{"id":1655,"date":"2020-03-09T15:34:51","date_gmt":"2020-03-09T15:34:51","guid":{"rendered":"http:\/\/practicalhealthpsychology.com\/?p=1655"},"modified":"2026-09-26T11:25:04","modified_gmt":"2026-09-26T11:25:04","slug":"the-importance-of-assessing-clients-coping-strategies","status":"publish","type":"post","link":"https:\/\/practicalhealthpsychology.com\/pt\/2020\/03\/the-importance-of-assessing-clients-coping-strategies\/","title":{"rendered":"A import\u00e2ncia de avaliar as estrat\u00e9gias de coping dos clientes"},"content":{"rendered":"\n<p><strong>Por Nadia Garnefski e Vivian Kraaij, Departamento de Psicologia Cl\u00ednica, Universidade de Leiden, Pa\u00edses Baixos<\/strong><\/p>\n\n\n\n<p>\u201c<em>O Rob acabou de saber que tem VIH (acontecimento negativo). Pensa que \u00e9 ele o respons\u00e1vel pelo que aconteceu (autoculpabiliza\u00e7\u00e3o) e evita estar com os amigos (retraimento). A situa\u00e7\u00e3o deixa-o triste. Quando est\u00e1 sentado em casa, n\u00e3o consegue parar de pensar nos seus sentimentos (rumina\u00e7\u00e3o) e acredita que aquilo que lhe aconteceu \u00e9 uma verdadeira cat\u00e1strofe (catastrofiza\u00e7\u00e3o). Como se sente triste, tem pouca energia. Como consequ\u00eancia, retrai-se ainda mais. Isso deixa-o ainda mais triste. Desta forma, o Rob fica preso numa espiral descendente<\/em>.\u201d<\/p>\n\n\n\n<p>As pessoas experienciam uma s\u00e9rie de emo\u00e7\u00f5es intensas em resposta a acontecimentos de vida negativos. Para lidar com estas emo\u00e7\u00f5es, as pessoas podem utilizar diferentes estrat\u00e9gias cognitivas e comportamentais. Este processo \u00e9 tamb\u00e9m designado por <em>coping.<\/em> <a href=\"https:\/\/epdf.pub\/stress-and-emotion-a-new-synthesis.html\">Lazarus define <em>coping<\/em><\/a> como os esfor\u00e7os de um indiv\u00edduo para gerir o stresse psicol\u00f3gico associado a situa\u00e7\u00f5es de dano, amea\u00e7a ou desafio. No exemplo do Rob, descrito acima, o acontecimento negativo foi receber a not\u00edcia de que estava infetado pelo VIH. Podem ocorrer muitos outros acontecimentos stressantes, desde situa\u00e7\u00f5es pontuais, como uma morte, um div\u00f3rcio ou a perda de emprego, at\u00e9 circunst\u00e2ncias de vida stressantes mais prolongadas, como <em>bullying<\/em>, uma carga de trabalho elevada ou problemas numa rela\u00e7\u00e3o. Assim, o <em>coping<\/em> diz respeito \u00e0 forma como gerimos diferentes tipos de situa\u00e7\u00f5es de vida stressantes.<\/p>\n\n\n\n<p>As estrat\u00e9gias de <em>coping<\/em> podem ser divididas em cogni\u00e7\u00f5es (o que se pensa) e comportamentos (o que se faz). Um exemplo de uma estrat\u00e9gia cognitiva de <em>coping<\/em> \u00e9 a autoculpabiliza\u00e7\u00e3o. As pessoas que utilizam esta estrat\u00e9gia culpam-se pelo que lhes aconteceu (o Rob culpou-se por ter sido infetado pelo v\u00edrus do VIH). Outros exemplos de estrat\u00e9gias cognitivas s\u00e3o a rumina\u00e7\u00e3o e a catastrofiza\u00e7\u00e3o. A rumina\u00e7\u00e3o consiste em pensar repetidamente nas emo\u00e7\u00f5es, sentimentos e pensamentos associados \u00e0 experi\u00eancia negativa. A catastrofiza\u00e7\u00e3o refere-se a centrar-se explicitamente nos aspetos mais desastrosos da experi\u00eancia. O Rob utilizou ambas as estrat\u00e9gias. Outros exemplos de estrat\u00e9gias cognitivas incluem: culpar os outros, aceita\u00e7\u00e3o, redirecionar a aten\u00e7\u00e3o para outros assuntos mais agrad\u00e1veis, planear os passos a dar, reavalia\u00e7\u00e3o positiva ou atribui\u00e7\u00e3o de um significado positivo ao acontecimento, e colocar o acontecimento em perspetiva (comparando-o com outros acontecimentos mais graves). No total, <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0191886900001136?via%3Dihub\">a literatura distingue nove estrat\u00e9gias cognitivas d<em>e coping<\/em><\/a><em>.<\/em> Um exemplo de uma estrat\u00e9gia comportamental de <em>coping <\/em>\u00e9 o retraimento, que consiste em afastar-se de situa\u00e7\u00f5es e contactos sociais, como aconteceu com o Rob. Outras estrat\u00e9gias comportamentais de <em>coping<\/em> incluem procurar distra\u00e7\u00e3o, tomar medidas para lidar ativamente com a experi\u00eancia, procurar apoio social e ignorar, isto \u00e9, comportar-se como se nada tivesse acontecido. No total, <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0191886918304318?via%3Dihub\">distinguem-se cinco estrat\u00e9gias comportamentais<\/a>.<\/p>\n\n\n\n<p>Foram desenvolvidos e validados dois instrumentos para avaliar, respetivamente, o <em>coping<\/em> cognitivo e comportamental: o <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0191886900001136?via%3Dihub\">Cognitive Emotion Regulation Questionnaire (CERQ)<\/a> e o <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0191886918304318?via%3Dihub\">Behavioral Emotion Regulation Questionnaire (BERQ)<\/a>. O CERQ foi traduzido e validado em v\u00e1rias l\u00ednguas. O BERQ est\u00e1 atualmente a ser traduzido para v\u00e1rias l\u00ednguas.<\/p>\n\n\n\n<p>A investiga\u00e7\u00e3o que analisou o papel das estrat\u00e9gias cognitivas e comportamentais de <em>coping<\/em> (utilizando o CERQ e o BERQ) identificou estrat\u00e9gias de <em>coping<\/em> mais e menos \u00fateis. <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S0191886906000377?via%3Dihub\">No que diz respeito \u00e0s estrat\u00e9gias cognitivas<\/a>: a rumina\u00e7\u00e3o, a catastrofiza\u00e7\u00e3o e a autoculpabiliza\u00e7\u00e3o podem ser consideradas como menos \u00fateis, enquanto a reavalia\u00e7\u00e3o positiva, a coloca\u00e7\u00e3o em perspetiva e o redirecionamento positivo da aten\u00e7\u00e3o tendem a ser mais \u00fateis. <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S0191886918304318?via%3Dihub\">No que diz respeito \u00e0s estrat\u00e9gias comportamentais<\/a>, o retraimento e ignorar podem ser considerados como menos \u00fateis, enquanto agir ativamente, procurar distra\u00e7\u00e3o e procurar apoio social podem ser considerados como mais \u00fateis. Estas s\u00e3o conclus\u00f5es gerais, em situa\u00e7\u00f5es espec\u00edficas, perante stressores espec\u00edficos, podem verificar-se outras conclus\u00f5es. O conhecimento das estrat\u00e9gias cognitivas e comportamentais de<strong>&nbsp;<\/strong><em>coping<\/em><strong>&nbsp;<\/strong>espec\u00edficas de cada cliente pode ajudar a compreender o c\u00edrculo vicioso dos seus problemas psicol\u00f3gicos e pode fornecer pistas para transformar padr\u00f5es desadaptativos em padr\u00f5es mais adaptativos.<strong>&nbsp;<\/strong><\/p>\n\n\n\n<p>\u201c<em>O Rob come\u00e7ou a fazer terapia. O terapeuta avaliou as suas estrat\u00e9gias cognitivas e comportamentais de coping e verificou que apresentava n\u00edveis elevados de autoculpabiliza\u00e7\u00e3o, rumina\u00e7\u00e3o, catastrofiza\u00e7\u00e3o e retraimento. Explicou-lhe que estas estrat\u00e9gias n\u00e3o s\u00e3o \u00fateis e podem at\u00e9 agravar a sua depress\u00e3o, ao coloc\u00e1-lo numa espiral descendente. Come\u00e7aram a trabalhar para interromper o retraimento e alterar os padr\u00f5es de pensamento negativos, utilizando t\u00e9cnicas da Terapia Cognitivo-Comportamental. Depois de algumas sess\u00f5es, o Rob voltou a ver os seus amigos e sente-se agora muito melhor.\u201d<\/em><\/p>\n\n\n\n<p><strong>Recomenda\u00e7\u00f5es pr\u00e1ticas<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Avalie sempre as estrat\u00e9gias de <em>coping<\/em> dos clientes em conjunto com a sua psicopatologia. Isto pode fornecer informa\u00e7\u00e3o importante para definir o foco da terapia.<\/li>\n\n\n\n<li>Fa\u00e7a psicoeduca\u00e7\u00e3o sobre o facto de as estrat\u00e9gias cognitivas e comportamentais de <em>coping <\/em>poderem contribuir para uma espiral descendente em dire\u00e7\u00e3o \u00e0 depress\u00e3o.<\/li>\n\n\n\n<li>Podem ser utilizadas t\u00e9cnicas gerais da Terapia Cognitivo-Comportamental para alterar estrat\u00e9gias cognitivas e comportamentais de <em>coping <\/em>desadaptativas, como a ativa\u00e7\u00e3o comportamental e o questionamento de pensamentos negativos.<\/li>\n<\/ul>\n\n\n\n<p><em>Translated by Maiara Moreto e Susana Mour\u00e3o<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Nadia Garnefski and Vivian Kraaij, Department of Clinical Psychology, Leiden University, The Netherlands \u201cRob has just heard that he has HIV (negative event). He thinks that he is the one to blame for this (self-blame) and he avoids seeing [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":1659,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"off","_et_pb_old_content":"<strong>By Nadia Garnefski and Vivian Kraaij, Department of Clinical Psychology, Leiden University, The Netherlands<\/strong>\r\n\r\n\u201c<em>Rob has just heard that he has HIV (negative event). He thinks that he is the one to blame for this (self-blame) and he avoids seeing his friends (withdrawal). The situation makes him sad. When sitting at home, he cannot stop thinking about his feelings (rumination) and believes that what has happened to him is a complete disaster (catastrophizing). Because he feels sad, he has little energy. As a result, he withdraws even more. This makes him even sadder. In this way, Rob is drawn into a downward spiral.<\/em>\u201d\r\n\r\n<!--more-->\r\n\r\nPeople experience a range of strong emotions in response to negative life events. To deal with these emotions people may use various cognitive and behavioral strategies. This process is also called coping. <a href=\"https:\/\/epdf.pub\/stress-and-emotion-a-new-synthesis.html\">Lazarus defines coping<\/a> as an individual's efforts to manage the psychological stress associated with conditions of harm, threat or challenge. In the example of Rob, above, the negative event was hearing the news that he was infected with the HIV virus. Many other examples of stressful events might occur, ranging from single events such as death, divorce or job loss, to more enduring stressful life circumstances such as bullying, high work load or relationship problems. Thus, coping relates to managing all kinds of stressful life conditions.\r\n\r\nCoping strategies can be divided into cognitions (what you think) and behaviors (what you do). An example of a cognitive coping strategy (thought) is <em>self-blame<\/em>. People who use this coping strategy blame themselves for what they have experienced (Rob blamed himself for having been infected by the HIV virus). Other examples of cognitive strategies are <em>rumination<\/em> and <em>catastrophizing<\/em>. Rumination means that one keeps thinking over and over about the emotions, feelings and thoughts that are associated with the negative experience. Catastrophizing refers to explicitly focusing on the disastrous aspects of the experience. Rob applied both these strategies. More examples of cognitive strategies are: <em>blaming others, acceptance, refocusing on other more pleasant matters<\/em>, <em>planning which steps to take<\/em>, <em>positive reappraisal<\/em> or <em>attaching a positive meaning to the event<\/em>, and <em>putting the event into perspective<\/em> (by comparing it to other, worse events). In total, <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0191886900001136?via%3Dihub\">nine cognitive coping strategies are distinguished in the literature<\/a>. An example of a behavioral coping strategy is <em>withdrawal<\/em>, which refers to drawing yourself back from situations and social contacts, which happened to Rob. Other behavioral coping strategies are <em>seeking distraction<\/em>, <em>actively taking steps to handle the experience<\/em>, <em>seeking social support<\/em>, and <em>ignoring<\/em>, which refers to behaving like nothing has happened. In total, <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0191886918304318?via%3Dihub\">five behavioral strategies are distinguished<\/a>.\r\n\r\nTwo instruments have been developed and validated for the assessment of cognitive and behavioral coping, respectively the <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0191886900001136?via%3Dihub\">Cognitive Emotion Regulation Questionnaire (CERQ)<\/a> and the <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/pii\/S0191886918304318?via%3Dihub\">Behavioral Emotion regulation Questionnaire (BERQ)<\/a>. The CERQ has been translated and validated in numerous languages. The BERQ is being translated in various languages at present.\r\n\r\nResearch that investigated the role of cognitive and behavioral coping strategies (by using the CERQ and the BERQ) has identified helpful and less helpful coping strategies. <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S0191886906000377?via%3Dihub\">With regard to cognitive strategies<\/a>: <em>rumination<\/em>, <em>catastrophizing<\/em>, and <em>self-blame<\/em> can be considered as less helpful and <em>positive reappraisal<\/em>, <em>putting into perspective<\/em> and <em>positive refocusing<\/em> as more helpful. <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S0191886918304318?via%3Dihub\">With regard to behavioral strategies<\/a>: <em>withdrawal<\/em> and <em>ignoring<\/em> can be considered as less helpful, and <em>actively approaching<\/em>, <em>seeking distraction<\/em>, <em>and seeking social support<\/em> as more helpful. These are general conclusions, in specific situations with specific stressors, other observations may be true.\r\n\r\nKnowledge about clients\u2019 specific cognitive and behavioral coping strategies may help to understand the vicious circle of people\u2019s psychological problems and might provide clues for changing maladaptive patterns into more adaptive ones.\r\n\r\n\u201c<em>Rob has started with therapy. The therapist assessed Rob\u2019s cognitive and behavioural coping strategies and found that he scored high on self-blame, rumination, catastrophizing and withdrawal. He explains to Rob that these strategies are not helpful and can even worsen his depression, by bringing him into a downward spiral. They start working on breaking through the withdrawal and changing the negative thought patterns by using techniques from Cognitive Behavioural Therapy. After a couple of sessions, Rob started seeing his friends again and now feels a lot better.\u201d<\/em>\r\n\r\n<strong>Practical recommendations<\/strong>\r\n<ul>\r\n \t<li>Always assess clients\u2019 coping strategies next to their psychopathology. This may provide important information for the focus of therapy.<\/li>\r\n \t<li>Provide psychoeducation about the fact that people\u2019s cognitive and behavioural coping strategies may be part of a downward spiral towards depression.<\/li>\r\n \t<li>General techniques from Cognitive Behavioral Therapy may be used to change maladaptive cognitive and behavioral coping strategies, such as behavioral activation and challenging negative thoughts.<\/li>\r\n<\/ul>","_et_gb_content_width":"","_uf_show_specific_survey":0,"_uf_disable_surveys":false,"footnotes":""},"categories":[32,35],"tags":[],"class_list":["post-1655","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-assessment","category-stress-and-coping"],"translation":{"provider":"WPGlobus","version":"3.0.5","language":"pt","enabled_languages":["en","id","my","bg","zh","hr","cz","da","de","es","fr","gr","he","it","ja","kr","lv","lt","hu","nl","no","pl","pt","ro","ru","sk","sr","fi","et","sv","tr","uk","hi","sw","ta"],"languages":{"en":{"title":true,"content":true,"excerpt":false},"id":{"title":false,"content":false,"excerpt":false},"my":{"title":false,"content":false,"excerpt":false},"bg":{"title":false,"content":false,"excerpt":false},"zh":{"title":false,"content":false,"excerpt":false},"hr":{"title":false,"content":false,"excerpt":false},"cz":{"title":false,"content":false,"excerpt":false},"da":{"title":false,"content":false,"excerpt":false},"de":{"title":false,"content":false,"excerpt":false},"es":{"title":false,"content":false,"excerpt":false},"fr":{"title":false,"content":false,"excerpt":false},"gr":{"title":false,"content":false,"excerpt":false},"he":{"title":false,"content":false,"excerpt":false},"it":{"title":false,"content":false,"excerpt":false},"ja":{"title":true,"content":true,"excerpt":false},"kr":{"title":false,"content":false,"excerpt":false},"lv":{"title":false,"content":false,"excerpt":false},"lt":{"title":false,"content":false,"excerpt":false},"hu":{"title":false,"content":false,"excerpt":false},"nl":{"title":false,"content":false,"excerpt":false},"no":{"title":false,"content":false,"excerpt":false},"pl":{"title":false,"content":false,"excerpt":false},"pt":{"title":true,"content":true,"excerpt":false},"ro":{"title":false,"content":false,"excerpt":false},"ru":{"title":false,"content":false,"excerpt":false},"sk":{"title":false,"content":false,"excerpt":false},"sr":{"title":false,"content":false,"excerpt":false},"fi":{"title":false,"content":false,"excerpt":false},"et":{"title":false,"content":false,"excerpt":false},"sv":{"title":false,"content":false,"excerpt":false},"tr":{"title":false,"content":false,"excerpt":false},"uk":{"title":false,"content":false,"excerpt":false},"hi":{"title":false,"content":false,"excerpt":false},"sw":{"title":false,"content":false,"excerpt":false},"ta":{"title":false,"content":false,"excerpt":false}}},"aioseo_notices":[],"aioseo_head":"\n\t\t<!-- All in One SEO 5.0.1.1 - aioseo.com -->\n\t<meta name=\"description\" content=\"{:en}By Nadia Garnefski and Vivian Kraaij, Department of Clinical Psychology, Leiden University, The Netherlands \u201cRob has just heard that he has HIV (negative event). 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