PSYC DCBT Chapter 13 Chapter 13: CBT: Coping Skills

PSYC DCBT Chapter 13 Coping Skills Treating problems that are maintained by a deficit of adaptive cognitionsTreating 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 approachesLike skills training generally, it uses a package of different behaviour modification approaches

PSYC DCBT Chapter 13 A. Self-Instructional Training Teaching people to teach themselves to cope effectively with difficult situationsTeaching people to teach themselves to cope effectively with difficult situations Internalized (covert) prompts (self-talk) that guide subsequent cognitions and behaviourInternalized (covert) prompts (self-talk) that guide subsequent cognitions and behaviour — Often being a overt instructions Particularly effective against impulsive, reactive, behavioursParticularly effective against impulsive, reactive, behaviours Focuses attention, guides behaviour, provides encouragement, evaluates performance, and reduces anxietyFocuses attention, guides behaviour, provides encouragement, evaluates performance, and reduces anxiety

PSYC DCBT Chapter 13 Self-Instructional Training for Children 1.Cognitive modeling (aloud verbalization) 2.Cognitive participant modeling 3.Overt self instructions 4.Fading of overt self instruction 5.Covert self instruction Always move from overt to convert (internalized) instructionAlways move from overt to convert (internalized) instruction

PSYC DCBT Chapter 13 B. Problem-Solving Training Problem solving is an active alternative to reactive fight or flight responses when dealing with stressProblem 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 strategyRather 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 orientationThe most important component is the first step of learning to adopt a problem- solving orientation

PSYC DCBT Chapter 13 Problem-Solving Training Basic Procedures (D’Zurilla, 1971) 1.Adopting a problem solving orientation 2.Defining the problem 3.Setting goals 4.Generating alternative solutions 5.Choosing the best solution 6.Implementing the solution 7.Evaluating the effectiveness of the solution

PSYC DCBT Chapter 13 C. Stress Inoculation Training Control of how we view and cope with situations over which we have little controlControl 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“Inoculation” implies that coping strategies that are developed for minor stressors will develop into strategies that can be used for very high stress events

PSYC DCBT Chapter 13 Stress Inoculation Training Three stages: 1.Conceptualization (education) Negative emotions as interpretations Negative emotions as interpretations New responses can be learned New responses can be learned 2.Coping skills acquisition Learning differential response Learning differential response Self reinforcement Self reinforcement 3.Application Visualization and role playing of stressful events Visualization and role playing of stressful events

PSYC DCBT Chapter 13 D. Cognitive Behavioural Couple Therapy Three pronged treatment package: 1.Training in communication and problem solving skills 2.Increased positive behaviour exchange Caring-days technique Caring-days technique CYPDSN technique CYPDSN technique 3.Training in cognitive restructuring Discrepancies in perceptions, attributions, expectations of partner’s behaviour Discrepancies in perceptions, attributions, expectations of partner’s behaviour

PSYC DCBT Chapter 13 Integrative Couple Therapy Addresses instances where a partner is unwilling to change a particular pattern of behaviourAddresses 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”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 behaviourInstead of behaviour change, the other partner must learn to accept the partner’s upsetting behaviour

PSYC DCBT Chapter 13 Do all behaviour therapies have a cognitive component? CBTs dominate the behaviour modification landscapeCBTs dominate the behaviour modification landscape Even developmentally delayed clients are aware of effects of reinforcement, and can be motivated to changeEven 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 affectedSuccess in using reinforcement suggests that cognitions (understanding) are always affected