BACR Conference 8th - 9th October 2009
Benefits of a
“One Day Stress Management
Workshop”
A Menu Based Option for Cardiac
Rehabilitation Patients
Katrina Fisher
Senior Occupational Therapist
Cardiac Rehabilitation Team
Luton & Dunstable Hospital NHS Foundation Trust
Bedfordshire
Toolkit
Patient’s Perspective
One Day Stress Management
Workshop for Cardiac Rehabilitation
Patients
Morning Workshop
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Welcome and introduction to the day
A-Z of coping strategies – on arrival
Ice breaker – list patient’s expectations of the day
Definitions of stress and anxiety
Causes of stress in relation to Human Performance Curve
The Autonomic fight / flight response
Comfort break………
Signs and symptoms of stress
Complete another HADS
Show “Don’t lose Heart video”
Feedback HADS scores
Break for lunch………
A-Z Coping Stategies
AROMATHERAPY JOKES
BOWLING
KITE FLYING
CROSSWORDS
LAUGHTER
DISTRACTION
MUSIC
EXERCISE
NOTHING
FISHING
ORGANISING
GOLF
POSITIVE
HUMOUR
QUIZZES
IRONING
RELAXATION
SWIMMING
TALKING
UNDERSTANDING
VISITING
WALKING
XYLOPHONE
YOGA
ZOO
Morning Workshop
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•
•
•
•
•
•
•
•
•
•
•
Welcome and introduction to the day
A-Z of coping strategies – on arrival
Ice breaker – list patient’s expectations of the day
Definitions of stress and anxiety
Causes of stress in relation to Human Performance Curve
The Autonomic fight / flight response
Comfort break………
Signs and symptoms of stress
Complete another HADS
Show “Don’t lose Heart video”
Feedback HADS scores
Break for lunch………
Afternoon workshop
• Welcome back and introduction
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to coping strategies
A-Z coping strategies
Cycle of change (Ref Prochaska
and Diclemente 1982)
Teach 4-5 coping strategies
Inform patients of other support
available: 1:1 session, referral to
clinical psychologist, counselling
arranged via GP
Make sure expectations have
been met
Evaluation forms completed
Close session.........
Choice of coping strategies
• Changing unhelpful thoughts into helpful thoughts
• Anger management techniques
• Energy conservation and pacing techniques using MET
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values
Goal setting using SMART principle
Assertiveness training
Problem solving techniques
Sleep hygiene techniques
Time management principles
Stability zones
Diaphragm Breathing and
Relaxation Techniques
• Diaphragm breathing techniques
• Relaxation techniques:
– Progressive
– Autogenic
– Visualisation
Afternoon workshop
• Welcome back and introduction
•
•
•
•
•
•
•
to coping strategies
A-Z coping strategies
Cycle of change (Ref Prochaska
and Diclemente 1982)
Teach 4-5 coping strategies
Inform patients of other support
available: 1:1 session, referral to
clinical psychologist, counselling
arranged via GP
Make sure expectations have
been met
Evaluation forms completed
Close session.........
Key Findings From the One Day
Workshop Evaluation
• 64% attended – 29% UTA and 7% DNA (2009)
• 94% patients reported “delivery of the workshop was
just right”
• 93% reported “the length of the session was just right”
• 90% “felt their knowledge of stress management had
improved”
• 12% patients referred for a clinical psychology
assessment
Key Findings From the Two Month
Follow up Evaluation of the
Workshop
• 93% reported that “they still use the ways of coping
identified on the day”
• 88% reported that “these ways of coping help them to
manage their stress more effectively”
• 80% HADS scores have reduced
20% significantly to within normal range
Future Plans
• Running a follow up day for patients
• Offering a similar stress management workshop for
partners and other family members
• Providing a professionally printed manual to support the
content covered in the workshop. Patients would be able
to continue to use this as a reference tool to maintain
effective stress management techniques
• Continue to develop the emergency in-patient Clinical
Psychology referral service
Any Questions?