coping, stress, OT

Coping and stress: A guide for OTs

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What are coping skills?

Coping skills are personal resources that one uses to manage difficult situations.  Common stressors in post-secondary populations include: financial pressures, exam and study-related stressors, and social stressors.1 Good coping skills have been correlated with persistence and retention in higher education.2   It is believed that coping skills are relatively stable over time. However, coping strategies can be improved. This is important since students who have higher self-efficacy in their ability to cope with stressors do better at coping with stressors.3

Occupational therapists, with their background in psychosocial practice, are qualified to work with students on learning and improving coping skills. 

Types of coping skills. 

Coping skills have been categorized into two or three primary types:4

  • Problem-focused coping
    • Problem-focused coping is considered “positive” coping since using this style more often results in positive adaptation to a stressful situation.  Examples of problem-focused coping include:  planning and preparation, problem reconstruction, and seeking social support.
  • Emotion-focused coping
    • Considered “negative” coping since using these types of coping strategies more often result in negative or unresolved adaptation to a stressful situation.  Examples include: avoidance and denial.
  • Meaning-focused coping
    • Meaning-focused coping usually occurs after other coping strategies have been unsuccessful.5 Meaning-focused coping allows for a more positive emotional outcome in the coping process.  Examples of meaning-focused coping include:  acceptance, rationalizing, and positive reappraisal – reframing the situation.

Tools to assess coping skills:

Coping Inventory for Stressful Situations (CISS). This tool measures the preferred coping styles of participants.  It is a 48 item self-report measure, asking participants how they respond in stressful situations measured on a five-point Likert scale.  

Response to Stress Questionnaire. Social Stress Version (RSQ-SSV) – 57 items that look at five factors of controlled and automatic responses to stress (coping factors and stress responses).   

Stress Management Questionnaire (SMQ).  Developed by Dr. Franklin Stein, an OT, the SMQ is a 128 item questionnaire that helps the client identify symptoms related to stress, stressors that cause a stress response, and identifies current coping strategies used by the client to cope with stress.

How to improve coping skills:6,7

  • Psychoeducation
    • Teach students about the impact of stress on health and academic performance.
    • Discuss controllable versus uncontrollable sources of stress.
    • Teach students a variety of coping strategies.
    • Instruct students how to use expressive writing to manage stress.
    • Practice problem-solving in stressful situations (role playing).
    • Teach students mindfulness:
      • Specific activities (meditation, breathing), and
      • Mindful acceptance (recognizing emotions and emotional states, taking a step back, getting grounded before responding)
    • Teach students what cognitive reappraisal is and how to do it.  
    • Two interesting handouts about coping can be found here and here
  • Improving social participation can be effective, since social adjustment improves positive coping.7,8 People with more social resources are able to look for and receive assistance when needed.
    • Discuss the benefit of social interaction for academic and personal success.
    • Discuss the benefit of a variety of social relationships, not just friends.
    • Practice meeting new people, engaging with different types of people, etc.   
    • Talk about balanced relatedness – finding the right friends.
    • Discuss and practice social norms and social skills for various situations.
    • Practice conflict management and assertiveness.
    • Practice using social media for social participation and academics.
  • Preparation for post-secondary studies.7,8 People who are better prepared for a situation tend to have better coping skills in that situation.  They know what to expect and can better manage the unexpected. 
    • Example programs an OT can consider: teach students how to identify and resolve housemate conflict, explore what it means to be an independent learner and what the expectations of post-secondary studies are, and learn stress management techniques before stress becomes a problem.


  1. Fisher, S. (1994) Stress in academic life: The mental assembly line.  London: Open University Press.
  2. Matheny, K. B., Curlette, W. L., Aysan, F., Herrington, A. & Gfroerer, C. A. (2002) Coping resources,perceived stress and life satisfaction among Turkish and American university students, International Journal of Stress Management, 9(2), 81–97.
  3. Meijer, J. (2001) Learning potential and anxious tendency: Test anxiety as a bias factor in educational testing, Anxiety, Stress and Coping, 14(3), 337–362.
  4. Lazarus, R. S. & Folkman, S. (1984) Stress, appraisal, and coping. New York: Springer.
  5. Folkman, S. (2008) The case for positive emotions in the stress process, Anxiety, Stress and Coping, 21(1), 3–14.
  6. Denovan, A. & Macaskill, A. (2013).  An interpretative phenomenological analysis of stress and coping in first year undergraduate.  British Educational Research Journal, 39(6), 1002-1024.
  7. Bettis, A.H., Coiro, M.J., England, J., Murphy, L.K., Zelkowitz, R.L., Dejardins, L., Eskridge, R., Adery, L.H., Yaroby, J., Pardo, D., & Compas, B.E. (2017).  Comparison of two approaches to prevention of mental health problems in college students:  Enhancing coping and executive function skills.  Journal of American College Health, 65(5), 313-322. doi:10.1080/07448481.2017.1312411
  8. Urquhart, B. & Pooley, J. A. (2007) The transition experience of Australian students to university: The importance of social support, Australian Community Psychologist, 19(2), 78–91.

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