Chapter 13: CBT: Coping Skills

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Chapter 13CBT Coping Skills
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Coping Skills

• Treating problems that are maintained by a
  deficit of adaptive cognitions
• No so much a matter of transforming maladaptive
  cognitions
• Like skills training generally, it uses a package
  of different behaviour modification approaches

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A. Self-Instructional Training

• Teaching people to teach themselves to cope
  effectively with difficult situations
• Internalized (covert) prompts (self-talk) that
  guide subsequent cognitions and behaviour
• Often being a overt instructions
• Particularly effective against impulsive,
  reactive, behaviours
• Focuses attention, guides behaviour, provides
  encouragement, evaluates performance, and reduces
  anxiety

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Self-Instructional Trainingfor Children

• Cognitive modeling (aloud verbalization)
• Cognitive participant modeling
• Overt self instructions
• Fading of overt self instruction
• Covert self instruction
• Always move from overt to convert (internalized)
  instruction

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B. Problem-Solving Training

• Problem solving is an active alternative to
  reactive fight or flight responses when dealing
  with stress
• Rather than treating a specific behavioural
  difficulty, problem solving skills can be taught
  as a general coping strategy
• The most important component is the first step of
  learning to adopt a problem-solving orientation

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Problem-Solving Training

• Basic Procedures (DZurilla, 1971)
• Adopting a problem solving orientation
• Defining the problem
• Setting goals
• Generating alternative solutions
• Choosing the best solution
• Implementing the solution
• Evaluating the effectiveness of the solution

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C. Stress Inoculation Training

• Control of how we view and cope with situations
  over which we have little control
• Inoculation implies that coping strategies that
  are developed for minor stressors will develop
  into strategies that can be used for very high
  stress events

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Stress Inoculation Training

• Three stages
• Conceptualization (education)
• Negative emotions as interpretations
• New responses can be learned
• Coping skills acquisition
• Learning differential response
• Self reinforcement
• Application
• Visualization and role playing of stressful events

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D. Cognitive Behavioural Couple Therapy

• Three pronged treatment package
• Training in communication and problem solving
  skills
• Increased positive behaviour exchange
• Caring-days technique
• CYPDSN technique
• Training in cognitive restructuring
• Discrepancies in perceptions, attributions,
  expectations of partners behaviour

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Integrative Couple Therapy

• Addresses instances where a partner is unwilling
  to change a particular pattern of behaviour
• More generally addresses need for individual
  independence and resists the desire for perfect
  partner
• Empathetic joining (understanding)
• Detachment from conflicts
• Tolerance building (conitive restructuring)
• Self-care independent of relationship
• Instead of behaviour change, the other partner
  must learn to accept the partners upsetting
  behaviour

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Do all behaviour therapies have a cognitive
component?

• CBTs dominate the behaviour modification
  landscape
• Even developmentally delayed clients are aware of
  effects of reinforcement, and can be motivated to
  change
• Success in using reinforcement suggests that
  cognitions (understanding) are always affected