Monday, February 10, 2014

Giving Superpowers to a Common Therapeutic Technique

Coping skills are an all too common suggestion for clients regardless of age or presenting problem.  This treatment technique is so widely used that clients and providers can lose sight of the power of creating good coping skills.  The tool then becomes ineffective, and it is no wonder that kids, in particular, will turn to their therapists or counselors and say “ok fine, just say deep breathing, count back from ten, and punch a pillow.”  Don’t get me wrong these are good coping skills, but it is clear that children sometimes go on autopilot to just make a list.  The pitfall is providers sometimes attempt to convince the child that these are valuable coping skills, and explain how to use them effectively.  This is good work.  However, my suggestion is to take a step back.  Being transparent here can be very powerful - “something tells me you’ve made this list before."  By showing the child, or adult, that you appreciate that this is a common strategy that does not always work, can be very helpful.  Then maybe have some examples in your back pocket - “I knew a kid your age who thought deep breathing and counting back from ten were silly, so you know what he used for a coping skill?  We created a story together about what his life would be like if he had super powers.  And so every time he got angry in school he would picture himself in that story.”  With an adult, use humor and let them know that you understand that deep breathing before an extremely stressful annual review will not cut it.  So, guide them to think about how they can take care of themselves - watching a favorite comedy the night before, taking a bath the night before, or planning dinner with their best friend the night after the meeting.  The key is to be transparent, tailor the coping skills, and don’t make a client have three if they just cannot think of more than one.  One is a good start, and then ask them to think of more for next time you meet.  You could ask them to mark on a calendar the toughest times of the day over a one week period, and use that information to help them brainstorm.  The next step to this technique's success is roleplaying it (even with adults)!  So, be creative and use humor.  We all cope everyday in a million different ways.  Think about five coping strategies you use and observe how individualized they are.  Help guide your clients to create the same personalized skills.

1 comment:

  1. Megan, how lovely to find your blog here this evening. I think you are talking about the all too often trance that therapists can fall into after doing this work for an extended period of time. It's easy to quit learning, quit thinking, and just reach into our dilapidated old tool bag to pull out familiar old tools with little regard for the individual client in front of us. I appreciate your nudge to stay awake and your superpowers intervention. Will so be stealing that one!