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Example Self-Help Plans: 3

Mark Dombeck, Ph.D.

Example 3: Manage Stress and Become Better Organized

Amy is in her late thirties. She is the divorced mother of three young children and has a highly responsible job as an emergency room doctor at the local hospital. She has been trying to find new daycare for her youngest child, a toddler. Her mother is caring for the toddler until daycare is arranged. Her eldest child Josh, in the second grade, is having trouble adjusting to a new school. Her middle child, now in kindergarten, has just been diagnosed with a learning disorder and Amy has been trying to find a tutor who understands dyslexia to work with the little girl. Apart from home stress, there has been a lot of work stress lately too. Two of the doctors on her shift are out ill with a flu that’s going around and she has been trying to orient a substitute doctor while making sure all of the incoming patients are served. There are many more ER patients than usual, due to the flu epidemic. Amy, who is generally highly organized and unflappable, finds herself in tears in her office. She realizes she can't cope with everything right now. She determines that she has taken on too much responsibility and feels exhausted. She draws up the following plan. Note how she combines problem-solving for her home and work issues, as well as her own primary issue (her tendency to overloading herself), and comes up with actions to resolve both short-term and longer term problems.

Goal 1 - Meet kids’ needs; learning disorder tutor, daycare arrangement, school adjustment counseling.

· Method 1 - Divide and Conquer:

· ask ex-husband to find and schedule a dyslexia tutor;

· ask mother to find daycare and make arrangements;

· meet personally with oldest child's teacher to find out how to help him adjust.

· Measurement - Tutor is scheduled, daycare is arranged and Josh says he feels happier in school.

· Deadline - By December 15 for tutor and daycare, and by January 30 for Josh’s adjustment.


Goal 2 - Relieve self of high level of work stress.

· Method 1 - Work with other doctors and hospital administration so as to contract with a group of substitute doctors. These doctors will receive orientation to this ER, and may be called in substitutes, as needed.

· Measurement - Trained doctors available as subs when needed.

· Deadline - As soon as possible. Push to have arrangements made for two months from now.


· Method 2 - Coordinate with other doctors to cover my evening shifts.

· Measurement - I will be home during the evenings and up with the kids in the mornings (a regular schedule, allowing me enough time to get a full night's sleep.

· Deadline - Make arrangements this week.


· Method 3 - I will walk 3 miles before work, three days per week.

· Measurement - I will feel more relaxed (because of the exercise).

· Deadline - Ongoing, 3 times per week.


Goal 3 - I will stop working more than my regularly scheduled hours.

· Method 1 - I will stop all thoughts of impressing my supervisor and proving to myself I am a good doctor (which will ensure I don’t volunteer for or accept extra hours).

· Method 2 - I will use a self-suggestion method, just after breakfast and just after dinner, with the message to myself that I want to pursue a well balanced life starting today.

· Measurement - I will notice that I have fewer thoughts of working any more than my scheduled hours.

· Deadline - Ongoing use of methods until thoughts are distinguished and I have not worked more hours than scheduled for at least three months.