accepting, adapting, copingwith DiabetesDr. Shewikar El BakryAss. Prof. Of PsychiatryBanha University

Introduction "I simply cannot cope with this!" How

often have you uttered just these words when you felt completely overwhelmed by all that you had to accomplish at work or at home? How often have you heard one of your clients with diabetes say, "I cannot manage diabetes in addition to everything else I do! I simply cannot cope!" Have you ever wondered exactly what that patient meant and how you might help your clients cope?

definitions of coping There are many who define coping as a

behavior that protects people from being psychologically harmed by problematic social experiences.

Coping serves a protective function that can be exercised in three ways:

1) by eliminating or modifying stressful conditions;

2) by perceptually controlling the meaning of the stressor; or

3) by keeping emotional consequences in bounds.

definitions of coping "constantly changing cognitive and behavioral efforts to manage specific external and/or internal demands that are appraised as taxing or exceeding the resources of the person.“

In other words, coping allows people to use various skills to manage the difficulties they face in life. 

When and How When did you find out

Reactions and stages

anger and denial to bargaining, depression, and finally resolution or acceptance.

Adjustment to a diagnosis of diabetes takes 6–9 months for children 

Worry???

What do you fear

Different from peers

Safety if alone

meals offered (are they safe and proper, time)

what happens if I forgot therapy

Injections

Play sports or not

Worry???Adolescents believe it is

Hard situation

Long-term supervision by parents

Balancing the demands of diabetes & life 

Adolescents Adolescence is marked by rapid biological,

physical, cognitive, emotional, and social changes

risk-taking behaviors

shift from parental support to peer support

 strong fear of non-acceptance by the peer group and exclusion from peer activities 

Identity development

Do we do that???wishful thinking in response to stress

Avoidant

depressive symptoms

Denial

This is negative coping skills

Why Coping??? greater use of approach (or problem-focused) coping strategies has been related to better metabolic control and better psychosocial adjustment in youths with type 1 diabetes

Coping Skills Training

When individuals cannot cope effectively with a problem situation, their confidence is decreased for dealing with the next problem, and they use less successful coping patterns.

Social problem solving

No black-or-white perspective six major problem-solving steps: 1) identify the problem,  2) determine goals,  3) generate alternative solutions,  4) examine consequences,  5) choose the solution, and  6) evaluate the outcome.

Communication Skills Training

Express yourself clearly appropriately and constructively

How to work with others to have good outcomes

Assertiveness

The steps used to teach social skills training are 

1) provide concrete instructions on how to handle a social situation, 

2) allow participants to witness a role-play of an appropriate model, 

3) have participants practice their own role-play, 4

) provide feedback on the participants' role-play,

5) give participants real-life practice, and 

6) carry out group follow-up

Cognitive-behavioral modification

Focuses on understanding one's own thoughts and feelings and changing self-dialogue to more positive messaging.

recognition of thoughts and feelings, problem solving, and guided self-dialogue

thoughts are based on fact or assumption

Body and behaviours in response to thought and feeling

list negative thoughts and formulate alternate positive thoughts to counter them

Stress Management Identify stressors

Reduce activities

Relaxation techniques

Breathing

Guided Imagery

Altering mental images with happier ones

Finally Know the symptoms Get help Attend a group

Questions

Thank You