1. Anxiety and Fear within the Playroom
Dianna Green, MSW LCSW

2. Learning Objectives
Identify differences in play therapy between fear, worry, anxiety, shame and embarrassment
Understand fear from a developmental perspective
Identify effective strategies for reducing fear/anxiety
How presentation will benefit audience: Adult learners are more interested in a subject if they know how or why it is important to them.
Presenter’s level of expertise in the subject: Briefly state your credentials in this area, or explain why participants should listen to you.

3. Points of Discussion Anxiety Disorders Fear
Shy and Embarrassment vs Fear/Anxiety
Development of Fear and Anxiety
Presentation of Fear and Anxiety
Addressing Anxiety and Fear in the Playroom
Lesson descriptions should be brief.

4. Anxiety Disorders
Generalized Anxiety Disorder, Separation Anxiety Disorder, Selective Mutism, Social Phobia Disorder, Specific Phobias, Panic Disorder
DSM 5 Criteria for GAD:
The presence of excessive anxiety and worry about a variety of topics, events, or activities. Worry occurs more often than not for at least 6 months and is clearly excessive.
The anxiety and worry is associated with at least 3 of the following physical or cognitive symptoms (In children, only 1 symptom is necessary for a diagnosis of GAD.):
Edginess or restlessness.
Tiring easily; more fatigued than usual.
Impaired concentration or feeling as though the mind goes blank.
Irritability (which may or may not be observable to others).
Increased muscle aches or soreness.
Difficulty sleeping (due to trouble falling asleep or staying asleep, restlessness at night, or unsatisfying sleep).
Example objectives
At the end of this lesson, you will be able to:
Save files to the team Web server.
Move files to different locations on the team Web server.
Share files on the team Web server.

5. Fear
Emotional state of arousal induced by real or imagined sense of danger or threat
Natural emotion serving a biological, healthy function
When Fear becomes problematic
Professional Reference: “Why Zebras Don’t Get Ulcers” by Robert Sapolsky

6. Shy and Embarrassment
Shy- being fearfully aroused by new or unfamiliar people or place
Embarrassed- fear of judgement from self
Learned and manufactured emotions

7. Anxiety/Fear Displayed by Children
Avoidance of activities, possibly both new and old
Changes in sleep patterns
Increase in speech production or psychomotor activities
Changes in mood or affect presentation
Excessive compliance
Increased Irritability
Lack of focus

8. Development of Fear/Anxiety
Children are born being able to recognize and express fear
Anxiety and worry require the ability to imagine!
Anxiety is a generalized and unfocused fear
Stress or anxiety in low doses can be helpful
Learning a new task
Assessing a new environment
Acquiring new skill set
Perfecting learned task/skill set

9. Anxiety and Fear in the Play room
Maintain structure and boundaries
Provide child client with opportunity to regain control (over self, over emotions, over environment)
Set realistic expectations and encourage caregivers and other adults in support system to do the same!
Demonstrate a respect of (not enabling) fears.

10. Appropriate Interventions
Many theories and strategies are appropriate, but all should include:
Must establish new coping skills
Identify cause of anxiety/fear
Help reduce anxiety and fear through use of new coping skill
What does this look like in your theory?