Let’s Talk Course Boost Your Mood Week 1

Welcome Housekeeping -fire exits, toilets, refreshments Introductions, who we are Questionnaires – which questionnaires? Why we use them. How often we need to take scores. Congratulations on making it this far! Handouts

Keeping safe This course is a Psychoeducational course not group therapy and we are not able to discuss individual problems with you Please refer to your course invite letter with regard to keeping safe You do not need to discuss anything in the group which may cause you distress If you feel unable to attend all steps of the course here or online or using the manual at home please go back to your GP to discuss your difficulties Hand-outs for week 1. CBT model (Hot Cross Bun) Mood monitoring sheet SMART goals

Thoughts of harming yourself Thoughts are very usual Intent and plans are different If you are intending to harm yourself, you need to seek further help Your GP will be informed of the Q9 score Samaritans Telephone Number is:08457 909090 Speak to your GP Speak to someone in your life

Increase in Likelihood of Intent 0 5 10 Not likely Very likely Ask yourself: Where are you now - what is the likelihood of harming yourself today? If the likelihood was to increase, what would you do? You can contact: Samaritans Telephone Number is:08457 909090 Speak to your GP/Out of Hours Service Speak to someone in your life

Group structure Weekly from 6.00-7.30pm but not in any ‘school’ holidays Psycho-educational group not a therapy group Weekly tasks to complete in between sessions

Ice-breakers

Group Contract What rules would you like the group to agree to over the next six weeks? Write group responses on interactive whiteboard and print out for group

Course Summary Week 1: Introducing low mood and depression Week 2: Behavioural activation and Looking after yourself Week 3: Behavioural activation continued and Time management Week 4: Introducing unhelpful thinking Week 5: Unhelpful thinking continued, positive self-talk and work-life balance Week 6: Planning for the future and what next

Week 1 Introductions – who we are & how this works Ground rules and contracts Ice-breakers Course overview Introduction to low mood & depression The CBT model – how it works. Motivation to change Personal Goals Homework tasks

What is low mood/depression? Group exercise... Split into small groups; write symptoms of low mood on post-it notes and put into these categories….. Behavioural Emotional Physical Cognitive (thoughts/images) …….stick onto body outline on flipchart.

What is low mood/depression? Changes in physical sensations... Low energy Changes in sleep Changes in brain chemistry Aches and pains

What is low mood/depression? Changes in thoughts... negative thinking slow, sluggish thoughts repetitive thoughts harsh self criticism unfair and unrealistic thinking not being able to concentrate poor and biased memory

What is low mood/depression? Changes in behaviours… Avoidance Increase in risky behaviours Withdrawing Not doing the things you used to do Putting off tasks Not caring about personal appearance

What is low mood/depression? Changes in emotions... no or limited pleasure felt when doing things/seeing people sadness numbness despair anxiety anger irritability frustration

How common is low mood/ depression? You are not alone. More than 15% of adults will get depressed at some time and 4% are depressed at any one time. It can happen to anyone. Getting depressed does not mean you are weak

What causes low mood? Group exercise.... Split into small groups; write down on post-its what you think are the causes of low mood or depression.

CBT model Thoughts Situation Physical sensations Emotions Behaviour “I’m never going to get better” “No one will want to be with me” “I will always feel like this” Situation Physical sensations No energy Reduced sleep Emotions Sadness Hopelessness Behaviour Withdrawing from people Not eating much Not taking care of self

Motivation to Change Pros of Staying the Same Pros of Changing Cons of

Discussion Collect examples of pros and cons of staying the same / making changes and put on white board

Cycle of Change Adapted from Prochaska and DiClemente (1986) NB: Ask the group to take a few minutes to look at this slide. Ask them why this slide / cycle is so important. Emphasise that sometimes people think that change happens spontaneously – one day they will wake up and ‘just feel different.’ Emphasise that we have to take an active role in feeling better. However, how successful we are will depend on where we are in the cycle. Sometimes there are a number of benefits to depression which helps to keep us where we are. Any ideas of possible benefits? E.g people might ‘look after us.’ We don’t have to take responsibility We don’t have to face anxiety caused by the unknown Withdrawal protects us from the possibility of being rejected or disappointed – who has heard the phrase, ‘if I don’t hope / look forward to it I won’t be disappointed.’ Emphasise difference between lapse and relapse Emphasise that lapses are normal and not always a sign of a full blown relapse. Talk about the idea that sometimes people think they have to feel differently before they behave differently Adapted from Prochaska and DiClemente (1986)

Setting goals Setting goals is important to identify what you want to achieve. Choosing areas that you want to try and change is a key part of successfully moving forward. Types of goals: - Long term goal(s) - Medium term goal (over 6 months) - Course goal (over 6 weeks)

SMART Goals What are SMART goals? Specific Measurable Achievable Rewarding Time-limited

SMART Goals Specific – Make you goal specific enough so you know exactly what you are working towards i.e. two sessions of exercise a week. Measurable – Make you goal measurable, that way you know when you have achieved them i.e. exercise sessions last for twenty minutes. Achievable – Make your goal realistic!

SMART Goals Rewarding – Make you goal fun and enjoyable, if you don’t find it rewarding it is much harder to keep it going i.e. going to a dance class may be more rewarding than going for a run. Time-limited – Set yourself a time-limit by when you want to achieve your goal. Without a deadline it is easy to lose motivation.

SMART Goals Putting it all together – example: “I will go to a Zumba class for 45 minutes twice a week for the next four weeks.”

Now It’s Your Turn! Spend 5 minutes setting your own SMART goal for the next 6 weeks Specific What specifically do you want to achieve? Measurable How will you measure your progress towards your goal? Achievable How sure are you that you are able to attain your goal? Relevant Why is your goal relevant to you? Time-limited Set a date by which you think you should be able to achieve your goal. Page 15 of GCOYL Depression as handout.

Workshop 1 summary The course and how it works Depression – its signs and symptoms Setting personal goals Any questions or queries?

Weekly Tasks Complete SMART goal setting Read through handout and complete the CBT Hot Cross Bun and Goal sheet before next week‘s session