The Role of OT Intervention in Stress Management of

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The Role of OT Intervention in Stress Management
of Adolescents

• Jenna Yeager, MA, OTR/L
• Towson University

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Adolescent Populations

• Developmental perspective
• Contexts
• the tasks of the current developmental period
• the relevant occupational roles
• the family dynamics

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Developmental issues of adolescents

• Viewed as a time of transition
• Bridge between childhood and adulthood
• Physical and sexual maturity
• Erikson Identity vs Role Confusion
• (Seifert, Hoffnung, Hoffnung, 2000)

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Tasks of adolescence

• New more mature relationships with peers of
  both sexes
• Masculine/feminine role
• Accepting physique using body effectively
• Preparing for an economic career

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Tasks of adolescence, continued

• Achieving emotional independence from parents and
  other adults
• Preparing for marriage/family
• Acquiring morals and ethics for guiding behavior
• Desiring and achieving socially responsible
  behavior

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Stigma of adolescence

• Adolescence is often portrayed as a period of
  stress and turmoil
• This perspective has been the dominant one versus
  viewing the period as a time of potential for
  growth and optimal functioning (Newcomb, 1996)

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Alternative conceptualization

• Adolescence as a time of birth, preparation,
  independence, and evolvement
• Also financial autonomy, identity formulation,
  expanding and deepening relationships, first
  sexual relationship, identification of and first
  steps toward life goals
• (Newcomb, 1996)

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Prevention approach

• Focus on protective, buffering, and resilience
  factors that can assist the adolescent to cope
  with stressors
• (Newcomb, 1996)

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Occupational Therapy

• Concerned with providing skills necessary for
  life occupations in the context of the
  individuals various environmental factors

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Role of OT in stress management

• Teaching coping skills - a psychoeducational
  approach is basis for teaching skills needed for
  coping with life stressors
• May include identifying problem solving
  strategies to deal with stressful situations
• Identifying healthy ways to cope with anxiety -
  such as relaxation, fun activities, ways to
  expend energy
• (Bruce Borg, 1993)

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Unique contribution of OT

• Relating coping to the occupational context
• Use of active learning via meaningful activities
  to gain skills, versus didactic methods
• Focus on stress management as a feature of
  adaptive assumption of life roles
• (Christiansen Baum, 1997)

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Examples of Psychoeducational OT in Stress
Management

• Use of assessment tools to evaluate coping skills
• Education of clients re the mechanics of stress
  and effect on humans
• Identification of stressors and their impact
• Identification of the signs of stress
• Identification and application of strategies to
  manage stress
• Activities designed to practice coping skills
• (Stein Cutler, 1998)

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Therapeutic Strategies

• Healthy routines balance of work, rest and play
• Establish health habits of sleep, exercise, diet
• Identification of support systems
• Identify healthy fun and leisure activities
• Relaxation strategies
• Engage in productive occupations
• Positive avenues for emotional expression

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Cognitive approaches

• Involve reframing or restructuring a problem
• Using self-talk to calm negative emotions
• Assumption of positive and empowering attitude
• (Stein Cutler, 1998)

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Impact on the Family

• 40 of parents studied during a 3 year period
  experienced a decline in psychological
  well-being during their childrens adolescence
  (Dubin, 1994)
• Practitioners must acknowledge and address impact
  on family members

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Role of the family

• Interactive dynamic where the stress of the
  adolescent affects the family and vice versa
• Everyone needs to be educated about the
  developmental tasks, and that adolescent needs to
  achieve autonomy
• Family needs to provide balance of support and
  autonomy
• Communication is essential!

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Respect for increasing autonomy

• Provision for private time and spaces
• Respect for confidentiality, unless safety is
  compromised
• Honoring feelings expressed
• Not allowing retreat

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Role of OT with the Family

• OT or other practitioners must be alert to signs
  among parents and siblings of difficulty coping
• Practitioners may offer suggestions for support
  groups
• Practitioners may offer education specifically
  designed for family members

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Precautions

• Warning signs for more serious pathology must be
  watched for depression, suicidality, eating
  disorders, compulsive behaviors, substance and
  alcohol abuse, rebellious behaviors
• In the case of presence of warning signs
  immediate referral to counseling services

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References Bruce, M. A. (1993). Psychosocial
occupational therapy Frames of reference for
intervention (2nd ed.). Thorofare, NJ
Slack. Christiansen, C. Baum, C. (1997)
Enabling function and well-being (2nd ed.).
Thorofare, NJ Slack. Dubin, M. (1994). How
teens strain the family. Philadelphia
Inquirer. Newcomb, M. (1996). Adolescence
Pathologizing a normal process. Counseling
Psychologist. Seifert, K. L., Hoffnug R. J.,
Hoffnug, M. (2000). Lifespan development (2nd
ed.). New York Houghton. Stein, F. Cutler, S.
K. (1998). Psychosocial occupational therapy A
holistic approach San Diego, CA Singular.