress symptomology
c. Potential strength – Increased self-awareness of the consequences of stress unique to
each participant
d. Activities/Techniques – Presentation of personal sources of stress by all participants,
Psychoeducation
3. Session Three
a. Goal – Introduce the concept of negative self-talk. Explain the connection between
thoughts, feelings, & behaviors according to the cognitive-behavior model.
b. Potential problem – Lack of receptivity to cognitive-behavioral model of therapy
c. Potential strength – Increased rapport between members, Increased self-awareness of
d. Activities/Techniques – Identify automatic thoughts and emotions (Beck, 2011, pgs.
137, 159), Psychoeducation
4. Session Four
a. Goal – Introduce the concept of evaluating and responding to automatic thoughts.
b. Potential problem – Resistance to changing automatic thoughts, Lack of belief in the
need to change thoughts
c. Potential strength – Self-disclosure between members, Possibility of catharsis,
Helpfulness from other students in evaluating thoughts from a third-person
perspective
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d. Activities/Techniques – Asking the evidence question, Asking the “alternative
explanation” question (Beck, 2011, pp. 172-173), Role-play, Homework,
Psychoeducation
5. Session Five
a. Goal – Identify and modify core beliefs.
b. Potential problem – Lack of readiness to go deeper into identity-related beliefs
c. Potential strength – Progress in building positive self-worth
d. Activities/Techniques – Restructuring Early Memories (Beck, 2011, p. 248),
Homework, Psychoeducation
6. Session Six
a. Goal – Begin teaching stress management skills. Teach participants relaxation and
mindfulness techniques.
b. Potential problem – Lack of closure in transition from automatic beliefs to skills
learning
c. Potential strength – Enthusiasm for more behavioral techniques
d. Activities/Techniques – Mindfulness & Relaxation Techniques (Beck, 2011, pp. 263-
264), Homework, Psychoeducation
7. Session Seven
a. Goal – Teach common ways to reduce stress. Help participants to adopt at least one
strategy of reducing stress.
b. Potential problem – Lack of follow-through from participants on stress reduction
strategy
c. Potential strength – Sense of empowerment happens for participants
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d. Activities/Techniques – Psychoeducation, Open Discussion
8. Session Eight
a. Goal – Create effective closure. Summarize group work over the previous sessions.
Inform group about referral resources.
b. Potential problem – Unrealistic expectations for change from one group
c. Potential strength – New lifestyle applications
d. Activities/Techniques – Evaluation form, Feedback
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References
American Counseling Association. (2014) Code of Ethics. Retrieved April 2, 2015 from
http://www.counseling.org
1 in 5 undergrads is constantly stressed. (2008, March 18). Retrieved April 2, 2015, from
http://www.nbcnews.com/id/23693229/ns/health-mental_health/t/undergrads-constantly-
stressed/#.VR2i6GOa-Sq
Beck, J. (2011). Cognitive-Behavior Therapy: Basics & Beyond. New York NY: The Guilford
Press.
College-Stress Test. Retrieved April 2, 2015 from
http://highered.mheducation.com/sites/0073382736/student_view0/health_psychology/
college_stress_test__/index.html
Holmes-Rahe Stress Inventory. Retrieved April 2, 2015 from
http://www.stress.org/holmes-rahe-stress-inventory/
Managing Stress. University Health Center, University of Georgia. Retrieved April 2, 2015, from
https://www.uhs.uga.edu/stress/wellnesslifestyle.html
Sanders, R. (2014, February 11). New evidence that chronic stress predisposes brain to mental
illness. UC Berkeley News Center.
Retrieved from http://newscenter.berkeley.edu/2014/02/11/chronic-stress-predisposes-
brain-to-mental-illness/
Scott, E. (2014, December 4). Cognitive Therapy for Stress Relief. Retrieved April 2, 2015 from
http://stress.about.com/od/professionalhelp/a/cognitive.htm
Stress and the College Student. (2004). Wellness Center, University of Illinois, Chicago.
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Retrieved April 2, 2015 from https://www.uic.edu/depts/wellctr/docs/Stress%20and
%20the%20College%20Student.pdf
Stress management. Cal Poly Student Academic Services. Retrieved April 2, 2015 from
http://sas.calpoly.edu/asc/ssl/stressmanagement.html
Stress management. Counseling & Mental Health Center, The University of Texas at Austin.
(2007). Retrieved April 2, 2015 from
http://cmhc.utexas.edu/clearinghouse/files/TI050.pdf
Appendix
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Evaluation Form
Rate the following on a scale from 1 to 5: 1 – Poor, 2 – Neutral, 3 – Fair, 4 – Good, 5 – Excellent
1. The group leader facilitated the sessions adequately and demonstrated effective
preparation, knowledge, and counseling skill.
1 2 3 4 5
Please comment:
2. The presentation of topics during group was easy to follow and helpful.
1 2 3 4 5
Please comment:
3. I gained a lot of skills in stress management and felt I learned a lot about who I am as a
person
1 2 3 4 5
Please comment:
Share any feedback you would consider helpful for group leaders for future stress management
groups. Comment:
Also, please share your own personal testimony of how this stress management group has been
helpful for you overall. Comment:
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(http://www.stress.org/holmes-rahe-stress-inventory/)
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)
College Stress Test
Please indicate whether you have experienced any of the following events in in the past year by
writing “yes” or “no”
__ Being raped
__ Finding out that you are HIV-positive
__ Being accused of rape
__ Death of a close friend
__ Death of a close family member
__ Contracting a sexually transmitted disease (other than AIDS)
__ Concerns about being pregnant
__ Finals week
__ Concerns about your partner being pregnant
__ Oversleeping for an exam
__ Flunking a class
__ Having a boyfriend or girlfriend cheat on you
__ Ending a steady dating relationship
__ Serious illness in a close friend or family member
__ Financial difficulties
__ Writing a major term paper
__ Being caught cheating on a test
__ Drunk driving
__ Sense of overload in school or work
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__ Two exams in one day
__ Cheating on your boyfriend or girlfriend
__ Getting married
__ Negative consequences of drinking or drug use
__ Depression or crisis in your best friend
__ Difficulties with parents
__ Talking in front of class
__ Lack of sleep
__ Change in housing situation (hassles, moves)
__ Competing or performing in public
__ Getting into a physical fight
__ Difficulties with a roommate
__ Declaring a major or concerns about future plans
__ A class you hate
__ Drinking or use of drugs
__ Confrontations with professors
__ Starting a new semester
__ Going on a first date
__ Registration
__ Maintaining a steady dating relationship
__ Commuting to campus, or work, or both
__ Peer pressures
__ Being away from home for the first time
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__ Getting sick
__ Concerns about your physical appearance
__ Getting straight A’s
__ A difficult class that you love
__ Making new friends: getting along with friends
__ Fraternity or sorority rush
__ Falling asleep in class
__ Attending an athletic event (e.g., football game)
http://highered.mheducation.com/sites/0073382736/student_view0/health_psychology/
college_stress_test__/index.html