Objectives
Taming the Worry Monster Play Therapy Techniques for Anxious Children Presented by Pam Dyson, MA, LPC-S, RPT-S Texas School Counselor Conference February 13, 2017 4:30pm – 6:00pm ©2017 Pam Dyson, All Rights Reserved
Understand the prevalence of anxiety in children and the need for timely intervention Identify common types of anxiety disorders and how they present in children Describe play therapy interventions that will help children manage anxiety
©2017 Pam Dyson, All Rights Reserved
Anxiety
Anxiety in Children
Natural human reaction involving mind and body Alarm system activated when a person perceives danger or threat Being scared of being scared
Most common psychological disorder of childhood Play therapy researchers have devoted more attention to studying anxiety than any other childhood disorder Consequently, a variety of evidence-based play interventions are available for resolving anxiety
©2017 Pam Dyson, All Rights Reserved
©2017 Pam Dyson, All Rights Reserved
Prevalence of Anxiety in Children 1 in 8 children are affected by anxiety
(Schaefer, 2010)
Risk Factors for Anxiety Genetics
(adaa.org)
8% of teens have an anxiety disorder with symptoms commonly emerging around age 6
Being female Temperament - Personality
(nimhnih.gov)
80 percent of youth with an anxiety disorder are not getting treatment
Life Events - Trauma Having another mental health disorder
(speakupforkids.org) ©2017 Pam Dyson, All Rights Reserved
©2017 Pam Dyson, All Rights Reserved
(mayoclinic.org)
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5 Things Never to Say to an Anxious Child It’s going to be OK. Trust me. There’s nothing to be scared of. Let me tell you all the reasons you don’t have to worry. Stop being such a worrier!
Anxiety Disorders DSM-5 Separation Anxiety Disorder Selective Mutism Specific Phobia Social Anxiety Disorder Panic Disorder Agoraphobia Generalized Anxiety Disorder
We don’t understand why you’re so worried. ©2017 Pam Dyson, All Rights Reserved
(Renee Jain, psychcentral.com)
Obsessive-Compulsive and Related Disorders DSM-5 Obsessive Compulsive Disorder Body Dysmorphic Disorder Hoarding Disorder Tricotillomania Excoriation (Skin Picking) Disorder
©2017 Pam Dyson, All Rights Reserved
Separation Anxiety
©2017 Pam Dyson, All Rights Reserved
©2017 Pam Dyson, All Rights Reserved
Trauma and Stressor Related Disorders DSM-5 Reactive Attachment Disorder Disinhibited Social Engagement Disorder Posttraumatic Stress Disorder Acute Stress Disorder Adjustment Disorders
©2017 Pam Dyson, All Rights Reserved
Separation Anxiety
©2017 Pam Dyson, All Rights Reserved
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Causes of Separation Anxiety
Selective Mutism
Change in environment: new home, school Stress: illness, death of a loved one or pet Overprotective parent: manifestation of parent’s own anxiety
©2017 Pam Dyson, All Rights Reserved
www.selectivemutismcenter.org
©2017 Pam Dyson, All Rights Reserved
Causes of Selective Mutism
Zelinger Fortune Teller
Manifestation of an inhibited temperament Genetic predisposition to anxiety May have one or more other anxiety disorders
©2017 Pam Dyson, All Rights Reserved
©2017 Pam Dyson, All Rights Reserved
Specific Phobia
www.drzelinger.com
Causes of Specific Phobia
Animal: dogs, snakes, insects
Traumatic events
Natural Environment: storms, water, dark
Panic attacks in the to-be-feared situation
Situational Phobias: flying, tunnels, bridges
Observing others undergoing trauma or demonstrating fearfulness
Blood-Injection-Injury: blood, needles, medical procedures ©2017 Pam Dyson, All Rights Reserved
Informational transmission: repeated warnings ©2017 Pam Dyson, All Rights Reserved
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Causes of Social Anxiety Disorder (Social Phobia)
Causes of Panic Disorder Connection with major life transitions
Genetic May follow a stressful or humiliating experience: teasing, bullying, rejection Environmental: learned behavior after observing anxious behavior of others ©2017 Pam Dyson, All Rights Reserved
Severe stress: death of a loved one, divorce can trigger panic attacks Medical conditions and other physical causes: Mitral valve prolapse, Hypoglycemia ©2017 Pam Dyson, All Rights Reserved
Causes of GAD Brain chemistry: abnormal levels of certain neurotransmitters in the brain such as serotonin, dopamine Genetic Life experiences: stress, trauma
©2017 Pam Dyson, All Rights Reserved
Causes of OCD Blocked flow of serotonin causes brain's "alarm system" to overreact and misinterpret information Genetic PANDAS - Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections ©2017 Pam Dyson, All Rights Reserved
Causes of PTSD
Intervention Models for Treating Anxiety
Traumatic or terrifying past experience
Psychoeducational – understand the nature of the anxiety
The more extreme and prolonged the threat, the greater the risk of developing PTSD
Strengthen parent-child relationship
Extent to which the event was unexpected, uncontrollable, and inescapable also plays a role
Calm the physical response of anxiety Externalize the anxiety with CBPT (Goodyear-Brown, 2010)
©2017 Pam Dyson, All Rights Reserved
©2017 Pam Dyson, All Rights Reserved
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Intervention Models for Treating Anxiety
Intervention Models for Treating Anxiety
Child needs to articulate their unique set of worries
Once a child understands the way anxiety works, has learned how to calm the physiology and can fight the fear through various coping strategies….. a precise set of graduated exposures can be structured.
Describes how the worries show up in their physical body Identifies anxiety producing thoughts
(Goodyear-Brown, 2010) (Goodyear-Brown, 2010)
©2017 Pam Dyson, All Rights Reserved
Butterflies in My Stomach
(Lowenstein, 1999)
©2017 Pam Dyson, All Rights Reserved
Worry Web
©2017 Pam Dyson, All Rights Reserved
©2017 Pam Dyson, All Rights Reserved
Anxiety Thermometer
©2017 Pam Dyson, All Rights Reserved
All Tied Up With Worry
©2017 Pam Dyson, All Rights Reserved
(kimscounselingcorner.com, 2012)
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Worry Dolls
Calming Cream
Worry Stones ©2017 Pam Dyson, All Rights Reserved
©2017 Pam Dyson, All Rights Reserved
Worry Monster
Anxiety Airplane
©2017 Pam Dyson, All Rights Reserved
©2017 Pam Dyson, All Rights Reserved
Dreamcatcher
©2017 Pam Dyson, All Rights Reserved
Bubble and Pinwheel Breathing
©2017 Pam Dyson, All Rights Reserved
(Goodyear-Brown, 2010)
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The Power of a Clipboard
Thought Stopping
(Goodyear-Brown, 2010) ©2017 Pam Dyson, All Rights Reserved
©2017 Pam Dyson, All Rights Reserved
What I Know – What I Don’t Know
(lynnlyonsnh.com)
©2017 Pam Dyson, All Rights Reserved
©2017 Pam Dyson, All Rights Reserved
References Goodyear-Brown, P. (2010). Strategic play therapy techniques for anxious preschoolers. In C. Schaefer (Ed.) Play Therapy for Preschool Children (pp. 107-129). Washington DC: American Psychological Association. Goodyear-Brown, P. (2010). Worry Wars: An Anxiety Workbook for Kids and Their Helpful Adults! Nashville, TN: Paris Goodyear-Brown. Lowenstein, L. (1999) Creative Interventions for Troubled Children & Youth Toronto: Champion Press.
FREE E-BOOK Favorite Therapeutic Activities for Children, Adolescents, and Families: Practitioners Share Their Most Effective Interventions www.lianalowenstein.com
Schaefer, C. (2010). Evidence supporting the benefit of play for mild to moderate behavior problems of preschool children. In C. Schaefer (Ed.) Play Therapy for Preschool Children (pp. 31-45). Washington DC: American Psychological Association.
©2017 Pam Dyson, All Rights Reserved
©2017 Pam Dyson, All Rights Reserved
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Child Therapy Toys will give DFW Center for Play Therapy Training attendees a discount on their purchases. Enter “Dyson” in the coupon box on the checkout page and you will receive a 15% discount. Code expires September 2020.
©2017 Pam Dyson, All Rights Reserved
©2017 Pam Dyson, All Rights Reserved
Pam Dyson, MA, LPC-S, RPT-S Practical Solutions to Child Behavior Problems
3900 Pebble Creek Ct., Suite 102 Plano, TX 75023
[email protected] 469-209-1590 ©2017 Pam Dyson, All Rights Reserved
Play Therapy Supply will give DFW Center for Play Therapy Training attendees free shipping on ANY order. Simply enter the coupon code PAM2017 in the box on the check out page.
Providing Affordable Continuing Education Opportunities for Play Therapy Credentialing
3900 Pebble Creek Ct., Suite 102 Plano, TX 75023 Phone: 469-209-1590
[email protected] www.dfwplaytherapy.com APT Approved Provider 10-269 TX LPC Approved Provider 2312, TX LCSW Approved Provider 6779 TX LMFT Approved Provider 831 ©2017 Pam Dyson, All Rights Reserved
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