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##  Promoting Stress Management: The Role of Comprehensive School Health            Programs. ERIC Digest.                                                       

INTRODUCTION
Stress has been defined as, "the inability to cope                with a perceived or real (or imagined) threat to one's mental,                  physical, emotional, and spiritual well-being [sic] which results in            a series of physiological responses and adaptations" (Seaward, 1997,            p. 5). In addition to responding physiologically, people may respond            cognitively and emotionally to stress. Studies indicate that 70-80%             of all disease and illness is stress-related (Seaward,                          1997). 
Stress affects each of the five dimensions of health:                  physical, mental, emotional, social, and spiritual. Examples                    of "distressors" (negative stressors) that children and adolescents             may confront within these dimensions include: illness, injury,                  inadequate nutrition, and low levels of physical fitness (physical              dimension); pressures to excel in academic and extracurricular                  activities, depression, and anxiety (mental/emotional dimension);               relational issues, peer pressure, and dysfunctional family                      lives (social dimension); and inability to find purpose in life or              to understand how individual lives contribute to a much larger and              grander universe (spiritual dimension). 
Rather than how much                  stress individuals experience, the critical issue seems to be how               they perceive stress and respond to it. Seaward (1997) points out               that coping with stress is an ongoing process. Therefore, it is                 critical that children and adolescents are given opportunities to               develop life skills that will help them effectively cope with daily             stressors, major life events, and change. The purpose of this Digest            is to examine how comprehensive school health programs may promote              stress management. THE COMPREHENSIVE SCHOOL HEALTH                            PROGRAM (CSHP)A recently conceptualized model (Allensworth,                 Lawson, Nicholson, & Wyche, 1997) describes four key elements of                CSHPs: community participation and focus, school environment,                   education, and services. Each of these areas is linked to enhance               the well-being of the entire school and community. Examples of how              stress management can be promoted through these components                      follow. COMMUNITY PARTICIPATION AND FOCUSSchool health efforts            must be coordinated with the community at large. There are numerous             ways in which stress management strategies can involve families and             communities: 
1. School health newsletters sent home and to                    community agencies may include health facts, tips, family activity              ideas, and resources for further information on a particular health             topic, such as time management. 
2. The Family Involvement                     Calendar (Birch, 1994) includes ideas for family participation in               health activities that reinforce a specific health topic or unit                that is being studied at school. 
3. Health fairs and community                nights that include enjoyable educational activities can be held at             the school (National PTA, 1997; Valentine, 1997); community groups              can be involved in program planning and delivery. 
4. Local                    newspapers, radio, and television stations can promote wellness                 activities including poster and/or writing contests for different               age groups focussing on the importance of stress management. Prizes             may be donated by local businesses, and winning posters and/or                  writings can be displayed within the school or community (e.g.,                 supermarkets). 
5. Guest speakers from the community can address               various stress management issues at student and staff health                    promotion programs. SCHOOL ENVIRONMENTThe school environment              includes the physical setting as well as the policy and                         administrative environment, psychosocial environment, and health                promotion for staff. Physical conditions that play a role in stress             and the overall learning process include school size, lighting,                 temperature and ventilation, noise control, crowding, sanitation and            cleanliness, and accessibility. The teacher's personality and                   behavior, respect for diversity and individual differences, and                 effective classroom management play a role in helping to ensure that            students feel a sense of belonging, security, and trust. A nurturing            emotional environment is especially important for those children and            youth whose families exhibit behaviors such as abuse and neglect,               violence, and alcohol and other drug abuse. School safety is                    directly associated with the stress experienced by students,                    teachers, and parents. Important areas that should be considered                regarding safety and injury prevention include playground safety,               violence prevention, conflict resolution, procedures for emergencies            and disasters, and promotion of smoke- and drug-free schools. 
It              is critical that teachers and other school staff possess emotional              wellness in order to manage their own lives as well as the lives of             the children within their circle of influence. According to                     Pransky (1991), teachers who have participated in school health                 promotion programs report decreased absenteeism, enhanced morale,               improvement in the quality of their teaching, enriched attitudes                about their personal health, and a sense of well-being. Moreover,               healthy teachers and staff serve as positive role models for                    children and their families. A staff wellness program might include             instruction in relaxation techniques, diet planning, communication              skills, smoking cessation, and incentives for lifestyle                         improvements, such as lower health insurance rates, bonus checks,               and free or reduced-cost health club                                            memberships. EDUCATIONVarious curricular areas offer practical            opportunities to promote stress management (Gilbert & Orlick, 1996;             DeWolfe & Saunders, 1995; Anderson & Haslam, 1994; Romano, 1992;                Miller & McCormick, 1991). School-based life skills programs that               focus on such strategies as relaxation, problem solving, and                    positive perspectives are successful in teaching children and                   adolescents how to control their stress (Gilbert & Orlick, 1996; De             Wolfe & Saunders, 1995). Miller & McCormick (1991) offer excellent              suggestions for teaching stress management and relaxation skills to             preschool and elementary children. These strategies can be                      effectively implemented by physical educators, classroom teachers,              and parents. 
Curricular areas that offer opportunities for                    curriculum infusion include: 
HEALTH EDUCATION. Mental and                     emotional health is one of the 10 major content areas of health                 education, and stress management techniques can be taught as a part             of this unit. Also, stress management can be addressed in other                 health content areas such as family living; nutrition; personal                 health; physical fitness; and tobacco, alcohol, and other drugs.                Personal and social skills--decision making, problem solving,                   communication, conflict resolution, peer resistance, and goal                   setting--are essential in helping children to cope with stress.                 There are numerous skill-building activities that can be used in the            classroom (see Bender, Neutens, Skonie-Hardin, & Sorochan, 1997;                Miller, Telljohann, & Symons, 1996; Fetro, 1992). 
PHYSICAL                    EDUCATION. Many of the health benefits derived from regular physical            activity are directly related to stress management, including the               reduction of depression and anxiety and the promotion of                        psychological well-being and improved vitality. Daily physical                  education  provides students with multiple opportunities to engage              in physical activity and to develop personal and social skills.                 Through quality physical education, students can learn various                  relaxation techniques (including the basics of deep breathing),                 acquire the knowledge and skills for participating in lifelong                  regular physical activity, develop self-discipline, learn how to                cooperate with others, and have fun in the process. 
CURRICULUM                INFUSION. There are other areas of the curriculum where stress                  management may be infused: language arts (children's literature,                creative writing, journal writing); social studies (Eastern                     traditions of meditation, yoga, Tai Chi; learning to appreciate and             value diversity; and learning to work cooperatively to solve                    problems); science (physiology of the stress response and relaxation            response); and art and music (creative ways to relax and express                thoughts and feelings). SERVICESChildren's health problems can            cause distress and, if undetected and untreated, hinder both health             and learning. School services that can help reduce children's stress            include health services; counseling, psychological, and social                  services; nutrition and food services; and comprehensive family                 services. School services may provide needed medical treatments,                teach effective management of health, serve as the primary source of            nutrition (if necessary), and offer services that deal with a                   variety of mental and emotional health issues that may cause                    stress. CONCLUSIONSchools play a vital role in stress                     management by assuring a healthy learning environment, providing                services for stress reduction, enhancing student and staff knowledge            and skills for coping with stress, and coordinating activities with             families and communities. The Comprehensive School Health Program is            an effective model for implementing stress management in schools and            communities to enhance the well-being of                                        children. RESOURCESThe American Institute of Stress, 124 Park             Avenue, Yonkers, NY 10703; (914) 963-1200.                                      http://www.stress.org 
Mental Health Net;                                      http://www.cmhc.com 
North Carolina Cooperative Extension Service.             Disaster Recovery: Children's Needs (includes information about                 recognizing stress in children and strategies for parents and                   teachers);                                                                      http://www.ces.ncsu.edu/depts/fcs/humandev/disint.html                          REFERENCESAllensworth, D., Lawson, E., Nicholson, L., & Wyche,            J. (Eds.). (1997). SCHOOLS AND HEALTH: OUR NATION'S INVESTMENT.                 Washington, DC: National Academy Press. 
Anderson, A., & Haslam, I.            R. (1994). A three phase stress inoculation program for adolescent              learners. JOURNAL OF HEALTH EDUCATION, 25(1), 4-9. EJ 478                       602. 
Bender, S. J., Neutens, J. J., Skonie-Hardin, S., & Sorochan,            W. D. (1997). TEACHING HEALTH SCIENCE: ELEMENTARY AND MIDDLE SCHOOL.            Boston: Jones and Bartlett. 
Birch, D. A. (1994). Involving                    families in school health education: Implications for professional              preparation. JOURNAL OF SCHOOL HEALTH, 64(7), 296-299. EJ 495                   635. 
De Wolfe, A. S., & Saunders, A. M. (1995). Stress reduction              in sixth-grade students. JOURNAL OF EXPERIMENTAL EDUCATION, 63(4),              315-329. EJ 517 187. 
Fetro, J. V. (1992). PERSONAL & SOCIAL                   SKILLS: UNDERSTANDING AND INTEGRATING COMPETENCIES ACROSS HEALTH                CONTENT. Santa Cruz, CA: ETR Associates. 
Gilbert, J. N., & Orlick.            T. (1996). Evaluation of a life skills program with grade two                   children. ELEMENTARY SCHOOL GUIDANCE & COUNSELING, 31,                          139-151. 
Miller, D. F., Telljohann, S. K., & Symons, C. W. (1996).            HEALTH EDUCATION IN THE ELEMENTARY IN THE ELEMENTARY & MIDDLE-LEVEL             SCHOOL (2nd Ed). Madison, WI: Brown & Benchmark. 
Miller, S., &                McCormick, J. (1991). Stress: Teaching children to cope [Special                feature]. JOURNAL OF PHYSICAL EDUCATION, RECREATION, and DANCE,                 62(2), 53-70. EJ 425 072. 
National PTA. (1997). BUILDING A HEALTHY            CHILD. Washington, DC: Author. 
Pransky, J. (1991). PREVENTION: THE            CRITICAL NEED. Springfield, MO: Burrell Foundation & Paradigm                   Press. 
Romano, J. L. (1992). Psychoeducational interventions for              stress management and well-being. JOURNAL OF COUNSELING &                       DEVELOPMENT, 71(2), 199-202. EJ 455 381. 
Seaward, B. L. (1997).               MANAGING STRESS: PRINCIPLES AND STRATEGIES FOR HEALTH AND                       WELL-BEING (2nd Ed). Boston: Jones and Bartlett. 
Valentine,                   J. (1997). Schools and communities work together for healthy                    children. WELLNESS MANAGEMENT, 13(1), 11. 
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This                   publication was prepared with funding from the Office of Educational            Research and Improvement, U.S. Department of Education, under                   contract number RR93002015. The opinions expressed in this report do            not necessarily reflect the positions or policies of OERI or the                Department.                                                                  **Title:** Promoting Stress Management: The Role of Comprehensive School Health            Programs. ERIC Digest.                                                       **Document Type:** Information Analyses---ERIC Information Analysis Products (IAPs) (071); Information Analyses---ERIC Digests (Selected) in Full Text (073); **Descriptors:**  Child Health,  Comprehensive School Health Education, Curriculum               Development, Daily Living Skills, Elementary Secondary Education,                Health Promotion,  Integrated Services,  Stress Management,  Stress            Variables                                                                    **Identifiers:** ERIC Digests                                                                 
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