By Anne Llewellyn, RN-BC, MS, BHSA, CCM, CRRN
Editor-in-Chief of Case in Point Magazine and the Case Management Resource Guide

Recently my husband asked me to talk to his friend’s wife who was having some serious problems. As we talked, she explained that she has been nervous, has not able to work or sleep, was very irritable and unable to cope with life’s little problems.

She has seen numerous doctors and on each visit been given medication to “address” her symptoms. On follow-up she would tell the doctor that the medication was not working, so she was given new medications in the hope that something would work to help her “feel better.” As a result she had an array of drugs for various problems and began to self-medicate in the hope that something would work.. I am sure by now you can see where this scenario is going.

One thing I realized as we spoke was that this woman did not have effective coping skills. As we all know, everyone faces problems and stressors as part of life. One of the things that can make the difference between getting through the tough times and tipping over into mental illness are effective coping skills.

Those who don’t have effective coping skills do as my friend did: shop around for an answer and many times turn against the very people who love them, and maybe even hurt themselves. Those who have effective coping skills somehow find the patience to work out problems and issues in a logical manner and generally have positive outcomes. As I researched ways to help my friend, I reviewed some of the key elements of effective coping skills. Here are some that are paramount.  

Talking it Out

Giving the person the opportunity and a venue to talk is important. Talking allows a person to verbalize feelings, helps them to feel validated and can serve as a springboard to problem solving. For those who don’t have insurance or don’t have access to a good psychologist, finding a support group is an alternative.

Support groups allow people to express their feelings in a non-threatening manner with others who have similar problems. For those who are not comfortable with airing issues out loud, journaling can provide another outlet for confusing feelings. Sharing specific sections can help bridge the gap to verbal sharing.

Problem Solving

Another coping skill is the ability to problem solve. Problem solving can be as simple as sitting down with someone you trust and brainstorming a list of possible solutions to a given situation. Asking someone what they’ve tried before in similar situations and what outcomes they experienced can be very telling. One way to learn how to problem solve is to make a list of problems and brainstorm about the options that might address the problem. Talking about the options and the consequences of each action, both positive and negative, is a way to allow someone to see what will happen as a result of the decisions they will make.

Giving a person space to make decisions is something that a trained therapist will do as part of the education toward positive coping skills.  The key for someone who is in crisis is to have a plan to check back frequently with the person to see if the solution is or is not working and to help modify as necessary. The goal is for the person to begin to feel confident about solving their own problems.

Stress Relievers

Finding ways to relax is another important coping skill to reduce stress. If you don’t find positive ways to relieve stress, people often turn to activities like overeating, smoking, drinking, drugs, sex or self-medication to mask their pain. The key is helping a person find an activity they like doing. Some people like quiet, relaxing activities like listening to music, drawing or journaling. Others may prefer to be active—running, bicycling, building things. Different activities may be appropriate in different situations, so helping someone develop a plan is important. Encouraging them to try new things to see which work best for them is a good way to start.

Coping skills are generally taught in childhood and developed throughout our lives. Many are not taught these skills as youngsters and grapple through life trying to get by. Others are taught them and lose sight of them through life’s struggles. As a case manager, we have an opportunity to assess our patients to see where they are and if they have the knowledge to how to use effective coping skills. Assisting a person to remember or begin the process of teaching coping skills can be one of the keys to an effective outcome when working with patients who are struggling to find their way.

Have a good week!