Chapter 13: CBT: Coping Skills

1. Chapter 13:CBT: Coping Skills CBT Chapter 13

2. 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 CBT Chapter 13

3. 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 CBT Chapter 13

4. 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 CBT Chapter 13

5. 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 CBT Chapter 13

6. Problem-Solving Training Basic Procedures (D’Zurilla, 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 CBT Chapter 13

7. 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 CBT Chapter 13

8. 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 CBT Chapter 13

9. 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 partner’s behaviour CBT Chapter 13

10. 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 partner’s upsetting behaviour CBT Chapter 13

11. 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 CBT Chapter 13