Behavioral Therapy Test 3: Cognitive-Behavioral Therapy: Coping Skills – Flashcards

-Used to treat the problems that are maintained by the deficit of adaptive cognitions -focus is not so much on what the patients are thinking as it is on what they are not thinking -goal is to change both patients cognitions and overt behaviors

-Self instructions: directed self talk the 6 functions are preparing to use self instructions, focusing attention, guiding behavior, providing encouragement, evaluating performance, evaluating performance, reducing anxiety. -self instructional training: teaching people to direct themselves to cope effectively with difficult situations.

-First used to treat children's impulsive behaviors -goal is to teach children to plan and think before acting: 5 steps. -Cognitive modeling: adult performs the task while verbalizing strategy -cognitive participant model: child performs the task as the model verbalizes the instructions overt self instructions: child performs the task while whispering the instructions covert self instructions: child performs task while saying the instructions to themselves

-patients being more actively involved in training, patients helping to generate the self instructions they use, good therapist patient relationship, involving natural change agents -increase transfer: making training materials (work sheets) similar to those used in the classroom, arranging training situations to normal classroom conditions. -increase generalization: using conceptual instructions that can be used in many different settings.

-use with a wide array of problems, usually used with children, can be used with adolescents who frequently acted aggressively (prepare to act, guide their behaviors, evaluate), can also be used with adults in intellectual disabilities.

-Problems are found everywhere it's a part of life, inadequate problem solving is associated with a host of psych problems -three steps: generate variety of potentially effective solutions to a problem -judiciously chooses the best of these solutions -implements and evaluates the chosen solution

-applications of problem solving to difficulties for which a patient has specifically sought treatment -used to treat a variety of disorders -because its broadly applicable coping skill, it often serves a dual purpose: treats the immediate problems, prepares patients to deal with future problems of their own; may prevent new symptoms from developing.

-general coping strategy for dealing with problems in daily life -for people at risk for dev psych problems or prevent relapse -prevention oriented; incorporated into regular classroom curriculum

1. Adopting problem solving orientation: recognize the problem exists. One's reaction to the problem might be the problem rather than the problem itself. 2. Defining the problem: problem seem vague, must define problem as specifically as possible 3. Setting goals: what must happen so that I no longer have the problem. Goals to focus on the problem situation and reaction to the problem situation or both. -Situation focus goals: aimed at changing the problem situation itself. -Reaction focused goals: aimed at changing one's emotional, cognitive and overt behavioral reactions to the problem situation 4. Generating alternative solutions:come up with as many alternative solutions as possible to maximize the chances of finding one that will be successful. Individual brainstorming: any possible solution is entertained, no matter how impractical or crazy it might appear. It steers patient in a new direction, counters the narrow rigid thinking. 5. Choosing the best solution : examining the potential consequences of each course of action. 6. Implementing the solution: mist have the skills to implement it properly 7. Evaluating the effectiveness of the chosen solution, if the problem exists repeat one or more of previous stages.

-might use modeling, prompting, self instructions, shaping and reinforcing -cognitive modeling: therapist might brainstorm aloud to illustrate this uninhibited, open-ended procedure

-useful with adolescents who resist unilateral adult decision and rule making -can incorporate family problem solving into parent training: increase cooperation and compliance

-solved current problems and teaches patients how to solve future problems. Beneficial for problems that involve conflict and require a decision -problem solving deficits linked to hopelessness and suicide risk -avoids the negative connotation for psychotherapy

-We cannot control the fact that stress is a part of the human experience, we will all experience stressors - we can control how we view and cope -stress: negative reaction to an event -therapy in which patients develop ways of coping with stress-evoking events first by learning coping skills and then by practicing them while being exposed to stressors.

1. Conceptualization: therapist explains that events themselves do not cause negative emotional reactions. Patients can learning coping skills that will allow them to reconceptualize and deal with potential stress-evoking events without becoming emotionally upset. 5 steps: Preparing for stress events, confronting and coping the stressor, dealing with temporary difficulties, assessing performance in coping with stressor, reinforcing. 2. Coping skills acquisition: patient learns and rehearses coping skills. 4 skills commonly used: progressive and differential relaxation, cog restructuring, problem solving self instructions, self reinforcement/self efficacy. Some do not know how to approach or solve problems. Most patients need motivation to continue performing skills once they are learned. 3. Application: patients apply new outlooks and coping behaviors, initially this is done by visualizing and role playing potentially stress evoking scenes. Then practicing the skill in session, next practicing skills while experiencing a stressor.

-Consists of specific procedures for handling the inevitable setbacks that occur in coping with real life stressors, involved identifying high risk situations in which relapse is most likely to occur. Learning and rehearsing coping skills that can be used in situations.

-Lapse: single isolated violation of abstinence -Relapse: Full blown return to the pretreatment behavior. -Patients are taught to view lapse as an error and as an opportunity for additional learning

1. Identifying high risk situations: negative emotional states, social pressure, interpersonal conflicts. 2. Learning coping skills: ability to use coping skills decrease probability of relapse, successful coping with high risk situations increase self efficacy. Skills: Assertive behaviors, problem solving skills, cognitive restructuring, social and communication skills. 3. Practicing coping skills. Practice in simulated high risk situations. Two aims: Learn to recognize high risk situations and automatically engage in well rehearsed coping skills. 4. Crease a lifestyle balance

-1. training in communication and problem solving skills. 2. Increasing positive behavior exchanges -can reduce couples distress, can also alleviate depression. only successful 2/3 couples. Only maintained improvement 1 and 2 years.

-Goals: emotional/cognitive acceptance of one's partner's upsetting behaviors. In case of domestic violence acceptance is not goal. -Acceptance does not mean resigning to a troubled relationship. Accepting partner's limitations can be a vehicle for promoting closeness. No pressure to change

-Empathic joining: partners' learning to understand and appreciate each other's experience of emotional pain within the relationship. requires careful listening, not judging. -Detachment: fosters acceptance by having partners distance themselves from their conflicts. Talk and think about difficulties as "it". -Tolerance building: learning ways to become less upset by partner's behaviors. Uses cognitive restructuring, picky becomes careful, scatterbrained becomes free wheeling. -Self care: each partner developing way to derive satisfaction and personal fulfillment independent of the relationship; asked to engage in self care activity.

-difficult to treat, they are complex, multifaceted, and over time the maladaptive interactions are mutually reinforced. -Prevention and relationship enhancement: Teaches skills to couple not in distress. -marriage check up: periodic assessment of relationship health, early interventions if difficulties are identified