agenda what is anxiety? what is depression? resilience what are the risk and protective factors in...

AGENDA What is Anxiety? What is Depression? Resilience What are the risk and protective factors in relation to anxiety ? Principles underlying the FRIENDS for Life program Steps of FRIENDS For LIFE Parental strategies for each stage of FRIENDS for LIFE How to foster healthy children? How to deal with anxious or difficult behaviours Support Options

What is anxiety? Anxiety is a common emotion. At some stage in our lives we will all feel anxious when faced with a difficult situation. Anxiety responses: Physiological sweating, increased heart rate, butterflies in the stomach Cognitive negative self talk such as I cant cope Behavioural avoidance of the anxiety provoking situation Flight or fight response

CHILD ANXIETIES All children experience anxiety as part of their normal development 0-5 MthsLoss of support, loud noises 7-12 MthsFear of strangers, fear of sudden, unexpected and looming objects 1 yrSeparation from parent, toilet, injury, strangers 2 yrsMany fears, including loud noises, animals, dark rooms, separation, large objects, change in environment 3 - 4 yrsMasks, the dark, animals, separation, noises 5 yrsBad people, bodily harm, animals, dark, separation 6 yrsSupernatural beings, bodily injuries, thunder and lightening, dark, sleeping or staying alone 7-8Supernatural beings, dark, fears based on media events, staying alone, injury 9-12 yrsTest and exams, school performance, bodily injury, physical appearance, thunder and lightning, death, the dark (low percentage) AdolescentsSchool, home, safety, political issues, personal relationships, personal appearance, natural phenomena, future, animals.

Anxiety can be Adaptive Mild to moderate levels of physiological arousal can help you to perform optimally: o On tests o Before a presentation o In sports and other performance activities If we didnt feel anxious, we would never get anything done!

NORMAL FEARS ANXIETY DISORDERS When does anxiety become a problem? Developmentally appropriate? Significant distress Duration Interference

Symptoms of Anxiety Worry (anticipatory) Avoidance Attention to threat Fast/sustained physiological arousal Psychosomatic complaints Difficulty in resting and going to sleep Shyness Social withdrawal Perfectionism Excessive:

Symptoms of Depression Sadness Loss of pleasure Social withdrawal Early morning insomnia Hopelessness and helplessness Irritability Negative memory biases Poor concentration Flat affect Appetite changes Excessive:

Behaviours Avoiding new things or taking risks Escaping from feared situations Frequent physical complaints and visits to sick bay (especially before particular events) School refusal Distraction and attention difficulties Seeking reassurance Perfectionistic tendencies frustrated when makes mistakes and when they cant get it right Staying close to a familiar person Resisting change, especially in routine Little eye contact Spending a lot of time alone Unwillingness to participate in class

Factors associated with an increased probability of onset of a disorder, greater severity, and longer duration 1.Temperament: Physiological sensitivity/low thresholds for stress 2.Threat focussed attention 3.Brain Development 4.Negative life events and trauma Risk Factors

Current scientific knowledge at present that we can use to teach skills to parents, school staff and children to make them resilient to life challenges Attachment/Affection Cognitive style Family Friendships Good Physical Health (sleep, daily exercise, diet) School/Work Creative play Evidenced Based Prevention Protective Factors

Resilience = the ability to bounce back Benefits of Resilience Children who are emotionally and socially skilled are more successful at school Children who are emotionally and socially skilled relate better to other children, teachers and parents. They are more competent in dealing with stress and school work (Aber, Jones & Cohen, 2000) Doing well in grade 8 could be better predicted from knowing childrens social competence 5 years earlier than from primary school academic results Children that have learnt empathy, emotional and social competence show significantly less behavioural problems at school, even if they are in adverse life circumstances (Caprara et al., 2000)

WHAT IS FRIENDS FOR LIFE? A program created to assist children to build resilience and self-esteem and to learn important skills and techniques to cope with feelings of fear, worry and depression. The symbolism drawn from the word FRIENDS is based on the following principles: The word FRIENDS helps children to remember each of the skills taught throughout the program (i.e. each letter stands for a new skill learned). Our body is our FRIEND and tells us when we are feeling worried or nervous by giving us clues. It is important to learn to be our own FRIEND and reward ourselves when we try hard. It is important to make FRIENDS, so that we can build our social support network and feel happier. FRIENDS can help us to cope with difficult situations more effectively.

Model of Intervention www.pathwayshrc.com.au Pathways Health & Research Centre

How can you help? You as parents and caregivers play a vital role in the development and maintenance of the skills taught in the FRIENDS programme. Each week your child (ren) will be introduced to specific skills to help build their resiliency. These skills need to be reinforced both during the program and in the home environment in order for change to occur. It is our aim that your child (ren), your families and community will both enjoy the FRIENDS for Life programme and will benefit from learning practical, useful skills for coping with stress, worry, fear and day-to-day challenges. It would be beneficial if you could keep track of progress frequency, duration, and intensity of challenging times + positive changes observed.

An Overview of An Overview of FRIENDS for LIFE FRIENDS for LIFE F F eelings R R emember to Relax I I can do it! I can try my best! E E xplore Solutions and Coping Step Plans N N ow reward yourself! Youve done your best! D D ont forget to practice! S S mile! Stay calm for life!

Home Activities At the end of each session Practice the skills learnt Opportunity to show family skills learnt Transfer skills to different contexts Fun and engaging Reward system at the back of workbook

Tips for parents/caregivers: Discuss individual and family goals that can be achieved over the coming weeks. Make goals specific and positive in nature (e.g. to keep my room tidy each day, to use friendly words when talking to my brothers and/or sisters, to complete my homework each night). Catch your child being brave (e.g. doing something new for the first time). Positively reinforcing all brave behaviour. Encourage your child to talk about the things that upset them including any fears or worries. Share some of your own childhood worries and fears. This will help to normalise the experience of anxiety and worry.

F = FEELINGS The program helps our children learn to identify when they are feeling worried or nervous by recognising their own individual body clues, which prompt them to calm down and relax. Learning to understand our own and other peoples feelings Working on feeling happy, brave and confident. How can you help your child tune into these body clues at home?

Feelings Tips for parents/caregivers: Try to verbalise what you think your child is feeling. Validate your childs feelings before problem solving as a way of letting your child know that you understand how they are feeling. Talking about feelings helps to communicate to children that all feelings are ok, however; it is what we choose to do with our feelings that count. Identify and discuss the strengths of each family member. Becoming aware of strengths will enhance and boost individual and family esteem. Use lots of descriptive praise to validate your childs strengths. Share with your child (ren) some of your own strengths.

R = REMEMBER TO RELAX This step teaches children to learn and practise a variety of relaxation techniques. These are important as we cannot think straight if we are not calm. Breathing By taking slow, deep breaths we can relax our body, our heart beats slower, and we feel less tense and worried. Muscle Relaxation When we tense and relax our muscles our body releases chemicals called endorphins which make us feel relaxed. Visualisation Imagining a peaceful, happy relaxing place can help us to feel calm. Quiet Time Activities that make yourself feel happy and relaxed. How can you help your family (both children and parents) to practise relaxation exercises that will help them to feel better?

Relaxation Tips for parents/caregivers: Encourage your child (ren) to verbalise what is happening inside of their bodies when they experience a variety of emotions. Let our child (ren) know that theses symptoms are your bodies way of telling you how you are feeling. Once children are aware of their body clues they need to do something about this. Encourage child to practice relaxation strategies. Practice / allocate quiet time each day. Encourage and practice deep breathing. Develop family relaxation menu of feel-good activities.

I = I CAN DO IT! I CAN TRY MY BEST! This step teaches children to tune into their self-talk. This is an important skill as thoughts influence feelings and behaviour. Children learn how to think in helpful ways, so they can feel better about themselves, and cope more effectively with difficult situations. 3 Main Stages: Awareness of negative self-talk, Challenging negative thoughts, and Replacing with positive thoughts. Positive attention = another important part of this process.

CHANGING UNHELPFUL THOUGHTS INTO HELPFUL (POWERFUL) THOUGHTS Im so hopeless, Ill never be good at anything! I did really well for trying. If I keep practising Ill get better. I must succeed in everything I do! I dont have to be good at everything I do. Nobody is perfect! No one will accept me if I make a mistake. Even if I make a mistake, people are not going to think any differently about me.

CHANGING UNHELPFUL THOUGHTS INTO HELPFUL (POWERFUL) THOUGHTS Ill probably forget all my lines, then Ill look like a total idiot! Ive practised my lines, and I know them. I wont forget them. Even if I do forget my lines it is not the end of the world. They are not going to like me. How do I know that they dont like me. Ive never met them before. Im going to be so nervous tomorrow. Im not going to be nervous tomorrow. I can do it! I dont know what to say. Ill just let them talk first and I can listen. Then Ill ask them what games they like playing.

CHALLENGING UNHELPFUL THOUGHTS Another way you can help your child change unhelpful thoughts into helpful thoughts is to challenge them be asking certain questions, and looking for evidence against the unhelpful thoughts. e.g. I cant do anything right. To find out how silly that thought is, ask some simple questions Is that really true? Are you exaggerating? Now try to make a helpful green thought by Naming 2 or 3 things that you can do well (e.g. at school, home, or at a friends house).

Everyone feels miserable sometimes. When we feel this way we often say things to ourselves that arent true. E.g. No-one likes me or I always mess everything up. Im not good at anything. We can challenge these thoughts by looking for evidence Are you exaggerating? Are you sure this is really going to happen? Is this really true? How much does it matter what other people think? Are you forgetting the positives? Can you really expect to be perfect at everything you do? What is the worst thing that could possibly happen? Challenging Questions

Positive Thinking Tips for parents/caregivers: Encourage your child to focus on the positives of situations and not the negatives. Positive attention can be an essential first step in thinking positively. Help your children to see life through a positive lens, and to see the glass as half-full. This takes practice! Help your child become aware of their self-talk and assist them in turning negative thoughts into positive and powerful thoughts. Help your child practice bossing back unhelpful thoughts and replacing them with more positive thoughts. Notice negative thinking in yourself or your child. Children model what they see and hear around them. If you recognise that you are saying unhelpful words or feeling tense or nervous then let your child know that you are aware of this. Then demonstrate coming up with an alternative positive way of looking at your situation.

E = EXPLORE SOLUTIONS AND COPING STEP PLANS This step teaches children to find ways to solve problems in difficult or worrying times. COPING STEP PLANS The steps plan involves breaking down a challenging situation into small, achievable, easy steps. The steps gradually become more difficult until the fear is overcome. Children should use the FRIENDS plan (deep breaths, thinking helpful thoughts) as they climb each step. The child should not climb the next step until they feel calm and relaxed on the current step. What challenging situations could you help your child to overcome?

Coping Step Plans Approaching difficult situations and fears in a gradual manner (graded exposure) Breaking down a problem situation into smaller, more manageable steps; focusing on one step at a time. Setting realistic goals. Can be short- or long-term. Could relate to: Overcoming a fear e.g. speaking in front of others, not being afraid of dogs Solving a problem e.g. facing a bully, getting along with a sibling, resolving a friendship issue, confronting somebody Preparing for an upcoming event e.g. going on school camp, a sporting match or carnival Learning a new skill e.g. learning to rollerblade, learning an instrument, playing a sport Completing a task e.g. finishing homework, submitting an assignment, presenting a speech, playing a piece of music Achieving something e.g. getting a role in a performance, getting into a sporting team

COPING STEP PLAN Here is an example of how to break down a fear of spiders into small steps. 7. Read a book that contains pictures of spiders. 6. Watch a documentary about spiders. 5. Hold a plastic spider in your hand. 4. Have a spider enclosed in a glass jar in another room. 3. Have a spider enclosed in a glass jar in the same room. 2. Hold the glass jar with the spider enclosed inside it. 1.Go close to a spider in its web outside. *It is important to negotiate rewards when each step has been achieved.

Role Models & Support Teams Tips for parents/caregivers: Identify the people whom you look up to in your life both now or in the past. Identify their strengths discuss with your child (ren) the ways in which these people have impacted your life. Have a family discussion as to the sources of supports available to you. For example, family, friends, community leaders, teachers, family GP, dance teacher etc. Try to focus on the solution to problems and not the problem itself.

6-BLOCK PROBLEM SOLVING PLAN The steps involved: 1.Define the problem (What is the problem?) 2.List the possible solutions (What could I do?) 3.List what might happen (consequences) for each possible solution. 4.Pick the best solution based on the consequences. 5.Put your plan into action (do it!) 6.Did it work? (Evaluate the strengths and weaknesses). In what situations would this be a useful strategy for your child?

6-BLOCK PROBLEM SOLVING PLAN There are always many different solutions to any problem we face. It is easier to choose a solution when you consider the consequences. It is often useful to solve problems with the help of other people. It is important to look at the good points and the bad points of the solution we choose, so we can decide whether the solution really was the best way of handling the problem. If the solution we choose had more bad points than good points, we can simply try another solution! That is, we dont give up!

Problem-solving Skills Tips for parents/caregivers: Encourage your child to identify specific tasks, fears, difficult upcoming events. Provide your child with praise every time they attempt something difficult, try something new, or are working towards their goals. Help your child to practise saying GREEN thoughts when faced with new situations of challenges. Share your own experiences in learning new tasks, overcoming fears, etc. Break skills and activities into small steps. Dont expect your child to progress to the next level until they have mastered the level below and feel confident with this.

N = NOW REWARD YOURSELF! YOUVE DONE YOUR BEST This step teaches children that its important to reward themselves when they cope with a difficult or worrying situation. REWARDS Rewards that are administered immediately and consistently positively reinforce childrens trying hard. What rewards could you give children for trying hard?

REWARDS EXAMPLES OF REWARDS Spending time engaging in their favourite activity Spending quality time with friends and family members Being allowed to stay up for an extra half an hour on the weekend Using star charts which work as tokens towards earning a grand reward (ideal for the coping step plan) Using a picture of a toy/game that the child really desires, cut into pieces like a jigsaw. Each time the child tries hard they pick a piece of jigsaw out of a hat. Once children have earned all the pieces and rebuilt the jigsaw they are rewarded with that toy/game.

Rewards Tips for parents/caregivers: Try to help your child focus on their effort in giving things a go and not necessarily the outcome of their efforts. Help you child to focus on what they can do well. This is likely to increase their willingness to give new things a go or to continue facing things they find difficult. Discuss with your child ways that they can feel good about themselves when they have done their best, despite things not going the way they planned. The more ideas and solutions generated and the more practice of these skills, the better skilled you and your children will become in dealing with problems/conflicts and managing life situations.

Skill Practice Sessions Tips for parents/caregivers: Try to incorporate the FRIENDS language into everyday life. Continue to challenge unhelpful thoughts (RED thoughts) and turn them into helpful thoughts (GREEN thoughts). Discuss situations where a coping step plan or the 6-block problem solving plan may be useful (e.g., going on school camp, sitting an exam, not being invited to a party, fighting over computer time at home). Continue to help your child generate personal ways to reward themselves for their efforts.

Skill Practice Sessions Tips for parents/caregivers: Help you child to identify future challenges (e.g., beginning a new school) and to set realistic goals for now and the future (e.g., learning to swim or attend school camp). Keep practising the FRIENDS skills each day to help your child (ren) manage current and future challenges. Daily practice of the FRIENDS skills will help maintain positive changes. However, setbacks may occur from time-to-time, this is to be expected. Dont despair! The FRIENDS skills are skills to be used in real-life situations both now and for the rest of your lives.

General Principles Self-Awareness: getting to know yourself, your patterns, your sensitivities, will help in regulation. Changing Habits: it takes time to change psychological and physical habits usually 2-3 months. Reciprocal Skills: all skills need to be practiced by all family members (top down + bottom up through the system). Modelling Skills: teachers model to participants, children model each other, children model their parents.

THANK YOU! Pathways Health and Research Centre www.pathwayshrc.com.au

agenda what is anxiety? what is depression? resilience what are the risk and protective factors in...

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