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OMG! A workshop on overcoming Stress and Anxiety

Before

After


Week 1 – Session Outline: Introduce Stress and Anxiety Week 1 Agenda

11:50-11:55 – Introductions 11:55 – 12:05 - Purpose and Rules of the Workshop 12:05 – 12:18 – Anxiety and Stress Brainstorm 12: 18 – 12: 22 – Mini Lecture 12: 22 – 12:25 – Homework

Week 1 – Outline

11:50-11:55 – Community Building Activity (ice-breaker) Toilet Paper Introduction (For Instructions, please see Activities for Week 1) 11:55 – 12:05 - State the Purpose and Rules of the Workshop (for an outline of the Purpose and Rules of the workshop, see Activities for Week 1) 12:05 – 12:18 – Anxiety and Stress Brainstorm (For instructions, see Activities for Week 1) 12: 18 – 12: 22 – Mini Lecture on the Importance of why you should manage your stress and anxiety. Why OMG? Lecture (For information regarding this lecture see Activities for Week 1). 12: 22 – 12:25 – State the importance of homework and hand it out. Homework: Stress and Me Observation Sheet (for a copy of the worksheet see Activities for Week 1)


Activities for Week 1: Title: Toilet Paper Introduction Materials: Three rolls of toilet paper. Instructions: Have the group members sit in a circle. Show the group a roll of toilet paper and tell them that they are about to go on a five day trip in the wilderness. Then pass the roll of toilet paper around the circle and tell the members that they should take as much toilet paper as they need. Once each member has had an opportunity to take a piece of toilet paper, have each member state on thing about themselves for each square of toilet paper they took.

Rules and Purpose of OMG Purpose: The following may be read word for word, or paraphrased to the group. The purpose of OMG (this workshop) is to address your ability to manage stress and anxiety. Therefore, the goal of this workshop is to teach you the necessary skills needed to manage everyday stressors and anxious thoughts. Such skills will incorporate Cognitive Behavioural Therapy, such as self-talk, redefining/reframing stressful situations, stress-inoculation training, and deep breathing exercises. Also, optional homework will be provided throughout the workshop in order to solidify skills that you will learn. Rules: The following is a brief list of rules that should be upheld throughout the workshop. The facilitator may write the rules in a manner that visually displays the rules to all group members (such as a chalkboard). The rules are also flexible and can be subjected to change. Confidentiality: what happens in this workshop stays in this workshop. Do not interrupt others when they are speaking Respect other people’s beliefs and what they say Be present: when others are speaking, listen attentively In order to be a part of this workshop, you must participate in the activities (or at least demonstrate that you are trying to participate). Homework is optional Be punctual/be on time Food and drinks are allowed in the workshop, as long as they will not be distracting. If at any time you feel overly anxious or overwhelmed, you may leave the room.


Anxiety and Stress Brainstorm Materials: Three large sheets of paper, colourful markers, and tape. Instructions: Have group members sit in a semicircle facing a wall. The facilitator will then tape each sheet of paper to the wall and title the sheets of paper “Definitions,” “Causes,” and “Effects.” Also write the following headings for each sheet: Headings for “Definitions” are “Stress” and “Anxiety,” and “Your Environment.” Headings for “Causes” are “Your environment,” “The World,” and “Yourself.” Headings for “Effects” are “Mind,” “Body,” and “Your environment.” Spend approximately four minutes discussing each sheet of paper, and ask the group members to state any words or sentences that come to mind when focused on a specific “title” or “heading.” As they state their thoughts, the facilitator will record them by writing them on the sheets of paper. During the discussions, the facilitator may interject information that he/she may feel to be lacking in the discussion. The facilitator may also clarify and define any of the “titles” or “headings.” The following are some definitions that the facilitator may use to direct or flesh out discussion: Anxiety: Is our reaction to stress. A basic definition is that anxiety is a painful or apprehensive uneasiness of mind. But prolonged anxiety is a completely different ballpark. It is an overwhelming feeling of dissatisfaction and restlessness, where nothing ever seems to be or feel right (http://www.troubledteen101.com/articles45.html). Stress: Is our reaction to particular events. It is our body’s way of rising to a challenge and preparing for a tough situation with focus, strength, stamina, and heightened awareness. There is both good and bad stress. Good stress is what allows us to handle emergency situations that don’t last for very long, and bad stress occurs when we are not in any immediate danger. Bad stress is caused by long lasting situations (such as a divorce or changing schools,) that zaps us of our resources and takes their toll on our bodies (http://kidshealth.org/teen/your_mind/emotions/stress.html). Mind: when discussing this heading, make sure the group members understand that this includes feelings and emotions. Your Environment: can include family life, school, friends, relationships and your job. The World: can include society, media, video games, the news, and culture (such as discrimination).


Script for Why OMG? Lecture: Instructions: the following script can be read word for word or paraphrased. The script can also be subjected to modification. Now you are probably wondering why you should take this workshop. You are currently experiencing one of the most stressful times of your life. There is constant change around you. Your bodies are changing (puberty is a major stressor), the world is changing at a very rapid pace, and you are about to make some major life decisions. These changes can take a major toll on your body. Such stresses, if not taken care of, can develop into major issues. Untreated “bad” stress has been known to cause ulcers, cramps and irritable bowel syndrome. It can also be a precursor to depression, anxiety attacks, sleep disturbances, and mental fatigue. Stress can also effect your immune system, and make it harder for your body to deal with infections. It also effects your cardiovascular system, and can lead to heart complications and high blood pressure. So, if you would like to gain some skills to handle your stress and anxiety, the following sessions will teach you some skills to help you deal with your stress.

Why is Homework Important: In general, the more effort and time you are willing to put into reaching your goal of being able to manage your stress and anxiety, the more likely that you will achieve that goal. Therefore, the homework in this workshop isn’t being given to you for the sake of giving you homework, it is being given to you in order to help you learn the skills needed to help you manage your stress.


OMG Homework: Stress and Me Observation Sheet Stress and Anxiety can have a large impact on our mind, bodies and social lives. It is for this reason that one of the methods used to combat stress is to recognize how it effects you. By being aware of the stressors in your life, you can change how you react to them and begin to find healthy ways to deal with the stress.

Instructions: Within the next week, describe a stressful experience and how it effected you and your life. The following categories have been provided to help you (feel free to describe more than one experience!) FEELINGS: Some examples might be anxious, scared, fearful, irritable, etc.

___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ THINKING: Some examples: “I can’t do this”; “I might have a panic attack”…

___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ PHYSICAL SENSATIONS: Some examples: racing heart, weakness in the knees”…

___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ BEHAVIOURS: Examples: attempts to avoid the situation, become “invisible” and silent…

___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________ ___________________________________________________________________


Week 2: Redefining Stress and Anxiety Week 2 Agenda

11:50-11:55 – The Anxious Hat Activity 11:55 – 12:00 – Rules and Suggestions 12:00 – 12:20 – Redefining Anxiety Activity 12: 20 – 12:25 – Hand out homework.

Week 2 – Outline

11:50-11:55 – Community Building Activity (ice-breaker) The Anxious Hat Activity (for instructions please see activities for week 2) 11:55 – 12:00 – Restate Rules and ask if anyone would like to suggest any changes. (for group rules, please see activities for Week 1) 12:00 – 12:15 – Redefining Anxiety Activity Redefining Anxiety Activity (for instructions please see activities for week 2) 12: 22 – 12:25 – Discuss and hand out homework. For Homework, please see Activities for Week 2


Activities for Week 2 The Anxious Hat Activity Materials: small pieces of paper, writing utensils, and a large hat. Instructions: Have group members sit in a circle. Then hand out a piece of paper to each group member. Once each group member has a piece of paper have them write what they feel is a stressful or anxiety provoking situation on the paper. When they are done writing the stressful or anxious situation, have each group member put their piece of paper in a hat. As soon as all pieces of paper are in the hat, pass the hat around the circle and have each group member take a piece of paper. Then one at a time, have each group member read the stressful or anxious situation to the group and say how that situation would make them feel or why it would be stressful.

Redefining Anxiety Materials: Cut outs of scenarios. Instructions: Divide the group into as many groups as there are scenarios (i.e. if you have five scenarios, then divide the group into five groups). Give each group a scenario, and ask them to come up with a positive way of defining the situation. In other words, have the group come up with positives associated with the scenario. Also have the group come up with negative thoughts that the person in the situations may be thinking, and redefine those thoughts so that they are more realistic and reflective of behaviour. For example, a lonely person may switch the thought “nobody likes me” with “I need to reach out, and make some friends.” Once the situation is redefined, have the groups briefly come up with a solution to the situation or ways someone could deal with the situation in a healthy way. Once all groups are done, have the groups briefly present their situation to the entire group. Premise the activity with a discussion/talk on how our thoughts and how we evaluate a situation can make it more stressful than it is. Note: It may be best to do one together as a group.


The following are the Stressful Scenarios: Mary had four very large assignments due on Friday, and she had only one week to complete them. On Wednesday she had a basketball game against the high school that won the provincial championships three years in a row! So she had to be at every practice so that she wouldn’t let her teammates down. So really, she only had Thursday night to work on her assignments!!! Steve was feeling very sick. He had a sore throat for two weeks now, but he never paid it a lot of attention because it wasn’t “that bad,” and now he is having trouble swallowing his food. He also loved to play video games and would stay up late at night trying to beat the game. So, now that he is both sick and tired, he is having trouble concentrating in class, and his end of year exams start next week! Angie just moved to Kingston and started at La Salle Secondary School. She doesn’t know anyone, and she feels that the other students don’t like her. She also has a skin condition that causes red blotches on her face and she worries that everyone will think it is Acne and will make fun of her behind her back. Her marks are also starting to slip in math class. Whenever she tries to study for math, she starts to worry about her marks and gets frustrated to the point that she can no longer concentrate. Alex was friends with everyone; he was also on the school football team and at the top of his classes. He did have a secret that was starting to cause him a lot of anxiety. For as long as he could remember, he found guys to be attractive. He was worried to tell anyone, his friends were always making homophobic jokes and they picked on one kid by always calling him a “fag.” His mom was also always trying to set him up with the neighbour’s daughter, and whenever she saw anyone on TV who was gay, she would mutter under her breath that they were all sick.


OMG Homework: Kicking Butt Sometimes our lives feel crazy and we have no idea what to do. Often we just want to scream and pull out all of our hair! One method to make such situations a little less crazy and keep us from going bald is choosing just one stressor and make it less stressful by breaking it into easily accomplishable steps.

Instructions: Choose one thing that is causing you to be stressful or anxious. Decide to change that stressor into something less stressful or nonexistent. Create some mini goals on how to fulfill your decision. Once you create your goals, develop small steps that you are going to accomplish in order to achieve those goals.

Stressor (what do you want to change?) __________________________________ Mini Goal 1: ___________________________________________________________________ Mini Goal 2: ___________________________________________________________________ Mini Goal 3: ___________________________________________________________________

Steps to achieve Goal 1 Step 1: ________________________________________________________________________ Step 2: ________________________________________________________________________ Step 3: ________________________________________________________________________

Steps to achieve Goal 2 Step 1: ________________________________________________________________________ Step 2: ________________________________________________________________________ Step 3: ________________________________________________________________________

Steps to achieve Goal 3 Step 1: ________________________________________________________________________ Step 2: ________________________________________________________________________ Step 3: ________________________________________________________________________


Week 3: Stress Inoculation Week 3 – Agenda

11:50-11:55 – A penny for your thought 11:55 – 12:20 – Stress Inoculation training 12: 20 – 12:25 – Homework For Homework, please see Activities for Week 3

Week 3 – Outline

11:50-11:55 – Community Building Activity (ice-breaker) 11:55 – 12:20 – Stress Inoculation training (see stress inoculation training worksheets in Activities for Week 3) 12: 20 – 12:25 – Discuss and hand out homework (Stress Inoculation Journal) For Homework, please see Activities for Week 3

Week 3 Activities: PENNY FOR YOUR THOUGHTS All participants are given a bag with pennies (each participant should have one penny for each member in the group - if there are 20 people, players each should have 20 pennies). Participants go around the room to each other and trade “a penny for a thought.” Participants trade pennies - and positive thoughts. Activity continues until all participants have shared with every member of the group and have a new bag of “pennies for thoughts.” Have the positive thought be something good that has happened to them in the last few weeks, or something good that they are looking forward to.

Note for Stress Inoculation Training: At the beginning of Stress Inoculation Training – discuss stressful events (such as interactions – speaking with the teacher etc.). (having someone bully you, or tell you bad things about yourself)


Stress Inoculation Training: Be prepared for stress! Stress Inoculation Training is like receiving a vaccine. In order to prevent us from becoming ill, we will often take a vaccine that prepares our bodies for dealing with a disease or virus. In other words, we give our bodies the tools and information needed to stay healthy. Stress Inoculation training is like giving us a vaccine to help us deal with stress and anxiety, but instead of receiving a needle, we learn various techniques to keep us calm.

Be Prepared: i)

Create an Anxiety Hierarchy: create a list of stressful events or things that cause you anxiety. Then rank them from the most stressful to the least stressful. You can use the following lines to create your list (1 is the most stressful, 10 is the least stressful).

1. _______________________________ 2. _______________________________ 3. _______________________________ 4. _______________________________ 5. _______________________________ 6. _______________________________ 7. _______________________________ 8. _______________________________ 9. _______________________________ 10._______________________________ ii)

Create coping statements to say to yourself before, during, and after stressful situations. These are phrases that you can say to yourself to help you calm down and feel good about the situation. The before statements can be used to help prepare you for a stressful situation that you know is going to happen.

1. Before: Preparing for the situation.

1. ___________________________________________________________ 2. ___________________________________________________________ 3. ___________________________________________________________ 2. During: Confronting the situation.

1. ___________________________________________________________ 2. ___________________________________________________________ 3. ___________________________________________________________


3. During: Coping with the effects.

1. ___________________________________________________________ 2. ___________________________________________________________ 3. ___________________________________________________________ 4. After: Reward yourself.

1. ___________________________________________________________ 2. ___________________________________________________________ 3. ___________________________________________________________ The following are some examples of Coping Statements (feel free to use them if you cannot think of any). 1. PREPARATION There’s nothing to worry about. I’m going to be all right. I’ve succeeded with this before. I know I can do each one of these tasks. It’s easier once I get started. I’ll jump in and be all right. Tomorrow I’ll be through it. 2. CONFRONTING THE STRESSFUL SITUATION Stay organized Take it step by step. I can do this; I’m doing it now. I can only do my best. Any tension I feel is a signal to use my coping exercises. I can get help if I need it. If I don’t think about fear, I won’t be afraid. If I get tense, I’ll take a breather and relax.

3. COPING WITH NEGATIVE EFFECTS Relax now! Just breathe deeply. There’s an end to it. Keep my mind on the task at hand. I can keep this within limits I can handle. I can always call _________. I am only afraid if I decide to be. I can decide not to be. I’ve survived this and worse before. Being active will lessen the fear. 4. REINFORCING SUCCESS I did all right. I did well. Next time I won’t have to worry so much. I am able to relax away anxiety. It’s possible not to be scared. All I have to do is stop thinking I’m scared.


Practice! Practice! Practice! Use the following method to help you prepare for stressful situations. i) Get mentally and physically relaxed: e.g. deep breathing, muscle relaxation, imagining ii) Visualize the first scene in the anxiety hierarchy: Describe your anxiety-provoking situation as clearly and with as much detail as possible (e.g. describes where you see yourself and where everything is located, the time of day etc.). iii) Identify escape routes: e.g., leave the room, use your coping statements to calm down, be ready to negotiate other terms, accept issues that you cannot change. iv) Start to cope: Once the visualized scene is clear in your mind, begin relaxing and using your coping statements/thoughts. Continue for 30-60 seconds –unless anxiety becomes too high. v) Rate your anxiety between 0 to 10 (0 = no anxiety 10 = major panic attack) vi) Do more deep relaxation as you picture yourself successfully handling the situation. vii) Repeat above. viii) Rate your anxiety 0 to 10 again. ix) When anxiety is low, move onto the next most stressful scene in the hierarchy. Don’t forget to reward yourself for having the courage to try new ways of coping with stress!


Week Four: Relaxation Week 4 – Agenda

11:50 – 11:55 Community Building Activity 11:55 – 12:00 Brainstorm 12:00 – 12:15 Deep Breathing 12:15 – 12:25 End of workshop celebration.

Week 4 – Outline

11:50 – 11:55 Introductory Activity 11:55 – 12:00 Mini brainstorm on what you do to relax and why it is important. 12:00 – 12:15 Teach deep breathing For instructions, please see the following page. 12:15 – 12:25 Closure/party – have some snacks and stress balls.

Activities for Week Four:

COLORS OF LIFE Take a bag of M&M's or Skittles candy and tell everyone to grab a handful...or specify a number (I prefer this if you have a large group so it doesn’t take so long- I suggest each family member take 5) You might also choose to split up in smaller groups such as children under 12, 12 and over, young adults etc. Assign a different meaning to each color, blue= family, green=hobbies, yellow=animals, brown= work or school etc. Participants must tell one thing about themselves for how many candies they have in their hands using the colors as their guide. They may also eat them as they share their information. (“Blue...I have two sisters.", then eats the candy. "Yellow...I have a dog named Kodi.", and eats the candy etc.)

For this Workshop, colours may represent things that calm me down. Blue – vacation spots (describe a calming place where you would like to go on vacation) Green – describe something in nature that calms you down. Red – describe an action that calms you down, such as jogging Yellow – describe something on TV or a book that calms you Brown – describe something that calms you when you are at school Purple – Describe a mental image – so a picture you imagine – that calms you


Instructions for Deep Breathing Place one hand on your chest and one on your abdomen. When you breathe in, allow your bottom hand to move. Breathe slowly and count slowly as you breathe. There is no such thing as going too slow. Slow is better than fast when practicing. Breathe in to a slow count of 3, hold your breath to a count of 1, and exhale to a slow count of 3. Breathe in through your nose and out through your mouth. Breathing in through your nose helps to prevent over-breathing. Practice, Practice, Practice. Deep breathing is any other skill‌ the more you practice, the easier it will become. Remind yourself that you are reducing your tendency to be physically anxious by practicing deep breathing. It may also be helpful to tag your practice to naturally occurring cues. For example, when you stop at a red light, every time a commercial comes on TV, or before you eat dinner. You may feel light headed or experience some other discomfort or feared sensations when you are practicing. This is NORMAL, is not dangerous, and is just because you are manipulating your breathing. If you feel anxious or uncomfortable while practicing the breathing, it is an excellent indication that deep breathing practice is just what you need to do to reduce your anxiety in the long run. Simply approach the practice more slowly. If you get too anxious, stop the exercise and come back to it later. Practice in short spurts but ALWAYS come back to the practice. Suggestion: try doing breathing exercise three times a day. Two minutes a day, which is about ten breaths.


OMG Workshop