Developing  Explana.ons  the  ‘vulnerability  -­‐  stress’  model  (a<er:  Zubin  &  Spring  1977)  

Zubin  &  Spring  (1977:  110)  suggest  that:  ‘…as   long   as   the   stress   induced   by   challenging   events   stays  below  the  threshold  of  vulnerability,   the   individual…  remains  well  within   the   limits   of   normality.  When   the   stress   exceeds  the   threshold,   the   person   is   likely   to   develop   a  psychopathological   episode   of   some   sort…   when   the   stress  abates   and   sinks   below   the   vulnerability   threshold,   the  episode  ends.’  

John  Butler  2014  

1.   iden.fy  examples  of  stressors  &  vulnerabili.es  

2.   iden.fy  some  posi.ve  coping  methods  /  protec.ve  factors  

3.   relate   this   to   the   stress   vulnerability   model   and   provide   an  explana.on  to  the  service-­‐user  and  family  members  

4.   op.on:  use  an  analogy  to  aid  explana0on  5.   create  a  sketch  with  the  service-­‐user  &  family,  which  you  can  

then  give  to  them  –  this  becomes  a  ra0onale  for  ac0on  

using  the  stress  vulnerability  model  

John  Butler  2014  

voices  

anxiety  

not  geVng  enough  sleep  

debts  

exam  pressures  

lack  of  support  

using  an  analogy:  the  stress  bucket  (based  upon:  Brabban  &  Turkington  2002)  

signs  &  symptoms  =  overflowing  

water  

vulnerability  factors  =  

the  size  &  strength  of  the  bucket  

stress  factors  

 (stress  =  the  level  of  

water  in  the  bucket)  

coping  strategies  =  hole(s)  in  the  

bucket  to  let  out  water  (lower  stress)  

John  Butler  2014  

voices  worsen   shou.ng  

out  

sleep  problems  

anxiety  

arguments  with  brother  &  sister  

mother’s  death  

being  bullied  /  in.midated  

more  vulnerable  =  a  shallower  bucket  

signs  &  symptoms  

vulnerability  factors  =  family  history;  sensi.ve;  solitary  

stress  factors  

a  more  vulnerable  person  =  a  smaller  /  shallower  bucket  

John  Butler  2014  

draw  your  own  stress  bucket  

signs  &  symptoms  =  overflowing  

water  

write  in  your  stress  factors  

 (stress  =  the  level  of  

water  in  the  bucket)  

Id  coping  strategies  =  hole(s)  in  the  bucket  

John  Butler  2014  

value  of  using  the  SV  model  the  ‘vulnerability  -­‐  stress’  model  (a<er:  Zubin  &  Spring  1977)  

the   model   generally   makes   sense   to   service-­‐users   and   carers  and   can   lead   to   a   common   understanding   leading   to   clearer  plans   and   interven.on   –   a   plausible   model   that   assists  engagement  

the  model  integrates  biological,  psychological  and  social  factors  

psychosis  is  viewed  as  episodic  and  related  to  stress  

represents  a  way   in  which  mental  health   status  at  a  par.cular  point  in  .me  may  be  regarded  as  a  con.nuum  applicable  to  all  people  (Hayes  2012)  

it  acknowledges  a  person’s  threshold  for  coping  

John  Butler  2014  

value  of  using  the  SV  model  the  ‘vulnerability  -­‐  stress’  model  (a<er:  Zubin  &  Spring  1977)  

offers  a   framework  to  build  on  strengths  and   increase  capacity  in  managing  stress  

encourages  early  detec.on  &  management  

focus   upon   enhancing   coping,   minimising   less   useful   ways   of  coping,  and  developing  protec.ve  buffers  against  stress  

encourages  hope  and  op.mism    

promotes  a  reduc.on  in  the  poten.al  of  relapse  

John  Butler  2014  

Key  References  Birchwood.   M.,   Hallec,   S.   &   Jackson,   C.   (1988)   Schizophrenia:   an   integrated  

approach  to  research  and  treatment.  Harlow,  Essex:  Longman  Group  UK  Ltd.  Brabban,   A.   &   Turkington,   D.   (2002)   The   Search   for   Meaning:   detec.ng  

congruence   between   life   events,   underlying   schema   and   psycho.c  symptoms.   In   A.P.   Morrison   (Ed)   A   Casebook   of   Cogni0ve   Therapy   for  Psychosis  (Chap  5,  p59-­‐75).  New  York:  Brunner-­‐Routledge      

Nuechterlein,  K.  &  Dawson,  M.  (1984)  A  Heuris.c  Vulnerability  /  Stress  Model  of  Schizophrenic  Episodes.  Schizophrenia  Bulle0n  10:  300-­‐312    

Zubin,  J.  &  Spring,  B.  (1977)  Vulnerability:  A  new  view  of  schizophrenia.    Journal  of  Abnormal  Psychology  86:  103-­‐126  

 

John  Butler  2014