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Cognitive-Behavioral Strategies for Treating Stress and Worry in Children: What Every Psychologist Needs to Know Dr. Caren Baruch-Feldman NYASP Conference.

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Presentation on theme: "Cognitive-Behavioral Strategies for Treating Stress and Worry in Children: What Every Psychologist Needs to Know Dr. Caren Baruch-Feldman NYASP Conference."— Presentation transcript:

1 Cognitive-Behavioral Strategies for Treating Stress and Worry in Children: What Every Psychologist Needs to Know Dr. Caren Baruch-Feldman NYASP Conference 2013 website:

2 GOALS FOR TODAYS TALK 1. Teach You Actual Cognitive Behavioral Strategies that Can Be Used to Treat Anxiety and Stress in Children. 2. Keep You Entertained.

3 Is Stress and Worry Good, Bad, or Something In Between? Dr. Caren Baruch-Feldman, Psychologist

4 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

5 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

6 When Should One Be Concerned About Their Childs 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

7 How Can Children Turn Their Worry Into an Appropriate Level of Concern To Feel Better? (1)Psycho-Educational (3) Changing Ones Behavior (physiological and avoidance) (2) Changing Ones Thoughts No? Yes! Dr. Caren Baruch-Feldman, Psychologist

8 Understanding Stress and Worry Nervous Systems Genetic Predisposition Worry as a Bad Habit Choose a Different Path Dr. Caren Baruch-Feldman, Psychologist

9 Changing Ones Thoughts How One THINKS About A Situation Affects How One Feels. Dr. Caren Baruch-Feldman, Psychologist

10 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

11 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

12 Experiment 3 Worried Florida Old Lonely Orange Bingo Conservative wrinkle Dr. Caren Baruch-Feldman, Psychologist

13 Expecting the Worst ……Worrying Dr. Caren Baruch-Feldman, Psychologist

14 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 wont help…… Dr. Caren Baruch-Feldman, Psychologist

15 Step 1: Identifying Negative or Irrational Beliefs/Thinking Traps IRRATIONAL BELIEFS Demandingness – SHOULDS/ MUSTS Awfulizing – It Is Terrible! Low Frustration Tolerance – I Cant Stand It! Global Rating of Self/Others. Self-Downing. Dr. Caren Baruch-Feldman, Psychologist

16 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

17 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

18 Mom, Im Worried! Test AnxietyExpecting 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

19 Mom- Im Confident! Confident Test Taker Realistic and Positive Thoughts There is no evidence that I will fail. I havent failed previous tests. Even if I fail, I am exaggerating how bad the results will be. Nobody gets left back in 7 th 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

20 Irrational vs. Rational IRRATIONAL BELIEFS Demandingness – SHOULDS/MUSTS Awfulizing – It Is Terrible! Low Frustration Tolerance – I Cant 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 Acceptance Dr. Caren Baruch-Feldman, Psychologist

21 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? Its the thinking that causes the emotional response. Dr. Caren Baruch-Feldman, Psychologist

22 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

23 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

24 Changing Behavior: Physical Sensations Spell Your Name with Belly Breaths Deep Muscle Relaxation Guided Imagery Dr. Caren Baruch-Feldman, Psychologist

25 Changing Behavior: Dont Avoid Facing Ones Fear or Stress Manageable and Hierarchical Manner Success Breeds Success Dr. Caren Baruch-Feldman, Psychologist

26 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

27 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. Whats the Best, Worst, Most Likely Outcome? Write Down a Story With a Better Outcome. Separate Thinking from Action. I am simply having the thought…. Cant 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

28 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 didnt fail, my behavior did. Failure is not fatal). Dr. Caren Baruch-Feldman, Psychologist

29 From Challenge to Opportunity After SANDY Seeing it as an OPPORTUNITY Dr. Caren Baruch-Feldman, Psychologist

30 CBT Worksheet SituationWhat 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

31 What Did I Learn? What Did You Learn? What Can You Do To Help Your Students to Decrease Stress? Dr. Caren Baruch-Feldman, Psychologist

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