Emotion-Focused Coping vs. Thriving Through Life

Emotion-Focused Coping in Therapy

Coping strategies are an integral part of many people’s experience with therapy, particularly because they support emotional regulation, distress tolerance, and acting effectively. The American Psychological Association (APA) defines a coping strategy as the following, “an action, a series of actions, or a thought process used in meeting a stressful or unpleasant situation or in modifying one’s reaction to such a situation…”. Emotion-focused coping, as defined by APA, is also aimed at trying to “control feelings,” using a variety of techniques, such as positive reframing, seeking social support, meditation and relaxation, “and other avoidance techniques… It has been proposed that emotion-focused coping is used primarily when a person appraises a stressor as beyond his or her capacity to change”. Now, it’s important to be clear: Emotion-focused coping strategies and problem-focused coping (i.e. problem solving) certainly have a place in therapy and they are a necessary part of skill development for our emotional regulation, functioning, and relationships.  

Coping strategies are particularly valuable for problems where we have some agency to change things or when there are skill deficits that can help someone living with extremely painful and difficult emotions. For example, healthy coping strategies could prevent self-destructive or harmful behaviours, which is why they might take precedence for mitigating risk of suicide with safety planning. Unfortunately, life is full of hardships, hurdles, and pain. When we cannot control the feelings that arise, what thoughts enter our mind, or circumstances in life, it’s important that there is room for a therapeutic approach that is not aimed at spending our energy controlling or modifying these qualities, but rather developing ways of normalizing them and continuing to do what matters to us. 

Evidence-Based Therapy That Is Less About Control

Acceptance and Commitment Therapy (ACT) is one of the third wave cognitive behaviour therapies that has demonstrated effectiveness in clinical research for treating mental illness and improving mental health. Studies have found that ACT helps people improve their quality of life in the face of chronic illness, grief and loss, trauma, depression, and anxiety disorders (Hayes, Levin, Plumb-Vilardaga, Villatte, & Pistorello, 2013; Twohig & Levin, 2017; Swain, Hancock, Hainsworth, & Bowman, 2013; Landy, Schneider, & Arch, 2015; Walser & Hayes, 2006; McLean & Follette, 2016). 

Unlike traditional cognitive behaviour therapy (CBT), ACT is less concerned with controlling your emotions and thoughts with strategies, such as distraction and relaxation techniques, emotional regulation, behaviour activation, or cognitive restructuring. Rather, ACT focuses on developing your self-awareness, clarifying your values, and improving your relationship with naturally occurring thoughts and feeling through process-based treatment (i.e., mindfulness, action planning, cognitive defusion strategies) by emphasizing the context in which your thoughts and feelings occur (Hayes et al., 2013; Twohig & Levin, 2017). ACT teaches people to consider their struggles in context by using techniques such as imagery, metaphors, and experiential exercises. After all, you can’t learn to play the guitar without practicing first. 

Distinguishing itself from other cognitive behaviour therapies, ACT recognizes the limitations in language for learning new ways of being. Rather than getting caught up in wording of cognitive reframes, rules, reason-giving, and rationalizations, ACT seeks to help people more readily view thoughts for what they are (i.e., words) in service of connecting them with their values through action. Research indicates that ACT has comparable outcomes to CBT in reducing symptoms of anxiety and depression, and improving quality of life (Swain et al., 2013; Landy et al., 2015; Twohig & Levin, 2017). Therefore, it is a strong alternative for clients to consider, particularly if they have not responded well to traditional CBT. 

Acceptance and Commitment Therapy is based on the theoretical framework of functional contextualism and relational frame theory (Twohig & Levin, 2017). In other words, ACT strategies are designed to emphasize context of thoughts/feelings rather than content, and process rather than outcome. ACT aims to help us develop psychological flexibility and adapt to what life brings us using it’s six core processes: acceptance, cognitive defusion, values, committed action, contacting the present moment, and self-as-context. 

Freedom in Flexibility

Psychological flexibility helps us to reduce the negative impact of distressing stories and sensations that our minds and bodies conjure up from our personal history. This gives us the space to take actionable steps towards what we care about in life – or our ‘values-congruent goals’. It’s about normalizing and making peace with the parts of ourselves that we struggle with, while also enhancing our ability to shift perspectives so that we can do more of what matters to us in the way that we want. Perhaps you’re already aware of parts of your life that you’ve been feeling disconnected from; for example, learning how to be present, having meaningful conversations with friends and family, nurturing yourself and self-development, enjoying leisure, or having agency in your work. 

ACT helps you clarify and connect with your ‘why’. Once you make this connection, you can develop skills to help you face difficulties and make meaningful changes to move towards the life you want. Hint: Some of these skills might include emotion-focused coping! Your values are like an encouraging friend guiding you through stormy waters; they are about reminding yourself who you are, who you want to be, and what you want to stand for. Your choice in action [or inaction] is inspired by your values. 

Therefore, ACT proposes that you do not have to rid yourself of anxiety, depression, PTSD, and pain before you live a full and meaningful life. Rather, you can learn to become less negatively impacted by thoughts and feelings, which helps you take action on what you want in life – starting now. 

References

Hayes, S. C., Levin, M. E., Plumb-Vilardaga, J., Villatte, J. L., & Pistorello, J. (2013). Acceptance and commitment therapy and contextual behavioral science: Examining the progress of a distinctive model of behavioral and cognitive therapy. Behavior Therapy, 44(2), 180-198. https://doi.org/10.1016/j.beth.2009.08.002

Landy, L. N., Schneider, R. L., & Arch, J. J. (2015). Acceptance and commitment therapy for the treatment of anxiety disorders: a concise review. Current Opinion in Psychology, 2, 70-74. https://doi.org/10.1016/j.copsyc.2014.11.004

McLean, C. & Follette, V. M. (2016). Acceptance and commitment therapy as a nonpathologizing intervention approach for survivors of trauma. Journal of Trauma and Dissociation, 17(2), 138-150. https://doi.org/10.1080/15299732.2016.1103111

Swain, J., Hancock, K., Hainsworth, C., & Bowman, J. (2013). Acceptance and commitment therapy in the treatment of anxiety: a systemic review. Clinical Psychology Review, 33(8), 965-978. https://doi.org/10.1016/j.cpr.2013.07.002

Twohig, M. P. & Levin, M. E. (2017). Acceptance and commitment therapy as a treatment for anxiety and depression: a review. Psychiatric Clinics, 40(4), 751-770. https://doi.org/10.1016/j.psc.2017.08.009

Walser, R. D. & Hayes, S. C. (2006). Acceptance and commitment therapy in the treatment of posttraumatic stress disorder. Cognitive-Behavioral Therapies for Trauma, 2, pp. 146-172.