anxiety session
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Anxiety Session. BRIDGES Program Stephanie Mealey MSW, RSW Karen Mackey OT (R) NL. Anxiety. Statistics Vary…. Anxiety disorders are the most common of all mental health problems, affecting approximately 1 in 10 people. (Canadian Mental Health Association) - PowerPoint PPT PresentationTRANSCRIPT
Anxiety Session Anxiety Session
BRIDGES ProgramBRIDGES Program
Stephanie Mealey MSW, RSWStephanie Mealey MSW, RSW
Karen Mackey OT (R) NLKaren Mackey OT (R) NL
Anxiety Anxiety
Statistics Vary….Statistics Vary…. Anxiety disorders are the most common of all mental Anxiety disorders are the most common of all mental
health problems, affecting approximately 1 in 10 health problems, affecting approximately 1 in 10 people. (Canadian Mental Health Association)people. (Canadian Mental Health Association)
Most common, chronic costly emotional disorder in Most common, chronic costly emotional disorder in the US (NIMH) and in 10 -17 countries (WHO)the US (NIMH) and in 10 -17 countries (WHO)
Practice evidence-BY FAR the most common mental Practice evidence-BY FAR the most common mental health referral to Central Intakehealth referral to Central Intake
Why the increase????Why the increase????
Increased awareness about anxietyIncreased awareness about anxiety
Lifestyles “bigger…better…faster…Lifestyles “bigger…better…faster…smarter…”smarter…”
Lack of skill buildingLack of skill building (modeling, integrating, naturally occurring)(modeling, integrating, naturally occurring)
World MessagesWorld Messages Economy, illness, threatsEconomy, illness, threats
Pathologizing normal stressPathologizing normal stress
Anxiety IS NORMAL Anxiety IS NORMAL Anxiety is normal and needed. Anxiety is normal and needed.
It serves as a natural alarm system that tells us there is It serves as a natural alarm system that tells us there is danger. danger.
Some people have sensitive alarm systems.Some people have sensitive alarm systems.
It helps us survive!It helps us survive!
Anxiety – Not all Bad!Anxiety – Not all Bad!
LiabilitiesLiabilities Higher levels of stressHigher levels of stress Personalizes Personalizes Easily exploited Easily exploited Difficulty setting Difficulty setting
limits/saying nolimits/saying no Excessive time spent Excessive time spent
doing or thinking about doing or thinking about taskstasks
Consumed by thingsConsumed by things
AssetsAssets CooperativeCooperative Motivated/drivenMotivated/driven Thoughtful/reflectiveThoughtful/reflective OrganizedOrganized Sensitive/IntuitiveSensitive/Intuitive LoyalLoyal CreativeCreative
Development of AnxietyDevelopment of Anxiety
PredispositionBiological sensitivity
PersonalityTemperament
Stress (good or bad)
Learned Anxiety Lack of stress skills
“Treadmill of life”
ANXIETY!!
Continuum of AnxietyContinuum of Anxiety
Common Anxieties Common Anxieties 5 years - separation, dark, animals, “bad people”5 years - separation, dark, animals, “bad people” 6 years - separation, harsh weather, ghosts, dark, 6 years - separation, harsh weather, ghosts, dark,
sleeping alone, bodily injury (all ages)sleeping alone, bodily injury (all ages) 7-8 years - ghosts, dark, fears based on TV viewing, 7-8 years - ghosts, dark, fears based on TV viewing,
staying alone staying alone 9-12 years - tests, school performance, start of physical 9-12 years - tests, school performance, start of physical
appearance, deathappearance, death 13-15 years - family and home issues, world concerns, 13-15 years - family and home issues, world concerns,
preparation for the future, personal appearance, social preparation for the future, personal appearance, social relationsrelations
Older - fear of isolation, natural events, sexual issues, Older - fear of isolation, natural events, sexual issues, economic issues, morality economic issues, morality
Taken from “The Worried Child.”
Effects of Anxiety Effects of Anxiety Physical Feelings
(Body)Muscle tensionRacing heart
Belly painNausea
Head ache Sweating
BehaviorAvoid/Escape/Flight
Disruptive or pressured behavior/fightFreeze
Seeking reassurance
Thoughts(Brain)What if…?
Thinking the worst
Anxiety ReactionsAnxiety Reactions
FlightFlight
AvoidanceAvoidance Tummy aches & Tummy aches &
painspains QuittingQuitting
LyingLying
FightFight
BehaviorBehavior Refusal Refusal Extreme Extreme
persistencepersistence PerfectionismPerfectionism Self-imposed Self-imposed
pressurepressure
FreezeFreeze
IndecisionIndecision
InactionInaction
When does it become a disorder...When does it become a disorder...
Distress or interference is much Distress or interference is much greater than anxiety experienced greater than anxiety experienced by other children of the same by other children of the same age age
When it interferes with daily When it interferes with daily functioning/causes impairmentfunctioning/causes impairment
When it is persistent When it is persistent When accommodations are When accommodations are
always necessaryalways necessary
When a kid just can’t be a kid!!!!
Why my child? Why my child?
The Perfect Storm
The TeenageBrain
Frontal lobe restructuredself-control, judgment, emotional regulation
AnxietyPredisposition, Temperament
Biological Sensitivity
Adolescent Stress Factors
DrugsSocial appraisal Belonging to a groupGetting good grades
The PerfectStorm
The PerfectStorm
Brain Brain
http://www.pbs.org/wgbh/pages/frontline/shows/teenbrain/view/
TreatmentTreatment
Insight and AwarenessGetting to know Anxiety
Insight and AwarenessGetting to know Anxiety
Skill Building Learning skills to mastery
symptoms
Skill Building Learning skills to mastery
symptoms
PracticeFacing Fears & Using skills
Language we use…Language we use…
Mastering anxietyMastering anxiety
Getting in charge Getting in charge
Turning the volume down Turning the volume down
Riding the waveRiding the wave
Building emotional muscle Building emotional muscle
Don’t Pathologize! Don’t Pathologize!
BRAIN-TargetsBRAIN-Targets
Beliefs about anxietyBeliefs about anxiety
Racing thoughts Racing thoughts “can’t turn the brain off”“can’t turn the brain off”
Negative self-talkNegative self-talk
Recurring thoughts or imagesRecurring thoughts or images
Brain-StrategiesBrain-Strategies
Education about anxietyEducation about anxiety
Awareness of factors influencing anxietyAwareness of factors influencing anxiety
Highlight assets (powerful thinker)Highlight assets (powerful thinker)
Awareness of Attention Awareness of Attention
Examine & challenge thoughtsExamine & challenge thoughts
Replace with more positive/realistic or less Replace with more positive/realistic or less anxious self-talkanxious self-talk
Scale Your Anxiety
1 2 3 4 5 6 7 8 9 10
Things that make my anxiety go
up the scale……
Things that make my anxiety
go down the scale……
I nvestigate what things influence your anxiety positively
or negatively……
Brain- Awareness Brain- Awareness
• Power of AttentionPower of Attention Our brains are powerfulOur brains are powerful What we choose to focus What we choose to focus
on will influence how we on will influence how we feelfeel
By being focused on our By being focused on our worries, we may miss worries, we may miss thingsthings
• Direction of AttentionDirection of Attention
• Biologically we are velcro for Biologically we are velcro for negative thoughts; teflon for negative thoughts; teflon for positivepositive
• Learning to direct our Learning to direct our attentionattention
We Blame Events We Blame Events
EVENTSTrying out for a team
Speaking in publicGoing to School
EVENTSTrying out for a team
Speaking in publicGoing to School
FEELINGSAnxiety Stressed Nervous
FEELINGSAnxiety Stressed Nervous
Thought Investigation and Thought Investigation and ChallengeChallenge
Ideas for helping…Ideas for helping…
Model positive/realistic ThinkingModel positive/realistic Thinking
Highlight the strengths of being an Highlight the strengths of being an powerful thinkerpowerful thinker
Help them use skills Help them use skills scaling scaling highlight positive/more realistic thinking highlight positive/more realistic thinking Help them scrutinize their thoughtsHelp them scrutinize their thoughts
Body Body
How your body reacts…How your body reacts…
Body - TargetsBody - Targets
The Basic (Sleep, Diet & Exercise)The Basic (Sleep, Diet & Exercise)
Body sensations Body sensations Muscle tensionMuscle tension Heart palpitations, SOB, dizziness, nausea, Heart palpitations, SOB, dizziness, nausea,
vomiting vomiting Inability to relax Inability to relax
Body Strategies Body Strategies
Create awareness of body stressCreate awareness of body stress
Learn relaxation skillsLearn relaxation skills
Highlight things that help you to relax Highlight things that help you to relax
Encourage proper care of the body Encourage proper care of the body (sleep, diet, exercise) (sleep, diet, exercise)
Body- The BasicsBody- The Basics
Back to the Basics
Fueling your Body
Eating right will help arm you to deal with any
stress or anxiety.
Are you giving your body what it needs?
Are you eating right?
Are you eating regularly?
Sleep Habits- Good or Bad?
Do you go to sleep at the same time most nights?
I s your sleep space reserved for sleeping only or is it
where you hang out all day?
Do you have a routine way to prepare f or bed?
Do you power down all the electronics (TV, cell phone,
gaming systems, lap top) an hour before bed?
Are you Keeping Active?
Do you take time daily to work out or are you more
of a couch potato?
I s most of your day spent doing non-physical
activities?
I s staying active important to you?
1…2...3...4...5...6...7...8...9...10
1…2...3...4...5...6...7...8...9...10
1…2...3...4...5...6...7...8...9...10
BRIDGES Program, Eastern Health 2013
Body Mapping Body Mapping
Body – Relaxation Body – Relaxation
Back to the Basics (Sleep, Diet, Exercise)Back to the Basics (Sleep, Diet, Exercise)
Play Detective- what already works Play Detective- what already works
Relaxation SkillsRelaxation SkillsVisualization, progressive muscle relaxation, deep Visualization, progressive muscle relaxation, deep breathing etc. breathing etc.
Ideas for helping…Ideas for helping…
Model Positive Self CareModel Positive Self Care
Encourage care of the basicsEncourage care of the basics
Help them use skills Help them use skills Remind them of their skills to relax Remind them of their skills to relax Provide an opportunity for them to practiceProvide an opportunity for them to practice Promote a relaxing environment at homePromote a relaxing environment at home
Behavior Behavior
What we do …What we do …
How we respond….How we respond….
Behavior Targets Behavior Targets
AvoidanceAvoidance
Emotional Outbursts Emotional Outbursts
Excessively Seeking Reassurance Excessively Seeking Reassurance
Behaviors Strategies Behaviors Strategies
Build Emotional MuscleBuild Emotional Muscle
Exposure & Habituation Exposure & Habituation
Additional Coping SkillsAdditional Coping SkillsAssertivenessAssertiveness
Time ManagementTime Management
Social SkillsSocial Skills
Problem Solving etc. Problem Solving etc.
Let’s ride the wave of anxiety& Build emotional Muscle
PRACTICE!!!!!!!!!!!PRACTICE!!!!!!!!!!!
Ideas for helping…Ideas for helping…
Model brave behavior Model brave behavior
Encourage approach behaviorsEncourage approach behaviors
Help develop exposure plansHelp develop exposure plans
Make exposure part of learning Make exposure part of learning
Tips for SupportersTips for Supporters
Listen to the teen & don’t minimizeListen to the teen & don’t minimize
Reduce stress Reduce stress
Have routines Have routines
Normalize anxiety & use age appropriate Normalize anxiety & use age appropriate language language
Model brave behavior Model brave behavior
Model problem solving skills, stress Model problem solving skills, stress management & relaxation management & relaxation
Tips for SupportersTips for Supporters
Avoid excessive reassurance Avoid excessive reassurance
Be mindful of your own reactions Be mindful of your own reactions
Realistic expectations, small stepsRealistic expectations, small steps
Give appropriate consequences Give appropriate consequences
Build self-confidenceBuild self-confidence
Encourage independenceEncourage independence
PRAISE!!!!PRAISE!!!!
You are helping them build skills to master their anxiety!
ResourcesResourcesThe The Responsive ClassroomResponsive Classroom approach is a widely used, research-approach is a widely used, research-backed approach to elementary education that increases academic backed approach to elementary education that increases academic achievement, decreases problem behaviors, improves social skills, achievement, decreases problem behaviors, improves social skills, and leads to more high-quality instruction. and leads to more high-quality instruction. (responsiveclassroom.org)(responsiveclassroom.org)
The FRIENDS program is a school-based anxiety prevention and The FRIENDS program is a school-based anxiety prevention and resiliency skill-building program. BC sponsored by the Ministry of resiliency skill-building program. BC sponsored by the Ministry of Children and Family Development (friendsinfo.net)Children and Family Development (friendsinfo.net)
MindMasters, Mini Mindmasters- Eastern OntarioMindMasters, Mini Mindmasters- Eastern Ontario
BC Anxiety WebsiteBC Anxiety Website
Skills for Life Skills for Life
Referral to Central Intake (local mental services) Referral to Central Intake (local mental services)
QUESTIONS????QUESTIONS????