goals for today’s talk

Cognitive-Behavioral Strategies for Treating Stress and Worry in Children and Adolescents

Dr. Caren Baruch-Feldman

Guidance EXPO 2013Westchester County Center, White Plains, New York

website: drbaruchfeldman.comemail: [email protected]

Dr. Caren Baruch-Feldman, Psychologist drbaruchfeldman.com

[email protected]

GOALS FOR TODAY’S TALK1. 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.


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Is Stress and Worry Good, Bad, or Something In Between?


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“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.


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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


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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.


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How Can Children Turn Their Worry Into an Appropriate Level of Concern To Feel Better?

(1) Psycho-Educational

(3) Changing One’s Behavior (physiological and avoidance)

(2) Changing One’s ThoughtsNo?Yes!


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Understanding Stress and Worry

• Nervous Systems • Genetic

Predisposition• Worry as a Bad

Habit• Choose a Different

Path


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Changing One’s Thoughts

How One THINKS About A Situation Affects How One Feels.


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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?


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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


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Expecting the Worst ……Worrying


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Changing Ones ThoughtsStep1: Identify Negative Thoughts.1)Look for Expecting the Worst.

Step 2: Question and Challenge Thoughts. 2)Where is the Evidence?3)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……


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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.


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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


Step 3: Develop Rational Beliefs/Thoughts

RATIONAL BELIEFS

• Wishes/ Preferences• Living in the Gray • I Can Stand It • Total Self Acceptance


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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


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.


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Irrational vs. Rational

IRRATIONAL BELIEFS

Demandingness – SHOULDS/MUSTS

Awfulizing – It Is Terrible!

Low Frustration Tolerance – I Can’t Stand It!

Global Rating of Self/Others - Self Worth

Tied to 1 Behavior or Action. Self-Downing

RATIONAL BELIEFS

Preferences

Living in the Gray

Realizing That They Can Stand It

Not Judging Themselves

Self AcceptanceDr. Caren Baruch-Feldman, Psychologist drbaruchfeldman.com

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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.


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Changing Behavior: Where Do I Feel Stress in My Body?

Heart Pounding BlushingChills Feeling FaintDizziness Shortness of BreathButterflies Shaky Headache Tightness in the chest


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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.


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Changing Behavior: Physical Sensations

• Spell Your Name with Belly Breaths

• Deep Muscle Relaxation

• Guided Imagery


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Changing Behavior: Don’t Avoid

• Facing One’s Fear or Stress

• Manageable and Hierarchical Manner

• Success Breeds Success


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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


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What Else Can You Do• 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.


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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


From Challenge to Opportunity

After SANDY Seeing it as an OPPORTUNITY


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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.


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What Did I Learn?

• What Did You Learn? • What Can You Do To Help Your Students to

Decrease Stress?


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goals for today’s talk

Documents

causes of stress

little stress

childs level of stress

children bacesu

school performance

adhd kids

anxious kids

white plains