1. Solving the Worry Puzzle
Norma Campbell, Mountain View School
Dale Carey, Mapleshade School
Trey Cushman, Meadow Brook School Betsy Sheehan, Meadow Brook School

2. Anxiety: What it is
Biological Explanation: (image from brainfacts.org )

3. Anxiety: What It Is
Diagram from:

4. Anxiety: What it is #1 Mental Health concern in the U.S.
1 in 5 children have a diagnosable anxiety disorder
Most frequent reason parents bring children to mental health providers.
Untreated anxiety is the leading predictor of depression in teens and adults.

5. There is Hope! Worry and Anxiety can and should be addressed.
Our brains can learn new ways of operating and coping. We can retrain our Amygdala!!!
Anxiety seeks comfort and certainty. The more that these are offered, the more that it grows. Instead, we will focus on skills to teach our children, and coaching skills for caretakers to help children learn to manage their anxious feelings and expand their living experience.

6. The “Attitudinal Shift”
“Don’t define your life through anxiety, confront it and figure it out.” – Lynn Lyons
Worry does NOT define you.
Talk to your worry-parents model how to.
Common Language: We work together at a team.

7. Externalizing Anxiety and Worry
Talk to your worry
Parents model how to:
Good Modeling “My worry bug kept telling me I have to start working on my presentation”
Bad Modeling “My Worry bug kept wondering if Grandma was going to survive during heart surgery” (Sharing an adult-only Worry)

8. Different Ways Kids Can Talk To Their Worries
Expect It
Take Care of It
Boss It Around

9. The Shift Kids Take Charge- They talk more, you talk less
-Switching Roles from explainer, fixer to coach and supporter

10. Coaching Your Child Without Reassuring Worry
-Remain Consistent and Calm
-Acknowledge worry and how uncomfortable it feels
-Be clear that you are no longer going to give worry what it wants or fall for its tricks
-Remind your child to externalize worry and talk back to it

11. Content
Process
Content doesn’t matter much.
Content changes
Focuses on fixing specific problems
Reassurance
Preparing for specific details of situations
Equips children with skills to address the process of worrying rather than the certain instances that worry creeps in.

12. Beware the Content Trap!
Event
Reassurance
Content Trap
Externalize
Every morning, child worries about vomiting at school
“You won’t vomit at school today. You look fine to me. You’re not sick.”
“If you feel sick, go to the nurse. It’s not a big deal to vomit. Why do you think you’re going to vomit every day?”
“That sounds like worry talking. What would you say back?”

13. Parent Feedback
“When he starts to verbalize wanting to avoid a fun activity, we try to remind him that we can't give "worry" the power to change our plans. We remind him about being in charge.” -Meadow Brook Parent

14. Push Back- Expect Resistance
-Ease in, with your child, come up with phrases you will use
- acknowledge worry, model, fighting worry together
Make a plan and follow it through, knowing that the hardest moments are the ones that are the most important to see it through,,

15. Plant the Seeds
Take opportunities to talk to your child about times you see other people allowing worry to control them. Even more importantly, give examples of when others, including yourself, describe being scared, nervous or unsure yet still succeeding.

16. Strategies to Address Worry
The “Puzzle Pieces” – Lynn Lyons & Reid Wilson

17. Seven Puzzle Pieces
Each piece teaches a skill to help parents and their kids shift their reactions to anxious thoughts, sensations and beliefs.
From: Anxious Kids/Anxious Parents
Lynn Lyons and Reid Wilson

18. Puzzle Piece ONE EXPECT TO WORRY
Stop acting surprised by each new occurrence of worry
Learn when to ignore those normal, expected worry thoughts and move on with life – and when to pay attention to them
Inventory those repeated situations when worry always appears

19. Expect to Worry
Parent Feedback: -A very helpful tip that I took from book "Anxious Kids, Anxious Parents", was to expect the worry. Don't be surprised when it happens, and also to remind (my child) of its predictable occurrences. We often remind (my child) how strong and brave he is, as well as how proud we are of him. I often tell him he's a "rock star":)!!! - Meadow Brook Parent

20. Expect to Worry Whenever: You're doing something new or different
You're unsure about plans
You have a lot of "what if" questions
You have to perform
Something scary is happening

21. Puzzle Piece #2 TALK TO YOUR WORRY
Don't try to avoid or eliminate it  
Externalize it and give it life and character
Personify it with color, shape, and sound
Let it know with your words that YOU are in charge
Worry says, "Blah, Blah, Blah...and you can't handle it"

22. Different Ways Kids Can Talk to Worry
EXPECT IT
"I know you're just trying to help..."
“You usually show up at these times so I am not surprised by you..." 
TAKE CARE OF IT
"I'm going to be feeling a little nervous and then it'll be over..."
"I'm safe, even though I feel scared..."
"I've felt this before and have gotten through it..." 
BOSS IT AROUND
"Not now, worry, but I'll get back to you on that..."
"You're not helping me, so I am going to ignore you..."
"Knock it off! Stop trying to scare me!"
"We are NOT a good team, worry."
"I will NOT play this game with you."
"I'm taking charge now, worry, and I am not going to listen to you anymore."
"You're being very clever, worry, but I'm not falling for your tricks."
"Stop trying to confuse me, worry – I can handle this."

23. Talk to Your Worry
Kids can: Draw their worry, write to it, role play with you about it, play with toys that represent their worry.
Picture of “Worry” from a Grade 1 student.

24. Puzzle Piece #3 BE UNSURE AND UNCOMFORTABLE ON PURPOSE
Parents provide the critical support role for children to meet with success. It's quicker and easier to provide comfort and reassurance, but DON'T! This is the experiential step where kids will actually learn that they can be flexible and that they are capable of managing their emotions.

25. Instead, Caregivers should:
Cue child to externalize worry and talk to it
When child wants reassurance, remind him to give himself the reassurance he wants.
Ask. "How might you answer that?" or "That sounds like worry talking...what can you say back?"
Come up with creative 'assignments' that help put the child in situations that provoke worry – and then help monitor progress with him

26. New Messages to Practice
"I'm willing to feel uncomfortable."
"I'm willing to feel unsure and to not know what might happen."
"I can relate TO my worry instead of FROM it."
"I'm willing to grab onto my courage and do it!"

27. Puzzle Piece #4 BREATHE
Teach kids how to calm their body, to reset their body and mind for managing worry in the moment
Help kids understand that the physical symptoms (headache, stomach ache, jitters) are caused BY the worry and anxious thoughts
Explore relationship with kids between their thoughts and their body's reactions

28. CALMING BREATH EXERCISE
1. Breathe out all the way
2. Take a deep breath in, counting to 5, letting your belly expand first, and then your chest
3. Slowly exhale, saying 'calm' or 'relax' to yourself
4. Let your muscles go limp and warm, loosen your face and jaw muscles
5. Remain in this resting position for a few more seconds, with an empty mind
6. Repeat 3 or 4 times until tension loosens

29. Puzzle Piece #5 Reminder Bridges
Anxious children suffer from amnesia
In order for children to generate reminder bridges, they must use their worries as a trigger to remember past skills
Worry for a moment, then immediately bridge to my success and move on
Learn from new experiences and create a pattern of remembering

30. Examples of Reminder Bridges
I really want to……
That reminds me of how….
That reminds me how I can handle……..
Go to that summer camp for a week.
I started sleeping over at Seth’s house.
Being uncomfortable at first.
Jump off the high diving board.
I learned last summer to dive off the edge of the pool.
Feeling scared the first time I try something.
Try out for the school musical.
I got cut from the soccer team the first year, but made it the next year.
Not knowing if I’ll make it, and even getting cut, too, if that happens.
Raise my hand and answer questions in class.
I answered everybody's questions about my project at the science fair.
Feeling nervous and doing it anyway.

31. Practicing Perfection
Anxious children often move away from risks because they cannot tolerate frustration and mistakes
Past errors are necessary building blocks to learning

33. Puzzle Piece # 6 Make A Plan

34. The Game Plan What is your goal?________________________
Do you really want this goal?
No, it’s not that important to me
Yes. I want it, but I’m not sure I can get there
What skills do you need to reach your goal? ________
_________________________________________
What do you already know how to do, that might help you reach this goal? _________________________________________
What do you want to say to yourself when you start to
worry? __________________________________________

35. Are you willing to not know exactly how things will turn out?
No! I HAVE to know, or I don’t want to do it!
Yes. I might not like it, but I’ll use my courage.
Are you willing to feel physically uncomfortable along the
way?
No! I HAVE to be calm or I won’t do it!
What can you do to practice your skills?
_____________________________________________

36. A Really Clever Guide to Winning Over Worries
Know what you want to accomplish
Remember past successes that can help you
Expect worry to show up
Talk to your worries so they can’t run the show
Make a plan and step into that new situation
Be willing to feel unsure and uncomfortable along the way
Let your breathing skills support you

37. Parent Reminders:
If you rescue a child earlier in the cycle, the child learns: - the greater the distress, the more responsive parents are - extra attention = fears are justified When adults are overprotective: - allow the child to avoid fearful contexts - child loses natural opportunities to break the vicious cycle of anxiety - child fails to learn productive coping strategies & self-reliance

38. Parents Who Experience Their Own Anxiety (especially about their child’s anxiety)
Have a difficult time with ignoring
Anxious parents don’t want children to feel what they feel, so they teach avoidance
Task: model calm postures
- Fearful facial expressions and body language reinforce anxiety
- Parents can think whatever they want, but should try to show confidence in the child through coping postures

39. Quick Notes About The Non-Anxious Parent
Are an important role model
Often marginalized if the other parent experiences their own anxiety

40. The Parents’ Job(s) Normalize anxiety Create some distance Stay calm
Create worry parts
Externalize
Support uncertainty
Acknowledge discomfort
Stay out of content
Be consistent and light
Model, model, model

41. School Refusal
Avoidance &/or positive reinforcement received for staying home Reduce anxiety Become powerful motivating conditions for a child to continue to refuse to go to school

42. The Importance of Experiential Learning
Talking (alone) does not change neural pathways
Need experience to impact the brain’s alarm system
Experiential learning is more memorable, and is needed to create powerful reference experiences
More work and creativity is required, but engagement is greater and progress much quicker

43. Creating Autonomy Problem solving
- Amygdala to Frontal Cortex (alarm system to thinking part)
- Accessing resources and building bridges
Internal Reassurance/Self Talk
- How do you talk to yourself?
- How do your words make the problem bigger or more manageable?
Decision Making
- There are different types of decisions
- You will make some good ones and some bad ones
- Making decisions and tolerating uncertainty are pals

44. Psychological Autonomy
Normal movement toward physical & psychological independence Parents shift from overprotecting to promoting competency = decrease in childhood anxiety

45. Psychological Autonomy
Encourage child to think independently
Teach them how to talk themselves through their fears, not talk them out of their fears
Don’t remove hurdle, teach them to jump over it
Focus on problem solving and negotiation of conflict
Begin to think for themselves, make their own mistakes, and gain confidence in their ability to access what they’ve mastered so far
“I can handle this” attitude

46. Video Summary
(5:05)

47. The Home, School & Community Connection
What were the most useful strategies?
“Making a plan and sticking to it! We feel like we're pretty good with consistency, but felt a little lost on what the correct approach was? With guidance from you and Dr. Rob, we felt like we were moving forward with the best possible approach for (our student).
We also felt very comfortable with you, keeping an open line of communication on the school front.

48. Resources for Families
www.
Wilson, R. & Lyons, L. (2013). Anxious Parents Anxious
Kids: 7 Ways to Stop the Worry Cycle and Raise
Courageous and Independent Children. Dearfoot
Beach, FL: Heal Communications, Inc

49. References
Lyons, L. (2013). Notes from Conference: Anxious Kids, Anxious Families. Northampton, MA Society for Neuroscience. (2013). {Diagram of Brain November 22, 2013}. Retrieved from Wilson, R. & Lyons, L. (2013). Anxious Parents Anxious Kids: 7 Ways to Stop the Worry Cycle and Raise Courageous and Independent Children. Dearfoot Beach, FL: Heal Communications, Inc. .(Diagram of Anatomy of Stress November 22, 2013) Retrieved from

50. Questions and Answers

51. Thank you!