Maureen O'Callaghan, Director of Calmspace Limited, is a stress managment consultant, trainer and researcher with a special interest in work with young people. For further information visit www.calmspace.co.uk, email: enquiries@calmspace.co.uk or call Maureen on 01476 572653
The aim of this short essay is to outline the causes and effects of stress on young people and to demonstrate how stress management training can be used to help young people to manage stress more effectively.
The essay draws upon my own experience of working with children and young people for over twenty years, my work as a complementary therapist, training in holistic health and spiritual well being, and the course material provided by The Stress Consultancy.
Young people and stress, the extent of the problem
The Mental Health Foundation (2005) suggests that young people who are mentally and emotionally healthy are able to:
develop psychologically, emotionally, creatively, intellectually and spiritually
initiate, develop and sustain mutually satisfying personal relationships
use and enjoy solitude
become aware of others and empathise with them
play and learn
develop a sense of right and wrong; and
resolve problems and set backs and learn from them
A study by the Mental Health Foundation found that 6 percent of young men and 16 percent of young women aged 16 to 19 experience mental health difficulties. The same organisation in 2001 found that 10per cent of children aged 5 to 15 experience mental health difficulties, including anxiety and depression. In the same year the World Health Organisation estimated that one in five young people under 15 suffer mental health difficulties. In the UK approximately 20,000 young people are admitted to hospital each year as a consequence of self-harm (Bird 1999)
Research for the Nuffield Foundation showed that the mental health of British adolescents over the past 25 years has sharply declined, with problems such as anxiety and depression increasing by as much as 70%. Other clinical data shows increased rates of suicides, eating disorders and self harm, juvenile disorder, drug abuse and binge drinking.
What are the causes and effects of stress in young people?
Stress has been defined as the condition that results when person/environment transactions lead the individual to perceive a discrepancy between the demands of a situation and the resources of their biological, psychological and social system ( Lazurus and Folkman) and in doing so to feel threatened.
As adults we have become increasingly aware of the impact of stress on our well-being, yet we often forget that young people are just as vulnerable to the negative effects of stress, maybe more so.
Mental health difficulties are particularly prevalent amongst specific groups of young people, these include:
young people who have experienced abuse
young people in care/care leavers
young homeless
young offenders
young people excluded from school, young people with physical disorders
young refuges
young people living in deprived inner cities or living in rural isolation
In 1999 the government White Paper Saving Lives: Our Healthier Nation reported that children living in the poorest households are three times more likely to experience mental health difficulties than children living in more affluent household ( Department of Health 1999).
Exams in particular are seen by young people as a major cause of stress. Researchers at the University of Hertfordshire interviewed 123 students and found one in ten had to seek medical attention due to stress-related symptoms. Britain’s pupils are among the most intensively examined in the world. Some sit as many as 105 exams in 14 years. During the 2004 exam period Childline saw a 50 per cent rise in calls from pupils complaining they were under too much pressure. At the time Carole Eason, Chief Executive of Childline urged the government to take measures to reduce exam stress
“ Exam stress affects almost every child at some point in their education and we are hearing from hundreds of children of children at this time of year who are struggling to cope with the pressure they are under.” “Some who call
Childline tell us exams are the last straw in their young lives. They may be suffering abuse, their families may be going through a break-up or they may be being bulled”.
I believe that the underlying cause of young people’s stress is their having to live in a world that they are not equipped to cope with. Their lives have become increasingly competitive, the pace of change has accelerated and the world has become more complex. At the same time young people no longer have the support and reassurance from a stable family life, adequate youth service provision and enough jobs and houses.
Unfortunately many young people turn to alcohol and/or recreational drugs to ease the symptoms of stress. Increasingly young people are being prescribed tranquilisers and anti-depressants which mask the symptoms of stress but do not address the underlying causes. I believe those working with young people have a key role to play in helping young people to manage stress effectively.
Helping young people, the role of the learning sector
“Education is vital to health. People with low levels of educational achievement are more likely to have poor health as adults….by improving education for all we will tackle one of the main causes of inequality in health”
(Department of Health 1999)
Perhaps the most important way in which those working with young people can help them to manage stress effectively is to act as a positive role model. They should be proactive in demonstrating how they manage stress in their own lives e.g. having a healthy diet, taking regular exercise, not taking on too much and applying time management principles, taking time out for hobbies and relaxation. They also need to able to demonstrate they are able to handle stressful situations without it having an adverse affect on either their emotions or their behaviour.
Young people are unable to learn in environment they find unsafe. For the adult working with young people the next priority is to create and maintain a safe learning environment i.e. one that does not add to their stress. This is achieved by:
providing young people with friends and being friendly and the worker being friendly and approachable
creating a calm atmosphere
providing opportunities for young people to work in small groups
ensuring the learning programme starts at a point young people can understand and does not progress too quickly
having a physically comfortable environment
using accessible language
not using physical or emotional threats
giving recognition and praise
( Ingram and Harris 1988)
All of the above needs to be in place if stress management training is to be successful.
In their recent report “Healthy Minds; Promoting emotional health and well-being in schools (July 2005) the Department for Education and Skills
examined the vital role played by schools in promoting the emotional well-being of their pupils. It analysed the practice in 72 schools and the impact of the guidance provided to schools four years ago in meeting the needs of young people with mental health difficulties i.e. the National Healthy Schools Standards (NHSS 1999). The DFES expressed concern that only a small minority of schools were working towards the standards and citing a major barrier being the low level of awareness of the importance of mental health issues.
They also found a lack of training for staff on mental health difficulties and that most training tended to focus on strategies for managing young people’s behaviour rather than on promoting positive approaches to relationships and resolving conflict. This is of major concern given the extent of the problem
“The schools identified one in twenty pupils with mental health problems although the Department of Health suggests a figure nearer one in ten”
( DFES 2005).
In Looking Forward to Thursdays (2003) Nicola Aylward provided an overview of the benefits of effective and well-targeted learning provision as:
building young people’s confidence and self esteem
providing structure and stability
providing support networks
providing opportunities for increased personal satisfaction and progression
empowerment
Within the context of effective and well targeted learning provision stress management techniques and training could make a positive contribution to young people’s well-being.
Therapeutic Information Giving
Providing information about stress, its causes and affects, can be reassuring to young people. It helps them to understand there is a logical explanation for the symptoms they are experiencing i.e. the Fight or Flight response, and perhaps more importantly they are not alone. It provides an opportunity for young people to recognise their own stress symptoms and what are the triggers. Increasing young people’s self-awareness and understanding is an important step in helping to manage the causes and effects of stress.
Listening to young people is the most valuable technique, encouraging young people to talk about how they are feeling and really listening to what they tell you. Apart from providing an opportunity for young people to express how they are feeling, it also helps those working with young people to clarify the issues. Art and music have been used successfully to allow young people to express their feelings
Breathing, Relaxation Training and Meditation
Helping young people to control their breathing i.e. developing deep abdominal breathing rather than shallow chest breathing has been found to be a useful stress management technique. Young people’s holding their breath in stressful situations is a natural response but it can lead to a habit of shallow breathing which in turn can contribute to a permanent state of stress and tension. The more stressed young people are the shallower their breathing is likely to be. Learning deep breathing techniques can both help young people to minimise the effects of stress and help control their responses to stressful situations
Long-term stress can contribute to muscular tension, which is most likely to be held in the neck, upper back, jaw and shoulders. This tension can lead to increased pain e.g. headaches, insomnia and fatigue. The tension response in the muscles has been learned early in the young person’s life, but it can also been unlearned through regular use of relaxation techniques. Teaching young people relaxation techniques will induce relaxation, increase their feeling of being in control, improve self-esteem and help them to take on difficult situations e.g. job interviews, without getting as stressed.
Meditation is an effective stress management technique that is suitable for young people and is simple to learn. It can be as easy as teaching them to breathe in and out slowly and calmly and to visualise their problems floating away on a cloud as they breathe out.
Another method of visualisation outlined by Rita Sparks (2004) shows how young people under the age of 16 can be helped to prevent the build up of repressed emotion by using the power of the imagination to deal with problems symbolically.
Cognitive Therapy
Negative thinking often undermines young people’s sense of worth. Young people are used to hearing and reading negative things about themselves e.g. that young people of selfish and lazy or they are out of control. They start to think that adults do not like them/or that they are being tolerated. The danger is that they get used to thinking like that and their thoughts then seem reasonable and justified. In her book Stress Busting for Children (2004) Rita Sparks puts forward a view that before the age of 16 children and young people will repress the emotional response they have to these negative thoughts. She argues it is the only way that children are able “to exist in an adult world, for without it they would find life extremely difficult.” She gives a warning that repression by children and young people can lead to symptoms that are detrimental to their health.
Cognitive therapy techniques can be used to help young people to identify the situations that are causing them stress and the associated thoughts, feelings and behaviours. Young people can then be helped to assess how these negative thought patterns are affecting their lives e.g. their relationship with the parents and peers. The third steps is to show young people how to observe their reactions to events and situations and to identify the belief that has contributed to the response e.g. a young person is stopped by the police, if they believe that all young people are victimised by police they may respond in a negative way. If on the other hand their belief is that the police are fair-minded they may respond way that is more positive. Young people can be helped to develop more positive thoughts and behaviours e.g. not all police are prejudiced against young people I will wait to see how I am treated before I make a judgement.
Developing mental strategies and time management
Encouraging young people to think ahead about a stressful situation and preparing how to deal with it can also help to reduce stress. Sarah McNamara ( 2002) suggests a sequence of imagining the situation in detail followed by preparation to minimise the worst effects, which includes having some contingency plans ready can help to reduce stress.
Introducing young people to the principles of time management can also be beneficial e.g. in developing an effective exam revision programme and ensuring the young person has realistic goals and includes time for relaxation.
Encouraging healthy eating
Stress takes its toll on the body so it is important that young people’s diets
provide the nourishment they need. Researchers at Cornell University, New York, found that people are more likely to eat unhealthy meals and snacks if they are feeling stressed. Young people should be encouraged to eat regular meals that are rich in protein and good quality carbohydrates. These foods will give the body a sustained release of energy and brain power. It is particularly important that young people are encouraged to eat food rich in Vitamin B and C. At the same time coffee, fizzy drinks, sweets and chocolate should be discouraged as these give a quick hit of energy and concentration but within an hour a young person will “come down” often feeling tired and unfocused.
Massage
An article in the Times Educational Supple on Emotional Literacy ( TES October 15 2005) outlined how fully-clothed peer massage covering the head, shoulders and back had been used successfully to help children to manage their emotions. “The success of peer massage is firmly rooted in the neurological system. Massage increases the outputs of serotin, the contentment hormone.” (Trower 2004). Schools in the UK who have implemented this programme have found the following benefits mirroring the effect in other countries; children become calmer and have improved concentration, they have more confidence and self-esteem, emotional health improves.
The Massage in Schools Programme was initially developed for primary school age children and it is recognised that adolescents would require a totally different approach because some young people may feel
“uncomfortable touching each other at this stage of their development” . Given the acknowledged benefits of the programme, it is hoped that people with skills, knowledge and experience of working with young people and in massage will be able to develop the programme to make it accessible to an older age range.
The Endorphin Effect
In his book The Endorphin Effect (2003) William Bloom outlines the benefits of creating a pool of endorphins as an antidote to the negative effects of the adrenaline and cortisol that are generated by stress. Providing young people with opportunities to have fun and to enjoy themselves will help to relieve the symptoms of stress and will help to build a reserve of endorphins in the body.
The book outlines a number of postures that are used to support the process e.g. Inner Smile and Curled Deer which are based upon martial arts disciplines.
Also contained in the book are some of the most powerful exercises I have ever used to deal with old stress and negative patterns. One exercise involves taking a piece of paper and drawing an outline of the body, then identifying something in the past that has caused you distress and instinctively drawing on the body where you felt the discomfort then writing next to it a few words that describe what it represents. You them slowly and carefully crumple up the paper and hold it to your heart, accepting and cradling it for a while. Next you carefully unfold the paper, look at it again, with compassion and understanding, and reflect on how the injury has blocked and frozen you. This process is repeated either immediately or later detailing all the major events that have caused distress. This is now an exercise that I have included, where appropriate, in stress management training with individual/groups of young people.
Conclusion
The recent “Youth Matters” Green Paper on young people ( DFES July 2005) aims to bring together cross-departmental thinking on policy for young people and to outline proposals to reform services for them in four areas:
empowering young people to engage in positive activities
fostering youth volunteering and community involvement
improving information, advice and guidance for young people
supporting young people at risk
These reforms are designed to link with the five outcomes for young people outlined in Every Child Matters i.e. being healthy, staying safe, enjoying and achieving, making a positive contribution and economic well-being. The proposals are based on the premises that there is a need for more things for young people to do and that this would lead to young people being less likely to get into trouble…… Creating a whole new generation of human “doings” rather than “beings”
“Even without the added pressures teenagers face today of looking good, doing well and building a seductive curriculum vitae to impress admissions tutors. Adolescence presents its own particular challenges as waves of self-doubt and confusion threaten to knock every youngster off course “
(McNamara 2000).
It is for this reason that I believe stress management training should be included in both the school and youth work curriculum in order to increase young people’s awareness and understanding of the causes and effects of stress and to help them build up a repertoire of strategies they can use to prevent stress and to deal with the negative effects of stress. It is perhaps one of the most important life skills they need to develop in order to ensure a happy and healthy life.
Bibliography
Lazarus RS and Folkman, Stress Appraisal and Coping, Springer, New York 1984
Bird L ( 1999) The Fundamental Facts: All the latest facts and figures on mental illness, Mental Health Foundation
Department of Health (1999) Saving Lives: Our Healthier Nation Stationery Office
Nicola Aylward ( 2003) Looking Forward to Thursdays NIACE/National Youth Agency
www.massageinschools.com (July 23rd 2005)
www.cheiron-quietplace.com ( July 23rd 2005)
www.mhf.org.uk ( July 23rd 2005)
Sarah McNamara (2000) Stress in Young People; what’s new and what we can do? Continuum
William Bloom (2004) The Endorphin Effect Piatkus
Rita Sparks ( 2004) Stress Busting for Children evolutionary pathways
Ingram and Harris (1988) Delivering Good Youth Work Russell House Publishing
www.dfes.gov.uk/publications/youth ( July 23rd 2005)