Stress management modalities/Lifestyle modification

What is Lifestyle modification?
Lifestyle modification is based on the premise that if the factors which increase and decrease stress in the client's life may be identified, it may be possible to alter some aspect of the client's lifestyle to decrease their overall stress level. This modality therefore depends on an environmental approach to assessment.

Methods
Events which act to cause stress in the client's life are identified through an initial subjective assessment process, and then on an ongoing basis during conversation with the client. Once a stressor has been identified, methods by which it could be reduced are discussed with the client, and if any of these methods are found to be suitable the client implements these changes into their lifestyle.

Client drinks 6 cups of coffee per day

The caffiene in coffee is a sympathomimetic agent, and therefore is a stressor. A simple lifestyle modification might be reducing the number of cups of coffee.

Example: Client has a very stressful and demanding job

Client should be encouraged to take their breaks, and in their breaks to go for a walk.

Experiences which help the client to reduce stress may also be identified through a similar process, and the client should be encouraged to increase the frequency of these events in their life where possible. Examples of experiences which oppose stress are physical exercise, spending time with friends and family, and recreational activities. Cardiovascular exercise is particularly effective against stress because it "burns off" the hormonal cocktail that is associated with stress.

Example: Client enjoys mountain biking, but "doesn't have the time"

Client should be encouraged to make the time.

Another method which is useful in the identification of stressors is having the client complete a stress log (Forman, 2007). The client should be encouraged to carry a notebook or other recording device with them during their daily activities. When they notice that they are becoming stressed by some situation, they should take some time to record details of this stressful event. Specifically they should record the date, time, the stressor, their physical reaction, their psychological reaction, and any coping techniques which they used in that situation.

Example

The benefit of using a stress log is that it helps the client to become aware of the types of events which cause them stress, and their reactions to these events. The client should bring their stress log to any appointments, and the details of the log should be discussed during the next session.

Practice guidelines
The amount of practice will depend on the client. Most lifestyle changes are fairly simple in nature, but are best implemented one or two at a time. The therapist should take care to ensure that the changes do not clash with other important aspects of the client's life.

Cautions
The therapist should be careful of scope of practice issues when recommending lifestyle modification. Advising a client to eat a healthy balanced diet and to cut down on the coffee is fairly common-sense, and perfectly fine for most people, but specific details of dietary prescriptions should be left to a dietician. The therapist should be particularly careful when interpersonal relationships are a factor in the client's stress. Interpersonal relation ship issues are often best left to a psychological health professional.

Referral is always an option, and a multi-disciplinary approach to stress management may in many cases be the best approach.