Stress Reduction and Prevention Stress Reduction and Prevention Edited by Donald Meichenbaum University of Waterloo Waterloo, Ontario, Canada and Matt E. Jaremko University ofM ississippi University, Mississippi Springer Science+Business Media, LLC Library of Congress Cataloging in Publication Data Main entry under title: Stress reduction and prevention. Bibliography: p. Includes index. 1. Stress (Psychology) I. Meichenbaum, Donald. II. Jaremko, Matt E. [DNLM: 1. Stress, Psychology —Prevention and control. 2. Stress, Psychological —Therapy. WM 172 S9156] BF575.S75S7737 1982 155.9 82-18926 ISBN 978-1-4899-0410-2 ISBN 978-1-4899-0410-2 ISBN 978-1-4899-0408-9 (eBook) DOI 10.1007/978-1-4899-0408-9 First Printing-February 1983 Second Printing-April 1984 Third Printing-March 1989 © Springer Science+Business Media New York 1989 Originally published by Plenum Press, New York in 1989 Softcover reprint of the hardcover 1st edition 1989 All rights reserved No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher To RICHARD S. LAZARUS whose work on stress and coping has influenced much of the research reported in this volume and to my former students and present colleagues ROY CAMERON, MYLES GENEST, and DENNIS TURK whose collaboration and friendship have continually enriched me. D.M. To CHARLES D. SPIELBERGER who was a source of encouragement from the beginning of this project. M.E.J. Contributors FRANK ANDRASIK, Department of Psychology, State University of New York, Albany, New York MARGARET A. APPEL, Department of Psychology, Ohio University, Athens, Ohio OFRA AYALON, Department of Education, University of Haifa, Haifa, Israel ROY CAMERON, Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada THOMAS M. COOK, Program of Social Ecology, University of California at Irvine, Irvine, California SEYMOUR EPSTEIN, Department of Psychology, University of Massachu setts, Amherst, Massachusetts EVA L. FEINDLER, Department of Psychology, Adelphi University, Garden City, New York WILLIAM J. FREMOUW, Department of Psychology, West Virginia Uni versity, Morgantown, West Virginia KENNETH A. HOLROYD, Department of Psychology, Ohio University, Athens, Ohio IRVING L. JANIS, Department of Psychology, Yale University, New Haven, Connecticut vii viii Contributors MATT E. JAREMKO, Depanment of Psychology, University of Missis sippi, University, Mississippi PHILIP C. KENDALL, Depattment of Psychology, University of Minne sota, Minneapolis, Minnesota DEAN G. KILPATRICK, Depanment of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina and People Against Rape, Charleston, South Carolina HOWARD LEVENTHAL, Department of Psychology, University of Wis consin, Madison, Wisconsin DONALD MEICHENBAUM, Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada DAVID R. NERENZ, Depanment of Psychology, University of Wisconsin, Madison, Wisconsin RAYMOND W. NOVACO, Program of Social Ecology, University of Cali fornia at Irvine, Irvine, California ETHEL ROSKIES, Depanment of Psychology, University of Montreal, Montreal, Quebec, Canada IRWIN G. SARASON, Department of Psychology, University of Wash ington, Seattle, Washington LOIS J. VERONEN, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina and People Against Rape, Charleston, South Carolina ROBERT L. WERNICK, Departments of Psychology and Psychiatry, University of Saskatchewan, Saskatoon, Saskatchewan, Canada Preface Since 1950, when Hans Selye first devoted an entire book to the study of stress,professional and public concern with stress has grown tremendous ly. These concerns have contributed to an understanding that has impli cations for both prevention and treatment. The present book is designed to combine these data with the clinical concerns of dealing with stressed populations. In order to bridge the gap between research and practice, contributions are included by major researchers who have been con cerned with the nature of stress and coping and by clinical researchers who have developed stress management and stress prevention programs. The book is divided into three sections. The goal of the first section is to survey the literature on stress and coping and to consider the implica tions for setting up stress prevention and management programs. Follow ing some introductory observations by the editors are the observations of three prominent investigators in the field of stress and coping. Irving JaniS, Seymour Epstein, and Howard Leventhal have conducted seminal studies on the topic of coping with stress. For this book they have each gone beyond their previous writings in proposing models and guidelines for stress prevention and management programs. While each author has tackled his task somewhat differently, a set of common suggestions has emerged. In the second section of the book, a cognitive-behavioral perspective on stress and coping as well as general guidelines for setting up training programs are considered. This section concludes with a description of a cognitive-behavioral stress inoculation training program. Several of the authors in Section III have used this stress inoculation training program in their work. The third section of the book, which is divided into three parts, focuses on specific stress prevention and management programs. The papers in Part A describe programs for a variety of medical problems, ix Preface x including hospitalized patients (Philip Kendall), burn patients (Robert Wernick), patients with psychophysiological disorders (Ken Holroyd, Margaret Appel, and Frank Andrasik), and Type A individuals (Ethel Roskies). Each of these authors provides descriptions of demonstration projects and reports on research in progress. We hope that the descrip tion of these projects will further stimulate research and clinical practice. Part B focuses on the stress related to being a victim. Ofra Ayalon discusses the stress related to being a victim of terrorist attacks in Israel. Lois Veronen and Dean Kilpatrick examine the plight of the female rape victim and what can be done to reduce subsequent stress reactions. Part C considers the application of stress management programs to specific populations. The chapter by Ray Novaco, Thomas Cook, and Irwin Sarason considers the stress accompanying military training and the various ways intervention may be undertaken. The socially anxious (Matt Jaremko) and adolescents acting out problems (Eva Feindler and William Fremouw) are two additional populations for whom stress reduction programs have been developed. In conclusion, some summary observations and comments on needed future directions are offered. In each of the chapters in Section III on specific applications, authors have been asked to review the literature for their population in terms of 1. the data that indicated the need for a stress management program; 2. performance and social analyses of their stressed population that indicate the role played by cognitive and affective factors and in terpersonal support systems in the coping process; 3. a critical evaluation of the training data for their specific popula tio1'ls; 4. a description of how one may conduct a coping-skills training pro gram on both a treatment and preventative basis; 5. a concluding brief discussion of needed future directions. The editors have provided comments and summaries throughout on the various programs. The editors believe that the authors have described interesting and provocative demonstration projects that reflect the current knowledge about stress and coping. The editors and the chapter authors recognize the limitations of the reported interventions; but nevertheless, there is a feeling of optimism and encouragement. It is in the spiri~ of critical-mindedness and enthusiasm that we offer this volume. It is dedicated to those who will critique and build on the efforts offered. DONALD MEICHENBAUM MATT E. JAREMKO Contents I: The Stress Literature: Implications for Prevention and Treatment 1 1. A Model for Stress Research with Some Implications for the Control of Stress Disorders Howard Leventhal and David R'. Nerenz 5 2. Natural Healing Processes of the Mind: Graded Stress Inoculation as an Inherent Coping Mechanism Seymour Epstein 39 3. Stress Inoculation in Health Care: Theory and Research Irving L. Janis 67 Concluding Comments to Section I 101 Il: Guidelines for Training 107 4. Stress Inoculation Training: Toward a General Paradigm for Training Coping Skills Donald Meichenbaum and Roy Cameron 115 Ill: APPlications Part A-Medical Problems 155 5. Stressful Medical Procedures: Cognitive-Behavioral Strategies for Stress Management and Prevention Philip C. Kendall 159 xi