Coping Skills and Adaptive Problem Solving

Fortunately, most people will find new ways to handle or cope with a crisis. Coping styles are the unique ways that patients deal with stress. For example, some cope with a stressful crisis by analyzing it, asking others for help, or gathering additional information. Some coping styles work better in certain situations than others. Box 45-2 lists some typical adaptive coping styles that can be suggested to patients, as well as pathologic coping styles that should be avoided whenever possible. Crisis resolution can be promoted by evaluating a patient's coping style and, when necessary, suggesting an alternative or more adaptive coping style. These new skills facilitate a patient's adaptation to the stressful life circumstances. In general, those who can flexibly use many coping styles are the most successful at crisis resolution and problem solving. Often, patients in crisis rely too heavily on one coping style, which may not be the most adaptive for a particular situation. Those patients who lack the capacity to develop new, more adaptive coping styles may become dysfunctional when confronted with a crisis.

To illustrate coping styles and new coping skills, review Case Study 3. Denise copes with threats of violence, isolation, and being controlled by her husband by keeping quiet and submitting to her husband's demands. This is patterned after the relationship with her father. After her physician discussed her somatic and avoidant coping style, he suggested that she could use his help and talk openly and directly about her safety concerns and needs. Denise's use of a new help-seeking and informational style enabled her to develop a safety plan, prepare to leave her home, and utilize church members to help get her child to a local shelter for battered women. She also was able to tell her parents about her fears and ask for their support and help.

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