Using stress and coping as an evaluation criteria for young people’s wellbeing

In some families, a young person’s wellbeing might be affected by a parent’s mental illness and associated factors through a stressful event or critical incident such as hospitalisation (due to their illness). The young person must develop effective coping strategies to deal with such an event if they are to have positive long-term health outcomes.

Programs and interventions dealing with stress and coping in young people might focus on:

• giving them opportunities to learn and practise adaptive problem-solving (coping) strategies
• working to minimise their inappropriate use of emotion-focused strategies.

Click on the headings below to read more.

Stress and coping as concepts

Over the last 30 years, the concept of stress has developed around the idea that a person’s environment or circumstances can be taxing and sometimes overwhelming to their wellbeing. Multiple ideas and theories about stress have emerged.

The concept of coping with stress focuses upon what can be done to manage stressful circumstances. There are also multiple ideas about coping with stress.

This section concentrates on a popular theory on stress and coping – the cognitive transactional model of stress – and reviews some measures designed to assess coping.

Theoretical background

Lazarus and Folkman (1984) proposed a cognitive transactional model of stress. This theory suggests that individuals cognitively evaluate or appraise life events according to their own person-related characteristics (including their coping resources) to determine the type and quality of an emotional response to a given event (Barlow, 1988). ‘Appraisals are conscious or unconscious judgements about the nature of the environment and one’s ability to respond to it’ (Bakal, 1992, p.72).

Definition of stress

Within this model, psychological stress has been defined as ‘a relationship between the person and the environment that is appraised by the person as taxing or exceeding his or her resources and endangering his or her wellbeing’ (Lazarus & Folkman, 1984, p.19). The central issue for a child or adolescent during or following a stressful event is ‘What can I do in relation to this stressor or thing that is happening to me?’ (Lazarus & Folkman, 1984). The answer is commonly termed as coping.

Definition of coping

Coping actions have been defined as ‘constantly changing cognitive and behavioral efforts to manage specific external and/or internal demands that are appraised as taxing or exceeding the resources of the person’ (Lazarus & Folkman, 1984, p.141). While there are thought to be many different types of coping, many outline coping as either problem or emotion-focused (Folkman et al., 1991; Frederikson & Dewe, 1995) and/or providing social support. Social support in this context means connectedness and/or problems with others. Definitions and measures of ‘social inclusion’ can be found under the ‘Community’ pages.

Problem-focused coping

Problem-focused coping activities are seen as efforts to change the environment itself or the young person in relation to the environment (Bakal, 1992; Folkman et al., 1991). Problem-focused ways of coping include cognitive problem-solving and decision making, interpersonal conflict resolution, information gathering, advice seeking, time management and goal setting, as well as problem-oriented behaviours such as joining a weight-control program (Folkman et al., 1991, p.243).

Problem-focused coping actions are generally useful in the short term – particularly if actions taken change the circumstance. They are also thought to be important long-term strategies as they help change the circumstance and/or reduce the impact of the stressor.

Example: For a young person facing the stressor of their parent being hospitalised, prior goal setting (eg through Ulysses agreements or family care plans) can be very important. Similar activities include getting help with practical things such as household chores or alternative accommodation.

Emotion-focused coping

Emotion-focused coping includes strategies that help the young person to manage their reaction (eg emotional response) to the stressor (Bakal, 1992; Folkman et al., 1991). Emotion-focused actions attempt to minimise the impact of the problem and are often aimed at regulating unpleasant emotions (eg fear, anger, sadness) associated with the event. Actions might include avoiding thinking about the problem or using techniques such as exercise or relaxation (Folkman et al., 1991) to take their mind off the problem and feel better.

Emotion-focused coping can be both valuable and problematical. In the short-term it can be very helpful in minimising the personal impact of stressors (Folkman et al., 1991) but in the long-term it can be ineffective and emotionally unhealthy, particularly in circumstances where the problem can and should have been dealt with.

Example: A young person experiencing their parent being hospitalised might listen to music on a continual basis or remain at school or with friends to avoid thinking about or facing the problem.

Measures of coping

There are multiple child and adolescent coping measures. For a summary see Table 1 in the Compas et al. (2001) paper ‘Coping with stress during childhood and adolescence: problems, progress, and potential in theory and research’. See ‘Key readings’ (below) for details.

Refer to the recommended measures listed below.

Programs and interventions

Sunshine Coast Koping Program: An outcome of this program is for individuals to develop learning strategies to cope in a family with mental health issues.

Key readings

Compas, B. E., Connor-Smith, J. K., Saltzman, H., Thomsen, A. H. & Wadsworth, M. E. (2001). Coping with stress during childhood and adolescence: problems, progress, and potential in theory and research. Psychological Bulletin, 127, 87-127.

Other references

Bakal, D.A. (1992). Psychology and health, New York: Springer.

Barlow, D. H. (1988). Anxiety and its disorders: the nature and treatment of anxiety and panic. New York: Guilford.

Folkman, S., Chesney, M., McKusick, L., Ironson, G., Johnson, D. & Coates, T.J. (1991). Translating coping theory into an intervention. In J. Eckenrode (Ed.). The social context of coping (pp.239-60). NY: Plenum Press.

Lazarus, R. S. & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.