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Symptoms of Stress
Physical symptoms includes;

Low appetite

Headache

New or recurrent bedwetting

Nightmares

Sleep disturbances

Upset stomach or stomach pain

Other physical symptoms with no physical illness

Emotional or behavioral symptoms may include:

Anxiety, worry

Unable to relax

New or recurring fears

Clinging, unwilling to let you out of sight

Anger, crying, whining

Unable to control emotions

Aggressive or stubborn behavior

Acting childish

Isolation

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Stress may be a response to a negative change in a child's life. In small amounts, stress can be good. But, excessive stress can affect the way a child thinks, acts, and feels.

Children learn how to respond to stress as they grow and develop. Many stressful events that an adult can manage will cause stress in a child. As a result, even small changes can impact a child's feelings of safety and security.

Pain, injury, illness, and other changes are stressors for children. Stressors may include:

Worrying about schoolwork or grades

Juggling responsibilities, such as school and work or sports

Problems with friends, bullying, or peer group pressures

Changing schools, moving, or dealing with housing problems or homelessness

Having negative thoughts about themselves

Going through body changes, in both boys and girls

Seeing parents go through a divorce or separation

Money problems in the family

Living in an unsafe home or neighborhood

SIGNS OF UNRESOLVED STRESS IN CHILDREN

Children may not recognize that they are stressed. New or worsening symptoms may lead parents to suspect an increased stress level is present.

Physical symptoms can include:

Decreased appetite, other changes in eating habits

Headache

New or recurrent bedwetting

Nightmares

Sleep disturbances

Upset stomach or vague stomach pain

Other physical symptoms with no physical illness

Emotional or behavioral symptoms may include:

Anxiety, worry

Not able to relax

New or recurring fears (fear of the dark, fear of being alone, fear of strangers)

Clinging, unwilling to let you out of sight

Anger, crying, whining

Not able to control emotions

Aggressive or stubborn behavior

Going back to behaviors present at a younger age

Doesn't want to participate in family or school activities

HOW PARENTS CAN HELP

Parents can help children respond to stress in healthy ways. Following are some tips:

Provide a safe, secure, and dependable home.

Family routines can be comforting. Having a family dinner or movie night can help relieve or prevent stress.

Be a role model. The child looks to you as a model for healthy behavior. Do your best to keep your own stress under control and manage it in healthy ways.

Be careful about which television programs, books, and games that young children watch, read, and play. News broadcasts and violent shows or games can produce fears and anxiety.

Keep your child informed of anticipated changes such as in jobs or moving.

Spend calm, relaxed time with your children.

Learn to listen. Listen to your child without being critical or trying to solve the problem right away. Instead work with your child to help them understand and solve what is upsetting to them.

Build your child's feelings of self-worth. Use encouragement and affection. Use rewards, not punishment. Try to involve your child in activities where they can succeed.

Allow the child opportunities to make choices and have some control in their life. The more your child feels they have control over a situation, the better their response to stress will be.

Encourage physical activity.

Recognize signs of unresolved stress in your child.

Seek help or advice from a health care provider, counselor, or therapist when signs of stress do not decrease or disappear.

WHEN TO CALL THE DOCTOR

Talk to your child's provider if your child:

Is becoming withdrawn, more unhappy, or depressed

Is having problems in school or interacting with friends or family

Is unable to control their behavior or anger

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Stress in childhood: MedlinePlus Medical Encyclopedia

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Stress may be a response to a negative change in a child's life. In small amounts, stress can be good. But, excessive stress can affect the way a child thinks, acts, and feels. Children learn how to respond to stress as they grow and develop.

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How to mange change:

1.Identify What Will Be Improved- Identify and understand what change you're about to undergo, understand why you're changing and identify how this change will benefit you.
2.Be flexible and creative- Change is going to be something completely new so allow change to do it's thing don't interfere keep you're mind open to new things, and give it a chance.
3.Be persistent- Once you undergo change don't revert back to you're old self be persistent and trust that the change you are going through will help better you're life.
4.Embrace the Change Cycle- Everyone goes through change it's normal for you to go through changes, so embrace the change cycle and evolve into new life. Don't be embarrassed by change because it's pretty much the way of life.

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Cause- Unmanageable change occurs
Effect- Progression of stress

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How to manage stress:

1. Understand your stress- Take some time to comprehend what's stressing you out. Try to clear that stress so you can be happier, healthier, and more productive.
2. Improve your sleep quality- By having more sleep, your body will be able to focus a lot better, have an improved mood, and will provide better decision-making.
3. Low to moderate exercise- By doing calm exercises, this can help focus on your muscle tension, deep breathing, and can be a distraction from what's stressing you out.
4. Stay connected- Being stressed can sometimes drain your social battery. Therefore, try to make some friends and communicate with your loved ones.
5. Nourish your body- By taking good care of your body, this can positively impact your health of the mind and body.

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"Within the autonomic nervous system, you have two particular branches. One is the sympathetic nervous system, that's known as the fight or flight system. The other is the parasympathetic nervous system, also known as the rest and digest system. The sympathetic system increases your heart rate, blood pressure, and blood sugar to help you preform when stress hits. The parasympathetic suppresses your heart rate and brings you back down to homeostasis."

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STOP NEGATIVE SELF TALK - Listen To This Everyday

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MedlinePlus Interactive Video: Managing Stress

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LibGuides: Stress and Anxiety Awareness: Videos online

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Definition of stress: Stress is a physical and emotional reaction that people experience as they encounter changes in life. Stress is a normal feeling. However, long-term stress may contribute to or worsen a range of health problems including digestive disorders, headaches, sleep disorders, and other symptoms. Stress may worsen asthma and has been linked to depression, anxiety, and other mental illnesses.

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Factors Determining Change
1. Duration: a longer subject is likely to succeed more when reviewed frequently rather than a short subject that is not frequently reviewed.
2. Integrity: there has to be truth, quality before change occurs
3. Commitment: must be committed to the desire to change
4. Effort: putting in responsibilities to make the change.

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Companies must pay as much attention to the hard side of change management as they do to the soft aspects. By rigorously focusing on four critical elements, they can stack the odds in favor of success.

Everyone agrees that managing change is tough, but few can agree on how to do it. Most experts are obsessed with "soft" issues, such as culture and motivation, but, say the authors, focusing on these issues alone won't bring about change. Companies also need to consider the hard factors-like the time it takes to complete a change initiative, the number of people required to execute it, and so forth.

When the authors studied change initiatives at 225 companies, they found a consistent correlation between the outcomes of change programs (success versus failure) and four hard factors, which they called DICE: project duration, particularly the time between project reviews; integrity of performance, or the capabilities of project teams; the level of commitment of senior executives and staff; and the additional effort required of employees directly affected by the change. The DICE framework is a simple formula for calculating how well a company is implementing, or will be able to implement, its change initiatives. The framework comprises a set of simple questions that help executives score their projects on each of the four factors; the lower the score, the more likely the project will succeed. Companies can use DICE assessments to force conversations about projects, to gauge whether projects are on track or in trouble, and to manage project portfolios.

The authors have used these four factors to predict the outcomes and guide the execution of more than 1,000 change management programs worldwide. Not only has the correlation held, but no other factors (or combination of factors) have predicted outcomes as successfully.

The Idea in Brief

Two out of every three transformation programs fail. Why? Companies overemphasize the soft side of change: leadership style, corporate culture, employee motivation. Though these elements are critical for success, change projects can't get off the ground unless companies address harder elements first.

The essential hard elements? Think of them as DICE:

Duration: time between milestone reviews-the shorter, the better

Integrity: project teams' skill

Commitment: senior executives' and line managers' dedication to the program

Effort: the extra work employees must do to adopt new processes-the less, the better

By assessing each DICE element before you launch a major change initiative, you can identify potential problem areas and make the necessary adjustments (such as reconfiguring a project team's composition or reallocating resources) to ensure the program's success. You can also use DICE after launching a project-to make midcourse corrections if the initiative veers off track.

DICE helps companies lay the foundation for successful change. Using the DICE assessment technique, one global beverage company executed a multiproject organization-wide change program that generated hundreds of millions of dollars, breathed new life into its once-stagnant brands, and cracked open new markets.

The Idea in Practice

Conducting a DICE Assessment

Your project has the greatest chance of success if the following hard elements are in place:

Duration

A long project reviewed frequently stands a far better chance of succeeding than a short project reviewed infrequently. Problems can be identified at the first sign of trouble, allowing for prompt corrective actions. Review complex projects every two weeks; more straightforward initiatives, every six to eight weeks.

Integrity

A change program's success hinges on a high-integrity, high-quality project team. To identify team candidates with the right portfolio of skills, solicit names from key colleagues, including top performers in functions other than your own. Recruit people who have problem-solving skills, are results oriented, and are methodical but tolerate ambiguity. Look also for organizational savvy, willingness to accept responsibility for decisions, and a disdain for the limelight.

Commitment

If employees don't see company leaders supporting a change initiative, they won't change. Visibly endorse the initiative-no amount of public support is too much. When you feel you're "talking up" a change effort at least three times more than you need to, you've hit it right.

Also continually communicate why the change is needed and what it means for employees. Ensure that all messages about the change are consistent and clear. Reach out to managers and employees through one-on-one conversations to win them over.

Effort

If adopting a change burdens employees with too much additional effort, they'll resist. Calculate how much work employees will have to do beyond their existing responsibilities to implement the change. Ensure that no one's workload increases more than 10%. If necessary, remove nonessential regular work from employees with key roles in the transformation project. Use temporary workers or outsource some processes to accommodate additional workload.

Using the DICE Framework

Conducting a DICE assessment fosters successful change by sparking valuable senior leadership debate about project strategy It also improves change effectiveness by enabling companies to manage large portfolios of projects. Example:

A manufacturing company planned 40 projects as part of a profitability-improvement program. After conducting a DICE assessment for each project, leaders and project owners identified the five most important projects and asked, "How can we ensure these projects' success?" They moved people around on teams, reconfigured some projects, and identified initiatives senior managers should pay more attention to-setting up their most crucial projects for resounding success.

When French novelist Jean-Baptiste Alphonse Karr wrote "Plus ça change, plus c'est la même chose," he could have been penning an epigram about change management. For over three decades, academics, managers, and consultants, realizing that transforming organizations is difficult, have dissected the subject. They've sung the praises of leaders who communicate vision and walk the talk in order to make change efforts succeed. They've sanctified the importance of changing organizational culture and employees' attitudes. They've teased out the tensions between top-down transformation efforts and participatory approaches to change. And they've exhorted companies to launch campaigns that appeal to people's hearts and minds. Still, studies show that in most organizations, two out of three transformation initiatives fail. The more things change, the more they stay the same.

A version of this article appeared in the October 2005 issue of Harvard Business Review.

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Everyone agrees that managing change is tough, but few can agree on how to do it. Most experts are obsessed with "soft" issues, such as culture and motivation, but, say the authors, focusing on these issues alone won't bring about change.

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Impacts of positive change
1. Visions
2. Resilience
3. Culture
4. Creative and Innovative Thinking
5. Well-being/Happiness
6. Performance and Enagagement

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We are skilled designers and facilitators of high engagement, strength-based, large-scale change.

We help with the human side of organizing, strategic change, and culture transformation in businesses, non-profits and NGO's, health care, education, government and religious organizations.

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How stress can affect your academic success

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Stress to Success!

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The importance of managing change- The greatest importance of change management is that it supplies the process and the arrangement to execute change. Successful change management will provide a smooth transition from the old to the new while preserving productivity. Change can be hard due to the fact that it is normally out of our control. In addition, fixed mindsets can often view change as a threat instead of embracing it. By accepting change, this helps you to be more flexible and open minded, therefore, you will soon gain a positive attitude of learning.

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Types of Changes include;
1. Operational changes: has effect on operations of how business is operated
2. Strategic changes: occurs in strategic business direction- introducing  a new technology
3. Cultural changes: affect basic system philosophies by which  a business is operated- diffusion of ideas
4. Political changes: affect the system of the government- applying a new policy.

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Abstract

As increasingly powerful informatics systems are designed, developed, and implemented, they inevitably affect larger, more heterogeneous groups of people and more organizational areas. In turn, the major challenges to system success are often more behavioral than technical. Successfully introducing such systems into complex health care organizations requires an effective blend of good technical and good organizational skills. People who have low psychological ownership in a system and who vigorously resist its implementation can bring a "technically best" system to its knees. However, effective leadership can sharply reduce the behavioral resistance to change-including to new technologies-to achieve a more rapid and productive introduction of informatics technology. This paper looks at four major areas-why information system failures occur, the core theories supporting change management, the practical applications of change management, and the change management efforts in informatics.

It's not the progress I mind, it's the change I don't like. -Mark Twain

Along with the inevitable failures, medical informatics has had many successes-probably more than should have been expected, given the challenges of the hardware, software, and infrastructure that faced us in the past. However, many of the successful systems were implemented as stand-alone systems that involved a modest number of people. Furthermore, the systems were often implemented in specific, limited areas that could see potential direct benefits from the systems. Typically, there were local champions, who made major and personal commitments to the success of the systems, and the enthusiasm of these champions was readily transmitted to the people with whom they worked directly. In turn, most of the people working on these systems felt like pioneers, and the literature of medical informatics is filled with their accomplishments.

When we embark today on designing, developing, and implementing more complex systems that have wider impact, a new set of challenges looms even larger. Certainly, technical challenges still exist; they always will. However, as our new systems affect larger, more heterogeneous groups of people and more organizational areas, the major challenges to systems success often become more behavioral than technical.

It has become apparent in recent years that successfully introducing major information systems into complex health care organizations requires an effective blend of good technical and good organizational skills. A "technically best" system can be brought to its knees by people who have low psychological ownership in the system and who vigorously resist its implementation. The leader who knows how to manage the organizational impact of information systems can sharply reduce the behavioral resistance to change, including to new technology, to achieve a more rapid and productive introduction of information technology.

Knowledge of the significance of people and organizational issues is not new. One of our informatics pioneers, Octo Barnett, identified political and organizational factors as being important 30 years ago. However, given the realities of that era, they were "well down the list." By 1998, Reed Gardner, another definite pioneer, stated in his Davies Lecture:

In my opinion, the success of a project is perhaps 80 percent dependent on the development of the social and political interaction skills of the developer and 20 percent or less on the implementation of the hardware and software technology!

We are seeing a shift in the balance of the people and organizational issues as opposed to the technical issues. An effective medical informatics change strategy can help convert what health care organizations are experiencing today-technology-centered tension-into welcomed opportunities that will lead to improvement in all phases of the health care process.

The content that supports both the intellectual content and strategy for this cornerstone comes from multiple disciplines, e.g. psychology, sociology, management, and anthropology. This paper discusses four major topics-why information system failures occur, the core theories supporting change management, the practical applications of change management, and the change management efforts in informatics.

Why Do Information System Failures Occur?

If only it weren't for the people, those awful people, always getting tangled up with the systems. If it weren't for them, the health care area would be an informatician's paradise.

Complex problems rarely have simple solutions. During the many stages of the solution process, there are numerous opportunities to go wrong, whether the solution tends to be a technical one or not. As we delve into increasingly complex medical informatics problems, we will increasingly face this challenge. In reviewing information system failures cited in the literature as well as drawing on our personal observations and experiences, we have seen the rising importance of the human issues that are often referred to as people and organizational issues.

presents a categorized overview of the reasons for contemporary failures in implementing major information systems. There is typically no one single cause in a given case. In fact, a snowball effect is often seen, with a shortcoming in one area leading to subsequent shortcomings in other areas. No precise statistics exist for the relative importance of the causes; however, personal observation tells us that the two most important are communications deficiencies and the failure to develop user ownership.

Table 1

Communication

Ineffective outgoing communication

Ineffective listening

Failure to effectively prepare the staff for the new system

Culture

Hostile culture within the information systems organization

Hostile culture toward the information systems area

No strategies to nurture or grow a new culture

Underestimation of complexity

Missed deadlines and cost overruns

Lost credibility

Scope creep

Failure to define and maintain original success criteria

Failure to renegotiate deadlines and resources if criteria do change

Organizational

No clear vision for the change

Unintended consequences

Ineffective reporting structure

Staff turnover

Staff competency

Provision of a technical "fix" to a management problem

Lack of full support of "boss(es)"

Roles and responsibilities not clearly defined or understood by everyone

Several people vying to be "in charge"

Adequate resources not available from the beginning

Failure to benchmark existing practices

Inability to measure success

Technology

System too technology oriented

Poor procurement

Lure of the leading (bleeding) edge

Inadequate testing

Training

Inadequate or poor-quality training

Poor timing of training-too early or too late

Leadership issues

Leader too emotionally committed

Leader's time over committed

Too much delegation without control

Failure to get ownership in the effort

Leader's political skills weak

"Lying" to get initial approval

Change and Change Management

Technology has indeed taken a place next to war, death, divorce, and taxes as a prime cause of bone-shuddering anxiety. -John Seymour

Change is a constant in both our professional and our private lives. Our children grow up taking for granted such things as powerful personal computers that we could not envision at their ages. The idea that human beings naturally resist change is deeply embedded in our thinking about change. Our language (e.g., "resistance to change"), our assumptions, and our mental models about change all seem to imply that something in our natures leads us to resist change. However, it is easy to find examples of human beings, from childhood on through old age, actively seeking out change of all sorts. Human beings do not necessarily resist change automatically; however, many people do resist being changed, i.e., having changes imposed on them.

Organizational change normally involves some threat, real or perceived, of personal loss for those involved. This threat may vary from job security to simply the disruption of an established routine. Furthermore, there may be tradeoffs between the long and short run. As an individual, I may clearly perceive that a particular proposed change is, in the long run, in my own best interests, and I may be very interested in seeing it happen, yet I may have short-run concerns that lead me to oppose particular aspects of the change or even the entire change project.

The rate of change is escalating in virtually all organizations. The pressure is intense on anybody connected with the health-related world to focus time and attention on understanding the forces driving the changing environment and develop or implement the information systems needed to support the altered environment.

Change Management

The phrase change management is very common in management articles as well as newspapers., Moreover, managerial interest in the topic has been stimulated by the comments of Peter Drucker as to whether one can manage change at all or merely lead or facilitate its occurrence within an organization. Nevertheless, using the traditional terminology, what is meant by change management, how did it evolve, and why has this concept become so important?

Change management is the process by which an organization gets to its future state, its vision. While traditional planning processes delineate the steps on the journey, change management attempts to facilitate that journey. Therefore, creating change starts with creating a vision for change and then empowering individuals to act as change agents to attain that vision. The empowered change management agents need plans that provide a total systems approach, are realistic, and are future oriented. Change management encompasses the effective strategies and programs to enable those change agents to achieve the new vision.

Today's change management strategies and techniques derive from the theoretic work of a number of early researchers.

Examples of Core Theories from Other Disciplines

In 1974, Watzlawick, Weakland, and Fisch published their now classic book, Change: Principles of Problem Formation and Problem Resolution. Theories about change had long existed. However, Watzlawick et al. found that most of the theories of change were philosophical and had been derived from mathematics and physics. Watzlawick et al. selected two theories from the field of mathematical logic on which to base their beliefs about change. They selected the theory of groups and the theory of logical types. Their goal of reviewing the theories of change was to explain the accelerated phenomenon of change that they were witnessing.

Watzlawick et al. concluded that the earlier theories explained first-order and second-order changes:

First-order change is a variation in the way processes and procedures have been done in a given system, leaving the system itself relatively unchanged. Some examples are creating new reports, creating new ways to collect the same data, and refining existing processes and procedures.

Second-order change occurs when the system itself is changed. This type of change usually occurs as the result of a strategic change or a major crisis such as a threat against system survival. Second-order change involves a redefinition or reconceptualization of the business of the organization and the way it is to be conducted. In the medical area, changing from a paper medical record to an electronic medical record represents a second-order change, just as automated teller machines redefined the way that many banking functions are conducted worldwide.

These two orders of change represent extremes. First-order change involves doing better what we already do, while second-order change alters the core ways we conduct business or even the basic business itself.

Golembiewski, Billingsley, and Yeager subsequently added another level of change, defining middle-order change as lying somewhere between the extremes of first- and second-order change. Middle-order change "represents a compromise; the magnitude of change is greater than first-order change, yet it neither affects the critical success factors nor is strategic in nature."

Kurt Lewin is credited with combining theories from psychology and sociology into the field theory in social psychology. Lewin focused on motivation and the motivational concepts that underlie an individual's behavior. Lewin believed that there is tension in a person whenever a psychological need or an intention exists, and the tension is released only when the need or intention is fulfilled. The tension may be positive or negative. These positive and negative tension concepts were translated into a more refined understanding of conflict situations and, in turn, what Lewin called "force fields."

Lewin indicated that there are three fundamental types of conflict:

Individuals stand midway between two positive goals of approximately equal strength. A classic metaphor is the donkey starving between two stacks of hay because of the inability to choose. In information technology, if there are two "good" systems to purchase or options to pursue, then we must be willing to choose.

Individuals find themselves between two approximately equal negative goals. This certainly has been a conflict in many organizations that wish to purchase or build a health informatics system. A combination of the economics, the available technologies, the organizational issues, among other factors, may well mean that the organization's informatics needs cannot be satisfied with any available products, whether purchased or developed in-house. Thus, the decision makers must make a choice of an information system that they know will not completely meet their needs. Their choice will probably be the lesser of two evils.

Individuals are exposed to opposing positive and negative forces. This conflict is very common in health care organizations today, especially regarding health informatics. This conflict usually occurs between the system users and the information technology or financial people.

Kurt Lewin's field theory allows the types of conflict situations commonly found in health care to be diagrammed and analyzed.

Small-group theory is another tool that is highly applicable to health informatics because of the way that health care environments and activities are organized. Caring for patients and educating students typically involves many small groups of people. Small-group theory can help us understand why there are such wide ranges of effectiveness among these groups.

These are just a few examples of the social science theories that can help the change management leader understand some of the underlying behavioral issues that need to be faced as health informatics technology is brought into today's complex health systems.

Practical Applications of Change Management

There is nothing more difficult to take in hand, more perilous to conduct, or more uncertain in its success, than to take the lead in the introduction of a new order of things. -Niccolo Machiavelli

One of the most difficult problems organizations face is dealing with change. In today's rapidly changing, highly competitive environment, the ability to change rapidly, efficiently, and almost continually will distinguish the winners from the losers. Many health-related organizations will disappear because they find themselves unable to adapt. Furthermore, many of the pressures for change in health care organizations are independent of technologic change. This means that informaticians working for change are doing so in organizations that are already highly stressed by other pressures.

Major organizational changes typically involve many different types and levels of personal loss for the people in the organization. For example, change always requires the effort to learn the new, which is a loss in terms of time and energy that could have been used elsewhere. Although some may welcome the learning opportunity, many of us don't want to invest that time and energy unless we are dissatisfied with the current arrangements or see powerful advantages to the proposed change. Upgrading to new software is a common example, in which the future benefits may not be seen as sufficient to outweigh the short-term investment required to learn the new programs.

Second, people want to feel good about themselves. Ideally, people are able to take pride in their work, feel responsible for a job well done, feel they are part of a high-quality enterprise, and feel that their time has some significance. In many work situations, the work itself and the organizational culture make it difficult for people to feel good about themselves. In these poorer situations, people usually invent strategies to help them feel better about themselves, and these strategies involve getting some sense of control, belongingness, and significance out of their work. Sometimes this involves opposition to management, on the assumption that management is always up to no good. More commonly, the worker-management relationships are not completely alienated. Still, the workers' strategies for achieving "good" feelings are unknown to or quite misunderstood by management. Therefore, change initiatives, unknowingly and unintentionally, threaten to cause the workers serious personal loss. Not surprisingly, the workers resist and do all they can to sabotage such change initiatives.

Third, change initiatives often require large losses for middle managers. Generally, people perceive that information systems increase the ability of top executives to know more about what is going on and to exert more direct control. This means a serious loss of personal and organizational significance for the middle manager. Sometimes middle managers fight this loss. Any significant organizational change involves changing habits, that is, changing the way we actually do our work. This usually involves changes in the way we interact, both with people and our tools. New systems require us to learn a new set of behaviors.

Types of Change

Changes in an organization can often be identified as one of four types, with the definite possibility of overlap among them:

Operational changes affect the way the ongoing operations of the business are conducted, such as the automation of a particular area.

Strategic changes occur in the strategic business direction, e.g., moving from an inpatient to an outpatient focus.

Cultural changes affect the basic organizational philosophies by which the business is conducted, e.g., implementing a continuous quality improvement (CQI) system.

Political changes in staffing occur primarily for political reasons of various types, such as those that occur at top patronage job levels in government agencies.

These four different types of change typically have their greatest impacts at different levels of the organization. For example, operational changes tend to have their greatest impacts at the lower levels of the organization, right on the firing line. People working at the upper levels may never notice changes that cause significant stress and turmoil to those attempting to implement the changes. On the other hand, the impact of political changes is typically felt most at the higher organizational levels. As the name implies, these changes are typically made not for results-oriented reasons but for reasons such as partisan politics or internal power struggles. When these changes occur in a relatively bureaucratic organization, as they often do, those working at the bottom often hardly notice the changes at the top. Patients are seen and the floors are cleaned exactly as they were before. The key point is that performance was not the basis of the change; therefore, the performers are not much affected.

Microchanges and Megachanges

When communicating about change, the models of Watzlawick and Golembiewski tend to be too abstract or difficult to explain. A more practical model that we frequently use divides changes into microchanges and megachanges, with no great attempt at elaborate definitions. As a first approximation, the following scheme can be used to differentiate between the two:

Using an information system as an example, modifications, enhancements, improvements, and upgrades would typically be microchanges, while a new system or a very major revision of an existing one would be a megachange. This scheme works surprisingly well for communication within organizations as long as we remember that one person's microchange is often another person's megachange. So while the system designers think they are making a minor change to enhance the total system, an individual end user may see the change as a megachange and resist it vehemently. When designing the total "people" strategy for any system, it is important to involve a variety of people from the very beginning, to clearly understand how groups function in the organization and how the work is really done.

The Cast of Characters

For any given change, people can occupy a wide range of roles that will strongly influence their perceptions of the change and their reactions to it. These are roles such as champion, end user, developer/builder, watchful observer, obstructionist, and such. As on the stage, some people may occasionally play more than one role. In other cases, the roles are unique. Unless we clearly identify both the players and their roles in any change situation, we risk making decisions and taking action based on generalizations that are not true for some of the key players.

An overview term often applied to the various roles is stakeholders. The stakeholders have some interest or stake in the quality of both the change and the change implementation process. The role of the stakeholders are subject to change, especially during a change process that extends over some time.

For those implementing change, the following steps are critical:

To identify what roles they themselves are occupying in the process

To identify what roles the others involved in the process are playing, being careful to recognize multiple roles

To identify carefully which role is speaking when one is communicating with those playing multiple roles

To monitor throughout the process whether any roles are changing

Resistance to Change

It is easy to change the things that nobody cares about. It becomes difficult when you start to change the things that people do care about-or when they start to care about the things that you are changing. -Lorenzi and Riley

Resistance to change is an ongoing problem. At both the individual and the organizational levels, resistance to change impairs concerted efforts to improve performance. Many corporate change efforts have been initiated at tremendous cost only to be halted by resistance among the organization's employees. Organizations as a whole also manifest behavior similar to that of individuals when faced with the need to change.

The relationship between individual and organizational resistance to change is important. An organization is a complex system of relationships between people, leaders, technologies, and work processes. From this interaction emerges organizational behavior, culture, and performance.

These emergent properties and behaviors are tightly linked in two directions to the lower-level interactions. Organizational resistance to change is an emergent property, and individual resistance to change can give rise to organizational resistance. A self-reinforcing loop of increasing resistance can develop as individuals create a environment in which resistance to change is the norm. That environment in turn encourages increased resistance to change among individual employees. The self-reinforcing nature of this loop can be tremendously powerful, defeating repeated attempts to break out of it.

Studies of system dynamics frequently reveal that major problems that everyone thought were external are actually the unintended consequences of internal policies. The basic dynamic behind this phenomenon is that the organization is made up of a network of circular causal processes: A influences B, which then influences C, which in turn influences A, i.e., the snake bites its own tail. Understanding these internal organizational dynamics is a prerequisite for leading effective change processes.

Rituals of Transition

All change involves loss. In many cases, change requires at the minimum that individuals give up familiar routines. In some cases, the loss is substantial, affecting position, power, networks of friends and colleagues, and such. In all these situations, rituals of transition can be crucial in assisting people to grieve and let go of the old and move on to the new.

The strategies for overcoming the barriers to change are quite diverse and touch on every aspect of the organization. No organization can begin using all the strategies at the same time or even in a short period of time. A better approach is to focus on one or two until they become part of the normal way of operating, i.e., until they become engrained in people's habits. Only then is it time to introduce another strategy. In this way, over time, the organization gradually improves its abilities to learn rapidly, to adapt to new conditions, and to embrace change.

Change Management Efforts in Medical Informatics

If you design something that works with an already existing model and doesn't require people to change their religion, the idea has a better chance of working. -Ted Selker, IBM

The current formal focus on change management in the medical informatics area is relatively new. Two early pioneers in analyzing the impact of information systems were Diana Forsythe and Henry Lundsgaarde. Diana Forsythe worked at the boundaries of cultural anthropology, medicine, and computer science. She was among the first anthropologists or sociologists to collaborate with computer scientists to study the work practices of computing. Her ethnographic work on software development in medical informatics revealed that cultural and disciplinary assumptions are routinely (but often unintentionally) designed into such software, potentially reducing the system's benefits to clinicians or patients. Her field research in various medical disciplines suggested ways in which software and other technology might better meet those needs.,, Henry Lundsgaarde, evaluated the PROMIS system. This study produced insights into people and organizational issues and is an excellent example of how to combine qualitative and ethnographic methods with quantitative ones.

A concerted effort to introduce the people and organizational aspects more formally and broadly into medical informatics began in 1993 with a working conference in Cincinnati, Ohio, held under the auspices of the International Medical Informatics Association (IMIA). The years since have shown that this working conference was a seminal event, in that it brought together for the first time isolated individuals interested in the topical area. A number of today's leaders in the area were present at that conference, representing different academic backgrounds, different types of organizations, and different countries.

Following that working conference, IMIA approved a working group to study further the organizational impact of computers in medicine. Other related working groups were approved by AMIA, the European Federation for Medical Informatics, and the Health Informatics Society of Australia. These working groups accepted as their charge some variation of the following theme-applying knowledge of human behaviors to the implementation of informatics in a health care environment.

The IMIA and AMIA working groups, under the initial leadership of Nancy Lorenzi, accepted a fourphase driving-wedge diffusion strategy to spread their messages across the profession. The first phase of this strategy was designed to build awareness of the importance of the topic of people and organizational issues in the area of health informatics. One diffusion product was the book Organizational Aspects of Health Informatics: Managing Technological Change, published in 1994. This was followed by a case studies book, Transforming Health Care through Information: Case Studies, published in 1995.

The second phase of the diffusion process was designed to educate people about the research from other disciplines, e.g. psychology, sociology, anthropology, and cognitive sciences, that is directly relevant to medical informatics. Products that support this diffusion strategy include the working group newsletter, Organized Aspects of Medical Informatics, edited by Bonnie Kaplan, PhD, and co-edited by Marilynne Herbert, PhD. Presentations at national and multinational conferences and publications in recognized informatics journals are other examples of this phase of the diffusion strategy.,,,

The third phase of the diffusion process is to apply established methods and models from other disciplines (e.g., psychology and sociology) to the medical informatics area. The working groups actively encourage current practitioners and students to model their medical informatics research efforts using documented and accepted concepts from other disciplines.

The fourth phase assumes that our ongoing research will reveal the need for some concepts and methods that are unique to medical informatics. This phase is designed to develop new, discipline-specific research methods and models. The working group encourages students in master's and doctoral programs as well as active researchers to consider innovative research designed specifically for the area of medical informatics.

The Road Ahead

I'm very interested in the future because I plan to spend the rest of my life there. -Robert Wood Johnson

As medical informatics becomes involved in ever larger and more complex systems, both the overall organizational leaders and the informatics leaders must adapt to the following realities.

When the impact of technologic change is being managed, people's needs come first: Without people, we don't have an organization. We must implement the new technologies to do what they do best-structured, repetitive work-and let the people do what they do best-think, be creative, and solve problems. People are far better at reviewing boring work than doing it. It is because of these concepts that workflow technology is rapidly changing the role of today's information worker from an information transcriber and mover to a true knowledge worker-an information user.

The knowledge workers are the foundation. According to Peter Drucker in "The New Society of Organizations," the world economy is in the midst of transformation to the "knowledge society." Increasingly, knowledge is not just one resource among many; it is "the primary resource for individuals and for the economy overall." The essential purpose of management in the knowledge society is to encourage systematic organizational innovation. Drucker makes the important point that in a knowledge economy, the true source of competitive advantage is not so much technology, research and development, or even knowledge itself. It is the people, the knowledge workers whose skills and expertise are the foundation for all innovation.

We need to develop a new way of looking at how we currently function in our organizations. Management and workers will have to come together to build better, more productive work environments by understanding the long-term issues affecting their future and by creating a new way of thinking about how these current enabling technologies can best be used.

Technology Is Not Enough

Because technology investments are largely made up of things (i.e., hardware and software), it is easy to make the mistake of believing that a technology is implemented once it has been bought and installed. In fact, nothing works without people. These human issues become magnified in the process of redesigning work processes. Many work-process redesign projects focus exclusively on technology and fail to address the human and organizational aspects of work. In these instances, organizations fail to explore nontechnical solutions to improving organization processes, such as training or changes in structures, procedures, and management practices. Most often, technology strategy drives organizational change. While the business strategy may be clear, it is often not reflected in a defined organizational change strategy.

Too many technically good applications have failed because of sabotage by users who like the old ways in which things were done. Managing the natural resistance to change and helping convert that resistance into commitment and enthusiasm must be a planned process. New systems should enhance the quality of work life and increase responsibility, empowerment, and motivation.

The Role of Customers

We must rethink our customers' needs, using the concept of customer in the broad sense in the complex health care world. Any time our customers see us doing something better, we win. The message is that we need to identify correctly those parts of our processes that are visible to our customers and consider reengineering them first. The real key is to ensure that we are getting the right process right. For example, Mutual Benefit in the United States transformed their insurance policy issuing and payment process. They were ecstatic with the results of redesigning what had previously been a 24-day process of paying insurance claims, after the redesign payments could be made, in less than a day, generally within three hours. Within 90 days after implementing the new processes, they filed for protection from their creditors. Why? They did not pay equal attention to re-engineering the processes that brought in the money.

However, the concept of customer needs is also important in the internal sense. In these times of increasing change, it will be even more critical that our people do not perceive that changes are being made just for the sake of change. When the culture is focused on constantly improving the meeting of customer needs, the rationale for rapid and frequent changes becomes much clearer to those in the organization. This point is constantly stressed by Oren Harari in his books and monthly columns in Management Review.

The Road to Success

Common wisdom suggests that technology drives change in the organizational environment, but common wisdom is wrong. Instead, information technology is a powerful enabling force that creates new options and opportunities in the environment for what organizations produce-whether goods or services-and how they produce it. The early response by innovative players drives change. Each of the enabling technologies has the potential to transform one or more dimensions of the workplace. Taken together they act as a powerful set of technologies that organizations will have to harness to be successful in the 21st century. There are no quick fixes. Solving these problems requires a response targeted to the needs of our organization, but we need to know how our organization's strategy will play out in the environment as a whole.

The road ahead will not be an easy one. However, the medical informatics area is poised to create outcomes that many of us could only dream of a few years ago. Our challenge will be to implement our concepts and systems as smoothly as possible, not wasting our precious opportunities and resources because we ignored the pitfalls of managing change.

Notes

This paper was the basis of a presentation by Dr. Lorenzi that was part of the Cornerstone on Managing Change, one of four Cornerstone sessions included in the program of the AMIA Annual Fall Symposium, Washington, DC, November 6-10, 1999.

Footnotes

*Paraphrased from Kurt Vonnegut, Jr., in Slaughterhouse-five: " `If only it weren't for the people, the goddamned people,' said Finnerty, `always getting tangled up with the machinery. If it weren't for them, earth would be an engineer's paradise.' "

References

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As increasingly powerful informatics systems are designed, developed, and implemented, they inevitably affect larger, more heterogeneous groups of people and more organizational areas. In turn, the major challenges to system success are often more behavioral than technical. Successfully introducing such systems into complex health care organizations requires an effective blend of good technical and good organizational skills.

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How to Effectively Manage Change | University of Aberdeen

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Negative consequences- If stress is not properly addressed, it can soon lead to depression. For example, a college student is overwhelmed over all the assignments that are due for the end of the semester. Furthermore, the student chooses to watch movies instead of working on their assignments because they would rather enjoy themselves than take some stress off.  Consequently, the assignments just keep stacking up on each other one by one until it is too much for the student to handle. The semester is finally ending and there are still many uncompleted assignments. The student failed their classes resulting in their GPA dropping too low and getting academically dismissed. This caused the student's parents to be disappointed in them, which then lead to the additional depression.

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How to stay calm when you know you'll be stressed | Daniel Levitin | TED

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Change your mindset, Change the Game

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Change your mindset, change the game | Dr. Alia Crum | TEDxTraverseCity

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"People react to change differently. Some people adapt quickly to stress, while others may not adapt as well and therefore experience the physiological changes of stress for longer periods."

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Stress from change is a natural part of life. Unfortunately, without appropriate stress management, it can affect our physical, mental, and emotional health. Therefore, understanding how change leads to stress, as well as how to manage that stress is an important part of leading a healthier, happier life.

How Change Leads to Stress

Throughout the course of your life, you will deal with change in many forms. Some changes are very minor and easy to get past. Other changes may be more significant, leading to elevated stress levels. Life changes can be both positive and negative.

Related Articles

In the late 1960s, two psychiatrists, Richard Rahe and Thomas Holmes, set out to determine how stressful life changes affected health via the stress response. They did this by examining more than 5,000 patient records to see if they could correlate stressful life events with illness. The result was the Social Readjustment Rating Scale, also known as the Holmes-Rahe Stress Inventory. It measures the amount of change in one's life that may affect stress levels, assigning a weighted numerical value to each stressful event based on its statistical effects on human health. Rahe performed follow-up research that backed up earlier findings.

The inventory lists both positive and negative changes that can cause stress.

Positive Changes

Positive change can be exciting, but it can also trigger a physiological stress response. Holmes and Rahe list multiple positive changes that may cause physiological stress responses including:

Marriage

Marital reconciliation

Pregnancy

Changing jobs

Outstanding personal achievement

Revision of personal habits

Christmas

Changing health habits

Buying a house

Gain a new family member

Retirement

Negative Changes

Change generally perceived as negative can be particularly stressful. Some negative changes that cause physiological effects of stress include:

Physiological Effects of Stress from Change

Stress can lead to numerous physiological changes. When you experience stress, your body releases many chemicals and hormones, such as cortisol and adrenaline, which prepare you for fight or flight. This type of response is a natural part of human physiology, and occurs in order to allow you to react to a perceived physical threat, according to the Mayo Clinic. This causes a number of changes including elevated heart rate and respiration, suppression of the digestive system, increased blood flow, and immunosuppression.

Fight or Flight

All of your physiological resources are diverted from normal functions to prepare you for fight or flight. Ideally, once the perceived threat disappears, then the hormones and chemicals will leave your system and your body function will revert to normal.

Unfortunately, the body can't differentiate between stress from an immediate physical threat and stress due to life changes. Life change stressors activate the physiological response in the same way. Because stress from these changes typically lasts much longer than a fight or flight situation, your body continues to respond for the long-term with stress chemicals and responses. The American Psychological Association notes that because of these changes, chronic stress can contribute to a number of health problems such as:

Signs of Poor Stress Adaptation

People react to change differently. Some people adapt quickly to stress, while others may not adapt as well and therefore experience the physiological changes of stress for longer periods. Brown University lists multiple signs that may indicate you're not adapting well to life's stressful changes, including:

According to WebMD, your body may also give you physiological signs you are under too much stress, including:

Mitigating the Effects of Stress

Fortunately, you can mitigate the potential effects of stress associated with change with smart stress management strategies.

Upcoming Changes

If you are aware of an upcoming change, such as a marriage or move, you can help to alleviate stress about the event in multiple ways.

Create an action plan: The World of Psychology recommends preparing instead of worrying. By setting manageable goals and creating a series of steps to get from one goal to another, you will feel more in control of the situation, which should help minimize your stress. This preparation should also help you reduce uncertainty, which will minimize worrying about the unknown associated with upcoming change.

Build a strong support network: According to the Mayo Clinic, social support is essential in alleviating stress. Seek mutually supportive relationships among multiple social groups, such as friends, family, work, volunteer activities, church, and hobbies. Having people you can lean on during your upcoming changes should help ease the way.

Take care of your physical health: The CDC notes that caring for your physical needs by eating healthy foods, exercising, finding time to relax, and getting plenty of sleep can help you cope with stress. This is especially important if you know big changes are on the horizon.

Eat healthy: According to WebMD, eating healthy can help boost your brain's serotonin levels, which will combat higher cortisol associated with stress.

One change at a time: If you've got a big change coming up, it's important that you create consistency in the rest of your life as much as possible. That's why it's best that you minimize other changes in your life as you prepare for a big change. For example, if you're going to be changing jobs soon it may be best not to attempt to change personal habits at the same time.

Sudden Changes

Sometimes, change occurs without warning. If you're currently in the middle of stress associated with change, there are a number of steps you can take to help your body and psyche cope and adapt.

Lean on your social network: Social support can greatly help increase resilience to stress, so spend time friends, family, and loved ones.

Use relaxation techniques: The American Psychological Association recommends relaxation techniques like meditation or deep breathing as a tool for coping with stress. Likewise, try to take time to relax every day, even if you just put your feet up for a few minutes.

Engage in hobbies: The American Heart Association recommends taking time to engage in activities you love, even if for just a few minutes.

Minimize caffeine intake: According to Duke University, caffeine can increase the effects of stress, so it's best to minimize caffeine during stressful times.

Laugh: The Mayo Clinic notes that laughter can help decrease the effects of stress, so pop a comedy in the DVD player or spend time with people who make you laugh.

Care for your health: Eat right and get as much sleep as you can so you don't put additional stress on your body.

Avoid drugs and alcohol: The CDC notes that turning to drugs and alcohol can add to stress instead of reducing it, so it's best to stay sober when you're under stress.

Focus on the problems you can solve, not those you can't: The American Association of Family Doctors suggests working to resolve any issues you can and avoiding worry about things you can't control.

Seek professional support: According to the National Library of Medicine, if stress management techniques do not work for you, then seek care from a qualified professional such as counselor, therapist, or social worker.

You're in Control

Throughout your life, you're likely to experience both change and stress many times. By recognizing that you have control over how you react to change and how you allow it to impact you, you can learn to effectively deal with the associated stress.

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Stress Associated with Change | LoveToKnow

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Stress from change is a natural part of life. Unfortunately, without appropriate stress management, it can affect our physical, mental, and emotional health. Therefore, understanding how change leads to stress, as well as how to manage that stress is an important part of leading a healthier, happier life.

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"Change is a good thing, it is inevitable, it is necessary and it, more often than not, leads to progress."

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By: Rita Balian Allen, Rita B. Allen Associates, September 2016
Executive Coach, Author, Trainer, Speaker, Leadership Development, Management Training and Career Development Consultant
=====================================================================================

Summer is behind us and as we get ready to go back to work or school, we may want to ensure we are doing so with an openness to new possibilities. Fall is a very good illustration of the positive effects of change and the significance that transformation can bring. It tells a compelling story and creates a vivid picture through nature. Change represents progress yet so often, it is met with resistance. At times, this resistance comes from concern or fear of the unknown effects the change may bring to oneself and/or to others. While we cannot control or even predict what changes will be presented to us on a daily basis, one thing we know for sure - and that is the only constant we can expect to face every day is change! Therefore, shifting our mindset to one that accepts change as a positive necessity in our careers and lives is likely to empower us for success.

Change is inevitable and in reality, it represents progress, moving forward in a way that yields more efficiency and/or effectiveness. Our goal is to embrace change and realize that we play a role in making it happen; leadership sets the tone and everyone contributes. Yes, it can be uncomfortable and challenging, yet change also allows us to grow and venture into new territories that may be quite foreign at first but very rewarding in the end. For example, when I first switched over to a smart phone from a blackberry, it took me a long time to get used to the touch screen. Fast forward to a few years later and I now have several devices and use numerous applications that allow me to be more efficient, creative and productive in my work.

We live in a global and multi-cultural economy and are doing business with individuals all over the world. Most organizations today have employees, clients, customers, vendors and other stakeholders throughout the world who are communicating and collaborating daily to achieve desired results. Every day we are faced with changes that may be in our economy, markets, industries, organizations, technologies, as well as leadership and people changes in our companies. When we can get comfortable with this fact and wake up every day embracing and welcoming change, we actually open ourselves up to never-ending opportunities and possibilities. In fact, managing change effectively is an essential leadership skill today. Not only is it required of leaders and managers but, as individuals, we all play a critical role in executing effective change.

Let me share another example to illustrate this point. In higher education, the traditional models of learning have been enhanced with virtual learning. The first several years I taught as a university lecturer, all the teaching was in a classroom. Over the years, a hybrid model was introduced and ultimately a completely virtual model. While I was resistant to these changes, I tried embracing them and have learned to appreciate the model much more than I ever imagined. As a matter of fact, many of the courses I have been teaching the past few years have been virtual which has enabled me to work with a diverse mix of students from all over the world at any one time and the opportunity to engage every single student in a substantive dialogue which would not happen in a live classroom! These experiences have enriched my knowledge and learning is a way that would not have happened if I didn't open myself up to new approaches. Being flexible and agile is important in order to grow and succeed.

Change is a good thing, it is inevitable, it is necessary and it, more often than not, leads to progress. I always like to reference Ben Franklin's quote within this conversation, "Life is ten percent what you make it and ninety percent how you take it." Putting this into practice can be difficult and require us to push out of our comfort zone. Doing so, however, leads to great things as we enhance our knowledge and experiences. One of my mottos is... "Get comfortable being uncomfortable." When we do, we truly grow and open up a world of possibilities we would not otherwise experience. Keeping ourselves open and actively looking for and engaging in ways that stretch ourselves with new behaviors, strategies, skills and knowledge. Do you make this a priority for yourself? Do you welcome and embrace change as a requirement for growth? When we do accept change as a positive necessity, we see it as a requirement and opportunity rather than an obstacle. There are many proven practices and models for how leaders and managers can manage change effectively. What can each individual do to play a role in managing and executing change? I have learned to ACT to effectively deal with change and have coached individuals and teams to do so as well.

ACT now to effectively deal with Change:

A ccept and Acknowledge the need for change

C ommunicate with all parties involved in a pro-active manner to Clarify and Comprehend the needs as well as the process required for the change to be implemented

T hrive in the progress change brings -- Throw yourself into the change, keep an open mind, Try new things, Test different approaches, Think about the impact on all, ask for and be open to feedback, Teach others your learnings, and Tell all

Rita Balian Allen is the president of Rita B. Allen Associates, a national career management firm specializing in executive coaching, leadership development, management training and career development. She is a lecturer at Boston-area universities, a sought-after speaker and presenter, the author of numerous articles, blogs and the book, "Personal Branding and Marketing Yourself: The Three Ps Marketing Technique as a Guide to Career Empowerment". She is a regular Huffington Post blogger and writes a career management column for Leadership & Management Books. Rita was voted one of the top ten executive coaches by the Boston Women's Business Journal.

Executive Coach, Author, Trainer, Speaker, Leadership Development, Management Training and Career Development Consultant

Business Executive Coaching Leadership Development career-management

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Accepting Change as a Positive Necessity

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By: Rita Balian Allen, Rita B. Allen Associates, September 2016 Executive Coach, Author, Trainer, Speaker, Leadership Development, Management Training and Career Development Consultant ===================================================================================== Summer is behind us and as we get ready to go back to work or school, we may want to ensure we are doing so with an openness to new possibilities.

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How to Get Better at Dealing with Change- Harvard Business Review

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How to deal with change:
1. Find the humor in the situation
2. Talk about problems more than feelings
3. Don't stress about stressing out
4. Focus on your values instead of your fears
5. Accept the past, but fight for the future
6. Don't expect stability

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Change is an unavoidable constant in our work lives. Sometimes it's within our control, but most often it's not. Our jobs or roles change - and not always for the better. Our organizations undergo reorgs and revamp their strategies, and we need to adjust.

Fortunately, there are ways to adapt to change, and even to take advantage of it.

Find the humor in the situation. Trying to find a funny moment during an otherwise unfunny situation can be a fantastic way to create the levity needed to see a vexing problem from a new perspective. It can help others feel better as well.

Pioneering humor researcher Rod A. Martin, who has studied the effects of different styles of humor, has found that witty banter, or "affiliative humor," can lighten the mood and improve social interaction. Just make sure it's inclusive and respectful. A good rule of thumb is that other people's strife is no laughing matter, but your own struggles can be a source of comedic gold.

Talk about problems more than feelings. One of the most common myths of coping with unwanted changes is the idea that we can "work through" our anger, fears, and frustrations by talking about them a lot. This isn't always the case. In fact, research shows that actively and repeatedly broadcasting negative emotions hinders our natural adaptation processes.

That's not to say you should just "suck it up" or ignore your troubles. Instead, call out your anxiety or your anger at the outset of a disorienting change so that you are aware of how it might distort your thinking or disrupt your relationships. Then look for practical advice about what to do next. By doing so, you'll zero in on the problems you can solve, instead of lamenting the ones you can't.

Don't stress out about stressing out. Our beliefs about stress matter. As Stanford psychologist Kelly McGonigal argues in The Upside of Stress, your reaction to stress has a greater impact on your health and success than the stress itself. If you believe stress kills you, it will. If you believe stress is trying to carry you over a big obstacle or through a challenging situation, you'll become more resilient and may even live longer.

When you start to feel stressed, ask yourself what your stress is trying to help you accomplish. Is stress trying to help you excel at an important task, like a sales presentation or a big interview? Is it trying to help you endure a period of tough market conditions or a temporary shift in your organizational structure? Is it trying to help you empathize with a colleague or a customer? Or is stress to trying to help you successfully exit a toxic situation?

Stress can be a good thing - if you choose to see it that way.

Focus on your values instead of your fears. Reminding ourselves of what's important to us - family, friends, religious convictions, scientific achievement, great music, creative expression, and so on - can create a surprisingly powerful buffer against whatever troubles may be ailing us.

In a series of studies spanning more than a decade, researchers led by Geoffrey Cohen and David Sherman have shown how people of all ages in a range of circumstances, from new schools and new relationships to new jobs, can strengthen their minds with a simple exercise: spending 10 minutes writing about a time when a particular value you hold has positively affected you.

The technique works because reflecting on a personal value helps us rise above the immediate threat, and makes us realize that our personal identity can't be compromised by one challenging situation.

Accept the past, but fight for the future. Even though we are never free from change, we are always free to decide how we respond to it.

Viktor Frankl championed this idea after returning home from three horrific years in Nazi death camps. He discovered that his mother, brother, wife, and unborn child were all dead. Everything in his life had changed. All that he loved was lost. But as fall became winter and winter gave way to spring, Frankl began to discover that even though he could never go back to the life he once had, he was still free to meet new friends, find new love, become a father again, work with new patients, enjoy music, and read books. Frankl called his hope in the face of despair "tragic optimism."

Frankl's story is an extreme example, of course, but that's all the more reason why we should find inspiration from it. If we fixate on the limitations of a specific change, we inevitably succumb to worry, bitterness, and despair.

Instead, we should choose to accept the fact that change happens, and employ our freedom to decide what to do next.

Don't expect stability. In the late 1970s a researcher at the University of Chicago named Salvatore Maddi began studying employees at Illinois Bell. Soon after, the phone industry was deregulated, and the company had to undergo a lot of changes. Some managers had trouble coping. Others thrived. What separated the two groups?

The adaptive leaders chose to view all changes, whether wanted or unwanted, as an expected part of the human experience, rather than as a tragic anomaly that victimizes unlucky people. Instead of feeling personally attacked by ignorant leaders, evil lawmakers, or an unfair universe, they remained engaged in their work and spotted opportunities to fix long-standing problems with customer service and to tweak antiquated pricing structures.

In contrast, Maddi found that the struggling leaders were consumed by thoughts of "the good old days." They spent their energy trying to figure out why their luck had suddenly turned sour. They tried to bounce back to a time and a place that no longer existed.

Although each of these six techniques requires different skills to pull off - and you'll probably gravitate toward some more than others - there's one thing that you must do if you want to be more successful at dealing with change: accept it.

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How to Get Better at Dealing with Change

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Change is an unavoidable constant in our work lives. Sometimes it's within our control, but most often it's not. Our jobs or roles change - and not always for the better. Our organizations undergo reorgs and revamp their strategies, and we need to adjust.

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Positive consequences of change- One of the biggest outcomes of change is Personal growth you grow and learn new things every time something changes. You discover new insights about different aspects of your life. Also you can change all your bad habits to good habits and nothing is better then improvement. Positive change is favorable change which could lead to you making better decisions in life leading you to the right path. Positive change can also help with health issues allowing you to eat more healthy or even maybe start working out more getting in the right shape.

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Dealing with Stress - Top Tips - NLC Library 

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"Make a list of all the things that you need to do and list them in order of genuine priority. Note what tasks you need to do personally and what can be delegated to others to do. Record which tasks need to be done immediately, in the next week, in the next month, or when time allows."

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Dealing with Stress - Top Tips | SkillsYouNeed

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Managing stress is a very personal thing, but there are also some tried and tested methods that may help. Learn more and try our top tips to avoid and manage stress.

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Shilpa Shetty suggests Tratak meditation to calm mind, reduce stress. -NLC Library 

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"We may not always have the power to change what's happening around us, but we can definitely control what happens within. That is possible only through Yoga. Give yourself the ability to calm the mind, reduce unwanted thoughts, center your wandering attention, and improve your focus through Meditation" -Shilpa Shetty

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Byline: Indo Asian News Service

Mumbai, July 19 (IANS) Actress Shilpa Shetty Kundra took to social media on Monday to suggest meditation that offers benefits like calming the mind, reducing stress and sharpening the eyesight. The ancient meditation practice is called Tratak.

"We may not always have the power to change what's happening around us, but we can definitely control what happens within. That is possible only through Yoga. Give yourself the ability to calm the mind, reduce unwanted thoughts, centre your wandering attention, and improve your focus through Tratak Meditation," Shilpa wrote in an Instagram post.

The actress, who is known for her penchant for Yoga, also mentioned the benefits of the meditation, which include increased concentration levels, fighting sleeping difficulties, sharpening eyesight and reducing stress.

On the work front, Shilpa is set to make her comeback into Hindi films after 14 years with the upcoming comedy "Hungama 2". The Priyadarshan directorial also features Paresh Rawal, Rajpal Yadav, Meezaan Jafri and Pranitha Subhash in key roles.

Copyright 2021 IANS, distributed by Contify.com

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Shilpa Shetty suggests Tratak meditation to calm mind, reduce stress.

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Byline: Indo Asian News Service Mumbai, July 19 (IANS) Actress Shilpa Shetty Kundra took to social media on Monday to suggest meditation that offers benefits like calming the mind, reducing stress and sharpening the eyesight. The ancient meditation practice is called Tratak.

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"When dealing with day-to-day stresses, it's tempting to just keep going until you're exhausted. Alternatively, procrastination--putting things off--adds more stress in the long run. Instead, chip away at that long to-do list. When the pressure mounts, though, give yourself a break." -Kathiann M. Kowalski

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Beth has had play practice four nights a week for the last month. She also has three projects due by Friday, including one for Honors English. Besides this, Beth has been fighting off a cold. When Beth's mom asks her to do the dinner dishes, it's the last straw.

"Why do I always have to do the dishes?" Beth shouts. "It's not fair!" Before her mother can answer, Beth turns and stomps upstairs to her room.

Beth's blowup is a reaction to stress. Stress is the mental and physical pressure you feel from circumstances perceived as threats, Called stressors. Stress starts with how you think about things, but it's not all in your mind.

Stress affects your entire body. When a stressful event happens, the body automatically causes the adrenal glands to release adrenaline, a hormone. The brain also signals the pituitary gland in the head to release another hormone called ACTH (adrenocorticotropic hormone). ACTH makes the adrenal glands release more adrenaline, plus hormones called glucocorticoids (e.g., cortisone, cortisol, and corticosterone).

The combined effect of the hormones raises heart rateand blood pressure. Blood moves away from the digestive system toward the brain and muscles, leaving an uneasy feeling in the stomach. Meanwhile, faster breathing makes more oxygen available to the body, and the liver releases extra glucose for a ready energy supply. Perspiration increases, too. In short, the body becomes like that of a threatened jungle animal--primed for "fight or flight."

These physical responses work great if you're faced with a roaring wild animal. If it's a heavy homework assignment, though, they're counterproductive. Not only do you still have to do the assignment, but now you feel worried and edgy. The muscles stay tense, which leads to head, neck, and shoulder pain. Meanwhile, the hormones and other chemicals keep coursing through the body, where they take their toll.

The physical consequences of stress can include headaches, heart palpitations, digestion problems, irregular bowel movements, insomnia, skin rashes, muscle pain, and an impaired immune system. Over time, stress interferes with the ability to function effectively. The consequences can include falling grades, the inability to concentrate, difficulty relating to people, emotional outbursts, and general irritability.

In extreme situations, stress can contribute to anxiety or depression. Some people try relieving stress with tobacco, drugs, or alcohol. Such self-treatment not only fails to solve the problem, but it can lead to serious substance abuse disorders.

"If we see a red flag, it tells us something's wrong," says Mitchell Schare, a psychology professor at Hofstra University in Hempstead, New York. "When we feel stress, it's telling us something's wrong in our life." Instead of ignoring stress, deal with it.

What Stresses You Out?

The first step in dealing with stress is identifying its causes. Everyone experiences some stress. After all, things would be pretty boring if there were no challenges or demands on us. The question, then, is which stressors cause undue pressure.

Some stressors are real, external factors, like Beth's cold. Other stress is self-imposed, such as worries about your appearance.

Significantly, not everything that causes stress is bad. Beth loves being in the school play, and she enjoys the challenge of being an honor student. But even positive things can put pressure on teenagers.

While everyone experiences stress, the teenage years present special challenges. "Teenagers go through many normal biological changes," notes Donald Freedheim at Case Western Reserve University in Cleveland, Ohio. These include growth spurts, hormonal changes, and development of secondary sexual characteristics. "If these changes occur early, the teenager may feel self-conscious with peers," explains Freedheim. "If late, the teenager may feel they will never occur."

School factors high on the list of stressors, too. "My school is very competitive, so the students stress about doing well in class, sports, and music," reports 17-year-old Bernadette from Long Island. Paul, 15, of Indianapolis, Indiana, also says his stress comes "mostly from schoolwork and grades." Indeed, in a recent poll by Shell Oil Company, teens said they felt the most pressure to get good grades and to get into a good college. Thinking ahead about possible careers and desired lifestyle can add to the stress.

Then there are the time demands of sports and other activities. "Usually you have to come home and do homework, and then you have sports, and then you have to do some of your chores," says Jennifer, 15, in Rocky River, Ohio. She often feels there's little time left for herself.

"Teenage years can be a very rough time," notes Freedheim. "Teens are dealing with issues of identity, independence, and interpersonal concerns; among others." Worries include: What is my potential? What do I tell my parents? Will people like me? And so on.

Last spring, for example, the junior and senior proms caused stress at Bernadette's school. "Everyone was worrying about limos, dresses, and dates," she says. Paul says he also feels stress about "relationships with friends and upcoming sports stuff."

Responsible decision-making also presents stress. "Teens are constantly confronted with this issue," says Schare. About one-fifth of the teen-agers responding to the Shell poll felt significant pressure to use drugs or alcohol. About 13 percent felt pressure to be sexually active.

Beyond these issues, life changes can cause major stress for teenagers. The death or serious illness of a parent, brother, sister, or close friend can be overwhelming. But also positive experiences like moving to a new house or being in a play can be stressful.

Becoming a parent, being arrested, or getting into a car accident can drastically change teenagers' lives. Obviously, these events cause stress. Abused teenagers also experience severe stress, along with other emotional and physical harm.

At the other extreme, people can feel lots of stress from minor annoyances. Getting stuck in traffic, forgetting your house key, or dealing with a rude salesperson are just a few examples. Significantly, people vary greatly in what inconveniences stress them out. Kate may get edgy and impatient waiting at the dentist's office, for example, while Mike calmly reads his sci-fi paperback.

Once you've identified your stress triggers, decide how to handle them. Sometimes you can avoid the stressor. For example, if you lose your keys often, start hanging them on a hook as soon as you get home. If you forget to do homework, write down all assignments in a notebook, and check the notebook every night. If you can't find anything in a messy bedroom, start keeping it neat. If you have too many activities, cut back on one or two.

You may need help to avoid other stressors. If your sister rummages through your stuff, enlist parents' help in getting her to respect your privacy. If someone harasses you at school, speak up to parents, a school administrator, or a guidance counselor. They can help address the situation, so you won't have to bear the burden alone.

Of course, many stressors can't be avoided. Beth still has to finish her projects by Friday. Jennifer still has homework and chores, plus sports practices. "Never put off anything until 'later,' because you just end up worrying about it more," suggests Paul.

"Try to take things slow and one at a time," recommends Chris, 14, from Long Island. Make a list and prioritize the demands on your time. As you check things off, the pressure eases.

Even if you can't change a situation, you can still address how you think or feel about it. Rather than deciding that everybody hates you, for example, you can recognize that the snobby clique at school has a problem. Rather than steaming about the bad driver who cut you off, be glad you learned to drive defensively. Rather than resent having to do the dishes, accept that you're part of a family where everyone has responsibilities. Instead of griping about a school project assignment, think about it as a challenge.

In other words, even though stress starts with an outside event, much of your response hinges on how you perceive that event. Try looking at things a different way.

For starters, consider how your response compares with an event's importance. On a scale of 1 to 10, you may feel a stress level of 8 when your sister leaves the room messy. In terms of seriousness, however, the event is probably only a 3. Such comparisons help avoid overreacting.

Also play the "so what" game. Ask what's the best or worst that could happen in a situation. Then think about each possible outcome objectively. In most cases, you can handle it.

On the other hand, some situations really are serious, such as parents getting divorced, a grandparent's death, or a brother with a drinking problem. In these cases, seek out support groups. Sharing normal emotions with people who have been through similar experiences can help you cope.

Counseling can help, too. "There is no embarrassment ever in recognizing that we have a problem and that we want to seek out guidance or advice or help," says Schare. "To seek out the help of a teacher, a school counselor, or a psychologist is really a very positive and mature step. One should never feel embarrassed about it."

When dealing with day-to-day stresses, it's tempting to just keep going until you're exhausted. Alternatively, procrastination--putting things off--adds more stress in the long run. Instead, chip away at that long to-do list. When the pressure mounts, though, give yourself a break.

Bernadette usually sings or plays the piano when she feels stressed out. Paul tries to take his mind off problems by reading a book. Jennifer listens to music or takes short walks. After the "time out," these teenagers can cope better with life's demands.

"I just relax and try to go with the flow of things," notes Chris. If this doesn't come naturally, try relaxation exercises. Deep breathing from the diaphragm helps. Visualization--thinking about calming images--also defuses tension.

Careful stretching helps too. "Movement induces relaxation because muscle groups work in pairs--while one group is contracting, the opposing group is relaxing," explains Hussein Eshref, author of Easy Exercises to Relieve Stress. When people feel stress, however, they continuously tense half of some muscle pairs. That causes spasms and pain and produces more stress. Stretching can get muscle pairs back into balance.

Teenagers who manage stress well get regular aerobic exercise, too. Aerobic exercise is activity that raises your heartbeat and breathing rate. If stress already has you primed for fight or flight, exercise takes advantage of the hormones and glucose in your system.

Aerobic exercise also raises levels of endorphins--hormones like serotonin,dopamine, and noradrenaline. These hormones help you sleep, keep energy levels up, and make you feel good. When the exercise is something you truly enjoy, like a favorite sport, your enjoyment increases even more. In short, exercise can counteract stress.

Beyond this, regular exercise boosts the body's immune system. The more physical ailments you can avoid, the less stress you have to deal with. Moreover, exercise helps you feel good about yourself.

Those positive' feelings can win the argument against negative thoughts that surface when things don't go as planned. The more you like yourself, the more likely you are to approach life optimistically. Accept that you're not perfect and that sometimes you'll make mistakes. Giving yourself a break helps rein in stress.

Good nutrition helps, too. Junk-food binges don't solve stress. Rather, they sap your energy and contribute to weight problems. In contrast, a healthy diet provides enough energy to get through the day and bolsters the immune system. So, take regular meal breaks and eat wisely.

Likewise, schedule enough sleep every night. Getting a minimum of eight hours a night is best. Exhaustion lowers the immune system and adds to stress. In contrast, a good night's rest lets you face each day's challenges feeling refreshed.

Why should teenagers learn effective ways to manage stress now? "First, to preserve the time and energy needed to devote to schoolwork," answers Freedheim, "and second, to initiate patterns for handling stress that will be useful as they grow into adulthood."

Conversely, failing to manage stress effectively leads to the physical and emotional tolls of stress discussed earlier. Beyond this, poor stress management can lead to difficulties in interpersonal relationships. These can compound the problems people face and make it even harder to function effectively.

Indeed, recommended stress management techniques for teenagers are "really the same things that we use with adults," notes Schare. Teenagers may have different problems from adults, but their feelings are no less real.

Like it or not, you will always face stress. Indeed, without any challenges, life would be boring. Add stress management to your list of things to master this school year. It's one lesson that will serve you well throughout life.

Signs that someone may be suffering too much stress include:

* change in eating habits

* sudden weight gain or loss

* neglect of personal appearance

* withdrawal from friends or favorite activities

* moodiness and irritability

* headaches, muscle aches

* inability to concentrate

Of course, you're not a trained professional, and these symptoms can signal other problems, too. But if you notice these signs in a friend, tell him or her what you see. Then ask if the friend wants to talk. If necessary, encourage the person to talk to parents, teachers, counselors, coaches, or a doctor. Reminding someone that he or she is not alone is one of the best things you can do for a friend.

what would you do?

Is there something you could do to avoid the stress in each of the following situations? If not, how might you cope with the stress?

Write down your responses on a piece of paper. Ask a friend to do the same; then compare your answers.

1. A close friend is moving away.

2. Your teacher assigns lots of homework.

3. Your brother takes too long in the bathroom each morning.

4. Your mom got laid off from work.

5. You're worried about the SAT exam.

6. You didn't make the soccer team,

7. You can't find a clean shirt to wear.

8. You don't have a date for Friday night's dance.

9. You feel like you have no free time.

10. You forgot to bring your math homework to class,

11. Customers at your part-time job are rude.

12. A classmate says something that upsets you.

13. Your sister ties up the telephone at home.

14. Your parents criticize some of your friends.

15. You don't understand a chemistry assignment.

Did your friend suggest responses you hadn't thought of? When stress arises in real life, it helps to seek input from other people. A trusted person's perspective may help you see new ways to deal with a stressful situation. Remember, no one has to deal with all life's stresses alone.

National Mental Health Association www.nmha.org/infoctr/pamphlets.cfm Pamphlet: "Stress: Coping with Everyday Problems"; access on Web.

American Academy of Family Physicians Family Doctor www.familydoctor.org/handouts/278.html "Stress"; access Web site.

Health4Teens www.health4teens.org "Stress"; access Web site.

Hazelden 1-800-328-9000 www.hazelden.org Book: #1151A Coping with Stress by Gwen Packard; call or access Web site and click on Bookstore; single copy $6.95.

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Beth has had play practice four nights a week for the last month. She also has three projects due by Friday, including one for Honors English. Besides this, Beth has been fighting off a cold. When Beth's mom asks her to do the dinner dishes, it's the last straw.

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"Stress is a meditational process in which stressors trigger an attempt at adaptation or resolution that results in individual distress if an organism is unsuccessful in satisfying demands."

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This article talks about:
1. Why stress management is important for students
2. Seeking professional help
3. Stress management techniques
4. Natural approaches to stress
5. Don't forget self-compassion

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Many high school students look forward to the freedom, independence, and fun promised by college, but the reality of this major life change can hit much harder than you may expect. The American Institute of Stress reports that around eight in every 10 college students experience stress frequently-especially during freshman year.

Factors such as moving away from home for the first time, having to make new friends, and keeping up with classes can make college a big challenge-not to mention dealing with the current coronavirus pandemic and all the changes that has brought about. To top it off, the situation becomes even more difficult when students suffer from some burden of financial stress.

With all this in mind, let's explore why stress management is important for your health and the best ways to go about it.

Why stress management is important for students

College is an ideal time to hone (or create) your stress management strategy, as stress is something you'll have to live with throughout your life. When present in excess or chronic, stress hormones can make you ill, contributing to a host of conditions such as anxiety, depression, heart disease, obesity, and Type 2 diabetes. Interestingly, the Anxiety and Depression Association of America reports that around 42% of college students state that anxiety is a concern, while around 30% feel that stress has impaired their academic performance. Finding ways to cut down on stress will help you reduce symptoms and enjoy the best that college life has to offer while keeping a healthy school-life balance.

Seeking professional help

If you find that stress and anxiety are getting in the way of your daily tasks and obligations as a student, or that they're stopping you from making the most of social opportunities, seek professional help to nip the problem in the bud. Your campus counseling center is a good place to start, and many colleges have psychology departments that offer free counseling. (You may also be able to take advantage of these services remotely; check with your school to see if it's a possibility!) If you prefer to see an external counselor, try someone recommended by a family member or friend. Recommendations and online feedback are good ways to see what others think about a professional.
Related: Mental Health: What It Is and How Students Can Find Help
Stress management techniques

One "gold standard" approach taken by therapists to reduce student stress is cognitive behavioral therapy (CBT), which focuses on how you feel and think about a situation and how it's intricately linked to how you behave. With CBT, your therapist may ask you to keep a journal to identify situations that trigger your stress or anxiety. They may then suggest behavioral changes with the significant ability to affect the way you view situations. They may also help you learn to challenge negative thoughts, replacing them with more realistic ones that lead to healthier behaviors.

Natural approaches to stress

Students should certainly try to tackle stress from a multifaceted perspective. Many natural methods have been found to be highly effective at reducing levels of the stress hormone cortisol. You could try yoga, Tai Chi, or mindfulness meditation.
Related: How to Make Your Semester More Mindful
One study by University of Oregon researchers found that meditation not only reduces stress in college students but also boosts academic performance as measured by test results. Another study by Coventry University showed that mind-body interventions such as meditation, yoga, and Tai Chi can actually reverse the molecular reactions in our DNA that cause mental and physical illness.
Related: Why It's Important to Take Care of Your Mental Health in College Find more mental health and stress management articles and advice right here on CollegeXpress.
Don't forget self-compassion

One last tip to remember when you're feeling burned out is to simply be kinder to yourself. Researchers at the University of British Columbia found that self-compassion could be the key to making it through your first year of college in a healthy and happy state. Researchers stated, "The psychological stress students may experience during the transition between high school and university can be mitigated with self-compassion because it enhances the psychological needs of autonomy, competence, and relatedness." These qualities in turn enhance a student's well-being.

Stress can sometimes spur you on to do your best work, but if it becomes chronic, it can trigger conditions like anxiety and depression, which could hamper what should be a special time in life-your first year in college. Seek help if you feel overwhelmed and try out a few mind-body techniques as well. Finally, remember to be as kind to yourself as you would to others; this is the essence of healing, energizing self-compassion.

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How to Manage Your Stress for Better Health as a Student

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Many high school students look forward to the freedom, independence, and fun promised by college, but the reality of this major life change can hit much harder than you may expect. The American Institute of Stress reports that around eight in every 10 college students experience stress frequently-especially during freshman year.

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"Many people benefit from practices such as deep breathing, tai chi, yoga, meditation or being in nature. Set aside time for yourself." -Mayo Clinic Staff

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