ANXIETY SYMPTOMS INTERVENTION 3 SESSION HANDOUTS

SESSION3ANXIETY SYMPTOMS INTERVENTIONSESSION HANDOUTSHandout 3.1:How Anxiety Affects My ThoughtsHandout 3.2:Anxiety and My BodyHandout 3.3:Linking Thoughts and FeelingsHandout 3.4:The Program CommitmentHandout 3.5:Why Are Thoughts Important?Handout 3.6:Self-TalkHandout 3.7:AlternativesHandout 3.8:What is Detective Thinking?Handout 3.9:How to Do Detective ThinkingHandout 3.10:Detective Thinking PracticeHandout 3.11:Learning about My Thoughts and FeelingsHandout 3.12:Detective Thinking 2003 Macquarie University Anxiety Research Unit

HANDOUT 3.1How Anxiety Affects My ThoughtsHow I Feel Depends on What I Think!Did you know that you can change how you’re feeling by thinking somethingdifferent? You’ll see how in a minute.Every minute of every day we are thinking about different things. We’re notalways aware of what we are thinking because it takes place automatically. Forexample if I say “Birthday” you might automatically think “Presents.”Have a look at these pictures. In the first one the girl is excited about her friendcoming over. What do you think the boy in the second picture is thinking? Writea thought in his thought bubble. 2003 Macquarie University Anxiety Research Unit

HANDOUT 3.1 (CONT.)Now have a look at this picture, there are two thought bubbles. In one thoughtbubble write a thought that would make the girl happy and then in the otherwrite a thought that may make the girl worried.Have a look at this next picture. There are two boys at the zoo looking at thecrocodiles. Circle the boy who you think would be the most frightened.Can you see now how thinking different things might change how you arefeeling? 2003 Macquarie University Anxiety Research Unit

HANDOUT 3.2Anxiety and My BodyAnxiety causes all sorts of things to happen to our bodies.Below is a picture of a body. Draw in all the things that you can think of thathappen to your body when you’re very worried. Then choose a different colorand draw the things that might happen to other people when they worry. 2003 Macquarie University Anxiety Research Unit

HANDOUT 3.3Linking Thoughts and FeelingsWhat you are thinking and how you are feeling have a lot to do with each other.Think of a time when you were really, really happy. In the shapes below, writedown what was happening, what was running through your mind and finallywhat you were feeling. Circle what your worry rating would have been in thatsituation.Now think of a time when you were really, really worried. In the shapes belowwrite down what was happening, what was running through your mind andfinally what you were feeling. Circle what your worry rating would have been inthat situation.Now you already know that you felt differently in those two situations but whatwas the difference between the two thoughts that you had in those situations? 2003 Macquarie University Anxiety Research Unit

HANDOUT 3.3 (CONT.)Now think of a couple of situations that have happened in the past few dayswhen you have been worried, even if it was just a little bit. For each one writedown what happened, what you were thinking and what you were feeling. If youhave trouble remembering what you were thinking, close your eyes and try toimagine that you are back in the situation. Don’t forget to rate how worried youwere in each situation.Can you see how your thoughts were linked to your feelings? We will belearning more about this in our meetings together. 2003 Macquarie University Anxiety Research Unit

HANDOUT 3.4The Program CommitmentYou’ve learned about anxiety, and what you might be able to do if you learnhow to manage your anxiety better. To learn how to manage anxiety, you, yourparent and the clinician are going to have to make a promise to spend timelearning and practicing these new skills.Below is a contract for everyone to sign. This will show that you are going to tryyour hardest to learn how to manage anxiety.We (all ofyour names) recognize that anxiety, fears, and worries havetaken too much control of your life. This isn’t very much fun, andtherefore we are all going to make a commitment to learn how tomanage fears and worries. We are committed to completing all ofthe activities in this intervention. We will do a little bit of workevery day. If we complete all of the activities, then on the of, this/next year we will do a special family activitytogether. This activity will just be for the child and parents makingthis agreement. The activity we would like to do is .We will spend at least hours each week doingthese activities.Signed:(Child)(Parents)(Clinician)Date: 2003 Macquarie University Anxiety Research Unit

HANDOUT 3.5Why Are Thoughts Important?If you learn to control your thoughts, you will go a long way to reducing theworries in your life. Every situation you are in goes like this:ooooFirst there is the EVENT, which is what is going on around you.Then there are your THOUGHTS, which are what go on in your head,like what you would write in your imaginary thought bubble if you were acartoon.There’s also your FEELINGS brought on by your thoughts which you canrate on your worry scale.Finally there is your BEHAVIOR, which is what you do.For example:EventMom ishome lateShe was in anThoughtaccident.She stopped toget dinner.Scared/FeelingWorriedPace up and downBehaviorHappy/ExcitedWatch TV whileyou’re waitingthe hallwaySo what you think can change how you feel and what you dobecause your thought comes first!!!Thoughts are important because they cause feelings and behaviors.Sometimes we have calm thoughts that make us feel good, and make usbehave in ways that lead to good results for us. Other times we have worriedthoughts that make us feel bad, and make us behave in ways that lead to badresults for us. 2003 Macquarie University Anxiety Research Unit

HANDOUT 3.6Self-TalkIn the situations below, come up with two different thoughts that the kids mighthave.Situation 1: You see a big dog in the street.Situation 2: Your Mom is home late. 2003 Macquarie University Anxiety Research Unit

HANDOUT 3.6 (CONT.)Situation 3: You’re asked to give a talk in class.Situation 4: You meet another kid. 2003 Macquarie University Anxiety Research Unit

HANDOUT 3.7AlternativesFor each situation, fill in a CALM thought a person might have and then fill inwhat the person might feel, what worry rating the person would give, and whatthe person might do.Do each one a second time and see what happens when the person has aWORRIED thought. Once again write the thought, how the person is feeling,what the worry rating is and what they might do next.Situation: You hear some strange noises at night.ThoughtsFeelingsBehaviorsCalmWorry Rating:WorriedWorry Rating:Situation: You haven’t done your homework for school.ThoughtsFeelingsBehaviorsCalmWorry Rating:WorriedWorry Rating:Situation: You want to invite a new friend to your party.ThoughtsFeelingsCalmWorry Rating:WorriedWorry Rating: 2003 Macquarie University Anxiety Research UnitBehaviors

HANDOUT 3.8What is Detective Thinking?People who worry a lot tend to make two mistakes when they are thinking:o They overestimate how likely it is that something bad will happen.ORo They overestimate how terrible it will be if that bad thing does happen.In the example (see Handout 3.5) where mom was home late the bad thought “shewas in an accident” overestimates how likely it is that mom had been in an accidenteven though there are lots of other things she may have been doing, like picking updinner.If a person doesn’t make a thinking mistake then the thought is a realisticone. That means that it is likely to be true.To control worries we need a way of deciding whether the thoughts behind thefeelings have mistakes in them or whether they are realistic. That way we can throwthe worried thoughts out and keep the realistic ones in our heads.One way to decide if there’s been a thinking mistake is to find evidencefor the thought. Evidence will give us clues that we can use to help us makethat decision.The best people at finding clues are detectives. A detective is a special person whotries to solve a mystery. Sometimes our thoughts are a bit of a mystery. They canmake us feel bad for no good reason. If we want to solve the mystery behind ourthoughts we need to act like detectives and find evidence for our thought. That way,we can decide whether the thought is realistic or not. If it’s not realistic we can find acalm thought to replace it.To go any further you need to decide who your detective is going to be. Maybe you’dlike to be Harry Potter or Hermoine, Scooby Doo or Spiderman, or the greatestdetective of all, Sherlock Holmes. You can be any detective you like or you can makeup a character. Your detective is going to help you when you are anxious to findevidence so you can think realistically.Who’s your detective? (Write in the name of your detective below.) 2003 Macquarie University Anxiety Research Unit Macquarie University Anxiety Research Unit

HANDOUT 3.9How to Do Detective ThinkingTo help your detective we have four steps for you to follow and a form for you towrite down all the evidence that is discovered about a particular worry.Steps for Detectives to Follow1. Write the event and then the thought behind the feeling. Use the worryscale to rate how worried you are when you think this thought.2. Look for the evidence. Ask what are the facts? What is likely to happen?What has happened to me and to others before?3. List all the alternative things that mighthappen.4. Write down a realistic thought toreplace the worried thought. Give anew worry rating.The Detective’s Evidence SheetOn the next page is an example of how afinished detective’s evidence sheet looks fora boy called George. This one is verydetailed. Sometimes you won’t have quite somuch evidence; other times you will have a whole lot more. Read through theexample before going any further.After you read through all of the evidence try to think up a realistic thought thatGeorge can use instead of his worried thought. Write it in the Realistic ThoughtBox on the table.How worried do you think George would be if he came up with all of thatevidence and believed his realistic thought instead? Write the worry rating intothe Realistic Thought Box as well. 2003 Macquarie University Anxiety Research Unit

HANDOUT 3.9 (CONT.)George’s Detective’s Evidence SheetRealistic ThinkingDetective’s Evidence SheetEventWhat is happening?ThoughtsWhat am I thinking?I have to give a presentation at school.People will notice how embarrassed I am and theywill talk about me behind my back.Worry Rating: 8What is the evidence?What are the facts?What else could happen?What happened when Iworried before?What is likely to happen?What has happened toother people?o I've given talks before and once I got reallyembarrassed.o I have seen some other kids get embarrassed acouple of times, so I'm not the only one who feelslike this.o I’ve heard other people say that they gave reallybad talks or felt really embarrassed about doingtalks, but I didn't notice that they did anythingwrong or looked embarrassed.o Even when I did notice that other kids wereembarrassed, I really didn't bother to talk about itmuch and I didn't hold it against them.o I might feel embarrassed, but people won'tnecessarily notice.o Most people look a bit nervous or embarrassedwhen they are speaking in front of a crowd, so Iwon't look different to most other people.o Even if people DO notice that I lookuncomfortable, it doesn't mean that they'll talkabout me in a horrible way.o I've given talks before and been embarrassed, butno one said anything much about it.o I’ve seen other people give talks and look reallyembarrassed, but people actually said kind thingsto them.What is my realisticthought? 2003 Macquarie University Anxiety Research UnitWorry Rating: