SESSION 6 LEARNING COPING SKILLS SESSION TOOLS Handout 6.1: The Anxiety Thermometer Handout 6.2: Problematic Coping Responses Handout 6.3: Developing a Personal Coping Strategy Handout 6.4: Instructions for Abdominal Breathing Handout 6.5: Rules for Writing Self-Calming Phrases Handout 6.6: Disrupting Negative Self-Talk
HANDOUT 6.1 The Anxiety Thermometer 1 Totally Relaxed 2 Somewhat Relaxed 3 Somewhat Anxious/Fearful 4 Very Anxious/Fearful 5 Extremely Anxious/Fearful
HANDOUT 6.2 Problematic Coping Responses 1. Avoiding all people and places that make you feel bad 2. Withdrawing from friends and family 3. Withdrawing from activities 4. Not asking for help (when you need or want it) 5. Dropping out of the Intervention 6. Drinking alcohol/taking drugs 7. Overeating 8. Watching TV or playing computer games excessively 9. Doing risky or dangerous things 10. Acting angry and aggressive/getting into fights 11. Blaming others 12. Not taking care of yourself (sleep, diet, exercise, grooming, etc.)
HANDOUT 6.3 Developing a Personal Coping Strategy How Useful? Skill Level? Not at all A little A lot Low Medium High BEFORE the reminder/stressful situation: Reducing unnecessary exposure Anticipating (self-talk, planning, support, etc.) Relaxation (abdominal breathing) Building resilience (good health habits, self-esteem, etc.) DURING the reminder/stressful situation: Seek support (from friends, family, counselor, etc.) Breathing techniques Time-out Distraction through positive activities (sports, exercise, hobbies, reading) Self-talk: Calming self-talk Difference between then and now Thought stopping Disrupting negative thoughts AFTER the reminder/stressful situation: Seek support (from friends, family, counselor, etc.) Self-talk (praising yourself, thought replacement, etc.) Journal
HANDOUT 6.4 Instructions for Abdominal Breathing [Adapted from E. Bourne, 1990] Inhale slowly and deeply though your nose into the "bottom" of your lungs - in other words, send the air as low down as you can. If you're breathing from your abdomen, your lower hand should actually rise. Your chest should move only slightly. When you've taken in a full breath, pause for a moment and then exhale slowly through your nose or mouth, depending on your preference. Be sure to exhale fully. As you exhale, allow your whole body to just let go (you might visualize your arms and legs going loose and limp like a rag doll). Do ten slow, full abdominal breaths. Try to keep your breathing smooth and regular, without gulping in a big breath or letting your breath out all at once. Remember to pause briefly at the end of each inhalation. Count to ten, progressing with each exhalation. The process should go like this: Slow inhale Pause Slow exhale (count "one") Slow inhale Pause Slow exhale (count "two") Slow inhale Pause Slow exhale (count "three") and so on. If you start to feel light-headed while practicing the breathing, stop for thirty seconds, and then start up again. Upon completing the exercise, have participant re-rate their anxiety level via the Anxiety Thermometer. Note changes.
HANDOUT 6.5 Rules for Writing Self-Calming Phrases Avoid writing negatives in your phrase. Instead of saying "I'm not going to get nervous when I go into the lunchroom," try "I am calm and confident about going into the lunchroom." Keep your phrase in the present tense. Keep your phrase in the first person. Begin them with "I" or refer to "I" somewhere in the statement. It's important that you have some belief in your positive selftalk. Don't choose something just because it is positive; what you choose has to be right for you!
HANDOUT 6.6 Disrupting Negative Self-Talk NOTICE that you are engaging in negative self-talk. STOP and ask yourself any or a of the following questions: "What am I telling myself that is making me feel this way?" "Do I really want to do this to myself?" "Do I really want to stay upset?" RELAX OR DISTRACT COUNTER negative self-talk by repeating a positive coping statement or affirmation over and over again.