With scattered thoughts, sweaty palms, and my heart beating like a drum, I glance at the door and cannot remember anything I prepared.
The interview is in 10 minutes, yet I want to run away.
Fear and anxiety lead to stress responses – cognitive, physical, and behavioral.
Deeply embedded and automatic, they evolved to provide humans with warnings, guiding present and future behavior while attempting to maintain a relatively stable internal state known as homeostasis (Brosschot, Verkuil, & Thayer, 2016; Varvogli & Darviri, 2011).
However innate these responses may be, there are ways to manage the stress you perceive.
This article offers our favorite stress-management activities and worksheets to help you deal with whatever challenge lies in your path.
Before you start reading, we thought you might like to download our three Stress & Burnout Prevention Exercises (PDF) for free. These science-based exercises will equip you and those you work with, with tools to manage stress better and find a healthier balance in your life.
This Article Contains:
- A Note on Stress-Management Approaches
- Our 3 Favorite Stress-Management Worksheets
- 3 Activities to Help Manage Stress
- Stress Management Within Therapy Sessions
- Worksheets for Your CBT Sessions
- 3 Printable Tools for Children
- Top 3 Exercises for Helping Students
- For Group Therapy Sessions
- A Take-Home Message
A Note on Stress-Management Approaches
Stress, or rather the perception of stressors, can be managed, and there are ways to do so:
- Preparation increases our sense of control and improves confidence.
- Relaxation reduces anxiety and restores focus.
- Maintaining physical health via a healthy lifestyle, balanced diet, and exercise underpins overall mental wellbeing.
Another way to manage stress is to reframe our perception of it.
Rather than see it as unwelcome and to be avoided, pressure can provide an essential opportunity for development and learning. Viewed as an opportunity to thrive, stress can be the motivation to perform at our very best and adopt a growth mindset (Lee, Park, & Hwang, 2016).
In what follows, we will point you toward a range of useful worksheets and tools you can use to help your clients better manage stress. Several of these come from our own Positive Psychology Toolkit, which is a comprehensive resource containing more than 350 exercises, activities, interventions, questionnaires, and assessments you can use to support your clients.
If you’re looking for more ways to grow your coaching or therapy practice using engaging, science-backed tools, be sure to check it out.
Our 3 Favorite Stress-Management Worksheets
A 2019 report found that in the UK alone, 12.8 million working days were lost due to stress, depression, and anxiety.
But help is at hand.
Multiple, evidence-based stress reduction techniques have been shown to lower stress levels, “resulting in a reduction of disease symptoms, lowering of biological indicators of disease, prevention of disease and improvement of patient’s quality of life” (Varvogli & Darviri, 2011).
Many of these techniques are described below and will help you to manage stress in your life.
1. Leaves on a Stream
Guided imagery is a powerful resource for placing your body in a relaxed state. Closing your eyes and visiting a peaceful scene – real or imagined – can release tension and offer a method for ongoing relaxation and a tool to use for times of stress.
Leaves on a Stream was created to help individuals let go of uncomfortable or unhelpful thoughts rather than get caught up in them.
Once comfortable, clients are asked to visualize a stream. Thoughts that arise, whether positive or negative, are placed on leaves that gently float away. Feelings associated with each thought (e.g., “I am bored”) can be observed and left to drift away until the next leaf arrives.
The metaphor can be useful during moments of distress to unhook someone from their thoughts or as a skill-building exercise.
Try out the Leaves on a Stream worksheet and practice it daily.
2. Diaphragmatic breathing
Diaphragmatic breathing is sometimes referred to as belly or deep breathing. It involves inhaling and exhaling from the abdomen rather than the chest.
This breathing technique leads to decreased oxygen consumption and heightened alertness. EEG recordings have also recorded increases in theta wave amplitude associated with reduced symptoms of generalized anxiety disorder (Jerath, Edry, Barnes, & Jerath, 2006).
By showing patients how to inhale and exhale more deeply and slowly several times a day, diaphragmatic breathing provides an effective relaxation technique, reducing residual stress levels and providing support during acute episodes of stress (Varvogli & Darviri, 2011).
3. Body Scan Meditation
Mindfulness can be cultivated by paying attention to breathing while focusing on different areas of the body one at a time. Distractions are observed, and attention is gently returned to the body part receiving focus.
Evidence from functional magnetic resonance imagining found that body scan meditation heightens brain activity linked to increased awareness of the present moment, focus, and stress reduction (Sevinc et al., 2018).
To read more about these steps, you can view or download the Body Scan Meditation worksheet.
Our free Mindfulness Exercises Pack includes the popular Leaves on a Stream tool and audio meditation, as well as two other mindfulness tools and audio files that you can download for free.
3 Activities to Help Manage Stress
1. Nature effect
The powerful effect of being outdoors has been validated many times and should not be underestimated.
Visitors to a park in Zurich were found to have significantly lower levels of stress, a reduced number of headaches, and a 40% increase in feelings of wellbeing. These positive effects were further elevated in those taking part in sports (Hansmann, Hug, & Seeland, 2007).
While drugs and therapy are often used as treatments for soldiers returning home with post-traumatic stress disorder, the medications and treatment frequently have to be continued for many years without providing a lasting cure. In response, nature-based therapy has begun to receive increased scientific attention.
In a 2016 study, veterans reported that merely being in the garden, often performing mindfulness activities, could improve the symptoms of their post-traumatic stress disorder (Poulsen, Stigsdotter, Djernis, & Sidenius, 2016).
The simple act of getting out into an open space can provide stress relief. We delve deeper into this in our post on Environmental Psychology.
We are all aware of the physiological rewards of exercise, but the psychological benefits are equally impressive and backed up by research.
Exercise regimes need not be extreme to be effective. Even modest levels of physical activity if performed regularly provide ongoing support for mental wellbeing, a growth mindset, and reduced levels of stress.
A great way to inspire you to start exercising may be found in our article on Mindful Running and Exercises.
3. Mindful movement
By replacing or combining some of our everyday car journeys with walking, we can become fully present in our day-to-day lives and improve mental health.
Indeed, a trial in 2017 found that combining walking with relaxation techniques is a great way to reduce levels of stress (Matzer, Nagele, Lerch, Vajda, & Fazekas, 2017).
Mindful walking combines the benefits of exercise, nature, and mindfulness.
Its goal is not to reach a destination, but to build an awareness of the moment, using the feet to anchor in the present. Pleasant and unpleasant bodily sensations such as muscle soreness are merely observed without opinion and let go.
Download and read the Mindful Walking script before going for a walk.
Stress Management Within Therapy Sessions
Many people seek help when stress makes healthy living difficult. Therapy can help address immediate difficulties and work on the underlying causes (Strauss et al., 2018).
1. Passengers on the Bus metaphor
We are often driven by emotions, thoughts, memories, and urges that we have little understanding of, never mind control over. The Passengers on the Bus metaphor helps individuals to accept and manage the difficulties that arise in their lives by bringing them to life in a relatable way.
In this metaphor, experiences are represented by passengers on a bus. The client is the driver of the bus and can look back at the passengers before returning attention to the road ahead.
The benefits of the metaphor are backed up by research. Cancer survivors asked to identify “persistently challenging thoughts, feelings, and memories/images about cancer” using the bus metaphor showed lower levels of anxiety brought on by prolonged stress from their illness (Arch & Mitchell, 2015).
Clients can work with their therapist to get to know their ‘passengers’ on the bus – whether emotions, feelings, or thoughts – understand what they do, and recognize how they influence the clients’ actions.
Click to download the Passengers on the Bus worksheet and give it a try.
2. Biofeedback training
Biofeedback builds on the concept of homeostasis introduced earlier. Using technology to measure and report brainwaves, skin temperature, breathing, and heart rate, the individual learns how to gain self-control over apparently involuntary bodily functions.
A recent meta-analysis of 24 studies confirmed that biofeedback training led to improvements in coping and offers a promising approach for treating stress and anxiety (Goessl, Curtiss, & Hofmann, 2017).
Individuals can ultimately learn to control their heart rate and blood pressure, reduce levels of stress, and even successfully treat high blood pressure and cardiac disease. Performed with a qualified therapist, these changes ultimately persist beyond the therapy (Varvogli & Darviri, 2011).
Worksheets for Your CBT Sessions
Many of us experience spontaneous thoughts as images rather than individual words or an internal conversation (Beck & Beck, 2011).
A child pictures an angry parent, and an employee imagines a demanding boss. They can be powerful, representing moments of fear or anxiety, and can be used in Cognitive-Behavioral Therapy (CBT) sessions.
The following questions can form the basis of a conversation to explore a mental image and the individual’s relationship with it, cognitively restructuring its interpretation.
|Consider the mental image|
|Did you imagine what your boss might look like when you asked about the promotion?|
|Can you imagine him now? What would he look like?|
|How are you feeling?|
|Can you see how you stopped at the worst image?|
|Can you picture what happens next? And then?|
|Do you feel better in the new image than before?|
|Let’s review from stopping at the worst image through to completion.|
Imagery can feel as real to the mind as being in the situation, so playing through images in advance can restructure thoughts and emotions and reframe the stress.
2. Daily Exceptions Journal
A journal can be a fruitful way to track life’s ups and downs. Positive CBT encourages monitoring the client’s strengths and the positive outcomes of life rather than focusing on the negatives.
By capturing what went well, it is possible to identify and record the skills and talents for reuse in other areas of your life.
Subsequently, walking through the journal during therapy reinforces successes, provides praise, and encourages discussion of the problems overcome.
Follow this link to download the Daily Exceptions Journal.
3 Printable Tools for Children
Sensory awareness involves paying attention to a specific sensory aspect of the body. It can be a great way to teach mindfulness to children.
1. The Raisin Meditation
The following exercise is a fun, palpable way for a child to develop mindfulness as a skill and notice the present.
Work through the Raisin Meditation worksheet following the steps with the child, paying attention to each sense in turn.
Children paying increased attention to their senses can learn to improve their focus and feel calmer.
2. Nature Play
Ongoing research has recognized the importance of playing and spending time outdoors on children’s mental wellbeing (Dankiw, Tsiros, Baldock, & Kumar, 2020).
Practicing underused senses such as sound can heighten a sense of awareness and promote mindfulness. This can be especially true in an unfamiliar environment, including walking through the countryside with family.
|1||Pause and listen|
|2||What can you hear that is nearby?|
|3||What can you hear that is far away?|
|4||What is the loudest sound?|
|5||What is the quietest sound?|
|6||Can you walk without making a noise?|
The questions can be tailored to the environment. Starting or pausing somewhere relatively quiet may assist the child’s focus more at the start.
Print the Nature Play worksheet here.
3. Anchor Breathing
Anchor breathing can be quickly learned and helps a child to focus their mind on one point.
Such mental training offers a valuable method for gaining perceived self-control and reducing stress.
|1||Imagine being on a boat, feeling calm and safe.|
|2||Attached to the boat is an anchor. It keeps you there, where you want to be, and happy.|
|3||Our bodies, like the boat, also have anchors, and they can help us focus. Our belly, our nose and mouth, and our chest and lungs can help us feel grounded.|
|4||With your hands on your chest, breathe in deeply.|
|5||Breathe out slowly.|
|6||Feel your ribs rise and fall.|
|7||As your mind wanders, gently bring it back to the anchor point.|
The Anchor Breathing method also works with hands placed gently on the belly or in front of the nose.
Top 3 Exercises for Helping Students
Research published in 2013 reported that a seven-week mindfulness-based stress reduction training course given to medicine and psychology students resulted in significant improvements in both mental distress and study stress (de Vibe et al., 2013).
The following three examples, along with the activities described above, can be learned quickly and implemented into a student’s daily routine to help manage both acute and chronic stress.
1. Urge Surfing
Coping with (often self-destructive) urges can be difficult, especially in times of stress. Such behavior can become a crutch, making us feel like we are taking control, when in reality, we are relinquishing it.
2. Meditation on the Soles of the Feet
Meditation on the Soles of the Feet provides a safe space to work on managing strong emotions and regulating the urge to be aggressive, often a byproduct of stressful situations (Kruk, Halász, Meelis, & Haller, 2004).
The individual is not asked to stop angry thoughts – anger does serve a useful purpose at times – but rather to bring them under control through a shift of focus.
The client, standing or sitting with their feet on the ground, is asked to cast their mind back to a time that caused them to react very angrily. Then they are told to stick with those angry thoughts, letting them flow without hindrance. After that, they shift their attention to the soles of their feet.
Stretching and moving their toes, they feel the texture of their socks, the surface of the ground, or the insole in their shoes. They maintain focus, breathing naturally until feeling calm and in control.
Learning to manage anger more effectively reduces stress and anxiety, and increases feelings of control.
Follow this link to download and use the Meditation on the Soles of the Feet.
Working through the Leaves on a Stream and anchor breathing techniques, which are part of our free Mindfulness Exercises Pack, will help students focus awareness on the present moment and acknowledge and accept their feelings, thoughts, and emotions.
For Group Therapy Sessions
Research has identified the benefits of combining mindfulness and group therapy to help manage stress and increase resilience and positivity (Seyyed Moharrami, Pashib, Tatari, & Mohammadi; Babakhani, 2017).
Here are two great examples of group exercises in mindfulness.
1. Walking Down the Street
The ability to observe, rather than react to, thoughts, emotions, and sensations is central to positive psychology.
The challenge is that the event and our thoughts about it are far from being the same.
The steps involved in the following exercise can be performed individually or in a group exercise, where everyone benefits from hearing one another’s thoughts.
|Step||Ask the group to:|
|1||Vividly imagine walking down a street and seeing someone they know well. They like the person and are happy to see them.|
|2||Make the image as real as possible: sights, sounds, smells, and bodily sensations.
Become aware of and discuss associated thoughts and emotions.
|3||Picture saying hello, while waving.|
|4||Imagine that your friend, rather than acknowledging you, walks by without a hint of recognition.|
|5||Consider how this makes you feel.
Become aware of the thoughts that go through your mind.
Walking through the scene and discussing it in the group can help to develop positive behavioral change by separating thoughts and feelings from impulses and actions and, importantly, shape feelings while breaking a negative cycle of thinking.
Download and work through the Walking Down the Street worksheet.
2. Passengers on the Bus metaphor (revisited)
The Passengers on the Bus metaphor, discussed above, can be used effectively in group settings.
This time, members of the group are assigned roles on the bus.
Explore the Passengers on the Bus Group Activity worksheet.
Resources from PositivePsychology.com
Building resilience helps clients bounce back from stressful situations and use coping mechanisms to turn them into opportunities for growth.
The Realizing Resilience Masterclass provides guidance, along with a set of practical tools, to build a more resilient mindset.
Also, you can download our three Resilience Exercises for free.
A Take-Home Message
Stress does not have to rule us. Stress should not be allowed to prevent us from doing what we want or need to do.
Instead, stress should be an enabler and drive us forward to build what we want and take on challenges that will allow us to grow.
There should be no excuse to hide from stress or become overwhelmed by it.
By using tools for coping and taking control, we can see stress as something natural that can invigorate and motivate us to overcome both planned and unexpected challenges.
These activities we shared will definitely help you manage stress. However, there are many other stress-management techniques to try out too. Identify those that work for you and implement them into your life. You will reap the benefits, especially before the next job interview or presentation.
Thank you for reading!
We hope you found this article useful. Don’t forget to download our three Stress & Burnout Prevention Exercises (PDF) for free.
If you wish to learn more, our Realizing Resilience Masterclass© is a complete, science-based, six-module resilience training template for practitioners that contains all the materials you’ll need to help your clients overcome adversity in a more resilient way.
- Arch, J. J., & Mitchell, J. L. (2015). An Acceptance and Commitment Therapy (ACT) group intervention for cancer survivors experiencing anxiety at re-entry. Psycho-Oncology, 25(5), 610–615.
- Beck, J., & Beck, A. (2011). Cognitive behavior therapy: Basics and beyond. Guilford Press.
- Bergstrom, C. (2018). Ultimate mindfulness activity book: 150 mindfulness activities for kids and teens (and grown-ups too!). Blissful Kids.
- Babakhani, K. (2017). The effectiveness of cognitive-behavioral therapy group on self-efficacy and quality of life of women with breast cancer. Multidisciplinary Cancer Investigation, 1(1).
- Brosschot, J. F., Verkuil, B., & Thayer, J. F. (2016). The default response to uncertainty and the importance of perceived safety in anxiety and stress: An evolution-theoretical perspective. Journal of Anxiety Disorders, 41, 22–34.
- Cassidy, T. (2016). Psychological benefits of adhering to a programme of aerobic exercise. Clinical and Experimental Psychology, 2(2).
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- De Vibe, M., Solhaug, I., Tyssen, R., Friborg, O., Rosenvinge, J. H., Sørlie, T., & Bjørndal, A. (2013). Mindfulness training for stress management: A randomized controlled study of medical and psychology students. BMC Medical Education, 13(107).
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- Kruk, M. R., Halász, J., Meelis, W., & Haller, J. (2004). Fast positive feedback between the adrenocortical stress response and a brain mechanism involved in aggressive behavior. Behavioral Neuroscience, 118(5), 1062–1070.
- Lee, C. S., Park, S. U., & Hwang, Y. K. (2016). The structural relationship between mother’s parenting stress and child’s wellbeing: The mediating effects of mother’s growth mindset and hope. Indian Journal of Science and Technology, 9(36).
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- Poulsen, D. V., Stigsdotter, U. K., Djernis, D., & Sidenius, U. (2016). ‘Everything just seems much more right in nature’: How veterans with post-traumatic stress disorder experience nature-based activities in a forest therapy garden. Health Psychology Open, 3(1).
- Sevinc, G., Hölzel, B. K., Hashmi, J., Greenberg, J., McCallister, A., Treadway, M., … Lazar, S. W. (2018). Common and dissociable neural activity after mindfulness-based stress reduction and relaxation response programs. Psychosomatic Medicine, 80(5), 439–451.
- Seyyed Moharrami, I., Pashib, M., Tatari, M., & Mohammadi, S. (2017). The efficiency of stress management group therapy in job stress and self-efficacy of nurses. Journal of Torbat Heydariyeh University of Medical Sciences, 5(1), 42–49
- Strauss, C., Gu, J., Pitman, N., Chapman, C., Kuyken, W., & Whittington, A. (2018). Evaluation of mindfulness-based cognitive therapy for life and a cognitive behavioral therapy stress-management workshop to improve healthcare staff stress: Study protocol for two randomized controlled trials. Trials, 19(209).
- Varvogli, L. & Darviri, C. (2011). Stress management techniques: Evidence-based procedures that reduce stress and promote health. Health Science Journal, 5, 74–89.