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Anxiety Toolbox - University at Buffalo

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Anxiety Toolbox
Melissa FallonJeanneKeahonKerry WagnerAmyClarvoeSUNY Oneonta
Outline
Psychoeducation/Orienting the Anxious ClientAssessmentFight or FlightAnxiety/Performance CurveSelf-careIntervention ToolboxExposure with Response PreventionWorryManagementMindfulnessDistressToleranceCoping with PanicSelf-Talk/Automatic ThoughtsRelaxationAudienceDiscussion of Best Practices
Assessment
TestingBAISTAIOther Critical Areas to AssessAlcohol and Other DrugsFamily History
Brain in the Palm of Your Hand
Brain stem-the most primitive part of the brain regulates heart rate and respiration. Directly controls our states of arousal, coordinates rapid mobilization of energy in anemergency.Limbic system-added emotions to thebrain’scapacities. It plays a central role ofcoordinatinghigher and lower brain structures.Amygdala-stores and processes emotional memory. Key player in triggering brain’s alarm system.Neocortex-the“thinking brain” that mediates complex information management and processing functions such as reflective analysis.
Fight or Flight
Triggering of thebrain’salarm system by some perceived threat–release of adrenalinandother hormones, increased heart rate and respiration, shift in blood supply, instant energy.Survival or chronic stressEmotional hijacking-occurs when theamygdalareacts to a present moment trigger by associating it with a strong memory circuit from the past. Powerful emotions and messages from the past flood our present experience. Theamygdalatemporarily “hijacks” the effective operation of the upper regions of the brain
Anxiety (Arousal)/Performance Curve
Performance
Arousal/ Anxiety
Anxiety (Arousal)/Performance Curve
Red ZoneTriggersSelf-careSelf-talk
Self-Care
PhysicalEatExerciseSleepTake time offPsychologicalJournalReadTake time to self-reflectPsychotherapyEmotionalSpend time with loved onesGive yourself affirmations, praiseCryLaugh
SpiritualSpend time with natureBe open to inspiration, aweMeditate, prayGive backWorkplace/ProfessionalTake breaksChat with co-workersIdentify tasks that are exciting or rewardingSet limitsBalanceStrive for balance among work, family, relationships, play, and rest
Interventions
Exposure with Response PreventionWorry ManagementMindfulnessDistress ToleranceCoping with PanicSelf-Talk and Automatic ThoughtsRelaxation
Exposure with Response Prevention
Explaining it with metaphor(e.g. habituating to a cold pool)Subjective Units of Distress Scale (SUDS) (1-100)Creating an exposure hierarchy and adjusting it as neededPutting it into practiceStart with SUDS of 50Sit with discomfort, don’t avoid itResponse PreventionNot just for OCD
Worry Management
What is worry?Productive and unproductive worryingPlanning for what you are scared ofAnswering the “what-ifs”Building trust in themselvesCognitive assessment of worriesBest case/worst case scenariosMost likely scenarioExposure and worryWorry hour
Mindfulness
Moment to momentnon-judgmentalawarenessFully present in the momentTaking a second look at our first impulse,thought,or actionA practice…..a way of beingAllows the old brain circuits conditioned by fear to die out to be replaced with new neural circuits
Circle of Liberation
FocusRelease
Distraction
Awareness
Mindfulness Tools
Become brain savvyFocused breathingCheck ins- witnessing &watching the mindSafe place visualization- activates prefrontal cortex which moderates the activation of the emotional center of the brainMindfulness in dailypractice- stop, breathe, reflect, choosePractice, practice, practice!
Distress Tolerance
Inventory of coping strategiesRadical acceptanceInstruction in managing feelingsFeelings are temporarySelf-care/self soothingDistraction
Coping with Panic
Panic Attack Education With Clients3 Steps to Manage PanicStep1-DeflatingthedangerStep 2- Breaking theconnection between bodily symptomsandcatastrophic thoughtsStep 3-AvoidfightingthepanicUtilizing Panic DiariesElectronic Reserve
Panic Diary
Distorted Beliefs & Automatic Thoughts
Automatic pilot (mindlessness)Cognitive Distortions-shoulds,personalizing, generalizing, filtering, emotional reasoning, etc.Themes & Messages- “I’m not good enough”, “people will leave me”Coping styles/schemasSkill deficits-trouble tolerating ambiguitySkill excesses-perfectionism
Treatment Tools
Self-instructional training- preparingfor and getting through situationsReassuring and calmingself-talkDisputing beliefs and countering thoughts with counterstatements, affirmations, mantrasSchema TherapyMindfulness12 step slogans
Process
AwarenessAcceptanceHonor/compassionLetting GoReplace
Deep Relaxation
Relaxation Education With ClientsKeys to Deep RelaxationUtilize it in sessionDailypractice-20-30minutes per daySoothingvoiceand calm settingKeeping it slow and mindfulLifestyle changesIncorporating downtimeEliminating/decreasingCATSExercise, healthy eating,sleepTimemanagementDelegationLetting go ofperfectionismOvercomingprocrastinationPermissionto say“No”RelaxationExamples- Practicedin SessionAudio Files

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Anxiety Toolbox - University at Buffalo