Coping.org:
Tools for Coping
with Life's
Stressors
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Techniques
are often considered the "art" of the science of psychotherapy,
research has shown that tasks, such as homework, assignments and Bibliotherapy,
strengthen treatment gains, generalize or carry over learning from session to
real experience, and actually allow for the learning of a new skill or enhancing
of an old skill. In ESBT, the goal of the use of techniques is to empower
clients who have come for therapy demoralized, wounded and often feeling like
outcasts. The techniques enable the clients to personalize their experience in
therapy so that the outcomes are uniquely theirs. This helps them to own the
outcomes of therapy as something, which they have done on their own with the
facilitation of the therapist. They are able to view themselves as competent
self-healers who can use therapeutic tasks to gain new coping skills and enhance
old ones. Their experience enables them to have renewed self-confidence,
increased self-worth and enhanced self-esteem. They begin to recognize that they
are their own best "helpers" and that therapist becomes seen as
teachers of the self-help therapeutic process.
Techniques
in ESBT are rooted in the TEA System of Recovery as identified in the Self-Esteem Seekers Anonymous, The SEA'S Program
Manual. The TEA
system is as follows
T - Thoughts
E - Emotions
A - Actions.
T
- Thoughts
The first goal of ESBT techniques is to help clients to analyze their thoughts or thinking about their lives and to identify the irrational, unrealistic or unhealthy beliefs, self-scripts or ideas which are the roots of their identified problem. Once clients have identified the "sick" thoughts, then they need to replace them with healthier, more rational, and realistic thinking, beliefs, self-scripts and ideas,
E
- Emotions
The
second goal of ESBT techniques is to identify the "sick" emotions and
feelings which were based and influenced on the old "sick" thinking
and once clients have identified new "healthier" thoughts to integrate
them into new "healthier" emotions and feelings. Their enables clients
to have a more healthier, rational and realistic emotional response to life so
that they can begin to feel better about themselves and their ability to handle
their own problems. As clients become able to think and feel more positively
about overcoming their presenting problems they experience feelings of
self-confidence, self-worth and self-deservedness.
A
- Action
The
third goal of ESBT techniques once clients have altered their "sick"
thoughts and "sick" emotions is to change their "sick"
actions and behaviors. Once clients have developed a healthier, more rational
and realistic way of thinking and feeling about themselves and their lives, they
can take actions to change their old behaviors. This enables them to exhibit new
behaviors, which are healthier, more rational and result in improved self-esteem
and increased coping capacity.
The
TEA system caveat is that clients cannot change their behaviors or actions
before they have changed their emotional and feeling response to life. When
people change their actions because they have read or been told about it and
know that it is the "correct" thing to do without the changed emotions
and feelings which need to go along, their new change falls flat and dies.
People need to change their thoughts and emotions before their actions become
"authentic" and have greater "staying" power.
The techniques used in ESBT fall into three categories:
Initiating, which are aimed at exploring clients' presenting problems so as to gain better understanding.
Challenging, which are aimed at assisting clients to change their thoughts, emotions and actions.
Concluding, which are aimed at evaluating clients' progress and degree of change.
The
initiating techniques begin at the first contact from potential clients. These
techniques help to screen clients for appropriateness for treatment. They are
used to educate them about the goals of brief therapy. They are a way for the
therapist to identify what are the identified and unconscious presenting
problems. They are aimed at identifying the explicit contract of clients as to
the "Why now" for seeking help. They are aimed at identifying the
implicit contract of clients as to what they at the subconscious or unspoken
level want the therapist to do for them. Some of the ESBT Initiating techniques
are:
1.
Conduct a Pre-session telephone call to assess what the presenting problem is
and to determine the motivation of the clients to be sure they are light bulbs
wanting to be changed. Talom (1990) recommends giving clients an initial
assignment in their pre-session call, which is to be completed prior to the
initial session.
2. Mail out psycho-social-medical history forms in advance to be filled out prior to the first session so as not to take up valuable time getting history and data, which can be gotten in more efficient ways. Include a copy of the SEA's Self-esteem Inventory to determine level of low self-esteem the client is experiencing.
3. Ascertain in the initial session if clients are ready for treatment or if someone else is pressuring them into treatment. Giving homework in the first session, which is to be completed, by the second session is one way to test motivation and readiness of clients.
4. Ask clients how soon they expect to be helped and what they see to be the obstacles, which will get in the way of resolving the problem. Make sure the clients are part of the treatment team immediately placing the responsibility on them to have a say in treatment outcome.
5. Train clients in problem analysis and goal setting. Have them define the presenting problem and help set the recovery goals.
6. Explain the length and nature of ESBT treatment so that they are educated up front about the therapy experience. This helps set realistic expectations about what is possible and not possible in ESBT treatment.
7. Keep clients in the "here and now" and help they recognize that only "in the present is change possible." To help clients recognize their reality, Messina (1999-2001) in the Tools for Coping Series introduces each book with this caution: “Our parents did the best they could knowing what they did at the time. We, as adults, must now take responsibility for our own lives and learn what "normal" is so that we can have healthier, more productive lives.”
8. Operate with the assumption that the length of treatment will only be 1 session and fall back to the assumption that treatment will stop by the third session. This keeps the focus of the work sharp and helps ascertain if the "light bulb is ready."
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Coping.org
is a Public Service of James J. Messina, Ph.D. & Constance M. Messina, Ph.D.,
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