Coping With Symptoms


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Coping With Symptoms

  1. 1. Coping with Symptoms Buddy Garfinkle, MSW
  2. 2. <ul><li>Definition of coping </li></ul><ul><li>“ To contend or strive especially </li></ul><ul><li>on even terms or with success” </li></ul><ul><li>Changing coping strategies may reduce stress </li></ul>Why coping?
  3. 3. The Stress Vulnerability Model of Schizophrenia
  4. 4. Common Symptoms Associated With Mental Illness
  5. 5. <ul><li>Negative symptoms </li></ul><ul><li>Absence of expression, drive, emotion, thought </li></ul><ul><li>  </li></ul><ul><li>Social Withdrawal </li></ul>Negative Symptoms-Lack of Interest or Pleasure
  6. 6. Psychotic Symptoms
  7. 7. <ul><li>Shift topics, usually unrelated and without logical sense </li></ul><ul><li>  </li></ul><ul><li>Difficulty in perceiving what is real </li></ul>Loose Associations
  8. 8. <ul><li>Medications </li></ul><ul><li>Social skills training </li></ul><ul><li>Cognitive Behavioral therapy </li></ul><ul><ul><li>Originally developed for residual symptoms, developed mainly for anxiety and depression </li></ul></ul><ul><ul><li>Up to 60% of individuals taking prescribed medication still have persistent symptoms </li></ul></ul>Treatment
  9. 10. <ul><li>Understanding persons experience irrespective of its connection to reality </li></ul><ul><li>Interest in the person’s experience </li></ul>Developing a Therapeutic Alliance
  10. 11. <ul><li>What appears to be a void, in fact, has a cognitive component of contemplation and observation </li></ul>Reduction of Negative Symptoms
  11. 12. <ul><li>May be biological in nature, or </li></ul><ul><li>May be reaction to past trauma </li></ul><ul><li>May be a learned behavior, emotional blunting </li></ul>Affective Flattening
  12. 13. Avolition
  13. 14. <ul><li>Positive symptoms may be connected to aberrant thought process </li></ul><ul><li>Personalizing bias </li></ul><ul><li>Jumping to conclusions </li></ul><ul><li>Cognitive rigidity </li></ul>Reduction of Positive Symptoms
  14. 15. Behavioral Basis of Treatment
  15. 16. <ul><li>Behavioral Response </li></ul><ul><li>Go for a walk, listen to relaxing music </li></ul><ul><li>Socialization </li></ul><ul><li>Medication </li></ul>Hallucinations-Auditory
  16. 17. <ul><li>Distraction </li></ul><ul><li>Focusing: allow the voice to exist and relax with it </li></ul><ul><li>Rational Responding </li></ul><ul><li>Anxiety or anger reducing techniques </li></ul><ul><li>Induce the voice for time limited period </li></ul><ul><li>Normalizing techniques, “this is my illness </li></ul><ul><li>Confronting the omnipotence of the voices-they are only voices and you don’t have to act upon them. </li></ul><ul><li>Assertiveness with the voices-develop a dialogue with them </li></ul>Cognitive Response
  17. 18. <ul><li>Focus on the effects of stress, or sleep deprivation, rather than the etiology of symptoms </li></ul><ul><li>Voice diary </li></ul><ul><ul><li>Ties voices and intensity to time of day triggers </li></ul></ul><ul><ul><li>Identifies patterns, triggering coping strategies Affective responses (anger, anxiety) may lead to unhelpful behaviors </li></ul></ul>Elicit the details of the experience
  18. 19. Patterns identified can lead to engaging the voices constructively
  19. 20. Generate coping strategies
  20. 21. Social skills training <ul><li>Relaxation techniques </li></ul><ul><li>Breathing </li></ul><ul><li>Progressive muscle relaxation </li></ul><ul><li>Guided imagery </li></ul>
  21. 22. <ul><li>Teach the connections between thoughts and feelings </li></ul><ul><li>Examine the evidence supporting the thoughts </li></ul><ul><li>Challenge and modify beliefs not supported by evidence </li></ul><ul><li>Explain automatic thoughts (biased thoughts) </li></ul><ul><li>Teach to challenge thoughts or develop coping strategies </li></ul>Cognitive Re-Structuring
  22. 23. Activity Scheduling-Frontline Intervention For Depression
  23. 24. <ul><li>With the mastery </li></ul><ul><li>of a skill, </li></ul><ul><li>developing a coping strategy for </li></ul><ul><li>symptom management the cognitive </li></ul><ul><li>mind-set will improve. </li></ul>Mastery and Pleasure Techniques
  24. 25. <ul><li>Observable </li></ul><ul><li>Self-report </li></ul><ul><li>Reduction of stress </li></ul><ul><li>Attainment of recovery goals </li></ul>How do we know when a person has mastered a coping strategy?