The principle underlying beck’s model can be adapted to form the basis of a stress manager’s approach in certain cases. Beck’s process involves emphasis on reality based interpretations of information and actively seeks to minimise the many ifs, buts, ands and maybes that may haunt the stressed individual. The approach developed by Beck aims to facilitate the client in focusing on reality based data to interpret environmental transactions. 

This is a technical way of saying that it is important to make sure that the client is interpreting what is going on around them accurately. People under stress tend to be focused on a negative issue, they may not be thinking properly. They can also ‘read into’ situations things which in reality are not there, it is their own interpretations which are faulty.

Common situations could include a stressed person’s partner asking a simple question and having it interpreted and responded to as a criticism. This is a regular occurrence, stressed individuals can become very defensive and see criticisms and sources of non-existent contention everywhere. They need to be made aware of this so that they can start the process of regaining control. 

The aim is to move the client away from negative cognitive (thought) processes and towards positive cognition. It often surprises people just how much control/influence they can exercise over their thought patterns, the breakthrough comes when it is realised how much of our cognition is the result of conditioning and habit. 

A good way of looking at this might be to consider just how much we think, and how much this reinforces how we behave, without actually realising that a changeable process is at work. It was Beck who formulated a working model of cognitive restructuring (changing the way and how we think) most suited to the needs of the stress manager. Indeed the emphasis of his work was on dealing with anxiety and stress related disorders.

According to Beck and Emery (1985), they state that "Anxious patients in the simplest terms believe that something bad is going to happen that they won’t be able to deal with."

They advanced 3 basic strategic questions detailing how a process of cognitive restructuring could be achieved in this case.

1. What is the evidence supporting the conclusion currently held by the client?

2. What is another way of looking at the same situation but reaching another conclusion?

3. What will happen if, indeed, the current conclusion/opinion is correct?

In my opinion this is a very useful approach. The experience of many therapists in private practice has shown that the majority of people worry about things that will never happen, or arrive at worst case scenarios having failed to analyse all of the available information.

A breakdown of this approach is needed to ensure that a therapist does not take too simplistic an approach to their work. Factors such as different environmental situations and sub-environmental factors such as individual differences etc. ensure that clients will respond differently to the various strategic questions. Therapists should be prepared to be as flexible as possible. 

Questioning techniques, such as this, can greatly assist clients who would benefit from greater clarity and understanding of their thinking processes. Faulty logic may lie at the heart of many stress induced/supported cognitive patterns. This model or cognitive style can also be adapted to great advantage into the client’s everyday life.

Questions that can be asked to open up the conversation or enlarge on subjects could be modelled using the following as reference points:

What is the evidence supporting the conclusion currently held by the client?

 

You’ve reached a conclusion, and the evidence to support this conclusion is?

 

What evidence is there against this conclusion?

 

Could you be reading into situation’s things that are not there?

 

Are habits being confused with fact?

 

Are generally held opinions being confused with fact?

 

Could your interpretations be on the negative side because of the stress you are under?

 

If you were under less stress would you see this exact same situation in the same way?

 

Are you seeing this situation in ‘all or nothing’ terms? In other words have you convinced yourself that there are only a very limited number of outcomes to the present situation?

 

Could your conclusions be extreme or exaggerated?

 

Are you emphasising certain parts of your experience and taking them out of context?

 

You are emphasising certain parts of your experience because?

 

Is the information you are depending on reliable?

 

You know that the information is reliable because?

 

Are you thinking ‘this IS going to happen, rather than, ‘this MAY happen’?

 

Are you confusing high probability events with low probability events?

 

Are your conclusions based on feelings rather than facts?

 

Have you made a value judgement rather than evaluate the facts?

 

Are you concentrating on small irrelevant details?

 

Are you failing to take into account the main picture?

 

Are you forming conclusions, or a series of different conclusions?

 

Is your thinking clear or do you find yourself thinking of a number of 

things simultaneously?

By employing such questioning techniques a client can be helped to identify and discover ways of coping with and correcting patterns of negative cognition and of faulty reasoning.

What is another way of looking at the same situation but reaching another conclusion?

The aim of this questioning approach is to help the client to open up their options and move them away from closed thinking processes. 

This also comes specifically under the banner of developing a client’s coping skills. Positive outcomes here would include the client developing alternative ways of looking at thing, learning to differentiate between fixed (things you have no control over) and floating (things that you can exercise some or total control over) aspects of their experience. Another goal here should be to help the client to find the positive side to their experience. 

This can be difficult sometimes but is generally beneficial and is worth developing. Questions such as, ‘And what good has come of this?’ or ‘what have you learned from this experience?’ are possible starting points.

What will happen if, indeed, the current conclusion/opinion is correct?

‘And if it happens, what then?’ The aim of this strategy is to get the client to have a good look at the whole or as large a part of the picture as is possible in order to bring the approaching ‘disaster’ into perspective. This strategy brings together coping skills and problems solving strategies. Note that this is not a license to tell a client what to do, you must continue to help them develop their own skills and processes. Beck and Emery suggested that the client and therapist work together to develop a variety of strategies that the client can use.

I would place great emphasis on the last part of the preceding sentence, ‘strategies that the client can use!’ This is the crux, and this is why it so important to develop any strategies in co-operation with the client. If you ever find that a client needs to be led and told what to do then you MUST refer them immediately to a clinician such as a clinical psychologist or to a GP for assessment and referral.

The ultimate aim of your therapy should be for the client to develop autonomous skills with respect to the 3 areas outlined above.

Staff Writer...

www.health-concern.com

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