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Anxiety: Behavioral and Cognitive Strategies for Treating Anxiety - 10 CEUs

Section 9
Coping with Regret

CEU Question 9 | CE Test | Table of Contents | Anxiety
Social Worker CEUs, Psychologist CEs, Counselor CEUs, MFT CEUs

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On the last track we discussed the second key to past redemption.  The second key to past redemption is restitution.  We also discussed living in the present. 

On this track we will discuss If Only’s.  Our discussion will focus on the overcoming regret technique, and will include the following three coping tools.  The three coping tools are making a wish I’d done it list, solving the problem before it starts, and developing the mental muscle to move on.  As you listen to this track, consider making notes in the manual that accompanied this course.  Could these tools and techniques help achieve your client’s treatment goals?

Overcoming Regret
Have you ever asked one of your clients, "What do you regret?"  If you did, you’d likely receive a variety of responses such as,  "I wish I’d saved sex for marriage."  "I wish I wouldn’t have agreed to help my sister move on the one day I have off."  "I wish I had completed college."  Or "I wish I had confronted my mother when she criticized how I disciplined my daughter."  

On the surface, most regrets have to do with something clients did or didn’t say, or something they did or didn’t do.  But would you agree that for anxiety clients there is usually more to it than that?  Think for a moment of three If Only's that have plagued your client within the past year or so.  How can you help your client go beneath the surface and discover something about themselves?  Perhaps the following technique could be productive.

Cognitive Behavior Therapy Technique: ‘Overcoming Regret’
Justin, age 32, often discussed regret in our sessions.  I felt that Justin’s sense of constant regret may have been contributing to his increased anxiety levels.  Therefore, I implemented the  ‘Overcoming Regret’ Technique. 

1. I stated, "First, let’s identify the source of your regrets."  As Justin thought about the things he wished he could take back, redo, or pretend never even happened, I asked him some of the following questions: "What motivated your behavior?  Why did you do what you did?  What were you feeling at the time?  What were you afraid of?  What were your other options?  What do you know now that you didn’t know then?"

For example, I asked Justin, "Why did you agree to help your sister move?"  Justin responded that he was afraid he would hurt her feelings by saying no.  I then asked him why he didn’t confront his mother when she criticized him regarding how he disciplined his daughter.  Justin indicated that he wasn’t sure where his mother’s role ends and his begins.  Some of Justin’s if only’s stemmed from simple choices like drinking too much or yelling at a coworkers.  But more often than not, they were driven by some deeper fear, a lack of confidence, an undeveloped skill, or missing a piece of information.

2. The second step in the  ‘Overcoming Regret’ CBT Technique is to find the lesson to be learned by identifying the root regret.  I asked Justin, "What have you learned from this experience?"  What would you do differently in a similar circumstance?"  After examining some of his common If-Only's, Justin realized that many were related to putting the needs of others before his own.  Justin stated, "Maybe I should stop saying yes to every request for my time."  As you probably know, the point of this second step is to explore how clients like Justin can use If-Only's to improve their life.

3. Finally, in addition to identifying the source of regrets and finding the lesson, the third step in the Overcoming Regret’ Technique is to make amends and move on.  Once Justin had identified the source of his If Only's and learned whatever lessons might be at the core of these regrets, he felt it was time to make it right.  Justin stated, "I guess I should tell my sister that the reason I treated her badly was because I wanted to tell her no, but couldn’t."  How might you have responded to Justin?  I stated, "Apologize to her, then let it go."  Would you agree that anxiety clients like Justin can benefit from making amends by restoring the person involved in their If-Only?

3 Tools for Coping with 'If-Onlys'
This three step technique for ‘Overcoming Regrets’ might apply to your client. This process, however, does not ensure that an if-only won’t rear its head again in the future.  So we’ll conclude this track with three more CBT tools for coping with anxiety causing if-onlys.  Could these benefit your client?

Tool #1:  Make a "Wish-I’d-Done-It" List
Could making a wish I’d done it list be productive for your client?  Clients often regret what they didn’t do more than what they did. A lack of education and not having children rank high on this list.  Granted, some client’s wish-I’d-done-its may be impossible.  

For example, a forty-five-year-old client may need to grieve that she didn’t have her own child while she learns to invest in her nieces and nephews.  But many of the things clients wish they had already done can still be done.  Perhaps your client can benefit from making a list of things he or she wishes they would have done by now and discover how many of them they can still do.  How soon might your client start?

Tool #2:  Solve the Problem Before It Starts
Anxiety levels can also be decreased by solving the problem before it starts.  For example, if your client knows she and her husband are going to have a meltdown because anxiety prevents her from being honest with him about her spending habits, should she put it off?  Of course not.  Perhaps you could suggest that she change her behavior now.  By not waiting until a crisis erupts, clients can predict how they will react to various anxiety triggers.  In other words, I influence my clients to  plan ahead for things they will regret and decide what they can do to avoid them.  Clients therefore learn to avoid the tragedy of regret.

Tool #3:  Develop the Mental Muscle to Move On
In addition to making a wish I’d done it list and solving the problem before it starts, a third tool for coping with anxiety causing If-Only's is developing the mental muscle to move on. This can be a difficult task for clients with anxiety.  I ask clients to think about their response to circumstances.  You might suggest your client rehearse a response several times.  Clients can work out their mental muscle by picturing life without dragging around If-Only's. You might consider asking your client, "How would you be different - what would your life look like - if you didn’t regret anything?"  Would you agree that the ultimate key to getting past your If-Only's is to move forward?

On this track we discussed If Only's . Our discussion focused on the overcoming regret technique, and included the following three coping tools. The three coping tools are making a wish I’d done it list, solving the problem before it starts, and developing the mental muscle to move on. 

On the next track we will discuss Assertiveness Training through Role Playing.  I use five steps in my Assertiveness Training.  The five steps are select an incident, role-play with another group member, have the client visualize the situation once more, have the client role play the situation twice with the other group member, and encourage the client

- Nakamura, B. J. Pestle, S. L., & Chorpita, B. F. (2009). Differential Sequencing of Cognitive-Behavioral Techniques for Reducing Child and Adolescent Anxiety. Journal of Cognitive Psychotherapy, 23(2), 114-135.
- Clark, D. A. & Reed, T. D. (2010). A Future We Wish to See: Racialized Communities Studies after White Racial Anxiety and Resentment. The Black Scholar, 40(4), 37-49.

Peer-Reviewed Journal Article References:
Fine, A., Cavanagh, C., Frick, P. J., Steinberg, L., & Cauffman, E. (2017). Can probation officers identify remorse among male adolescent offenders?Psychological Assessment, 29(6), 754–761.

Garverich, S., Prener, C. G., Guyer, M. E., & Lincoln, A. K. (2020). What matters: Factors impacting the recovery process among outpatient mental health service users. Psychiatric Rehabilitation Journal. Advance online publication.

Kumar, P. (2019). The impact of trivial attributes on inaction inertia. Journal of Experimental Psychology: Applied, 25(4), 733–743. 

Webster, G. D., Smith, C. V., Orozco, T., Jonason, P. K., Gesselman, A. N., & Greenspan, R. L. (2020). Missed connections and embarrassing confessions: Using big data to examine sex differences in sexual omission and commission regret. Evolutionary Behavioral Sciences. Advance online publication.

Online Continuing Education QUESTION 9
What are three CBT coping tools regarding anxiety causing if only's? To select and enter your answer go to CE Test.

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