The ‘Coping with Stress workshop parts one and two’ are based on and adapted from day 3 of the Save the Children Psychological First Aid Training Manual for Child Practitioners.

Facilitator notes:

This is part one of the ‘Coping with stress’ workshop. It is very important that all participants who attend part one also have the opportunity to attend part two of this workshop. It is preferable to do both workshops close to one another.

It is helpful to prepare most of the flip charts needed for this workshop in advance, so you can concentrate on discussions. The flipchart notes that can be prepared in advance are written in blue.


1. Welcome the participants to this workshop on coping with stress.

2. Divide the participants into five groups. Ask that the participants stay in these groups for the whole workshop.

3. Now explain:
“Living in challenging situations, for example, where there is conflict or a disaster has taken place can be very difficult. It is hard to watch people suffer and grieve when they have lost loved ones or are afraid of what will happen to them in the future.

You are likely to feel emotions yourself and to meet others who also have many different emotions, including sadness, confusion, anger, guilt and fear. You may be personally challenged by fearing for your safety and that of your loved ones; by not finding work or working too long hours; by suffering from lack of sleep or limited access to healthy food. You may be separated from your family, or have many other challenges.

Feeling stress from living in a crisis situation is a very normal occurrence. If the stress grows or continues for a long time and is left unattended, it may begin to affect your well-being in a negative way. This will affect your ability to cope with the continuing challenges you face.”

4. Read out the overall objectives of the workshop on the flipchart and explain what they are:

       Objectives of workshop:
             • To empower participants in recognizing signs and symptoms of stress.
             • To explore ways of reducing stress and providing peer support.

5. Explain that there are two parts to the ‘Coping with stress workshop’: Part one focuses on recognizing the signs and symptoms of stress, and part two explores ways of reducing stress and providing peer support.

6. Continue by saying:

“First we are going to talk about what stress is and what different types of stress there are, and then how to identify early signs of stress.”

7. Allow time for reflection and questions.

What is stress?

1. Give all the participants a small piece of paper. Ask them to take a few minutes to think about and write down their definition of stress.

2. When they have finished, ask a few of the participants to share their definitions. You do not need to hear all the answers. You will provide more information during the discussion.

3. Read out the following explanations of stress on the flipchart:

There are two kinds of stress:

        Good stress enables you to ‘fight or flight:’
            • stress is required for motivation and safety.

        Bad stress outweighs resources to cope and makes you:
            • feel overwhelmed
            • unable to live up to own and others’ expectations
            • feel out of balance.

4. Explain:

“It is difficult to define precisely what stress is, because it can differ from person to person. It is sometimes explained as a reaction of the mind and the body to a threat, challenge or a change in one’s life. An example of a threat is a car that suddenly speeds towards you. A challenge could be learning new skills at work. A change could be starting a new job or becoming a parent.

It is important to understand that stress in small doses is good for us as it motivates us to focus, be active, and to react quickly to protect others or ourselves. The so-called ‘fight or flight’ response enables us to run to avoid being hit by the car, to be extra focused and concentrated when learning new skills, and to create the energy it takes to deal with the new job or child.”

5. Ask the participants:

“Please spend ten minutes talking to the person on your left. Talk about stress factors in your life, and then identify the three most common.”

6. After 10 minutes, invite everybody to return to plenary to share the common stressors in their lives.

7. Now draw a picture of a balance on the flipchart as shown below:


8. Explain:

“Sometimes there are too many stressors at the same time, or the same type of stress persists for a long time and we are unable to cope. We feel overwhelmed and unable to live up to our own or other’s expectations. The demands of life exceed our resources and abilities to cope, and we feel out of balance. Today we will focus on the negative stress that makes us feel out of balance”

9. On the next flipchart draw the following illustration under the title: How does stress affect us?


10. Continue by saying:
“Stress may affect us physically, emotionally, socially and spiritually, and has an impact on our behaviour and well-being. Generally, stress affects our ability to function.”

Signs and symptoms of stress

1. Provide the groups with flipcharts and markers and ask them to discuss what the signs and symptoms of stress are in the different domains. Give one domain to each group as follows:

     Group 1: Physical
     Group 2: Emotional
     Group 3: Social
     Group 4: Spiritual
     Group 5: Behavioural

2. Ask the groups to list the signs and symptoms on their flipchart to present in plenary.

3. Allow around 15 minutes for this task. If the groups need inspiration, you can share a few of the examples of typical stress symptoms as listed in the following table.

The Antares Foundation developed these lists.


4. Ask the groups to share their findings in plenary.

5. After each presentation, ask those that are listening if they want to add something to the lists.

6. Explain: “Stress also affects communication and behaviour in groups. Do you know how?”

7. Allow for reflection and examples.

If they are unsure of what you mean, provide some examples:

“Negative impacts of stress are, for example, the formation of cliques, gossiping, complaining, negative attitudes towards change, or negative behaviour between group members towards one another.

Positive impacts of stress may be a feeling of solidarity, an open atmosphere with honest communication and no gossiping behind people’s backs, mutual respect among friends, and use of interpersonal skills to solve conflicts and misunderstandings.”

8. Explain: “Now we have explored signs and symptoms of stress. Next we will talk about different kinds of stress and the sources of stress in your own lives.”

Balloon exercise

This is a physically energizing activity that is fun and difficult at the same time.

Aim of activity: To promote teambuilding involving group collaboration and individual persistence.


1. Ask the participants to remain with their groups and stand up.

2. Give each group one balloon and ask them to blow it up.

3. Explain: “Your task is to keep the balloon up in the air. It must not touch the ground.”

4. Ask the groups to start. After about a minute, give them another balloon, and tell them they have to keep this one up in the air too.

5. Continue adding a balloon every minute until each group has three or four balloons to keep afloat at the same time.

6. End the activity and ask the participants to sit in a semi-circle.

7. Ask: “How did this activity reflect stressors in your life?”

8. If nobody refers to these aspects, you can highlight two points:

“While it was probably fun in the beginning, when you had only one balloon to keep afloat, the task became gradually more difficult and challenging when you added more balloons.

Having too many balloons at the same time may have overwhelmed you and become difficult to handle. You need to balance the number of balloons, just like you need to balance your life.

Ultimately, you could only keep the balloons afloat if you were helping each other. This is very similar to real life: Sometimes we need each other’s help to cope with the challenges of life.”

Types of stress

Aim of activity: To discuss the different types of stress and how they affect us.


1. Explain the following types of stress on the flipchart:

     Types of stress
      1. Basic stress
      2. Cumulative stress
      3. Burnout
      4. Traumatic stress

“There are four main types of stress: basic stress, cumulative stress, burnout and traumatic stress. Most people experience basic stress from time to time, or even on a daily basis. This is the kind of stress, as mentioned earlier, that can be motivating and good for us. However if there is too much of it, it can disrupt our balance, functioning and well-being.

We can try to overcome basic stress by physical and psychological adjustments. If we succeed, the stress symptoms will go away, but if we don’t, the stress symptoms will remain or grow. This is the kind of stress that can disrupt your life in a harmful way.”

Cumulative stress is the most common type of stress and occurs when there is an accumulation of basic stress. We find we are no longer able to overcome the stress by physical and psychological adjustments. Examples of cumulative stress are on-going exposure to people in distress during a crisis situation, or an unhealthy working environment which doesn’t improve.

Signs of cumulative stress typically build up slowly with early warning signs of boredom, fatigue, anxiety and feelings of sadness. This is often followed by problems in concentrating and remembering things, and minor health problems. If it gets worse, it can lead to problems with relationships, increased alcohol and drug use, and changes in a person’s usual level of performance. Severe signs of cumulative stress are continued problems with relationships, negative health changes and personality changes.”

2. Ask the participants if they know what the term ‘burnout’ means? Use the following explanation to add to their contributions:

“Burnout is a severe state of emotional and physical exhaustion caused by excessive and prolonged stress that makes you feel overwhelmed and unable to meet demands. It is typically work-related, but can also be related to family or other societal expectations. It may start as disinterest or lack of motivation, but can eventually affect your productivity, sapping your energy and making you feel hopeless, powerless, negative and resentful.”

3. Ask the participants if they know what signs and symptoms of burnout are?

Examples are:

   •   long-lasting physical and emotional exhaustion
   •   irritability
   •   lack of energy
   •   feeling detached from everyone, withdrawal, isolation
   •   reduced or lack of enthusiasm and motivation to work
   •   decrease in a sense of personal accomplishments
   •   hopelessness
   •   decrease in work efficiency
   •   sadness
   •   pessimism and cynicism.

4. Continue by explaining:

“Burnout can eventually threaten your ability to maintain your job, your relationships and your health. Burnout is sometimes confused with depression, as the symptoms are similar to those of depression. However burnout is different as it is related to an environment that is overwhelming. If the situation remains unchanged and burnout continues, there is a risk that the affected person will develop a more general depression.

Burnout can also be confused with symptoms of grief. Although the symptoms may be similar, the causes of burnout, depression and grief are different and therefore need to be dealt with differently.”

5. Now ask the participants if they know what the traumatic stress is? Use the following explanation to supplement their contributions:

“The fourth type of stress is traumatic stress, with two sub-types: critical incident stress and secondary traumatisation stress.

“Critical incident stress results from exposure to a critical incident, like a natural disaster, an accident or violence. Critical incidents tend to be sudden and disruptive, and often threatening. The incident is beyond normal experience and creates overwhelming demands that affect coping. It disrupts both a sense of being in control and fundamental perceptions of one’s environment as safe and predictable.

Critical incident stress can begin immediately after the critical incident or may be delayed. It may start days, months or even years later. It is important to remember that the reactions of critical incident stress are normal reactions to abnormal events.”

6. Ask the participants what are normal reactions and/or feelings to have in response to traumatic incidents?

Supplement with some of the examples below:

   •   anger at those who caused the incident or situation, at the injustice or because it happened to you and not to someone else.
   •   deprivation and suffering from material or moral losses.
   •   despair alternating with hope for better times.
   •   anxiety that the incident will happen again, or about losing control or losing loved ones.
   •   powerlessness and feeling of being overwhelmed by the situation or because you were unable to help or save yourself or others.
   •   helplessness as no-one could protect you or others or was able to change the situation.
   •   guilt because you are alive and others are not, or because you were not well prepared to assist and warn others.
   •   shame about inner feelings like helplessness and grief or about your reaction to the situation.
   •   grief that you or others are hurt or others died.

7. Explain that although these kinds of symptoms are normal, if they do not lessen over time or seem to be increasing, then the affected person may need professional help and support in order to recover.

8. Explain that when somebody works with or spends time with others who are traumatised by what crisis or emergency events, then there is a high chance the person will experience secondary traumatisation. This is when somebody is deeply affected by a traumatic event, even though they may not have experienced it themselves.

9. Continue by explaining:

“Secondary traumatisation is a state of exhaustion and dysfunction – biologically, psychologically and socially – as a result of prolonged exposure to traumatised persons.”

10. Ask the participants if they have any questions, and address these.

Monitoring signs and symptoms of stress

Facilitator note: The ‘Checklist: Signs of stress’ is a worksheet for the participants to take home.

1. Give each participant a copy of the ‘Checklist: Signs of stress,’ and explain that this is a worksheet they can take home and use to monitor their stress levels.

2. Explain that you would like them all to fill it in now, to get an idea of the stress levels in the entire group. Make sure that everyone knows the results will be anonymous.

3. Ask the participants to complete the worksheet and give everyone a small slip of paper and ask them to write the score they got on the checklist. Ask them not put their name on the paper.

4. Collect the papers and write on a flipchart how many people scored in the different categories: under 20; 20 – 35; 36 – 45.

5. Ask the participants to reflect on the results.

6. Explain:
“Those of you who have a high score may feel worried or confused. However, assessing your stress level is the first step in making changes to reduce it. You can keep this worksheet and complete it at regular intervals to see if you are successful at reducing the impact stress is having on your life.”

7. Thank the participants for their contributions, and explain that the next workshop, ‘Coping with stress part two,’ will focus on identifying sources of stress and finding ways to cope with or reduce stressors.

‘Coping with Stress workshop parts one and two’ are based on and adapted from day 3 of the Save the Children Psychological First Aid Training Manual for Child Practitioners.

Checklist: Signs of stress 



(score 1)

(score 2)

(score 3)


I feel tense or nervous.





I have a lot of physical complaints (e.g., headaches, racing heart, chest or stomach pains, chronic colds).





I feel chronically tired or fatigued, even when I have had enough sleep.





I feel jumpy or “on edge.”

(e.g., the smallest noise makes me jump).





I’m sad and feel like I could cry.





I have lost my sense of humour.





I have trouble making decisions. I go over the issues in my mind, again and again, and they don’t get any clearer.





I feel overwhelmed or fearful. I long for a place I feel safe.





I act impulsively or take risks I shouldn’t take.





I have trouble concentrating or focusing on my work.





I have trouble planning and thinking clearly.





I am less efficient or more disorganized at work than usual.





I misplace or lose things I need for work or forget appointments or forget to do tasks.





I have sleep problems (trouble falling asleep or staying asleep, or sleeping too much, or nightmares)





I am irritable; minor inconveniences or demands annoy me a lot. (e.g., I over-react to the failings of others, or I find myself arguing with friends or family members more than I used to).




Add up your score and see the indications below.
   •   Under 20: Your state of stress is normal.
   •   From 20 – 35: Stress is beginning to impact you negatively.
   •   From 36 – 45: You seem to be severely impacted by stress. Ask for help from someone close to you or contact your doctor.