Anxiety Toolbox Student Workbook 2016 08 17...Page 3 Counseling Services Anxiety Toolbox Workbook (805) 756‐2511 (24/7) counseling.calpoly.edu Welcome! Welcome to Anxiety Toolbox,

Page1CounselingServices

AnxietyToolboxWorkbook(805)756‐2511(24/7) counseling.calpoly.edu

AnxietyToolbox

StudentWorkbook

CalPolyCounselingServices(805)756‐2511

counseling.calpoly.edu



TableofContents

WelcomeFrequentlyAskedQuestionsInSessionWorksheetsSession1WorksheetsSession1:StressCurveSession1:Anxiety‐AvoidanceRollerCoasterSession1:ThreatSystem(FightorFlight)Session1:CrossSectionalFormulation(example)Session1:CrossSectionalFormulation(blank)Session1:CommonAnxietySymptomsSession1:FeelingsWheelSession1:SleepHygieneSession1:HomeworkAssignmentSession1:CrossSectionalFormulation(blank)Session2WorksheetsSession2:CrossSectionalFormulation(example)Session2:UnhelpfulThinkingStylesSession2:IdentifyingTriggersWorksheetSession2:HomeworkAssignmentsSession2:Homework:IdentifyingTriggersSession2:CrossSectionalFormulation(blank)Session3WorksheetsSession3:AlternativeResponseWorksheet(example)Session3:IfYou’reHavingTrouble…Session3:AlternativeResponseWorksheet(blank)Session3:PleasantActivitiesSession3:MyPlanforManagingAnxietyAppendixStressversusAnxietyUnderstandingAnxietyDisordersGroundingExercisesBreathingExercisesOnlineResourcesAppsBooksforFurtherReading

Page3Page4Page5Page6Page7Page7Page8Page9Page10Page11Page12Page13Page14Page15Page18Page19Page20Page21Page22Page23Page25Page28Page29Page30Page32Page35Page36Page38Page39Page40Page41Page43Page44Page44Page44



Welcome!

WelcometoAnxietyToolbox,afast‐paced,3‐sessionseminarintendedtohelpincreaseyourunderstandingandknowledgeaboutanxiety.Thegoalistoprovideyouwithsomeskillstorecognizeandmanagesymptomsyoumaybeexperiencing.Wehopeyoufindithelpful.Thegoalofthisseminaristoprovideyouwithlife‐longtoolsyoucanusewhilefacinganxiety‐triggeringsituations.Remember,thisinterventionisnotintendedto“getridof”youranxiety.Whileoccasionallyunpleasant,someanxietycanactuallybeahelpfulandmotivatingemotion.Ourhopeisthatthesethreesessionsprovideyouwithajumpingboardfromwhichtointegrateskillsintoyourdailylifeintheserviceofreducinganxiety.Bytheendofthiscourse,youwillhavereceivedalotofinformationandattimesitmayfeeloverwhelming.Rememberthatlikeanyskill(e.g.,learningtorideabike),theskillsyouwilllearninAnxietyToolboxtaketimeandpracticetomaster.Attimes,youmayencounterobstaclesand/orfinditdifficulttointegratetheseskillsintoyourdailylife.That’sokay,it’showchangeworks,andaswithallchange,it’simportanttopracticeasmuchasyoucan,evenafterencounteringsetbacks.Thinkofyourpracticeoftheseskillsasaformof“mentalhealthhygiene.”Attheoutset,itmayseemtediousandyoumayquestionwhyyouneedtopracticetheseskillssooften.Thinkofitlikedentalhygiene—youbrushyourteethmultipletimesadaytopreventthebuildupofplaqueandultimatelytopreventcavities.Similartobrushingyourteeth,dailypracticepreventsabuildupofanxietyandstressovertime.Themoreyoupracticeandusetheseskillsaspartofyourdailyroutine,thelesstedioustheymayseembecausetheysimplybecomearegularpartofdailylife.Shouldyouwishtofocusmoreindepthonanyofyouranxietyrelatedconcerns,youmaydebriefwithatherapistfollowingcompletionofAnxietyToolboxtodiscussoptions.Ifatanytimeyoufeelthatyouneedadditionalsupport,pleaseletyourAnxietyToolboxleaderknoworcontactCounselingServicesat(805)‐756‐2511.Youmayalsofindadditionalresourcesonlineatcounseling.calpoly.edu



FrequentlyAskedQuestions(FAQ)

WhatisAnxietyToolbox?AnxietyToolboxisafast‐pacedthree‐sessionseminarspecificallydesignedtohelppeoplewhostrugglewithavarietyofanxiety‐relatedconcerns(e.g.,panicattacks,GeneralizedAnxiety,testanxiety).Thegoalofthisseminaristoprovideeducationonanxietyandtoteachcopingskillsformanaginganxietysymptoms.WhydoesAnxietyToolboxusea3‐sessionmodel?TeachingAnxietyToolboxoverthecourseof3sessionsallowsyousufficienttimetolearntheconceptswithtimetopracticebetweensessions.Keepingittothree50‐minutesessionsallowsyoutofindtimeinyourbusyscheduletolearntheseskills.WhatifIneedmorethan3weekstolearnthemodel?Youarenotalone.TheskillstaughtinAnxietyToolboxaredifficultandtaketimetobuild.Forthisreason,weofferafollowupanxietygroupintendedtoprovidefurthersupportforpracticingtheseskills.WhatifIdon’tfeelcomfortableingroups?Manypeoplefeelalittleanxiousaboutparticipatinginagroup.AnxietyToolboxisstructuredandcurriculum‐driven,likeanacademicclass.Youarenotrequiredtospeaktotheentiregroupifyoudonotfeelcomfortabledoingso.Thefacilitatorsrespecteachparticipant’srighttoshareonlywhattheyarecomfortablesharingandneverrequireyoutosharesensitiveorpotentiallyembarrassinginformationaboutyourself.WhatifIhaveanurgentneedtoseeacounselorduringAnxietyToolbox?SimplyletthefacilitatororCounselingServices’frontdeskstaffknowandtheywillfacilitateyougettingthehelpyouneed.WhydoIhavetodohomework?Thefocusofthisworkshopisonbuildingskillstocopewithanxiety;inordertoachievethatgoal,regularpracticeisessential.Themoreyoupractice,themoreyoumayfindyougetoutofthisworkshop.Theassignmentsareforyouandonlyyou,intheserviceofyourownpersonalgrowth.Youwillnotberequiredtoprovideyourresponsesatanytimeduringthisworkshop;however,it’simportanttobringyourresponsesasyoumaybeaskedtolookbackonorelaborateonapriorassignmentduringtheworkshop.WhatifIdidn’tdomyhomework?Weencourageyoutocometogroupregardlessofwhetherornotyouwereabletocompletethehomeworkassignment.Ifyouforgetyourworkbook,wecanprovideyouanewone.Wecanalsoassistyouinworkingonexampleswhenthehomeworkisreviewed.



INSESSIONWORKSHEETS



SESSION1:ANXIETY101



Anxiety‐AvoidanceRollerCoaster

Adaptedfrom‐http://www.therapistaid.com/therapy‐guide/cbt‐for‐anxiety





CrossSectionalFormulationSituation(When?Where?What?Withwhom?Whatdidyoufeelanxiousabout?) Astudentinvitedmetoapartyinmyresidencehall,butIdidn’tknowherverywellandfeltanxiousaboutgoing.

Physical(Whenanxious,whatphysicalsensationsdidyouexperience?Whatdidyounoticeinyourbody?) Heartracing,tightchest,shallowbreathing,hot

Cognitive(Whatwentthroughyourmindwhenyoufeltanxious?Whatdidthatsayormeanaboutyouorthesituation?) Iwon’tknowanyoneatthepartyandwillfeelawkward.NoonewilllikemebecauseI’msosociallyawkward.Iwon’thavefun.ButifIsayno,thispersonwon’tlikemeandIwouldn’tmakefriends.

Behavioral(Whatwasyourfirstinstinctand/orautomaticresponse?Whatdidyoudoand/oravoiddoingatthetime?)Myfirstinstinctwastosayno.IavoidedsayingnobuttellingherthatIwouldthinkaboutit.Inevergotbacktoher.Ididn’tgototheparty.

Emotional(Whatemotionscameupforyouwhenyoufeltanxious?) Scared,ashamed,Lonely,agitated,nervous



Physical(Whenanxious,whatphysicalsensationsdidyouexperience?Whatdidyounoticeinyourbody?)

Cognitive(Whatwentthroughyourmindwhenyoufeltanxious?Whatdidthatsayormeanaboutyouorthesituation?)

Behavioral(Whatwasyourfirstinstinctand/orautomaticresponse?Whatdidyoudoand/oravoiddoingatthetime?)

Emotional(Whatemotionscameupforyouwhenyoufeltanxious?)

CrossSectionalFormulationSituation(When?Where?What?Withwhom?Whatdidyoufeelanxiousabout?)



CommonAnxietySymptomsPhysicalSymptoms

o Increasedheartrateo Shortnessofbreatho Chestpainorpressureo Chokingsensationo Dizziness,lightheadednesso Sweating,hotflashes,chillso Nausea,upsetstomach,

diarrheao Trembling,shakingo Weakness,unsteadiness,

faintnesso Tensemuscles,rigidityo Drymoutho Other:________________________

BehavioralSymptoms

o Avoidanceofthreatcuesorsituations

o Escape,flight

o Pursuitofsafety,reassurance

o Restlessness,agitation,pacing

o Hyperventilation

o Freezing,motionlessness

o Difficultyspeaking

o Other:___________________________

CognitiveSymptomso Fearoflosingcontrol,being

unabletocopeo Fearofphysicalinjuryor

deatho Fearof“goingcrazy”o Fearofnegativeevaluations

byotherso Frighteningthoughts,images,

ormemorieso Perceptionsofunrealityor

detachmento Poorconcentration,

confusion,distractibilityo Narrowingofattention,

hypervigilanceforthreato Poormemoryo Difficultyinreasoning,lossof

objectivityo Other:___________________________

EmotionalSymptomso Feelingnervous,tense,

woundupo Feelingfrightened,fearful,

terrifiedo Beingedgy,jumpy,jitteryo Beingimpatient,frustratedo Other:__________________________

AdaptedfromTheAnxietyandWorryWorkbookbyClarkandBeck



FeelingsWheel



SleepHygieneWhatisSleepHygiene?‘Sleephygiene’isthetermusedtodescribegoodsleephabits.Considerableresearchhasgoneintodevelopingasetofguidelinesandtipswhicharedesignedtoenhancegoodsleeping,andthereismuchevidencetosuggestthatthesestrategiescanprovidelong‐termsolutionstosleepdifficulties.

1. Getregular.Gotobedandgetupatmoreorlessthesametimeeveryday,evenonweekendsanddaysoff!

2. Getup&tryagain.Gotosleeponlywhentired.Ifyouhaven’tbeenabletofallasleepafter30minutes,getupanddosomethingcalming(notstimulating)untilyoufeelsleepy,thenreturntobedandtryagain.

3. Avoidcaffeine&nicotine.Avoidconsuminganycaffeine(coffee,tea,soda,chocolate)ornicotine(cigarettes)foratleast4‐6hoursbeforegoingtobed.Theseactasstimulants

andinterferewithfallingasleep

4. Avoidalcohol.Avoidalcoholforatleast4‐6hoursbeforebedbecauseitinterruptsthequalityofsleep.

5. Bedisforsleeping.Donotttouseyourbedforanythingotherthansleepingandsex,sothatyourbodycomestoassociatebedwithsleep.

6. ElectronicsCurfew.Don’tuseback‐litelectronics60minutespriortobed,astheartificiallightpreventshormonesandneuronsthatpromotesleep.

7. Therightspace.Makeyourbedandbedroomquietandcomfortableforsleeping.Aneyemaskandearplugsmayhelpblockoutlightandnoise.

8. Nonaps.Avoidtakingnapsduringtheday.Ifyoucan’tmakeitthroughthedaywithoutanap,makesureitisforlessthananhourandbefore3pm.

9. Sleeprituals.Developritualstoremindyourbodythatitistimetosleep,likerelaxingstretchesorbreathingexercisesfor15minutesbeforebed.

10. Noclock‐watching.Checkingtheclockduringthenightcanwakeyouupandreinforcesnegativethoughtssuchas“Ohno,lookhowlateitis,I’llnevergettosleep.”

11. Keepdaytimeroutinethesame.Evenifyouhaveabadnightsleepitisimportantthatyoutrytokeepyourdaytimeactivitiesthesameasyouhadplanned.Thatis,don’tavoidactivitiesbecauseyoufeeltired.Thiscanreinforcetheinsomnia.

Adaptedfromhttp://www.cci.health.wa.gov.au



Session1:HomeworkAssignmentHomework1:Completeatleast1SimpleCrossSectionalFormulationworksheetforreviewnextweek(multipleblankcopiesprovidedstartingonpage15)Homework2:PracticeDeepBreathingHomework3:Implement1SleepHygieneTip




















CrossSectionalFormulation

Situation(When?Where?What?Withwhom?Whatdidyoufeelanxiousabout?)




SESSION2:AUTOMATICTHOUGHTS

ANDUNHELPFULCOGNITIONS



Situation(When?Where?What?Withwhom?Whatdidyoufeelanxiousabout?) Astudentinvitedmetoapartyinmyresidencehall,butIdidn’tknowherverywellandfeltanxiousaboutgoing.

Physical(Whenanxious,whatphysicalsensationsdidyouexperience?Whatdidyounoticeinyourbody?) Heartracing,tightchest,shallowbreathing,hot

Cognitive(Whatwentthroughyourmindwhenyoufeltanxious?Whatdidthatsayormeanaboutyouorthesituation?) Iwon’tknowanyoneatthepartyandwillfeelawkward.NoonewilllikemebecauseI’msosociallyawkward.Iwon’thavefun.ButifIsayno,thispersonwon’tlikemeandIwouldn’tmakefriends.

Behavioral(Whatwasyourfirstinstinctand/orautomaticresponse?Whatdidyoudoand/oravoiddoingatthetime?)Myfirstinstinctwastosayno.IavoidedsayingnobuttellingherthatIwouldthinkaboutit.Inevergotbacktoher.Ididn’tgototheparty.

Emotional(Whatemotionscameupforyouwhenyoufeltanxious?) Scared,ashamed,Lonely,agitated,nervous

CrossSectionalFormulation





IdentifyingTriggersWorksheet

Whileattimesitmaybedifficulttoidentifyatrigger,understandingyourtriggersforanxietyisanimportantstepinhelpingyouknowwhentoimplementand/oremphasizepracticeofthecopingstrategiesyouwilllearninAnxietyToolbox.Triggerscanbeexternalevents(e.g.,atest)orinternalstimuli(e.g.,aphysicalsensationoremotion)thatledtoyourexperienceofanxiety(i.e.,theemotional,physical,cognitive,andbehavioralsymptomspreviouslydiscussedduringthisworkshop).Rememberthatsometimesthesymptomsthemselvescanbeatriggerthatstartsthecycleofanxiety.Thefollowingaresometypicalcategoriesinwhichtriggersmightappearwithexamples:ResponsestoInternalStimuli: Emotions:e.g.,feelingdown,fearorworry MentalImages:e.g.,replayinginterpersonalinteractionsorperformance

experience PhysicalState:e.g.,racingheartbeat,lightheadedness,tightnessinchest Thoughts:e.g.,“Imightfailthistest”,“Thatpersonmustnotlikeme”,“If

someonetalkstomeinclass,Iwon’tbeabletohandleit.”ResponsestoExternalStimuli: PresenceofOthers:e.g.,attendingasocialevent,meetingwitha

professor,spendingtimewithroommates,familyinteractions PhysicalSetting:e.g.,aclassroom,openareasoncampus,insideacar SocialPressure:e.g.,feelingpressuredtomakefriends,feelingpressured

toperformwellinschool(incomparisontoyourpeers) Activities:e.g.,asportsevent,aparty,goinghomefortheweekendListsometriggersyouexperiencerelatedtoyouranxiety:

1._______________________________________________________________________________________________

2._______________________________________________________________________________________________

3._______________________________________________________________________________________________

4._______________________________________________________________________________________________

5._______________________________________________________________________________________________



Session2HomeworkAssignments

Homework1:CompleteIdentifyingTriggersWorksheetonpage22‐23Homework2:Completeatleast1SimpleCrossSectionalFormulationworksheetforreviewnextweek(multipleblankcopiesprovidedstartingonpage24)



Homework:IdentifyingTriggersPayattentiontoanytriggersforanxietythatyoumayexperienceoverthenextweek.Writethemdowninthefollowingcategories.Youmayhavetriggersinallofthecategoriesoryoumaynoticetriggersinonlyoneortwocategories.(Usethe“other”categoryfortriggersyoufeeldon’tfitintheoptionslisted.)Emotions:

1.________________________________________________________________________________________

2.________________________________________________________________________________________

3.________________________________________________________________________________________

MentalImages:

1.________________________________________________________________________________________

2.________________________________________________________________________________________

3.________________________________________________________________________________________

PhysicalStates:

1.________________________________________________________________________________________

2.________________________________________________________________________________________

3.________________________________________________________________________________________

Thoughts:

1.________________________________________________________________________________________

2.________________________________________________________________________________________

3.________________________________________________________________________________________



PresenceofOthers:

1.________________________________________________________________________________________

2.________________________________________________________________________________________

3.________________________________________________________________________________________

PhysicalSetting:

1.________________________________________________________________________________________

2.________________________________________________________________________________________

3.________________________________________________________________________________________

SocialPressure:

1.________________________________________________________________________________________

2.________________________________________________________________________________________

3.________________________________________________________________________________________

Activities:

1.________________________________________________________________________________________

2.________________________________________________________________________________________

3.________________________________________________________________________________________

Other:

1.________________________________________________________________________________________

2.________________________________________________________________________________________

3.________________________________________________________________________________________
























SESSION3:ALTERNATIVERESPONSES,GROUNDING,ANDSELF‐CARE;PUTTINGITALL

TOGETHER



AlternativeResponseWorksheet

Situation:(When?Where?What?Withwhom?Whatdidyoufeelanxiousabout?)

Astudentinvitedmetoapartyinmyresidencehall,butIdidn’tknowherverywellandfeltanxiousaboutgoing.

AlternativeThoughtsandImages:(Arethesethoughtshelpful?Aretheanxiousthoughts100%true/accurate,100%ofthetime?Whatareotherwaysoflookingatthis?Whatisthebiggerpicture?)ImaynotbeassociallyawkwardasIthink.Ifsheinvitedme,sheprobablywantsmethere.ImightstillhaveanokaytimeevenifIamanxious

AlternativeBehaviors:(Whatcouldyoudothatwouldbemorehelpfulforyou,others,&/orthesituation?Whatarecopingstrategiesthatmightbehelpful?)CopingStrategiesICanUse: Deepbreathing

Distractmyself

Seeksupportfromafriend/familymember

Doapleasurableactivity

Usealternativeresponseworksheet

AlternativeFeelings:(Whatarefeelingsthataremorehelpful?Whatifyouactedandthoughtdifferentlyaboutthesituation?Howmightthesechangeshelpyoufeeldifferently?)Excited

Wanted

Liked

Hopeful

OriginalOutcome:(Whatwastheoriginaloutcome?)IstayedinmyroomandwatchedNetflix.

DesiredOutcome:(Usingthesenewalternatives,whatwouldyouliketheoutcometobeinthefuture?)IwanttogotothepartysothatIcanmakefriends.IfIfeeltoouncomfortable,Icanalwaysleave.



Ifyou'rehavingtrouble,askyourselfthesequestions:Wheneverwerecognizeananxiety‐relatedthought,feelingorbehavior,itcanbeveryhelpfultoaskourselvesthefollowingquestions:

AlternativeTHOUGHTS:1. Whatareotherwaysoflookingatthissituation?2. AmIlookingatthewholepicture?3. Whatmightbeamorehelpfulwayofpicturingthissituation?4. WhatunhelpfulthinkingstylesmightIbeusinghere(seebelow)?5. Whatistheevidencethatmythoughtsaretrue?Isthereanalternativewayofthinking

aboutthissituationthatismoretrue?6. Whatistheprobabilitythatmythoughtswillhappen?Whataresomeotherthingsthat

couldhappenthatareequally,ifnotmore,probable?7. HaveIhadanyexperiencesinthepastthatsuggeststhatthisthoughtmightnotbe

COMPLETELYtrueALLofthetime?8. CanIreallypredictthefuture?Isithelpfultotry?Whatismorehelpful?9. AmIexaggeratinghowbadtheresultmightbe?Whatismorerealistic?10. CanIreadpeople’sminds?Whatelsemighttheybethinking(that’snotsonegative)?11. Ifafriendorlovedonewereinthissituationandhadthisthought,whatwouldItell

them?

CommonCognitiveDistortions(UnhelpfulThinkingStyles)AllorNothingThinking:thinkinginabsolute,blackandwhitecategories

Over‐generalizing:seeingapatternbaseduponasingleeventorbeingoverlybroadinconclusionswedraw

MentalFilter:onlypayingattentiontocertaintypesofevidence(e.g.,dwellingonthenegatives)

Disqualifyingthepositive:discountingthegoodthingsthathavehappened

JumpingtoConclusions:Mindreading:imaginingweknowwhatothersarethinkingFortunetelling:predictingthefuture

Magnification(catastrophizing)andminimization:blowingthingsoutofproportionorinappropriatelyshrinkingsomethingtomakeitseemlessimportant

EmotionalReasoning:assumingbecausewefeelacertainway,whatwethinkmustbetrue

Should/MustThinking:Usingwordslike“should”,“must”,“oughtto”or“haveto”

Labeling:assigninglabelstoourselvesorothers

Personalization:blamingyourselfforsomethingyouweren’tentirelyresponsibleforORblamingothersandoverlookingwaysyoumayhavecontributedtotheoutcome



AlternativeBEHAVIORS:1. WhatcouldIdointhemomentthatwouldbemorehelpful?2. What’sthebestthingtodo(forme,forothers,orforthesituation)?3. Ifmyfearedsituationhappens,howwillIcope?WhatcopingskillscanI

usetohandlemyfearedsituation?WhathaveIdoneinthepastthatwassuccessful?

4. AmIneedingtoworkonacceptance,lettinggoofcontrol,beingokaywithlessthanperfect,orhavingfaithinthefutureandmyself?

5. Breathe:Focusyourattentiononyourbreathing.Imagineyouhaveaballooninyourbelly,inflatingonthein‐breath,deflatingontheout‐breath.

AlternativeFEELINGS:1. WhatmightitfeellikeifIacted/thoughtdifferently?2. WhenI’mnotfeelingthisway,doIthinkaboutthissituationdifferently?3. ArethereanystrengthsorpositivesinmeorthesituationthatImightbe

ignoring?4. Whatelsemightthisanxietyberelatedto?Isitreallyaboutfeeling_______?5. Tellyourself:“Thisfeelingwillpass.It’sanormalbodyreaction.”



AlternativeResponseWorksheetSituation(When?Where?What?Withwhom?Whatdidyoufeelanxiousabout?)

AlternativeThoughtsandImages:(Arethesethoughtshelpful?Aretheanxiousthoughts100%true/accurate,100%ofthetime?Whatareotherwaysoflookingatthis?Whatisthebiggerpicture?)


Distractmyself




AlternativeFeelings:(Whatarefeelingsthataremorehelpful?Whatifyouactedandthoughtdifferentlyaboutthesituation?Howmightthesechangeshelpyoufeeldifferently?)

OriginalOutcome:(Whatwastheoriginaloutcome?)

DesiredOutcome:(Usingthesenewalternatives,whatwouldyouliketheoutcometobeinthefuture?)



AlternativeResponseWorksheetSituation:(When?Where?What?Withwhom?Whatdidyoufeelanxiousabout?)



Distractmyself









AlternativeResponseWorksheetSituation:(When?Where?What?Withwhom?Whatdidyoufeelanxiousabout?)



Distractmyself









PleasantActivitiesActing Amusing

peopleAttendingaconcert

Beachcombing Beingalone Beingwithanimals

Beingatthebeach

Beingcomplimented

Beingcoached Beingcounseled

Beinginthecountry

Beingatafamilyget‐together

Beingatafraternity/sorority

Beingwithfriends

Beingwithhappypeople

Beinginthemountains

Beingwithmyroommate

BeingwithsomeoneI

love

BeingtoldIamloved

Beingwithmyparents

Bird‐watching

Boating/canoeing

Budgetingmytime

Buyingthingsformyself

BuyingsomethingforsomeoneIcareabout

Camping Caringforplants

Canning/Makingpreserves

Cheeringforsomething

Collectingthings

Combing/brushingmy

hair

Completingadifficulttask

Complimentingorpraisingsomeone

Cooking Counselingsomeone

Dancing DatingsomeoneIlike

Designing/Drafting

Discussingmyfavoritehobby

Doingartwork Doingexperiments

DoingfavorsforpeopleI

likeDoing

houseworkDreamingat

nightDrivinglongdistances

Eatinggoodmeals

Exploring/Hiking

Expressinglovetosomeone

Feelingthepresenceofa

HigherPower

Fishing Fixingmachines

Gardening/Doing

yardwork

Gatheringnaturalobjects

Givinggifts Givingapartyforsomeone

Gettingupearly

Gettingmassages

Givingmassages

Goingtoanamusementpark/zoo

Goingtoabarber/beautician

Goingtoaconcert

Goingtolectures

Goingtoaluncheon/potluck

Goingtoahealthclub/sauna/spa

Goingtothemovies

Goingtoamuseum

Goingonnaturewalks/fieldtrips

Goingtoaplay Goingtoarestaurant

Goingtoareunion

Goingtoaspiritual/

peacefulplace

Goingtoasportsevent

Havingcoffee/teawithfriends

Havingdaydreams

Havingfriendsovertovisit

Havingalivelytalk

Havinglunchwithfriends

Havinganoriginalidea

Havingsparetime

Hearingjokes Helpingsomeone

Hiking Horsebackriding

Improvingmyhealth

Kickingsand/pebbles/leaves

Kissing Knitting/crocheting

Laughing Learningsomethingnew

Listeningtotheratio

Listeningtomusic

Lookingatthestars/moon

Makingcharitabledonations

Makingfoodtogiveaway

Makinganewfriend

Meditating/Doingyoga

Planningororganizingsomething

Playingsports

Playingcards Playingmusic Playingwithapet

Playinginnature

Playingaboardgame/chess

Photography Repairingthings

Reading Reminiscing Ridinginanairplane

Running/jogging

Sayingprayers Seeingbeautifulscenery

Seeingoldfriends

Sewing Shaving Singing Sleepinglate Smellingaflowerorplant

Seeinggoodthings

happentopeople

Solvingapuzzle/

crossword

Speakingaforeignlanguage

Stayinguplate

Smilingatpeople

Takingabath Usingmystrengths

WatchingTV Writinginajournal



PuttingitallTogether:MyPlanforManagingAnxiety

1. Myprimaryanxietysymptomsinclude:(pg.11)

a. Emotional:

b. Physical:

c. Cognitive:

d. Behavioral:

2. Someofmyunhelpfulwaysofthinkingare:(e.g.,allornothingthinking,

catastrophizing,etc.)(pg.20)

3. Mysituationalandcognitivetriggersare:(e.g.,unfamiliarsituations,negativethoughts,etc.)(pg.21,23‐24)

4. Themosthelpfulgroundingtechniques(pg.41‐42):

5. Themosthelpfulrelaxationexercise:



6. Thebesttimeandplacetopracticerelaxationexercises:

7. WhenIfeeloverwhelmed,itishelpfulformeto:(pg.30‐31,35,43)

8. PositivechangesIcanmaketohelpmysleepinclude:(e.g.,noTV30minutesbeforebed,wakeupatthesametimedaily,turnphoneoff,etc.)

9. MYGOALS:Name2goalsyouwouldliketoachieveoverthenextfewmonths,relatedtoanxietyandself‐care.Think:specific,achievable,andmeasurable.a. Name2goalsyouwouldliketoachieverelatedtoANXIETY(e.g.,

Thinkingaboutthestrategiesyoufindmosthelpful,whatwouldyouliketotry,howoften,when,etc.?)

i. ______________________________________________________________________

ii. ______________________________________________________________________

b. Name2goalsyouwouldliketoachieverelatedtoSELF‐CARE:(Whatwillyourself‐carelooklikeoverthenextfewmonths?Thesecouldbegoalsrelatedtonutrition,exercise,sleep,schoolwork,leisureactivities,etc.)

i. _______________________________________________________________________

ii. ________________________________________________________________________

10. Reminderaboutplanandgoals:

___________________________________________________________________________________

___________________________________________________________________________________

___________________________________________________________________________________





StressversusAnxiety

EverydayAnxiety(Stress) AnxietyDisorder

Inresponsetoaknownenvironmentalfactor

Inresponsetoanunknownsourceorinresponsetotheexperienceofstress

Symptomsgoawaywhenthestressorgoesaway

Symptomsremaindespitenoidentifiablestressor

Worryaboutlivingawayfromhomeforthefirsttime,passingaclass,aromanticbreakup,orotherimportantlifeevents

Constantandunsubstantiatedworrythatcausessignificantdistressandinterfereswithyourdailylife

Embarrassmentorself‐consciousnessinanuncomfortableorawkwardsocialsituation;feelingnervousaboutmeetingnewpeople

Avoidanceofsocialsituationsduetofearofbeingjudged,embarrassed,orhumiliated

Feelingnervousorsweatingbeforeabigtest,classpresentation,stageperformance,orothersignificantevent

Panicattacksthatseemoutoftheblueandpreoccupationwiththefearofhavinganotherone

Realisticfearofadangerousobject,place,orsituation(e.g.fearofpoisonoussnakes)

Irrationalfearoravoidanceofanobject,place,orsituationthatposeslittleornothreatofdanger(e.g.fearofelevators)

Makingsurethatyouarehealthyandlivinginasafeenvironment

Performinguncontrollablerepetitiveactions,suchasexcessivecleaning,checking,touchingorarranging

Adaptedfrom:http://www.adaa.org/understanding‐anxiety



UnderstandingAnxietyDisordersWhileanxietyisanormalandadaptiveexperienceforeveryone,anxietydisordersarecharacterizedbysignificantdistressorimpairmentinsocial,academic/occupational,orotherimportantareasoffunctioning(e.g.,yourgeneralabilitytofunctioninlife).Someofthemostcommonanxietydisordersinclude:GeneralizedAnxietyDisorder: Chronicandunrealisticworrythatfeels

difficulttocontrolabouteverydaythings(i.e.,thingsthatdonotworrymostpeople)

SocialAnxietyDisorder: Chronicworrysolelyrelatedtosocial

situationsPanicDisorder: Characterizedbyepisodesof“panic”that

includethingslike:adrenalinesurge,fearoflosingcontrol,chestpain,racingheart,shortnessofbreath,dizziness

Phobias: Specificfearsthatareexcessiveinnature

andoftenleadtoavoidingthatwhichisfeared(e.g.,publicspeaking,heights,tunnels,etc.)

Obsessive‐CompulsiveDisorder: Excessiverumination(thinking)with

repetitivebehaviorstoreduceanxiety



GroundingExercises

Whenpeoplebecomeoverwhelmedwithdistressingthoughtsorfeelings,includingintenseanxiety,activitiesthatkeepyourmindandbodyconnected(called“grounding”)canbehelpfulinregainingasenseofstabilityandmentalfocus.Thefollowingareanumberofgroundingexercisestochoosefromtohelpfirmlyanchoryouinthepresentmomentandprovideyouwithspacetochoosewheretofocusyourenergy.Youmayneedtotrymultipledifferentexercisestofindoneortwothatworkbestforyou.1. Remindyourselfofwhoyouarenow.Stateyourname,ageandwhereyou

arerightnow.

2. Taketenslowdeepbreaths.Focusyourattentiononeachbreathonthewayinandonthewayout.Saythenumberofthebreathtoyourselfasyouexhale.

3. Splashwateronyourfaceorplaceacoolwetclothonyourface.

4. Paypurposefulattentionasyouholdacold(non‐alcoholic)beverageinyourhands.Feelthecoldness,andthewetnessontheoutside.Notethetasteasyoudrink.Youcanalsodothisexercisewithawarmbeverage.

5. Finda“groundingobject”tohold,lookat,listento,and/orsmell.Thiscouldbeasoftobjectsuchasapilloworstuffedanimal,asmoothstoneyoufoundonthebeach,apictureofabeautifulsceneorlovedone,and/oranyotherobjectthatrepresentssafetyorcomfort.

6. Listentomusic.Paycloseattentionandlistenforsomethingnewordifferent.

7. Ifyouwakeupsuddenlyduringthenightandfeeldisorientedordistressed,remindyourselfwhoyouareandwhereyouare.Lookaroundtheroomandnoticefamiliarobjectsandnamethem.Feelthebedyouarelyingon,thesoftnessofthesheetsorblankets,thewarmthorcoldnessoftheair,andnoticeanysoundsyouhear.Remindyourselfthatyouaresafe.



8. Feeltheclothesonyourbody,whetheryourarmsandlegsarecoveredornot,andthesensationofyourclothesasyoumoveinthem.

9. Whilesitting,feelthechairunderyouandtheweightofyourbodyandlegspressingdownonit.

10. Ifyouarelyingdown,feelthecontactbetweenyourhead,yourbodyandyourlegs,astheytouchthesurfaceyouarelyingon.Startingfromyourhead,noticehoweachpartfeels,allthewaydowntoyourfeet,onthesoftorhardsurface.

11. Stop,look,andlisten.Noticeandnamewhatyoucanseeandhearnearbyandinthedistance.

12. Lookaroundyou,noticewhatisfrontofyouandtoeachside,namefirstlargeobjectsandthensmallerones.

13. Getup,walkaround,takeyourtimetonoticeeachstepasyoutakeonethenanother.

14. Ifyoucan,stepoutside,noticethetemperature,thesoundsaroundyou,thegroundunderyourfeet,thesmellintheair,etc.

15. “54321”GroundingExercise:o Name5thingsyoucanseeintheroomwithyou.o Name4thingsyoucanfeel(tactile;e.g.“chaironmyback”or“feet

onfloor”)o Name3thingsyoucanhearrightnowo Name2thingsyoucansmellrightnowo Name1goodthingaboutyourself

16. Writeand/orsaygroundingstatementso Thissituationwon’tlastforevero Thistooshallpass.o Icanridethisoutandnotletitgetmedown.o Myanxiety/fear/sadnesswon’tkillme;itjustdoesn’tfeelgood

rightnow.o Thesearejustmyfeelingsandeventuallythey’llgoaway.

Adaptedfrom:http://www.livingwell.org.au/well‐being/grounding‐exercises/



BreathingExercisesBelly(orDiaphragmatic)BreathingYoucandothisexerciseinanyposition,butitishelpfultodothisexercisewhilelyingdownwhenfirstlearningbellybreathing.1. Liecomfortablyonyourback,withapillowunderyourhead,yourkneesbent

andyourbackflat.Youcanstretchyourlegsoutifthat'smorecomfortable.

2. Placeonehandonyourbellyandonehandonyourupperchest.

3. Inhaleslowlyandexpandyourbellyasyoubreathesothatyourlowerhandmoveswithyourbelly.Thehandonyourchestshouldremainasstillaspossible.

4. Slowlyexhale,focusingonthemovementofyourbellyandlowerhandasitreturnstoitsoriginalposition.

5. Repeatsteps3&4forseveralminutes,alwaysfocusingonthemovementofthebellyasyoubreathe.Ifyourmindwanders,gentlybringyourattentionbacktoyourbreathing.

Breath‐CountingExerciseThisexercisefocusesontheuseofcountingwiththerhythmofthebreath.Startwithashortperiodoftimeandgraduallyincreasethetime.Setatimersothatyoudonothavetoworryaboutwhentostop.1. Findacomfortableposition.Takeseveraldeepbreathsandsettleinto

yourself.Youmayeithercloseyoureyesorkeepthemopen,dependingonyourowncomfort.Ifyoukeepthemopen,fixthemonanobjectoraspotontheflooraboutfourfeetinfrontofyou.Youreyesmaybeeitherfocusedorunfocused.

2. Takedeep,comfortablebreaths.Noticeyourinhalation.Thepausebetweeninhalingandexhaling,yourexhalation,andthepausebeforestartingagain.

3. Asyouinhale,count,“one...”Asyouexhale,count,“two...”Inhale,“three...”Exhale,“four...”Continueuntilyoureach10thenstartover.

4. Ifyoulosecount,simplybeginwith“one”onyournextinhalation.

5. Ifyounoticeyourmindhaswandered,gentlynoticethis,andreturnyourfocusbacktocountingyourbreath.

6. Ifyounoticeanybodysensationscatchingyourattention,focusonthatsensationuntilitfades.Thenreturnyourattentionbacktocountingyourbreaths.



OnlineResourcesCalPolySLOCounselingServices‐GuidedMeditationshttps://www.youtube.com/playlist?list=PLI44jVzqiSNuYrPNPWHc6BTqrwBXtlhrSMayoClinicStressReductionWebsitehttp://www.mayoclinic.com/health/mindfulness‐exercises/MY02124MeditationOasiswww.meditationoasis.comMindfulwww.mindful.orgMindfulnessResearchGuidehttp://www.mindfulexperience.org/UCLAMindfulAwarenessResearchCenter‐GuidedMedicationshttp://marc.ucla.edu/body.cfm?id=22

AppsforyourSmartphone,Tablet,orComputerACTCoachBreathe2relaxBreathingtechniquesbyHemalayaaCBTi‐Coach

MindfulnessCoachMindshiftT2MoodTrackerTakeabreak!

BooksforFurtherReadingTheAnxietyandPhobiaWorkbookbyBourne(2011)

TheAnxietyandWorryWorkbookbyClark&Beck(2012)

GetOutofYourMindandIntoYourLifebyHayes&Smith(2005)

Self‐EsteembyMcKayandFanning(2005)

TheMindfulWayWorkbookbyTeasdale,Williams,Segal,&Kabat‐Zinn(2014)

TheMindfulnessWorkbook: ATeachYourselfGuidebyLangley(2013)

TheRelaxation&StressReductionWorkbookbyDavis,Robbins,Eshelman&McKay(2008)

Anxiety Toolbox Student Workbook 2016 08 17...Page 3 Counseling Services Anxiety Toolbox Workbook (805) 756‐2511 (24/7) counseling.calpoly.edu Welcome! Welcome to Anxiety Toolbox,

Documents