These are my go-to steps when working with a child/teen who is beginning to feel the tidal wave of anxiety coming over them. Apply your own scenario here. Keep in mind these basic steps and you will be more helpful to your child/teen during these trying times. Know that despite your best efforts, major spikes in anxiety happen and are often unforeseen and unavoidable (however, they can be less severe with a little help). Know that more than anything else, your child/teen will benefit from your ability to stay calm, remain supportive, and show patience.
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1) Awareness: Complete a thought record worksheet (specifically around recognizing and rating automatic negative thoughts and recognizing the body’s response to these negative thoughts). Pair thought record worksheet with completion of a cartoon if reason for anxiety spike is unclear (cartoon what happened leading up to panic…”we were walking from the car into the school, then you began to cry…something happened in between the car and the school…”). Link for how to cartoon (https://spectrumshare.com/2012/08/01/guest-post-storyboarding-with-dave-nelson-of-the-community-school/) (
Link to Thought record worksheet – http://www.getselfhelp.co.uk/docs/ThoughtRecordSheet7.pdf
2) Regulate Body: Place your hand on your chest (over heart) and monitor the beats while taking slow, deep breaths (goal of recognizing the escalated HR and then slowing HR down). Hold breath in for 5 seconds and exhale slowly. Regulation can come from any action that physically settles the body and rebuilds a sense of rhythm (hand-in-hand running into jogging into walking with a parent, stair climbing while counting 1.2.3.4, tossing a bean bag back and forth singing “hot potato”, etc).Another great grounding exercise is called “SSS54321” (https://spectrumshare.com/2012/10/16/guided-grounding-exercise-bringing-your-child-back-into-the-present/)
3) Self-statement: ” I know this feeling…it’s anxiety… I’ve beaten it many times before. It’s okay to feel anxious about _________ (ex: new things). Remember the wall-ball tournament, baseball practice, and surgery at Randall’s (examples of challenges faced by other clients). I got through them all. I’ll get through this too. I just have to break it down into small manageable steps. I can take one step at a time.”
4) Regroup and Make a Plan (in a contained and less stimulating environment): If need be, walk outside…take a moment to use self statement, label exaggerated anxious thoughts (catastrophic thoughts – “everyone’s looking at me and thinking…”), heart beat regulation exercise with deep breaths, make a plan (step-by-step plan of how we’re going to get through the next 5 mins…30 mins…1 hour).
5) Be willing to leave: If truly not able to settle down and panic is not decreasing…leave and try again another time. When you (parent) push too hard, you slip into the realm of distrust (kid -“they won’t listen to me even when I’m feeling really unsafe”).
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