Canadian Journal of Occupational Therapy

Canadian Journal of Occupational
Therapy
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Short-term Stress Management Programme with Acutely Depressed In-Patients
Franklin Stein and Janet Smith
Canadian Journal of Occupational Therapy 1989 56: 185
DOI: 10.1177/000841748905600407
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CJOT — Vol. 56 — No. 4
"#.440;44.*4-

Short-term Stress Management
Programme with Acutely
DerAressed In-Patients
Franklin Stein, Janet Smith

Key VVords:
* Biofeedback, methods
• Depression
• Stress managernent training

Franklin Stein, OTR, Ph.D., FAOTA
was Director, Occupational Therapy
Programme, University of WisconsinMilwaukee, Milwaukee, WI, at the time
of writing. He is presently Director,
School of Medical Rehabilitation, University of Manitoba, Winnipeg. Manitoba, R3E OW3.
Janet Smith, OT(C) is Staff Occupational Therapist at the Edmonton General Hospital, Alberta.

October/Octobre 1989

Abstract

A shori-term stress management programme was carried out as a pilot study
with seven acutely depressed in-patients.
Various techniques in muscle relaxation
and biofeedback were used in a sixsession programme designed to decrease
anxiety and to cope more effectively
with stress. One occupational therapist
served as a group facilitator and teacher
of stress management techniques while
a second occupational therapist served
as the group recorder During the one
and a half hour sessions specific techniques were practthed by the patients.
These techniques included Benson's
Relaxation Response, visual imagery,
Jacobson's Progressive Relaxation, heart
raW and finger temperature biofeedback
and behavioural rehearsal. A Stress
Management Que,stionnaire, developed
by the first author, was used to help the
patients become more aware of the
symptoms of stress, stressors that
"trigger"symptoms and everyday activities that can be used to control stress.
The State - Arzxiety Scale was administered pre- and post-intervention to
assess the reduction of anxiety. Results
showed that there was a significant reduction in anxiety at the .05 level using
a correlated Nest. Qualitative cotnments
from the patients at the end of the stress
management programme indicated that
the sessions had a positive effect in
increasing their ability to relax and in
learning to recognize individual stress
reactions as well as new alternatives to
coping with stress.

In the 17th century, Robert Burton
(1632/1938), an Oxford scholar and
recluse, wrote his classical work The
Anatonzy of Melancholy. This work summarized the western world's view of
the causes and treatment of depression, and concluded with:
Melancholy is either a disposition
or habit. In disposition, it is that
transitory melancholy which goes
and comes upon every small occasion of sorrow, need, sickness, trouble, fear, grief , passion or perturbation of the mind ... And from these
melancholy dispositions, no men living is free. (p. 125)
These remarkable insights of Burton
still ring true 350 years later. Depression is a universal phenomena that is an
integral characteristic of human thought
and behaviour. It is estimated that between one tenth and one quarter of the
adult population of the United States
will suffer from depression at least once
during their lifetime (Munoz, 1987).
Severe depression is a significant public health problem throughout the world
that has continually challenged the psychiatric community. Historically, treatment of severe depression has included
both organic rernedies such as medication; psychosurgery (e.g., lobotomy);
electroconvulsive therapies; and psychosocial methods such as creative art
therapies, spiritual counselling, psychotherapy and behavioural methods.
In general, depression can be characterized as a biopsychosocial disorder that has at multifactorial etiology
with severity of symptoms ranging from

185

CJOT — Vol. 56 — No. 4
mild, moderate to severe. The current
edition of the DSM-IIIR (American
Psychiatric Association [APA], 1987)
includes the following symptoms as
being characteristic of a major depressive syndrome:
1. depressed mood
2. markedly diminished interest or
pleasures in activities
3. significant weight loss or weight gain
4. disturbance in sleeping
5. motor disturbances
6. fatigue or loss of energy
7. feelings of worthlessness and excessive or inappropriate guilt
8. diminished ability to think, concentrate or make decisions
9. recurrent thoughts of death and
suicide.
The average age of initial onset is in
the later 20's with symptoms developing over days to weeks. Prodromal or
early clinical indicators of a depression
include generalized anxiety, panic attacks, phobias or mild depressive symptoms which may occur over a period
of several months (APA, 1987, p. 220).
In classifying depressive disorders,
theorists have made the distinction between endogenous or psychotic depression and reactive or neurotic depression. Although this distinction is
highly controversial, it has been substantiated by factor analytic research
evidence (Leber, Beckham, & DankerBrown, 1985).
In understanding the etiology of depression, it is generally accepted that
some people have a vulnerability to
depression that could be due to genetics, damaging effects of earlier adversity, the lack of social supports or an
interaction between these factors (Wing
& Bebbington, 1985, p. 776).

Stress and Depression
It has long been known by researchers
and clinicians that psychosocial stress
contributes to many illnesses and disabilities including bronchial asthma, hypertension, headaches, rheumatoid arthritis, dermatitis and ulcerative colitis
(Alexander, 1950). The theoretical models and experimental data describing
the effects of stress on the body were
first described by Walter Cannon (1939)
in his classical work, The Wisdotn of
the Body. Selye (1956) later elaborated
upon Cannon's work and described the
general adaptation syndrome directly
linking psychological factors with physiological responses. Since the initial

186

research by Cannon and Selye, scientists throughout the world have broadened the area of stress research, examining neurochemical and physiological evidence implicating stress as a
contributing factor in diverse illnesses,
diseases and disabilities.
The latest frontier of stress research
is in the area of psychoneuro-immunology and the interactions between
brain, behaviour and the immune system (Glaser et al., 1987). The research
presented is based on this link between
stress, physiological reactions and depression (Dupue, 1979).
Billings and Moos (1985) raise the
question: "Why do stressful life circumstances lead to depression among
some persons but not others?" (p. 941)
To answer this question, they propose,
"that the depression-related outcomes
of stressful life circumstances are influenced by individuals' personal and
environmental resources as well as by
their appraised and coping responses"
(p. 941). In other words, they are proposing that individuals' reactions to
stress are dependent upon their inner
resources and support networks. Some
people may on the one hand be stress
resistant while others rnay be prone to
stress. The ability to handle stress may
also vary during one's life tiine. It is
implied from this model that we may
be able to teach individuals to learn
how to cope more effectively with stress
by providing (1) specific exercises and
techniques that inoculate the individual to stress, (2) treatment programmes
to increase social skills and self-esteem
and (3) ongoing support groups. Research evidence has demonstrated that
depressed persons are less socially
skilled than non-depressed individuals (Lewinsohn, Antonuccio, Steinmetz,
& Teri, 1984; Libet & Lewinsohn, 1973;
Youngren & Lewinsohn, 1980). Clinical studies of the effectiveness of
assertiveness training and social skills
training in lessening depression have
also shown positive results (Sanchez &
Lewinsohn, 1980; Wells, Hersen, Bellack , & Himrnelhoch, 1979). In these
studies, social skills training included
role playing, modelling of skillful behaviour by the therapist, feedback, positive social reinforcement and coaching
in eye contact, gestures, smiles and
voice volume (Becker & Heimberg,
1985). Pearlin and Schooler (1978)
found that a sense of environmental
mastery, along with high self-esteem

lessen the effects of life stress and can
protect one from becoming severely
depressed. In addition, I3eck (1963,
1974) theorized that people vvho are
filled vvith self-blame are vulnerable
to depression. There are also data (Billings & Moos, 1985; Wilcox, 1981) to
support the concept that social support is effective in lessening depression among individuals experiencing
stressful life events.
The underlying assumption guiding
this research study is that if a depressed
patient can cope more effectively with
stress then the patient will be able to
gain control over his illness.

Cognitive Behavioural Therapies
-

In recognizing the relationship between stress and psychogenic factors
in depression, researchers and clinicians have developed cognitive-behavioural therapies. In general, cognitivebehavioural therapies comprise various treatment techniques that attempt
to change a patient's behaviour through
structured learning (Dobson, 1988). For
example, the patient is taught to control anxiety, to increase the ability to
problem solve, to learn how to relax,
and to cope more effectively with stress.
A psychoeducational approach with
the mentally ill seeks to create a learning environment to foster patient independence (Crist, 1986). Using a
psychoeducational approach, Lewinsohn, Antonuccio, Steinmetz, and Teri
(1984) developed a unique method for
the treatment of depression, incorporating cognitive-behavioural techniques.
This method entitled "The Coping with
Depression Course" is offered in 12
two-hour sessions conducted over eight
weeks. Follow-up sessions are held one
and six months post. The course is
conducted using a group format with
six to eight participants. Lectures and
skill development experiences include
relaxation , increasing pleasant activities, changing negative cognitions and
improving social skills. Outcome studies of the Coping with Depression
Course have been positive (Brown &
Lewinsohn, 1984; Steinmetz, Lewinsohn , & Antonuccio, 1983; Teri &
Lewinsohn, 1981; Lewinsohn, 1987).
In the present study, the cognitivebehavioural and psycho-educational
theoretical frameworks were integrated
into a short-term stress management
programme for acutely depressed inpatients. This approach, if proven

October/Octobre 1989

CJOT —
effective, could serve as a clinical model
for occupational therapists working
with acutely depressed patients. In
testing this approach, the author proposed the following research questions:
1. Can acutely depressed in-hospital
patients be taught to reduce their
anxiety through a short-term structured stress management programme?
2. Specifically, is biofeedback-mediated
relaxation therapy helpful in reducing anxiety in depressed patients?
3. What are the typical symptoms,
stressors and coping activities identified by this sample of depressed
patients?

Methodology
Measurement Instruments
One of the two scales from the StateTrait Anxiety Inventory (STAI) (Spielberger, 1983), was used to measure
anxiety. The S-Anxiety Scale (used in
the study) is made up of 20 items and
assesses how people feel at the time of
testing which is defined as a "Transitory
emotional condition characterized by
subjective feelings of tension and apprehension " Anastasi, 1982, p. 530).
Test-retest reliability in normal college students for the S-Anxiety Scale
ranged from .16 to .54. "What such
low correlations indicate is an interaction between persons and situational
stress" (Anastasi, 1982, p. 530). In other
words, the S-Anxiety Scale is a sensitive measure to use when examining
short term intervention.
The Stress Management Questionnaire (SMQ) (Stein, 1987; Stein &
Nikolic, 1989) which normally takes
20 minutes to complete, consists of

three parts: symptoms, stressors and
coping activities. The patient is requested to check yes or no to each of
158 items, and then to rank order the
responses from 1 to 10 in each part,
assigning the rank of 1 to the most
severe symptom or stressor, or to the
activity that most relieves stress.
The SMQ was developed (a copy of
the SMQ is available from the first
author) over a five-year period where
more than 600 subjects completed the
questionnaire. Individual items were
selected originally from an open-ended
questionnaire. Three experimental editions were used as the basis of the
current form. Concurrent or predictive validity have not been measured
for the SMQ. Based on the preliminary research in selecting items, the
SMQ possesses a high degree of content validity defined as "...essentially
the systematic examination of the test
content to determine whether it covers a representative sample of the
behaviour domain to be measured"
(Anastasi, 1982, p. 131).
In a test-retest reliability of 34 college
students (mean age of 27), the percentage of concurrence of responses (after
two weeks) ranged from 85% to 89')/0.

Subjects
The patients for the pilot study came
from a general hospital unit located in
an urban metropolis in Western Canada. The screening criteria for patient
inclusion was as follows: (a) primary
diagnosis of depression, (b) age 20-45
years old, and of at least average
intelligence.
Eight voluntary patients were referred

56 -- No. 4

to the research study after obtaining
administrative and ethics approval.
Seven patients completed the study
and one patient dropped out voluntarily. The descriptive characteristics of
patients are shown in Table 1.
In general, the patient group can be
described as a typical sample of depressed adults. They included six females and one male, all received antidepressive medication, had at least a
high school education and were mostly
single or separated. The average length
of their illnesses was nine years, the
average age of onset of depression was
27 years old and the average number
of depressed episodes per individual
was five.

Intervention
The stress management group met
for six consecutive weekly sessions that
lasted approximately an hour and a
half. Cognitive-behavioural methods
were integrated into the group process. The researcher lead the group and
the co-leader recorded the sessions.
Each session focused on stress management techniques that could be used
in everyday life. An outline of the stress
management protocol is summarized
in Table 2. The sessions consisted of
lectures by the researcher on the nature of stress, practice sessions in stress
management techniques, biofeedback,
and relaxation methods, and a group
discussion of how individual patients
experience the symptoms of stress, the
everyday stressors in their lives and the
activities that are useful in controlling
stress. A short description of the stress
management techniques employed in
the study are discussed below.

Table 1
Descriptive Characteristics of Patients

Subject
l(Female)
2(Male)
3(F)
4(F)
5(F)
6(F)
7(F)

Age Education

Occupation

Marital
Status

32
37
31
45

High School
University
High School
University

Medical Secretary
Veterinarian
Secretary
Teacher

Single
Single
Single
Separated

35
30
39

High School
High School
High School

Hairdresser
Homemaker
Nurses' Aid

Divorced
Married
Married

October/Octobre 1989

Diagnosis
Depression (post-partum)
Unipolar Depression
Unipolar Depression
Depression, Obsessivecompulsive
Bipolar-Depressed State
Unipolar Depression
Unipolar Depression

Age of Onset Number of
of Depression Depressed
Symptoms
Episodes
19
23
25

4
6
6

35
32
21
38

10
3
6
2

187

CJOT — Vol. 56 — No. 4
Table 2
Outline of Stress Management Protocol
Session Overall Purposes

Establish psychoeducational environment
to discuss stress
management techniques

Tests Administered

Techniques Introduced

Homework

— Stress Management — Benson Relaxation Response — Practice relaxation
Questionnaire
— Progressive Relaxation
response
— State-Trait Anxiety
(isometric contraction and
Inventory
relaxation)

2

Discuss the relationship
between stress and the
onset of symptoms

— Visual Imagery
— Back Massage

— Keeps daily stress
diary

3

Discuss everyday
stressors in environment

— Heart Rate and Finger
Temperature Biofeedback

— Practice relaxation
techniques

4

Discuss individual
reactions and activities
to manage stress

— Behavioural Rehearsal of
Stressful Situations

— Identify difference
between tension
and relaxation

5

Identify pleasant
activities to counteract
stress

— Deep Breathing
— Paradoxical Intention

— Practice progressive
relaxation by
associating negative
thoughts with
muscle tension and
calm thoughts with
muscle relaxation

Summarize and evaluate
experience and discuss
how stress management
can be incorporated into
every day activities

Stress Management Techniques
Employed in the Study
The Relaxation Response (Benson,
1979). This technique, based on meditation, contains four basic components
necessary to elicit the relaxation response. "The components: a comfortable position; a quiet environment;
repetition of a prayer, word, sound or
phrase; and adoption of a passive attitude when other thoughts come into
consciousness" (p. 140).
Progressive Relaxation (Jacobson,
1938). Essentially this technique, that
is widely used in stress management
programmes, is based on the premise
that relaxation is the opposite of tension or anxiety. The subject is trained
to systematically contract and relax
groups of muscles, starting from the
lower extremities.
188

— Stress Management
Questionnaire
— State-Trait Anxiety
Inventory
— Individual Evaluation

Paradoxical Intention (Walker,
1975). This technique is based on the
theory that individuals develop fears
and tensions because of anticipatory
anxiety. In using this technique, the
individual is told to think of something
he fears most or to create a negative
emotion such as anxiety. By creating a
negative feeling, the individual begins
to cognitively control the symptom.
Visual Imagery (Korn & Johnson,
1983). The investigators in the current
study used guided imagery as a technique to help the patient create a pleasant experience by imagining a dream
house. While the patients were in relaxed positions, the therapist had the
patients create mental images of each
room in their dream house. The exercise took about ten minutes to complete. After the exercise, the patients
were encouraged to share their images

— Follow-up
individual
compliance

of their dream houses with the group.
Behavioural Rehearsal (Monti, Corriveau, & Curran, 1982). "In essence
behavioural rehearsal offers patients a
unique opportunity to practice new
skills, to receive constructive criticisms
in area.s of potential improvement and
to receive social praise for using these
skills" (p. 191).
The Stress Management Questionnaire and S-Anxiety Scale were administered during the first and sixth session. A qualitative evaluation forrn filled
out by the patients was also administered during the final session. Patients were encouraged to follow-up
on the stress management techniques
as homework assignments, to practice
relaxation techniques and to keep a
daily stress diary. (See Table 2.) In
session five, paradoxical intention was
used in which the patient was asked to

October/Octobre 1989

CJOT - Vol. 56 - No. 4
cognitively create an anxiety state or
to feel a depressed emotion. The patient was then asked to cognitively
create a pleasant feeling. The exercise
was paired with contracting the muscles of the face and upper extremities
and creating muscle tension and then
relaxing or letting go these muscles
and creating a relaxed mood. The patient practiced pairing tension with
flexed muscles and relaxation with loose
muscles.

Portable biofeedback equipment
was used in enabling the patients to
monitor finger temperature and heart
rate. The patients were instructed
to use the biofeedback equipment as
physiological rneasures of their ability
to produce a relaxed state. Biofeedback was used to increase the patient's
cognitive control of psychophysiological mechanisms in the autonomic
nervous system (Olton & Noonberg,
1980).

Results
Table 3 summarizes the patients' responses on the SMQ. For each patient, the first five ranks are listed in
regard to the symptoms of stress,
stressors and activities to relieve stress.
Since one of the major purposes of
the SMQ is to help the patient to become aware of the psychophysiological nature of stress, the individual responses are of prime importance. For

Table 3
Results from Stress Management Questionnaire
Subject

Symptoms

Stressors

Activities to Relieve Stress

1

1. Defensive
2. Angry
3. Tense
4. Anxious
5. Sweaty palms

1. Having no control over situation
2. Criticisrn
3. Arguments
4. Feeling too much pressure at school or work
5. Being evaluated for performance

1. Being by myself
2. Watch TV
3. Avoid situation
4. Eating
5. Listening to music

2

1. Neck/low back pain
2. Chest pains
3. Angry
4. Irritable
5. Keeping eye contact

1. Financial situations
2. Being late for an appointment
3. Having no control over a situation
4. Poor performance on a test
5. Failure to meet goals

1. Avoid situation
2. Relax (lie down)
3. Walking
4. Listen to music
5. Exercising

3

1. Fatigue
2. Concentrating
3. Angry
4. Anxious
5. Tremors

1. Lack of self confidence
2. Problems in relationships
3. Pressure at work
4. Being in crowds
5. Trying to please people

1. Avoid situation
2. Go shopping
3. Listen to music
4. Cleaning house
5. Analyze situations

4

1. Constipation
2. Dryness in mouth
3. Fatigue
4. Frequent urination
5. Headaches

1. Financial situations
2. Driving in traffic
3. Excessive noise
4. Being evaluated
5. Lack of confidence

1. Go to dinner
2. Cleaning house
3. Eating
4. Exercising
5. Being busy

5

1. Keeping eye contact
2. Tremors
3. Remembering
4. Nervous
5. Tense

1. Feeling too much pressure at school or at work
2. Finatncial situations
3. Feeling guilty for inadequate bahaviour
4. Meeting deadline
5. Studying for exam

1. Listen to music
2. Dancing
3. Crocheting
4. VVatch TV
5. VValking

6

1. Muscle tension
2. Anxious
3. Tremors
4. Reacting
5. Sarcasm

1. Problems in relationships
2. Raising children alone
3. Financial situations
4. Not meeting goals
5. Gaining weight

1. Eating
2. Cleaning house
3. Take a drive in a car
4. Avoid situation
5 Baking

7

1. Concentrating
2. Headaches
3. Muslce Tension
4. Not ranked
5. Not ranked

1. Excessive noise
2. Being unprepared
3. Speaking in front of group
4. Not ranked
5. Not ranked

1. Exercise
2. Needlecraft
3. Not ranked
4. Not ranked
5. Not ranked

October/Octobre 1989

189

CJOT

Comparison of Pre - Post Test Differences on State Anxiety Scale
for Depressed Patients

2
3
4
5
6
7

Pre-test Score

Post-test Score

Difference

75
49
60
71
54
54
64
mean = 61

52
44
69
57
51
30
58
mean = 51.6

-23
-5
+9
-14
-3
-24
-6

2.122*

The process itself enables the individual to gain insight in order to change
behaviour.
Table 4 summarizes the results of
the State-Anxiety Scale administered
pre- and post experiment. Six of the
seven patients had positive results,
meaning that their anxiety scores decreased. (See Table 4.)
As a qualitative measure of improvement, the investigator administered an
evaluative survey during the post session. Six of the seven patients felt that
the group experience on stress management was helpful and one patient
felt it was helpful sometimes.
One subject felt that the group could

Table 5
Patients' Responses Identifying the Most Helpful Stress Management Technique

Stress Management Techniques
Relaxation Response
Visualizing Dream House
Telling or listening to funny story
Tensing muscles by imagining a brick wall
Writing an angry letter and destroying it
Relaxing each muscle of the body
Role playing a stressful situation
Filling out the stress management questionnaire
Relaxing by using heart rate monitor
Relaxing by increasing finger temperature
Daily diary of stress

190

Number of Responses
Percent
(out of 7)
7
5
5
4
4
3
3
2
2
2

—

No. 4

Discussion and Conclusion

a = S-Anxiety Score for Working Adults = 36
S-Anxiety Score for Depressive Reactive Patients = 54.4
(Spielberger, 1983)
b = A minus sign(or negative difference) indicates a decrease in anxiety
*Significant difference between pre- and post-test scores at .05 level, 6df
example, Subject lfeels that having no
control over a situation can cause her
to become defensive, angry, tense or
anxious. She finds that being by herself, watching TV, or avoiding the situation will relieve her stress. These results have clinical significance although
they do not atternpt to answer the question: Is the individual coping effectively
with stress? The results demonstrate
the wide variance in the vvay the depressed individual responds to stress.
There are no generalized stress symptoms or stressors that precipitate stress.
For the investigators, the significance
of the results is in the cognitive process of analyzing the nature of stress.

Vol. 56

be improved by adding more theory
on the nature of stress. The relaxation
response and visualizing a dream house
were the two experiences that patients
felt were the most helpful. (See Table 5.)

Table 4

Subject

—

100
71
71
57
57
43
43
29
29
29
14

The major purpose of this pilot study
was to determine if a group of depressed patients can reduce their anxiety through a short-term highly structured stress management programme.
The results demonstrated that six of
the seven patients did reduce their anxiety and the group as a whole showed
significant improvement. Since there
was no control group, the results may
have been influenced by the Hawthorne
Effect in that the improvement may be
based on the attention from the investigators. The generalized efficacy of a
structured stress management programme with depressed patients is still
problematic. However, the effectiveness
of a stress management programme in
reducing anxiety with depressed patients in a clinical setting has been
demonstrated. This was also positively
reinforced by the patients' qualitative
responses.
It is no surprise that a cognitivebehavioural approach is effective with
depressed patients. During the last 20
years, clinical research on cognitive
therapy has demonstrated its effectiveness (Sacco &13eck, 1985). Also previous research has shown that cognitive
therapy is as effective as pharmacotherapy in reducing depression (Murphy, Simons, Wetzel, &. Lustman, 1984).
Since cognitive-behavioural therapy
appears to be very effective with depressed patients, occupational therapists should seriously consider incorporating components into a comprehensive treatment approach for depressed patients. Johnston (1986), a
senior occupational therapist at the
UCLA Neuropsychiatric Institute in
Los Angeles, California, explored the
use of cognitive-behavioural techniques
with depressed patients in a day treatment setting. She concluded that cognitive-behavioural techniques are appropriate areas in which occupational
therapists can develop interest and expertise. Johnston advocated that the
role of the occupational therapist is to
teach cognitive-behavioural techniques
that involve interpersonal, problem solving and self-management skills.

October/Octobre 1989

CJOT - Vol. 56 - 14.1;6:. 4
From this pilot study, we can conclude that a stress management programme for acutely depressed inpatients was helpful in reducing anxiety. The major implications of this study
for occupational therapists working
with depressed patients are.
1. Stress management can be taught to
patients in a short-term structured
group, incorporating cognitivebehavioural techniques and biofeedback.
2. Depressed patients respond individually to stressors and display unique
symptoms.
3. Depressed patients can be taught to
increase their repertoire of coping
activities in dealing with stress.
4. Individual stress management programmes can be devised using the
individual data from the Stress Management Questionnaire.
For the clinical investigator, further
research questions remain, such as:
1. Do patients with exogenous depression respond better to stress rnanagement than patients with endogenous depression?
2. How can stress management techniques be incorporated into the depressed patients everyday life?
3. What are the most effective stress
management techniques for depressed patients, such as relaxation
therapy, biofeedback and cognitive
behavioural methods?
4. Does learning how to cope more
effectively with stress prevent relapse
in the individual who is vulnerable
to depression?
5. Finally, it is suggested that this pilot
study be replicated with a control
group and larger sample, thereby
increasing the internal validity and
generalizability of results to the population of depressed patients.

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Benson, H. (1975). The relaxation response. New
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Benson, H. (1979). The mind/ body effect. New
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Billings, A. G., & Moos, R. H. (1985). Psychosocial
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191

CJOT — Vol. 56 — No. 4
Resume

Un programme de courte duree de
controle du stre.ss a ete mene comme
etude pilote aupres de sept clients hospitalises pour depression aigue. Differentes techniques de relaxation musculaire et de retroaction biologique ont
ete utili sees dans un programme en six
seances concu pour diminuer l'anxiete
et controler le stress de facon efficace.
Un ergotherapeute agissait en tant que
facilitateur de groupe et professeur des
techniques de controle du stress pendant

W.F.O.T. CONGRESS
APRIL 19909
MELBOURNE, AUSTRALIA
• OVERWHELMING RESPONSE
TO CALL FOR PAPERS,
460 ABSTRACTS RECEIVED.
• Countries contributing abstracts
include: Australia, Botsvvana,
Canada, Denmark, England,
Finland, Iceland, India, Ireland,
Japan, Malaysia, Netherlands,
New Zealand, Nigeria, Norway,
Portugal, Sweden, Switzerland,
Singapore, South Africa, USA
and West Germany.
• Registrations have been received
already. The first overseas registration being from Hong Kong.
Super Saver registration fee
deadline 1st January 1990.
• Pre conference workshops filling
fast. Book early to get the workshop of your choice.
• Students world wide requesting
information on billeting. Several
schools have set about fund raising
to ensure representation at the
WFOT Congress in Melbourne.
Further Information from
WFOT Secretariat:
1st Floor, 387 Malvern Road,
South Yarra, VIC 3141.
Phone: 03 824 0022.
FAX: 03 240 0771.

192

qu'un deuxieme agissait comme rapportelt,: Durant les seances d'une duree
d'une heure et demie, les patients se
sont exerces a des techniques specifiques. Ces techniques comportaient la
reponse a la relaxation d'apres Benson,
l'imagerie visuelle, la relaxation progressive de Jacobson, la mesure des battements cardiaques et de la temperature
digitale en rapport avec le processus de
retroaction biologique et la repetition
du comportement. Un questionnaire sur
le controle du stress mis au point par le
premier des deux auteurs a ete utilise
pour aider les clients a mieux reperer
les symptomes du stress, les eMments

declencheurs et les activites de tous les
jours qui peuvent etre utilisees pour
controler le stress. L'echelle du niveau
d'anxiete (State Anxiety Scale) a ete
utilisee avant et apres l'intervention
pour evaluer la diminution de l'anxiete.
Les resultats ont demontre, a l'aide du
rapport de correlation, une diminution
significative de l'anxiete. Les commentaires de nature qualitative emis par les
clients a la fin du programme orzt demontre l'effet positif des seances sur
l'augmentation de leur habilete a relaxer
et a apprendre a reconnaitre les reactions individuelles de stress de meme
que de nouvelles facons de le maitriser.

ALZHEIMER SOCIETY OF CANADA
The Alzheimer Society of Canada is pleased to announce the enhanced
research programme targeting $600,000 for the 1989-1990 granting cycle.
The Society has substantially increased its financial commitment to
research and is offering a new programme with two focuses: biomedical
research stream and caregiving research stream. VVithin each granting
stream there will be three categories of research awards: Training Awards,
both Doctoral and Post-Doctoral; Career Support; and Research Grants.
Application forms, detailed specifics of eligibility requirements and selection criteria are available from the address belovv.
The deadline for receipt of applications if November 15, 1989. For
further information please contact:
Alzheimer Society of Canada,
1320 Yonge Street, Suite 302,
Toronto, Ontario, M4Y 1X2
(426) 925-3552.

SOCIETE ALZHEIMER DU CANADA
C'est avec plaisir que la Societe Alzheimer du Canada annonce la mise en
oeuvre d'un programme de recherche de 600 000 $ pour l'exercice 1989-90.
La Societe a augmente sensiblement le financement affect& a la recherche
et offre dorenavant un nouveau programme a deux volets; la recherche
biomedicale et la recherche sur les soins de sante. Trois categories de bourse
de recherche seront attribues pour chaque type de recherche: Bourse de
formation, bourse de doctorat et bourse post-doctorat; Aide professionelle;
et Bourse de recherche.
Les formules de demande et les criteres de selection sont disponsibles de la
Societe. La date limite de reception des demandes est le 15 novembre 1989.
Pour recevoir de plus amples renseignements, priere de conrimuniquer avec:
Societe Alzheimer du Canada,
1320, rue Yonge, Bureau 302,
Toronto (Ontario), M4T 1X2
Tel (416) 925-3552.

October/Octobre 1989