Mind/Body Health

Stress Management

Submitted to Michael Olpin, Ph.D., CHES to partially fulfill the requirements for Health 3200 Methods of Health Education Lucienda Taylor, Major, Health Promotion Weber State University, 2009

Table of Contents
Introduction Overview ...........................................................................................................................4 Focus and Topics ..............................................................................................................6 Unit 1: Stress Management ....................................................................................................7 Unit Goals and Objectives .....................................................................................................8 Lesson Plan I Targeting Stress Recognizing Stressful Situations ............................................................................9 Goal ....................................................................................................................9 Objectives ..........................................................................................................9 Introduction ........................................................................................................9 Activity I (Icebreaker): Identifying Your Stress ................................................9 Activity II: Animal Statues ................................................................................10 Activity III: How Do You React To Stress ........................................................10 Activity IV: Daily Stress Diary..........................................................................11 Evaluation and Summary ...................................................................................11 Lesson I Appendix .............................................................................................12 References ......................................................................................................12 Worksheet 1.1 Are You Stressed Out? Quiz .................................................13 Worksheet 1.2 Coping With Stress (Blank) ...................................................14 Worksheet 1.3 Coping With Stress (Teacher Guide).....................................15 Worksheet 1.4 Daily Stress Diary..................................................................16 Lesson Plan II Personal Stress Management Recognizing the Stress Response............................................................................18 Goal ....................................................................................................................18 Objectives ..........................................................................................................18 Introduction ........................................................................................................18 Activity I (Icebreaker): Top Ten Stressors ........................................................18 Activity II: What Are the Signs of Stress?.........................................................19 Activity III: Deep Breathing ..............................................................................19 Activity IV: Stress Reduction Plan ....................................................................20 Evaluation and Summary ...................................................................................20 Lesson II Appendix ............................................................................................21 References ......................................................................................................21 Worksheet 2.1 Top Stressors .........................................................................22 Worksheet 2.2 Symptoms of Stress ...............................................................23 Worksheet 2.3 What Can Be Done? ..............................................................24 Worksheet 2.4 Contract .................................................................................25

3 Lesson Plan III Targeting Stress Stress Management Activities.................................................................................26 Goals ..................................................................................................................26 Objectives ..........................................................................................................26 Introduction ........................................................................................................26 Activity I (Icebreaker): Balloon Stomping ........................................................26 Activity II: Journal Review ................................................................................27 Activity III: Flowing Comfort ...........................................................................27 Activity IV: Pulling It All Together ...................................................................27 Evaluation and Summary ...................................................................................27 Lesson III Appendix ..........................................................................................28 References ......................................................................................................28 Worksheet 3.1 Flowing Comfort Script .........................................................29 Worksheet 3.2 101 Stress Relievers...............................................................31 Works Cited ...........................................................................................................................32

Introduction
Overview Many define stress as a state of mental or emotional strain or suspense. (The Trustees of Princeton University, 2009) Most people face stressful situations daily. Some may be perceived as good, exciting events that bring joy to our lives. It is this perception that influences how we interpret and react to stressful situations. It is the opinion of the author that how we feel about stress and how we choose to manage it directly affects our emotional, physical and behavioral health. Life can take a toll on an individuals health. Death, chronic disease, divorce, job loss among othersthese are common situations that can bring tremendous stress and distress into ones life. But even daily stressors can be overwhelming and throw life out of balance by affecting psychological and physical health. (American Psychological Association). Increasingly, scientists, health professionals and the like are discovering the mind/body health connection. Mind/body health focuses on the interactions among the brain, mind, body, and behavior and the powerful ways in which emotional, social, and behavioral factors can directly affect health. (National Institutes of Health, 2009) Did you know (Amagada, 2009): * Stress and anxiety is estimated to affect well over 19 million Americans and growing. * 33% of Americans suffer job burnout which is thought to be due to stress at the work place. * The National Institute for Occupational Safety and Health in giving their stress statistics is predicting depression (which is one the many effects of stress) to be a leading cause of absenteeism from the work place. * About 70% of workers are unhappy in their current employment due to work related stress. * Over $290 Billion dollars is spent in the US economy every year relating to compensation claims from on-the-job stress, health insurance, low-productivity and disability. * 66% of Americans would seriously welcome help in dealing with stress in their lives. * Stress is not confined to adults only. More and more children and teenagers are becoming affected by stress every year. * One factor contributing to increasing levels of substance abuse amongst teenagers is related to their perception of their level of stress. Mind/body, and specifically stress management approaches have many benefits and advantages. Most evidence points to the following items retrieved from an article from the National Institute of Complimentary and Alternative Medicine (National Institutes of Health, 2009):

5 * Mechanisms may exist by which the brain and central nervous system influence immune, endocrine, and autonomic functioning, which is known to have an impact on health. * Multi-component mind-body interventions that include some combination of stress management, coping skills training, cognitive-behavioral interventions, and relaxation therapy may be appropriate adjunctive treatments for coronary artery disease and certain pain-related disorders, such as arthritis. * Multimodal mind-body approaches, such as cognitive-behavioral therapy, particularly when combined with an educational/informational component, can be effective adjuncts in the management of a variety of chronic conditions. * An array of mind-body therapies (e.g., imagery, hypnosis, relaxation), when employed pre-surgically, may improve recovery time and reduce pain following surgical procedures. * Neurochemical and anatomical bases may exist for some of the effects of mindbody approaches. In this unit plan, mind/body health with an emphasis on stress management will be explored.

Focus and Topics

There will be three lesson plans that will focus on learning about stress and how we deal with it as individuals. Journaling and practicing relaxation techniques will also be included to give participants alternative methods of dealing with their stress. Each unit will consist of three lesson plans designed for use in a class of approximately 15-20 individuals. Each lesson plan is expected to last 50 minutes. The lesson plans are depicted below in bullets, under each respective unit plan.

Unit Plan
1. Stress Management

Lesson Plan Titles

* Targeting Stress o Identifying Your Stress * Personal Stress Management o Top Stressors o Signs of stress * Stress Management Activities o Laughter best medicine o Guided imagery

Unit I
Stress Management

Grant me the serenity to accept the things I cannot change; courage to change the things I can; and wisdom to know the difference. ~ Reinhold Niebuhr

Unit Goals and Objectives

Main Goal: To help individuals gain a greater understanding of stress, the impact it has on their lives and ways to help manage it. Major Objectives * By the end of the program period, individuals will gain a greater understanding of stress and the role it plays in health and well-being. * By the end of the program period, individuals will believe that they are in control of the stress in their lives. * By the end of the program period, individuals will put a stress management plan into action to control the role stress plays in their lives. Target Audience: All individuals seeking to reduce the role of stress and the affect it has on their quality of life, well-being and happiness.

Lesson Plan I
Targeting Stress
Recognizing Stressful Situations
Goal To help individuals understand stress and the role it plays in health and wellbeing. Objectives * Individuals will identify five positive ways to cope with stress. * Individuals will sense the importance of managing and reducing the amount of stress in their lives. * Individuals will participate in activities designed to recognize stress triggers. Introduction (5 min) Philosophers, theologians, and scientists have divided a person into many different parts in an effort to describe what makes us unique from the rest of the animal kingdom. However, recently the focus has been on how the body works together as one unit. We know that it does not matter where stress starts; it soon spreads to affect all the parts that make up who we are. Physical stressors affect the way we think (our mind) and the way we feel about our self (our soul). The way we feel about our self (for example, feelings of guilt or shame) affects the way we think about our self and impacts on the way our body works (US Army Center for Health Promotion and Preventative Medicine). Stress is any demand positive or negative that affects our bodies or minds. This can be a negative event such as a test, divorce, or illness. It can also be an event that is positive and brings excitement into our lives such as a wedding, a birth, or graduation. Recognizing the things that make us feel stressed is an important part of keeping our stress levels under control. (Amagada, 2009) We cannot nor should we try to eliminate stress from our lives. Without the good stressors in our life, we would be very bored. But watch out because too much stress can leave us feeling burned out and/or ill. (US Army Center for Health Promotion and Preventative Medicine) Activity I (Icebreaker) (10 min): Identifying Your Stress Have the class complete the Are You Stressed Out? Quiz Worksheet 1.1 (Appendix 1) and pick out one area of their lives that where they would like to improve their stress management skills. Write the following on the board: The one area I want to improve is: Have the class discuss results of the quiz and the areas that each individual would like to improve.

10 Activity II (10 min): Animal Statues Instructions: All individuals will sit in a circle. The facilitator asks two individuals to go in to the middle of the circle and act like different animals in different situations. The facilitator chooses instructions that contrast being stressed with being relaxed. * Show us how a cat would feel if a dog was coming close to it. * Show us how a cat would feel lying in the sun. * Show us how a dog would feel getting scratched behind the ears. * Show us how a dog would feel going to the vet. * Show us how a mouse would feel finding a piece of cheese. * Show us how a mouse would feel smelling a cat nearby. * Show us how a monkey would feel swinging in the trees. * Show us how a monkey would feel if the other monkeys had a banana and it didnt. * Show us how a bird would feel flying. * Show us how a bird would feel if a cat was about to pounce on it. * Show us how a squirrel would feel eating a nut. * Show us how a squirrel would feel being chased by a dog. * Show us how a bear would feel as it hunts for food. * Show us how a bear would feel as it is being hunted by a trapper. * Show us how a chicken would feel as it struts around the yard pecking at food. * Show us how a chicken would feel as it is plucked of its feathers and is about to be butchered for its meat. Do animals have feelings like people? What feelings do people have that are the same sorts of feelings animals have? Being afraid? Feeling safe? Being excited or sad? This activity contrasts the effects of stress (eustress & distress) on the body. Provide a short period for questions and/or comments regarding the activity. Activity III (15 min): How do you react to stress? Explain to the class that people respond to stress in many different ways depending on their personalities, life experiences and situations they may face. Some responses may be beneficial because they help us to re-focus our attention on needed tasks or can help us to recognize changes that need to happen in our lives. Some responses may interfere with our ability to make positive changes. Have the class break into teams and hand out the To Avoid/To Do worksheet 1.2 (Appendix 1). Give each team five minutes to brainstorm ways they might respond to a stressful situation. List the answers from worksheet 1.3 (Appendix 1) and take time to discuss and compare with the lists the students have created. Remind students not to become critical or upset with their own lists. You cant change unless you know how.

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Activity IV (5 min): Daily Stress Diary Explain to students that the purpose of a stress diary is to increase ones awareness of the types of stress being faced on a daily basis. Hand out the stress diary (Appendix 1, 1.4). Tell students that for the next few days they will make a note of any and all activities that put a strain on their energy and time, trigger anger or anxiety, or precipitate any negative physical response. On day three of the Unit Plan, students will review the log and identify stressful activities that can be modified or eliminated from their schedules. Tell the students that as they begin to record events, they may notice patterns in which they find themselves becoming more stressed. From this they can begin to take steps to make adjustments to these patterns. Evaluation and Summary (5 min) Provide a short question and answer session. The activities included here have been designed help students recognize stressful situations and learn positive coping mechanisms to deal with them. Ask students to explain what new ways they learned to cope with stress and which negative ones they would like to eliminate. Remind them to use their stress diaries to start assessing their daily patterns.

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Appendix I
References and Resources

References: Amagada, J. (2009, February 28). Stress Statistics - Will You Be Another Stress Statistic? Retrieved November 13, 2009, from Ezine Articles: http://ezinearticles.com/?Stress-Statistics---Will-You-Be-Another-StressStatistic?&id=2049516 Olpin, M., & Hesson, M. (2007). Activities Manual for Stress Management for Life:A research-based experienctal approach. Belmont: Thomson Higher Education. Thomas, T. (2007). Mind/Body Health. Ogden: WSU. US Army Center for Health Promotion and Preventative Medicine. (n.d.). Targeting Healh: Stress Management. Retrieved November 24, 2009, from Targeting Health: Stress Management USACHPPM: http://www.hooah4health.com/toolbox/stress/default.htm

13 Worksheet 1.1

Are You Stressed Out?

Take this quiz* to find out.
Check the box if the statement is true about you.

I often have digestive upsets.

I tend to lose my temper easily. I have trouble sleeping. People say I am a "worry wart." I have difficulty concentrating. I feel tired and drained all the time. I watch a lot of TV. I often get migraines or tension headaches. I feel "blue" and have a hard time getting over it. I am really impatient with other people I feel "burned out." I feel the harder I work, the more behind I get.
* adapted from the American Heart Association. (1993). Common sense about feeling tense. Dallas, TX: Author.

Count the Checks.

If your score is:
0-3 Congratulations! You dont seem to be experiencing many common symptoms of stress. Through Targeting Stress you will discover new ways to maintain your lowstress habits. 4-8 You have quite a few symptoms of stress. Learn how to cope better by participating in Targeting Stress and working through the exciting material that follows. 9-12 The many symptoms you are experiencing may be related to high levels of stress.

14 Worksheet 1.2

Coping with Stress

To Do To Avoid

15 Worksheet 1.3

Coping with Stress

To Do
Physical activity Go for a walk Sleep at least 4 hours while in a field environment and 7-8 hours per night elsewhere Talk with a friend Eat a healthy diet Be assertive Develop a hobby Manage your time Take mini-vacations throughout the day (one-three minute breaks from work to stretch, take a walk, etc.) Take a vacation (also, take a day of leave before and at the end of your vacation) Practice relaxation Have fun

To Avoid
Being a couch potato Yelling at your spouse, family, and friends Sleeping too little or too much

Withdrawing from others Eating too little or too much Being aggressive or passive Working harder, not smarter Letting time manage you Not taking a break throughout the day Eating lunch at your desk Skipping lunch Being a workaholic Not taking time off from work

Dwelling on problems Alcoholic beverages, caffeine, and tobacco

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Lesson Plan II
Personal Stress Management
Recognizing the Stress Response
Goal To help individuals gain a greater understanding of the signs and symptoms of stress. Objectives * Individuals will learn about the stress response and what triggers it. * Individuals will sense the importance of developing stress relief strategies to counteract their stress response triggers. * Individuals will participate in activities designed to help them to control their stress triggers. Introduction (5 min) People react to stress in many different ways. Discovering your personal stressors and having effective ways to combat them are important in the overall management of stress. Not all stress comes from a crisis. Most of us think of stress as a negative experience, but that is not always the case. Eustress (good stress) occurs during exciting periods of our life, such as a marriage or birth of a baby. This type of stress also helps us reach our peak performance. How can we change our perceptions to alleviate some of the stress we feel? By avoiding areas that overstress us, altering our environment to better suit our needs, and learning to accept or adapt to different situations, we can help ourselves stay well and balanced. (Love To Know Corporation, 2008)

Activity I (Icebreaker) (10 min): Top Ten Stressors Have the students write down their top ten stressors on worksheet 2.1 (Appendix 2). Offer some examples such as finances, work hours, conflicts with family members, etc. Next have them rank them with 1 being the most stressful and 10 being the least stressful. Have students pair up and share their stressors. Explain that they may find that the share some stressors. Knowing that we arent alone in how we feel can help us feel better and less stressed.

19 Activity II (10 min): What Are The Signs of Stress? The purpose of this activity is to demonstrate how quickly our emotions can be influenced by seemingly insignificant things in our environment. The facilitator will introduce an irritating influence in the hopes that participants will feel unsettled or uncomfortable. Once the influence stops, ask the participants to focus on how they felt during the exercise. The facilitator will then assist the group in performing calming exercises. At the end of this activity, handout the Stress Symptoms worksheet 2.2 (Appendix 2) and ask the group reflect on the entire experience and discuss the symptoms they experienced during the stress period and later during the breathing exercise. Instructions for the activity are in a step by step nature below: 1. Talk to the group about the effect that stress can have on the mind and body. 2. As you are talking turn on the irritating influence (such as loud, grating music or noises) while continuing to discuss emotional intelligence. The music should be loud enough for everyone to hear but not so loud they cannot hear the facilitator. a. It is critical that the facilitator respond as if the music is not playing (no wincing, twitching, rolling, body stiffening, etc). Note that if someone asks you to stop the music, calmly tell him or her you will stop it in a little while or if asked to turn it down, pretend to do so without truly changing the volume. 3. At the conclusion of the brief discussion on stress affects hand out worksheet 2.2 and discuss the symptoms the group discussed. 4. Move on to the next exercise. Activity III (10 min): Deep Breathing The facilitator asks the individuals to notice how they are breathing and how their bodies feel after the stress experience in the prior exercise. He then has the students focus on their breathing and instructs them as they do so. Ask individuals to do the following while saying silently I amrelaxed: 1. 2. 3. 4. 5. 6. Exhale deeply, contracting the belly. Inhale slowly as you expand the abdomen. Continue inhaling as you expand the chest. Continue inhaling as you raise the shoulders up towards your ears. Hold for a few comfortable seconds Exhale in reverse pattern, slowly. Release shoulders, relax chest, and contract the belly. 7. Repeat.

20 Explain that this exercise will require gentle practice in order that inhalation and exhalation be smooth and balanced. At the end of the exercise ask students how they feel compared to the beginning of the exercise. Ask them where and when else they could use this exercise. Is it helpful? Suggest they try it the next time they are in a stressful situation and feel themselves becoming tense, sad, or angry. Activity IV (10 min): Stress Reduction Plan Discuss how balance is the key to stress management. If we spend too much time at work, our relationships suffer. If we spend too much time in play, work performance will suffer. We have to remain aware of our needs and pay attention to the signs and symptoms are bodies give us as keys to our stress levels. Hand out worksheet 2.3 and 2.4 (Appendix 2) and discuss the activities we can participate in to control stress levels. Challenge the students to pick an activity and set up a plan for stress reducing activities. Have them write a contract to themselves and post it somewhere they will see it daily. Evaluation and Summary (5 min) Provide a short question and answer session. The activities included here have been designed to recognize the signs of stress and a simple activity for combating them. Students should understand and feel that they can control some of the negative effects of stress and set a plan to reduce their personal stressors.

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Appendix II
References and Resources

References:

Love To Know Corporation. (2008, August 27). Stress Management. Retrieved November 13, 2009, from Stress Management Lesson Plans: http://stress.lovetoknow.com/Stress_Management_Lesson_Plans Thomas, T. (2007). Mind/Body Health. Ogden: WSU. US Army Center for Health Promotion and Preventative Medicine. (n.d.). Targeting Healh: Stress Management. Retrieved November 24, 2009, from Targeting Health: Stress Management USACHPPM: http://www.hooah4health.com/toolbox/stress/default.htm

22 Worksheet 2.1

My Top Stressors
Stressor

23 Worksheet 2.2

Stress symptoms: Effects on your body, feelings and behavior

Stress symptoms often mimic symptoms of other problems. You may think illness is to blame for that nagging headache, your frequent forgetfulness or your decreased productivity at work. But the common denominator may be stress. Indeed, stress symptoms can affect your body, your thoughts and feelings, and your behavior. Stress may be affecting your health, and you may not even realize it. Recognize common stress symptoms then take steps to manage them.
Effects of stress ... ... On your body ... On your thoughts and feelings ... On your behavior

Headache Chest pain Pounding heart High blood pressure Shortness of breath Muscle aches Back pain Clenched jaws Tooth grinding Stomach upset Constipation Diarrhea Increased sweating Tiredness Sleep problems Weight gain or loss Sex problems Skin breakouts

Anxiety Restlessness Worrying Irritability Depression Sadness Anger Mood swings Job dissatisfaction Feeling insecure Confusion Burnout Forgetfulness Resentment Guilt Inability to concentrate Seeing only the negatives Limited attention span Crying easily

Overeating Undereating Angry outbursts Drug abuse Excessive drinking Increased smoking Social withdrawal Crying spells Relationship conflicts Decreased productivity Blaming others

24 Worksheet 2.3

What Can Be Done to Reduce Stress.

(From the American Cancer Society)
1. Break down every big job into small components so it doesn't become overwhelming to you. Make a list of the work you want to accomplish each day. Prioritize your list and work on accomplishing the top 3 items. 2. Do neck rolls frequently throughout the day to relieve the stiffness and tightness in neck muscles. Let your shoulders drop. Release the tension. 3. Become more aware of your surroundings. By deliberately slowing down your walk and conversation, you absorb more of your surroundings and reorient yourself to a slower pace. 4. Avoid being a perfectionist. Put your best effort into whatever you are doing; then relax and don't worry about the results. Perfection implies unrealistic expectations. Perfectionists are hard to live with because of the excessive demands they make on themselves and others. 5. Temporarily remove yourself from the situation when problems begin to overwhelm you. Once your mind is rested, you will see solutions. 6. Be assertive. Take action and speak clearly and openly on your ideas and needs.

7. Take time out from your work. Schedule regular vacations and opportunities to get away from it all. Try to plan these in such a way that they are long enough and frequent enough to allow you to relax and change your routine and pace. 8. Exercise regularly and moderately. Research has suggested that those who exercise regularly, i.e., 3 to 4 times a week, tend to live longer and healthier lives than those who do not. Walk, run, bike, play sports. 9. Maintain a reasonable diet. Three meals a day is important for all of us. A number of research studies have suggested that those who have 3 meals a day (especially those who eat breakfast) live longer and healthier lives. Avoid junk food and try to eat a balanced diet. Listen to your body and its reaction to your food intake. If you attend to your body's reactions, you will learn the importance of regular and balanced meals. 10. Develop outside interests and activities. Total involvement in job or home responsibilities can produce total isolation and an obsession with work. Relax on weekends by doing something different from the pattern you have established during the week. 11. Think about something entirely different than work. Close your eyes and visualize an extremely relaxing and peaceful scene. Try to see it as clearly and distinctly as you can in your mind's eye. Color in the trees and the ocean. Focus on color. Let yourself relax. Let the tension slip away. Take a breath--deeply and slowly. 12. Talk it out. When things get to you, find someone you can talk to and confide in. Expressing your feelings has a purpose. It allows you to release the feelings of tension and anger that have built up. Effective communication with others is a key factor in being able to cope with stress. Keep the channels of communication open with those close to you. Learn to talk about your frustrations and thoughts.

25 Worksheet 2.4

Contract with Myself

I want to help myself keep more of a balance in my life. For the next seven days, I will _____________________________________________ each day at _______________________. If I am unable to do it at that
(insert time)

time, I will do it at ______________________. To prevent interruptions,

(insert time)

I will ________________________________________________________ _____________________________________________________________ _____________________________________________________________ Signed: ______________________________ Dated: _______________

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Lesson Plan III

Targeting Stress
Stress Management Activities
Goal To provide students with activities that will help them reduce their stress. Objectives * Individuals will gain a greater understanding of what activities help to lower stress. * Individuals will sense the importance of using stress reduction techniques to improve their well-being. * Individuals will participate in activities designed to help individuals feel the calming affects of stress reduction activities. Introduction (5 min) Stress activities can help us bring balance back into our lives. They are especially helpful when we are having trouble sleeping, feeling irritable or unmotivated, and worrying uncontrollably. (Love To Know Corporation, 2008) During these times, it is important that we focus on ourselves and bring focus and balance back so that we can focus on other responsibilities in our lives. There are many activities, like the deep breathing exercise we experienced in the last lesson, we can do to offset the negative effects of stress. Humor, games, and meditation are good and fun activities. Activity I (Icebreaker) (10 min): Balloon Stomping This activity has been designed to create a fun, relaxed environment conducive to learning and to teach that humor, interaction with others, and exercise can help reduce stress. Instructors will need to blow up small balloons and attach a rubber band to the end prior to beginning the lesson. Have students attach a balloon around one or both ankles. The goal is to stomp on the balloons of the other players while keeping them from stomping on yours. Define an area (boundaries) for the game to take place. When a player loses his balloons, he/she must step out of bounds. Students can introduce themselves as they are eliminated. At the end of the game, ask the students how they are feeling and discuss how humor, interaction with others, and exercise are positive ways to manage stress.

27 Activity II (10 min): Journal Review In the first lesson, we discussed how writing in a journal can help us to see patterns and events that we can now recognize as stressful. Have students discuss the stressful situations and events they discovered were triggers in their life. Ask them if they used tried using new techniques to help manage the stress they were feeling. Have them brainstorm ways of removing these triggers or how to handle them when they occur. Have students offer suggestions to others. Activity III (15 min): Flowing Comfort The purpose of this activity is to provide students with a relaxation exercise that will help them to feel the benefits of proper stress management techniques. The instructor will need a CD player, relaxing music, the Flowing Comfort script (Appendix 3) and yoga mats. Have the students find a place where they can lie down on their backs, fully stretched out. Turn off the lights and have the students do a brief deep breathing exercise to settle down. Start music and begin reading from the script. At the end of the activity, students will be asked to specifically evaluate how they feel about their participation. Activity IV (5 min): Pulling It All Together Have students discuss how they feel after completing the Flowing Comfort activity. Ask if they feel better or worse than before the activity. Discuss how relaxation techniques offer a positive and effective way of managing stress. Ask students why they think these types of activities are beneficial. Explain about the long-term benefits of practicing stress management. Give students 101 Stress Relievers worksheet 3.2 (Appendix 3) and encourage them to remember how they are feeling at the end of the exercise. Evaluation and Summary (5 min): Provide a short question and answer session. The activities included here have been designed as to provide students with the opportunity to feel how effective stress management can be in making them feel good. Discuss the plans they put in to place during the prior lessons and encourage them to continue stress management practices to improve health and well-being.

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Appendix III
References and Resources
References: Engleman, N. (2009). Stress Management. Ogden: Natalie Engleman. Love To Know Corporation. (2008, August 27). Stress Management. Retrieved November 13, 2009, from Stress Management Lesson Plans: http://stress.lovetoknow.com/Stress_Management_Lesson_Plans Olpin, M., & Hesson, M. (2007). Activities Manual for Stress Management for Life:A research-based experienctal approach. Belmont: Thomson Higher Education. Olpin, M., & Hesson, M. (2007). Stress Management For Life. Belmont: Thomson Higher Education.

29 Worksheet 3.1

Flowing Comfort
For the next few minutes, we will do the relaxation exercise called Flowing Comfort. You may want to remove your shoes, jewelry, watch, contact lenses or glasses. As you lie down, your arms should rest comfortably at your sides. Separate your feet and turn them slightly toward the outside. Now, lets begin. Make yourself as comfortable as possible. Gently close your eyes. Take a nice easy deep breath in through your nose and exhale. Again, a deep breath inand exhale. Continue to breathe deeply in and out, keeping your eyes closed. (Long pause) Allow all thoughts of your past and future to just drift away. Bring yourself fully to this moment by focusing on the sound of my voice and your inner experience. I will guide you to place your attention into various parts of your body. If your mind wanders, gently bring it back to the sound of my voice and your inner experience. If you find yourself having difficulty experiencing any sensations, simply allow your awareness to follow the process. Do not try too hard to make this happen. Be playful and gentle with yourself. Continue to breathe evenly and deeply. Bring your awareness down into your feet. Just place your attention on your feet. Begin to notice the sensations of your feet. How do your toes feel? Are they warm or cold? Notice the balls of your feet and the arches. Easily move back and forth from one foot to the other as you passively observe this area of your body. As you are focusing on your feet allow a sensation of comfort to flow through your feet. Just let feelings of comfort, of relaxation and ease flow through your feetMove your attention up into the ankles. Allow the feelings of comfort and relaxation to flow up into your ankles as your attention gently moves up. As you continue breathing deeply, move your attention up into the calves and shins of your legs. Mentally visit each part of this area of your body and notice all the sensations. Passively observe the shins, the front part of each of your lower legs. Slowly move around to the back part, the calves of your legs. Notice any sensations as you passively observe your calves. Slowly move up and down both of your calves. As your attention remains in the lower parts of your legs, let this feeling of comfort and relaxation flow into this part of your legs. Feel the waves of comfort flowing. As you take another deep breath, allow your attention to move into the upper part of your legs. Places your awareness into your thighs and slowly observe your upper legs from your knees up to your hips. Slowly move your attention up and down each of the upper parts of your legsup and downand gently notice any feelings in that area of your body. Notice the flow of relaxation strengthening as it gently moves up into your upper legs, relaxing each part of your legs. Take another nice, deep, comfortable breath. Bring your attention now into the hip and pelvic region of your body. Sense this feeling of flowing comfort and relaxation gently flowing through this area of your body, bringing deep relaxation as it flows. As you continue breathing very deeply and comfortable, move your attention into your torso. Slowly scan this part of your body. Take a moment to view the front part of your body your waistyour abdominal musclesyour backyour shoulders. As your awareness rests on your shoulders, allow the message of comfort to flow up into your shoulders from one to the other. Feel the gentle relaxing comfort flow through your shoulders and notice your shoulders just melting, just relaxing. Just passively observe this part of your

30 body and notice all the sensations. As you do this, allow these feelings of comfort and relaxation to continue flowing through this area of your body bringing deep rest and relaxation. Allow your attention to move into your arms. Sense the waves of relaxation and comfort flowing down each arm beginning at the shoulders and gently moving through your upper arms, your elbows, your lower arms, your wrists, your hands, fingers and thumbs. Notice the sensation of comfort creating a feeling of heaviness in your arms, a feeling of relaxation that is flowing down through your arms. As your breathing continues evenly and deeply, move your attention into your neck and face. Gently focus your attention on your neck. Sense the comfort flowing up through your neck. Let this sensation of rest and relaxation flow into your jaw muscles, into your mouth, your tongue, your lips, all the muscles throughout your face. Picture it circling around and around, through your neck and face, bringing rest and relaxation to the area. With your next deep breath, move your attention now into your right temple just a little above and forward from your right ear. Place your full attention here. And as you are attending to this part of your face, very slowly move across your forehead toward your left temple. As you awareness moves, notice this sensation of comfort and relaxation expanding, spreading to all other parts of your head. Notice that this feeling of comfort is flowing through your entire head, bringing rest and relaxation to all of the muscles in every part of your head. Gentle, flowing rest, relaxation and comfort spreading through your entire head. Now take a moment to send one more wave of comfort and relaxation from the top of your head slowly down through your neck, down through your shoulders, back and torso, down through your hip area. Notice the comfort flowing through your legs, and down into your feet. Every part of your body is bathing in this sensation of pure relaxation and rest. Now, with a nice, deep breath, remind yourself that you can easily return to this very relaxed feeling and bathe in stillness. Completely enjoy this feeling of deep relaxation. Allow yourself to be still and rested(Long pause). We will now prepare to end this session. First take a deep breath in and out, filling your lungs fully and then easily releasing the breath. Gently begin to move your fingers, handsyour armslegs, and feet to revive the muscles. Keeping your eyes closed, turning your head from side to side looking around the room. Gently stretch your whole body by extending your arms. Turn, now, to lie on your side, bring your knees up toward your chest. Very slowly open your eyes and slowly lift yourself up into a sitting position. Remain her for a few moments, enjoying the feelings of relaxation and stillness that you are feeling.

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