2/8/ List three homework assignments to give anxious families. 2. Describe three ways that families strengthen anxious patterns.

Transcription

1 1. List three homework assignments to give anxious families. 2. Describe three ways that families strengthen anxious patterns. 3. Describe the difference between content and process when treating anxiety. 1

2 An anxious mother, due to her own cognitive bias toward threat and avoidance of threat, may overprotect her children regardless of the child s temperament and become more involved than other, less anxious mothers. Lead researcher Golda Ginsburg reports data showing that the children of parents diagnosed with an anxiety disorder are up to seven times more likely to develop an anxiety disorder themselves, and up to 65 percent of children living with an anxious parent meet criteria for an anxiety disorder. Hudson & Rapee, Journal of Clinical Child & Adolescent Psychiatry, Dec. 2002; 31(4): 553 Ginsburg, et al., The Child Anxiety Prevention Study: Intervention Model and Primary Outcomes. Journal of Consulting and Clinical Psychology, 77(3), June 2009, Anxious parents and children... Children of anxious parents are more likely to Children of anxious parents are more likely to Barrett, Rapee, Dadds, & Ryan, 1996; Bogels & Zigterman, 2000; Weems, et al.,

3 handle discomfort and uncertainty manage emotions demonstrate flexibility make mistakes and manage failure Accommodation Anything done in service to the avoidance, without any teaching or skill building adjusting family routines or schedules school accommodations with no weaning plan allowing unacceptable behavior and referring to it as anxiety medication with no therapy/skill building Dear : We are currently working on Peter s worry, particularly the difficulty he has been having staying in class. His pattern has been to complain of a stomach ache, go to visit the nurse, receive a Tums, and then return to class about minutes later. As you know, Peter has been doing this at least twice a day for the last month. Peter, his parents, and I have been working on a new plan, with a goal of helping Peter recognize his worry, manage the physical discomfort he feels, and stay in the classroom if possible. Peter has been taught several tools to do this, and he has been practicing them. He s doing very well, but we need your help. If Peter asks to go to the nurse, please remind Peter of his tools (including ). Cue Peter to use them, and allow him the time and space to do so. It shouldn t take him long, and he knows what to do. 3

4 Peter does not want other kids to know about this, so please plan with him about how you might cue him privately. A secret word or signal, or a private moment, would be great. Of course, if Peter for some reason is not able to manage his worry, even after prompting and practicing, he may go to the nurse. He won t be there long she has a plan, too It is important that we all use the same language with Peter, and that we all support his efforts. We are referring to Peter s discomfort as worry, and it is important that we move away from using the term sick, especially when talking about his stomach ache. Key for Peter is the phrase, I feel uncomfortable right now, but I can handle this. Peter knows all about this plan, and is motivated to experiment with it in the classroom. We so appreciate your support along the way. 4

5 We ve been putting your (my, our) anxiety in charge of this family for a while now, so we re going to start changing the way we react to it. 5

6 Trigger Worried Thoughts Amygdala Activated Physical Response Intensified Physical Reactions More Worried Thoughts 6

7 Avoidance Happens... in a desperate effort to get and stay comfortable. So what s wrong with getting comfortable? Child Worries Seeks Immediate Comfort through Avoidance Cycle of Avoidant Worry Feels Uncomfortable with Uncertainty Feels relief Handling Discomfort Means Movement... Cycle of Normal Worry Child Worries Feels Uncomfortable with Uncertainty Learns Skills to Manage Uncertainty Moves Forward Using Skills Trigger Worried Thoughts Amygdala Activated Physical Response Intensified Physical Reactions More Worried Thoughts 7

8 The message is NOT that we are eliminating or avoiding the physical symptoms, but that they can be managed and perceived through a different lens. 8

9 Trigger Worried Thoughts Amygdala Activated Physical Response Intensified Physical Reactions More Worried Thoughts From Douglas s mom: (He s in first grade ) Later that night while putting him to bed, I asked him how skiing went. This is what I got basically in one breathe... It was awesome and I was so good they moved me up three levels. The worry monster tried to break into my brain so I told him to fuck off and then I just skied all day. End of story 9

10 I understand how upsetting this is right now. Let s allow this emotional wave to pass, and then I bet we can come up with some ways to move through this. You ve done a great job of showing me how you re feeling. I really understand. We might not know exactly how to fix it yet, but I m smart and you re smart, so maybe we can step back from the emotions for a minute and figure out what we need to do next. 10

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12 I don t know exactly how this is going to go, but I know I can go inside, and pull out the resources that will help me get through this challenge. 12

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