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Brief Interventions for Anxiety Disorders with Children and Adults
Brief Interventions for Anxiety Disorders with Children and Adults

Section 17
Intervention for Children

CEU Question 17 | CE Test | Table of Contents | Anxiety
Counselor CEUs, Psychologist CEs, Social Worker CEUs, MFT CEUs

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♦ Video Time Visualization
Next, I will outline for you two techniques by Shurts I use specifically with children. While I am explaining the technique, think of a child in a foster home who has suffered abuse, a child who has an illness, a child who is acting out behavior in school, or a child with behavioral symptoms following his parents' divorce.

This first intervention is called video time. Here's a brief outline of what I say to the child. This may take several sessions. I say:

"Remember when your mom and dad had that big fight, right before dad left? What happened? Did you feel pretty sad or angry?" "No, I felt it was my fault" was the reply. After we explore this I ask, "If you could put a number from 1 to 10 on your feelings with 10 being at the top busting with feeling, what number would you say?"

After I explain this further, I say... "Imagine you are at home and you are going to watch a video. This is a video of the night your father got mad and left. Begin watching the video of that night. Now rewind your video back to the beginning, just like when you rent a video. Watch it in fast forward. Rewind it fast. Forward it even faster. Rewind even faster. Play forward even faster still. Rewind still faster. Continue forwarding and rewinding faster and faster until the video "POP" destructs.

"Now wrap your arms around yourself from shoulder to shoulder. Love yourself the best you can at this moment. Now with your arms around yourself, watch the video again. Is your feeling any less strong? Now imagine a new video showing you doing something you really like to do. How do you feel now? (Rate: 0-10)."

Here's an outline of video time
1. Awareness
of the feeling, situation, and habit your client wants to change. Rate: 0-10, 10 being the highest/most intense.
2. Watch movie going forward of you with whatever you want to transform.
3. Imagine self at home. Watch movie forward of you with what you want to transform.
4. Rewind.
5. Faster forward. Faster rewind and forward video until it self-destructs in smoke.
6. Hug self and love yourself the best you can at each moment while watching movie of you with old habit. Imagine a new future having your desired goal.
7. Notice the differences. Rate: 0-10.

8 Steps for the Picture on The Wall
Children who are good at visualizing really like this one. Here is what I say:
"Think back to the scene of you on the playground when the kid pushed you down.
1. If you could put a number from 0 to 10 on your feelings with 10 being at the top busting with feeling, what number would you say?
2. See an 8x10 picture out in front of you with the scene from the playground.
3. In the bottom right-hand side of this picture, see a picture the size of a postage stamp of you with the result you desire.
4. Start bringing this whole picture in towards you. As it comes towards you, say, "Whish" very long and drawn out. Also, as it comes towards you, the little picture grows bigger and bigger.
5. At the end of saying, "Whish," the little picture is now the size of the 8x10 and is near you. Faster and faster.
6. Hug and love yourself the best you can at each moment while seeing yourself with your desired result.
7. Notice what is different. Rate: your feelings now from 0-10.
8. If necessary, repeat."

♦ Outline of the Picture on The Wall Intervention.

1. Become aware of what you want to transform. Rate 0-10 (10 most intense).
2. See 8x10 picture of you with what you want to transform.
3. Postage stamp size picture of you with desired results is in bottom right-hand corner.
4. Say, "Whish," with picture coming toward you. Little one getting bigger and bigger. Small picture is now 8x10 size and jumps inside you.
5. Repeat steps 2-4. Picture comes in faster and faster until you see you with only the desired result.
6. Hug and love yourself the best you can at each moment while seeing yourself with desired outcome.
7. Notice what is different. Rate: 0-10.
8. Repeat, if necessary.

Anxiety Disorders of Childhood and Adolescence

- Rhoads, J. C. and Donnelly, C. L. Anxiety Disorders of Childhood and Adolescence. Pediatric Psychiatry Network.

Peer-Reviewed Journal Article References:
Fehr, K. K., Russ, S. W., & Ievers-Landis, C. E. (2016). Treatment of sleep problems in young children: A case series report of a cognitive–behavioral play intervention. Clinical Practice in Pediatric Psychology, 4(3), 306–317.

McGovern, C. M., Arcoleo, K., & Melnyk, B. (2019). COPE for asthma: Outcomes of a cognitive behavioral intervention for children with asthma and anxiety. School Psychology, 34(6), 665–676.

Schaeffer, M. W., Rozek, C. S., Berkowitz, T., Levine, S. C., & Beilock, S. L. (2018). Disassociating the relation between parents’ math anxiety and children’s math achievement: Long-term effects of a math app intervention. Journal of Experimental Psychology: General, 147(12), 1782–1790.

Van der Giessen, D., Colonnesi, C., & Bögels, S. M. (2019). Changes in rejection and psychological control during parent–child interactions following CBT for children’s anxiety disorder. Journal of Family Psychology, 33(7), 775–787.

What is an example of interventions specifically intended for children who have an anxiety disorder? To select and enter your answer go to Test.

Summary and Conclusion
We have discussed the intervention techniques of the Cognitive Model: overcoming resistance to learning, keeping brief therapy brief, assisting your client in distancing himself or herself from the anxiety, guidelines for asking specific questions, techniques to explore the questions of What's the evidence? What's another way of looking at it? and So what if it does happen? Also, we discussed how to help your client to break the vicious cycle of anxiety, cognitive mapping restructuring, and ways to raise self-confidence, as well as visualizations to use with children.

Four Techniques I Use
In conclusion, I'd like to share the 4 techniques I use the most frequently with clients.
First, I find making the client aware that their anxiety may come from thoughts which are so fast that they are unaware of the cause of their anxiety.
Second, to understand the difference between "I am anxious" and "I feel anxious."
Third, pending assessment of other disorders, having the client separate from the anxious thoughts by saying, "Mary is upset about the expression on her husband's face."
Fourth, putting the situation in perspective and developing a cause of action if their worst fears materialize.

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