Evaluate the behavioral interventions for managing stress, addressing the types of stress-related problems for which each is successful.

A. Relaxation training is suitable for a wide range of problems in a variety of people, including children, adolescents, and adults.
1. Techniques such as progressive muscle relaxation are easy to learn.
2. Relaxation is an excellent choice for helping people manage daily stress, sleep problems, and stress related to treatment for cancer and other stressful chronic conditions.
B. Cognitive behavioral therapy (CBT) is effective in treating many stress-related conditions.
1. CBT addresses the cognitions that may create stress and teaches ways to cope more effectively.
2. Stress inoculation is one type of CBT that is effective in helping with problems such as managing school or workplace stress, but it can also be useful in treating posttraumatic stress disorder (PTSD).
3. Cognitive behavioral stress management is directed toward stress management and is one of the most effective approaches for PTSD.
C. Emotional disclosure is also helpful in managing stress.
1. Talking or writing about traumatic events can relieve distress, possibly through the process of self-reflection that occurs when people use language to frame their experience.
2. People who use this process experience decreased distress and increased health.
3. Finding meaning in the traumatic experience and finding some positive aspect of the trauma adds to the effectiveness of emotional disclosure.
D. Mindfulness has been studied by Dr. Jon Kabat-Zinn for 30 years as a method for managing stress to improve mental and physical health.
1. Mindfulness is awareness or consciousness achieved by deliberately focusing attention on the present moment in an accepting, non-judgmental way. It is derived from Zen Buddhist meditation practices.
2. Kabat-Zinn developed an eight-week stress reduction program based on exercises teaching mindfulness skills, e.g. focusing on one's breathing, body sensations, sounds, everyday activities, and thoughts.
3. Most people naturally focus on the past and/or the future in responding to stress; mindfulness meditation redirects attention to the immediate situation in the present.
4. Literature reviews suggest mindfulness-based stress reduction interventions can lower stress, depression, and anxiety for breast cancer patients; increase pain acceptance in lower-back pain patients; and reduce stress and potentially improve the progression of disease for HIV-positive patients.
5. Mindfulness may also improve physical health: better immunity, lower stress hormones, and lower blood pressure in cancer patients were associated with a mindfulness-based stress reduction intervention. Adults at risk for hypertension also had lower blood pressure via this intervention.
6. Mindfulness-based stress reduction interventions appear to improve mental health by decreasing worry, focusing attention, and decreasing people's natural tendencies to dwell on stressful experiences.
7. Some studies find that even mindfulness-based stress reduction interventions shorter than eight weeks can still achieve benefits similar to eight-week programs.