Clinical support
How to address maladaptive coping strategies
Learn what maladaptive coping strategies are, some common examples, why they develop, and healthier alternatives that actually reduce stress over time.
By Kat Boogaard • Clinically reviewed by Jolene Clatterbuck, LPC, MNT
What to know
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Maladaptive coping strategies are behaviors that offer short-term relief but create long-term harm, and they show up across nearly every presenting condition, from anxiety and depression to PTSD and substance use disorders.
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Distress that won’t let up, avoidance that keeps spreading, and real costs to a client’s relationships, work, or health are all key clues to look for. Treatment usually draws on CBT, DBT, ACT, EMDR, or motivational interviewing.
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Strong documentation and less admin work leave more room for the clinical focus these patterns demand. Headway supports that with built-in templates, assessments, and streamlined billing.
Introduction
Most clinicians have encountered maladaptive coping strategies before — and they know how stubborn they can be. Behaviors like avoidance, substance use, procrastination, or self-harm are usually well-established by the time a client walks into a session. Every client copes with some blend of strategies that help and strategies that cost them. The clinical work is rarely about removing a behavior outright — it's about widening the range a client can draw from.
Understanding more about what maladaptive coping strategies actually are, why they happen, and how to identify them will help you craft a treatment plan that gets to the root cause (and not just the surface-level behavior). This guide covers what you need to know.
What are maladaptive coping strategies?
As you likely know, maladaptive coping strategies are behaviors people use to manage stress, difficult emotions, or overwhelming situations. They’re maladaptive because, while they offer some short-term relief, they often create long-term problems.
Some common maladaptive coping strategies examples clearly show how this works: avoiding a hard conversation by picking a fight over something completely unrelated, or numbing a bad day with a couple of drinks.
The clinical marker of whether a coping strategy is maladaptive hinges on this question: What happens after the initial relief fades? Does the behavior actually lower distress and help the client function better over time? Or does it just buy them a few hours before the same problems come back (often even bigger than before)?
A coping behavior can feel helpful in the moment and still be maladaptive if it limits a client’s options, damages their relationships, or leaves the real stressor completely unaddressed.
Adaptive vs. maladaptive coping strategies: What’s the difference?
Adaptive coping strategies help a client manage a stressor in a way that eases the emotional load and supports their functioning over time — like problem-solving, seeking support, or using healthy self-soothing techniques.
Maladaptive coping does the opposite. It might ease distress in the moment, but it leaves the underlying problem untouched (or even makes it worse). Whether a behavior reads as maladaptive, however, depends partly on cultural norms around emotional expression, family involvement, and help-seeking, plus a client's material circumstances.
And it’s not always about the behavior itself. Take distraction as just one example. Scrolling for 10 minutes during a quick break between meetings is different from scrolling for six hours to avoid an overdue conversation or an uncomfortable emotion. It’s the same behavior, but with a different outcome.
Separating maladaptive coping strategies from adaptive ones depends on how often the behavior shows up, how intense it gets, and whether it’s replacing necessary action (or just putting it off).
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Common maladaptive coping strategies clinicians see in clients
Maladaptive coping shows up differently across clients, but a handful of patterns tend to come up over and over again. Here’s a quick look at patterns worth assessing:
- Avoidance and escape: Steering clear of anything (like certain conversations or entire environments) that causes distress, which usually just gives the stressor room to grow.
- Substance use: Reaching for alcohol or drugs to dull difficult emotions instead of processing them.
- Procrastination: Delaying a task to dodge the anxiety it brings up, even when the delay makes the eventual task even harder.
- Emotional eating or food restriction: Using food (or the control of food) to manage feelings.
- Social withdrawal and isolation: Pulling away from relationships to avoid vulnerability, judgment, or conflict.
- Rumination and overthinking: Replaying a problem on a loop, which can feel like problem-solving but only just fuels anxiety.
- Aggression and outbursts: Redirecting stress or hurt outward, often at a target that has little to do with the original source.
- Self-harm: Using physical pain to manage overwhelming emotions.
- Reassurance-seeking and codependence: Relying on others to regulate anxiety or self-worth, which can chip away at a client’s ability to cope on their own.
- Denial: Refusing to acknowledge a problem’s severity, which delays a client from having to address it at all.
- Maladaptive daydreaming: Retreating into daydreams to escape real-world stress, often to the point of disrupting daily functioning.
- Compulsive behaviors: Repeating a ritual or action to temporarily decrease anxiety, even when the compulsion has little logical connection to the fear that’s driving it.
What causes maladaptive coping?
Maladaptive coping strategies usually develop as an honest attempt to deal with something overwhelming. They stick around because, at some point, they worked.
Understanding where a client’s behavior began will help you conceptualize their case and find the best treatment approach. Here are a few potential starting places:
- Disrupted developmental sequence: If someone doesn’t get the chance to build healthy coping skills at the right developmental stage, they’re more likely to reach for whatever works instead. That behavior can hang around into adulthood.
- Adverse childhood experiences: Early trauma, neglect, or instability is associated with survival-based responses like avoidance or numbing that can persist long after the original threat is gone.
- Emotional invalidation: Clients who were taught that their feelings were wrong, excessive, or inconvenient often learn to suppress or disguise their emotions.
- Later-life stressors: Even clients with solid coping skills can default to maladaptive patterns when a stressor (like grief, job loss, or illness) grows beyond what those skills were built to handle.
- Coping rigidity: A strategy that worked once can become the only tool a client reaches for, regardless of whether or not it fits the situation.
- Ongoing material stressors: Financial strain, unstable housing, caregiving demands, discrimination, or an unsafe environment can make a coping behavior the most available option a client has. When the stressor is ongoing and outside the client's control, treatment focuses on support and harm reduction alongside skill-building rather than substitution alone.
No single origin explains every case, and many clients are dealing with more than one factor. But tracing where a pattern started can help you understand why it keeps going — even when the client knows it’s working against them.
How maladaptive coping connects to mental health conditions
Maladaptive coping strategies and mental health conditions tend to feed each other. A diagnosis can make certain coping patterns more likely, and then those same patterns can deepen (or drag out) the diagnosis they’re tied to. Here’s how that plays out across a few common conditions:
- Anxiety disorders: Avoiding a daunting situation brings anxiety down quickly, which teaches the brain that avoidance was necessary because the situation really was dangerous. That ultimately reinforces the anxiety around that trigger.
- Depression: Low energy and low motivation make it tempting to withdraw from people and activities. But that removes a person from the things — like social contact, a sense of accomplishment, or a routine — that would actually help lift their mood. This can make their depression worse.
- PTSD: Numbing or avoiding reminders of trauma keeps a client from having to feel the distress connected to the memory. Unfortunately, avoidance also prevents the memory from being processed and integrated, which is what needs to happen for PTSD symptoms to ease up.
- Substance use disorders: A client might start using a substance to dull their anxiety, depression, or trauma symptoms. But eventually, the substance use becomes its own diagnosis that masks the original symptoms and even adds new ones (like withdrawal and cravings).
- Personality disorders: In conditions like borderline personality disorder, behaviors like reassurance-seeking or emotional outbursts are often used to manage an intense fear of abandonment or an unstable sense of self. While it temporarily eases the fear, it strains the relationships the client is trying to hold onto — which feeds the instability behind the behavior.
Each condition creates a reason why the maladaptive coping feels necessary — and then that coping keeps the underlying condition in place. It’s a loop, and it shows why it’s so important to address the coping behavior along with whatever is driving it.
Recognizing maladaptive coping with clients
Maladaptive coping doesn’t always come with an obvious red flag, especially when clients perceive their behaviors as normal or don’t connect them to the stress they’re really trying to manage. There are a few clues to help you spot them, whether you see them in session or in a client’s history:
- Stress that persists or gets worse despite the client’s efforts: The client keeps “coping,” but there aren’t any meaningful differences in how they feel. That’s a sign that their coping method itself might be the issue.
- Avoidance that spreads across different areas of the client’s life: What started as avoiding one specific trigger (like a person, task, or place) starts creeping into more and more parts of the client’s daily life.
- Functional impairment in relationships, work, or health: The behavior is starting to have real costs, such as a relationship, job, or their physical health.
- Shame, secrecy, or guilt around the behavior: The client might hide the behavior, downplay it, or only bring it up indirectly, which often means they already sense it’s a problem.
- Inability to change the behavior, despite understanding its negative impacts: The client can name what they’re doing and even agree it’s not working, but still can’t seem to stop.
While a single clue can’t tell you the whole story, several taken together are usually a good sign that a client’s coping strategy has crossed into maladaptive territory. Standardized assessments (Brief-COPE is a common one) can help confirm what you’re already noticing.
Evidence-based approaches for treating maladaptive coping
There are many different maladaptive patterns, which means there are also many different ways to treat them. Finding the right fit usually depends on the specific behavior, what’s driving it, and any related conditions that are in the picture. That said, there are a few modalities that come up frequently:
- CBT: Helps clients identify the thoughts that fuel their maladaptive behavior and replace them with more accurate and less stressful ones. This is an especially solid starting point for patterns tied to anxiety or depression.
- DBT: Builds tolerance for distress and emotion regulation skills, which makes it particularly useful for clients who rely on self-harm, impulsivity, or emotional outbursts to deal with their intense feelings.
- ACT: Focuses on accepting difficult emotions instead of avoiding them, while also helping clients act in line with their values rather than trying to escape any discomfort.
- EMDR: Targets the memories of trauma that are causing avoidance and numbing, which makes it especially useful for clients who are using maladaptive coping in response to traumatic memories they haven’t processed.
- Motivational interviewing: Helps clients work through their own ambivalence about change, which matters most for coping behaviors (like substance use) that a client isn’t fully ready to give up yet.
The most effective approach goes beyond the behavior itself to address what’s underneath that coping strategy. That’s why many conditions end up layering two or three modalities together.
Clinical strategies to help clients replace maladaptive coping
Treating maladaptive coping goes beyond identifying patterns and their causes — it’s just as much about helping clients find something that works in place of that behavior. Here are a few strategies to help guide that process:
- Name the pattern together: Help the client see the behavior clearly (and without shame) as a strategy that made sense at one point but no longer works for them now.
- Map the trigger and its function: Get specific about what sets the behavior off and what it’s actually doing for the client.
- Build a menu of adaptive alternatives: Give clients more than one option so they don’t keep defaulting to the same maladaptive behavior simply because it’s familiar.
- Use graded substitution: Swap in the new strategy gradually rather than all at once, especially for behaviors the client relies on heavily.
- Layer in mindfulness and distress tolerance skills: These help clients ride out the urge to use the old behavior so they can reach for a new one instead.
- Strengthen social support and accountability: Loop in the people and structures that help reinforce the new pattern outside of your sessions.
- Plan for lapses with self-compassion: From the outset, build the expectation that a slip back into the old pattern is an expected part of the process (not a failure) so it doesn’t completely derail progress when it happens.
This process doesn’t happen overnight, and it rarely happens in a straight line. In any scenario, your goal is to help reduce a client’s reliance on maladaptive coping mechanisms and make sure a client has something more sustainable to replace them with.
FAQs about maladaptive coping
Can maladaptive coping be unlearned?
Yes. These are learned behaviors, which means they respond to treatment. With the right approach, clients can build new patterns over time. However, this change usually takes consistent practice — not a single session or insight.
Is procrastination a maladaptive coping strategy?
It depends on the frequency and function. Occasional procrastination is normal. But when it’s used consistently to help a client avoid anxiety at the cost of their responsibilities or goals, it crosses into maladaptive territory.
What is the most common maladaptive coping strategy?
Avoidance is one of the most common, showing up across anxiety, depression, PTSD, and beyond. It offers quick relief but tends to just reinforce the distress a client is trying to escape.
Are maladaptive coping strategies the same as mental illness?
No. Maladaptive coping is a behavior, not a diagnosis. It can show up with or without a mental health condition, though the two frequently overlap and influence each other.
How Headway supports providers treating maladaptive coping
Treating maladaptive coping takes focus, and that’s hard to come by when admin work eats into your session prep time.
Headway’s documentation tools simplify that side of the job with templates for treatment plans and progress notes, built-in assessments, and streamlined billing. Headway supports more than 90,000 mental health providers nationwide, giving them back the time they need to focus on cases like these.
This content is for general informational and educational purposes only and does not constitute clinical, legal, financial, or professional advice. All decisions should be made at the discretion of the individual or organization, in consultation with qualified clinical, legal, or other appropriate professionals.
© 2026 Therapymatch, Inc. dba Headway. All rights reserved. No part of this publication may be reproduced without permission.
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