Stress Management Curriculum: Meeting the Needs of High School Students by Lisa Astling A project submitted in partial fulfillment of the requirements for the degree of MASTER OF EDUCATION with emphasis in CURRICULUM AND INSTRUCTION WEBER STATE UNIVERSITY Ogden, Utah July 29, 2022 Approved Stress Management Course 2 Table of Contents Abstract ........................................................................................................................................... 3 Acknowledgments .......................................................................................................................... 4 Nature of the Problem ..................................................................................................................... 5 Literature Review ........................................................................................................................ 7 Stress in High School .............................................................................................................. 7 Consequences of Untreated Stress .......................................................................................... 8 The Need for a Class Specific to High School Students ....................................................... 12 Current Interventions Have Limited Success ....................................................................... 13 A Comprehensive Stress Management Course for High School Students ........................... 15 Purpose .......................................................................................................................................... 20 Methods ........................................................................................................................................ 21 Content Discovery .................................................................................................................... 21 Curriculum Development .......................................................................................................... 23 Lesson Plan Content and Structure ........................................................................................... 25 Evaluation ................................................................................................................................. 25 Feedback ................................................................................................................................... 26 Objectives and Assessments ................................................................................................. 26 High School Level Learning ................................................................................................. 27 Discussion, Practice Time, and Format ................................................................................ 27 Skill Relevancy ..................................................................................................................... 27 Self-efficacy .......................................................................................................................... 28 Other Suggestions ................................................................................................................. 28 Discussion ..................................................................................................................................... 29 Future Research ........................................................................................................................ 34 Final Conclusion ....................................................................................................................... 35 References ..................................................................................................................................... 37 Appendix A ................................................................................................................................... 44 Appendix B ................................................................................................................................... 45 Appendix C ................................................................................................................................... 48 Appendix D ................................................................................................................................... 49 Appendix E ................................................................................................................................... 50 Appendix F ................................................................................................................................... 66 Stress Management Course 3 Abstract High school students are experiencing just as much stress as adults. In addition to high academic expectations, secondary-age students encounter stress with significant life events and developmental milestones, a social life that is in flux yet formative, and imminent decisions about the future. Yet, with all this stress, there are few comprehensive stress management classes available in high schools to help them maneuver this tumult with health and balance. This project aimed to determine the learning needs of high school students concerning stress management and develop a curriculum and format that would meet those needs. The curriculum is based on post-secondary stress management course content. The lesson plans are adapted to provide students with a significant portion of experiential learning through discussion, feedback, ample skill practice time, and immediately applicable assessments. Eight stress management lesson plans for high school learners were developed with these adaptations and evaluated by two secondary health teachers and one school counselor, all of whom teach stress management principles within their curriculum. Stress Management Course 4 Acknowledgments I am incredibly grateful to all who listened to my crazy ideas, encouraged me along the way, and made me feel like this is a worthy project that will hopefully give meaningful and healthy direction to high school students. I would like to thank Dr. Louise Moulding for answering my every question, for guiding me through the process of thinking and writing like an academic, and even introducing my low-tech brain to high-tech tools. I would like to thank Dr. Yimin Wang for agreeing to be on my thesis committee and for helping me wend my way through technical writing. When Dr. Wang decided to move out of state, Dr. Sheryl Rushton stepped in without complaint and gave helpful and guiding feedback, for which I am grateful. I would especially like to thank Dr. Michael Olpin. My journey for this project began with his excellent Stress Management class at Weber State University, after which I knew I wanted to help more people understand the nature of stress and how to prevent and manage it. He generously offered his expansive expertise, access to all his resources and creations, and enthusiastic encouragement. Lastly, I would like to thank my husband, my rock, who supported and encouraged me all along the way, with no end of “you can do this” comments, and my boys for doing homework alongside me and expressing empathy. Stress Management Course 5 Nature of the Problem Compared to adulthood, life during high school is supposed to be a time of minimal responsibilities and maximum enjoyment, favoring a low-stress climate (MacCann et al., 2012). Instead, high school students are experiencing just as much stress as adults (Bethune, 2014) due to high academic expectations, adjusting to the meaning and pressure of fluctuating relationships, and the manifestation of significant life events. In response, school administrators, teachers, and researchers have proposed and executed a variety of stress management interventions to capitalize on the developmental stages that high school students experience (Frydenberg, 2004), in hopes of using them for immediate application to decrease the rates of stress, anxiety, and depression (Pascoe et al., 2020) as well as decrease nonproductive coping strategies (Frydenberg, 2004). Many of the researched stress management interventions that are offered from elementary age (Dubow et al., 1993; Kraag et al., 2006; Zeng et al., 2016) to adolescence (Binning et al., 2019; Bonnesen et al., 2020; Caplan et al., 1992; Fridrici & Lohaus, 2009; Frydenberg, 2004; Hampel et al., 2008; Kraag et al., 2006; Lowe & Wuthrich, 2021; McCraty et al., 1999; Nikitha et al., 2015; Perry et al., 2017; Reschly et al., 2008; Yeager & Dweck, 2012; Zeng et al., 2016) through post-secondary age (Capp & Williams, 2012; Conley et al., 2013; Yusufov et al., 2019), have made an effort to add to or incorporate stress management principles and techniques into the current curriculum. However, though contemporary interventions have had some success, they have been limited by issues such as improper teacher training (Bonnesen et al., 2020; Schiepe-Tiska et al., 2021), difficulties with program fatigue, lack of time (Bonnesen et al., 2020; Frydenberg, 2004), and curriculum misalignment (Bonnesen et al., 2020). With limited intervention success, students can suffer short-term and long-term consequences of unmanaged stress (Pascoe et al., 2020). Initial physical effects caused by the Stress Management Course 6 body’s stress response, such as disrupted digestion, increased breathing and heart rate, and suppressed immune function, can be prolonged if not remitted and may influence not only physical and mental health (Olpin & Hesson, 2021) but academic behavior and performance as well. Without healthy stress response techniques, students may engage in unhealthy maladaptive coping strategies like self-harm (Perry et al., 2017) and substance abuse (Nikitha et al., 2015; Pascoe et al., 2020) that could, in addition to physical threat, compromise their school attendance and attention (Binning et al., 2019; Kraag et al., 2006; Pascoe et al., 2020). These short-term consequences can lead to a trickle-down effect increasing the occurrence of long-term problems with physical health (Olpin & Hesson, 2021), mental health (Caplan et al., 1992; Lowe & Wuthrich, 2021; Mosanya, 2021; Pascoe et al., 2020), and even societal health (Pascoe et al., 2020). Short-term stress management interventions have shown that some physical and mental benefits can be achieved across all ages, though the long-term effects of such interventions have not been studied. Aside from the limited stress management interventions in elementary and secondary schools, some post-secondary schools have had a great response to a comprehensive, full-semester stress management class that indicates longer-term success (Conley et al., 2013; Yusufov et al., 2019). Notwithstanding the benefit and positive response to collegiate courses, an effort to make a comprehensive stress management class available for high school students has been lacking. Stress Management Course 7 Literature Review Stress in High School Stress is a “demand made upon the adaptive capacities of the mind and body” (Olpin & Hesson, 2021, p. 3). Secondary-age students report that they regularly feel stress in their lives (Bethune, 2014), and whether they know it or not, that stress challenges their ability to adapt and may lead to maladaptive coping behaviors if they are not taught healthy coping skills (Kraag et al., 2006; Nikitha et al., 2015; Pascoe et al., 2020; Perry et al., 2017). Students in secondary education regularly experience stress from several sources. A top stressor for secondary students is academic stress which includes good grades (Bouchricka, 2021; James, 2015), college preparation (James, 2015; Lowe & Wuthrich, 2021), testing, and homework (Bouchricka, 2021; Binning et al., 2019; James, 2015; Kraag et al., 2006; Lowe & Wuthrich, 2021; Nikitha et al., 2015; Pascoe et al., 2020; Perry et al., 2017). Non-academic related stressors include social concerns (Bouchricka, 2021, Kraag et al., 2006; Yeager & Dweck, 2012), extra-curricular activities or sports pressures, bullying issues (Bouchricka, 2021), physical development (Binning et al., 2019; Bouchricka, 2021; Nikitha et al., 2015), significant life events (Fridrici & Lohaus, 2009; Pascoe et al., 2020; Perry et al., 2017), school and life transitions (Reschly et al., 2008), family life and relationships (James, 2015; Kraag et al., 2006; Lowe & Wuthrich, 2021), a feeling of lack of control (Mosanya 2021; Kraag et al., 2006; Lowe & Wuthrich, 2021; Pascoe et al., 2020) and perfectionism (Lowe & Wuthrich, 2021). To determine rates of academic stress, in 2012, The Organisation for Economic Co-operation and Development (OCED) administered a survey of 540,000 students, ages 15-16, in 72 countries and found that 66% of students reported feeling distressed about poor grades, 59% said that they worry a test will be difficult, and 55% reported feeling very anxious about taking Stress Management Course 8 tests (as cited in Pascoe et al., 2020). These high percentages result from the pressure colleges place on basing admission and scholarships on grades and extra-curricular achievement. Consequences of Untreated Stress Short-term Consequences. With such high percentages of stress, students experience short-term effects and consequences like a decrease in executive function, the capacity to learn and hold information in the brain, filter and control our thoughts and impulses, and employ flexibility to adjust priorities and perspectives. Executive function begins to develop in early childhood, expands through adolescence, and manifests in decision-making, attention skills, working memory, and self-control (Pascoe et al., 2020). The stress response, known as the fight-or- flight mode, is affected by executive function. When the body reacts to stress with a fight-or-flight response, the sympathetic nervous system initiates a cascade of physiological activity (Olpin & Hesson, 2021). Stress hormones, including adrenaline and cortisol, increase metabolism, supply a burst of energy, and shunt blood from the digestive tract into muscles and limbs, increasing muscle contraction and tension. The cardiovascular system increases output, elevating blood pressure, breathing, and heart rate. A few systems that are not needed for a quick response to stress decrease function, such as digestion, the excretory system, and the immune system. This protective activity is an automatic stress response that lasts up to one minute, followed by a short return to homeostasis (Olpin & Hesson, 2021; Pascoe et al., 2020). But if a student experiences the fight-or-flight mode too often or for prolonged periods, executive function is weakened and can result in short-term and long-term academic, physical, mental, and societal consequences (Olpin & Hesson, 2021). While there are a few authentic fight-or-flight moments in life, our bodies cannot distinguish between fight-or-flight responses to actual danger or the stress that comes from more Stress Management Course 9 mundane issues, like traffic jams or disagreements. Because everyday stressors occur more often, the body is at risk for physical and mental burnout from a constant heightened alert of perceived stress. Without knowing how to cope and manage these effects, students who feel regular stress may experience prolonged short-term impacts that can wear the body down with little time to rest and recover (Olpin & Hesson, 2021). Specific short-term effects of stress that students may experience include greater tension, leading to less quality and quantity of sleep and exhaustion (Bethune, 2014; Pascoe et al., 2020), changes in eating (Bethune, 2014), decreased physical activity contributing to overall poor health (Pascoe et al., 2020; Kraag et al., 2006), increased or decreased appetite, weight gain or loss (Pascoe et al., 2020), apathy, emotional exhaustion, and symptoms of depression and anxiety (James, 2015). When a student feels stress due to any source, that stress can manifest in any facet of life, including academics. Because stress leads to decreased executive function, immediate academic consequences may include reduced concentration, memory, and mental clarity (McCraty et al., 1999; Pascoe et al., 2020; Shonkoff et al., 2011). Without even knowing the reason behind the loss of executive function, students may feel a general decline in motivation (Binning et al., 2019; Pascoe et al., 2020), leading to a decreased desire to plan or organize classes, assignments, and time, or it may affect the ability to reason appropriately and make decisions regarding academic pursuits (McCraty et al., 1999). Additionally, decreased executive function may lead students to employ non-productive coping skills such as worry, wishful thinking, ignoring a problem, self-blame, and keeping to themselves (Frydenberg, 2004) to delay dealing with a stressful situation or because they do not know any other way to cope. Student stress not only affects the individual but also affects school management. Supposing a student does not have the skills to cope with stress, their feelings can manifest Stress Management Course 10 through a show of anger, fear, hostility, and violence (McCraty et al., 1999), which can lead to property destruction or peer mistreatment, thereby increasing disciplinary episodes at school (Binning et al., 2019; Kraag et al., 2006). Experiences with discipline issues can help a student form a positive moral system by teaching positive coping or possibly decreasing self-confidence and coping options, creating a downward cycle of maladaptive coping and negative reinforcement. Such dysfunctional coping behaviors significantly influence adolescent psychological development (Kraag et al., 2006) and change a student’s self-narrative, possibly leading to increased interaction with the criminal justice system (Binning et al., 2019). Property destruction and peer mistreatment are not the only maladaptive coping strategies used when students do not have the resources and skills to cope with stress. Unfortunately, continued high stress leads students to desperate attempts of stress relief such as alcohol consumption, tobacco use, and legal and illegal substance abuse (Caplan et al., 1992; Nikitha et al., 2015; Pascoe et al., 2020). Another method of immediate relief perceived by teenagers is engaging in risky sexual behavior (Nikitha et al., 2015), possibly leading to sexually transmitted diseases. Whether these methods are used for actual relief, perceived relief, or distraction, they do not relieve the root cause of stress, perpetuating the problem and leaving some forms of immediate relief to possibly develop into addiction (James, 2015; Olpin & Hesson, 2021). Ultimately, some students' stress may contribute to suicidal ideation, behavior, and completion (Perry et al., 2017). These short-term consequences, combined with non-productive and maladaptive coping, negatively impact general academic and life performance (Binning et al., 2019; Kraag et al., 2006; Pascoe et al., 2020), which, if left untreated, can lead to consequences with a more lasting effect. Stress Management Course 11 Long-term Consequences. Short-term consequences of stress, while challenging to work through, seem quickly remediated in comparison to the long-term effects that can leave lasting mental, social, and physical repercussions. Unremitted stress is related to decreased motivation, lack of mental clarity, and poor academic performance, all of which contribute to dropping out of high school altogether (Binning et al., 2019; Pascoe et al., 2020). Ceasing a high school education is related to decreased lifelong learning capacity, reduced likelihood of secure employment, and poor mental health. Education cessation is also associated with increased illness, unemployment, reliance on social welfare programs, and poverty (Pascoe et al., 2020). Without knowing how to handle stress during adolescence, students may perpetuate poor coping into adulthood, where life decisions come with higher risks and higher stakes that influence individual lives and have a trickle-down effect on families and society. Societal and individual physical health is also at risk if the short-term physical consequences of stress persist and develop into long-term health problems that affect productivity and the quality and quantity of life (Pascoe et al., 2020). Running at a high-stress level consistently during childhood and adolescence maintains the fight-or-flight physiological response, leading to prolonged physical harm, particularly to the heart. The body’s natural, protective reaction to immediate danger increases cardiovascular output, blood pressure, breathing, and general heart function by increasing production for just enough time to fight or flee. But if stress becomes chronic, the body’s protective reaction becomes its enemy. The continuous high cardiovascular function can lead to blood clotting, greater oxygen demand which increases blood pressure, vascular resistance, and chronically high levels of cortisol that promote heart-related inflammation. Chronic stress also depresses the immune system by causing cortisol to slow the production of white blood cells and natural killer cells that prevent and fight Stress Management Course 12 illness. Other long-term health problems related to chronic stress include early aging and inflammation that plays a role in noncommunicable diseases, from cancers to memory-related disorders (Olpin & Hesson, 2021). Physical consequences can lead to or result from the mental effects of stress. Of particular concern is the growing number of students with long-lasting depression and anxiety due to chronic stress or stressful life events (Pascoe et al., 2020). Anxiety and depression are some of teenagers' main concerns regarding themselves and their peers (Horowitz & Graf, 2020). When stressed, higher-order thinking shuts down to give attention to the basic need of the moment. With chronic stress and worry, higher-order thinking cessation may persist, increasing the risk of mental decline (Olpin & Hesson, 2021) and influencing the ability to deal with conflict on personal or global levels, which may perpetuate anxiety and depression (Fydenberg, 2004). Consequently, in studying the mind-body connection between depression, anxiety, and academics, a 15-year study of Swedish adolescents found that those with depression and anxiety were less likely to achieve post-secondary graduation by age 30 (Jonsson et al., 2010). Similarly, a 25-year longitudinal study in New Zealand found that declining education and economic outcomes during ages 21-25 were significantly connected with a high number of depressive episodes occurring during adolescence. Education pursuit aside, most concerning is the finding of the same study that increased depression and anxiety episodes during adolescence were positively associated with an increase in major depression, anxiety disorder, suicide ideation, and suicide attempt in ages 21-25 (Fergusson et al., 2007). The Need for a Class Specific to High School Students With this high concentration of stressors, students experience a kind of immediate reality workshop within the school environment (Kouzma & Kennedy, 2004), in which they explore Stress Management Course 13 coping behaviors (Frydenberg, 2004). With high numbers of students reporting increased worry, stress, and anxiety, Pascoe (2020) suggested employing a stress management intervention at this age to prevent current and further maladaptive coping and poor mental and emotional consequences. A study from the Center on the Developing Child at Harvard University (Shonkoff et al., 2011) emphasized the importance of using the high school years to develop executive functions that will help students be mentally flexible and be able to filter and control impulsive thoughts that sometimes dictate poor choices and coping methods. Without using stress management to maintain good executive function, Frydenberg (2004) stated that using nonproductive coping strategies in response to stress increases with age, beginning at ages 14-16, and therefore would be a prime time for an intervention. Additionally, compared to younger ages, high school students are more cognizant of and able to name their stress and stressors (Bethune, 2014; Bouchricka, 2021; James, 2015). With a keen awareness of the stressors they are facing and a higher level of executive function, given the tools, high school students are more likely than younger students to take responsibility for their stress mitigation (Lowe & Wuthrich, 2021). By taking advantage of the high school student condition, stress management intervention can increase self-efficacy (Lowe & Wuthrich, 2021) and establish stronger feelings toward their school experience (MacCann et al., 2012), resulting in both immediate and future successful academic outcomes ((Shonkoff et al., 2011; Yeager & Dweck, 2012; Zeng et al., 2016). Current Interventions Have Limited Success Witnessing the short and long-term effects of stress, administrators, teachers, and researchers have already answered the call to help students become more flexible and resilient through incorporating stress management skills and techniques into the current curriculum of Stress Management Course 14 varying academic subjects. Most interventions have been of relatively short duration yet have yielded immediate academic improvement (Lowe & Wuthrich, 2021; Pascoe et al., 2020; Yeager & Dweck, 2012; Zeng et al., 2016), as well as an increase in positive behaviors, a decrease in misbehaviors (Caplan et al., 1992; Lowe & Wuthrich, 2021; Nikitha et al., 2015; Zeng et al., 2016), and a more healthy teacher-student interaction. In two meta-analytic studies, one of 43 stress management programs (Yusufov et al., 2019) and one of 83 programs (Conley et al., 2013) all showed positive short-term results. Still, long-term results were not obtained, indicating that the sustainability of short-term stress management interventions and outcomes remains relatively unknown. Though the short-term interventions resulted in at least modest success in student engagement (Pascoe et al., 2020; Reschly et al., 2008; Zeng et al., 2016), better academic performance (Lowe & Wuthrich, 2021; Yeager & Dweck, 2012; Zeng et al., 2016), and improved mental well-being (Lowe & Wuthrich, 2021; Mosanya, 2021; Perry et al., 2017; Zeng et al., 2016), there were several significant limitations reported by teachers. Some intervention programs required current teachers to attend training of varying lengths that took time away from their already heavy responsibilities (Bonnesen et al., 2020; Lowe & Wuthrich, 2021; Schiepe- Tiska et al., 2021). When teachers agreed to undergo training, lasting anywhere from hours to days, some felt conflicted about how to incorporate a stress management program into their current, seemingly unrelated curriculum (Bonnesen et al., 2020). Despite discerning the need for students to receive a stress management intervention, after initial implementation, teachers became fatigued with the additional duty and competing interests (Bonnesen et al., 2020; Frydenberg, 2004). Interestingly, in a two- and four-year follow-up to a “Best of Coping” program, Frydenberg (2004) found that students belonging to some classes maintained their Stress Management Course 15 training better than other classes and concluded that a higher success rate was associated with instructors who demonstrated consistency and competency of the curriculum delivery (Frydenberg, 2004; Goncy et al., 2015), as well as a finding that teacher rapport influences program success (Bonnesen et al., 2020). When integrating a program into a class curriculum with general teachers, success is subject to teacher willingness, training, expertise, self-efficacy, stamina, and rapport. Alternatively, a few studies were conducted by using school counselors (Bonnesen et al., 2020; McCraty et al., 1999) or off-site proctors such as post-grad students (Caplan et al., 1992; Dubow et al., 1993; Fridrici & Lohaus, 2009), where teachers either monitored or co-taught the program. Teachers looked more favorably upon these implementations in which program success was not their responsibility alone. While using auxiliary instructors is a promising possibility to relieve some responsibility for teachers, such an adjustment would require additional employees and a better student-to-counselor ratio than currently exists at 415:1, according to the national average in the 2020-21 school year (American School Counselor Association, 2021). A Comprehensive Stress Management Course for High School Students Offering high school students an entire semester of stress management before they experience the stress associated with college life or other pursuits can help establish a healthy adjustment and response to new adult responsibilities, adjustments to new curriculum, educational and employment demands, new social environments, and independent self-care (Conley et al., 2013). Since there is very little evidence or research indicating that a stress management class exists for high school students, it is proposed that a curriculum for such a class be developed to provide increased time for learning and practicing concepts and skills, a proficient teacher, and a proven curriculum adapted for high school needs. Stress Management Course 16 Increased Time. Feedback from the following studies suggests that longer-term interventions would produce even greater and more long-lasting success based on short-term success. Teachers in 15 Denmark high schools were asked to incorporate stress management principles into their curriculum for 405 minutes over the course of the year. At the end of the year, teachers suggested that students need more time to achieve success and recommended offering a complete course (Bonnesen et al., 2020). In a fourth-grade class where teachers incorporated stress management principles for 585 minutes over the course of a semester, teachers recommended at least a post-program booster course so skills would not be lost (Dubow et al., 1993). Yusufov et al. (2019) analyzed 43 short-term stress management interventions in post-secondary schools and dubbed them all immediately successful. However, because there was no long-term follow-up data, researchers were concerned that students might return to their baseline stress levels over time if not offered continued assistance. Most notably, Conley et al. (2013) conducted a meta-analysis of 83 post-secondary mental health promotion and prevention programs that included stress management principles. They discovered that interventions of longer duration, specifically complete courses, were possibly more effective because students had more time to master concepts and application of skills. Additionally, allowing more time to practice a variety of skills rather than psychoeducation alone leads to more student success (Dubow et al., 1993; Yusufov et al., 2019). Providing more time for experiential learning, including the use of workbooks (Hampel et al., 2008; Lowe & Wuthrich, 2021), valuable discussion and feedback loops, and peer group work (McCraty et al., 1999; Mosanya, 2021; Reschly et al., 2008; Yusufov et al., 2019) increases student success. Proficient, Specialized Teacher. Perhaps the most important benefit of a comprehensive course is a proficient and consistent teacher. In recent years, social and emotional learning (SEL) Stress Management Course 17 programs have been incorporated into classroom curricula using teachers of all topics and ages. In a follow-up study to SEL implementation, teachers reported feeling incompetent regarding SEL content and delivery due to a lack of training. The teachers also expressed concern that there might not be enough time to teach SEL in addition to their curriculum or that it would detract from or not naturally connect with their curriculum (Schiepe-Tiska et al., 2021). Similarly, in a bullying prevention study in which teachers were asked to incorporate principles into their current curriculum, there was such discrepancy in instruction that researchers concluded program success depended upon the teacher's competency, as well as having a good relationship with students (Goncy et al., 2015). Finally, Conley et al. (2013) found that out of 83 stress management programs, those with continuously supervised skill-oriented programs were over seven times more likely to obtain success than those with occasional or uninvested supervising teachers. Adapting Post-Secondary Curriculum for High School Needs. Full semester stress management courses and workshops are now widely available in post-secondary education and are accepted as essential options in managing collegiate academic and social life (Benjet, 2020; Conley et al., 2013; Yusufov et al., 2019). Since there are very few stress management courses available for high school students, post-secondary content will be a foundation for developing a curriculum with adaptations for high school student needs. Yusufov et al. (2019) suggest that since high school students face unique stressors and are on a different learning level than collegiate students, a curriculum for stress management should be tailored to their specific needs. Adapting a college-level course to the needs of a high school student requires switching from a lecture-style format to an engaging and experiential classroom format. High school students are more likely to achieve understanding and application through lessons that provide frequent Stress Management Course 18 opportunities to discuss, respond, learn from a variety of learning formats and student perspectives, problem solve, and give and receive educational and behavioral feedback (Allen et al., 2013; Harbour et al., 2015). Such an open format environment will foster characteristics and skills that research suggests are critical for adolescent stress management. Self-efficacy, Growth Mindset, and Cognitive Behavioral Therapy. A repeated observation in stress management research for adolescents is the need for students to gain self-efficacy (Caplan et al., 1992; Dubow et al., 1993; Frydenberg, 2004; Hampel et al., 2008; Kraag et al., 2006; Lowe & Wuthrich, 2021; Yeager & Dweck, 2012). Self-efficacy is a “self-assessment of one’s ability to perform specific tasks in specific situations,” which is different from self-esteem that indicates self-worth or self-concept, a general, broader belief of self (Martinez, 2010). Albert Bandura proposed the concept of self-efficacy in his social cognitive theory asserting that humans learn socially and experientially, which builds confidence in the ability to perform tasks (Martinez, 2010). Social and experiential learning requires more practice time than a college lecture-style course might allow. Incorporating more time for skill practice into a high school course curriculum can help students discover their capabilities, increasing their competence in solving stressful problems rather than resorting to non-productive relief or avoidance (Frydenberg, 2004). Specifically, research indicates that teaching and practicing grit and growth mindset (Mosanya, 2021; Samuel & Warner, 2021; Zeng et al., 2016), and cognitive behavior therapy skills (Fridrici & Lohaus, 2009; Frydenberg, 2004; Lowe & Wuthrich, 2021; Perry et al., 2017; Reschly et al., 2008) will be particularly helpful in developing self-efficacy. Therefore, the proposed high school stress management curriculum will include a significant time allowance for skill practice, a separate lesson on grit and growth mindset (Polirstok, 2017), and will incorporate age-appropriate cognitive behavioral skills. Stress Management Course 19 Communication. Two aspects of communication recommended for high school learners are, learning how to communicate and encouraging communication practice through discussion. In a study regarding autonomic recovery to stress in middle school children, students were taught to communicate openly and honestly and listen intuitively to others. Students who could intervene in stressful situations due to healthy interpersonal and intrapersonal communication could modulate their autonomic response, thereby reducing stress (McCraty et al., 1999). Teaching high school students how to communicate effectively in family and social settings will help relieve stress (Kouzma & Kennedy, 2004; Kraag et al., 2006), establish social competence (McCraty et al., 1999), and help manage conflict (Frydenberg, 2004). Adapting a lecture-style college course to provide an environment of expression that offers frequent class discussion, small-group discussion, and teacher-pupil interaction can give students valuable practice in coping language (Frydenberg, 2004), emotion and behavior control (Shonkoff et al., 2011). Recommended Topics Specific to High School Students. Skills suggested explicitly for high school students that are taught in college courses include time management (Bouchrika, Imed, 2021; Kouzma & Kennedy, 2004; Lowe & Wuthrich, 2021), money management (Conley et al., 2013), relaxation, problem-solving (Fridrici & Lohaus, 2009; Lowe & Wuthrich, 2021; Perry et al., 2017; Reschly et al., 2008), goal setting, and sleep habits (Lowe & Wuthrich, 2021). Skills not explicitly named in college syllabi but identified in the research as helpful for high school students are emotion regulation (Perry et al., 2017), examination preparation, and identifying social support (Lowe & Wuthrich, 2021). Using the commonly taught stress management topics and those specifically suggested for high school learners, adaptation for a high school stress management course will focus on Stress Management Course 20 increased practice time for skills and communication, high student engagement, varied learning tactics, discussion, feedback, and relevant assessments. Purpose High school students are experiencing high amounts of stress, comparable to adults (Bethune, 2014). The sources of their stress come from academic pressures (Pascoe et al., 2020), difficulties with sociality and relationships (Bouchrika, 2021), and the strain of critical life events common during adolescence (Fridrici & Lohaus, 2009; Pascoe et al., 2020; Perry et al., 2017). Considering that high school students experience increased stress at this time of life, providing a stress management intervention would help them prevent or manage the stress they feel and help decrease non-productive and maladaptive coping strategies (Frydenberg, 2004). Direct application of stress management skills helps students connect and appreciate their school environment and experience (MacCann et al., 2012), increases their chances of academic success (Binning et al., 2019; Kraag et al., 2006; Pascoe et al., 2020), and improves mental health (Caplan et al., 1992; Lowe & Wuthrich, 2021; Pascoe et al., 2020). Providing a stress management course can help avoid the consequences of untreated stress, leading to short-term and long-term negative academic, physical, mental, and societal consequences (James, 2015; Kraag et al., 2006; Pascoe et al., 2020). Administrators, teachers, counselors, and academics have attempted to help high school students decrease stress by implementing stress management interventions. However, most interventions have been short-term programs with short-term success or have lacked data to analyze long-term results (Caplan et al., 1992; Dubow et al., 1993; Hampel et al., 2008). Stress management interventions that teachers have incorporated into their curriculum have met with impediments such as poor teacher buy-in (Bonnesen et al., 2020), teacher fatigue (Bonnesen et Stress Management Course 21 al., 2020; Frydenberg, 2004), improper training (Bonnesen et al., 2020; Schiepe-Tiska et al., 2021), and a lack of consistent and competent lesson delivery (Frydenberg, 2004; Goncy et al., 2015). Post-secondary schools have also recognized the need for stress management to enhance student success and have begun to provide a complete course with excellent success (Conley et al., 2013). This project aims to adapt a collegiate stress management course format and curriculum to a high school elective course that would help students prevent and manage stress. Using commonly taught stress management topics and those specifically suggested for high school learners, adaptation for a high school stress management course will focus on increased student engagement through significant time allotment for skill practice, ample opportunity for discussion and feedback, varied learning tactics, and relevant assessments. Methods After receiving Institutional Review Board (IRB) approval (see Appendix A) for this project, an outline of core lessons and eight lesson plans was developed for a high school stress management course to exemplify the structure of a class. The content of this course is based on the topics covered in post-secondary stress management courses and is adapted for high school level learning and adolescent needs. High-frequency topics in college courses make up the basis for high school content. However, topics that research has suggested would be particularly applicable to high school students were also included. Ultimately the course consists of 44 class periods in a semester, but for the scope of this project, only eight lesson plans will be evaluated. Content Discovery In the state of Utah, of the twelve institutions within the Utah System of Higher Education (USHE) and the private higher education institutions (State of Utah, 2022), seven of Stress Management Course 22 them offer a full stress management course, and one institution offers an ancillary stress management certification class of shorter duration. To identify the content of post-secondary courses, six of the seven institutions that offer the class responded to a request for a copy of their syllabus. Additionally, a Google search produced syllabi for five higher learning institutions and one residential STEM high school within the United States. All syllabi are as recent as 2012. A list of topics was compiled from each syllabus and combined into a master list of commonly taught topics (see Appendix B, Table 1). The master list was then divided into two categories: educational topics (see Appendix B, Table 2) and skills (see Appendix B, Table 3), ordered from most commonly taught to least. From the information the syllabi provided, all schools teach the educational principles of “nature of stress” and the “physiology of stress.” Ten schools teach “nutrition,” and nine schools teach “stress emotions” and “negative coping.” Eight schools teach the “sociology of stress” and “stress and disease,” and finally, six schools teach “personality traits” and “relationships – stress and support.” Nine topics follow the most commonly taught principles but are not named here because they are minor topics according to count. Regarding stress management skills, ten schools teach “resource management: time and money” and “meditation and mindfulness.” Nine schools teach “exercise,” and eight teach “progressive muscular relaxation.” Seven schools teach “diaphragmatic breathing,” “yoga,” “humor therapy,” and “autogenic training,” while six schools teach “journal writing” and “mental imagery and visualization.” Twelve topics are covered by less than half of the schools. Regarding the compilation of topics, only topics explicitly listed in the syllabi were included, so there is a possibility that each school covers more than what the syllabi indicate. Also, a few course syllabi listed assignment numbers associated with the required text rather than Stress Management Course 23 titles. While referencing the texts to align the corresponding assignments with topics, an effort was made to glean topic titles that dictated syllabi organization and topic inclusion. Also of note is the relationship of textbooks to topics used (see Appendix B, Table 4). Four universities all use texts or workbooks by Brian Seaward and therefore follow a similar content and pattern (Seaward, 2018, 2021). Interestingly, other courses focus on common topics without using texts by the same author. Using the most commonly taught topics and skills of twelve courses from different schools provides a sound basis for developing a high school stress management curriculum framework. Curriculum Development Initially, the intent of this project was to adapt the content to the needs of high school students, but it became clear that most of the commonly taught topics were relevant for high school students, but that the methods and format for teaching the topics needed adaptation. Research suggested that students who were more engaged in learning stress management skills and had more time to practice them had greater success in managing their stress. Additionally, two of the most beneficial tools for stress management were characteristics rather than skills, namely, self-efficacy and a grit and growth mindset. While these characteristics can be discussed, they can only be cultivated through experience. Therefore, course adaptations shifted from a lecture-style format to a facilitative-style format, focusing more on student contribution, discussion, and skill practice time. The course goals created to guide facilitative lesson plan development are as follows: 1. The lesson plans will meet the objectives pertaining to the lesson topic and enable students to understand stress management principles and skills. 2. Content and teaching methods will engage high school-level learners, using real-life examples, deep questioning, discussion, and opportunities to transfer knowledge and synthesize concepts. Stress Management Course 24 3. Stress management lessons will provide sufficient time for teacher-student and peer-peer discussion and feedback to encourage communication skills and practice. 4. Students will be given sufficient classroom time to learn and practice stress management skills through assessments, group work, individual reflection, and experience management and relaxation techniques. 5. Stress management skills within the lesson plans will relate to the lesson's topic to encourage knowledge transfer. 6. Assessments for each lesson plan will help students shift stress perception and encourage behavior change through practice, analysis, and implementation. 7. Through sufficient discussion and practice time, students will develop self-efficacy, the belief that they can meet challenges and complete tasks, thereby decreasing the stress that may accompany such challenges. Each lesson plan contains its own objectives based on collegiate course objectives collected from the twelve syllabi and using the Health II Utah Core Standards relating to stress management (see Appendix C, Tables 1 and 2). The commonly taught topics and skills in college stress management courses and suggested topics for high school students became the basis for creating a stress management course outline (see Appendix D). The outline includes a list of 17 lesson plans highlighting core topics and skills used in college courses. Using only 17 lesson plans in a semester of 44 class periods allows for lesson expansion based on student needs, special speakers and activities, and school schedules. For the scope of this project, eight lessons will be evaluated. Each lesson is divided into segments of instruction topics, skill development, practice time, and discussion and feedback time. With these divisions, this lesson plan format allows at least 45 minutes of discussion and practice time in an 85-minute class period to help students increase self-efficacy through experiential learning. Stress Management Course 25 Lesson Plan Content and Structure The content and curriculum from Dr. Michael Olpin’s stress management class (Olpin, 2021) and the accompanying textbook (Olpin & Hesson, 2021), provided the groundwork for the high school course, with a light influence from Brian Luke Seaward’s textbook, which was used in four collegiate courses (Seaward, 2018). Dr. Olpin also offered the use of YouTube videos he created to guide students through relaxation techniques. Each lesson plan includes a hook (5 minutes), discussion-style instruction on the lesson topic (30 minutes), skill development and practice time (30 minutes), follow-up discussion and feedback time (15 minutes), an in-class and homework assessment, and an exit ticket (5 minutes). I use several questions throughout the lesson to help students engage in the learning process, make connections with content, practice communicating, and help transfer skills and knowledge to employ in their lives. The discussion and feedback sections list questions intended to help students synthesize the information from the lesson and spark further discussion. All assessments are formative in nature to assist students in progressing toward stress management application in their own lives. New vocabulary words are introduced and discussed throughout the lessons but are not the focus of assessments. Most assessments are submitted on Canvas with laptops each student has to help maintain the privacy of personal answers, though there are a few in-class collaborative worksheets as well. All exit tickets to be completed on Canvas during class time are to help students incorporate a principle from the lesson into their lives (see Appendix E for lesson plans). Evaluation Two secondary school health teachers and a counselor from a local school district evaluated the stress management curriculum adapted for high school students. Health teachers currently teach a stress management element according to the state’s core curriculum standards Stress Management Course 26 and can judge the lesson plans based on content, format, and suitability. The counselor, who previously taught high school English, is now a counselor that teaches stress management principles in elementary schools and is also suited to judge the lesson plans based on content, format, and suitability. Evaluators were asked to appraise eight lesson plans using questions based on the course goals. Questions covered lesson objectives and content, age-level learning, opportunities for discussion and feedback, assessment relevancy, sufficient practice time, and the likelihood of developing self-efficacy (see Appendix F). Feedback Evaluators were given questions that reflect the course's objectives to assess whether the lesson plans' content, format, and purpose meet the learning needs of high school students in a stress management course. They were asked to answer seven Likert-scale questions ranging from 1 - “strongly disagree,” to 5 - “strongly agree,” a general feedback question, and an option to give feedback to single lesson plans. Aside from very few specific suggestions for single lesson plans, evaluators responded with general feedback and ideas; therefore, all feedback is incorporated in the sections below. Objectives and Assessments All evaluators strongly agreed that the lesson plans met the objective stated for each lesson but did not comment further regarding objectives. All evaluators also strongly agreed that the assessments encouraged perception shift and behavior change. However, there was one comment that perhaps too much behavior change was expected from just one lesson. The other two evaluators noted with excitement the inclusion of the Thoughts and Choice lesson and Grit and Growth Mindset lesson as a powerful catalyst for behavior change. Two evaluators recommended making sure to give examples of complete assessments before allowing students Stress Management Course 27 to work on their own or with a group. One evaluator recommended creating assessments for vocabulary words to help students internalize and retain understanding. High School Level Learning The two evaluators that teach high school marked “agree” in response to whether the lesson plans are appropriate for high school-level learners, and the third evaluator marked “strongly agree.” One of the evaluators that marked “agree” suggested that this course would be most beneficial for juniors and seniors after they’ve already taken a sophomore-level Health course, which would provide a good foundation to build upon where they discuss body systems and have a short introduction to stress management. Another suggested that using multiple media formats to keep students engaged will help with instruction at the high school level. Discussion, Practice Time, and Format Two evaluators agreed, and one strongly agreed that the lessons provide sufficient discussion time. One evaluator commented that the lesson plans seem to be the right amount of content and practice time for an 85-minute class period. Two evaluators suggested that the lesson plans include a follow-up analysis and practice time at the beginning of each lesson to reflect and discuss the skills previously taught and practice again or use that time for a short meditation. One evaluator suggested using real-life examples in discussions to help keep students' attention and observe applicability. Another noted that the frequency of breathing and meditation exercises would be beneficial for students. Skill Relevancy Two evaluators agreed, and one strongly agreed that the skills taught within the lesson plans are relevant to the lesson and stress management. One evaluator encouraged repeating skills rather than introducing new skills with every lesson. Suggestions to enhance skill Stress Management Course 28 instruction and relevancy include using student experiences whenever possible, using resources and media often that teach a skill or concept to maintain engagement and intrigue, using the “hook” as a skill practice exercise, and using as many experiential, hands-on activities as possible to encourage application and synthesis. Self-efficacy Self-efficacy is a difficult concept to rate and ascertain from reading through lesson plans. I defined self-efficacy in the evaluation question as the belief in your ability to meet challenges and complete tasks. Using this definition, two evaluators strongly agreed, and one agreed that the lesson plans would help students develop self-efficacy. While evaluators did not explicitly name self-efficacy in their comments, some indicated the concept. For instance, the suggestion to use real-life experiences to help students understand applicability and capability will help increase self-efficacy, as well as the recommendation to increase practice time and experiential learning. One evaluator was excited about the inclusion of the Grit and Growth Mindset lesson plan, exclaiming that kids need grit and resilience and must be reminded often that they are capable of meeting challenges. Other Suggestions Some feedback for specific lessons included clarifying the empathic listening steps in the Communication lesson, including the use of SMART (Specific, Measurable, Actionable, Realistic, Time-based) goals in the Time Management lesson, and using a competitive bean bag activity to let students experience the effects of fight-or-flight mode in the Physiology of Stress lesson. Aside from those specific suggestions, most of the comments were general recommendations. One evaluator advised remembering reluctant learners and diverse personalities who may have difficulty working in groups or joining discussions and creating a Stress Management Course 29 learning option for them. Another classroom management suggestion was to assign partners for group work rather than let students choose their own to avoid feelings of exclusion. Two evaluators suggested creating a calming and relaxing atmosphere by playing calming music and offering students to dress comfortably and bring yoga mats. One evaluator commented that her students seemed more engaged when she reads or creates guided meditations rather than having the students listen to a recording. Discussion The research for this project clarified that high school students have a genuine and even desperate need to manage their stress. But research also indicated that high school students need not only stress management concepts but also that teaching methods must be facilitative, experiential, and reflective to achieve enduring success. Based on this finding, overall goals for the course and the lesson plan format were created based on suggestions from research that would utilize topics taught in college but adapt to teaching methods that would produce the greatest success for high school students to succeed in managing their current and future stress. Six concepts surfaced as the most important abilities and characteristics for high school students to develop that would help them examine their physical, mental, and emotional stress responses. Once these responses are identified, each student can modify their response by learning and practicing stress management skills. These six concepts include self-efficacy (Caplan et al., 1992; Dubow et al., 1993; Frydenberg, 2004; Hampel et al., 2008; Kraag et al., 2006; Lowe & Wuthrich, 2021; Yeager & Dweck, 2012), grit and growth mindset (Mosanya, 2021; Polirstok, 2017; Samuel & Warner, 2021; Yeager & Dweck, 2012; Zeng et al., 2016), learning and practicing communication skills (Kouzma & Kennedy, 2004; Kraag et al., 2006; McCraty et al., 1999), cognitive behavior therapy skills (Fridrici & Lohaus, 2009; Frydenberg, Stress Management Course 30 2004; Lowe & Wuthrich, 2021; Perry et al., 2017; Reschly et al., 2008), increased practice time (Conley et al., 2013; Hampel et al., 2008; Yusufov et al., 2019), and student engagement (Pascoe et al., 2020; Reschly et al., 2008; Zeng et al., 2016). Rather than stress management topics, these six concepts became the driving force behind creating course goals and a lesson format that would facilitate durable knowledge and skill application. Two of the most impactful means of helping students cultivate these abilities and characteristics are providing a proficient teacher and ample time for practice. As Conley et al. (2013) indicated, students were seven times more successful in managing stress when their practice was supervised. Goncy et al. (2015) found that when the supervising teacher is competent in the topic, they are better able and willing to engage students. Many of the researched stress management interventions were programs that required general teachers to incorporate an intervention into their curriculum. Still, success was limited because the teachers weren't well trained in stress management theory and technique, and it detracted from their curriculum (Schiepe-Tiska et al., 2021). The evaluators for this project demonstrated the need for providing topic proficiency as they were able to give valuable and pertinent feedback based on their experience with teaching stress management. Providing qualified teachers to teach stress management principles and dedicated to teaching that subject alone should be like providing for the needs of any other school subject. Additionally, as the evaluators have had experience teaching secondary students, they also suggested that a teacher needs to be adept in classroom management skills, particularly with a high discussion format. To assist teachers in providing ample time for practice, the format of the lesson plans for this project followed a recommendation by Pascoe et al. (2020) to use the academic classroom environment to increase student engagement in learning to manage stress rather than employ a Stress Management Course 31 lecture-style format. Since a full-semester stress management course in post-secondary settings saw more durable success because students were allowed more time to master concepts and application of skills (Conley et al., 2013), this project determined how to use that extended time in a high school setting. The lesson plan format allows for at least 45 minutes of learning through experience, including facilitative instruction, the use of formative assessments (Hampel et al., 2008; Lowe & Wuthrich, 2021), discussion and feedback time, and peer group work (McCraty et al., 1999; Mosanya, 2021; Reschly et al., 2008; Yusufov et al., 2019). All evaluators responded that the balance between instruction time and experiential time is appropriate and necessary to master the concepts and skills. Two evaluators suggested adding even more discussion time at the beginning of each class period to review and analyze the skills taught in the previous lesson. This suggestion will be implemented in the lesson plan structure to help students process and solidify concepts and skills for reinforcement, as mentioned by Dubow et al. (1993). Increasing time for student engagement by providing real experience is necessary to build grit and open minds to possibilities beyond instinctive reactions. Yeager and Dweck (2012) observed that teaching stress management principles is not as effective as when combined with teaching resiliency skills and a growth mindset. Students who are open to learning new things in new ways and are willing to take risks have better academic outcomes (Polirstok, 2017; Zeng et al., 2016) and are better able to manage their stress (Mosanya, 2021). Though the grit and growth mindset concept was not explicitly listed as a central topic in college courses, based on the frequency it was mentioned in relation to high school students in the research, a single lesson plan was created for the topic. By making students aware of the principles of grit and growth and providing a name for such a mentality, students have a concrete objective to pursue. The basis for this lesson was built upon suggestions from Polirstok (2017), who used The Choice Map Stress Management Course 32 developed by Marilee Adams (as cited by Polirstok, 2017) to help students understand how to learn from and persevere through consequences. Evaluators were enthusiastic about this lesson, noting that students need to be trained and often reminded that they are capable of doing hard things. Grit and growth mindset and engaging students in experiential learning strengthen the possibility of gaining self-efficacy, the belief that one can complete complex tasks and challenges. When a student can gain self-efficacy, stress is minimized through increased motivation, aspiration, ability to perform, and progress (Hampel et al., 2008; Kraag et al., 2006; Lowe & Wuthrich, 2021). Self-efficacy and behavior change takes time to develop (Hampel et al., 2008; Kraag et al., 2006) and require more time than a short-term intervention will allow. One of the evaluators wondered if perhaps too much behavior change is expected from just one lesson plan, diluting or eliminating the behavior change and self-efficacy. However, the research indicates that even the short-term interventions where behavior change was expected led to immediate academic improvement (Lowe & Wuthrich, 2021; Pascoe et al., 2020; Yeager & Dweck, 2012; Zeng et al., 2016), an increase in positive behaviors, and a decrease in misbehaviors (Caplan et al., 1992; Lowe & Wuthrich, 2021; Zeng et al., 2016). Behavior change occurs with any length of intervention, but the question is whether increasing the length of intervention increases the longevity of the behavior change. Conley et al. (2013) indicate that the longer the duration of the intervention, specifically complete courses, were more likely to result in enduring behavior change for college students. One main reason for proposing a high school course is to provide students more time over the course of a semester (Caplan et al., 1992; Conley et al., 2013) to see if behavior change and practice help them adopt, nourish and become Stress Management Course 33 comfortable with the belief that they are capable of and can follow through with difficult tasks in their current situation and throughout their lives. Two essential skills that will help with durable behavior change are cognitive behavioral therapy skills (Fridrici & Lohaus, 2009; Frydenberg, 2004; Lowe & Wuthrich, 2021; Perry et al., 2017; Reschly et al., 2008) and communication skills (Frydenberg, 2004; Kouzma & Kennedy, 2004; Kraag et al., 2006; McCraty et al., 1999). Evaluators agreed that holding discussions and providing feedback to students through individual and group work would help students synthesize skills and concepts. However, one evaluator encouraged remembering reluctant learners who are timid toward discussion participation or do not express themselves well with lists or worksheets. As this project is foundational, teachers will need to make accommodations for individual students as necessary or provide different response options for all students to accommodate preferences and learning styles, giving every student the best chance of success. Evaluators were particularly excited to see the lessons of Thought and Choice, Levels of Responding, and Grit and Growth Mindset to help students develop cognitive behavioral skills. Using cognitive behavioral techniques to teach students what to think about what they are thinking helps them be aware of and evaluate their emotional and mental responses to stress. One of the evaluators gave an example of her student's response to the simple concepts of stress and eustress. She said that her students thought all stress was “bad,” but when they were taught that eustress was “good” stress that prompts optimal performance, they recognized that their emotional stress response didn’t have to be extreme and therefore perceived stress differently. Cognitive-behavioral adjustments such as this are taught and practiced throughout the lesson plans to prompt perception change. Though, one evaluator questioned whether it would be more effective for students to focus on fewer skills with more repetition than present a great variety of Stress Management Course 34 skills. Conley et al. (2013) support the notion of routine skill training, particularly cognitive behavioral therapy and grit and growth mindset. However, Frydenberg (2004) suggests that expanding skill repertoires allows students to choose the most applicable skills. According to the collected syllabi, college courses focus on teaching a variety of skills, giving students a wide range of possibilities to choose from that appeal to their personality and circumstance. This project outlined 17 lesson plans of core topics and skills that can be expanded into multiple class periods if necessary. But an entire semester of 44 class periods will allow for both the introduction of a variety of skills and additional days for skill repetition, evaluation, and feedback. Future Research Due to the lack of available stress management courses for high school students, adopting this course as an elective naturally becomes experimental. There are several further steps and research that could influence development and adjustment. The first issue to consider is the qualifications a teacher needs to become specialized in stress management content. Currently, stress management principles taught within the Health II course are very introductory and, according to evaluators, are covered in 1-2 class periods which does not require extensive training. When qualifications are determined, the next matter would be how to provide this course to a broader high school audience. Second, installing this elective stress management course would guide experimentation on whether the research-based course goals match the actual needs of high school students. The lesson plan format accentuates much discussion, feedback, and practice time but may not be realistic from a classroom management standpoint. These activities and assessments within the lesson plans are based heavily on collegiate classes and activities that may be too challenging for Stress Management Course 35 high school learners. If so, as one evaluator suggested, requiring prerequisite health classes that provide foundational knowledge may be advantageous. Third, implementing this whole class could generate several research topics regarding the effectiveness of skills. Useful inquiry may include which skills appeal to high school students over others, which concepts or skills are received well and which are difficult to understand, and which skills prove durable over time. Additionally, analysis of assessment efficacy would help determine whether they prove to inspire behavioral change or whether they fall in the category of time-fillers and busy-work. Ultimately, future research for this class should include whether long-term, comprehensive stress management training results in long-term perception and behavioral change resulting in stress relief. Specifically, as this project identifies, research should include measurements to determine whether the concepts and skills students learn to increase their belief that they can do hard things, combatting the physical, emotional, and mental stress that is perceived in life's challenges. Final Conclusion Socially defined, stress makes us feel nervous, angry, or frustrated and is a regular part of life. Technically defined, stress is “a demand made upon the adaptive capacities of the mind and body” (Olpin & Hesson, 2021, p. 3). Whether the stress response is initiated due to actual or perceived physical or emotional danger, the physiological cascade of protective mechanisms is meant to help us survive. But increasingly, the unrelenting stressors that high school students are experiencing today prompt prolonged activation of heightened body functions leading to short-term and long-term consequences that can affect the substance and trajectory of life. High school students can be taught to prevent stressful situations or manage their stress by providing them Stress Management Course 36 with experienced and topically trained teachers in an environment where they can have more time to learn and practice skills and tools to help build stress management muscles that can serve them throughout their lives. Aside from the abundant research proving the need for adolescents to receive stress management training, every person I have told about this project has responded positively that this course is just what students need. One of the teachers who evaluated this project exclaimed, “I would love to take this class!” The concern over the influence of stress on physical and mental health is real and palpable and leaves people of all ages searching for relief. 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Practical stress management: A comprehensive workbook (6th ed.). Academic Press. Romero, David. (2020). PHED 160: Stress Management for Healthy Living. https://web-app. usc.edu/soc/syllabus/20201/49972.pdf Samuel, T. S., & Warner, J. (2021). “I Can Math!”: Reducing Math Anxiety and Increasing Math Self-Efficacy Using a Mindfulness and Growth Mindset-Based Intervention in First-Year Students. Community College Journal of Research and Practice, 45(3), 205–222. https://doi.org/10.1080/10668926.2019.1666063 Schiepe-Tiska, A., Dzhaparkulova, A., & Ziernwald, L. (2021). A mixed-methods approach to investigating social and emotional learning at schools: Teachers’ familiarity, beliefs, training, and perceived school culture. Frontiers in Psychology, 12. Seaward, B. L. (2018). Managing stress: Principles and strategies for health and well-being (9th ed.). Jones & Barlett Learning. Seaward, B. L. (2021). Essentials of managing stress (5th ed.). Jones and Bartlett Learning. Seaward, B. L. (2019). Essentials of managing stress. Jones & Barlett Learning. Stress Management Course 43 Shonkoff, J. P., Duncan, G. J., Fisher, P. A., Magnuson, K., & Raver, C. (2011). Building the brain’s “air traffic control” system: How early experiences shape the development of executive function. Contract, 11. State of Utah. (2022). Colleges & Universities. Utah.Gov. https://www.utah.gov/education/colleges.html Stephens, Annie. (2021). PE 2100—Stress Management and Wellness Concepts. Utah Valley University. (2022). SLSS 1100 Stress Management. Wu, Ed. (2018). PSY 2430-01 Stress Management. Yeager, D. S., & Dweck, C. S. (2012). Mindsets that promote resilience: When students believe that personal characteristics can be developed. Educational Psychologist, 47(4), 302–314. Yusufov, M., Nicoloro-SantaBarbara, J., Grey, N. E., Moyer, A., & Lobel, M. (2019). Meta- Analytic Evaluation of Stress Reduction Interventions for Undergraduate and Graduate Students. International Journal of Stress Management, 26(2), 132–145. https://doi.org/10.1037/str0000099 Zeng, G., Hou, H., & Peng, K. (2016). Effect of growth mindset on school engagement and psychological well-being of Chinese primary and middle school students: The mediating role of resilience. Frontiers in Psychology, 7, 1873. Stress Management Course 44 Appendix A IRB Permission Letter June 10, 2022 Louise Moulding Lisa Astling Students, Teacher Education Re: Exempt - Initial - IRB-AY21-22-399 The Need for a Stress Management Course for High School Students Dear Louise Moulding: The Weber State University Institutional Review Board has rendered the decision below for The Need for a Stress Management Course for High School Students. Decision: Exempt Approval: June 10, 2022 Selected Category: Category 1. Research, conducted in established or commonly accepted educational settings, that specifically involves normal educational practices that are not likely to adversely impact students’ opportunity to learn required educational content or the assessment of educators who provide instruction. This includes most research on regular and special education instructional strategies, and research on the effectiveness of or the comparison among instructional techniques, curricula, or classroom management methods. Findings: Research Notes: Subjects are considered adults, signatures/consent are required, and they may choose not to participate. Anonymity and confidentiality are addressed appropriately, and the type of information gathered could not "reasonably place the subjects at risk of criminal or civil liability or be damaging to the subjects' financial standing, employability, or reputation" (Code of Federal Regulations 45 CFR 46, Subpart D). You may proceed at this time; you have one year to complete the study. Please remember that any anticipated changes to the project and approved procedures must be submitted to the IRB prior to implementation. Any unanticipated problems that arise during any stage of the project require a written report to the IRB and possible suspension of the project. Due to the nature of your curriculum project, it is recognized that this project did not involve human subjects. If you have any questions, please contact your review committee chair or irb@weber.edu. Sincerely, Natalie Williams, Ph.D. Chair, College of Education IRB Sub-committee Weber State Institutional Review Board Stress Management Course 45 Appendix B College Stress Management Topics and Texts Table 1 1 Olpin, Michael, 2021 2 Carlsen, Chalyce, 2019 3 Wu, Ed, 2018 4 Stephens, Annie, 2021 5 Utah Valley University, 2022 6 Farnsworth, Jackie, 2021 7 Daw, Pauletta, 2021 8 Romero, David, 2020 9 Finger Lakes Community College, 2012 10 Calhoun, Anquinetta V., 2020 11 Illinois Mathematics and Science Academy, 2019 12 Deree College, 2015 Table 2 Educational Topics Taught in College Courses Table 3 Skills Taught in College Courses Stress Management Course 47 Table 4 Required or Referred Textbooks in College Courses 1 Seaward, 2018 2 Olpin & Hesson, 2021 3 Seaward, 2019 4 Greenberg, 1990 5 Romas, J.A. & Sharma, M., 2022 Stress Management Course 48 Appendix C Objectives from College Courses and High School Health II Table 1 Table 2 Utah Core Standards for Mental and Emotional Health; Health II Health II: Mental and Emotional Health (MEH) Students will apply knowledge to reduce risk factors and enhance factors that promote positive mental and emotional health. Standard HII.MEH.1 Apply stress management techniques to a personal stressor and eval-uate their effectiveness. Standard HII.MEH.2 Research current modes of technology and media use and how they impact mental and emotional health. Standard HII.MEH.3 Explore ways individuals, families, and communities can understand, accept, and reduce the stigma of individuals with mental health disorders. Standard HII.MEH.4 Research school and community mental health resources and deter-mine when professional health services may be required. Standard HII.MEH.5 Research and demonstrate knowledge of risk factors and warning signs of suicide and know how to seek help when needed. Standard HII.MEH.6 Use accurate information to formulate a health-enhancing message for mental health and suicide prevention. Stress Management Course 49 Appendix D Core Topics Lessons in bold were evaluated for this project. Lesson Number Lesson Topic for Instruction Skill Development Practice 1 Introduction to Stress Management/The Nature of Stress Restful breathing Variety of breathing techniques 2 The Physiology of Stress Guided relaxation Guided relaxation 3 Stress and Disease 4 Perception and Stress Cognitive restructuring Perception change 5 Thoughts and Choice Cognitive therapy Irrational vs. rational ideas 6 Levels of Responding Progressive relaxation Progressive relaxation 7 Grit and Growth Mindset Dealing with failure Mantra meditation 8 Mindfulness Identify mindfulness vs. mindlessness Observations Outside 9 Stress Emotions Overcoming fear and anger Steps to overcome fear 10 Nutrition & Exercise Yoga Yoga 11 Communication; Listening and Questioning Facets of Communication Role-play communication 12 Sociology of Stress Identifying technostress Phone notification experiment 13 Resource Management; Time Sharpen Saw Humor therapy and Art therapy 14 Creative Problem-Solving Cost/Benefit Analysis Problem solving steps 15 Meditation Thought watching techniques Guided & silent meditation 16 Goal Setting/Values Identifying values Values Clarification Activity 17 Healing Environment Environment evaluation Music therapy & share Stress Management Course 50 Appendix E Lesson Plans for Evaluation Stress Management Lesson Plan #1 Lesson Topic: Introduction to stress management/The Nature of Stress Lesson objectives: Students will identify their sources of stress. Students will learn, practice, and choose a restful breathing technique for personal use. Students will discuss the meaning of vocabulary words (in bold). Students will discuss and evaluate their stressors and stress-relief methods. Materials: Graphic organizer of holistic health; top ten stressors Canvas assignment; Projector, internet, YouTube, Nearpod. Hook and instruction (5 min): Use Nearpod for students to respond anonymously to the questions below. Read aloud some of the answers for each. Slide 1. What things stress you out? Slide 2. How do you feel when you are stressed out? Slide 3. What do you do to relieve stress? Instruction (30 min) What is stress? Is stress good or bad? Name ways that stress can be good. Name ways that stress can be bad. Do other things make you stressed, or do you make you stressed? Can you control stress? How? 1. Some stress is okay and useful (eustress) 2. Too much stress can cause problems (distress, acute vs. chronic stress) 3. Stress doesn’t happen to us; we activate our stress 4. You can alleviate, control, or prevent stress. In-class assignment: Divide the class into five small groups, and hand out one graphic organizer/student. Categories: physical, mental, emotional, spiritual, social. Be sure to define “spiritual” as values that guide a person, not necessarily religious meaning. Each group discusses and writes the definitions of each category on the page, then lists at least three ways that stress affects each category. Each group will report on one of the categories. Acknowledge that each category is affected by stress, so when we manage stress, we need to pay attention to managing each category. This is a holistic approach. Use Nearpod to respond anonymously to this question: What are ways we adapt or adjust our lives to deal with stress? Group discussion: healthy vs. non-healthy stress management methods; what are the consequences of both? (Drugs, alcohol, eating, procrastination, screaming, withdrawal, self-harm, etc.) Stress Management Course 51 Skill development and practice (30 min): Restful breathing Assess respiration rate for 1 minute. Prep question: Why would breathing help reduce stress? View “Why do we need oxygen to survive?” Ask: Based on the video, why would breathing help reduce stress? (Breathing affects every cell, necessary for energy, warms body, release CO2, activates the parasympathetic nervous system (opposite of stress), distracts from stress) Lead class through diaphragmatic breathing. Practice: Breathing stations. Post clear and simple instructions for various breathing exercises around the room. Allow students 5-7 minutes at each station, one student from each group should read the instructions out loud. Use a timer to signal station change. Diaphragmatic breathing Alternating Nostril Breathing Visualization breathing Box breathing 5-finger breathing Discussion and feedback (15 min): What did you notice or feel during the breathing exercises? How can you implement breathing exercises every day? How do you know the difference between good stress and bad stress? Why will knowing the difference help manage stress? Why is a holistic approach to stress management necessary and effective? Homework Assignment: On Canvas - The Nature of Stress: List you top ten stressors Exit ticket (5 min): Fill in text box on Canvas What was the most helpful piece of information or skill you learned today? Stress Management Course 52 Stress Management Lesson Plan #2 Lesson Topic: The Physiology of Stress Lesson Objectives: Students will analyze the body’s short-term and long-term reactions to stress. Students will distinguish between life-threatening stressful situations and no real physical threat. Students will describe the cause and effects of the flight-or-fight response. Students will discuss the meaning of vocabulary words (in bold). Materials: Picture of body and systems projected on dry erase board. Dry erase markers. Canvas worksheet for in-class assignment. YouTube guided relaxation, by Dr. Michael Olpin. Hook (5 min): Chased by a bear scenario: fight or flight (FOF) response. Relay an exciting camping story where a bear approached. What is your first response? (I’m in danger) a conscious thought that you choose. Then physiological FOF response of survival. Survival is the only reason for the stress response. It lasts less than 1 minute, just enough time to get you away. Instruction (30 min): Homeostasis – when your body functions comfortably (rest & repair). But in FOF, the body gives physical reactions to help you either fight or flee. What do you think happens with each of these body systems? As students list answers to questions below, draw an up or down arrow by the body part or system and briefly discuss the response. What are the systems that increase during FOF? What are the systems that decrease during FOF? How many times in the last month have you been in physical danger? How many minutes? Note that events are not long and/or not often. True stress doesn’t and shouldn’t last long. Acute and chronic stress: have a student hold a backpack out from the body to see how long can hold while you continue the discussion. When no longer holding up make the point that muscles can handle acute stress, but not continued tension. What happens if your body continues with fight or flight stress? Refer to the body on board again and ask students to analyze what might happen if systems continue at the heightened response for a long time. Explain: General Adaptation Syndrome – the process in which the body tries to adapt to stress. Draw a graph of GAS in stages: Homeostasis, perceived threat, alarm stage (FOF/energy up), stage of resistance, stage of exhaustion. Point our chronic stress continues the FOF reaction. How can understanding the stress response help us manage stress? If all stress begins with a thought (I’m in danger) and our bodies are unable to distinguish between true stress and more mundane stress, then our mind can tell our bodies what to be stressed about. In-class Assignment: Think-pair-share Stress Management Course 53 On the worksheet, circle the situations that are life-threatening situations that might initiate the fight-or-flight response, then share your thoughts about the questions below with a student sitting next to you: Does stress happen to us, or do we choose stress? Can someone make you stressed? (He stressed me out, this class stresses me out) Skill development and practice (30 min): Guided Relaxation Benefits of relaxation are the opposite of fight-or-flight: slows heart rate, reduces blood pressure, slows breathing, reduces the need for O2, increases blood flow to muscles, decreases muscle tension, helps w/sleep Tips for relaxation: use headphones, dark and quiet, minimize noises -don’t force it; be passive, when mind wanders, gently refocus, no expectation, keep trying, more important how you feel after than during Practice: Use a guided relaxation recording from Dr. Michael Olpin. 15 minutes. Before beginning encourage students to open their mind to new experiences. This will seem goofy, but if used seriously, can do some serious good. Remind students that each individual has their own experience. Eyes will be closed; therefore you don’t need to worry about what your neighbor is doing. https://www.youtube.com/watch?v=LEksHPL9CFg Students should remain sitting upright in their chairs. Discussion and feedback (15 min): What thoughts did you have during the guided relaxation? How did you feel at the end of the guided relaxation? How does categorizing stress as life-threatening or no real threat influence mental/emotional well-being? How can you explain that you feel stressed in situations that are not life-threatening? Homework Assignment: On Canvas under Physiology of Stress, fill out and submit a Stress Self-assessment Exit ticket (5 min): Fill in text box on Canvas Using the discussion about stress today, answer these two prompts: I used to think. . . Now I think . . . Stress Management Course 54 Stress Management Lesson Plan #4 Lesson Topic: Perception and Stress Lesson Objectives: Students will evaluate the perception of a personal stressor. Students will employ cognitive restructuring to change their perception of stress. Students will formulate grit and growth responses to a top ten stressor. Students will discuss the meaning of vocabulary words (in bold). Materials: Projector/screen, Dr. Olpin video, perception slide show, perception worksheet, Student laptops for Canvas access. Hook: (5 min) Show the slide show presenting zoomed-in and zoomed-out pictures. With each zoom-in picture, ask students what they think they see, then reveal the next slide of what it actually is. After the slides, ask: How do your perceptions influence experiences? Instruction (30 min): Show this statement on the next slide: Stress is the physiological survival response to a perceived threat. What is the most important word in that sentence? (Perceived) What is perception? (person’s cognitive interpretation of events). Can you choose how you perceive things? What initiates the stress response? (Threat thought – “Uh-oh”) Threat thought=stress. If we can change the way we perceive a threat, then we can prevent that initial thought and prevent the stress response. Use these three questions to help adjust your thinking about a stressful situation. 3 questions to ask yourself to help prevent the stress response from activating: 1. Am I in danger? (If no then stress response is not initiated) 2. Can I handle this situation without physical pain or dying? (Important to answer because if you can do something without stress, you will perform better) example: taking a test 3. Can I think about this differently? (Cognitive restructuring) Go through stressful situations below and think through how to think about them differently. Identify the stressful feelings, then identify possible restructure. *Seeing a police officer on the road *Taking a test *Being down one point on a sports team and it’s up to you to score *Driving behind a slow driver when you are in a hurry *Bullying What is the difference between a challenge and a stressful situation? (How you perceive it). In-class assessment: Open your Canvas account and look at your Top Ten Stressors Assignment. In a new document or using the text box, use the three questions to prevent stress for each item and write about if and/or how you can think differently about them. (List or show the 3 questions on the board). Stress Management Course 55 Skill development and Practice (30 min): Skill: Cognitive Restructuring – how to see things differently Introduce what a “hardy” person is (also called grit and growth): 1. Views potentially stressful events as interesting and meaningful. 2. Sees change as healthy and as an opportunity for growth. 3. Perceives some degree of control in the situation. A hardy person uses 3 C’s: 1. Commitment – turning problems into opportunities 2. Challenge – view change as a challenge rather than a threat 3. Control – What things can you control? Warning: Beware of self-limiting beliefs. Whether you think you can or you can’t, you’re right. Just like you can change the way you perceive situations, you can change the way you perceive yourself. Practice: Find a partner. Sometimes seeing things from someone else’s perspective or getting someone else’s input can help you see things differently. Use one of your top ten stressors that you feel comfortable discussing to fill out the table. Ask your partner what suggestions they have to help you change your perception. Turn in your paper for grading. Discussion and feedback (15 min): What did you discover as you filled out the perception change table? Did your partner make any helpful suggestions that caused you see things differently? What other discoveries did you make about using your thought processes to prevent stress? Why did I include a column asking about failure? Homework Assessment: None Exit ticket (5 min): How did our discussion about perception change the way you think about your capabilities? Stress Management Course 56 Stress Management Lesson Plan #5 Lesson Topic: Thoughts and Choice Lesson Objectives: Students will demonstrate techniques to overcome cognitive distortions. Students will evaluation irrational thoughts and compose rational responses. Students will discuss the meaning of vocabulary words (in bold). Materials: Worksheet with 12 irrational ideas, projector, screen. Thoughts and Choice slides. Hook (5 min): Show this picture to begin a discussion about how different people see or define the world differently. May need to explain some of the “ists.” Discussion question: What influences how you see the world? Follow-up: Can you choose how you see the world? Instruction (30 min): Because we can choose how to see the world and situations, we can be proactive in managing stress by changing our cognition (the way we think) and react positively by changing our cognition. To be cognitively proactive, we need to be aware of some of our cognitive distortions (magnifying thoughts out of proportion to their seriousness), so we can relearn how to process stressful events. For each distortion below, discuss with the class what it is and ask for examples, then show examples from slides. What is . . .? All-or-nothing thinking: either you are perfect or a failure. (Slide 2) Personalizing: assume responsibility for things out of your control. (Slide 3) Discounting the positive: refusing compliments or denying yourself satisfaction. (Slide 4) Assuming the worst: awfulizing, believing everything will turn out poorly. (Slide 5) Self-made borders: assuming you can’t do something you’ve never tried. (Slide 6) Techniques to overcome cognitive distortions (progressive animation slide 7): Positive self-talk: How can you tell if your self-talk is positive or negative? Give students an example situation and a minute to think through their reaction to help them discern whether they lean toward positive or negative self-talk. (Example: you receive a lower grade than you thought on a test). Thought-stopping: when you detect a negative thought, stop the thought and think a positive thought. This can prevent a stress response. Power Language: can’t vs. won’t. Show on the screen words that upgrade negative to positive words. Threat > challenge; Fear > curiosity; complain > gratitude. Going with the flow: accepting situations we cannot control. Give the class a few scenarios to employ techniques to overcome positive distortions. What can you do if you find yourself thinking. . . “I can’t believe I failed a test! I’m so dumb!” “I sent a text to Sally, but she hasn’t responded. I must have made her mad.” “You played so well in your game today. It was just luck.” In-class assessment: no formal assessment Stress Management Course 57 Skill development and Practice (30 min): Skill: Cognitive therapy 12 Irrational Ideas (adapted from Albert Ellis) 1. I must be loved by everyone, and everyone must approve of everything I do. 2. Certain acts are awful or wicked, and people who perform such acts should be punished. 3. It is horrible when things are not the way I like them to be. 4. Misery and unhappiness are forced on me by other people and events. 5. If something is or may be dangerous or fearsome, I should be terribly upset and obsess about it. 6. It is easier to avoid difficulties and responsibilities in life than to face them. 7. I absolutely need something or someone stronger than me to rely on to succeed. 8. I should be thoroughly competent, intelligent and achieving in all possible respects. 9. Because something once strongly affected my life in the past, it must determine my present and future behavior; the influence of the past cannot be overcome. 10. I must have absolute and perfect control over things. 11. Human happiness can be achieved by staying in my comfort zone. 12. I have no control over my emotions, I can’t do anything about how I feel when things happen. Practice: In groups of 3 or 4, using the 12 Irrational Ideas worksheet, read the irrational thought, then write an opposing rational idea in 1-2 complete sentences. Each person needs to contribute ideas for each answer. Then choose one idea and come up with a scenario to act out in front of the class that shows the change from an irrational idea to a rational idea. Example: 1. I must be loved by everyone. Irrational: Bob told me that he didn’t like my idea of a scenario for this assignment. He must think I’m stupid. Rational: We are just coming up with ideas, then we can choose which one works best. My idea isn’t the best or the worst, it’s just an idea and doesn’t reflect my intelligence. Discussion and feedback (15 min): How would these irrational thoughts contribute to stress in your life? How easy, or difficult, was it to come up with rational ideas? How easy, or difficult was it to listen to and use other’s ideas? (Be open to new thought) What are some tools you could use to help you remember to change an irrational idea to a rational idea? Homework Assessment: In the Canvas text box for the Thoughts and Choice assignment, write down two thought patterns you recognize in yourself in any situation from now until the next class. They can be two positive, two negative or a mixture. Write whether you changed your thinking about those thoughts and if that helped. Exit ticket (5 min): After our discussion, what do you think about your ability to change your thinking? Stress Management Course 58 Stress Management Lesson Plan #6 Lesson Topic: Levels of Responding Lesson Objectives: Students will distinguish between events they can and cannot control. Students will distinguish between ineffective and effective responses and adapt a stressful reaction to a calming response. Students will experience progressive relaxation. Students will discuss the meaning of vocabulary words (in bold). Materials: Slide with a picture collage of life events, levels of responding, and muscle systems. Hook (5 min): Show a slide with a picture collage of events in life. Have students name the things they can control (our thoughts/actions/words, boundaries, spend time), then the things they cannot control (natural disasters, what other people think/say/do, accidents, world events). We’ve discussed some ways we can control our thoughts and actions, but how can we manage the things we do not have control over? Example: Someone pushes you in the hall, causing you to spill the contents of your backpack. What are some ways that you can react? Instruction (30 min): Please make sure to mention in this lesson that while we cannot control how people treat us or what they say, if you are personally harmed, please seek help from a trusted adult. When things happen that we can’t control, the only thing we can control is how we react to them, which influences our stress response. There are ineffective and effective ways to respond (with each level, ask for examples they might experience): Ineffective Attachment/Rightness: I am right, and you can’t convince me otherwise. (breeds anger or loss of self-esteem when realizing I am wrong) Judgment/criticism/blame: put a label on something or someone to elevate our self-worth, reflect our inadequacy (defensive) Resistance/Complaining: wishing things were different (breeds anger) Effective response Observation: noticing something without reacting emotionally Discovery: learning, seeking to understand. How can this add to the quality of the experience? Allowance/acceptance: What is happening is ok. Gratitude: showing appreciation or thankfulness for the moment or things in the moment. Show the students the slide of what the levels of responding sound like (see below) and use the example of being stuck behind a slow driver to go through the levels of responding, i.e., How would you respond with observation. . .? Stress Management Course 59 In-class assessment: Think of a situation in the last week where you felt stressed (anxious/angry). Use the Levels of Responding worksheet to write, in 1-2 complete sentences, corresponding possible reactions to the event/thought. Skill development and Practice (30 min): Skill: Progressive Relaxation Sometimes it takes a lot of work to control your response to stressful events and we end up tense despite our efforts. Using methods of relaxation can help relieve tension. Progressive relaxation is a great way to physically release tension. What do you muscles do in FOF mode? If your muscles remain tense for a long period of time they become tight and begin to affect other body parts/systems. (Show slide of muscle connectivity). Muscles cannot be tense and relax at the same time, so when you become tense you can train your muscles, or just give them the opportunity to relax. Practice: Students may lay down or sit at their desk. Lead students through a progressive relaxation, use Dr. Michael Olpin’s YouTube video: https://www.youtube.com/watch?v=ZdkjP2n9G4E Inhale while tensing a group of muscles, hold breath for 4-8 seconds, then slowly exhale while slowly releasing muscle (15-30 sec). Imagine the tension releasing and notice how different relaxation feels. Move through groups of muscles. Discussion and feedback (15 min): Different people respond to differently to relaxation techniques, what did you discover during the exercise? What visualizations did you use during the relaxation exercise? What ones could you use to help you relax even more? I led you through the exercise, how do you think you could do this yourself? Why do you think the levels of response would be effective, or ineffective? Homework Assessment: none Exit ticket (5 min): Based on our discussion of levels of response, what is one way that you could realistically change your response to stressful events? Usefulness Ways We Respond to Events Sounds Like (What we say to ourselves) How this response makes us feel Effective Leads to feelings associated with relaxation. Gratitude I appreciate . . . Joy, serenity, contentment Allowance/Acceptance It’s okay . . . I can live with this. . .I can go with the flow. . Peace, release, relaxation, freedom Discovery I wonder . . . What would happen if? What can I learn from this? Inquisitiveness, curiosity, growth Observation I am noticing . . . Calm Ineffective Leads to feelings associated with stress. Resistance/Complaining I wish things were different.. Boredom, fatigue, anger Judgment/Criticism/Blaming This is really a . . . He is really a (insert negative noun). Guilt, shame, low self-worth, false pride Attachment/Rightness This must be a certain way. . . Using words like must, have to, need to, should Mistrust, anxiety, anger, disappointment Stress Management Course 60 Stress Management Lesson Plan #7 Lesson Topic: Grit and Growth Mindset Lesson Objectives: Students will prepare a short summary of judger/learner mindsets. Students will apply grit and growth mindset examples to perceived situations of failure. Students will analyze their grit and growth mindset with a meditative experience. Students will discuss the meaning of vocabulary words (in bold). Materials: October Sky YouTube clips, hook slides, judger and learner slides, Canvas, laptops Hook (5 min): Lessons from nature: nature finds a way. Show a picture collage of images where plants grow in unlikely places. Ask: What do these things have in common? Seeds were not planted in usual areas, so why didn’t they die? What did they need in order to grow? What lessons can we learn from this? (There are ways to grow and succeed even when you think there are not) Instruction (30 min): Two important words for today: Grit - persevering to achieve goals even after setbacks, and Growth - the belief that intelligence and talents can change over time. Watch the two October Sky YouTube clips and have students watch for examples of grit and growth. October Sky #1 https://www.youtube.com/watch?v=cP_OM5VVcSo October Sky #2 https://www.youtube.com/watch?v=ynGvGgy6K2Q Students will probably mention the number of failures the boys had. What does failure make you feel like, or what does it make you believe about yourself? (makes the goal seem less attainable, distorts your perceptions about your abilities, makes you believe you are helpless, creates an unconscious “fear of failure,” pressure to succeed increases performance anxiety). Revisit the definitions of grit and growth. If you had grit, how would you work through failure? How would that help you through failure if you had a growth mindset? Connect to stress management: Why would we talk about grit and growth in a stress management class? How would these two principles help manage stress? (Fear of failure can lead to stress and anxiety, limiting your actions and opportunities) Introduce a Choice Map. (show definitions on a slide so students can continue to look at them for guidance) Learner mindset – curious, thoughtful, open, choice, solution-focused, and win-win mindset. Judger mindset – automatic reactions, blame-focused, win-lose mindset. Give an example of failure. Hurting a friend’s feelings. How would a judger mindset react? What might they call themselves? What would a learner mindset do? What would they ask themselves? In-class assessment: see Skill Skill development and Practice (30 min): Stress Management Course 61 Skill: Divide class into groups of 4-5. Each group will watch a short video on Canvas, assigned by the teacher, exemplifying instances of failure. Groups will discuss: How that person might feel about the failure. What judgments they might be placing on themselves. What questions that person could ask to help? How can they make this a win-win situation? Each group will give a 2-minute summary for the whole class. Practice: Mantra Meditation. After discussing grit and growth, we are going to try something new that you will need a growth mindset for. Explain mantra meditation, explaining and emphasizing a passive attitude. 1. Sit w/ dignity and close your eyes 2. Repeat your mantra (one word or short phrase). 3. When your mind wanders, return your focus to passively repeating your mantra. 4. Do not be in a hurry to end. 5. Enjoy the benefits of relaxation. Allow at least 5 minutes for mantra meditation. Dim lights, assure students you will keep time. Remind them that meditation is not clearing your mind of all thought, it is allowing your thoughts to pass through without judgment. Discussion and feedback (15 min): What were some things you noticed about yourself while you were meditating? Did you feel successful or unsuccessful with this meditation? Why? What would a judger mindset say about the experience? What would a learner mindset say? I asked earlier how grit and growth could reduce stress, but after learning more about judger and learner mindsets, grit and growth, what new thoughts do you have about the impact of this information on stress management? Homework Assessment: Choice Map (Dr. Marilee Adams) Students will fill out a choice map under Grit and Growth on Canvas using an experience where they felt they failed, or using one from a book/movie. They will answer prompts for the learner path and the judger path. After filling out the path prompts, students will write a short summary of how the learner path shows grit and growth. Submit only on Canvas to protect privacy. Exit ticket (5 min): What is one area of your life that a grit or growth mindset would impact positively? How? Stress Management Course 62 Stress Management Lesson Plan #11 Lesson Topic: Communication; listening and questioning Lesson Objectives: Students will apply empathic listening skills in a conversation. Students will identify and resolve thinking errors regarding fear of asking questions. Students will evaluate the effectiveness of empathic listening. Students will discuss the meaning of vocabulary words (in bold). Materials: Nail in the head YouTube video, slides. Hook (5 minutes): Watch the Nail in the Head video. https://www.youtube.com/watch?v=- 4EDhdAHrOg Two people are trying to communicate in this video. What are the parts of communication from this video? (talking, listening, eye contact, hand gestures, voice, and volume) What did the man try to do? (fix the problem) What did the woman want him to do? (listen, empathize) When the man changed his method of communication, how did the woman react? (like she had been heard) Did it take care of the problem? (No) Is it ok for the listener not to take care of the problem? (Yes, the talker has control of the problem) Instruction (30 min): Relationships are a big part of our lives. How well we communicate with others affects our level of stress, not just the actual communication, but the consequences of how or if we communicate. Communication is one of the most essential parts of a healthy relationship, and also one of the top reasons relationships fall apart. What are some problems that could happen while communicating? (forgetting information, saying the wrong thing, not meaning what you say, neg. voice inflections, not communicating at all, fighting, facial expressions, not listening, etc.) When we think about communication, we think primarily about talking, but talking is only one side of the coin. Good communication involves listening to the message delivered. Great communication involves empathic listening (active listening with the intent to understand genuinely). While listening, you are paying attention to verbal language, body language, and tone. You are focusing on the person talking, not thinking about what you are going to say next or thinking of anything else. Ask a student to come up and share a story that elicited some emotion. Show the stages of listening. Ask students in the class to look for good listening skills. Ask the story-telling student how they felt about the communication. What good (or bad) listening skills did you notice? Empathic listening has four stages (Slide 1): 1. Mimic the content of the communication. (restate) 2. Rephrase the content in your own words. (you mean. . .) 3. Reflect feeling. (It sounds like you are feeling... ) 4. Rephrase the content and reflect that feeling. (So, you’re feeling - - - - about - - - -?) Other tips for good conversation (Slide 2) With each tip, ask, why would this be helpful for a good conversation? Listen more, talk less. Suspend judgment. Look for interesting aspects of the other person. Avoid giving advice. Allow moments of silence. Listen with your eyes and your heart as much as your ears. Use appropriate body signals. Maintain eye contact. Ask questions for clarity. Stress Management Course 63 Sometimes even when we are ready to listen to answers, we have stress asking questions.? What are some thinking errors that you might have about asking a question? (I will look dumb, I shouldn’t ask questions, intimidating, judgment from teacher or peers, teacher anger). What are some examples of positive self-talk, thought-stopping, power language or going with the flow to combat thinking errors about asking questions? There are different methods of asking questions that help increase your confidence in asking and clarify what you need to know. Methods of asking questions (Show slides with these question options and discuss, using an example of asking your math teacher a question): Open questions, to gather info and facts: “What are the. . .” Probing questions to gain detail: “Can you explain. . . “ Hypothetical questions to suggest an approach or idea: “If I could do this, then. . . “ Reflective questions to check understanding: “So would you say . . . “ Open ended questions for more info.: “How do you think . . .” “What do you mean by. . . “ “How do you feel about. . “Would you explain. . . “ In-class assessment: see skill practice Skill development and Practice (30 min): Skill: Talking, listening, asking questions, eye contact. Practice: Choose a partner. Explain the last TV show or YouTube video that you watched (G rated), including how you felt about the episode, to you partner. The listener should look their partner in the eye, every few minutes, 1.Restate what you heard, or rephrase the content in your own words. 2.Decode what is being said by stating, “it sounds like you.. “, 3.Then sum up what you understood the show to be about and how they felt about it. 4.Ask clarifying questions throughout. 5.Remember to keep eye contact, watch body language and vocal tone to decode feeling. Switch being the talker and listener. If time, have students ask get to know you questions with a student they do not know. Discussion and feedback (15 min): What did you notice was difficult or easy when you were the listener? When you were the talker, what helped you feel heard and understood? What did you feel when you were listening? How would learning how to listen decrease your stress? How would learning how to ask questions decrease your stress? Homework Assessment: Ask a teacher a question and describe the interaction and how you felt afterward. Enter you description in Canvas under Communication; listening and questioning. Exit ticket (5 min): While doing skill development, come ask the teacher a question, making eye contact, speaking clearly, and listening for the answer. Stress Management Course 64 Stress Management Lesson Plan #13 Lesson Topic: Resource Management; Time Lesson Objectives: Students will prioritize a task list and judge whether tasks are controllable. Students will compare reasons for procrastination and discuss methods to overcome them. Students will consider the importance of choosing a time for self-care. Students will discuss the meaning of vocabulary words (in bold). Materials: Time log worksheet, blank papers if needed. Colored pencils. Mandala art papers. Hook (5 min): Tell the story or show the video of “Sharpen the saw.” https://www.youtube.com/watch?v=REdUBHcgJws When you take time to sharpen your saw, you end up being more productive than you do by packing activities in. Just like you have a choice with your thoughts and how you react to a stressful situation, you have a choice in how you spend your time. Choosing how to spend your time makes you feel more in control, decreasing stress. As our sense of control increases, our stress tends to decrease. Instruction (30 min): Planning is one of the best tools to help you manage time. There are many time management strategies, but most suggest focusing on your highest priority items. You can plan your day in detail, or you can be general; we will focus on something in between. Definition of time: one event happening right after another. Definition of management: the art or manner of controlling. What is the definition of time management? (the art of controlling the events of our days) In-class assessment: On a piece of paper, or new document, make a list of the six most important tasks you need to accomplish today. (You will be uploading this assignment by submitting the document or taking a picture and submitting it). Some of your events will be urgent, and some will be important. What is the difference between urgent and important? (urgent calls for immediate action) Look at your list and order them from 1-6, 1 being the most important task. Distinguishing between events you can and cannot control might change the order of your tasks or even eliminate tasks. Control vs. non-control: write suggestions on the board for the categories below. What can’t we control? (environment, people’s reactions, the passage of time, the past) What can we control? (our thoughts, reactions, actions, feelings) Why is it important to distinguish between things you can control and not control when trying to manage your time? Look at your list and determine whether you can control the events or not. What could you do with the events that you can’t control? (Let go/take it off your list). Make a new list next to your first, titled “other events,” listing things you usually do during the day. Which of these events are time-zappers? When you look at both lists, which one appeals to you more? Why? If our “other events” list seems more appealing, how can we accomplish what we need to? Stress Management Course 65 (Integrity)– if you commit to nothing, you’ll be distracted by anything. What is procrastination? Why do we procrastinate? 1. Perfectionists – fear of making mistakes. 2. Dreamers – have big goals but no plan of action or details. 3. Worriers – see problems rather than solutions, avoids change. 4. Crisis makers – wait until pressure mounts to take action. 5. Defiers – resist new tasks and don’t follow through. 6. Overdoers – make the job harder than it needs to be. What category do you identify with, if any? If your task list looks so overwhelming that you procrastinate with other events, what could you do to overcome procrastination? 1. Break up into small tasks 2. Avoid cramming by preparing better. 3. Manage your time zappers. 4. Work hardest during your “best time” of the day 5. Let some things go undone 6. Learn how to say “no” 7. Delegate 8. Establish acceptable perfection 9. Do the most difficult or most unpleasant tasks first. 10. Reward yourself Look at your task list again. In a third space write, “plan of attack,” and write some things that you can do to help you accomplish your tasks and avoid procrastination. Skill development and Practice (35 min): Skill: We began the class taking about the value of sharpening your saw so you can be more productive in accomplishing your tasks. After talking about tasks, how can you take time to sharpen your saw? Practice: Humor therapy vs. Art therapy Show a funny 10 min video (funny animal video) https://www.youtube.com/watch?v=BkD2nN5275c Or other allowed humorous video for 10 minutes. Then ask students to color in a mandala drawing. Allow 10-15 minutes. Discussion and feedback (15 min): Did either therapy feel like a waste of time? Why or why not? (point out that the goal is to give your mind a break – you get to choose how your mind takes a break) What did you notice about your list of tasks? How can you make it a habit to create a task list? Would making a tasks list make you less stressed or more stressed? 80/20 rule – you get 80% of your events done, with only 20% effort. Do you think this is a true principle? Why or why not? Homework Assessment: Fill out the time log found on Canvas: Resource Management; time. Choose one 24-hr period to record everything you do from hour to hour. Even include driving places. Don’t change anything about your day to make it seem like you are having the ideal day, this is just for you to observe. Submit on Canvas. Exit ticket (5 min): Name one way you can manage time zappers. Stress Management Course 66 Appendix F Evaluation Form Stress Management Course 67 Stress Management Course 68 Single Lesson Plan Feedback Option (repeated for each lesson)