Are you a diabetic child and you sometimes pass through difficulties. Sometimes scared and worried sometimes secretive about your illness??

1. accepting,
adapting,
coping
with Diabetes
Dr. Shewikar El Bakry
Ass. Prof. Of Psychiatry
Banha University

2. Introduction
 "I simply cannot cope with this!" How often
have you uttered just these words when you
felt completely overwhelmed by all that you
had to accomplish at work or at home? How
often have you heard one of your clients with
diabetes say, "I cannot manage diabetes in
addition to everything else I do! I simply
cannot cope!" Have you ever wondered
exactly what that patient meant and how
you might help your clients cope?

3. definitions of coping
 There are many who define coping as a behavior
that protects people from being psychologically
harmed by problematic social experiences.
 Coping serves a protective function that can be
exercised in three ways:
 1) by eliminating or modifying stressful conditions;
 2) by perceptually controlling the meaning of the
stressor; or
 3) by keeping emotional consequences in bounds.

4. definitions of coping
 "constantly changing cognitive and
behavioral efforts to manage
specific external and/or internal
demands that are appraised as
taxing or exceeding the resources
of the person.“
 In other words, coping allows
people to use various skills to
manage the difficulties they face in
life.

5. When and How
 When did you find out
 Reactions and stages
anger and denial to bargaining,
depression, and finally resolution or
acceptance.
 Adjustment to a diagnosis of diabetes
takes 6–9 months for children

6. Worry???
 What do you fear
Different from peers
Safety if alone
meals offered (are they safe and proper, time)
what happens if I forgot therapy
Injections
Play sports or not

7. Worry???
Adolescents believe it is
Hard situation
Long-term supervision by parents
Balancing the demands of diabetes & life

8. Adolescents
 Adolescence is marked by rapid biological,
physical, cognitive, emotional, and social
changes
 risk-taking behaviors
 shift from parental support to peer support
 strong fear of non-acceptance by the peer
group and exclusion from peer activities
 Identity development

9. Do we do that???
wishful thinking in response to stress
Avoidant
depressive symptoms
Denial
This is negative coping skills

10. Why Coping???
 greater use of approach (or
problem-focused) coping strategies
has been related to better
metabolic control and better
psychosocial adjustment in youths
with type 1 diabetes

11. Coping Skills Training
 When individuals cannot cope
effectively with a problem
situation, their confidence is
decreased for dealing with the
next problem, and they use less
successful coping patterns.

12. Social problem solving
 No black-or-white perspective
 six major problem-solving steps:
 1) identify the problem,
 2) determine goals,
 3) generate alternative solutions,
 4) examine consequences,
 5) choose the solution, and
 6) evaluate the outcome.

13. Communication Skills Training
 Express yourself clearly appropriately and constructively
 How to work with others to have good outcomes
 Assertiveness
 The steps used to teach social skills training are
 1) provide concrete instructions on how to handle a social
situation,
 2) allow participants to witness a role-play of an appropriate
model,
 3) have participants practice their own role-play, 4
 ) provide feedback on the participants' role-play,
 5) give participants real-life practice, and
 6) carry out group follow-up

14. Cognitive-behavioral modification
 Focuses on understanding one's own thoughts
and feelings and changing self-dialogue to
more positive messaging.
 recognition of thoughts and feelings, problem
solving, and guided self-dialogue
 thoughts are based on fact or assumption
 Body and behaviours in response to thought
and feeling
 list negative thoughts and formulate alternate
positive thoughts to counter them

15. Stress Management
 Identify stressors
 Reduce activities
 Relaxation techniques
Breathing
Guided Imagery
Altering mental images with happier
ones

16. Finally
 Know the symptoms
 Get help
 Attend a group