Previus Versin: September 10, 2007 Updated Versin: Octber 2, 2007 PILI Ohana Facilitatr s Guide Lessn 5: Managing and Reducing Negative Thughts and Emtins. Questin/Tpic Script Reminder/Activity Welcming & Intrductin: Ask if participants wuld like t pray (E km mai!) What did we talk abut last time? Alha and welcme t the furth lessn f the PILI Ohana Family & Cmmunity Prgram. Befre we get started, let s review what we learned frm ur last lessn by talking abut yur prgress. We discussed several things during the last activity. We talked abut hw t identify ways that yu and yur family/friends can be healthy at scial events, increase yu and yur family s/friends understanding f cultural beliefs that relate t healthy living, and identify ways t increase scial supprt in the hme and in the cmmunity. We als reviewed reasns why scial situatins can be challenging, which include (pule) befre starting. Icebreaker: Tell us ne thing that yu and yur family/ friends did t prepare fr challenging scial situatins (5 minutes) Review the gals and main ideas frm the last sessin Ensure the participants are clear n the gals and these main ideas Ask participants if they have questins r cncerns abut what was cvered Timeframe: 5 minutes Having t much tempting fds t chse frm r being tempted by what ther peple eat. Being pressured t eat mre than yu want because yu dn t want t be rude. Being arund inactive peple. Since mst f us have faced and will face challenging scial situatins, we talked abut ways t prepare yurself befrehand. Sme f these ways include: 1
Previus Versin: September 10, 2007 Updated Versin: Octber 2, 2007 Questin/Tpic Script Reminder/Activity Bringing healthy dishes t ptlucks. Fcusing n activities rather than eating. Psitining yurself away frm the fd area. What are sme ther ways we talked abut? Preparing yurself befre a scial situatin is helpful, but smetimes we need t knw hw t respnd t pressure during the party. S we als rle played different situatins t be better prepared. Did anyne encunter any situatins they wuld like t share? We als cmpleted mst f the Meal and Activity Planning fr Scial Situatins Wrksheet, which helped us explre Whether r nt yu and yur family and/r friends are eating healthy at scial gatherings; and Whether r nt yu and yur family and/r friends are being active at scial gatherings. Then we lked at ur cultural beliefs and hw they relate t healthy living. We als explred which f ur cultural beliefs can supprt being mre healthy. Finally, we discussed hw scial supprt can help yu meet and maintain yur healthy living and weight gals. Let s review yur family s Remember we asked yu and yur supprt persn, family and friends t change the dishes Review frm Activity 4 by engaging participants 2
Previus Versin: September 10, 2007 Updated Versin: Octber 2, 2007 Questin/Tpic Script Reminder/Activity and friends activities since the last time we met. in discussin n their prgress. yu listed n the Meal and Activity Planning fr Scial Situatins Wrksheet t make them mre healthy, cmplete the Create a Bigger Supprt Circle Using Cmmunity Resurces Wrksheet, and cntinue t keep track f yur family s/friends activities fr the Fit Family Challenge. Let s start with the Meal and Activity Planning fr Scial Situatins Wrksheet. Wuld anyne like t share sme f the ways they went abut making fd dishes healthier? Ask all participants t pull ut their Meal and Activity Planning fr Scial Situatins Wrksheet and Create a Bigger Supprt Circle Using Cmmunity Resurces wrksheet. [Allw apprximately 5 minutes fr participants t share sme f their examples with the rest f the grup.] Nw, let s take a lk at the Create a Bigger Supprt Circle Using Cmmunity Resurces Wrksheet. The purpse f this activity was fr yu t lk at the cmmunity resurces yu have identified during previus activities and find places where healthy supprt netwrks f peple are available t supprt yur healthy lifestyle gals. [Allw participants apprximately 5 minutes t review and share sme f their answers.] Hw many f yu were able t identify places where yu can find scial supprts? If yu were able t identify places with scial supprt netwrks, hw did yu g abut meeting r interacting with peple? What were sme f the psitive things abut this activity? What were sme f the things yu Begin with the Meal and Activity Planning fr Scial Situatins wrksheet. Ask 2 participants t share ways they made a dish healthier. Review the Create a Bigger Supprt Circle Using Cmmunity Resurces wrksheet. Ask abut resurces available t help participants find scial supprts. Review Fit Family Challenge activity t 3
Finally, we asked yu t cntinue t keep track f yu and yur family s/friends physical activities using the Fit Family Challenge pamphlet. Hw many f yu were able t cmplete the Mnth 4 sectin f this activity? Hw many f yu were able t achieve yur weekly gals? Hw has it been t cntinue t cmplete this activity? In what ways has this activity been helpful fr yu? [Allw participants 5 minutes t discuss their experiences with this activity. Jt dwn ntes abut the psitive and negative aspects f the wrksheet.] Previus Versin: September 10, 2007 Updated Versin: Octber 2, 2007 Questin/Tpic Script Reminder/Activity fund difficult abut this activity. see hw many peple were successful at meeting their gals. Ask participants abut any psitive experiences r challenges they encuntered when engaging in this activity. Ask each participant fr any questins r cncerns. Answer all questins as best yu can. If yu d nt knw the answer, tell the participant yu will get back t them with the answer Remember: praise all effrts, n matter hw small. When participants talk abut prblems with eating tgether, prblem slve with them. Timeframe: 15 minutes Let s review ur actin plan. Let us take sme time befre getting started with tday s activity t review the actin plans yu made fr yurselves in Lessn 1 thru 8. Please take time t review participants prgress n actin plans. Encurage any 4
Previus Versin: September 10, 2007 Updated Versin: Octber 2, 2007 Questin/Tpic Script Reminder/Activity Hw are the actin plans wrking fr yu? psitive aspects f fllw thrugh. [Ask participants t find their actin plans and discuss their prgress; help participants t prblem slve.] Help them prblem slve ways t vercme difficulties they may be having. Timeframe: 10-15 minutes What are the gals f this sessin? The gals f this sessin are t help 1) Manage yur negative thughts and emtins (depressin, anxiety, and stress) in difficult situatins, 2) Increase yur family s/friends understanding f hw negative thughts and emtins can impact yur healthy living gals, and 3) Identify cmmunity resurces, which can help yu manage yur negative emtins and/r stress. What are negative thughts and emtins? The tpic f negative thughts and emtins was cvered in Lessn 8 f the PILI Lifestyle interventin. It reminded us that everyne experiences negative thughts at times. Ask participants t pen t Lessn 8 in their participant flders. Ask participants t share examples f hw a negative thught 5
Previus Versin: September 10, 2007 Updated Versin: Octber 2, 2007 Questin/Tpic Script Reminder/Activity But, negative thughts can smetimes lead t negative emtins such as stress, anger, anxiety, sadness, feeling bad abut yurself r frustrated. lead t a negative emtin and vereating r physical inactivity. Negative emtins can then lead t vereating r being inactive. Wuld any like t share an example f hw a negative thught lead t a negative emtin and vereating r physical inactivity? Timeframe: 5 minutes What kinds f situatins can lead t negative thughts r negative emtins? There are tw types f situatins, which can lead t negative emtins. These include majr life events such as unemplyment and divrce r daily life hassles such as a stressful wrk cmmute, changes in daily rutines, r bad weather. Let s make a list f 5 majr life events and 5 daily life hassles that may lead t negative emtins fr yu and yur family. Ask participants t make a list f 5 majr life events and 5 daily hassles that may lead t negative emtins. Write list n flip chart. What are sme cmmn negative thughts, and what can we d abut negative thughts? We als discussed sme cmmn types f negative thughts. Wuld anyne like t give us an example f a type f negative thught and what it means? (Ask participants t identify the cmmn types f negative emtins, and discuss meanings r examples f each type. Handut Cmmn Types f Negative Thughts Handut) We als discussed ways t reduce negative thughts befre they turn int negative emtins. What are sme f the ways that wrk fr yu? (Ask participants t share ways t reduce negative thughts befre they turn int negative emtins.) Ask participants t give an example f a type f negative emtin and what it means. Then handut Cmmn Types f Negative Thughts Handut Befre sessin, write dwn the list f ways t reduce negative thughts befre they turn int negative emtins n flip chart t help participants 6
Previus Versin: September 10, 2007 Updated Versin: Octber 2, 2007 Questin/Tpic Script Reminder/Activity recall materials. (Lessn 8 page 4) D nt shw list until they have ffered suggestins. Timeframe: 3 minutes Hw can I change my negative thughts int psitive thughts? Wuld anyne like t share specific examples f hw t talk back t yur negative thughts with psitive nes? Other examples include, I shuld have eaten less dessert. He/she lst three punds this week, and I nly lst ne. We are ging t lk at bth f these statements. What are ways yu can wrk twards mre balanced statements? [Handut Ways t Change Negative Thughts int Psitive Thughts fr review.] Write examples f negative thughts n flip chart befre the lessn. Ask participants t share ways they can wrk twards mre balanced statements. Fr example: It was my chice. Next time I can decide nt t eat s much. It s nt a race. X and I can lse weight at different rates and bth succeed. Timeframe: 3 minutes Hw can I deal with my negative emtins? Peple can deal with negative emtins by dealing with yur negative thughts early. But, there are times when we feel sad, nervus, stressed but dn t knw why. What are sme ways yu can deal directly with negative thughts that may get in the way f yur healthy lifestyle gals? Ask participants t share ways they can deal directly with negative thughts that may get in the way f healthy lifestyle gals. Have participants identify strategies that wrk best fr 7
Which strategy has been wrking best fr yu? Which strategy wuld yu like t try t use? Previus Versin: September 10, 2007 Updated Versin: Octber 2, 2007 Questin/Tpic Script Reminder/Activity them and strategies [Ask participants t share ways they may deal with they wuld like t negative thughts r emtins. Handut Ways t Deal use. with Negative Thughts.] Timeframe: 5 minutes What events, feelings, r situatins can lead t vereating r physical inactivity? When certain events, feelings, r situatins ccur befre meals, there is a tendency fr us t vereat. Hwever, nt every individual reacts t the same events, feelings, r situatins in the same way. What are sme examples f triggers fr yu? Shpping when hungry. Eating n the run. Nt being prepared fr difficult situatins and hw t deal with them. Setting unrealistic expectatins. Hw can yu better prepare fr these things? Shp with a list and after eating smething. Schedule specific times fr eating r prepare meals ahead f time. Recgnize difficult situatins ahead f time and plan fr dealing with them. Fcus n activities t reach realistic gals. Write dwn a cuple f triggers (listed and/r discussed) n flip chart after yu ask participants t share. If they are unable t cme up with examples, write dwn thse listed. Ask fr ways t better prepare fr dealing with these triggers. Yu can use answers given, but let participants brainstrms ways t prepare. Timeframe: 3 minutes What kinds f during meal behavirs lead t vereating? Other behavirs that lead t vereating actually ccur during meals. What kinds f behavirs tend t lead t vereating fr yu? Eating quickly. Eating when experiencing negative thughts r negative emtins. Thinking, I slipped already, s why dn t I have anther piece f cake. Eating accrding t urges. Write dwn a cuple f during meal behavirs (listed and/r discussed) n flip chart after yu ask participants t share. If they are unable t cme up with examples, write dwn thse listed. 8
Previus Versin: September 10, 2007 Updated Versin: Octber 2, 2007 Questin/Tpic Script Reminder/Activity Ask fr ways t better Hw can yu better prepare fr these situatins? prepare fr dealing with these behavirs. Eat slwly and chew yur fd well. Take the time t enjy what yu are eating. Try t relax befre eating when yu are experiencing negative emtins, and use ther strategies t reduce negative thughts r emtins. Change thinking t I slipped, but I can still get back n track. Remember 80/20 rule. Set specific times fr eating, and try t stick t them. Eat the same time every day. Yu can use answers given, but let participants brainstrms ways t prepare. Timeframe: 3 minutes What happens after yu vereat? When individuals vereat, they may experience negative thughts r emtins. What are sme cmmn reactins t vereating? Feeling guilty fr vereating. Deciding t give up n healthy eating gals. Thinking, I am a failure. I can t d this. Feeling upset at yurself fr giving int urges. Write dwn a cuple f cnsequences f vereating (listed and/r discussed) n flip chart after yu ask participants t share. What are mre psitive ways t react t vereating r slips? Recgnizing that slips are nrmal and reminding self t be mindful f hw much ne eats. Change thinking t I can still be successful and reach my healthy living gals. Everyne slips nce in a while. I can still d this. If they are unable t cme up with examples, write dwn thse listed. Ask fr mre psitive ways t react t vereating r slips. Yu can use answers given, but let participants 9
There are examples f events, situatins, and feelings, which can decrease chances f exercising. Wuld anyne like t share sme examples? There are als thughts and behavirs that ccur during exercising, which can lead t physical inactivity? What are they? We may als experience negative thughts r feelings abut skipping ur exercise rutines? What are sme examples? Previus Versin: September 10, 2007 Updated Versin: Octber 2, 2007 Questin/Tpic Script Reminder/Activity Allw yurself t cheat nce in a while. brainstrms ways t prepare. Althugh we fcused n eating mre than yu wuld like, these examples can be applied t physical inactivity. Ask abut physical inactivity. Write respnses n flip chart. Ask fr events, situatins and feelings which decrease chances f exercising. Ask fr thughts and behavirs that ccur during exercising that may lead t physical inactivity. Ask fr negative thughts/feelings abut skipping exercise rutines. Hw can yu help yur family/friends understand hw negative thughts and emtins can impact yur healthy living gals? Family and/r friends can help yu better manage yur negative thughts and emtins. There are several ways yu can help yur family and friends understand hw negative thughts and emtins can impact yur healthy living gals, which include: Educating yur family/friends abut yur healthy lifestyle gals s that they can prvide the types f supprt yu need. Increased supprt may help t reduce Discuss the ways participants can help their family and friends understand hw negative thughts and emtins can impact their healthy living gals. Ask abut ther ways. Timeframe: 5 minutes 10
Previus Versin: September 10, 2007 Updated Versin: Octber 2, 2007 Questin/Tpic Script Reminder/Activity negative thughts abut weight lss. Educating yur family/friends abut negative thughts and emtins by sharing these materials with them. Making specific requests (e.g., reviewing PILI Lifestyle materials) f a supprt persn, family member, r friend. Having smene t keep yu n track can als be helpful. Identifying a key persn wh yu can call when yu are in a difficult situatin. Talking abut yur prblems may help yu cme up with effective slutins. Sharing yur successes with family members s that yu may celebrate tgether. It is imprtant t cntinue t enjy and reward yur accmplishments (i.e., weight lss and weight lss maintenance). Always thanking yur family/friends fr their supprt. Shwing yur appreciatin will help t make thers feel gd abut supprting yu. Are there ther ways that yur family and/r friends have helped yu decrease negative thughts and emtins? If s, what are they? What are high risk situatins fr vereating r physical inactivity? Nw we are ging t cmplete a part f the Learning t Recgnize and Deal with High Risk Situatins Wrksheet. High risk situatins are situatins, which may trigger vereating r physical inactivity. We are ging t spend sme time walking thrugh a high risk situatin fr vereating, and yu will cmplete the part n physical activity during the break. Let s review the example. Example: High Risk Situatin: Eating dnuts Review example f a high risk situatin. Cmplete questins 11
2. What kinds f behavirs d yu engage in while yu eat? Eating quickly Nt chewing slwly Eating mre than I wuld like 3. What feelings r thughts d yu have while yu are eating r after yu eat mre than yu wuld like? Thinking, I slipped. I ll keep eating mre. Thinking, I am a failure. I can t d this anymre. Feeling guilty Feel like a failure r discuraged 4. Hw can yu better deal with this situatin? Put high calrie snacks away s that they are nt visible Plan fr dinner befre yu get hme Think I slipped, but I can still be successful. Use ther strategies t deal with fight with husband/wife G fr a shrt walk t calm dwn befre starting dinner 5. Hw can yur family and/r friends help yu deal with this situatin? Ask fr help frm yur husband/wife in dealing with the children Previus Versin: September 10, 2007 Updated Versin: Octber 2, 2007 Questin/Tpic Script Reminder/Activity and candy that are n yur kitchen cunter fr High Risk Situatin #1 n the 1. What feelings r thughts and events happen befre r during this situatin? Feeling tired Feel stressed abut wrk Had a fight with husband/wife The children are arguing with each ther N plans fr dinner Learning t Recgnize and Deal with High Risk Situatins Wrksheet. 12
Previus Versin: September 10, 2007 Updated Versin: Octber 2, 2007 Questin/Tpic Script Reminder/Activity Explain t children that yu had a hard day, and yu really need their help Are there any questins befre we mve n? Nw, I wuld like yu and yur supprt persn t take sme time t pick a specific but cmmn high risk situatin that may lead t vereating. Hw can yu identify cmmunity resurces, which can help yu manage yur negative emtins and/r stress? [Allw participants apprximately 15 minutes t cmplete the first part f the activity. Have a cuple f participants share their examples with the grup.] Pick ne answer frm questin #5, and rle play ways t ask yur family and/r friends fr help in dealing with high risk situatins with yur supprt persn. We have spent sme time discussing ways yu can manage yur negative thughts and emtins in difficult situatins and ways t increase yur family s/friends understanding f hw negative thughts and emtins can impact yur healthy living gals. Nw, let s discuss hw yu can identify cmmunity resurces, which can help yu manage yur negative emtins and/r stress. Many f yu may have already identified cmmunity resurces, which help yu reduce negative thughts and emtins and stress. Ask participants if they have any questins abut the example. Answer questins as best as yu can. Give them apprximately 15 minutes t cmplete the questins fr the first high risk situatin. Ask participants t share examples. Timeframe: 20 minutes Review Using Cmmunity Resurces t Help Yu Reduce and Manage Negative Thughts and Emtins Wrksheet. Answer any questins participants may have abut the wrksheet. Timeframe: 3 minutes 13
Previus Versin: September 10, 2007 Updated Versin: Octber 2, 2007 Questin/Tpic Script Reminder/Activity We are asking yu t cmplete an exercise called Using Cmmunity Resurces t Help Yu Reduce and Manage Negative Thughts and Emtins during the break. Let s review the instructins and answer any questins befre reviewing what we talked abut tday. [Review instructins fr Using Cmmunity Resurces t Help Yu Reduce and Manage Negative Thughts and Emtins Wrksheet.] What have we cvered tday? Let s end ur lessn by reviewing what we learned this sessin. We cvered three main ideas tday, which were: 1) Managing yur negative thughts and emtins (depressin, anxiety, and stress) in difficult situatins, Review the tpics discussed in this sessin. Timeframe: 2 minutes 2) Increasing yur family s/friends understanding f hw negative thughts and emtins can impact yur healthy living gals, and 3) Identifying cmmunity resurces which can help yu manage yur negative emtins and/r stress. We reviewed infrmatin abut negative thughts and emtins frm the PILI Lifestyle Prgram Lessn 8. We als talked abut ways t deal with negative thughts and emtins. Then we fcused n identifying specific events, situatins and feelings that may lead t vereating, during meal behavirs that may lead t vereating, and cnsequences f vereating. We als discussed ways we can 14
Previus Versin: September 10, 2007 Updated Versin: Octber 2, 2007 Questin/Tpic Script Reminder/Activity help family and friends understand the impact f negative thughts and emtins n ur healthy living gals. What can I d with my family/friends until we meet again? Finally, we briefly reviewed the next cmmunity resurces activity. Again, we wuld like yu t share what was discussed in this meeting with the rest f yur family/friends. Befre we meet again, we wuld like yu t 1) Identify a high risk situatin, which may lead t physical inactivity and answer each f the questins n the Learning t Recgnize and Deal with High Risk Situatins Wrksheet, and 2) Cmplete the Using Cmmunity Resurces t Help Yu Reduce and Manage Negative Thughts and Emtins Wrksheet s that we may review them at ur next meeting. Remind participants f between sessin activities. Remind participants f what t bring with them t the next lessn. Timeframe: 2 minutes 3) Remember t keep track f yur family s/friends activities fr the Fit Family Challenge s that we may give yu all f yur pints. Please remember t bring yur: 1) Learning t Recgnize and Deal with High Risk Situatins Wrksheet, 2) Using Cmmunity Resurces t Help Yu Reduce and Manage Negative Thughts and Emtins Wrksheet, 3) Fit Family Challenge lg, and 4) Participant flder with yu and yur family supprt persn t the next meeting n fr us t 15
Previus Versin: September 10, 2007 Updated Versin: Octber 2, 2007 Questin/Tpic Script Reminder/Activity review. What will we cver during the next sessin? Next time we will briefly review the 6 family and cmmunity lessns we cvered. Des anyne have any questins befre we end? [Pause t allw participants t ask final questins.] Thank yu all fr attending this sessin. We lk frward t next time when we hear mre abut yu and yur family/friends ways t reduce negative thughts and emtins and where yu are n yur fit family/friends challenge. Answer all questins as best yu can. If yu d nt knw the answer, tell the participant yu will get back t them with the answer. Thank participants. And end w/ pule if apprpriate. Timeframe: 3 minutes Dn t frget t cntinue with the actin plan yu created in Lessns 1 thru 8 f the PILI Lifestyle Prgram. 16