Worcs Session 1 Introduction May2012

Choice, Responsiveness, Integration & Shared Care

Choice, Responsiveness,

Integration & Shared Care

Isaac Maddox HouseShrub Hill Road, WorcesterWR4 9RWTel: 01527 488 000

www.worcsmhp.nhs.uk|

Welcome to Managing Low MoodAnd AnxietySession 1


Housekeeping

Fire alarms Toilets

Smoking Breaks

ParkingMobile phones (turn off unless

expecting urgent call)


Agreed Sharing

Punctuality Confidentiality is a must at all times Not talking over others Respecting others opinions Respecting others beliefs, views, culture Respecting others experiences Turn off mobiles Feel free to take ‘time out’

• If you leave the session and do not return, one of our facilitators may follow to see how you are

Please call us on 01905 760118 if you are unable to attend a session

Is there anything you would like to add?


Course Overview

Week 1: Introduction to the programme and to the CB approach

Week 2: Understanding & Managing Depression and Low Mood

Week 3:Understanding Anxiety and Panic

Week 4: Managing Anxiety and Panic

Week 5: Challenging Negative Thoughts

Week 6: Stress Management and Well-Being

Week 7: Maintaining Your Progress


What to Expect

• Facilitators are like personal trainers….!

• Education on the signs and symptoms of anxiety and depression

• Introduce techniques to manage anxiety and depression

• Informal group discussion using examples • Individual activities outside the group – Homework

• PHQ-9 and GAD-7 questionnaires


Please take some time to fill out a questionnaire .....


Self harm and Keeping Safe

Fleeting thoughts are not uncommon when people are feeling low and distressed.

Fleeting thoughts are thoughts that come into our heads and go out again without dwelling on them.


Self harm and Keeping Safe

However, Persistent thoughts of harm to yourself or others are those that involve actively planning, feeling hopeless

and feeling like there is no other way out.

What to do:

Talk to your GP as an urgent appointment requirement

Go to A & E or out of hours GP clinics

Ring Samaritans on: 08457 90 90 90

Get a friend/family member to stay with you


Treatments : Medication

• Take as prescribed

• Side effects You may experience some side affects initially when you start

taking your medication but these usually subside within a few weeks. Follow the advice within the packet and speak to your GP if you have any concerns.

• 6 months post-improvement It is usual for the GP to advise you keep taking your medication six

months after you start feeling better. This is because evidence has shown this has greater long term effects. When it is time to reduce your medication your GP will usually discuss options for reducing this gradually.


•Keep talking to your GPWe are not able to offer individual advise on medication as part of this course. Our advice would be to keep talking to your GP about any queries you may have.

Treatments : Medication continued


What are your hopes or fears about the group


Today’s Session

• Understanding your difficulties• What is cognitive behavioural therapy?• How can a CB approach help us understand our

difficulties?• How are our thoughts, emotions, physical

feelings and behaviour (what we do) linked?• Goal setting• A breathing technique


What is a ‘Cognitive Behavioural Therapy’ Approach?

Cognitive behavioural therapy looks at the way in which our thoughts can be connected to our moods, the things we do, and the way we feel physically and emotionally.


Cognitive Behavioural Model of Depression and Anxiety

CognitionsCognitions: : Thoughts, Thoughts, beliefs, beliefs, attitudes and attitudes and imagesimages

Behaviour:Behaviour:What we do, What we do, how we how we behavebehave

EmotionsEmotions: : How we feel, How we feel, our moodour mood

Physical Physical Symptoms:Symptoms: How we feel in How we feel in our bodies, our bodies, bodily bodily symptoms/ symptoms/ sensationssensations


Win The Lottery

Thoughts

Emotions

Behaviour

Physical feelings

What would you do?


The Traffic Accident

• When there's a traffic accident, police ask for witnesses to come forward and describe what happened. They like to have as many witness statements as possible so that they can build up enough evidence to give them a broader, more realistic version of events. The drivers of the cars, the passengers and on lookers will all have slightly different perspectives, depending on where they were, how far they were, how good a view they had, what else was going on, how much danger they felt they were in, how the accident affected them, what the accident means to them.

• It's the same principle with everything - each situation, event, conversation, means something different to all those involved, and also to those not involved.


Situation/ environment:

A friend Walks Past you in the street and doesn’t stop

Thoughts

?


Thoughts

“They’ve ignored me”

“I must have done something wrong”

“They don’t like me anymore”

Situation/ environment:

A friend Walks Past you in the street and doesn’t stop

Emotions

?


Thoughts




Situation/ environment: A friend Walks Past you

EmotionsUpsetConfused Worried

Physical Affects/Feelings

?


Thoughts





EmotionsUpsetConfused Worried

Physical Affects/FeelingsTearfulTired

Stomach Churning

Behaviour

?


Thoughts





Emotions

UpsetConfused Worried

Physical Affects/FeelingsTearfulTired

Stomach Churning

Behaviour Ruminate – (think

about what happened)

Avoid FriendAvoid contact


Exercise: Susan is standing in a line at the grocery store and thinks ‘this always happens to me - I always pick the wrong queue. I wish I had stayed at home. I don’t know why I bother’.

What mood do you think Susan will be in? How do you think she will feel physically?What do you think she will do?How will doing this make her feel?


Situation/ environment

Thoughts

Emotions

Behaviour

Physical feelings

What if you did one thing differently?


Exercise: Derek is standing in a line at the grocery store and thinks ‘I cant cope with this queue, everyone is looking at me and I need to leave’.

What mood do you think he will be in? How do you think he feel physically?What do you think he will do?How will doing this make him feel?


Situation/ environment

Thoughts

Emotions

Behaviour

Physical feelings

What if you did one thing differently?


Cognitive Behavioural Model of Depression and Anxiety

CognitionsCognitions: : Thoughts, Thoughts, beliefs, beliefs, attitudes and attitudes and imagesimages

Behaviour:Behaviour:What we do, What we do, how we how we behavebehave

EmotionsEmotions: : How we feel, How we feel, our moodour mood

Physical Physical Symptoms:Symptoms: How we feel in How we feel in our bodies, our bodies, bodily bodily symptoms/ symptoms/ sensationssensations


Goal Setting

•Goal setting is an important part of helping you get back on track

•Goals give us an aim to work towards and help us plan how we can achieve this goal (short term, mid term, long term)

•Planning goals helps us know when we have achieved them or what else we need to do to get there

•Common goal: To feel better.Ask yourself: ‘How will I know I am feeling better?’ ‘What would I be doing differently to show that I am feeling better?’


Goal Planning – The Six Steps

Successful goals are specific to you and based on what you value.

You could consider the following: life long goals? What activities give you the greatest feeling of pleasure and achievement? What have you always wanted to do but been afraid to attempt?

1. List all the ideas that come into your head about what you really want. Think in terms of Home/Family, Work and Leisure/personal development.


The wheel of life

Fun, Leisure and

Recreation

Personal Growth and

Learning

Significant Other /

Romance

Physical Environment

(eg. Home)Career

Money

Health

Friends and Family

0 10

INSTRUCTIONSTake the centre of the wheel as 0 and the outer edge as 10, rank your level of satisfaction with each area out of 10 by drawing a straight or curved line to create a new outer edge (see example with hand out)


2. Re-examine these ideas – make them SMART

3. Create an action plan outlining the steps you need to take to achieve your goals.

4. Identify any obstacles and plan for them.

5. Build in rewards for when you complete stages and achieve goals.

6. Visualise the end result, have a clear mental image of what things will be like when you achieve your goal.


Where to Start…At home...

• Try to identify your own ‘cycle’ – record on the handoutsSituations, Thoughts, Feelings, your actions/behaviour… consequences?

• What would you like to change? How would you like things to be different? Record some goals on your handouts. Try the wheel of life for yourself.



Breathe out to the count of 11

Breathe out to the count of 11

Breathe in to the count of 7

Breathe in to the count of 7

It some times help to visualize breathing round the square….


Any Questions?

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Worcs Session 1 Introduction May2012

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