40
ACT for Parents of Anxious Children 2015 Revised 7-17-2015 ACT for Parents of Anxious Children Manual Lisa W. Coyne, PhD New England ACT Institute/Early Childhood Research Clinic Phoebe S. Moore, PhD University of Massachusetts Medical School

ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

  • Upload
    others

  • View
    0

  • Download
    0

Embed Size (px)

Citation preview

Page 1: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

ACTforParentsofAnxiousChildrenManual

LisaW.Coyne,PhDNewEnglandACTInstitute/EarlyChildhoodResearch

Clinic

PhoebeS.Moore,PhDUniversityofMassachusettsMedicalSchool

Page 2: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

ManualOverview

Session1:Mindfulness:FindingStillness Objective1:ListeningtoParentingObstacles

Objective2:CreatingConnections/CenteringExerciseObjective3:NoticingandnormalizingparentingstressObjective4:IntroducingPresentMomentAwareness

HomePractice:Mindfulnessindailylife

Session2:Defusion:WeatheringThoughts&FeelingsObjective1:ListeningtoDifficultParentingThoughts&FeelingsObjective2:Homepracticecheckin:MindfulnessindailylifeObjective3:CreatingConnections/CenteringExerciseObjective4:IntroducingHowtheMindWorks,Fusion/ExperientialAvoidance,&Defusion

HomePractice:Defusion/WeatheringParent-ChildInteraction

Session3:TheMatrix:MovingTowardsvs.MovingAway Objective1:ListeningtoChallengingInteractionswithyourChild

Objective2:CreatingConnections/CenteringExerciseObjective3:Homepracticecheckin:Defusion/NoticingWhatHappensinParent-ChildInteractionObjective4:IntroducingConceptofWorkability/AcceptanceviatheMatrix(ofwhatisoutofyourcontrol)inParent-ChildInteractionHomePractice:TrackingTowards&AwayMoves

Session4:Valuing/CommittedAction:DoingWhatMatters Objective1:CreatingConnections/CenteringExercise

Page 3: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

Objective2:Homepracticecheck-in:TrackingTowards&AwayMovesObjective3:ListeningtoCoreParentingValuesObjective4:IntroducingValuing/CommittedActioninParentingConsistencyHomePractice:PracticingParentingCommitment

Session5:ParentingwithAnxiety:CourageintheContextofCaring

Objective1:CreatingConnections/CenteringExerciseObjective2:Homepracticecheck-in:PracticingParentingCommitmentObjective3:UnderstandingtheImpactofAnxietyonParentingObjective4:UsingACTtoConnectwithParentingValueswhenAnxietyisPresentHomePractice:PracticingParentingCommitmentwhenAnxietyisPresent

Session6:Self-Care:There’sOnlyOneYou Objective1:CreatingConnections/CenteringExercise

Objective2:ListeningwithCompassion/Self-as-Context(Defusing“Failure”)Objective3:HomePracticeCheck-In:PracticingParentingCommitmentwhenAnxietyisPresentObjective4:CreatingaTouchstone:TurningBacktoValues/CommittedActionHomePractice:KeepingitGoing&MakingTimeforYou

Page 4: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

GeneralGuidelines1. ImportanceofModeling:RemembertoactivelymodeltheACTcomponentsyouteach,in

yourlanguage,inyourpresence,inyourwillingnesstoacknowledgeyourownmistakesandlimitations,inyourwillingnesstoshowandacceptyourowndifficultemotions.

2. OneSizeDoesNotFitAll–adaptasyouwish,keepingtheobjectivesinmind:ThismanualwaswrittentogiveyouaclearstructureonwhichtobaseyourACTparenttrainings,ANDtogiveyouthefreedomtouseyourownfavoriteexercisesandACTtoolswithinthisstructure.Sowhileitisimportanttoaccomplishthe*goals*ofeachsession,*how*youdothatisuptoyou,solongasyoudotheseinawaythatisadherenttothemanualstructure.

3. Don’tbeafraidtothrowoutthemanualorchangetheorderinwhichyoupresentthings–attendtowhat’sgoingoninthegroup:Todate,therehavebeennostudiesonsequencingACTcomponents,thus,youcanfeelfreetomovethingsaroundasyouwish.Again,justmakesureyoumaintainthestructure(doallthecomponentsaddressed)inthemanual.

4. ListentoyourHeart–whatareyou,astheworkshopleader,workingon?Noticewhereyouare,inyourownheadandheart,asyoudeliverthematerialinthismanual.Whatisthevaluethatyouwouldlikeyourworktorepresent?

5. Leanin,andmakespace,ifthingsarerough:Ifthingsarechallengingduringyourgroups,orifyouyourselfarehavingatoughday,orfeelingyourownfearsabouthowthingsaregoing,leanin.Keepthempresent.Theywillguideyouasyouworkwiththeparents.

6. ShapeasyouGo:useACT-consistentlanguagefromtheget-go.Shareyourfeelingswhenuseful.Noticeandreflecttheprocessofwhatisgoingonintheroomasithappens:Itissoimportanttonoticeandcommentonprocessesasyoudelivertheseworkshops.Doyounoticeachangeintheroomafterexperientialexercises?Dopeoplefeelmoreorlessconnected?Areyoufeelingconnectedyourself?Istheretension?Noticethese,andbringawarenessandattentiontothem–yours,andtheparticipants.

7. Humorcanbehelpful,oravoidance–useittokeepparentsengaged,tolightenthingsupwhenyouchoose,tovarythetoneofyourworkshoptokeepitfrombecomingboring:Prettyself-explanatory.Donotice,however,whenlaughterservesanavoidantfunction.

8. ToSlideorNottoSlide?Sometimesslides,withveryfewwordsandlotsofcompellingimages,arehelpful.Sometimestheyaredistracting,andacrutchthattakesthefocusawayfromwhat’sgoingoninthegroup.Itisentirelyuptoyouifyouchoosetousethemornot.

Page 5: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

Session1:Mindfulness:FindingStillnessObjective1:PreludetoValues/CreatingConnections/CenteringExerciseObjective2:ListeningtoParentingObstaclesObjective3:NoticingandnormalizingparentingstressObjective4:IntroducingPresentMomentAwareness

HomePractice:Mindfulnessindailylife *MaterialsNeeded:Whiteboardandmarkers,pen/paper,MindfulnessinDailyLife

handout/worksheet,andifyouaredoingamindfulnessoftasteexercise,somethingtouseasastimulus(mints,chocolates,etc.)

Introductiontothegroupandpresenters(5minutes).Groupco-leadersintroducethemselves,andgivethegroupabriefdescriptionoftheactivitiesandexpectations.Thefollowingscriptcanbeparaphrasedforparticipants:

“Thisisa6sessionworkshop,andit’simportanttocometoallsessions,aswe’llbeworkingondifferentskillsineachsession.Inthisworkshop,wewillbetalkingaboutparenting,thethoughtsandfeelingsthatariseforyouintoughmomentswithyourchild,andwhattodoaboutthem.Therewillbeopportunitiesforyoutosharethesewiththegroup,althoughyoudonothavetoshareanythingatallifyoudonotwishto.Thisworkshopwillbeamixofthetwoofusspeakingwithyou,andexperientialexercises.Thismeansthatwewillalsoaskyoutotrysomethings,inordertomoreeffectivelydemonstratetheskillswearetryingtoteach.Forexample,ifyouwantedtolearnhowtorideabicycle,youcouldreadaboutit,orwecouldtellyouaboutit.Butreally,thebestwaywouldbeforyoutotryit,andtokeeptryingit,andpracticing,untilyoucandoit.Theskillswe’llteacharesortoflikethat,soit’simportantthatwegiveyouchancestotrythemhereingroup,andathome.Startingnextweek,we’llgiveyousomebriefformstofillouttohelpusseehowthingsaregoingforyou.Again,participationintheseisvoluntary,andwewillaskyourpermissiontotrythesethingseachtime.Finally,it’simportanttomentionthatweagreethatwhatwediscussinthisgroupisprivate,andwekeepwhatwesharewithinthegroup.Isthatokwitheveryone?Doesanyonehaveanyquestionsorcomments?”PreludetoValues:Whyareyouhere?Needabriefexercisethatwewillcomebacktolaterto“prime”participantstodiscussvalues.

Objective1:CreatingConnections/CenteringExercise(5minutes)Thegoalhereistogiveparticipantsanexperientialopportunitytoconnectwitheachother,andtocontactboththatthiscanbealittlebitchallenging,aswellasrewarding.Belowisanexercisethatcanbequiteusefultostartthingsoff.

Page 6: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

ConnectionExercise(suggested)

“Ifyouarewilling,pleasetakeamomenttostandupwhereyouare.Ifyoulike,movetoaplacewhereyouhavesomeroomaroundyou.Takeamomenttotakeagentlestretch,orwhateverfeelsrightforyou.(groupleadercandirectthis,orletparticipantsdowhattheychoose).Nowtakeamomenttoconnectwithyourbreathing.Noticeyourbodytakinginair,fillingyourlungsandnourishingeverycellofyourbody,fromyourheadtoyourtoes.Andexhale,noticingthatasyoubreathe,youarepartoftheworldaroundyou.Eachinbreath:anopening,atakinginofnourishment.Eachoutbreath:acompletelettinggo.Justtakeamomenttoconnectwithyourbreath,withyourbodybeingapartofthisworld,andwithyourselfinthismoment,righthere,rightnow,justasyouare,inthisroom,withthisgroup.

(pause).Takeamomenttonoticethepeoplearoundyou.Ifyouarewilling,seeifyoucannoticeeachone,*really*noticethem,evenbriefly,andmakeeyecontactasyoudo.Noticethateveryoneherehaslaughedsohardthattheirsideshavehurt,oritwashardtocatchtheirbreath.(pause)Noticethateveryoneherehasworkedreallyhardforsomething.(pause)Noticethateveryoneherehasexperienceddisappointment.(pause)Noticethateveryoneherehashadadayordayswhenitwashardtogetupinthemorning.(pause)Noticethateveryoneherehasexperiencedjoy.(pause)Noticethateveryoneherehasfeltdisappointedbysomethingorsomeonetheylove.(pause)Noticethateveryoneherehasexperiencedgiving,orreceivinglove.(pause)Noticethateveryoneherehasexperienceddoubt,orfear,orsadness.(Noticethateveryoneherehasexperiencedloss.(pause)Noticethateveryoneherehaslongedforsomething,perhapscomfort,orpeace(pause).Asyounoticeeachother,seeifyoucangivesomesmallgiftofacknowledgement,orconnection,orawarenessthatyouseethem.(pause)Seeifyoucannoticewhatitisliketoallowyourselftobeseen.(pause)

Gentlylettinggoofthispartoftheexercise,takeagentlestretch,orwhateverfeelsrighttoyou,andfindyourseats.”

HelpfulHint:Itmaybeusefultoprovideabriefopportunitytoinviteparticipantstoprocessthisexercise,oryoumaychoosetosimplymoveon.Someoptionsforprocessingthisincludeaskingparticipantsanopenquestionaboutwhattheexperiencewaslike(thisisverychallenging,giventhatthisisafirstsession),ortoaskiftheroomfeelsdifferentnow–oriftheyfeeldifferentintheroom/groupthantheydidwhentheyfirstwalkedit(easier),ortomodelforthembysharingwhattheexperiencewaslikeforyouasagroupleader(easiest).

OtherExerciseIdeas:

Objective2:ListeningtoParentingObstacles(Lifeiswhatgoesonwhenyouareplanningotherthings)(15minutes)

Page 7: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

Thepurposehereistwofold:first,togetparentsincontactwithwhatbroughtthemhere,andwhattheyhopetogetoutoftheworkshop,andsecond,toprovidesomepsychoeducationthestressesthatariseasanaturalconsequenceofraisingachild.(Ifappropriatetothegroupofparents,groupleadersshouldalsotouchupontheparticularstressesthatarisewhenparentingachildwithemotionalandbehavioralspecialneeds,orspecifictoASD).Workshopleadersshouldworktowardsmakingaspaceinwhichparentsfeelsafesharingtheirdifficultmoments,ina“connected”way–inotherwords,connectingwiththeirexperienceastheyshareit.Groupleadersshouldalsobemindfulinthelanguagetheyuseinreflectingparticipantresponses:specifically,thisisanopportunitytoshapedefusionskillsbyusingphraseslike,“Soyourmindistellingyou,”and“Sothereisstoryabout…”Finally,groupleadersshouldnoticetheirownconnectiontowhatparticipantssay:inotherwords,itisimportantforgroupleadersto“showup”also,andsharewhatyounoticeinlisteningtoyourparticipants.Areyoumoved?Areyounoticinghowparticipantslook,orhowtheychoosetolookawayastheyspeak?Doestheirposturechange?Doyounoticeotherparticipantsnoddingandlisteningin?Noticing,andperhapssharingsomeoftheseobservationscanbehelpfulinfacilitatingthegroupprocess.Belowisascriptthatgroupleaderscanuseorparaphrasetointroducethissectionofthegroup,aswellassomeoptionsthatgroupleaderscanuseorparaphraseinordertofurtherfacilitatethiscomponentofthesession. PsychoeducationaboutParentingStress:

Groupleadersmayask,“Whydopeoplebecomeparents?”Afterobtainingafewresponses,say“Didyouknowthatalthoughwehaveaculturalmyththathavingchildren/afamilymakesushappier,researchsuggeststhatmostparents

• experienceloweremotionalwell-being• lessfrequentpositiveemotions• morefrequentnegativeemotions• lowermaritalsatisfaction• andgreaterlevelsofdepression

…thannonparentsdo.” OtherExerciseIdeas:

-Askparentstogoaroundtheroom(orevenbetter,pairup),tellthenameofyourchild,onethingyouappreciateaboutthem,andonechallenge,encouragingparticipantstoreallylistentoeachotherandnoticewhatitisliketohearthesethings.

Page 8: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

-Usea“difficultparentingstory”thatyoumightreadordescribetoparticipants,andaskingthemtolistentowhatresonatesmostforthem

-Showoneoftheoptionalcartoonsorimagestoelicitdiscussion,ifyouchoosetouseslides–forexample

HelpfulHints:Bewaredisconnected“stories.”Iftheseshowup,theywillhavea

“familiar”or“well-worn”feeltothem.Ifyounoticethis,youmightaskparticipantsiftheyexperiencethiswhentheyaretellingthestory,getthemtoslowdown,andreallylistentothewords.Inaddition,youmaynoticea“cost”tothedifficultiesandchallengesthatparentsarereporting–seeifyoucangetintouchwiththat–putyourselfintheirshoes.Reflectitbacktothem.Seeiftheycancontactthe“cost”oftheirstrugglesalso.”Objective3:Noticingandnormalizingparentingstress(15minutes)Thegoalofthisobjectiveistohelpparentstobecomeawareofandbegindiscussingthethoughtsandfeelingsthatariseinthecontextofparentingstress,andtonormalizethem.Belowaresomeoptionsforintroducingthissectionoftheworkshop.NormalizingParentingStressDiscussion/Exercise:Ask,“Haveyoueverhadthethoughtthatyoudon’tknowhowtohandleaparticularbehaviorinyourchild?Orthatyoudon’tknowwhattodo?Haveyoueverhadthefeelingthatit’ssometimeshardtobearoundyourchild,especiallyifit’sbeenatoughdayforyou?Ifyouareexperiencingastressfulmoment,whatdoesyourbodyfeellike?Wheredoyouphysicallycarrystress?”Inviteparticipantstonoticewhethertheyhaveeverexperiencedthesetypesofthoughts,feelings,andsensations.Havethemnoticethattheyarenotalone,andthatthesearecommonlyexperiencedbymostparents,atonetimeoranother.Referbacktothedataonparentingpresentedearlier.Youmayalsochoosetopresentthisdata,fromanAPAreportonstress:

Page 9: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

“Whileparentsreportsimilarsourcesofstressastherestofthepopulation(80percentcitemoney,72percentciteworkand72percentcitetheeconomyasstressors),manyalsoreportthatfamilyresponsibilitiesareasignificantsourceofstress(73percent).Resultsfromthesurveysuggestthatparentsfeelthattheyareunderagreatdealofstress(nearlyone-thirdreportfeelingthisway)andunderstandtheimportanceofmanagingit(69percentsaymanagingstressisimportant).However,onlyone-third(32percent)believetheyaredoinganexcellentorverygoodjobofmanagingtheirstress.”Also,“Whilethemajorityofparentsdon’tthinktheirchildrenarestronglyaffectedbytheirstress,childrenreportotherwise.Nearlythree-quarters(69percent)ofparentssaythattheirstresshasonlyaslightornoimpactontheirchildren,yet91percentofchildrenreporttheyknowtheirparentisstressedbecausetheyobserveamultitudeofbehaviors,suchasyelling,arguingandcomplaining.Whentheirparentsarestressedorworried,nearlyhalfoftweens(47percent)andone-thirdofteens(33percent)saythattheyfeelsad;one-thirdoftweens(36percent)and43percentofteenssaythattheyfeelworried;andone-quarter(25percent)oftweensand38percentofteensfeelfrustratedwhentheirparentsarestressed.Childrenwhosaytheirparentsarealwaysstressedaremorelikelytoreporthavingagreatdealofstressthemselvesthanthosewhosaytheirparentsareneverstressed(17percentvs.2percent).”ExcerptedfromAPAStressinAmericafindings,November,2010;http://www.apa.org/news/press/releases/stress/2010/national-report.pdfObjective4:IntroducingPresentMomentAwareness(20minutes)Thegoalofthiscomponentistoprovideparentswiththepracticeofpresentmomentawareness,andtogivearationaleforthatintheirdailylives.GroupleadersmayuseanyACTpresentmomentscriptsorexerciseshere,althoughweencouragetostartsimply,withbriefpracticethatparentscaneasilyintegrateintodailylife,orintopositive/neutralinteractionswiththeirchildren.Belowisasamplescripttointroducethesession.

IntroductiontoPresentMomentAwareness:

Say,“Whatsometimeshappenswhenpeoplegetcaughtupindifficultthoughts,feelings,andsensationsassociatedwithparentingstress,isthattheylosecontactwiththepresentmoment.Forexample,haveyoueverbeenpreoccupiedwithsomething,putdownyourcarkeyssomewhere,andthenhadnoideawhereyouputthem?Ordaydreamingorworryingaboutsomething,andnothearingsomeoneinyourfamilycallforyou?Thoseareexamplesofbeingstuckinyourmindratherthanbeinginthepresentmoment.Fortunately,youcanlearntodropintothepresentanytimeyouwish,ifyoulearnandpracticetheskillsovertime.Verysimply,theskillsinvolvepayingpurposefulattentiontowhatyouareexperiencinginthepresentmoment,withcuriosity,andwithoutdefense.Ifyouarewilling,we’lltryanexercisesoyoucanseewhatwemean.”Conductpresentmomentawarenessexercise,suchasmindfulnessofbreath,ofsound,oftaste,ofphysicalsensationsinthebody.

Page 10: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

Haveparticipantsnoticewhenpassingthoughtspullthemoutofthepresentmoment,andencouragethemtocomeback.Keeptheexercisebrief,perhaps5minutes.Debriefparticipants,andnormalizedistractions,difficulty,orease–ensurethattheyunderstandthatarangeofreactionsisabsolutelyok.

HomePractice:MindfulnessindailylifeAssignment:Topracticemindfulnessatleastoncedaily,eitherwhileengagedindailytasksoractivities(doingdishes,eating,driving,packingalunch)andmoreimportantly,duringneutralorpositiveinteractionswithyourchildorspouse.Makesureyoutroubleshootwiththemwhentheymightbeabletodothis,helpthemworkouthowtoremember(givethemthehomepracticehandout),andcommittoatleastonceperday.Remindthemthatwe’llgooverthesefirstthingsinsession2.

Page 11: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

Session2:Defusion:WeatheringThoughts&FeelingsObjective1:ListeningtoDifficultParentingThoughts&FeelingsObjective2:Homepracticecheckin:MindfulnessindailylifeObjective3:CreatingConnections/CenteringExerciseObjective4:IntroducingHowtheMindWorks,Fusion/ExperientialAvoidance,&Defusion

HomePractice:Defusion/WeatheringParent-ChildInteraction*MaterialsNeeded:Whiteboardandmarkers,pen/paper,homeworkcheck-insheets,MindfulnesshandoutObjective1:ListeningtoDifficultParentingThoughtsandFeelingsAllowparentstomeetandchattogether,andinagentlyguidedway,helpelicittheirstrugglesandtriumphsfromtheweek.Listencarefullyforproblematicthoughtsorbeliefs,andwhenyouhearthem,beginshapingdefusionrightfromthebeginningofthegroupbyusingreflectionstemssuchas“Soyourmindistellingyou…”or“Soyouarehavingthethoughtthat…”Inaddition,youmightcallattentiontocommonalitiesacrossthesethoughtsamongstthegroupofparents,aswellashighlightinguniquenessesoftheirexperience.Itwillalsobeimportanttohelpparentstonoticehow“sticky”orcompellingorpowerfulthesethoughtsareastheyspeakaboutthem.Youcandothisbymodelingyourself,forexample,“WhenIhavethethoughtthatIamirritatedandcan’ttoleratethat,Ihaveahardtimenoticinganythingelsebutthat.”Oryoumightsay,“InoticethatIstrugglemorewiththoughtswhentheyshowupwithstrongemotion.”Finally,writedownsomethoughtsonawhiteboardorelsewheretouselaterinthesessionasexamples,tokeepthesessionastightlytailoredtoyourparentsaspossible.Objective2:Homepracticecheckin:Mindfulnessindailylife***MAKESUREYOUGIVEPARENTSTHEHOMEWORKCHECKSHEETANDHAVETHEMCOMPLETEIT.Elicitfromparentshowtheydidonthehomework,andinparticular,anyobstaclestodoingit,andwhattheynoticedwhentheydiddoit.Iftheyneedhelpplanningwhentobemindfulduetolimitedtimeorlotsofstressetc.helpthemdothat.Iftheyareevaluatingwhetherthe“effects”ofmindfulnessarepositiveornegative,simplyaccepttheirexperiences,andreiteratethatthegoalisnottohaveapositiveornegativeexperience,buttosimplybringcuriosityandopennesstotheirlives,andtopracticepresentmoment

Page 12: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

awareness.Encouragecontinuedpractice,andemphasizethatdifficultiesinpayingmindfulattentionarequitecommon.Overtime,however,thepracticegetseasier,justlikeanyotherskillthatisfrequentlyandconsistentlypracticed.Finally,encouragethemtokeepcheckinginwiththeirownexperience,andnoticingwhatpresentmomentawarenessislike.Objective3:Conductabrief5-minutecenteringexerciseofyourchoicetohelpparentsgetcenteredinthepresentmoment,andreadytoengageinamoremindfulandcuriouswaywiththegroupcontentandeachother.Objective4:IntroducingHowtheMindWorks,Fusion,andDefusion

a. HowtheMind(Verbal/SymbolicProcesses)WorksSay,“Sometimeswhenwestrugglewithourthoughts,wehavelessenergyandbandwidthtopayattentiontobeingeffectiveparentsinthosemoments.”Iwouldliketoshowyouhow,andwhy,thiscanhappen.Areyouwillingtodosomeexerciseswithme?(Makeeyecontactwitheachparticipantandelicitanodorotherformofagreement.)Therearenumerousexercisestohelpparticipantsexperiencewhatismeantby“fusion.”Somefavoritesare: 1.The“MaxtheDog”StoryAcoupleleaveforworkandleaveMaxoutsidealldayinthecoldwindandrain,withnofoodorshelter.Whentheyreturnhomelateintheevening,howdoesMaxrespond(elicitresponses)?Howmight*you*respond(elicitresponses)?Notetoparticipantsthathumansresponddifferentlythandogsbecausewehavelanguagethatallowsustoimaginethefuture,andrememberthepast,andreacttothemliketheyareinthepresent.Andthatthosefunctionscanbemorepowerfulthantheimmediatefunctionsoffood,warmth,andcomfort(whicharetheonesthedognotices,nothavinglanguage).

2.MeetingYourMindExercise“Iamgoingtoputthreeunfinishedsentencesuponthe(projector,whiteboard,etc.)Isimplywouldlikeforyoutonoticeeach,andnoticeandwritedownwhatthoughtpopsintoyourhead.Wouldthatbeok?”Presentthesethreesentencefragments:

• Goodparents(are–verbisoptional)…(pause)• Badparents(are)…(pause)• Iama…(pause)

Page 13: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

Ask,“Whatdidyounotice?Whichonespoppedintoyourheadmorequickly?Whataboutthatlastsentence?Didanythingelsepopintoyourhead–images,ormemories?Didyouhappentonoticehowyourbodyfeltwhenyouhadthat(orthose)thought(s)?Doesthatremindyouofanything?Areanyofthesethingsthatotherparentsaresayingfamiliartoyou?Haveyoueverhadthosethoughts?”Makesureyouwritedownthethoughtsonaboardforparentstosee.Youwillrefertothemlateronintheworkshop.3.TheParentingCrystalBallExerciseThisisanexerciseinwhichparentsareaskedtoimaginetheirchildindetail,andtowritedown3thingsthat*must*happenfortheirchildinlife.Youmaychoosetogiveanexampletogetthemstarted,suchas“Iwishformychildtobelovedandcherishedandsafe.”Haveparentswritethesedowninorderofimportance,numberingthem1,2and3.Thentellparentsthatyouhaveacrystalball,andthatthatcrystalballtellsthefutureforyourchild.Havethemlookatandread#3,andsay,“Thecrystalballtellsmethatthisisnotgoingtohappen–yourchildwillnothavethisintheirlife.Crossitoffthepaper.”Encouragethemtoobservetheirthoughts,feelingsandphysicalreactionsastheydothis.Repeatfornumbers2,and1.Askforreactions.Say,“Noticehowpowerfulasimplethoughtexerciselikethiscanbe,andhowthesethoughts–whicharenotreal–elicitedemotions,behaviors,andphysicalresponsesfromyou.Thisisanexampleofhowwecanget“Fused”withor“hooked”byourthoughts.Werespondtothem,regardlessofhowrealisticornot,asreal,literaltruthsatanemotionallevel,evenifwereassureourselvesthattheyareinfactnotreal.

b. IntroducingtheUnworkabilityofExperientialAvoidanceSay,“Sometimeswetrytodealwithunwantedthoughtsandemotionsbyavoidingorsuppressingthem.Thisiscalledexperientialavoidance.Forexample,(provideanexampleortwo).Canyouthinkofsomewaysthatpeoplecommonlyusetoavoidthinkingaboutorfeelingunpleasantorunwantedthings?Giveparentstimetogeneratesomeofthese.Writethemdown.Ask,“Sowhatdoyounoticeabouthowthesework?Howeffectivearethey?”Simplynotewhatparentssayaboutthis,andreflectthisinamindfulwaybacktothem.Thensay,“Seemslikeyouarenoticingthatthesestrategiessometimeswork,perhapsintheshortterm,butthatthethoughtsandfeelingsstillremainafterward.Sometimestheyevenseemtogetstronger,andtakeupmorementalspace!Interesting.Areyouwillingtotrysomeexercisessowecanfocusinonhowexperientialavoidancestrategiesmightwork?(makeeyecontactandelicitconsentfromparticipants).Therearenumerousexercisestoshowthefutility,orunworkabilityofexperientialavoidance.Somefavoritesare

1. WhatAretheNumbers?:Thisisanexerciseinwhichparticipantsareaskedtoworkashardastheycantorememberthreenumbers:1,2,3.Oncetheyhave

Page 14: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

doneso,theyareaskedtotryashardastheycantoforgetthosenumbers.Individualsreportthattheycannot,andfindthathumorous,typically.Thisisalightheartedillustrationthatattemptstoavoidordismissthoughtsareoftenineffectiveor“unworkable.”

2. Don’tthinkaboutChocolateCake3. Milkvs.MilkMilkMilk

c. DefusionStrategies:StrategiesforHandlingThoughtsandFeelings(20-30

minutes).Wewillgothroughanumberofdifferentwaysofaddressingthesetypesofthoughtsandfeelings.Generallyspeaking,wewillgoovertwostrategies:1)usingexperientialavoidance,orattemptstocontrol,minimizeoravoidthesetypesofthoughtsandfeelings,whichhasbeenfoundinnumerousstudiestobeunhelpful,andattimestoparadoxicallyincreasethefrequencyorintensityofthesetypesofthoughtsandfeelings,and2)mindfulness&acceptance,orawarenessandwillingnesstoexperienceone’sthoughtsandfeelingsastheyareinthepresentmoment,withoutdefenseorattemptstochangethem.Wewilluseexperientialexercisestodemonstrateeachoftheseconstructs.Thefollowingaresomeexamplesofcommonlyused“experientialexercises:”

1. HavingtheThoughtExercise:Wemightaskaparenttovolunteeradifficult

thought,whichwewouldthenwriteonapieceofpaper.Wewouldaskforavolunteerfromtheaudience(andifnoonevolunteers,wewouldconductthisbetweenthegroupco-leaders).Thevolunteerwouldbeaskedtoputthe“thought”inhisorherhand,anditwouldbeheldtherebytheco-leader.Thevolunteerwouldthenbeaskedtopush,ashardastheycould,againstthe“thought”andtheco-leadershand.Thisisoftenhumoroustovolunteers.Wethenaskthevolunteertonoticehoweffortfultheexperiencewas(theirresponseistypicallythatitisquiteeffortful).Next,weasktheparticipanttosimplyletthe“thought”restintheirhand,andaskthemtonotehoweffortfulthatis(“notatall”or“mucheasier”isthetypicalresponse).Wedescribethefirstexperienceassimilartoexperientialavoidance,andthesecondtoacceptance.

2. LeavesonaStream.ThisisanothercommonlydoneexperientialexerciseinACT.

Itinvolvesindividualsclosingtheireyes,takingafewmomentstonoticetheirbreath,andsimplynoticingtheirthoughtsastheyariseandpass.Theyareencouragedtoimaginethesethoughtsprintedonleavesthatfallintoastream

Page 15: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

andarecarriedaway.Thegoalofthistypeofexerciseistoteachparticipantstheskillofmindfulawarenessofinternalevents(cognitions),withoutanyattempttochangethoseevents.

3. ToddKashdan’sTEDXtalkfromUtrecht.Thisisagreat,briefintroductionto

defusionstrategiesfromapositivepsychologyperspective.Ifyouhavetime,youmightshowit–itisabout15minuteslong,andgivesagreatexampleofthe“I’mhavingthethought”exercise.

4. ThoughtsasMentalWeather.Introduceparentstothenotionthatthoughtsare

likementalweather,sometimesmildandsometimesstrong,andalwayschanging.Havethemdoabriefexperientialexerciseinwhichtheynoticetheirchangingthoughtsandlinkswithemotionsandphysicalsensationsinthemoment.

HomePractice:Defusion/WeatheringParent-ChildInteractionSay,“It’snotuncommonthatdifficultthoughtsandfeelingsshowupinyourinteractionswithyourchildren,asyoudescribedtomeinthebeginningofthegroup(highlightthechallengingthoughtsparticipantsdescribedatthebeginningofthegroup).Beingwithyourchildisagreatopportunitytopracticeyourdefusionskills.First,ithelpstomindfullynoticewhatthoughtsandfeelingsyouarehavingatthemoment(Youcanhavethempracticesimplemindfulnessofthoughteitherasyourcenteringexerciseinthebeginning,ornow.Youmayaskparticipantstopracticemindfulawarenesswithapleasantandachallengingparentingmomentoftheirchoice,privatelyduringtheworkshop,forabout10minutes.Followingthatcomponent,parentswillbegivenanopportunitytosharetheirexperiencewiththegroup,iftheywish.).Next,whateverthoughtsyounotice,practiceusingthisstem:“InoticeIamhavingthethoughtthat”andpracticenoticingyourthought,andholdingitverylightly.

Assignment:Topracticemindfulness&defusionatleastoncedaily,eitherwhileengagedininteractionswithone’schild(positiveornegative,purposefulorunplanned).Makesureyoutroubleshootwiththemwhentheymightbeabletodothis,helpthemworkouthowtoremember(givethemthehomepracticehandout),andcommittoatleastonceperday.Remindthemthatwe’llgooverthesefirstthingsinsession3.

Page 16: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

Session3:TheMatrix:MovingTowardsvs.MovingAway Objective1:ListeningtoChallengingInteractionswithyourChild

Objective2:CreatingConnections/CenteringExerciseObjective3:Homepracticecheck-in:Defusion/NoticingWhatHappensinParent-ChildInteractionObjective4:IntroducingConceptofWorkability/AcceptanceviatheMatrix(ofwhatisoutofyourcontrol)inParent-ChildInteractionHomePractice:TrackingTowards&AwayMoves

MaterialsNeeded:Whiteboard/markers,homeworkcheck-insheets,Matrixhandouts,adigitalvoicerecorderObjective1:ListeningtoDifficultParentingThoughtsandFeelingsAllowparentstomeetandchattogether,andinagentlyguidedway,helpelicittheirstrugglesandtriumphsfromtheweek.Listencarefullyforproblematicthoughtsorbeliefs,andwhenyouhearthem,continueshapingdefusionrightfromthebeginningofthegroupbyusingreflectionstemssuchas“Soyourmindistellingyou…”or“Soyouarehavingthethoughtthat…”Inaddition,youmightcallattentiontocommonalitiesacrossthesethoughtsamongstthegroupofparents,aswellashighlightinguniquenessesoftheirexperience.Itwillalsobeimportanttohelpparentstonoticehow“sticky”orcompellingorpowerfulthesethoughtsareastheyspeakaboutthem.Youcandothisbymodelingyourself,forexample,“WhenIhavethethoughtthatIamirritatedandcan’ttoleratethat,Ihaveahardtimenoticinganythingelsebutthat.”Oryoumightsay,“InoticethatIstrugglemorewiththoughtswhentheyshowupwithstrongemotion.”Finally,keepthesessionastightlytailoredtoyourparentsaspossible–someofthesethoughts/feelingswillshowupagainwhenyougoovertheMatrix.Objective2:Conductabrief5-minutecenteringexerciseofyourchoicetohelpparentsgetcenteredinthepresentmoment,andreadytoengageinamoremindfulandcuriouswaywiththegroupcontentandeachother.

Page 17: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

Objective3:Homepracticecheckin:Defusion/WeatheringDifficultParent-ChildInteractions***MAKESUREYOUGIVEPARENTSTHEHOMEWORKCHECKSHEETANDHAVETHEMCOMPLETEIT.Hereislastweek’shomeworkassignment:Assignment:Topracticemindfulness&defusionatleastoncedaily,eitherwhileengagedininteractionswithone’schild(positiveornegative,purposefulorunplanned).Makesureyoutroubleshootwiththemwhentheymightbeabletodothis,helpthemworkouthowtoremember(givethemthehomepracticehandout),andcommittoatleastonceperday.Elicitfromparentshowtheydidonthehomework,andinparticular,anyobstaclestodoingit,andwhattheynoticedwhentheydiddoit.Iftheyneedhelpplanningwhentobemindfulduetolimitedtimeorlotsofstressetc.helpthemdothat.Seewhatshowedupfortheminchallengingchildinteractions–didtheygethooked;ifso,whathappenednext?Didtheynoticegetting“hooked,”andweretheyabletobringthemselvesbacktoamoremindfulanddefusedstate?Ifso,whathappened?Ifyounoticethattheyarebeatingthemselvesupfornotdoingthehomepracticecorrectly,seeifyoucanworkthosethoughtsintoadefusionactivityasyougooverthehomework(ie,justhavethemnoticethattheyarehavingthoughts).Youcanalsoencouragethemtoreinforceeachother(ie,onecantelltheothermembers“Soyouarehavingthethoughtthat…”).Objective4:IntroducingConceptofWorkability/AcceptanceviatheMatrix(ofwhatisoutofyourcontrol)inParent-ChildInteractionInthissegment,youshouldgoovertheMatrixjustasKevinPolkhastaught.UsethewhiteboardandmarkerssothatparentscanhaveaclearvisualoftheMatrixandhowitworks.Say,“TonightIwanttospeakfromtheperspectiveofpsychologicalflexibility–ordoingmoreofthethingsthatareimportanttoyou,yourchild,andyourfamily.Wouldyoubewillingformetodescribetoyouthisperspective?(Makeeyecontactwitheachgroupmember,andgetanodfromeach.)You’llnoticeonmyboardhereatthetopthatIhavewritten“FiveSensesExperiencing.”Whatareour5senses?(Havegroupparticipantsdescribesight,smell,touch,taste,andhearing).NowI’dlikeyoutopickupyourpen.Noticewhatitlookslike(pause,andmodelthiswholeexerciseforthem).Nownoticeifitmakesasound(pause,tappenontable,etc).Nownoticehowitfeels(Pause,feelpen).Nowseeifithasasmell(pause,youdo

Page 18: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

thesame).Finally,youcantasteitifyouwant(pause).Ok?Sothat’sprettyclear(dothiswithsomehumor).Now,Iwouldlikeforallofyoutoputthependowninfrontofyousothatyouarenolongertouchingit,andtocloseyoureyes.(pause).Now,pleasecalltomindthepen–howitlooked,felt,sounded,smelled,andyes,youcanevennowimaginehowittastes(pause).Nowyoucanopenyoureyes.Noticethedifferencebetweenexperiencingyourpenwithyour5senses,andinyourmind.Ok?That’sthefirsttoolinvolvedinpsychologicalflexibility–noticingthedifferencebetweenwhenyouareexperiencingtheworldfromyour5senses,andwhenyouareexperiencingitthroughyourthoughts. Now,you’llnoticethatoverhereonthissideoftheMatrix,Ihavewrittentheword“Towards.”Allofushavethingsinourlivesorourfamiliesthatwewouldliketomovetowards.Forexample,Imightput“xx”forme(givearealexample,suchasabetterrelationshipwithone’schild,ormoreconnectionwithaspouse,etcetc).Whataboutyou?Whataresomethingsthatyou’dliketomovetowardsinyourlife?**Donotjudgeparentresponses–simplywritethemdown–UNLESS–theysaysomethingthatindicatesthattheywouldliketomoveAWAYfromthatthing–like“Lessfighting”etc.Iftheydogiveyousomethinglikethis,theneitherwriteitintothequadrantoftheMatrixforthoughtsandfeelingswe’dliketomoveawayfrom.Obtain5-6responsesfromparents.Now,whenyouaremovingtowardsthesethings(pointtotheitemsontheboard),thingssometimesshowupinsideusthatwe’drathermoveawayfrom.Forexample,whenIammovingtowards“xx,”sometimes“yy”showsup(eg,anxiety,anger,fear,thoughtslike“Idon’thavetime”etcetc).Whataresomethingsthatshowupforyouthatyou’drathermoveawayfrom?Haveparentsnamethoughtsorfeelings.Makesureyouput“quotationmarks”aroundthethoughts.Say,“Wewriteallthesethingsinthelowerleftquadrant,becausetheyarethingsthatshowupinsideus.Justlikethethingsthatwethinkaboutthatwe’dliketomovetowards.Now,whenthesethingsshowupthatyouwouldliketomoveawayfrom,whataresomethingsthatyoudotomakethemgoaway?Forexample,I“xx”(eg,drink,yell,avoid,watchTV,ignorethekids,etcetc).Notethattheseareallthingsthatyoudo-theyarebehaviorsthatfolkscansee,sotheygoabovetheline.Sowhataresomethingswedotomoveaway?Listwhattheparentssay.Onceyouhavealistofthingsfolksusetomoveaway,talkthemthroughhoweachofthesestrategiesworks.Drawalinefromtheavoidedcontent(bottomquadrant,thoughtsandfeelings)andthematchingstrategy–iftheparentsaysthatthestrategyworksintheshorttermandnotinthelongtermoriftheysayitdoesn’tworkatall(ormakesthingsworse),thendrawanarrowbackdowntothecontent.Youshouldeventuallygetabunchofcirclesthatlooksalittlebitlikeahurricane.Asktheparentstonoticewhattheyseeregardinghowthesestrategieswork.Youmayaskwhatthedrawinglookslike–theymaysay,awhirlpool,orstorm.Askifthestrategiesareusefulinmoving

Page 19: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

towardsthings–theanswershouldbeanobviousno.Finally,askparentstoletthelefthalfoftheMatrixsitforabit,andthenhavethemlistthingsthathelpthemmovetowards.Again,provideanexample.Participantsmaylistactionsthatare“alittlebittowards,andalittlebitaway.”Ifthisisthecase,seeiftheycandescribeapercent(percenttowards,percentaway).Oncetheyhavegeneratedalistof5-6ormore,havethemnoticewhattheysee–askiftheyneedtomanageanyofthecontentinthelowerleftquadrantinordertomovetowardsthingsthatareimportant.Askiftheythink,basedonthedrawing,whetheritmightbehelpfultomanagethatcontent(inthelowerleftquadrant)inordertomovetowardsthethingsthattheycareabout.Thedrawingshouldsuggestthatitisnot.Highlightforparentsthatitisimportanttonoticetwothings–whethertheyareexperiencingwiththeir5sensesinthepresentmoment–andwhethertheyaremovingtowardsorawayfromthethingsthatmatter,orwhethertheyareengagedincounterproductiveattemptstomanageinternalcontent–whichdoesn’treallyworkwelltomanagethatcontent,ORtomovetowardsstufftheycareabout.GiveeveryoneaMatrixhandoutortwo.Discusswhatgoesonindifficultparent-childinteractions–andthatparentscannoticewhethertheyareintheirheadsorinthemoment,andwhethertheirbehaviorismovingtowardssomething,ormovingawayfromsomething.ParentscanusetheMatrixtohelpthemtracktheirmoves,andseehowtheyworkObjective5:HomePractice–TrackingTowardsandAwayMovesUsingtheMatrix.Haveparentsworkontrackingwhethertheyareengagedintowardsorawaymoves,andhowthosemoves“work”forthem.Havethemwritedownatowardsorawaymove,especiallyintheirrelationshipsorinteractionswiththeirchildren,andseehowtheywork,onceperday.Givethemthehomeworksheet.Remindthemthatyouwilldiscussthesenextweek,especiallylookingathowthesemoveswork.

Page 20: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

Session4:Valuing/CommittedAction:DoingWhatMatters Objective1:a.CreatingConnections/b.CenteringExercise

Objective2:Homepracticecheck-in:TrackingTowards&AwayMovesObjective3:ListeningtoCoreParentingValuesObjective4:IntroducingValuing/CommittedActioninParentingConsistencyHomePractice:PracticingParentingCommitmentMaterialsNeeded:Whiteboard/largeflipchartandmarkers;homeworksheets,Matrixhandouts,HomePracticeAssignments,pensandblanksheetsofpaperforparents(fortheNon-DominantHandExercise),andifyouchoosetouseit,theValuesAssessment.

Objective1a:ListeningtoDifficultParentingThoughtsandFeelingsAllowparentstomeetandchattogether,andinagentlyguidedway,helpelicittheirstrugglesandtriumphsfromtheweek.Listencarefullyforproblematicthoughtsorbeliefs,andwhenyouhearthem,continueshapingdefusionrightfromthebeginningofthegroupbyusingreflectionstemssuchas“Soyourmindistellingyou…”or“Soyouarehavingthethoughtthat…”Inaddition,youmightcallattentiontocommonalitiesacrossthesethoughtsamongstthegroupofparents,aswellashighlightinguniquenessesoftheirexperience.Itwillalsobeimportanttohelpparentstonoticehow“sticky”orcompellingorpowerfulthesethoughtsareastheyspeakaboutthem.Youcandothisbymodelingyourself,forexample,“WhenIhavethethoughtthatIamirritatedandcan’ttoleratethat,Ihaveahardtimenoticinganythingelsebutthat.”Oryoumightsay,“InoticethatIstrugglemorewiththoughtswhentheyshowupwithstrongemotion.”Finally,keepthesessionastightlytailoredtoyourparentsaspossible–someofthesethoughts/feelingswillshowupagainwhenyoureviewtheMatrix.Objective1b:BriefCenteringExercisearoundAcceptanceConductabrief5-minutecenteringexerciseofyourchoicearoundacceptancetohelpparentsgetcenteredinthepresentmoment,andreadytoengageinamoremindfulandcuriouswaywiththegroupcontentandeachother.Youmayguidethemtopresent

Page 21: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

momentawareness,andinvitethemto“allow”theirfeelings,ortoimagine“thatyourfeelingslandlightlyinthem.”Anotherwaytoencourageacceptanceistohavethemphysicalizetheiremotionsorthoughts–imagineholdingeachgentlyinthepalmoftheirhands.Thiswillhelpwithplacingdifficultthoughtsandfeelingsinahierarchicalframe(I=notjustmythoughtsandemotions;Iholdmythoughtsandemotions).Objective2:Homepracticecheck-in:TrackingTowards&AwayMoves***MAKESUREYOUGIVEPARENTSTHEHOMEWORKCHECKSHEETANDHAVETHEMCOMPLETEIT.Hereislastweek’shomeworkassignment:Haveparentsworkontrackingwhethertheyareengagedintowardsorawaymoves,andhowthosemoves“work”forthem.Havethemwritedownatowardsorawaymove,especiallyintheirrelationshipsorinteractionswiththeirchildren,andseehowtheywork,onceperday.Givethemthehomeworksheet.Remindthemthatyouwilldiscussthesenextweek,especiallylookingathowthesemoveswork.Youmaynoticeatthispointthatsomearegettingstuckon“acceptance”becauseonthewaytomakingtowardsmoves,difficultfeelingsandthoughtsgetintheway.Whenthishappens,makesureyouredirectthemtobacktotheMatrixsothattheycancontactthefunctionoftheirchoicesinthemoment:i.e.,howdoesworkingonmanagingthoughtsandemotionswork?Drawtheirattentiontowhentheyaregettingstuck.ItmayalsobeusefulatthispointtointroduceanACTmetaphoraboutacceptance,suchasJoetheBum(or“theUninvitedPartyGuest”);thequicksandmetaphor;MuleintheWell;ortheTwoMonksZenkoan:TheMonk’sHeavyLoad

Onefine,warm,springday,twomonks–oneyoungandoneold–weretravelingtoavillagefarfromtheirmonasterytodosometrading.Inthehighmountainswheretheylived,therewereonlysmalltrailsbetweenvillages,noroads,andfewbridges.Thespringhadbeenespeciallywarm.Winter’sdensesnowwasmeltingquicklyandmanystreamshadbecometooswollenanddangeroustocross.

Afterwalkingadistanceonarugged,steeptrail,thetwomonkscameuponafastmovingstreamwereayoungwomanstoodtimidlyonthebank,afraidtocross.Theyoungmonkremindedhimselfthataspartofhisreligioustraining,hehadvowednevertotouchanyoneoftheoppositesex.

Page 22: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

Henoddedtotheyoungwomanashepassedherby,liftedhismonk’srobeupslightlyandcarefullybegantonegotiatethestream.Buttohisamazement,theeldermonkspedrightpasthimwhilecarryingtheyoungwomaninhisharms!Whentheoldmonkputherdowninthefarshore,shebowedrespectfullytohiminthanks.Notsayingawordinreply,hegaveherabright,broadsmileandwentonhiswaywithaquickstep.

Theyoungmonksawthattheelderhadcontinuedonwithouthim.Withsomeefforthefinallymanagedtocatchup.Butastheywalkedon,heconsideredandconsideredandreconsideredtheoldmonk’sactionbackatthestream.Witheachpassingmilehisthoughtsgrewangrierandangrieruntilhourslater,hestoppedinhistracks,flushedwithrage.Heshoutedandsputteredattheoldmonk,”Youbrokeyoursacredvows!Youwerenevertotouchawoman!Howcanyouforgiveyourself?Youshouldnotbeallowedbacktoourmonastery!”

Surprisedatthisoutburst,theoldmonkturnedtofacehim.“Idroppedthatwomanhoursago,”hesaid.“Haveyoubeencarryingherallthistime?”

Trythefollowingexercisetoseewhatyou,asaparent,havebeencarryingallthistime.

Askparents,“WhatCanYouChoosetoPutDown?”Takeaboutfiveminutesnowtothinkaboutthisstatement:Inorderformetohaveafreemind,anopenheart,andanunyieldingapproachtoparentingwell,Ineedtoletgoof….Allowdiscussion.

Objective3:ListeningtoCoreParentingValues

Say,“Whenthingsgetdifficult,it’sprobablyhardforyoutorememberthelasttimeyousatbackandconsideredthethingsthataretrulyimportanttoyou.Ifyou’relikemostparents,yourvalueshavelikelygottenlostinthetasksofdailyliving.Ifyou’relikemostparents,whenparentingbecomesdifficult,youmayfeellikeyouarejustgoingthroughthemotions.Howdoesthismanifestonaphysicallevel?Youmayfeelexhaustedandoverwhelmed,orexperienceasortofheaviness.Oryoumayfeelnumbandcheckedout,orperhapsyouhaveasenseofurgencyandfeeltrapped.Considerthesefeelings:

1. Seeifyoucanrememberatimewhenyouhavefeltstretchedtoothin.

2. Whathappenedwhenyoustruggledtomanageyourchild’smisbehavior?

3. Whatfeelingsshowedup–didyourfeelingscolortheentireinteraction?

4. Ifyoucoulddescribethosemomentsas“spaces,”wouldtheyfeelroomy

andexpansive,orrather,smallandcramped,areasinwhichyoumustfighttogetout?

Quitelikely,youexperienceasortoftunnelvisionwhenyougetintosituationslikethese,suchthatyouronlygoalistodowhateverisnecessarytostopyourchild’sproblembehavior.Theworldmaynarrowtothisoneinteraction,which,youmayfeel,isthebarometerbywhichyoumeasureyoursuccessorfailureasaparent.

Page 23: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

Here’sadifferentidea:whatiftherewasawayyoucouldchoosehowtorespondtoyourchild,insteadofsimplyreactingtosituations?Whatifyoucouldchooseyourdirection,evenwhenyouarereactingtowhateverishappeninginthemoment?Valuesarechosendirectionsorwaysofbeing.Youmightthinkofyourvaluesasyourchosenpurpose.Theyarenotdestinations,butrather,pointsonacompassthatguideusthroughourlives.Sometimes,whenwetalktoourclientsweusethewordvaluesinsteadofvaluing,whichisreallywhatwemean.Tohelpyoubegintounderstandwhatismeantbyvaluing,let’stryanexercise.

Atthispoint,youmayleadthemthroughyourchoiceofValuesexercises.Somefavoritesare“Eighty-YearOldYou”(meaningfulandbrief,iftimeisshort);“TheNon-DominantHandExercise”(longer,andalsoquitepowerful);oryoumaychoosetogothroughtheValuesAssessmentwiththem.

Eighty-YearOldYouFirstconnectinwithyourfeetagainsttheground,andyourbreath,andyourbodyasawhole.Bringyourattentiontoyourshoulders,noticingiftheyarecarryinganytensionorstrain…gentlybringingthemuptoyourears,andthenlettingthemdrop…andjustnoticingyourbreathing.Noticinghowtheinbreathallowsforanewbeginning…andtheoutbreathallowsforcompletelettinggo.(pause)Noticingifyourmindisbusyorstuckonotherthings…andmakingroomforthatwithkindnessandcompassion.Whereyouareisexactlywhereyouneedtobe….andthenjustcomingbacktoyourbreathandyourbreathing.Andwhenyou’reready,I’mgoingtoinviteyoutoimaginethatyour80-yearoldyou,thisolder,wiser80-yearoldyou–who’sbeenthroughallthatyouhavebeenthrough,andmuchmuchmore…hascometoanACTworkshopandappliedatleastsomeofwhatthey’velearned.Andbyallmeansthey’renotperfect…they’vegoneoffcoursemany,many,manytimes…yetthey’verecognizedwhenthey’vegoneoffcourseandlearnedfromit….they’veevenchangeddirectionsometimes.Andthisolder,wiser80-yearoldyouhiscomingtogiveyoujustthreebitsofadvice.Thefirstbitofadviceis“Youspendfartoomuchtime…”Whatmightyourolder,wiseryoutellyouspendfartoomuchtimedoing?Sofar,afavoritehasbeenworrying…90percentofpeoplesayfartoomuchtimeworrying–mightbedifferentforyou.Thenextoneis“Youspendfartoolittletime…”Whatmightthisolder,wiser80-yearoldyoutellyouthatyouspendfartoolittletimedoing?Andlastbutnotleast,theolder,wiser80-yearoldyouwillrecommendthatyoumakejustonechangeinyourlifefromthisdayforward.“Soifyoucouldmakejustonechangeinyourlife,fromthisdayforward,thisiswhatI’drecommend.”(pause)andgentlylisten,andbreathe.Andjustnoticingtherippleeffectthatmightincurinyourlifeifyoumadethisonechange?Whatdifferencewouldthatmakeinyourrelationshipwithyourself,andwithothers?

Theexerciseisnowcomingtoanend.Inalittlewhile,Iwillaskyoutoopenyoureyesandwhenyoufeelready,Iwantyoutotakeafewminutestowritedowninyourworkmaterialswhat80-yearold

Page 24: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

youhastoldyou.After2-3minutes,allowparticipantstosharetheiranswers,notingsimilaritiesinresponsesacrossgroupmembers.

TheNon-DominantHandExerciseMakesureparentshaveasheetofpaperandapen.Preparethemtowritewiththeirnon-dominanthand.Doaverybriefcenteringexercise,andaskthemtocompletethefollowingsentences.Whenyouarefinished,askparentstocompletethesesentences:

� Ifeel

� Ineed

� Ilongfor

� I’mscared

� I’mstrugglingwith

� Idreamof

� Ipretendthat

� It’shardformetotalkabout/it’shardformetotellyou

� IfIhadthemoney,Iwould

� IfIhadthecourage,Iwould

Ifyouhavetime,youmaychoosetogothroughtheValuesAssessmentinstrumentwithparentsinsteadoforadditionaltotheseexercises.

Objective4:IntroducingValuing/CommittedActioninParentingConsistencySay,“AsFredRogerssaysitinTheWorldAccordingtoMr.Rogers,(p.32),“Yourarelyhave

timeforeverythingyouwantinthislife,soyouhavetomakechoices.Andhopefullyyourchoicescancomefromadeepsenseofwhoyouare.”Butasyounoticedthisweekandlastweek,lotsofthingsshowupwhenwethinkaboutvalues–thoughtsthat“Thesearenotpossible;”“I’mtootired;”“Idon’thavetimetothinkaboutthesethings–Iambarelymakingit.”Feelfreetorefertothoughtsandfeelingsthattheparentsinthegrouphavedescribed.Notethattofollowone’svaluesisnaturallytofeelvulnerable.

Say,“Iwouldlikeforyoutodoathoughtexercisewithme.Imaginesomeonethatyoucaredeeplyabout–achild,afriend,apartner.Imaginethatyouareasleepinthehouse,andyouhearan

Page 25: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

intrudercomein,headingdowntotheroomofyourlovedone.Whatwouldbethemostimportantthingtoyouinthatmoment?Whatwouldyoudo?(parentstypicallysaytheywouldwanttheircaredaboutpersontobesafe,andwoulddosomethingtoensurethat).Ask,“whatifyouwerescared?”“Whatifyouweretired?”“Whatifyouhadthethoughtthatyoucouldgethurtyourself?”“Wouldthesethingschangewhatwasimportanttoyou?”“Wouldyouletanythinggetinthewayofkeepingyourlovedonesafethebestyoucould?”Thatisametaphorforwhatwemeanby“commitment”inACT–doingwhatmattersmost,nomatterwhat.

Allowsometimefordiscussion,andhowthismaybeusefulinparentingsituations.

HomePractice:PracticingParentingCommitmentHaveparentscompletethisworksheet,andtracktheirvaluesmovesonadailybasis.

Assignment:Thisweek,weencourageyoutopracticetakingcommittedactiontowardsyourvalues.Pleasecompletethefollowingexercise,writingdownyourresponses.Next,trackyourcommittedactionseachday,untilthenextsession.We’llgooverthesenexttimewemeet.

• Stateyourvalue

• Whatgetsintheway/whatyouhavebeendoinginstead

• Onesmallthingthatyoucommittochanging,fromthisdayforward

• Thatyouarewillmakemistakes,andwhenyounotice…

• Youwillacknowledgethisandturnbackinyourchosendirection

Page 26: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

Session5:ParentingYourAnxiousChild:CourageintheContextofCaring Objective1:CreatingConnections/CenteringExercise

Objective2:HomePracticeCheck-In:PracticingParentingCommitmentObjective3:UnderstandingtheImpactofAnxietyonParenting:ManagingOurOwnFearsandRespondingtoFearinOurChildObjective4:UsingACTtoConnectwithParentingValueswhenAnxietyisPresentHomePractice:PracticingParentingCommitmentwhenAnxietyisPresent***Materialsneeded:HomePracticeTrackingSheet,HomePracticeAssignmentforWeek5

Objective1a:ListeningtoDifficultParentingThoughtsandFeelingsAllowparentstomeetandchattogether,andinagentlyguidedway,helpelicittheirstrugglesandtriumphsfromtheweek.Listencarefullyforproblematicthoughtsorbeliefs,andwhenyouhearthem,continueshapingdefusionrightfromthebeginningofthegroupbyusingreflectionstemssuchas“Soyourmindistellingyou…”or“Soyouarehavingthethoughtthat…”Inaddition,youmightcallattentiontocommonalitiesacrossthesethoughtsamongstthegroupofparents,aswellashighlightinguniquenessesoftheirexperience.Itwillalsobeimportanttohelpparentstonoticehow“sticky”orcompellingorpowerfulthesethoughtsareastheyspeakaboutthem.Youcandothisbymodelingyourself,forexample,“WhenIhavethethoughtthatIamirritatedandcan’ttoleratethat,Ihaveahardtimenoticinganythingelsebutthat.”Oryoumightsay,“InoticethatIstrugglemorewiththoughtswhentheyshowupwithstrongemotion.”Finally,keepthesessionastightlytailoredtoyourparentsaspossible.

Objective1b:Conductabrief5-minutecenteringexerciseofyourchoicetohelpparentsgetcenteredinthepresentmoment,andreadytoengageinamoremindfulandcuriouswaywiththegroupcontentandeachother.Youmayconsiderusingthefollowingscript:

“Ifyouarewilling,pleasetakeamomenttogetsettledinyourseat.Ifitfeelsright,takeagentlestretchorafewdeepenedbreathstobegintofocusonpresentmoment

Page 27: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

sensations.Nowtakeamomenttonoticeyourbreathing.Noticethesensationsofbreathing,therisingandfallingofthechest,coolorwarmfeelingsasthebreathcomesinandoutofthenose.Imagineeachbreathbringsinnourishment,somethingthatyouneed,whetherthatisenergyorcalmnessorwisdom.Imagineeachoutbreathisalettinggo,arelease.Feelyourbodysupportedbyyourchairand,witheachoutbreath,settleindeeper.(pause).Takeamomentnowtothinkbacktoourfirstmeeting,wherewebegantoimaginewhatwehopedtoseechangeinourlives,inourrelationshipswithourchildren,andinourparentingchoicesandbehaviors.Wheredidyoubegin?Whatchangeswereyouhopingfor?Havethesewishesremainedthesame,orhavetheychangedoverthecourseofourmeetings?Noticewhatthoughtsandfeelingsappearasyoureflect.”

Objective2:HomePracticeCheck-In:PracticingParentingCommitment***MAKESUREYOUGIVEPARENTSTHEHOMEPRACTICECHECKSHEETANDHAVETHEMCOMPLETEIT.Hereislastweek’shomepracticeassignment:Haveparentscompletethisworksheet,andtracktheirvaluesmovesonadailybasis.

Assignment:Thisweek,weencourageyoutopracticetakingcommittedactiontowardsyourvalues.Pleasecompletethefollowingexercise,writingdownyourresponses.Next,trackyourcommittedactionseachday,untilthenextsession.We’llgooverthesenexttimewemeet.

• Stateyourvalue

• Whatgetsintheway/whatyouhavebeendoinginstead

• Onesmallthingthatyoucommittochanging,fromthisdayforward

• Thatyouarewillmakemistakes,andwhenyounotice…

• Youwillacknowledgethisandturnbackinyourchosendirection

Indiscussion,listencloselyforparents“beatingthemselvesup,”ornegativelyevaluatingtheiractions,feelings,orgeneralcompetenceinparentingoraspeople.Makeaspaceforthosethingstobeheardinthegroup,andmodelwillingnessandacceptancetositwith

Page 28: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

them.Ifyouarewillingtoshareapersonalstorytocontribute,thatmodelingmayalsobehelpful.

Objective3:UnderstandingtheImpactofAnxietyonParenting

Beginthispartofthesessionwiththiscaseexampleorasimilarexampletailoredtothegroup’sspecificneeds.Useawhiteboardorsimilartorecordgroupresponses.

Birthdaypartycaseexample:Imaginethatyouhavebroughtyour6yearoldchildtohisfirstbirthdaypartyforaclassmate.ThepartyisbeingheldatPumpItUp,agiantgymfullofjumphouses.Blacklightsarebeingusedandthereisaloudbackgroundnoiseofpumpsblowingupthejumphousesaswellaspopmusicplayedathighvolume.Otherchildrenarebouncinginandoutofthejumphouseswithenergy,shoutingwithexcitement.Yourchild,uponwalkingintotheroomandtakinginthescene,isshrinkingbacktowardsyou.S/helooksneartears.

Academicanxietycase:Imaginethatyour11yearoldchildhasschool-widetesting(suchastheMCASorPARCC)scheduledfortomorrow.Itisthenightbeforethetest,ands/hehasbeenaskingquestionsallafternoonaboutwhattoexpect,whethers/hewilldoOKonthetest,andwhathappenstokidswhodonotpassthetest.Thesamequestionshavebeenrepeatedmultipletimes.Atdinnertime,s/herefusestoeat,complainingofstomachpain,andasksyouifs/hecanstayhometomorrow.

Reassurancecaseexample:Imaginethatyour13-year-oldchildhasastrongfearofbecomingillorthrowingup.Shehasjustheardfromagoodfriendwhositsnearheratschoolthatthefriendhasthestomachflu.Yourchildhasstartedhyperventilatingandisreviewingoutloudallthepotentialwaysshemighthavebeenexposedtothestomachflu.Sheasksyou,“AmIgoingtogetsick?”andrequestsyoutakehertemperature.

a. RespondingtoOurChild’sFearorAnxiety:Experientialexercisesanddiscussion1. Experientialexercise:Imagineyourselfastheparentofthischild.

a. Whataresomefeelingsthatmightcomeupforyou?i. Acknowledgethatvariousnegativeemotions,includinganxiety,

anger,frustration,exhaustion,etc.arelikelytocomeupinthissituation;usecontextofacceptanceinthisdiscussion

b. Asyouimagineyourselfinthissituation,whatthoughtsdoyounotice?

Page 29: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

i. Practicedefusiontechniquesasyoureviewcatastrophizingthoughts,overestimationofprobabilityofnegativeoutcomes,andotherthoughtsassociatedwiththesituation

ii. Notetheverbalrulesthatmayappearinthisdiscussion(“Goodparentsdonotallowtheirchildrentobecomedistressed”“Mychildwillbedamagedbystrongnegativeemotions”“Mychildcan’ttoleratestrongemotions”“Ican’ttoleratestrongemotions”)

c. Doyounoticeanybehavioralimpulses–isyourmindgivingyoureactivebehavioralsolutionstothediscomfortyouareexperiencingastheparentofthischild?Lookforthefollowingcommonbehavioralimpulses;youmaypotentiallydiscusstheminthecontextof“towards”and“away”moves(thematrix).

i. Rescue/Escapeii. Otheravoidanceiii. Accommodate,parenttakesoverallorpartoftheexperienceiv. Chideorpunishv. Otherresponses(e.g.,ignore,invalidate,minimize)vi.

Formatted: List Paragraph, Indent: Left: 4.44 cm

Page 30: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

d. Howdothesebehavioralimpulseslineupwithyourparentingvalues?

i. Arethesetowardsmovesorawaymoves?ii. Whatmighthappenintermsofshort-vs.long-termchild

outcomesifweusethesestrategies?iii. othernegativeemotions,suchasfrustration,anger,orboredom?

2. Experientialexercise:Nowimagineasituationspecifictoyourownchild–atimewhens/hewasveryanxious.Repeattheexerciseabove.

Objective4:UsingACTtoConnectwithParentingValueswhenAnxietyisPresent

Ifyoucanslowdownandmakespaceforyourowndiscomfortwiththesituation,whatmindfulbehavioralchoicesmightyoumake?Ifyouhadcouldstayconnectedtoyourparentingvaluesevenwhenupsetbyyourchild’sdistress,whatmightchangeinyourbehavioralresponse?Whatotherapproachesmightyoumindfullychoose?Whatmighthappenintermsofshort-versuslong-termchildoutcomesifyouusethesevalues-drivenbehaviors?Istherevalueinallowingyourchildtolearntotolerateoracceptanxietyandstilldothingstheylove?

Experientialexercise:

PartI:Now,returntothatimagewejustworkedwith,asituationinwhichyourownchildisveryanxious.Again,pauseandnotewithyourobservingmindthethoughts,feelingsand

Page 31: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

behavioralimpulsesthatarecomingupforyouinthissituation….Now,begintoimagineyournew,values-focusedresponsetoyourchild’sbehavior.Canyouimagineholdingthesefeelingsandthoughtslightly,andatthesametimebeingwillingtostillmoveforwardtowardsmakingspacetoallowyourchildtoexperiencewhateveritiss/heisexperiencing.Imagineyourexperienceinthemomentoftryingoutthe“towards”parentingbehavior.[therapistmaygentlypromptparentstobringinACTconcepts,e.g.“allowingspaceforyouruncomfortablefeelings”“noticingthatyouarehavingthethought:‘Ineedtorescuemychild;”“bringingintoawarenessyourparentingvaluearoundhelpingtosupportindependence,givingchildspacetodevelopconfidence;”“noticingyourimpulsetofixthesituationforyourchild,butmovinginsteadtowardyourparentingvalue;”etc.]

Processthisexerciseindiscussionwiththegroup.

PartII:NowI’dliketotakeanimaginarytripintothefuturewithyou.Imaginenowthatitisyourchild’scollegegraduation.I’dlikeyoutoimaginethatyouhave,overtheyearsleadinguptothisgraduation,workedhardtogiveyourchildthespacetolearntotolerateandworkwithnegativefeelingslikeanxiety.Eventhoughithasbeenhard,youhavesupportedyourchildintakingonnewchallenges,andyouhaveallowedhimorherroomtocopewithallthefeelingsandthoughtsthatcomeupwiththenewchallenges,likeschoolwork,dating,friendships,andnewexcitingactivities.Youhavelistenedtoandsupportedhimorherovertheyears,butyouhavenotrescued,excessivelyreassured,ortakenresponsibilityforhisorherfeelings.Imaginethat,byparentinginthisway,yourchildhaslearnedtobeconfidentandflexibleevenwhenanxietyispresent.Takeamomentnowtoimaginewhatnewactivitiesyourconfident,flexiblechild,nowayoungadult,hastriedforthefirsttimeincollege–andwhatnewskillshemighthavediscoveredhehas.Imaginethekindsoffriendshipsandrelationshipsthatheorshemayhavebuilt.Imaginethefuturelyingaheadforyourchild,whonowknowss/hecanhandleunpleasantfeelingswithouthavingtoturnawayfromwhatisimportant.

HomePractice:PracticingParentingCommitmentwhenAnxietyisPresent

Haveparentscompletethisworksheet,andtracktheirvaluesmovesonadailybasis.

Assignment:Thisweek,weencourageyoutopracticetakingcommittedactiontowardsyourvaluesinthespecificcontextofyourchild’sanxiety.Pleasecompletethefollowingexercise,writingdownyourresponses.Next,trackyourcommittedactionseachday,untilthenextsession.We’llgooverthesenexttimewemeet.

Page 32: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

• Stateyourvalue

• Whatgetsintheway/whatyouhavebeendoinginstead

• Onesmallthingthatyoucommittochanging,fromthisdayforward

• Thatyouarewillmakemistakes,andwhenyounotice…

• Youwillacknowledgethisandturnbackinyourchosendirection

Page 33: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

Session6:Self-Care:There’sOnlyOneYou Objective1:CreatingConnections/CenteringExercise

Objective2:HomePracticeCheck-In:PracticingParentingCommitmentwhenAnxietyisPresentObjective3:ListeningwithCompassion/Self-as-Context(Defusing“Failure”)Objective4:CreatingaTouchstone:TurningBacktoValues/CommittedActionHomePractice:KeepingitGoing&MakingTimeforYou***Materialsneeded:HomePracticeTrackingSheet,HomePracticeAssignmentforWeek5,ParentingManifestoHandout,Post-TreatmentMeasures+SASE

Objective1:CreatingConnections/CenteringExercise

Beginthiscenteringexerciseswithbriefdiscussionaboutthepastweek,andanystrugglesthattheparentsmaybehaving.Afteranopportunityfortheparentstoconnectwitheachotheraroundthesedifficulties,invitethemtotrythisexercise.

Say,“Settleintoyourchair,andgetintoapositionofrelaxedalertness,closeyoureyes,anddrawyourattentiontoyourbreath...youdonotneedtochangeyourbreathing,justnoticeyourbreathing...youcanpayattentiontotheairgoinginandoutofyournoseortheriseandfallofyourstomach...(severalseconds)...nowshiftyourfocustoyourbodyandnoticeifthereisanytensioninyourbody...again,noneedtodoanythingtochangethis,justnotice...andnowshiftyourfocusagaintoanyemotionsyoumightbefeeling,noticethequalityoftheemotion(strong,faint,painful,comfortable,sharp,dull...)andwherethatmightbeobservableinyourbody.(somethinglikethat,youcouldaltertoyourneeds,evenshortenandjustkeepthefocusonthebreath)I'dlikeyounowtotryanimagerypractice...considertheimageofabeingthattoyouconveyscompassion...thiscouldbeapersoninyourlifenoworinthepast,aspiritualfigure,oranimaginedbeingthatyouhavenotyetmetorheardabout...abeingthathasqualitiessuchaskindness,wisdom,strength,flexibility,courage,andanendlesscapacitytolove...takeamomenttobringthisbeingtomind...considerwhatthisbeinglookslikeinasmanydetailsasyoucanbringtomind...Nowimaginethisbeingsittingnexttoyou,youasyouarenow,withtheemotionsthatyouhavenow,thethoughtsandexperiencesyouarehavingatthismoment...imaginethisbeing,thisbeingwithsomuchkindness,wisdom,strength,flexibility,courageandlove,buthis/herhandonyourshoulderandwiththisgestureshowingtoyousomuchcompassion,caring,completeacceptance...ofyou,justasyouare...allowthosefeelingstobewithyounow...(andthensomethingtocomebacktothepresent...like,allowthesefeelingsofcompassiontostaywithyouasyouexpandyourawarenessbacktoyourbreath...andnowtotheroomaroundyou...whenyou'reready,openingyoureyes...)

Page 34: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

Objective2:HomePracticeCheck-In:PracticingParentingCommitmentwhenAnxietyisPresent

Haveparentscompletethisworksheet,andtracktheirvaluesmovesonadailybasis.

Assignment:Thisweek,weencourageyoutopracticetakingcommittedactiontowardsyourvaluesinthespecificcontextofyourchild’sanxiety.Pleasecompletethefollowingexercise,writingdownyourresponses.Next,trackyourcommittedactionseachday,untilthenextsession.We’llgooverthesenexttimewemeet.

• Stateyourvalue

• Whatgetsintheway/whatyouhavebeendoinginstead

• Onesmallthingthatyoucommittochanging,fromthisdayforward

• Thatyouarewillmakemistakes,andwhenyounotice…

• Youwillacknowledgethisandturnbackinyourchosendirection

Indiscussion,listencloselyforparents“beatingthemselvesup,”ornegativelyevaluatingtheiractions,feelings,orgeneralcompetenceinparentingoraspeople.Makeaspaceforthosethingstobeheardinthegroup,andmodelwillingnessandacceptancetositwiththem.Ifyouarewillingtoshareapersonalstorytocontribute,thatmodelingmayalsobehelpful.Objective3:ListeningwithCompassion/Self-as-Context(Defusing&Accepting“Failure”)

Thegoalofthiscomponentoftheinterventionistohelpparentsvoicetheirworriesandthoughtsoftheirownperceivedshortcomings,andtositwiththosewithcompassion.Akeypartofthisinvolveshelpingparentscontacthowstrugglingwiththesetypesofself-evaluativethoughts“works.”Tothisend,youmaywantto

*DrawupontheMatrixagain,ifyoufeelthatparentsresonatewellwiththat.

*Engageparentsindefusion/acceptanceexercisesinwhichtheynoticeandstepbackfromthesetypesofthoughts,suchasthefollowing…

AcceptanceandwillingnessasanalternativeExerciseAim:Togiveadirectexperienceofacceptance.Acceptance–Anexerciseofmindfulness

Page 35: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

Inthisexperientialexerciseofmindfulnessyouwillgetthechancetoobserveandexperiencewhathappenstoyouwhenpainful,sad,orstressfulthoughtscomeintoyourmind.Sitcomfortablyinthechair.Sitforwardinthechair,sothatbothfeetareflatonthegroundandsothatyoudon’tleanagainstthebackofthechair.Letyourbodyrestinitself.Sitcomfortablywithyourbackstraight,yetrelaxed.Becomeawareofwhereyouarerightnow.Takealookaroundtheroomforashortwhile.Closeyoureyesgently.Becomeawareofthesensationofyourfeettouchingtheground,yourbodytouchingthechair.Iwouldliketostartbyinvitingyoutomakecontactwithyournaturalbreathing.Thatwayofbreathingthatfeelsnaturalforyou.Youdon’tneedtostrainyourselforinfluenceyourbreathing,justallowyourbodytotakecareofyouandyouonlyneedtobepresentwithyournaturalbreathingmovement.(Pause1minute)InthisnextphaseIwanttoinviteyougetintothepositionoftheobserverofyourbreathingwhileatthesametimebewithyournaturalbreathing.Sowithoneeye,staywithyournaturalbreathingandwiththeothereyeseeifyoucantakeastepoutsidesothatyouareabletoobservewhatthisnaturalbreathinglookslike.Whattherhythmlookslike,howdeeporhowshallow,whereinyourbodyyoufeelthismovementandevenhowitfeelsinyourwholebodywhenyoubreatheinthisway.Trynottojudgeyourbreathing,inonewayoranother.Simplyobserveit,asitis.(Pause1minute)Inthisphase,Iwanttoinviteyoutoreachoutandpullinathoughtthatisveryirritating,unacceptable,stressfulorpainfulforyouaboutyourchild,orparenting,orrelationshipwithyourfamilytoday.Whenyouhavefoundthisthought,bringitin.Asyoubringthisunacceptablethoughtintoyourbreathing,Iwantyoutojustobservewhathappenstoyourbreathingandyourbody.Remember,noneedtojudge,justobservewhathappenstoyourbreathingandyourbody.(Pause1minute)Pleasereturnnowtoyournaturalbreathingagain,yourstablerhythmofbreaththatyourbodyprovidesforyou.(Pause1minute)InthisfinalphaseofthisexerciseIinviteyoutoonceagainreachoutandpullinthesameunacceptablethoughtintoyourbreathing,butthistime,Iinviteyoutoconscientiouslymaintainyournaturalbreathingwhileyoupullthisthoughtin.Youarewithyourbreathingandstaytherewhileyouatthesametimewithalongarmpullthisunacceptablethoughtin.Watchwhathappenswiththisunacceptable,irritatingorpainfulthoughtasitlandsinyournaturalmindfulbreathing.(Pause1minute)Letusendthisexercisewithafewwords.Youmayrepeatthestatementsquietlytoyourself.Iallowallmyexperiencesthatcometometolandpeacefullyinme.Allsensations,memoriesfromthepast,preoccupations,impulsestoavoidortocling,orworriesforthefuture,areallowedtolandinmypeace.Ichoosenottogeneratesomuchmoreunnecessarypainformyselforothers.IamawareofhoweasilyIgetcaughtinthetrapofreactingtoimpulsesaimedatshorttermavoidanceofunpleasantfeelings,orclingingtofeelgood.Inowchoosemystepsofactionformyselfbasedonwhatishealthyforme.Ichoosetoactwithdignityandrespectformyself.Becomeawareofthesensationofyourbodytouchingthechair,yourfeettouchingtheground.Feelthatyouarecompletelypresentinyourbody.

Page 36: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

Whenyoufeelready,youmaygentlyopenyoureyesand,ifyouwant,youmaystretchalittle.Thisistheendoftheexercise.

*Helpparentsnoticethatitishardtoshowcompassionfortheselfinmomentslikethisandaddressthatwithself-compassionexercises,suchasthefollowingoptions…

Say:Allparentsmakemistakes.Whenyoudo,youmaybeatyourselfup.Forinstance,youmighttellyourselfthatyouneverparentwellorthatyoushouldjustgiveupbecauseyoujustcan’tgetitright.Whenyounoticeyourmindstartingupwiththissortoftalk,remindyourselfthatyou’rehuman.Yourmindmaytellyouthatyouareyourmistakes.Noticethoughtsliketheseforwhattheyare:simplythoughts.Andwhatifyouwereyourmistakes?Youmightstoptryingtodothingsdifferently,oryoumightgrowsoangryorfrustratedwithyourselfthatyoumightgiveup.Ifthisisconsistentwithyourexperience,trythefollowingexercise.Self-CompassionExerciseOption1:TheWildGeeseAskparentstoclosetheireyesandgetcentered,andtosimplylistenandallowwhateverthoughtsandfeelingsshowup.Allowtimetodiscussafterward.Read,“TheWildGeesebyMaryOliverYoudonothavetobegood.Youdonothavetowalkonyourkneesforahundredmilesthroughthedesertrepenting.Youonlyhavetoletthesoftanimalofyourbodylovewhatitloves.Tellmeaboutdespair,yours,andIwilltellyoumine.Meanwhiletheworldgoeson.Meanwhilethesunandtheclearpebblesoftherainaremovingacrossthelandscapes,overtheprairiesandthedeeptrees,themountainsandtherivers.Meanwhilethewildgeese,highinthecleanblueair,areheadinghomeagain.Whoeveryouare,nomatterhowlonely,theworldoffersitselftoyourimagination,callstoyoulikethewildgeese,harshandexcitingoverandoverannouncingyourplaceinthefamilyofthings.”Self-CompassionExerciseOption2:Self-Compassion/Acceptance(Restwithbreath).Thinkofsomeoneimportanttoyou(oryourchild).Imaginethemfully–thegoodthings,andtheirritatingthings…Sendthemgoodwillandkindness.Mayyoubesafe.Mayyoube

Page 37: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

peaceful.Mayyoubehealthy.Mayyoubekindtoyourself.Mayyouacceptyourselfasyouare(repeat).Andifthispersonisgoingthroughahardtime,add“aspossible”attheendofeachpraise–gettingintouchwithfeelingsofcare,concern,andkindness…Nowimagineyourselfinthisperson’spresence.Maywebesafe.Maywebepeaceful.Maywebekindtoourselves.Mayweacceptourselvesaswear.eNoticinghowsafeyoufeelwiththisperson,howmuchyoucareforthem–howmuchtheycareforyou.Nowfocusyourattentiononyourself.Youdeservecaring,kindness,love.Asyouconsiderthesethings,allowyourselftobringtomindsomeaspectofyourself,somemistakeyou’vemade,that’sbeenbotheringyou.Somethingperhapsyoucriticizeyourselffor,orthatmakesyoufeelinadequateinsomeway.Trytogetintouchwithyourfeelingsaboutit–sad,frightened,isolated,inadequate–havehowyoufeltwhenyouyou’vethoughtaboutthis?Wheredoyoufeelthisinyourbody?Tightnessinthroat?Heavinessinheart?Tensioninshoulders?Seeifyoucanallowthemtobethere,asnaturalfeelingsthatarisewhenwejudgeourselves.Getintouchwithhowmuchsufferingiscausedbyourself-judgmentsorfeelingsthatwearen’tgoodenough.Sometimesourgreatestsufferingiscausedatourownhands,bystrugglingwithbeliefsthatwemustbeperfect.Seeifyoucangetintouchwiththepersonfeelingthesedifficultthings.MayIbesafe.MayIbepeaceful.MayIbekindtoyourself.MayIacceptmyselfasIam.Ifhardtodo,tryputtingyourhandgentlyonyourheart,andfeelingthewarmththere.(repeat)Ifyoufindyourselfdistracted,that’sfine–makespaceforthat–andwhenyouareready,comebacktothephrases,andtheunderlyingwishforgoodwill,andtheintentionbehindthewords.Rememberthateveryoneisinthesameboat.Everyonefeelsinadequateinsomeway,orthattheyhavefailed.Thisisthehumancondition.

*Someparentsmayhavedifficultyhavingcompassionfortheirchildratherthanthemselves.Ifthisisrelevant,youmaytrythefollowingexercise:

ChildCompassionExercise:RememberWhenFindafewminutesforquietreflection.Readthroughtheexerciseonceortwicesoyoudon’thavetoreferbacktothebookduringthemeditation.Sitinacomfortablechairandcloseyoureyes.Bringyourmindbacktoyourearliestmemoriesofyourchildasanewborn.Bringyourselfbackintotheskinofthepersonyouwereinthatmoment.Noticethesmallsizeandweightofyourchild,howhesmelled,thedelicatesoftnessofhisskin.Bringyourselfbackintothatmomentandnoticehowyoufelt—perhapsjoyful,peaceful,orinaweofthiscompletelynew,amazinglittlebeing,andtheterrorofyournewresponsibility.Noticethatthissmall,vulnerable,incrediblystronglittlechild,forwhomthewholeworldwouldopenupinlimitlesspossibility,isthesamepersontodayashewasthen.Seeifyoucanseehisfacenowthathehasgrown.Seeifyoucanseetracesofthatnewborninhisfacenow.Hestillcarriesnowthesamevulnerabilityandstrengthyoufeltthen.Seeifyoucanmakeaspaceforthatvulnerabilityandstrengthinacompassionatewayasyoucomebacktothepresent.

Page 38: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

Ask:Whatwasitlikeforyoutoparticipateinthepreviousmeditation?Whatifyoucouldgentlyholdthatrich,fullexperienceofyourchildinyourawarenessregardlessofwhatyourchildisdoinginthemoment?Say:Partofmindfulawarenessisnoticingthecontinuityofyourexperience:whenyourchildstrugglesandwhenyouasaparentstruggle,you’rethesamebeingsinyourworstmomentsasyouareinyourbestmoments.Onewaytohelpholdthatunderstandinginyourawarenessistoexpect,withcompassion,yourchildtodothenextrightthing.Veryoftenparentsexpecttheworst,especiallyintimesofgreatstress.Youdon’thavetobelievethisofyourchild—indeed,ifyouarguewithyourmindaboutwhethershewillorwon’t,you’llslipoutofthemomentintothehypotheticalfuture.Youcanchoose,however,tosimplyactwiththatawarenessofyourthoughtswhileholdingthisthought:Mychildcandothenextrightthing.Ifyourmindwandersintothenegative,suchasunpleasantmemoriesorworriesaboutthefuture,simplyacknowledgethatandgentlyleadyourmindbacktothemoment.Objective4:CreatingaTouchstone:TurningBacktoValues/CommittedAction

CreatingaTouchstoneWritingExercise

Conductabriefcenteringexercise,tohelpparentsfocus,andtheninvitethemtodoawritingexerciseinwhichtheyputdownthefollowing,whichwillremainprivate,althoughyoushouldinvitethemtoshareonepiecewiththegroup,iftheyarewilling

• 1.Tellyourchildyourhopesforyourrelationshipandwhatyoumostwantforherorhim.

• 2.Writeaboutyourfearsandyourvulnerabilities.Tellhimwhatyouareworriedmightstandinthewayofyourhopesanddreamsforhimorher.

• 3.Finally,tellyourchildhowcommittedyouaretostandforhimorherortodotherightthingforhim—nomatterhowharditgets.

Say,“Putthisletterinasafeplace.Oneday,perhapswhenyourchildattainsaparticularmilestoneorachievessomethingspecial,comebacktoit.You’llknowtherightmomentwhenitpresentsitself.Readthislettertoyourselfand,ifyouchoose,shareitwithyourchild.”

HomePractice:KeepingitGoing&MakingTimeforYou

Homework:Askparentstocommittotakingonesmallstepinthedirectionofself-care,evenifthisistakinga5minutewalk,havingasmallsnack,closingthebedroomdoortohavepeaceforafewminutes,TV,exercise,meditation,reading–whatevertheychoose.Makesuretheychoosesomethingthatisfeasibleandsustainable,andhavethemmakethatcommitmenttothegroup.

Page 39: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015

SHARETHISASANENDINGCEREMONY,orhandoutatendofsession

Page 40: ACT for Parents of Anxious Children Manualanzact.com/wp-content/uploads/2013/10/ACT-PAC-Manual-Lisa-Coyn… · useful. Notice and reflect the process of what is going on in the room

ACTforParentsofAnxiousChildren 2015

Revised7-17-2015