Transcript Stress and Anxiety in the Life of Your Child Presented by

Cognitive-Behavioral Strategies for
Treating Stress and Worry in
Children and Adolescents
Dr. Caren Baruch-Feldman
Guidance EXPO 2013
Westchester County Center, White Plains, New York
website: drbaruchfeldman.com
email: [email protected]
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
GOALS FOR TODAY’S TALK
1. Increase Your Understanding
of the Causes of Stress Faced
by Students.
2. Teach You Cognitive
Behavioral Strategies that
Can Be Used to Treat Worry
and Stress in Children and
Adolescents.
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
Is Stress and Worry Good, Bad, or
Something In Between?
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
“The Yerkes-Dodson
Law of Arousal
Performance increases
with arousal, but only
to a certain point.
When levels of
arousal become too
high, performance
will decrease.
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
Why Are Children So Stressed?
• Pressure to Succeed
• Need to Be Good at
Everything
• Play Dates, “White
Van”, and Helicopter
Parents
• Internet/ Access to
Information
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
When Should One Be Concerned
About Their Child’s Level of Stress?
• Behaving Differently From Usual
• Avoids Activities That He/She
Used to Enjoy.
• Significant Change in School Performance.
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
How Can Children Turn Their Worry Into an
Appropriate Level of Concern To Feel Better?
(1) Psycho-Educational
(2) Changing One’s Thoughts
(3) Changing One’s Behavior
(physiological and avoidance)
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
Understanding Stress and Worry
• Nervous Systems
• Genetic
Predisposition
• Worry as a Bad
Habit
• Choose a Different
Path
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
Changing One’s Thoughts
How One
THINKS
About A
Situation
Affects How
One Feels.
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
Experiment 1
What Do You See?
Look around the room and try to find all the
examples of RED you can see.
What have you spotted?
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
Experiment 2
Picture yourself in the following situation:
You are standing in line at the bank. There are
about 50 people around. A robber enters and
fires his weapon. You get shot in the arm, but
no one is hurt.
Would you consider yourself lucky or unlucky?
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
Experiment 3
Worried
Florida
Old
Lonely
Orange
Bingo
Conservative
wrinkle
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
Expecting the Worst ……Worrying
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
Changing Ones Thoughts
Step1: Identify Negative Thoughts.
1)Look for Expecting the Worst.
Step 2: Question and Challenge Thoughts.
1)Where is the Evidence?
2)Is it Helpful?
Step 3: Come Up With More Realistic and
Optimistic Thoughts to Feel Better.
1)There is no evidence…
2) Worrying won’t help……
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
Step 1: Identifying Negative or Irrational
Beliefs/Thinking Traps
IRRATIONAL BELIEFS
•
Demandingness – SHOULDS/ MUSTS
•
Awfulizing – It Is Terrible!
•
Low Frustration Tolerance – I Can’t Stand It!
•
Global Rating of Self/Others. Self-Downing.
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
Step 2: Question and Challenge
Thoughts
• Where is the evidence that
what I am expecting will
happen?
• Is it helpful how I am thinking?
• Would I think the same way if a
friend presented this issue?
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
Step 3: Develop Rational Beliefs/Thoughts
RATIONAL BELIEFS
•
•
•
•
Wishes/ Preferences
Living in the Gray
I Can Stand It
Total Self Acceptance
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
Mom, I’m Worried!
Test Anxiety
Expecting the Worst
• I am going to fail!
• It is going to be
terrible!
• I will need to repeat
the grade.
• If I fail I am a bad
person!
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
Mom- I’m Confident!
Confident Test Taker
Realistic and Positive Thoughts
• There is no evidence that I will
fail. I haven’t failed previous
tests.
• Even if I fail, I am exaggerating
how bad the results will be.
Nobody gets left back in 7th
grade because of one test.
• Worrying is a waste of energy.
It is really the worst thing I can
do. Since when I worry, I am
not paying attention fully to
the test.
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
Irrational vs. Rational
IRRATIONAL BELIEFS
RATIONAL BELIEFS
Demandingness –
SHOULDS/MUSTS
Preferences
Awfulizing – It Is Terrible!
Living in the Gray
Low Frustration Tolerance –
I Can’t Stand It!
Realizing That They Can
Stand It
Not Judging Themselves
Global Rating of
Self/Others - Self Worth
Tied to 1 Behavior or Dr. Caren Baruch-Feldman, Psychologist Self Acceptance
drbaruchfeldman.com
Action. Self-Downing
[email protected]
Rational Emotive Imagery
• Picture a bad event clearly. One that has either
already happened or that you believe likely to
happen. Take your time. Fill in the details. Visualize
the people involved, hear them talk, describe the
environment, let the situation happen in your mind.
Feel the emotions; you can do it. Keep imagining until
the emotions are as disturbed as you can get them.
• After a minute or two, change your emotions from
disturbed to merely unpleasant. Did you change your
thinking? Was your thinking more realistic? It’s the
thinking that causes the emotional response.
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
Changing Behavior: Where Do I
Feel Stress in My Body?
Heart Pounding
Blushing
Chills
Feeling Faint
Dizziness
Shortness of Breath
Butterflies
Shaky
Headache
Tightness in the chest
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
Changing Behavior: Physical Sensations
• Be A Detective
Use your symptoms as
clues to knowing when
you are feeling
worried.
Think of fear not as a
signal to RETREAT, but
rather consider it a
CUE to go forward.
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
Changing Behavior: Physical Sensations
• Spell Your Name
with Belly
Breaths
• Deep Muscle
Relaxation
• Guided Imagery
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
Changing Behavior: Don’t Avoid
• Facing One’s Fear or
Stress
• Manageable and
Hierarchical Manner
• Success Breeds
Success
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
Coping Cat- FEAR Plan
•
•
•
•
•
F = Feeling Frightened?
E = Expecting Bad Things to Happen?
A = Attitudes and Actions that can Help.
R = Results and Rewards
FEAR Ladder or Situation Cards
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
What Else Can You Do
•
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Possibility vs. Probability. Determine How Likely It Will Happen.
Productive vs. Unproductive Worry
Living in the here and now, not the future.
Acceptance, not fighting pink elephants.
Be A Good Role Model-Mirror Neurons
Give Worry a Name.
Set Aside a Worry Time.
What’s the Best, Worst, Most Likely Outcome?
Write Down a Story With a Better Outcome.
Separate Thinking from Action. I am simply having the thought….
Can’t Tell Someone to Relax/Calm Down. The Person Needs to Get There
Him/Herself.
• Positive Psychology: Grateful Activity, Journal the Positive, Random Acts of
Kindness.
• Exercising, Eating, and Sleeping Right.
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
SUMMARY
• An intolerance for uncertainty and a
need for control are at the heart of
worrying.
• Be a long-term hedonist vs. a short term
one.
• Live in the moment.
• Turn failure into opportunity (e.g., I
didn’t fail, my behavior did. Failure is not
fatal).
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
From Challenge to Opportunity
After SANDY
Seeing it as an OPPORTUNITY
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
CBT Worksheet
Situation
What is the Feeling Associated with the
Situation?
How are you thinking about the
situation?
Challenging those thoughts
1. What Is the Evidence?________
2. How Is It Helpful? ________
New more helpful way of thinking.
New Feeling.
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]
What Did I Learn?
• What Did You Learn?
• What Can You Do To Help Your Students to
Decrease Stress?
Dr. Caren Baruch-Feldman, Psychologist
drbaruchfeldman.com
[email protected]