Transcript Chapter 13: CBT: Coping Skills

Chapter 13:
CBT: Coping Skills
PSYC4030 6.0D
CBT Chapter 13
Coping Skills
• Treating problems that are maintained
by a deficit of adaptive cognitions
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No so much a matter of transforming
maladaptive cognitions
• Like skills training generally, it uses a
package of different behaviour
modification approaches
PSYC4030 6.0D
CBT Chapter 13
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
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Often being a overt instructions
• Particularly effective against impulsive,
reactive, behaviours
• Focuses attention, guides behaviour,
provides encouragement, evaluates
performance, and reduces anxiety
PSYC4030 6.0D
CBT Chapter 13
Self-Instructional Training
for Children
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2.
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Cognitive modeling (aloud verbalization)
Cognitive participant modeling
Overt self instructions
Fading of overt self instruction
Covert self instruction
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Always move from overt to convert
(internalized) instruction
PSYC4030 6.0D
CBT Chapter 13
B. Problem-Solving Training
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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 problemsolving orientation
PSYC4030 6.0D
CBT 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
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CBT Chapter 13
C. Stress Inoculation Training
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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
PSYC4030 6.0D
CBT Chapter 13
Stress Inoculation Training
Three stages:
1. Conceptualization (education)
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Negative emotions as interpretations
New responses can be learned
2. Coping skills acquisition
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Learning differential response
Self reinforcement
3. Application
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Visualization and role playing of stressful events
PSYC4030 6.0D
CBT Chapter 13
D. Cognitive Behavioural
Couple Therapy
Three pronged treatment package:
1. Training in communication and problem
solving skills
2. Increased positive behaviour exchange
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Caring-days technique
CYPDSN technique
3. Training in cognitive restructuring
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Discrepancies in perceptions, attributions,
expectations of partner’s behaviour
PSYC4030 6.0D
CBT Chapter 13
Integrative Couple Therapy
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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”
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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
PSYC4030 6.0D
CBT Chapter 13
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
PSYC4030 6.0D
CBT Chapter 13