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Brief Interventions for Anxiety Disorders with Children and Adults

Section 11
Stress, Coping, and Anxiety

Question 11 | Test | Table of Contents

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So What if It Happens?
De-catastrophizing, Coping Plans, and Point/Counterpoint.

1. De-catastrophizing: When predicting dire consequences, the anxious client does not utilize all of the information available to them, and as you know, rarely takes into account the dire predictions that failed to materialize. You, of course, attempt to widen the range of information on which the client bases his or her forecast, and to broaden their time perspective.

2. Coping Plans: At times, the anxious child or adult fears he or she will be unable to cope. You then, of course, collaboratively develop a variety of strategies that the person can use to manage the anxiety. I stress on coping with the situation, not on mastering it.

Barbara's Socializing Plan
Barbara, anxious about socializing with groups of people, developed the following plan:
1. Using self-distraction
(focusing on others' body posture.)
2. F
ocusing on the "task" of conversing and behaving appropriately.
3. Using a coping technique with images (turning negative images into positive ones).
4. Using a brief form of relaxation (deep breathing).
5. Using the incident to gather evidence about her thinking. She rehearsed this plan in the therapist's office before trying it all in the real situation.

3. Point/Counterpoint. You can use all of the strategies mentioned previously in a general strategy of point/counterpoint. Here's an example...

Therapist: You seem to have a lot of reasons why you believe the feared event is going to happen, why it is so terrible, and why you wouldn't be able to handle it. Since you have those arguments down so well, let's work together to dispute them with other possibilities. I'll give you the fearful ideas, and you give me the counter ideas. When you run out of positive counterpoints, we'll switch roles and I'll give the counterpoints.

The client and I switch back and forth between these roles and help each other out in developing better counterpoints. The client often surprises himself or herself with the number of counterpoints they can generate.

♦ 4 Positive Counterpoints to Anxiety
Generally four counterpoints are covered in this strategy:
1. The probability of the feared event;
2. Its degree of awfulness;
3. The client's ability to prevent it from occurring; and
4. The client's ability to accept and deal with the worst possible outcome.
The therapist should present his counterpoint (anti-anxiety) with strength and confidence. (Beck)

Peer-Reviewed Journal Article References:
Mortensen, R. (2014). Anxiety, work, and coping. The Psychologist-Manager Journal, 17(3), 178–181. 

Szabo, A., Ward, C., & Jose, P. E. (2016). Uprooting stress, coping, and anxiety: A longitudinal study of international students. International Journal of Stress Management, 23(2), 190–208.

Weigold, I. K., & Robitschek, C. (2011). Agentic personality characteristics and coping: Their relation to trait anxiety in college students. American Journal of Orthopsychiatry, 81(2), 255–264.

What are interventions to assist your client in answering the question "So What If It Happens?" To select and enter your answer go to Test