S tress Management Program

1. Stress Management Program Abdullah Alzahem, BDS, MME, PhD Director, Quality Assurance Unit, KSAU-HS Consultant, Advanced General Dentistry Section, KAMC Ministry of National Guard - Health Affairs Riyadh, Saudi Arabia

2. Objectives • Define stress • Identify the significance of stress • Determine sources of stress • Point out the major stressors • Recognize the indicators of stress • List the signs of stress • Measure psychological stress • Apply Cognitive-Behavioral Therapy for stress management • Manage time better

3. Overview • Pre-test • Dental Education Stress Awareness • Cognitive-Behavioral Therapy for Stress Management • Time Management Skills • Post-test

4. Significance of Stress in Dental Education • Underlying tendency towards perfectionism based on an academic history of high achievement and powerful expectations of scholastic excellence • New form of clinical competitiveness also emerges. Such transitions can affect levels of self efficacy, which in turn can affect both achievement and psychological health.

5. Significance of Stress on Dental Students • Increasing stress may decline performance • High level of stress can result in a wide variety of physical and psychological complaints

6. Definition of Stress • Stress defined in medical dictionary as ‘an organism's total response to environmental demands or pressures’ • Atkinson et al. stated that ‘the term stress describes external demands (physical or mental) on an individual’s physical and psychological well-being

7. Sources of Stress in Dental Education • There are more than 38 sources for stress in Dental Education reported in literature (DES Questionnaire) • These stressors related to five factors in Dental Education; • Living accommodation factor • Personal factor • Educational environment factor • Academic factor • Clinical factor

8. Major Stressors in Dental Education • Exams • Requirements (Clinic & Lab) • Patients • Lack of time for Relaxation • Faculty feedback or criticism • Financial problems

9. Indicators for Stressed Student • Low grades and marks • Low academic achievement • Unprofessional altitude • Illicit drug use • Cigarettes smoking • Lack of social integration and depersonalization • Depressed mood • Memory problems • Alcohol consumption

10. Signs of Stress Physical Signs Emotional Signs General irritability Acute anxiety attacks Depression Lack of libido The loss of a sense of humor Poor concentration Sadness, guilt, fatigue, apathy, and helplessness or failure Hostility of confidence Loss of confidence • High blood pressure • Heart disease • Digestive disorders • Ulcers • Loss of appetite • Over eating • Cramps • Breathlessness • Dry mouth • Sleeplessness • Sweating • Frequent headache • Skin rashes

11. Measuring Stress • Ask yourself if other people find you stressful • Keep a diary of the days that you feel highly stressed • Measure Blood pressure, heart rate, and adrenaline production • Measure stress by responding to the following questionnaires in the next slide.

12. Measures of Stress • Psychological Symptom Measure (PSM) • Dental Environment Stress (DES) Questionnaire • Visual Analog Scale (VAS) • General Well-being Inventory (GWI) • Perceived Stress Scale (PSS) • Symptom Questionnaire • Brief Symptoms Inventory (BSI) • State-Trait Anxiety Inventory (STAI) • Beck Depression Inventory (BDI) • Maslach Burnout Inventory (MBI)

13. Stress Management Stage 1: Reducing the symptoms associated with stress (anxiety, depression, losing control, insomnia, vulnerability etc.) using a holistic program for relaxation training and recuperation. Clients often use a voice activated Dictaphone to tape sessions to use at home to augment what is gained in therapy.

14. Stress Management Stage 2: Using standard CBT in the areas identified as causing negative thoughts, beliefs and images, clients learn to identify the themes which generate faulty thinking ("I'm not good enough", "I'm going to fail", "I'm stupid" etc.) and learn to test their thoughts as hypotheses rather than take them as facts.

15. Stress Management Stage 3: In the last stage of CBT treatment clients work on the deeper core beliefs/schemas that have been developed during their early life (up to 16 years of age).

16. Deep Breathing Exercise • Put your Index and Middle finger on your forehead • Close your right nose opening by your thump • Inhale air slowly without sound from left nose opening • Close your left nose opening by your small finger • Exhale air slowly through your right nose opening • Repeat the cycle for 10 minutes

17. Cognitive-Behavioral Approach • Situation • Physical Reaction • Mood • Behavior • Thought Physical Reaction Situation/ Environment Mood Behavior Thought

18. THOUGHT RECORD

19. Time Management • Ben Franklin (1748) Advice to a young tradesman; “Remember that time is money” • Tom Rubens mentioned; “Time is worth more than money”

20. Time Management Skills • Make lists • Prioritize tasks • Divide large tasks into smaller steps • Group similar tasks • Monitor progress

21. Eliminate Time Thieves! • Failure to set goals, priorities, or deadlines • Too much socializing • Failure to say no • Interruptions • Disorganization • Procrastination • Poor communication • Failure to delegate • Fatigue • Trying to do too much

22. Basic Tips on Time Management for Students • Minimize distraction • Prepare your study environment • Select proper time of the day for you to study • Focus totally on your studying for at least 40 minutes at a time, and try to take a five-minute break • Use efficiently your time during travel and waiting • Set in the front of the class to concentrate more • Cross each task off your TO-DO-LIST when the job is done, it is satisfying to see a list shrink

23. Tips on Studying Routine • Study period length • Scheduling • Set a list of your to-dos • Cramming before exam • Watch what you eat • Get enough sleep • Exercise in breaks • Apply 80/20 rule (Pareto Principle)

24. Debriefing Steps for Managing Time • Prioritizing Objectives (Priority Matrix) • Planning Tasks (TO-DO Lists) • Allocating Time (Scheduling)

25. Thank You