Parenting Children with Anxiety: Parenting Children with Anxiety: - - PowerPoint PPT Presentation
Parenting Children with Anxiety: Parenting Children with Anxiety: Becoming a Parent Coac Becoming a Parent Coach Dr. Susan Buchanan, Ph.D., C. Psych. Psychologist Front ontena nac F c Fami mily of ly of Schools Presen Schools Presentat
Front
nac F c Fami mily of ly of Schools Presen Schools Presentat tation
Fe February 2 2014
Psychologist
1st
st
What is What is Anxie Anxiety? y? 2nd
nd
Ho How Do w Do Thoughts and F Thoughts and Feelings Af eelings Affect Anxiety? ct Anxiety? 3rd
rd
Ho How Can Y w Can Your Child Learn t ur Child Learn to R Relax? lax? 4th
th
Ho How Can Y w Can You Help Y elp Your Child Learn t ur Child Learn to Manage Manage Anxie Anxiety? y?
What Causes
What Causes Anxie Anxiety in y in Children? Children?
Normal F
Normal Fear ars? s?
When Does Anxiety Become a Pr
When Does Anxiety Become a Problem?
Anxie
Anxiety Disor y Disorder ers in s in Childhood Childhood
Fear ars are a normal & natural par s are a normal & natural part of lif
9 months: fear of separating from caregiver & fear of strangers 2 to 3 years: natural fears develop 9 to 10 years: self-consciousness develops
Ho How do y w do you decide if y u decide if your child’s f ur child’s fear is “abnormal”? ar is “abnormal”?
Anxie
Anxiety is y is normal. normal.
Anxie
Anxiety is y is no not danger t dangerous.
Anxie
Anxiety is y is adaptiv adaptive.
Anxie
Anxiety becomes a pr y becomes a problem when our body reacts in
the absence of real danger the absence of real danger.
So, c So, children with anxie ildren with anxiety pr y problems can sim
ly be thought of as ha thought of as having normal w ving normal worries that ha rries that have become become more e more extreme and more intrusiv xtreme and more intrusive than those of o e than those of other her children. ildren.
Does y
Does your c ur child ild’s anxie s anxiety int y interfere or cause dif ere or cause difficulties f iculties for y r your ur ch child?
Ke Key:
If causing upse If causing upset and distress. t and distress. If st If stopping activities she or he pre
iously liked. d. If af If affecting y cting your child academically ur child academically, socially , socially, or , or in athle in athletic pur ic pursuits. uits.
When our body reacts in the absence of real danger… When our body reacts in the absence of real danger…
rapid heart rate rapid breathing, feelings of shortness of breath, or breath
holding
discomfort or pain in the stomach, nausea feeling very hot or cold sweating trembling or shaking numbness or tingling headaches chest pain or discomfort dizzy, lightheaded, or unsteady feelings feelings of a lump in the throat or choking feeling things are unreal or feeling detached from oneself
situations (e.g., going to par parties with friends, ies with friends, pla playing outside at recess) ing outside at recess)
repeat
repeatedly asks f edly asks for r reassurance
estions
engages in
engages in inappr inappropriat
e saf
Anxious children t Anxious children tend t nd to… Have fewer friends Engage in fewer after-school activities. May do well at school, but not as well as they could.
As adults, the
As adults, they ma may… y… Be more likely to abuse alcohol and other drugs, be
unemployed, have illnesses and visit medical clinics, be depressed and even suicidal. Most adults diagnosed with anxiety recognize that Most adults diagnosed with anxiety recognize that their anxie their anxiety star y started in ed in childh childhood.
Separation Anxiety Disorder Generalized Anxiety Disorder Social Anxiety Disorder Specific Phobia Obsessive Compulsive Disorder Post-traumatic Stress Disorder Selective Mutism School Refusal Behaviour Panic Disorder
Identify Negativ
Identify Negative Aspects of Being Anxious Aspects of Being Anxious
Identify Ho
Identify How Y w Your Body R ur Body Responds t sponds to Anxiety & Anxiety & Fear ar
Teach the Language of F
ach the Language of Feelings eelings
Teach Y
ach Your Child t ur Child to Identify Anxious Thoughts Identify Anxious Thoughts
Build Ne
Build New Coping Strat w Coping Strategies gies
FOCUS on identifying
CUS on identifying
(What keeps the anxiety going when the cause or trigger is over?)
The w
The w
The w
(Com (Comple plete this f e this form t rm toge gether ther )
Can be yo
your f feelings, w what yo you b believe eve t that yo your c child feels, or an eels, or an anon anonymous anxious per ymous anxious person. son.
Mak
Make a list of w a list of ways in ys in which y which your child’s lif ur child’s life will will be be dif different when anxiety is no longer bossing him or her erent when anxiety is no longer bossing him or her ar around.
Increased heart rate, blood
pressure
Breathing harder Shaky legs Sweaty hands Muscle tension Upset stomach
Parasym Parasympathetic Ner athetic Nervou
s Syst System: em:
About the body
s response to f fear ar.
The f
The fear response is ar response is the “fight or flight response. the “fight or flight response.
It w
It won’t hur t hurt y you and y u and you will be OK. u will be OK.
Our goal is t Our goal is to t teach y ach your child…. ur child….
Fear response… ar response… Increased heart rate,
blood pressure
Breathing harder Shaky legs Sweaty hands Muscle tension Upset stomach
What aspect of our
What aspect of our body’s functioning body’s functioning can w can we change and change and contr control? l?
Paced breathing or Calm Breathing
Paced breathing or Calm Breathing
Pr
Progressiv
e Muscle Relaxation laxation
Visualization
Visualization
Mindful Meditation
Mindful Meditation
Common elements: Common elements:
Quie Quiet place a t place away fr from distractions.
Dedicat Dedicated time. Same time, e d time. Same time, ever eryda yday. Comf Comfor
table furniture. Seat Seated or la ed or laying position. ying position. Ey Eyes closed or looking at ONE spo es closed or looking at ONE spot. Listen to to Re Relaxation Re Record rding.
Place y
Place your hand on y ur hand on your st ur stomach.
Breathe in
Breathe in thr through y ugh your nose. ur nose.
Counting 1, 2, 3. 4. Pause.
Breathe out thr
Breathe out through y ugh your nose or mouth. ur nose or mouth.
Counting 1, 2, 3, 4. Pause
If y
If you breathe out with y u breathe out with your mouth, k ur mouth, keep it closed eep it closed except f cept for a small hole, the size y r a small hole, the size you w u would use t uld use to suck suck
KEY POINTS: Slow breathing. Filling and emptying lungs.
Breathe in
Breathe in thr through y ugh your nose. ur nose.
Breathe out
Breathe out in slo in slow, gentle, long breaths. , gentle, long breaths.
Image blo
Image blowing a bubble – wing a bubble – big, rainbo ig, rainbow bubbles. w bubbles.
Imagine blo
Imagine blowing the bubble higher and higher wing the bubble higher and higher. KEY POINT KEY POINT: Slo Slow, gentle, long breath out. , gentle, long breath out. Added visual image helps t dded visual image helps to engage children in the engage children in the activity activity.
Mak
Make a f a fist. Hold it tight. Tight
Feel the t eel the tension. nsion. No Now, let go. let go. Let y Let your hand dr ur hand drop.
Feel
eel the t the tension draining out of y nsion draining out of your hands, do ur hands, down wn your f ur finger ngers.
Letting Go. Relaxing. laxing. REPEA REPEAT THIS A SECOND TIME. THIS A SECOND TIME.
Do this f
Do this for dif r different areas of the body: head/f erent areas of the body: head/face, ace, shoulder shoulders, arms, st s, arms, stomach, legs.
KEY POINT KEY POINT: Creat Create t tension in the nsion in the muscles. Let go of t
nsion. Feel the absence of t eel the absence of tension.
lax.
Tell y
ll your arms that the ur arms that they f feel eel wa warm. . The They f feel eel wa warm and hea and heavy.
Repeat this tw
peat this two times.
peat for each large area r each large area
Tell y
ll your head that it f ur head that it feels eels calm and cool calm and cool. . Your ur forehead and head f rehead and head feels eels calm and cool calm and cool.
KEY POINT KEY POINT: Visualizing the relax Visualizing the relaxed f d feeling in the body eeling in the body – feeling eeling w warm, hea rm, heavy, and relax and relaxed, BUT y d, BUT your head is calm and ur head is calm and cool when it is relax cool when it is relaxed. d.
Visualization Script: Visualization Script:
Imagine in your mind, a place where you feel
relaxed, calm, and happy. Write the story together.
This image is specific to each person. Engage all of the senses: What does it smell like?
Look like? Feel like? Sound like? Taste like?
KEY POINT KEY POINT: Engage all senses in the visualization. F Engage all senses in the visualization. Focus the cus the mind on pleasant, calming images. mind on pleasant, calming images.
Relaxation training: laxation training:
Practice so the feeling is familiar. Practice so your child can use it in daily living. Practice will be able to shorten the time it
takes to obtain the feeling.
St
Stops the stress response.
Initiat
Initiates the relaxation response. s the relaxation response.
“F
“Feel Good” (endor eel Good” (endorphines) hormones are hines) hormones are released with relaxation training e released with relaxation training exer ercises, cises, meditation… meditation…
Identify Negativ
Identify Negative Aspects of Being Anxious Aspects of Being Anxious
Identify Ho
Identify How Y w Your Body R ur Body Responds t sponds to Anxiety & Anxiety & Fear ar
Teach the Language of F
ach the Language of Feelings eelings
Teach Y
ach Your Child t ur Child to Identify Anxious Thoughts Identify Anxious Thoughts
Build Ne
Build New Coping Strat w Coping Strategies gies
De Developing a Ne loping a New Language of w Language of Feeling W eeling Words “A F Feeling V eeling Vocabular cabulary”
Name the f
Name the feeling. eeling.
Teach feeling words by playing games.
The W
Introduce your child to the
feeling thermometer.
Measures intensity of the
feeling.
10 9 8 7 6 5 4 3 2 1
Feeling v
eeling vocabular cabulary: sad, w : sad, worried, angr rried, angry, mad, e mad, etc. c.
Ho
How big w big is y is your W ur Worr rry Dragon? y Dragon?
Refer t
r to the F the Feeling Thermome eeling Thermometer – r – use the language of se the language of number numbers s
Identify Negativ
Identify Negative Aspects of Being Anxious Aspects of Being Anxious
Identify Ho
Identify How Y w Your Body R ur Body Responds t sponds to Anxiety & Anxiety & Fear ar
Teach the Language of F
ach the Language of Feelings eelings
Teach Y
ach Your Child t ur Child to Identify Anxious Thoughts Identify Anxious Thoughts
Build Ne
Build New Coping Strat w Coping Strategies gies
Self- Self-Talk or alk or Automatic Thoughts matic Thoughts Identify Thinking T Identify Thinking Traps aps Learn t Learn to Le Let Go and t t Go and to Train Y ain Your Brain t ur Brain to Think Right Think Right
Thoughts are things w
Thoughts are things we sa say t y to our
elves in our head. s in our head.
Thoughts are im
Thoughts are impor portant because the ant because they cause f cause feelings elings and beha and behaviour viours.
Thoughts can either be calm or w
Thoughts can either be calm or worried. rried.
Worried thoughts can of
rried thoughts can often be changed b n be changed by being a being a good det good detectiv ctive & e & looking f looking for e r evidence. idence.
Understand what thoughts are
Understand what thoughts are
Become skilled at identifying y
Become skilled at identifying your o ur own thoughts. n thoughts.
Practice b
Practice by k keepin eeping a journ a journal or a w l or a worr rry jar/bo y jar/box
Anxious f
Anxious feelings go along with thoughts of danger elings go along with thoughts of danger.
Anxious children e
Anxious children expect bad things t pect bad things to happen. happen.
Worried thoughts
rried thoughts lead t lead to f fear ar, w , worr rry, sh shyness, or yness, or anxie anxiety.
Your feelings depend on what you are telling yourself about a situation. No one can make you angry. You make yourself angry. Your BELIEFS about a situation or event determines how you feel about it.
1. 1.
Anxious people will o Anxious people will overestimat erestimate ho how lik w likely it is ly it is that bad e that bad events will occur ents will occur.
2. 2.
Anxious people usually assume that the outcomes Anxious people usually assume that the outcomes
uences of feared e ared events will be ents will be catastr catastrophic or unbearable. phic or unbearable.
Fo For ex example, d doing h homewo work.
OVERES ERESTIMA TIMATING THE CONSEQUENCES… TING THE CONSEQUENCES…
Walking with blinder
lking with blinders
Only seeing the negative and overlooking the good in a situation.
The R
The Repe petit titor
If it happened once it is always going to happen that way.
The Catastr
The Catastrophiser (P phiser (Pessimist) essimist)
Always thinking the ‘worst ever’ is going to happen.
The A
The Avoider
Staying away from situations you think are scary without trying
first.
The Mind R
The Mind Reader or F ader or Fortune T une Teller ller
Jumping to conclusions about a person/thing/situation without
the facts. The Shoulds
The Shoulds
The ‘Shoulds’ is like having a cold. I should always do everything right. I shouldn’t make mistakes.
The P
The Perfectionist ectionist
Setting expectations that are too high. Perfectionism
is not a human option.
Be a detective and look for Thinking Traps
By learning t
By learning to think more realistically think more realistically, y , you can learn t u can learn to contr control y l your anxie ur anxiety.
Reality is
ality is that bad things will happen. A that bad things will happen. At these times, it these times, it is is appr appropriat
e to be anxious. be anxious.
Goal is t
Goal is to t teach y ach you ho u how t w to manage anxie manage anxiety most of the y most of the time, when it is time, when it is excessiv cessive and out of pr and out of propor
tion to the real the real situation. situation.
A
A situation that doesn’t ha situation that doesn’t have a a clear cause or outcome. clear cause or outcome.
Situation could ha
Situation could have dif different causes… erent causes…
POSITIVE POSITIVE NEUTRAL NEUTRAL NEGA EGATIVE IVE
Activity: tivity: Sam is w Sam is walking do lking down the wn the stree street t and sees a big dog and sees a big dog sitting on the y sitting on the yard. What thoughts w What thoughts would be uld be helpful helpful in this n this situation? situation? And unhelpful? And unhelpful?
Anxious people t
Anxious people tend t nd to o
erestimate the pr the probability
that their negativ that their negative thoughts about a situation are thoughts about a situation are TR TRUE. UE.
Learn ho
Learn how t w to realistically e realistically evaluat aluate the lik the likelihood that lihood that their int their interpre rpretation/belief is true. tation/belief is true.
Learn ho
Learn how t w to realistically e realistically evaluat aluate the lik the likelihood that lihood that their int their interpre rpretation/belief is true. tation/belief is true.
5 steps:
1.
Identify what you are worried about (i.e., your worried thought).
2.
Gather evidence for worried thought.
3.
Gather alternative/positive thoughts.
4.
Evaluate the evidence and decide…how much do you believe it to be true now?
5.
What can be my alternative thoughts?
I can do this, I will be OK.
I can do this, I will be OK.
I am str
I am stronger
than I think.
I can handle this.
I can handle this.
I can cope with most things.
I can cope with most things.
I can f
I can feel anxi eel anxious and stil
l do it.
I will no
I will not le t let anxie t anxiety st y stop me fr
ving fun.
It’s just anxie
It’s just anxiety, it’s no it’s not danger t dangerous, and it’s just t
arily y uncomf uncomfor
table. e.
These are just m
These are just my anxious thoughts. I don’t ha anxious thoughts. I don’t have t to belie believe e them. them.
Anxie
Anxiety is bullying me! I don’t ha y is bullying me! I don’t have t to list listen. en.
I don’t need t
I don’t need to assume the w assume the worst. t.
It’s ok
It’s okay.
Some
Sometimes w times we can le can let the thoughts float a t the thoughts float away lik like though thought bubbles or t bubbles or imagine them floating a imagine them floating away do down a stream. wn a stream.
We don’t alw
don’t always ha ys have t to challenge thoughts, challenge thoughts, some sometimes w times we can just “LET THEM GO”. can just “LET THEM GO”.
Identify Negativ
Identify Negative Aspects of Being Anxious Aspects of Being Anxious
Identify Ho
Identify How Y w Your Body R ur Body Responds t sponds to Anxiety & Anxiety & Fear ar
Teach the Language of F
ach the Language of Feelings eelings
Teach Y
ach Your Child t ur Child to Identify Anxious Thoughts Identify Anxious Thoughts
Build Ne
Build New Coping Strat w Coping Strategies gies
Identifying Goals Identifying Goals Creating a F Creating a Fear Ladder ar Ladder Exposure, Exposure, Exposure Exposure, Exposure, Exposure Reward f for Ef r Effort no not Outcome t Outcome
Star
Start with an activity that ANXIET t with an activity that ANXIETY S Y STOPS. Choose one that
he/she w he/she wants t nts to do again (THIS IS Y do again (THIS IS YOUR GO UR GOAL). AL).
Mak
Make a list of all the st a list of all the steps in eps involv lved in doing these activities ed in doing these activities again (THESE ARE Y again (THESE ARE YOUR S UR STEPS). EPS).
Rank or
Rank order these situations accor der these situations according t ing to le level of f l of fear (use ar (use fear thermomet ar thermometer) (THIS IS Y r) (THIS IS YOUR PLAN). UR PLAN).
Just do it!
Just do it!
Check in:
Check in: Recor cord ho how it w w it went at each st nt at each step. ep.
Step Anxiety Rating
Give public speaking speech to the class and answer questions. 10/10 Raise my hand to answer a question during class. 9/10 Ask a question after someone else’s public speaking speech. 9/10 Practice public speaking speech in front of two friends, looking up every few seconds. 8/10 Volunteer to read part of a book passage during English class. 8/10 Imagine giving my public speaking speech to the class. 7/10 Read public speaking speech in front of two friends after school in the classroom. 6/10 Read public speaking speech in front of my best friend after school in the classroom. 4/10 Practice public speaking speech alone in front of the mirror. 3/10 Read public speaking speech alone in my room. 2/10
What is m What is my goal? goal? To be able to give my public speaking speech in front
It is normal t
It is normal to w want t nt to a avoid distressing situations,
ho however r it is no it is not helpful t helpful or health
Danger
Dangers of a
r the long term, rm, avoidance actually maintains anxie
Alt
Alternativ rnative action plan: e action plan:
is… the belief the belief that one can succeed at tasks. that one can succeed at tasks.
Nothing diminishes anxiety faster than action. Nothing diminishes anxiety faster than action. Walter Anderson The only thing we have to fear is fear itself. The only thing we have to fear is fear itself. Franklin D. Roosevelt And the day came when the risk to remain And the day came when the risk to remain tight in the bud was more painful than the risk tight in the bud was more painful than the risk it took to blossom. it took to blossom. Anais Nin
Identify Negativ
Identify Negative Aspects of Being Anxious Aspects of Being Anxious
Identify Ho
Identify How Y w Your Body R ur Body Responds t sponds to Anxiety & Anxiety & Fear ar
Teach the Language of F
ach the Language of Feelings eelings
Teach Y
ach Your Child t ur Child to Identify Anxious Thoughts Identify Anxious Thoughts
Build Ne
Build New Coping Strat w Coping Strategies gies
ALWAYS CONSIDER……
We Website R Resources: Anxie Anxiety BC y BC http://www http://www.anxie nxietyb tybc.com/ Mindma Mindmast sters CD CD http://ww http://www.child hild-y
th-health. lth.ne net/e t/englis ish/pub h/publicatio ions ns-a
nd-resources/mind /mindmasters- rs-cd-tra track-lis list/ Minds Minds Up! ! http://theha http://thehawnfound undatio tion.org/m rg/mindup/ indup/ Childre Children’s Mental Hea Mental Health Ontario (CMHO) th Ontario (CMHO) http://ww http://www.kid idsmenta talhe lhealth. lth.ca ca/ RBC & RBC & Childre Children’s Mental Mental Health Health http://ww http://www.rbc.com/co /community mmunity-s
ustainability/comm inability/community/childrens-ment unity/childrens-mental-health/trust al-health/trusted-resour resources.html ces.html Books: Books: What to to d do w when y you w worry to too m much? By Da By Dawn wn Hueb Huebne ner Think Good F Think Good Feel Good eel Good by Paul Paul Stal allard