Problem-focused coping involves confronting the problem and reconstructing it as
manageable. Three types of problem-focused coping skills have been defined:1 Seeking information and support, involving building a knowledge base by accessing
any available information.
2 Taking problem-solving action, involving learning specific procedures and behaviours
(e.g. insulin injections).
3 Identifying alternative rewards, involving the development and planning of events
and goals that can provide short-term satisfaction.Emotion-focused coping involves managing emotions and maintaining emotional
equilibrium. Three types of emotion-focused coping skills have been defined:1 Affective, involving efforts to maintain hope when dealing with a stressful situation.
2 Emotional discharge, involving venting feelings of anger or despair.
3 Resigned acceptance, involving coming to terms with the inevitable outcome of an
illness.Therefore, according to this theory of coping with the crisis of a physical illness,
individuals appraise the illness and then use a variety of adaptive tasks and coping skills
which in turn determine the outcome.
However, not all individuals respond to illness in the same way and Moos and
Schaefer (1984) argued that the use of these tasks and skills is determined by three
factors:1 Demographic and personal factors, such as age, sex, class, religion.
2 Physical and social/environmental factors, such as the accessibility of social support
networks and the acceptability of the physical environment (e.g. hospitals can be dull
and depressing).
3 Illness-related factors, such as any resulting pain, disfigurement or stigma.Implications for the outcome of the coping process
Within this model, individuals attempt to deal with the crisis of physical illness via
the stages of appraisal, the use of adaptive tasks and the employment of coping skills.
The types of tasks and skills used may determine the outcome of this process and such
outcome may be psychological adjustment or well-being, or may be related to longevity
or quality of life (see Chapter 16). According to crisis theory, individuals are motivated to
re-establish a state of equilibrium and normality. This desire can be satisfied by either
short-term or long-term solutions. Crisis theory differentiates between two types of
new equilibrium: healthy adaptation, which can result in maturation and a maladaptive
response resulting in deterioration. Within this perspective, healthy adaptation involves
reality orientation and adaptive tasks and constructive coping skills. Therefore,
according to this model of coping the desired outcome of the coping process is reality
orientation.66 HEALTH PSYCHOLOGY