FACING YOUR FEARS - ANXIETY GROUP FOR OLDER KIDS

Anxiety Prevention Groups for my older kiddos was always a big more intense.   By the time they were in 5th or 6th grade, some of the fears have turned into phobias. The fears and phobias were so intense, they interfered in classroom functioning. Therefore for my program, it was a priority to work on anxiety prevention during social work services.  Clearly many of my students need outside therapy as well, but parents either 1) do not have insurance or money or 2) do not have the time as they are single parents of multiple kids.  So in my program, I often do therapy 2-3 times a week with the more severe kiddos. 

My go to curriculum here is FACING YOUR FEARS. Excellent curriculum especially made for higher functioning students with ASD and anxiety, Authors: Judy Reaven Ph.D., Audrey Blakely-Smith Ph.D., Shana Nichols Ph.D., Susan Hepburn Ph.D.

The curriculum is Cognitive Behavioral Therapy based. Following is an overall idea of suggested sessions.  For my kids, we did a lot of repetition and I also customized many topics to include my kiddos areas of special interested.  This is a wonderful program because we talk about how much WORRY has taken over there lives -- there are examples and concrete ways of looking at how much time is spent on worrying. We talk about the physiological symptoms in the body and use the worry thermometer to measure things every day.  Finally we make a list (a fear ladder so to speak) of the things that cause worry, in order of minor to major.  We come up with a plan for gradually becoming desensitized to these things -- sometimes taking only the tiniest of steps.  We use video modeling to show our selves success and use that in conjunction with the actual exposure.  I have used many videos from YouTube to help in this.  Now don't forget, for these students, during the same timeframe, I have a parent group.  So I have to get the parent buy-in to help with providing feedback that decreases and DOES NOT REINFORCE the fears.  So many parents do not realize they actually have made their child's fears worse by giving into some of the most ridiculous behaviors!  This curriculum also includes a series of nice videos by some kids  who themselves have worked the program to overcome a fear - such as a fear of dogs.  I really recommend this program.   

Introduction
Session 1: Welcome to Group: Words We Use for Worry
Session 2: When I Worry
Session 3: Time Spent Worrying
Session 4: What Worry Does to My Body: Beginning to Measure Worry
Session 5: The Mind-Body Connection
Session 6: More Mind-Body Connections: Introduction to Exposure
Session 7: Introduction to Exposure (Continued) 
Session 8: Practicing Exposure and Making Movies
Sessions 9-13: Facing Fears and Making Movies
Session 14: Graduation
Booster Session

RUNNING A PARENT ANXIETY GROUP

When I reviewed curriculum for anxiety prevention, almost all the most effective ones (research based) had parent components.  Of course they did!  You cannot expect to make behavioral changes, especially in younger children, without the cooperation of their parents.

I totally love running my parent group.  I found that parents where very interested in the topic!  We ran the group very similar content wise to that of the kids.  Fortunately, COOL KIDS came with this manual.  I added additional information, videos on what is anxiety, articles on how we "get" anxiety, and also how deal in the moment and how to prevent anxiety.  Many parents expressed they had anxiety themselves, which we know from the research that parents with anxiety are more likely to "transmit" their anxious tendencies and responses to their children.  It is not inevitable, but we see it happen often.  I think my parents liked the group because many of them learned about how to deal with their own anxiety.

Click on my Parent Informational Letter to download a free sample

The toughest thing about the parent group was finding a common time for everyone to meet. Fortunately, I had a lot of moms who were 'stay-at-home'.  By the second year, I wound up offering a morning and an afternoon group.  For a few parents, I scheduled individual sessions a few times when they could take off work.  Attendance was often a problem as well, but I didn't want to be too hard on this.  I always emphasized that, "it only works if you come".  Also, I often offered coffee and bagels to sweeten the deal.  We had a group email and if 50% of the group could not come to a session, we would re-schedule. 

A large amount of the training was teaching and practicing relaxation techniques with the parents. We used apps, scripts and activities - we had parents try to schedule in relaxing types of activities, especially prior to bedtime.  We discussed what worked and what didn't work.  We probably spent the most time on 2 different types of relaxation and that was deep breathing (we called it cool breathing or belly breathing) and progressive muscle relaxation. The parents were more apprehensive to practice during group than the kids!  I'll go into what we used to practice relaxation in another blog. But for now, I'll show you one of our favorite resources was this video on YouTube.  Click on the image to see the video for yourself!

Belly Breathing, on YouTube by Common and Colbie Caillat is a favorite!

The parent manual in the Cool Kids program pretty much outlines session by session.  I added in a time for feedback, as the group sort of worked as a support group as well.  We also went over additional resources that anyone found to work on relaxation.  One of the first things we covered after the psycho-educational portion ("what is anxiety and how do you 'get' it") was to talk about how we respond to our children's anxiety.  This was were I saw the most change and most lightbulbs going off.  This article, by Go Zen, and online anxiety prevention program, sums it up nicely.  I printed this out and gave it to parents.  Click on the image to access a copy of it.  We'll talk about Go Zen in another blog post, as it is for older kids and also discuss the desensitization process. that we worked on.

Go Zen article, "5 Things You Should Never Say to an Anxious Child"

GETTING THE GROUP GOING

Running the child anxiety group was always a highlight of my week.  First of all, we called the group, very appropriately, COOL KIDS.  So right away the kids loved being a part of it.  After we covered our lessons on, "what are feelings", and more in depth on the feeling of "anxious" or "worried", I use a lesson called, "The 3 parts to anxiety".  This explains to kids that you feel anxiety in your body, in your thoughts and in your actions.  This is the CBT underpinnings of this program.

To see this product in my Teachers Pay Teachers store,click on the image

Next we introduced the concept of varying degrees of feelings by using a thermometer.  It was color coded, had numbers and pictures to insure that our guys were able to understand.  We also attached a bead with a string so the kids could easily move it up and down without having to say anything.  This also demonstrated the concept that feelings can get more intense, but they can also decrease.We practiced using this in group for a variety of make believe situations.  Then we used it throughout the day in the classroom, checking in to try and make sure our kids could demonstrate how to use it.

Click on the image for a free download of this lesson

   

Next we took an inventory of what our kiddos could identify as being anxiety provoking.  This was to be used to customize our lessons and work with the parents.  We did this by circling the images that represented scary things from a series of images.  However, some of the guys wanted to circle everything, so for my little guys or my early learners, we used it more like a game. 

Depending on level of functioning, student either circled the image or used
them to play the game.  CLICK ON THIS IMAGE TO SEE THIS PRODUCT IN MY TpT STORE.

HERE'S HOW WE PLAYED THE GAME

Cut out the pictures in the first 7 pages of the above document, being sure to include the picture and the caption together. Next cut out the 3 different circles with the captions “a little or not really”, “some” and “a lot”. Use a container, such as small buckets or boxes and attach one label on each container. Cut out the practice items. Using these, explain to your student that there are some things that I like “a little or not really”, “some” and “a lot”. Show each practice item to your student and place it one at a time in the container labeled, “a little or not really”, “some” and “a lot”, depending on your preference. Now ask the student to do the same with the practice items (ice cream, broccoli, onions) Once you have determined your student is able to understand the exercise, move on to the items under “What makes you worry?” Give one picture at a time to the student and allow him to place the image in the container corresponding to how worried it makes them feel.

Don't forget to do your confidentiality!