Philosophy

Clinical interventions towards managing family stress are of great importance. A number of them may be employed to manage stress in family which results from various stressors events. The need for family togetherness, understanding and support is also very vital. This paper explores into the clinical interventions that can be used by family in managing stress and how effective they are.

What is stress What are causes of stress

In day to day lives, people are faced by pressure and tension which is a result of what happens around them.  In defining stress, Gerald (1994) asserts that any bodily or mental pressure and tension caused by physical, emotional and chemical factors can be termed as stress. Stress affects our emotions, mental condition and physical conditions

Causes of stress
People suffer from various stresses which are caused by various events that one goes through in life. Stress can be caused by stressors in work place, ones social interactions with others, conflict between work and family responsibilities, diseases, traumatic experiences and physical environment. Domestic conflicts, losses, child abuse, diseases, parenting problems, children unappealing behaviors, high expectations may be the cause of stress in a family. Murders have also been identified as one of the causes of stress. Deaths, divorce, changes in jobs, new relocation as well as frightening experiences such as hospitalization and physical trauma usually results into stress. Stress may also be triggered by  eventsepisodes such as loneliness, independence, sexuality, feeling overwhelmed by situation out of ones control and high expectations of either by oneself or by others. The need to employ available clinical interventions to manage the stress is therefore indispensable. (Gerald 1994)

Types of stress
Stress is broadly defined into to two groups i.e. bad stress (distress) and good stress (eustress). Eustress is helpful since it occurs before one performs a certain duty. It enables one to be prepared physically, mentally and psychologically to achieve a certain objective. On the other hand distress, occurs when normal routine is adjusted or altered. Both the body and mind are affected. Other types of stress include acute stress which occurs as a result of immediate change of routine chronic stress which is as a result of constant routine change(s). It affects ones mind and body in long term period. (Gerald 1994).

Is Family Therapy an effective intervention in reducing stress
Family therapy is one of approaches that a family can employ to treat stress.  According to Diseth (2005), family therapy based on identifying and treating child with stress as early as possible is very effective. However family therapy requires to be combined with individual psychotherapy and pharmacotherapy. This will effectively handle dissociative disorders in children and adolescents. Family therapy application in treating stress will thus require to be combined other clinical interventions otherwise it may not result into desired outcomes.

Nixon etal 2003 in their work where twenty one years preschoolers were recruited as social validation comparison condition,  reported that family therapy involving the standard parent- child interaction therapy (PCIT) for family with young conduct problem children, has some benefits.  Since a child greatly trusts hisher parent, this approach may greatly work in treating stress associated with children.

A parent has a big role to play in eliminating stress in family set up. Before a parent can offer healthy support, guidance, and facilitate problem solving for effective coping, there is need to be at best.  Heshe should start by understanding and assessing the stressor events. Stressors events variation is wide. Consideration for the type of stress should be preceded by the assessment or intervention in therapeutic work. Various facts such as the level of stress family member is experiencing, family perception of the problem, and strategies used to manage the stress by the family should be established. There is need to establish the source of the stressor. It should be established if the source is external or internal. Through such a guideline the family therapy will certainly achieve desirable results. (Sharon etal 2010)

Family therapy that emphasize in first identifying type of stress  in terms of  normative or nonnormative, duration and density of the stressor, the number of stressors the family is handling and how long the stress has been experienced has resulted to positive results. A questions about how many stressors has the family been handling simultaneously, can be of great help, in deciding on the clinical intervention to be employed while dealing with the stress at hand. Some stressors such as job loss, marital distress, financial strains, medical complications and unexpected pregnancy may occur simultaneously or consecutively in a family. Families simultaneously dealing with stressors are more vulnerable and more likely to experience negative symptoms.  Family therapy based on such knowledge of the contextual circumstances surrounding them will be effective. (Sharon etal 2010)

There is need for defining relationship boundaries allowing individuality as well as the connectedness as far as family members are concerned. The family systems relationship boundaries should be made flexible, cloistered with support, warmth, and togetherness. On the other hand, ambiguity about family roles should be eradicated. This will ensure that every family member is responsible and available to perform hisher part.

For example, a parenting stress in the family may be solved through parental behavioral training. (P.B.T).This method calls for altering the behavior reinforcement. The parent needs to acquire new skills to assist him or her in parenting. These skills should be based on operant techniques.  Skills taught include how to use contingent supervision strategies, including enforcing consistent rules, using developmentally appropriate responses and expectations and the importance of the positive reinforcement role. Parent may agree on contingency contract such as token economy. In this case the child who the parents are parenting is rewarded when heshe record good behaviors in terms of respectful behavior at school, at home, and early completion of homework and so on. Such a method has proved to be effective given that children are a bit nave. (Sharon etal 2010)
Is a cognitive behavioral intervention an effective intervention reducing stress

Cognitive behavioral intervention include identifying  potential cognitive distortions while at the same time reinterpreting the inaccurate perceptions as far as the stressor events is concern. Differently thinking about the stressor events will influence the behavior and emotions in the family. This intervention should emphasize in modifying victims cognition through collaborative empiricism (Epstein  Baucom, 2002). In assessing this intervention various writers have different claims.

According to Kerr and Channen (2003), cognitive analytical therapy can also be employed by the family in dealing with stress. It is a useful approach and generates meaningful as well as helpful understanding of what context of stress for both the treating team and the patient.

De Vente 2008 claims that, cognitive-behavioral treatment (CBT) has been associated with great effectiveness in treating psychopathology. However this intervention success in treating patients with clinical levels of work-related stress has been wanting.  In treating anxiety, cognitive behavioral therapy has been reported to be effective in short term and medium term. The self help approaches which are based on cognitive behavioral therapy principles also can be effective as far as stress management is concerned.

Family should work together with the therapist in examining the cognitive interpretation validity, how far the cognition reflects objective reality as well as the cognition adaptiveness for relationships in the family. The need to employ didactic approach will play a big role. Probing further into the cause of the problem, environment surrounding the stressors events and the main players will avail more information attributed to the stressor event. (Sharon etal 2010)

Is a mindfulness intervention an effective in reducing stress
Allen etal (2006) claims that, therapeutic application of mindfulness is growing rapidly. Combining mindfulness approach to treating stress, with well developed conceptual model used in therapeutic action, mindfulness becomes an effective approach in treating not only stress, but also a wide range of physical and mental health problems.

Krasner etal (2004) reported that, there is an increasing in empirical medicine literature about mindfulness based interventions. Mindfulness empowers one to work with hisher stress, illness, demand for daily living and challenges. Mindfulness offers a true participatory as well as biopsychological oriented medicine thus enabling bidirectional healing to take place. Mindfulness intervention has been noticed to result into significant improvement to sleep disturbances, depression, parenting problem and personality disorder.

Taccin etal (2003) claimed that, a significant improvement was reported in mental adjustment, stress related factors, and locus of control to a group of 27 women who were suffering from breast cancer. Levels of anxiety were reported to decrease while positive mental adjustment increased significantly. The level of sense of helpless and hopelessness as well as anxious preoccupation was noted to diminish.  This is a clear indication that mindfulness intervention has been effective as a clinical intervention to treating stress. Since mindfulness intervention emphasize on one acknowledging that there is a challenge, as well as a wise attention to the challenge without judging the present moment, its effectiveness can substantially be pleasant.

Baer (2003) claims that, mindfulness skills towards clinical interventions have become popular method of managing stress in the family. Mindfulness involves bringing ones attention to the internal and external experiences occurring in the present moment, and is often taught through a variety of meditations exercises.(p125).  Mindfulness training is a clinical intervention whose use is growing rapidly.

Conclusion
Various clinical interventions may be used to treat stress by a family. These methods include the cognitive approach, mindfulness based intervention, family therapy and affirmation. Their effectiveness depends on the stress they are treating, the patient perception and factors surrounding the stressors event.