Anxiety and Fear within the Playroom Dianna Green, MSW LCSW

Learning Objectives Identify differences in play therapy between fear, worry, anxiety, shame and embarrassment Understand fear from a developmental perspective Identify effective strategies for reducing fear/anxiety How presentation will benefit audience: Adult learners are more interested in a subject if they know how or why it is important to them. Presenter’s level of expertise in the subject: Briefly state your credentials in this area, or explain why participants should listen to you.

Points of Discussion Anxiety Disorders Fear Shy and Embarrassment vs Fear/Anxiety Development of Fear and Anxiety Presentation of Fear and Anxiety Addressing Anxiety and Fear in the Playroom Lesson descriptions should be brief.

Anxiety Disorders Generalized Anxiety Disorder, Separation Anxiety Disorder, Selective Mutism, Social Phobia Disorder, Specific Phobias, Panic Disorder DSM 5 Criteria for GAD: The presence of excessive anxiety and worry about a variety of topics, events, or activities. Worry occurs more often than not for at least 6 months and is clearly excessive. The anxiety and worry is associated with at least 3 of the following physical or cognitive symptoms (In children, only 1 symptom is necessary for a diagnosis of GAD.): Edginess or restlessness. Tiring easily; more fatigued than usual. Impaired concentration or feeling as though the mind goes blank. Irritability (which may or may not be observable to others). Increased muscle aches or soreness. Difficulty sleeping (due to trouble falling asleep or staying asleep, restlessness at night, or unsatisfying sleep). Example objectives At the end of this lesson, you will be able to: Save files to the team Web server. Move files to different locations on the team Web server. Share files on the team Web server.

Fear Emotional state of arousal induced by real or imagined sense of danger or threat Natural emotion serving a biological, healthy function When Fear becomes problematic Professional Reference: “Why Zebras Don’t Get Ulcers” by Robert Sapolsky

Shy and Embarrassment Shy- being fearfully aroused by new or unfamiliar people or place Embarrassed- fear of judgement from self Learned and manufactured emotions

Anxiety/Fear Displayed by Children Avoidance of activities, possibly both new and old Changes in sleep patterns Increase in speech production or psychomotor activities Changes in mood or affect presentation Excessive compliance Increased Irritability Lack of focus

Development of Fear/Anxiety Children are born being able to recognize and express fear Anxiety and worry require the ability to imagine! Anxiety is a generalized and unfocused fear Stress or anxiety in low doses can be helpful Learning a new task Assessing a new environment Acquiring new skill set Perfecting learned task/skill set

Anxiety and Fear in the Play room Maintain structure and boundaries Provide child client with opportunity to regain control (over self, over emotions, over environment) Set realistic expectations and encourage caregivers and other adults in support system to do the same! Demonstrate a respect of (not enabling) fears.

Appropriate Interventions Many theories and strategies are appropriate, but all should include: Must establish new coping skills Identify cause of anxiety/fear Help reduce anxiety and fear through use of new coping skill What does this look like in your theory?