MANAGEMENT OF ANXIETY

Respected Course
Instructor

 Dr. Saima Majeed

 Ph.d Clinical Psychology
 Senior Clinical psychologist (PIMH)
Group Presentation
Psychological
Group Members, Names Interventions & Managmten
1)Tania Sikander Introduction of Anxiety
Psychoeducation
Mood Monitering and activity
chart
2) Syed Fakhar Abbas zaidi Relaxation exercises:
Deep Breathing
Progressive Muscle
Relaxation(PMR)
Sleep Hygien Tips
3) Zunaira Qayyum Khan Systematic Desensitization
In Vivo Exposure
Virtual reality Exposure
4) Islahuddin Thought challenging Technique
CBT TECHNIQUES FOR ANXIETY

5) Maryam Shahzadi ABC Model in REBT

RESPECTED TEACHER AND MY DEAR
CLASS FELLOWS

 I'm Tania Sikander. I am going to

give you an overview about anxiety
and its pathology. Let's have a look
at it …
Prevalence of Anxiety Disorder

 Anxiety Disorders affect 40 million

people in the United States. It is the
most common group of mental
illnesses in the country. However,
only 36.9 percent of people with an
anxiety disorder receive treatment
Normal Anxiety vs. Anxiety Disorder

 Anxiety is a normal and often healthy

emotion. However, when a person
regularly feels disproportionate
levels of anxiety, it becomes a
psychological disorder.
What is anxiety?

 The American Psychological

Association (APA) defines anxiety as
“an emotion characterized by
feelings of tension, worried thoughts
and physical changes like increased
blood pressure.”
 Here’s how therapy can
 help.
Anxiety disorders differ considerably, so therapy
should be tailored to your specific symptoms and
diagnosis.
 If you have obsessive-compulsive disorder (OCD),
for example, your treatment will be different from
someone who needs help for anxiety attacks.
 The length of therapy will also depend on the type
and severity of your anxiety disorder. However,
many anxiety therapies are relatively short-term.
 According to the American Psychological
Association, many people improve significantly
within 8 to 10 therapy sessions.
When does anxiety need treatment?

 If it's disturbed your daily life

adaptive functioning. If it's disturbed
your occupational domain. If it's
disturbed your social domain.
 Behavioural Activation

 Examples of Pleasurable Activities:

 Listening to music

 Drawing/painting

 Yoga/meditation

 Going to a sporting event

 Going to a restaurant

 Visiting/telephoning a friend
Mood Monitoring and
Activity
Chart
Time Sun Mon Tue
6-7 AM
Wed Thu Fri Sat

7-8 AM

8-9 AM
Clien
t
910AM Nam
10- e:
11AM XYZ
11-12
Noon
12-
01PM
Till 07
pM
Psychoeducation

 Psychoeducation is an evidence-based 
therapeutic intervention for patients and
their loved ones that provides information
and support to better understand and cope
with illness.
 Psychoeducation refers to the process of
providing education and information to those
seeking or receiving mental health services,
such as people diagnosed with mental health
conditions (or life-threatening/terminal
illnesses) and their family members.
RESPECTED TEACHER AND MY DEAR CLASS FELLOWS

 I'm Fakhar Zaidi and I am going to

tell you about relaxation techniques
to overcome anxiety. And sleep
hygiene tips.
 Deep breathing
 Progressive Muscle
Relaxation(PMR)
 Sleep hygiene tipes
Importance of Deep Breathing Deep
breathing

 helps you to avoid the "fight-or-flight"

response to stressful situations. In
these situations, your body's automatic
systems are on high alert and signal
your heart to beat faster and breathing
rate to increase. This way, you will be
more likely to use this technique when
faced with situations that trigger
symptoms of social anxiety disorder
(SAD) or other issues with anxiety.
Steps of Deep Breathing

 Find a quiet place free of

distractions.
 Place one hand on your upper chest
and the other hand on your stomach.
…
 After a take a deep breath in
through your nose, slowly exhale
while counting to three.
 Continue this pattern of rhythmic
breathing for three to ten times.
Progressive Muscle
Relaxation(PMR)
 First, the client gets into a comfortable
position in a comfortable chair such as a
recliner.
 In progressive muscle relaxation (PMR), the
person systematically tenses and relaxes
each of the major muscle groups in the
body.
 The relaxation exercise should be conducted
in a quiet room orsome other place that has
no major distractions. Next, the client closes
his or her eyes and tenses and relaxes each
muscle group
 Starting with the first muscle group,
the dominant hand and arm, the
client tenses the muscles tightly for
about 5 to 10 seconds and then
abruptly releases the tension

 This allows the client to feel the

contrast between the tension and
relaxation in that particular muscle
group
 Muscle Group Method of Tensing

Make a tight fist, curl toward shoulder, bend arm to elbow.

Dominant hand and
arm. Same as dominant
.Open eyes wide and raise eyebrows. Make as many wrinkles as
Nondominant hand and
possible on your forehead
arm . .
Forehead and eyes Frown, squint eyes, wrinkle nose.
Neck Clench teeth, protrude chin. Corners of mouth should be
 
pulled down.
Upper cheeks and nose .
Upper back, chest Shrug shoulders and pull shoulder blades back
Jaw, lower face, as far as possible, as though trying to have them touch one another.
Shoulders, upper back,
chest Bend forward slightly at waist, protrude stomach, tighten muscles
as
. much as possible, making them very hard .

Squeeze buttocks together, push down into chair at same time .

Abdomen
Push large muscle on top of thigh against smaller areas on bottom of
  thigh. Make muscles hard, press them against each other.

Buttocks . Pull toes up till they point toward head. Stretch and harden muscles
Dominant upper leg in calf.
Point toes outward and downward, stretching foot.
. Same as dominant

Dominant lower leg Same as dominant.

Same as dominant.
 
Dominant foot .
Nondominant upper legt.
Nondominant lower leg .
Sleep hygiene tipes
 Avoid daytime naps.
 Donot forced for sleep
 Clean the bed before sleep
 Don't stay in bed awake for more
than 5-10 minutes.
 Don't watch TV, use the
computer,mobil or read in bed.
 Drink caffeinated drinks with caution.
 Avoid inappropriate substances that
interfere with sleep.
 Have a quiet, comfortable bedroom
 Get some exercise (like PMR Deeb
Breathing)
 Coping statements
Sleep is not necessary
Rest is necessary
RESPECTED TEACHER AND MY
DEAR CLASS FELLOWS

 I'm Zunaira Qayyum Khan, and I am

going to tell you about Exposure
Therapeutics techniques to
overcome anxiety. Here are the
techniques ...
Systematic
Desensitization
 Systematic desensitization is a type
of behavioral therapy based on the
principle of classical conditioning. It
was developed by Wolpe during the
1950s. The number of sessions
required depends on the severity of
the phobia. Usually 4-6 sessions, up
to 12 for a severe phobia. Systematic
desensitization involves three main
steps.
Relaxation exercise

 Systematic desensitization involves

three parts: Learning relaxation skills
technique. First, I as a therapist will
teach my client a relaxation
technique to reduce her physical
anxiety response (such as trembling
and hyperventilating), and to
encourage relaxation
Creating a hierarchy of
fears (1)
 After learning relaxation techniques,
you’ll develop a fear hierarchy for
the phobia or feared situation. This
hierarchy typically involves 10 levels
of fear. You’ll likely go through the
following steps to do this: First, you’ll
identify the most frightening level of
your fear or the “level 10” fear.
Creating a hierarchy of
fears (2)
 Next, you’ll identify the least frightening level
of your fear or the “level 1” fear. Then, you’ll
list the levels in between and rank them by the
amount of fear they trigger. For example,
seeing a photo of what you fear might be a
level 3, but actually touching the thing you
fear could be a level 8 or 9. Next, you’ll
develop ways to expose yourself to each level
of fear. This is usually done with the help of a
therapist. Finally, you’ll begin exposing
yourself to your fear, starting with the least
frightening items on your list
In vivo exposure

 Directly facing a feared object

situation or activity in real life. For
example, someone with a fear of
snakes might be instructed to handle
a snake, or someone with social
anxiety might be instructed to give a
speech in front of an audience.
Virtual reality exposure

 In some cases, virtual reality

technology can be used when in vivo
exposure is not practical. For
example, someone with a fear of
going to crowded places might take a
virtual tour of people in a shopping
mall. Virtual reality exposure is also
called 3D exposure.
RESPECTED TEACHER AND MY
DEAR CLASS FELLOWS
 I'm Islahuddin, and I am going to tell
you about CBT therapeutic
techniques to overcome anxiety.
Here are the techniques ...
Cognitive behavioral therapy
(CBT) for anxiety
 Cognitive behavioral therapy (CBT) is
the most widely-used therapy for
anxiety disorders. CBT addresses
negative patterns and distortions in
the way we look at the world and
ourselves.
situation.

 For example, imagine that you’ve

just been invited to a big party.
 Consider three different ways of
thinking about the invitation, and
how those thoughts would affect
your emotions.
Cognitive behavioral therapy
(CBT) for anxiety
 Thought #1: 
 The party sounds like a lot of fun. I love
going out and meeting new people!
 Emotions: Happy, excited
 Behavior: active, optimistic

 Thought #2: Parties aren’t my thing. I’d

much rather stay in and watch a movie.
 Emotions: Neutral
 Behavior : Normal ,relaxed
situation

 Thought #3: I never know what to say

or do at parties. I’ll make a fool of
myself if I go.
 Emotions: Anxious, sad
 Behavior : irritable, aggressive
Thought challenging in CBT for
anxiety
 Thought challenging—also known as cognitive
restructuring—is a process in which you
challenge the negative thinking patterns that
contribute to your anxiety, replacing them with
more positive, realistic thought. three steps:
 Identify the negative thought.
 2:Challenge the negative thought
 3:Replace the negative thought with a realistic
one.
 As you can see, the same event can lead to
completely different emotions in different
people. It all depends on our individual
expectations, attitudes, and beliefs. For
people with anxiety disorders, negative ways
of thinking fuel the negative emotions of
anxiety and fear. The goal of cognitive
behavioral therapy for anxiety is to identify
and correct these negative thoughts and
beliefs. The idea is that if you change the way
you think, you can change the way you feel.
Identify the negative thought

 In this case, the thought is, “I feel so

awkward at parties. Everyone must think
I’m a loser.” In a CBT session, it may take
some time to uncover this thought. At first,
you might talk to your therapist about your
feelings toward going to parties, and how
you feel when you attend one. Together,
you’ll find the root thoughts behind your
anxiety and tackle each one separately.
Challenge the negative thought

 why you feel awkward at parties.

 What if ….
 Why u think like this.
Replace the negative thought
with a realistic one
 You feel awkward doesn’t mean
other people see you that way.”
You may feel uncomfortable at parties and
assume people dislike you, but they
wouldn’t invite you if they thought you
were a loser, and you get invites all the
time! Your thoughts and feelings aren’t
based on facts.
CBT TECHNIQUES FOR
ANXIETY
 Here are three simple techniques
that focus on the thinking and
behaving part of a person to help
them take back control.

 1: Focus on how the feelings will change

 2: Chew it over and act normal
 3: Catch the underlying assumption and
chase down logical conclusions
Focus on how the feelings will
change
 Feelings always shift, and even just
remembering that is useful. Having
your client write or think about how
they expect their feelings to improve
and the first little indications that
anxiety.
 “I am feeling somewhat nervous,
which is natural. When those feelings
change I expect to feel calm again.”
2:Chew it over and act normal

• Talk softly and calmly

• Smile
• Salivate
• Breathe deeply
• Have an open body posture.
• Proper eye contact
Catch the underlying assumption and chase down
logical conclusions

 If someone feels anxious about something, it’s because they

have a fear of some consequence. If I fear attending a party I
might ask myself, “What consequence do I fear?”
 I might decide, “I fear meeting new people.”
 But what is the consequence of that? “They might not like me!”
 But what is the consequence of that? “I will feel upset.”
 But what is the consequence of that? “I will feel that I am
unlikable!”
 And so on. Then we can go on to, “But how will I deal with that?”
 “I will remember people who do like me.”
 “I will soon forget about the party.”
 “I will remember that I can be wrong when assuming people don’t
like me.”
RESPECTED TEACHER AND MY DEAR
CLASS FELLOWS
 I'm Maryam Sehzadi, and I am going
to tell you About REBT therapeutic
techniques to overcome anxiety.
Here are the techniques ...
 About REBT Developed in the 1950s
by psychologist Albert Ellis, REBT is
focused on helping clients change
irrational beliefs
The ABC Model in REBT

 Allow me to illustrate with an REBT ABC model

example from my life in which irrational
thoughts would lead to anxiety: Activating
event: Someone criticizes my yoga teaching.
Belief (irrational): I’m a horrible yoga teacher.
Consequence: I feel anxious and worthless. In
this example, I might be tempted to say, “I feel
anxious (C) because I was criticized today (A).”
But A does not cause C. I only feel anxious and
worthless because of what I’m telling myself:
“How dare I not be perfect? I’m so awful. It’s
intolerable to experience criticism.”
An REBT Exercise to Reduce
Anxiety
 The following are questions to ask yourself to
identify, dispute, and replace irrational beliefs. You'll
notice the order of the A, B, and C are rearranged
(some refer this to the ACBDE model of REBT). This
helps us to get to the actual underlying belief. A:
What is the activating event that triggered a
response? C: What are the consequences? What are
you feeling? B: What are you telling yourself to make
yourself feel that way? What demands are you
making? D: What is the evidence that this belief must
be true? How can you prove it? What effect are you
creating if you continue to make it true? E: What do
you prefer but not need in order to feel okay?
Cognitive Errors:

 These are inaccurate or irrational

automatic thoughts.
 Catastrophizing
 Overgeneralization
 All or Nothig
 Disqualifying the positive
 Jumping to conclusion
 Mental Filter
 Personalization
Thank you

Thank you for listening to

our presentation.