STRESS MANAGEMENT FOR YOUR ADOLESCENT: PARENT ESSENTIALS

Transcription

1 STRESS MANAGEMENT FOR YOUR ADOLESCENT: PARENT ESSENTIALS Nancy L. Heath, PhD OVERVIEW: STRESS MANAGEMENT FOR YOUR ADOLESCENT Background Understanding Stress Strategies for Stress Concluding Comments 1

2 INTRODUCTION BACKGROUND ACADEMIC STRESS AND SUICIDE IN HONG KONG ACADEMIC STRESS: Academic stress in Hong Kong has been found to be associated with depression and suicidality. The view that academic results determines the future puts great pressure on students to achieve and the competitive system makes success challenging. (Lee, M. T. Y., Wong, B. P., Chow, B. W.-Y., & McBride-Chang, C., 2006) 2

3 BACKGROUND YOUR ADOLESCENT IS NOT ALONE 38.7% of young people in Hong Kong reported moderate to extreme anxiety Stress is increasing in both young people and parents 1 in 3 students in Hong Kong suffer from stress, anxiety or depression HONG KONG Stress among adolescents in Hong Kong is on the rise. VS. NORTH AMERICA 1 in 3 youth report moderate to severe stress BACKGROUND STUDENT STORIES 3

4 BACKGROUND WHY SO MUCH STRESS? CAUSES OF STRESS IN A COMPLEX WORLD Performance More competitive Genetic/ Temperament Peer Family More connected More stressed World Events More aware BACKGROUND CAUSES OF STRESS FOR ADOLESCENTS: HONG KONG 60% Parental Expectations 38% Socializing with Friends 13% Extracurricular Activities 18% Academic Performance High Self- Expectations 50% 26% Family Relationships 12% Other 4

5 BACKGROUND CONTRIBUTORS OF STRESS Stress is within the individual, a within person experience. CULTURE INSTITUTIONS COMMUNITY FAMILY Social and cultural values Indirect environment (ex. parents workplaces, schoo system) Neighborhood, Classrooms, Peer groups Immediate surroundings (ex. family, friends, partners) UNDERSTANDING STRESS: WHAT IS STRESS? 5

6 UNDERSTANDING STRESS STRESS IS AN INTERNAL EXPERIENCE WE HAVE WHEN WE PERCEIVE THE DEMANDS OF THE SITUATION ARE MORE THAN WE CAN COPE WITH. UNDERSTANDING STRESS WHAT IS STRESS? I m going to fail this test! STRESS 6

7 UNDERSTANDING STRESS MEASURE OF STRESS In the last month have they: 1. Been upset because of something that happened unexpectedly? 2. Felt that they were unable to control the important things in your life? 3. Felt nervous and stressed? 4. Questioned their ability to handle their personal problems? 5. Felt that things were just not working out for them? Cohen, S., Kamarck, T., & Mermelstein, R. (1994) UNDERSTANDING STRESS RESPONDING EFFECTIVELY TO STRESS Responding effectively to stress involves the use of multiple strategies to regulate emotions at different time points of a stressful situation EVENT BEFORE DURING AFTER 7

8 UNDERSTANDING STRESS EMOTION REGULATION Emotion regulation is a term used to describe the process by which we manage the experience and expression of our emotions and has three parts: REACTIVITY How easily you react to stimuli with emotion INTENSITY How intensely you feel the emotion RECOVERY How long the emotion persists, or how quickly you recover from the emotion UNDERSTANDING STRESS EMOTION REACTIVITY SCALE Reactivity: I tend to get emotional very easily Not at all like me...completely like me Intensity: When I experience emotions, I feel them very strongly/intensely Not at all like me...completely like me Recovery: When I am angry/upset, it takes me much longer than most people to calm down Not at all like me...completely like me

9 Performance UNDERSTANDING STRESS IS STRESS ALWAYS BAD? Stress is often thought of as bad, but it can actually be protective and good! The human brain is hard-wired to respond to danger. The fight or flight response is what has helped humans protect themselves from danger throughout evolution. Whether the threat is real or perceived, our stress response is activated, which has physiological effects. UNDERSTANDING STRESS GOOD VS. BAD STRESS Exhaustion Relaxed Anxiety/panic/anger Inactive Breakdown Too little stress Optimal Stress Stress Overload Burnout Stress Level 9

10 IDENTIFYING STRESS SIGNS OF STRESS.. EMOTIONAL Nervousness Oversensitivity Irritability Anger PSYCHOLOGICAL Rumination Hopeless/ Poor Problem-solving Catastrophizing Difficulty concentrating PHYSICAL Headaches Muscle tension Fatigue Stomach aches BEHAVIOURAL Drug/alcohol use Excessive internet use Self-injury Change in eating habits Difficulty sleeping IDENTIFYING STRESS STRESS PROFILE Psychological/Emotional Physical Behavioral Difficulty concentrating Racing thoughts Persistent worry Forgetfulness Difficulty falling asleep due to racing thoughts Low self-esteem Difficulty making decisions Blowing things out of proportion Confusion Unable to let go of unsettling thoughts or feelings Headache Stomach pain and/or digestive problems Feeling tired Muscle tension Jaw clenching or teeth grinding Difficulty falling asleep due to tenseness Skin conditions (ex. rash or hives) Neck or back pain Change in appetite (increased or decreased) Rapid heart beat or tightness in chest Nail biting Constant pacing Persistent foot tapping or constant fidgeting Angry outbursts Frequent crying spells Avoiding situation that cause stress Overeating or not eating enough Fast or abrupt speech Getting into fights Poor choices to manage stress (ex. Not eating properly, substance use, self-injury) SCORE SCORE SCORE 10

11 IDENTIFYING STRESS KEEP IN MIND! Keep in mind, stress in adolescents does not always look like stress! Stressed adolescents may: Be tired, non-responsive Appear to "not care" Never try to ramp up stress Be angry or non-compliant IDENTIFYING STRESS IDENTIFYING STRESS OVERLOAD ADOLESCENTS Stress comes and goes for no apparent reason. Feel unable to cope. Can t seem to relax; feel tense most of the time. Feel a general loss of control. Stress becomes problematic when it interferes with day-to-day functioning 11

12 IDENTIFYING STRESS STRESS OVERLOAD ANXIETY AND DEPRESSION Struggling with chronic stress can lead to anxiety/depression Stress Anxiety/ Depression Anxiety/depression reduces one s ability to cope IDENTIFYING STRESS STRESS AND UNHEALTHY COPING Excessive gaming/internet use Substance abuse Overeating or food restriction Non-suicidal self-injury Suicide Risk 12

13 EMOTION REGULATORY STRESS MANAGEMENT STOP, THOUGHT CHALLENGE MUSCLE RELAXATION BREATHING MINDFULNESS DISTRESS TOLERANCE SELF-CARE 13

14 COGNITIVE BEHAVIOURAL: THOUGHT CHALLENGE For self-critical rumination or repetitive negative thoughts. Adolescent visualizes a stop sign I am so stupid! Which indicates to stop and take a deep breath And challenge the critical thought as if they were their own best friend. MUSCLE RELAXATION Muscle Relaxation Physically turns off the stress response. No cognitive requirements. Can be done anywhere. Involves tensing and then relaxing each muscle group in the body. As you tense-relax you focus on and notice the FEELING of the muscles. 14

15 MUSCLE RELAXATION Muscle Relaxation Physically turns off the stress response. No cognitive requirements. Can be done anywhere. Involves tensing and then relaxing each muscle group in the body. As you tense-relax you focus on and notice the FEELING of the muscles. BREATHING 1: ESSENTIAL STRESS MANAGEMENT Belly breathing Diaphragmatic or Belly breathing is the most effective type of breathing to manage stress, the goal should be to be doing this most of the time. 15

16 BREATHING 1: ESSENTIAL STRESS MANAGEMENT Belly breathing Diaphragmatic or Belly breathing is the most effective type of breathing to manage stress, the goal should be to be doing this most of the time. BREATHING 2: ESSENTIAL STRESS MANAGEMENT To calm down: Calming breath Place your right hand over your heart, your left hand on your lower abdomen below the navel. As you inhale/exhale try to make your belly hand go up and down while keeping your heart hand mostly still. Inhale through the nose for 4 slow counts, hold for 2, exhale through the mouth for 6 slow counts. 16

17 BREATHING 2: ESSENTIAL STRESS MANAGEMENT MINDFULNESS: WHAT IS IT? Acceptance of presentmoment experience Awareness of the present moment Paying attention on purpose Kabat-Zinn,

18 MINDFULNESS: EFFECTIVENESS Mindfulness has been used in a number of high stress demanding professions to enhance performance and ability to function under stress MINDFULNESS IN HONG KONG 18

19 MINDFULNESS IN HONG KONG MINDFULNESS IN HONG KONG 19

20 MINDFULNESS: Informal Mindfulness Mindful Moments (e.g., grounding, coming to your senses etc.) There are many mindfulness strategies to choose from. Mindful Practices (e.g., body scan, mindful movement, sitting meditation etc.) Achieving Mindfulness MINDFUL MOMENTS: COMING TO YOUR SENSES Brief moments where we become aware of our senses without judgments or labeling (30s-2min) EXAMPLE: momentary awareness of physical sensations, of sounds, etc. Should be interspersed throughout the day, ideally once per hour 20

21 MINDFUL MOMENTS: COMING TO YOUR SENSES Just listen MINDFULNESS: MEDITATION SPOTLIGHT SPOTLIGHT attention on different aspects of your moment-to-moment experience Observing breath, sensations, emotions, and thoughts in turn without judgment Enhances awareness and concentration, helps us understand thoughts as just thoughts Helps us be less influenced by our inner critic 21

22 MINDFULNESS: MINDFUL MOVEMENT Focusing attention on your body and movement with acceptance Develops a sense of body awareness and grounding in the present moment MINDFULNESS: BODY SCAN Focusing attention to body parts in progression and without judgment Helps us to become aware of and more connected to our body and be able to let go of tension in our body Grounds us in the moment 22

23 MINDFULNESS: BODY SCAN Focusing attention to body parts in progression and without judgment Helps us to become aware of and more connected to our body and be able to let go of tension in our body Grounds us in the moment Some common challenges Restlessness Distracting Thoughts Physical Discomfort Intense Emotions or Extreme Discomfort MINDFULNESS: BODY SCAN Focusing attention to body parts in progression and without judgment Helps us to become aware of and more connected to our body and be able to let go of tension in our body Grounds us in the moment 23

24 MINDFULNESS: YOGA NIDRA Bringing awareness to different parts of the body in sequence to relax the body This strategy will help your adolescent achieve a deep state of relaxed sleep DISTRESS TOLERANCE When all else fails, distress tolerance are strategies for managing when your adolescent feels like what they are feeling inside is INTOLERABLE, and can NOT stand it. 24

25 DISTRESS TOLERANCE Distraction TIP Ride the Wave DISTRESS TOLERANCE: DISTRACTION Distraction might seem easy, but sometimes, when an adolescent is upset, worried, angry, or sad, it can be hard for them to think about anything else. Distraction is sometimes viewed as a negative thing, but it can get us through bad moments. Ask them to try an activity or spend time with someone! Have them focus on someone else! Have them play music or use their creative outlet! 25

26 DISTRESS TOLERANCE: TIP T I P T is for temperature. We can adjust the temperature of our body. Cold water on our face. I is for Intense Exercise. Increase your heart rate. P stands for paced breathing, calming breath. DISTRESS TOLERANCE: RIDE THE WAVE Riding the wave means being the observer and watching our emotions in all their intensity. COMFORTABLE WITH DISCOMFORT! 26

27 SELF-CARE TRAINING FOR STRESS Often, adolescents (and us!) may make unhealthy choices at the most stressful of times to manage their stress. Structure that improves lifestyle: Sleep, Regular healthy eating, Aerobic exercise 3X week Self-care means doing the opposite during high stress taking care of themselves by making healthier choices. Idea of going into training for periods of high stress! THE BIG PICTURE: SURVIVING FAILURE Growth Mindset Grit Dr. Carol Dweck of Stanford University s growth mindset: When students understand failure as learning, it makes them stronger and they achieve better. Dr. Angela Duckworth of University of Pennisylvania research on grit recognizes that achievement isn t reserved for those with highest intelligence, but for those who redefine their failure and continue to strive for success and persevere. Duckworth, 2007; Dweck,

28 THE BIG PICTURE: SURVIVING FAILURE Growth Mindset Grit Failure helps me learn I haven t got it YET Excellence does not mean perfection it means persistence in achieving your goal Duckworth, 2007; Dweck, 1988 SURVIVING FAILURE When your adolescent compares themselves to others, they might feel like the first path is the only way to achieve success. In reality, many people don t have that single path. We find alternative paths and still achieve our goals! FAIL FAIL FAIL Path to success? FAIL 28

29 SURVIVING FAILURE Path to success? FAIL Actual path for many! When your adolescent compares themselves to others, they might feel like the first path is the only way to achieve success. In reality, many people don t have that single path. We find alternative paths and still achieve our goals! FAIL FAIL FAIL FAIL FAIL FAIL FAIL GRID OF STOP, THOUGHT CHALLENGE MUSCLE RELAXATION BELLY BREATHING CALMING BREATH MINDFULNESS COMING TO YOUR SENSES BODY SCAN SITTING MEDITATION MINDFUL MOVEMENT YOGA NIDRA DISTRACTION TIP RIDE THE WAVE SELF-CARE GROWTH MINDSET GRIT 29

30 IN SUMMARY STRATEGY RECOMMENDATION: WHEN AND WHERE TO USE IT The following section will briefly present where and when you can use strategies. HOME SCHOOL ELSEWHERE RECOMMENDATIONS: AT SCHOOL When they re preparing for an exam Right before a difficult exam or assignment After an exam or difficult assignment Self-care training (e.g., get enough sleep, eat healthy and exercise) Having a regular mindfulness practice (e.g., practice minutes per day) Yoga nidra TIP Muscle Relaxation (they can do this invisibly in their seat!) Calming Breath Mindful Movement Growth Mindset Grit Stop, thought challenge Mindful movement 30

31 RECOMMENDATIONS: ELSEWHERE When they re feeling selfcritical When they re feeling anxious When they re feeling distressed Growth Mindset Grit Stop, thought challenge Belly breathing Body scan Muscle relaxation Calming breath Momentary mindfulness Muscle relaxation TIP Calming breath Ride the Wave Distraction S STUDENT STORIES 31

32 WHAT YOU CAN DO AS A PARENT WHEN TO SEEK PROFESSIONAL HELP FOR YOUR ADOLESCENT? Is their day-to-day functioning significantly impacted? Are they engaging in unhealthy coping behaviors/avoidance to manage his or her stress? Is their stress severe, pervasive and lasts? CONCLUDING COMMENTS CONCLUSION When adolescents understand their own stress, they are stronger! CULTURE INSTITUTIONS COMMUNITY FAMILY With strategies for stress management they are more resilient! And with the right perspective, they can consider other ways of succeeding! 32

33 S DOWNLOADABLE S Perceived stress scale (PSS) Emotion Regulation Scale: reactivity, intensity and recovery Stress Profile Recommendations Grid of strategies S DOWNLOADABLE S Perceived stress scale (PSS) Emotion Regulation Scale: reactivity, intensity and recovery Stress Profile Recommendations Grid of strategies 33

34 S DOWNLOADABLE S Perceived stress scale (PSS) Emotion Regulation Scale: reactivity, intensity and recovery Stress Profile Recommendations Grid of strategies S DOWNLOADABLE S Perceived stress scale (PSS) Emotion Regulation Scale: reactivity, intensity and recovery Stress Profile Recommendations Grid of strategies 34

35 S DOWNLOADABLE S Perceived stress scale (PSS) Emotion Regulation Scale: reactivity, intensity and recovery Stress Profile STOP, THOUGHT CHALLENGE MINDFULNESS MINDFUL MOVEMENT MUSCLE RELAXATION COMING TO YOUR SENSES BELLY BREATHING BODY SCAN CALMING BREATH MEDITATION SPOTLIGHT YOGA NIDRA DISTRACTION TIP Recommendations Grid of strategies RIDE THE WAVE SELF-CARE GROWTH MINDSET GRIT S DOWNLOADABLE S TedTalk: Angela Duckworth TedTalk: Carol Dweck Growth mindset vs. Fixed mindset 35

36 S DOWNLOADABLE S TedTalk: Angela Duckworth TedTalk: Carol Dweck Growth mindset vs. Fixed mindset S DOWNLOADABLE S TedTalk: Angela Duckworth TedTalk: Carol Dweck Growth mindset vs. Fixed mindset 36

37 S FREE SMART PHONE APPLICATIONS The Parent Toolkit is a one-stop shop to support your adolescent s success from pre-k to 12th grade. It has helpful tips to work learning and a healthy lifestyle into your busy schedule. Produced by NBC News and sponsored by Pearson. Smiling Mind is modern meditation, a unique web and app-based program developed by psychologists and educators to help bring balance to people s lives. The app provides developmentally appropriate mindfulness/stress management activities that can be selected for children, teenagers, or adults. Pacifica gives you psychologist-designed tools based on Cognitive Behavioral Therapy, mindfulness meditation, relaxation, and mood/health tracking. Happify brings you effective tools and programs to take control of your emotional wellbeing. Their techniques are developed by leading scientists and experts who've been studying evidence-based interventions in the fields of positive psychology, mindfulness and cognitive behavioral therapy for decades. THANK YOU! Dr. Nancy Heath nancy.heath@mcgill.ca QUESTIONS 37