Currently I work with a teen who has tremendous anxiety, specifically when in school. His anxiety presents as fear of certain individuals in the school who he believes are threatening (school police officer, vice principal, etc), and an overall feeling of being unsafe in the school environment. When in my office, this young man can recognize these negative automatic thoughts (“I’m not safe…someone is going to arrest me”) and re-evaluate them (by recognizing they are unrealistic beliefs based on fear, not on fact). However, when on his own and in the moment, he still struggles to recognize and then reevaluate these negative and debilitating thoughts – Thoughts that greatly impact his ability to function and be successful in school.
With that said, here is my next step intervention for this young man: PHONE OR IPOD, with TIMER, set incrementally throughout the day with reminders of time elapsed (time left), cue to recognize negative thoughts and reevaluate them, positive and empowering self-statements, cue to get support from safe school individuals, etc. Preferably the technology can be set on a vibrate mode, to avoid disruption. Also, it would be important to make school staff aware of this intervention beforehand.
Here’s what it might look like.
TIMER GOES OFF – “4 hours left: Your halfway through the day. Take 5 deep breaths (hold them in your chest and slowly let them out). Recognize the negative automatic thoughts and REVALUE THEM (as facts or beliefs/have these thoughts been true in the past?/what makes you feel they are true now?/is it possible your mind is making something feel stronger or more likely than it actually is?/etc). YOU CAN DO THIS. YOU’VE DONE IT BEFORE, hundreds of times. Ask for help when you need it.
TIMER GOES OFF – “3 hours left: There are people here who care about you and want to support you. You’ve gotten through this day safely. Recognize your negative automatic thoughts. How are these thoughts making your body feel? Revalue what is belief and what is fact. You cannot predict the future. Just complete one class at a time.
TIMER GOES OFF – “2 hours left: Your almost home. Focus. YOU ARE SAFE. You can do this and have done it hundreds of times. Do SSS54321 grounding exercise. (Sights, sounds, sensations).
TIMER GOES OFF – “1 hour left: You’re so close. Picture yourself walking through the doors, heading towards home, dropping your bag as you get through the door, listening to music in your room, and relaxing. You made it.
TIMER GOES OFF– “GO HOME. YOU’RE SAFE. YOU MADE IT! YOU DIDN’T LET YOUR THOUGHTS DEFEAT YOU.”
Above is just an example of how this might work. This intervention is a built in support/trigger to use skills, that the individual can rely on when they cannot rely on themselves. This should be done for each individual differently and should speak to particular insecurities/anxieties that have been previously identified.
As always, let me know if you use this idea and how it works for you or your child. I’ll keep you posted as to this young man’s response.