Thursday, December 1, 2011

Coping Toolbox

When people seek mental health treatment, it's often because the strategies they've been using to cope with life's challenges - strategies that may have developed over many years - either no longer work, or have begun to cause even bigger problems that the ones they're supposed to solve (think substance abuse, eating disorders, self injury, etc).

A major task early in treatment is developing alternative strategies to manage distress - strategies that are more effective for the client's current difficulties, and/or don't involve risk or cause further problems. There is some trial and error involved in identifying these alternative coping strategies, because each person is unique, and what works for one may not work for another. As my clients begin to experiment with things they're learning in treatment, I often encourage them to start a "coping toolbox" - an actual collection of items and written cues that can be brought out during period of distress.

I've been putting a toolbox together to bring in for "show and tell" in a skills group. Here's what I'm including, by category:

1) Self-Soothing
Self-soothing uses the 5 senses to calm oneself. In my toolbox I have: a sample vial of perfume (scent), a few hard candies (taste), a small stuffed toy and a rock, both with sentimental value, and a stress ball (texture), a relaxation recording and meditation balls that ring (sound), and a pretty object (sight).

2) Mindfulness
I have a miniature finger labyrinth that I use for mindfulness. I also have recordings of progressive muscle relaxation and visualization that I include here.

3) Emotional Awareness
I have a magnet that has various emotions represented as faces, to aid in the identification of the specific emotion. I also have crayons and pen/paper for writing or drawing about the feelings at hand.

4) Opposite-to-Emotion Action
DBT teaches that it's sometimes helpful to counteract distressing emotions that are not helpful in the moment with actions that are associated with opposite emotions. So, I have in my tool box a deck of cards with jokes and riddles on them, and a book of affirmations.

5) Distraction
When all else fails, it can be useful/necessary to take a break from the distress by distracting. I have a card game that can be played by one player, and my ipod that has puzzle games on it.

What would you put in your coping toolbox?

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