Beta blockers - Drugs primarily prescribed for use for heart conditions, for example to reduce blood pressure. But they are often sued to reduce the physical symptoms of stress., How beta blockers work - Beta blockers have antagonist action, meaning that they work by reducing the activity of the sympathetic nervous system therefore reducing the subsequent symptoms. They are beta adrenoceptor blocking agents, meaning that they block receptor sites for the hormones adrenaline and noradrenaline., Different types of beta blockers - Non-selective beta blockers such as propanol block adrenaline and noradrenaline in other areas of the body, as well as the heart., Off-label use - Beta blockers are primarily prescribed approved for use for conditions such as high blood pressure and angina., Use by musicians - Alan Lockwood (1989) studied over 2000 musicians in major US symphony orchestras and found that 27% used beta blockers and 19% used it on a daily basis., Evaluation- benefits on performance and self-reported levels of stress - . Neftel et al. (1982) gave string players a beta blocker (antenolol) or a placebo 6.5 hours before performing. The participants in the antenolol group had lower heart rates and were able to play more complex parts of the music more accurately., Evaluation- benefits for other aspects of stress - Schwabe et al. (2011) suggest that one of the negative effects of stress is that stressed people fall into habits (such as addiction) rather than focusing on their important goals., Evaluation- long-term effectiveness - . Although beta blockers target the outward physical signs of stress, they do not address the psychological and emotional side., Evaluation- side effects (ethics) - Generally side effects from beta blockers tend to be mild and temporary., Evaluation- using beta blockers to enhance performance (ethics) - The use of beta blockers by musicians and in sport raises The fact that beta blockers are banned for use in most sports suggests that they are viewed as unethical., Evaluation- the impact of prescribing drugs off-label (social) - .This means that well-controlled long-term research into the effects of the drug is likely to be limited., Evaluation- possible over prescription (social) - Statistics indicate that prescriptions of the beta blocker propranol rose by 7% between 2012 and 2013., SIT (Stress Inoculation Training) - Meichenbaum (1985,2007) first described the process of SIT, suggesting that an individual should develop a form of coping before a problem arises so they are protected (in a same way that a vaccination protects against a disease)., Inoculation - In medical terms, inoculation means to try and prevent a disease by vaccinations against it, often by using a weakened form of the disease., The importance of perception - the transactional model of stress identifies the importance of how a person perceives the stressor and also how the person sees their ability to cope with it, The process of SIT - It is usually carried out over 8-15 sessions and there may also be some follow-up sessions., The 3 overlapping phases to SIT - Conceptualisation, skills acquisition (and rehearsal), and application (and follow through)., Conceptualisation - In this phase, the relationship is established between the client and trainer. ., Skills acquisition (and rehearsal) - In this stage, clients are helped to acquire coping skills and consolidate those they already have., Application (and follow through) - In this stage the client will practice applying the coping skills to a vareity of situations that become increasingly demanding (linked to the idea of inoculation)., Evaluation- studies into effectiveness - Saunders et al. (1996) reviewed 37 studies into the effectiveness of SIT in the workplace and concluded that it was effective in enhancing performance under stress and reducing anxiety., Evaluation- determining which part is effective - One study that has tried to separate out key elements was carried out by Moses and Hollandsworth (1985)., Evaluation- comparison to other methods - Foa et al. (1991,1999) have carried out a series of studies comparing the effectiveness of SIT with other methods for the treatment of female victims of sexual assault., Evaluation- risk of harm (ethical) - being asked to rehearse situations that a client finds stressful could cause a form of psychological harm to the individual., Evaluation- using SIT in the military (ethical) - A review of SIT in the military found that, although Special Forces personnel were well prepared to deal with acute stress like that encountered on the battlefield, they were less well prepared to deal with chronic stress such as problems with family life (Robson and Manacapilli, 2014)., Evaluation- stress in society (social) - Meichenbaum (2007) highlights the need for effective interventions to combat Stress such as terrorist attacks, increased poverty and violence., Evaluation- impact on the economy (social) - Blumenthal et al. (2002) suggests that giving people the tools to cope with stress in whatever form it arises this can have very positive effects on the economy and society.,

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