Introducing No Worries - Primary on behalf of Sheri Wright Specialist Senior Educational Psychologist (Emotional Health and Well Being) Dr Aimée Webster Educational Psychologist

No Worries - Primary A Cognitive Behaviour Therapy (CBT) Programme aimed at reducing anxiety in children Facilitator’s Manual Kim Jeffries - Principal Educational Psychologist Sheri Wright - Specialist Senior Educational Psychologist Shropshire Educational Psychology Service Targeting Mental Health Support Safeguarding Support Services

Cognitive Behaviour Therapy Behavioural Psychology All behaviour is learnt Observable behaviour Reinforcement of behaviour Cognitive Psychology Aaron Beck (1976) working with depressed patients discovered that their own thoughts were leading to feelings of depression

The Negative Cycle The aim of the programme is to disrupt the negative cycle and to replace it with more positive thinking and behaviour. The links between thoughts, feelings, behaviour and physiology are highlighted throughout the programme. Adapted from Stallard 1988

Unhelpful Thoughts about Ourselves and Our Future I’m not very good at making friends I’m never going to be happy Everything I do goes wrong These unhelpful thoughts can make us feel unhappy and worried. Feeling unhappy and worried can often stop us from doing things. If we do less, we become less successful.

An example of a negative cycle Thoughts That’s the worst I’ve ever played. That’s the worst I’ve ever read out loud. That’s the worst I’ve done in maths/numeracy. Body Signs Red cheeks. Heat beating faster. On the verge of tears. Feelings Embarrassed. Disappointed. Behaviour Decides not to attend training anymore. Decides not to read aloud again. Decides not to try in maths/numeracy.

The Psycho-Social Model This programme uses the psycho-social model (Williams and Garland 2002) Feelings Physiology Behaviour Thoughts This model looks at the interaction between our thoughts, feelings, behaviour and physiology

No Worries - Primary Session 1 Establishing the Group Session 2 Signs and Signals Session 3 Relaxation Session 4 Helpful versus Unhelpful Thinking Session 5 Challenging Unhelpful Thoughts Session 6 Achieving Our Goal Session 7 Planning for Success Session 8 You are Not on Your Own

Structure of Each Session Warm up Psycho-educational Activity Relaxation Between session task

Warm Up Activity Giraffes Can’t Dance - Giles Andreae and Guy Parker-Rees Read the story and ask the children to identify whether Gerald is having a thought or a feeling or action by putting their hands on their head (for thoughts) or heart (for feeling) or moving arms (for action).

Anxiety has a Biological Function Facilitator’s Notes Anxiety has a Biological Function   When we feel threatened, the body releases adrenaline to prepare us for fight, flight or freeze.   (Adapted from SEAL (Social and Emotional Aspects of Learning) Secondary Resource sheet i.4.1: Fight or Flight)  

What happens when we pay attention to unhelpful thoughts? Session 4 - Activity 3   What happens when we pay attention to unhelpful thoughts? In groups of 2 - 3, discuss the possible outcomes in terms of feelings and behaviour of paying attention to these unhelpful thoughts.  Thought Feelings What We Do “I don’t think she likes me”   “I’m rubbish at Maths” After an argument with my friend - “You are not my friend any more” “I bet everyone thinks I’m stupid” “Everyone else is going to the party”

Session 5 - Handout Positive Self-Talk Sometimes when people have recurring unhelpful thoughts it can be helpful to counteract this with positive self talk or helpful thinking. These are some common examples: I can try my best. It doesn’t matter what they think. I’ve done it before I can do it again. It’s OK to make mistakes. People won’t be concentrating on me. My family and friends will support me. I’ll give it a try. Between Session Task Try to identify a recurring unhelpful thought and replace it with some positive self talk. Be prepared to come back to the group and talk about your positive self-talk and what difference it has made.

Quantitative Evaluation Tools   Spence Children’s Anxiety Scale (8 – 15 years) SCARED-R (The screen for Child Anxiety Related Emotional Disorders – Revised (6 – 19 years)). Zung Self-Rating Anxiety Scales (For Adults)

Qualitative Evaluation   Children’s Centre staff reported after their Adult Parents/Carers Group: “One parent came back into the room after the last session and told us” ‘I started the group with a diagnosis of post-natal depression, I really feel that I am leaving without it!’.

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