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Rationale/Literature ReviewIntroductionAnxiety is one of the most pervasive mental health concerns affecting elementary-aged children, yet a significant number of students with anxiety disorders remain underserved (Thompson, 2013). The hallmark symptoms of an anxiety disorder are persistent and debilitating, impairs a child's functioning and exceeds what is considered developmentally normal (Keeley & Storch, 2009). Anxiety disorders typically have an onset in childhood or early adolescence (Kessler, Berglund, & Demler, 2005). Both retrospective and prospective studies indicate that they show limited remission over time (Bruce, Yonkers, & Otto, 2005). Regulation of attention, or attention control, is the ability to concentrate on a particular task, thoughtfully process and experience, solve a problem, or purposefully shift attention from one stimulus to another. The gradual enhancement of attention regulation abilities throughout childhood and adolescence enables children to better self-regulate their emotions (Rueda, Posner, & Rothbart, 2004). Research reveals that children who struggle with anxiety are less capable of controlling or shifting their attention (Muris et al., 2006). Furthermore, anxious children demonstrate attention bias in that they are hyper-attentive to threatening stimuli and have a tendency to show a negatively biased interpretation of seemingly neutral stimulus (Chorpita, Yim, Moffitt, Umemoto, & Francis, 2000; Vasey & MacLeod, 2001). Another factor that is likely to influence emotional regulation is the degree to which a child feels capable of attenuating symptoms of anxiety (Suveg & Zeman, 2004). In a study comparing 26 children ages 8 to 12 years old with anxiety disorders to children without anxiety, Suveg and Zeman found that anxious children reported lower self-efficacy in regulating their anxiety and sadness (2004). Children with diminished emotion-regulation self-efficacy may be less inclined to actively engage in adaptively managing emotions during anxiety-provoking situations. In fact, evidence suggests that individuals with anxiety have a tendency to suppress emotionally expressive behavior, which is likely to increase sympathetic activation of cardiovascular systems (Gross, 2002). In other words, the suppression of anxious feelings and behaviors does not lessen the internalized physiological experience of those feelings and may lead to diminished self-efficacy in managing emotionally arousing situations.The Need for Early, School-Based InterventionsThere are several known risk factors for anxiety disorders, including inhibited temperament, poor cognitive skills, negative attitudinal styles, and poor coping skills (Cichetti, 1998). Often times these features of the disorder are already interfering with an individual’s functioning. Subsequently, a large proportion of children who are selected on the basis of risk of anxiety, already meet the criteria for an anxiety disorder (Rapee, Kennedy, & Ingram, 2005). If untreated, anxiety has the potential to cause significant disruption to a child’s developmental trajectory due to high levels of comorbidity (Kendall, Rodger, & Palmer, 2010). This indicates that early intervention is important in providing relief from current interfering symptoms. Anxiety in school-aged children predicts below-average academic achievement (McLoone et al., 2006), with longitudinal research reinforcing the relationship between anxiety disorders and later educational underachievement (Ialongo, Edelshon, Werthamer-Larsson, Crockett, & Kellam, 1995). The school environment represents an optimal context for addressing early child anxiety by offering interventions within the school community. This may overcome many of the perceptual barriers to accessing community-based mental health services (Isfud & Rapee, 2005; Kendall, Settipani, & Cummings, 2012). Furthermore, school is the second most frequented setting by children, representing a significant resource to help children develop positive coping skills and address behavioral and emotional difficulties (Knoff, 2006). Interventions facilitated by members of the school community, such as counselors and teachers, rather than an external professional, may enhance trust and contribute to the development of a positive school climate. Specifically, interventions targeted during the early school years presents multiple advantages, given the neuroplasticity of young children and the suggestion that maladaptive behavior and coping strategies are not as ‘fixed’ at an early age (Hirshfield-Becker & Biederman, 2002). Multi-cultural Considerations/ Social Justice Issues Few youth, especially low-income minority youth, receive early interventions to prevent negative developmental outcomes (Kataoka, Stein, Jaycox, 2003). School-based services may be particularly important for underserved ethnic minority youth who traditionally are less likely to receive such services, despite increased risk of anxiety and other mental health problems, due to poverty and community fiscal factors (Sieger, Rojas-Vilches, & McKinney, 2004). Latino children, in particular, are at risk for not receiving mental healthcare, due to disproportionate numbers without health insurance, parental preferences, and an unrecognized need for services (Algeria, Canino, & Rios, 2002). Delivering mental health services through the school system can address key financial and structural barriers that often prevent low SES and ethnic minority children from receiving needed services (Bledsoe, 2008).Overall Outcome GoalsThe overall outcome goals of the “Worry Warriors” anxiety small group are based on the ASCA and North Carolina Guidance Curriculum Essential Standards. The aim is for students to be able to recognize symptoms of anxiety, explore causes of their personal anxieties, and develop coping strategies to manage their anxiety. 100% of the students should feel more knowledgeable about anxiety and better able to manage it, as a result of the group. The foundation of the group is based on the following ASCA and NSGES standards:? PS:B1.3 – Identify alternative solutions to a problem.? PS: B1.4 -Develop effective coping skills for dealing with problems.? PS:B1.12- Develop an action plan to set and achieve realistic goals.? PS: C1.10 – Learn techniques for managing stress and conflict.? RED.C.2.1- Identify situations from your daily life in terms of problems andsolution strategies.Overall Evaluation Plan At the start of the first group session, students will be given two, brief pretests assessing their perception of their anxious behaviors and their coping skills. At the close of the final session, they will be given a post-test to assess the progress made. (Reference appendix x for pretest/post-test measures). Furthermore, perception data will be collected throughout the duration of the group, inquiring about the students’ knowledge about anxiety, confidence in their ability to cope, and personal successes in managing their anxieties. In addition, parents and teachers will be asked to assess their perceptions of the students’ anxiety and ability to cope, prior to the group. Upon completion of the group, the counselor will follow up with each of the students, their teachers, and their parents, every month, for the remainder of the academic year.LogisticsSelection and Screening of Members Immediately following the first semester, parents and teachers will receive a needs assessment form seeking to identify 5th grade students who are struggling with anxiety. Furthermore, they will be asked to identify individuals who would likely benefit from an anxiety group for students who need to learn healthy coping strategies. The students will also be given a list of possible small groups that they can participate in. The counselor will make note of parallels between interested students and those suggested by parents and teachers. Subsequently, the counselor will identify those who will progress to the screening process. The counselor will individually interview each of the candidates for the group, and ask specific questions from the Screening Questionnaire. The following requirements must be met, in order for the student to qualify for the group:The student must be struggling with a form of anxiety.The student must show genuine interest in being a part of the group.The student has a need to develop coping skills to manage their anxiety.The student does not demonstrate ill intentions for the group, as a whole or ulterior motives for joining.Students who successfully meet these four criteria, will be chosen for the Worry Warriors anxiety group. From here, the student and their family will learn more specific details, including informed consent. Parents should sign and return the informed consent papers, in a timely manner. Group Composition Ideally, the Worry Warriors group will consist of six to eight, fifth grade students. When forming the group, the counselor will also consider a few other significant factors. In determining who is chosen, ethnicity will be a factor. Because minority students are underserved for mental health related issues, it is likely that the counselor will choose an appropriate number of minorities to be a part of the group. It is imperative that the group is culturally diverse, for the benefit of both the counselor and the group members. A culturally diverse group will be representative of how anxiety effects people from different backgrounds. In addition, the counselor will take personalities into consideration. Students who have friendship issues with one another will not be a good fit for the group. Worry Warriors Orientation Prior to the first group session, parents will be invited to an hour long, orientation meeting. This meeting, hosted by the counselor, will be an information session detailing the group’s goals and objectives, and overall purpose. Parents will receive a tentative outline of the group activities. This orientation meeting will also serve as a Q&A session, for the parents with specific inquiries. Through this open discussion, the counselor will have the opportunity to build rapport with the parents whose children will be joining the group.Techniques and Theories The Worry Warriors anxiety small group, will be a psycho-educational group, invoking techniques from a variety of theories. The students will begin to explore their personal causes of anxiety, challenge their worries, and acquire coping skills to address them. Techniques from the following theories will be used:Person-Centered Therapy-Throughout the duration of the group, I will use the basic elements of person-centered therapy to establish and maintain rapport with group members. These elements include genuineness, unconditional positive regard, and empathy. This will encourage students to be open and less hesitant to reveal their anxieties.Solution-Focused Therapy (SFBC)-At the beginning of every session, I will encourage the students to share how they were able to successfully cope with their anxiety, since the previous session. This is congruent with the solution-focused emphasis on finding “exceptions.” In addition, I will use scaling in my pretest and post-test evaluations, to assess the level of anxiety each student feels and their confidence in the ability to cope.Cognitive-Behavioral Therapy (CBT)-The majority of the group activities will be focused on changing the students’ anxious thoughts, in order to change their behaviors. They will learn how to replace negative self-talk with positive affirmations, challenge their cognitive distortions, and learn relaxation techniques. In addition, they will be assigned homework at the end of every session. Subsequently, I will follow up by discussing their homework assignments at the beginning of the following session. Lesson Plan TemplateSchool Counselor: Simone Diggs Date: 2014-2015Activity: Worry Warriors Small Group Lesson 1: “ The Worry Web”Grade: 5ASCA and NCGES Student Standards (Domain/Standard/Competencies): PS:B1.3 – Identify alternative solutions to a problem.PS: B1.4 -Develop effective coping skills for dealing with problems.PS:B1.12- Develop an action plan to set and achieve realistic goals.PS: C1.10 – Learn techniques for managing stress and conflict.RED.C.2.1- Identify situations from your daily life in terms of problems and solution strategies.Learning Objective(s):Students will be able to identify their personal feelings of anxiety.Students will be able to accurately measure the extent of their worries.Students will be able to choose a specific anxious thought to address. Students will be able to name at least 2 physical symptoms of anxiety.Materials:Pretest evaluation formsStarbursts for Icebreaker activityCopies of Liam's Worry Web short story“My worries” personal anxiety logsYarn in multiple colorsScissorsTapeSharpiesSticky notesHat with notecards insideStickersProcedure:Introduction (15 minutes)Informed consent/Ground Rules (7 minutes) -Students will begin by taking two pretest evaluations. Following this, I will begin the session by discussing the significance of confidentiality. Then, we I will introduce the formally established rules (“The 3 R's”- Be Respectful, be Responsible, be Ready to learn)! I will also give students the opportunity to add to the rules list, if they feel additional rules are necessary.Icebreaker- Meet and Treat (8 minutes)-Prior to the group session, I will prepare a bowl of three different colored starburst candies (yellow, red, and orange). As each student arrives, I will request that they each choose one of every color Starbursts, from the bowl. The yellow starburst will represent their name, the red will represent their grade, and the orange will represent their favorite hobby. They will take turns sharing their information for all three categories, as an introduction.Main activities (35 minutes)“Picking up on our symptoms of anxiety” (5 minutes)-This activity is designed to introduce the topic of anxiety, and help students identify the physical symptoms associated with anxiety. I will begin by asking if anyone knows what anxiety is. Following this brief discussion, I will explain that anxiety causes us to feel many physical symptoms, that can be frightening. I will pass around a hat (ideally a warrior helmet, to fit the theme of the group), with cards that have symptoms of anxiety written on them. Each student will pick a card and share the symptom it says, with the group. “Liam's Worry Web” short story activity (25 minutes)-Every student will receive a copy of a short story titled “Liam's Worry Web,” about a spider who is very worried. I will allow the students to take turns reading parts of the short story. Following this, I will ask a few brief questions to check for comprehension. I will continue by explaining that our worries are a lot like Liam's. I will give each student a worksheet with two columns labeled, “My Worries” and “How I handled them.” On this sheet, students will have the opportunity to list five things that are worrying them, from greatest to least. This sheet will be significant for the duration of the group, and referenced weekly. Once students have identified and ranked their worries, I will provide them with a sticky note and sharpie, and ask them to write their #1 worry on the post-it. Then, I will direct their attention to me, so we can begin creating our worry web. One by one, students will contribute to the web by bringing me their worry post-it, and cutting a long piece of yarn, to attach it to. The end result will be a large web of multi-colored yarn, attached between two walls. Every piece of yarn will have the respective worry taped to it. Debrief: I will explain that sometimes we have so many worries, it is difficult to tell them apart. This causes us to sometimes worry throughout the day, without even knowing why we are worried. I will pass out prepared bags of multi-colored yarn/post-its to each student. They will be given a homework assignment to make their own personal worry webs, using the worries from the sheet they listed them on, at the start of the activity. They will simply label each strand with a worry, cut the strands that represent smaller worries, and entangle them together. The overall goal will be to cut the strands smaller, as they learn coping strategies throughout the group process. In addition, students will be asked to focus on their reactions to the #1 worry on their “My Worry” log and how they deal with it, until the next group session. Summary/Closing (5 minutes)-I will ask each student to name one thing we did in the session, in order to provide a comprehensive summary. I will add any important details that they miss. I will open the floor for questions. Finally, I will ask students to write down two physical symptoms of anxiety we learned about, in the lesson. When they turn in their paper, they will receive a sticker, to end on a positive note!Plan for Evaluation: How will each of the following be collected? Process Data: -This group will consist of 6-8, fifth grade students. At the beginning of the session, I will take attendance to account for any absences.Perception Data:- In order to evaluate whether students are able to successfully able to name and measure their personal anxieties, I will reference their “My Worries” logs. In order to evaluate whether they are able to recognize signs of anxiety, I will collect their papers from the closing assignment.Follow-up: -Students will be given two homework assignments. The first assignment will be to create their own personal worry webs. The second assignment will require them to address worry #1 on their “My Worries” log. Lesson Plan TemplateSchool Counselor: Simone Diggs Date: 2014-2015Activity: Worry Warriors Session 2: “Get Hope, Learn to Cope”Grade: 5ASCA and NCGES Student Standards (Domain/Standard/Competencies): PS:B1.3 – Identify alternative solutions to a problem.PS: B1.4 -Develop effective coping skills for dealing with problems.PS:B1.12- Develop an action plan to set and achieve realistic goals.PS: C1.10 – Learn techniques for managing stress and conflict.RED.C.2.1- Identify situations from your daily life in terms of problems and solution strategies.Learning Objective(s):Students will be able to identify at least three coping skills, to deal with anxiety.Students will be able to distinguish healthy coping skills from unhealthy coping skills.Students will be able to choose one personal area of anxiety to focus on from their “My Worries” log.Materials:Question Ball for Icebreaker activityHat with coping cards for Coping Card Charades Index cardsMarkers “What Can Your Brain Focus On” Worksheets Worry BoxFlip-chartProcedure: (50 minutes)Icebreaker: “Catch, Tell, Pass” (5 minutes)- Prior to the session, I will create a question ball. This is simply an oversized beach ball with a variety of icebreaker questions, such as “What is your favorite vacation spot?” or “Who do you admire most”? Students will take turns passing the question ball to one another. Whatever question your right thumb lands on is the one you have to answer. The questions will all be very general, however, I will give them the option to choose a different question if there are any they feel uncomfortable answering. This activity is a brief, engaging way to begin building rapport within the group. As the counselor, I also plan to participate in the icebreaker, in attempt for the students to build rapport with me. (The questions do not require in-depth self-disclosure). Worry Web Follow Up (5 minutes)-Directly after the icebreaker, I will ask everyone to take out their personal worry webs and “My Worries” logs. I will open the opportunity for students to share anything about their personal worry web. We might discuss how the worry affected them, how they handled it, what they would like to change, etc. I will also ask if anyone's #1 worry that we used in our group worry web has lessened, indicating that it needs to be cut shorter.Coping Cards Charades (10 minutes)-I will introduce the topic of Coping. I will explain that our brain cannot hold anxious thoughts when we're using it for other things. Next, I will pull out our Warrior hat, with index cards in it. This time, the index cards will each have a coping strategy written on them. The students will each pick a card from the hat, and subsequently act out whatever the coping strategy the card indicates. The other group members will have to guess what the strategy is. Healthy vs Unhealthy Coping Strategies (10 minutes)-On a flip-chart, I will draw a table, with two columns reading, “Healthy” and “Unhealthy.” Based off of the coping strategies they just role-played, I will ask each student to come write one healthy coping strategy on the flip-chart. Proceeding this, I will have students brainstorm unhealthy coping strategies, as a group. They will add these to the chart as well. I will facilitate a very brief discussion about why we should use the healthy ways to cope, rather than the unhealthy.Creative Coping (10 minutes)-Using the index cards and markers provided, students will design 3 of their own coping cards. They can choose any of the healthy coping strategies, write it on their card, and decorate the cards, as they please. I will request that students put their cards aside until the end of the session.Closing/Recall Time (10 minutes)-First, I will pass out a worksheet to students titled “What Can Your Brain Focus on When You're Anxious”. On this worksheet, there is an image with four blanks. In each of the four blanks, students will be required to write a healthy coping strategy. These papers will be turned into me for assessment purposes. (see appendix x for worksheet)-Next, I will give group members another homework assignment. I will ask them to address worry #2 on their “My Worries” log, and encourage them to use one of their new coping skills to handle the worry, until next session. - I will direct everyone's attention to “The Worry Box.” This will be a decorative box I will create, prior to group. This box will be designed as a safe place for students to submit their worries that they do not wish to share with the group. I will explain that they can drop off their worries in the box, anytime they wish to. I will do my best to address the individual concerns of each student, in private.-We will end the session by having each person state what they enjoyed best about group, this session.Plan for Evaluation: How will each of the following be collected? Process Data: -This group will consist of 6-8, fifth grade students. At the beginning of the session, I will take attendance to account for any absences. Perception Data: -In order to assess if students are able to identify healthy coping strategies and distinguish them from unhealthy coping strategies, I will collect their “What Can Your Brain Focus On When You’re Anxious?” worksheets (see appendix x). To evaluate whether students can choose an anxiety to focus on coping with, I will reference their “My Worries” log.Follow Up: -Students will be assigned to focus on handling worry #2 on their “My Worries” log, until next session. Lesson Plan TemplateSchool Counselor: Simone Diggs Date: 2014-2015Activity: Worry Warriors Lesson 3: Crafting Worry AwayGrade: 5ASCA and NCGES Student Standards (Domain/Standard/Competencies):PS:B1.3 – Identify alternative solutions to a problem.PS: B1.4 -Develop effective coping skills for dealing with problems.PS:B1.12- Develop an action plan to set and achieve realistic goals.PS: C1.10 – Learn techniques for managing stress and conflict.RED.C.2.1- Identify situations from your daily life in terms of problems and solution strategies.Learning Objective(s):1. Students will be able to identify worries from Wemberly Worried.2. Students will be able to identify an antecedent for one of their worrying behaviors.3. Students will be able to challenge one of their worries.Materials:Projector for Wemberly Worried videoPopsicle sticksMarkersMiscellaneous crafting décorGlue“Challenge your worry” worksheetsProcedure (50 minutes):Welcome back/ Worry Check (10 minutes)-We will start by addressing the students’ personal worry webs. I will ask if anyone wants to share how they shortened a worry, since last week. I will also ask if someone can give a brief summary of the coping skills lesson we covered in the previous session. We can have an open discussion about if any coping methods they learned have helped them to successfully decrease their anxiety. Wemberly Worried (10 minutes)-As a group, we will watch the video Wemberly Worried, about a girl who worried about everything. During the video, I will ask students to write down three things Wemberly worried about. I will collect their papers, then we will discuss Wemberly’s anxieties. I will inquire about things in the video students observed and allow them to express if they ever worry about any of the things Wemberly worries about. Worry Dolls Activity (20 minutes)-In the video, Wemberly coped with her worries by rubbing her toy bunny’s ears. I will explain to the students that we can make worry dolls of our own. An old Guatemalan tradition, children who worried would create worry dolls to express their worries to, before bedtime. Then, they would place the doll under their pillows, and wake up worry-free the next morning. We will create our worry dolls using popsicle sticks, markers, glue, and miscellaneous crafting items. Students can be as creative as they would like to, even naming their dolls. I will explain that they can take their worry dolls anywhere, as a reminder to relax when they start feeling anxious.Closing: The Challenge (10 minutes) :-Each student will receive a “Challenge Your Worry” worksheet. On this worksheet, they will be asked to choose a personal worry. Then, they have to assess what caused their worry, if it makes sense, the worst/best outcomes of their worry, and if they have control over it. I will collect their worksheets. Following this, I will open the floor for questions or concerns. I will end the session on a positive note, by allowing students to present their worry dolls, if they would like to. Last but not least, I will remind students to address worry #3 on their “My Worries” log, as a homework assignment for next time. (see appendix x for “Challenge Your Worry” worksheet)Plan for Evaluation: How will each of the following be collected? Process Data:This group should consist of six to eight, fifth-grade students. I will take attendance at the beginning of the session, to check for absences. Perception Data: I will collect students’ papers they use to identify three anxieties addressed in the Wemberly Worry video, to assess if they are able to accurately identify anxieties. I will also collect their “Challenge Your Worry” worksheets to assess if they are able to find an antecedent for/challenge one of their personal worries.Follow Up: Students will be assigned to cope with worry #3 on their personal “My Worries” log. Lesson Plan TemplateSchool Counselor: Simone Diggs Date: 2014-2015Activity: Worry Warriors Lesson 4: The Power of PositivityGrade(s): 5ASCA and NCGES Student Standards (Domain/Standard/Competencies): PS: B1.3- Identify alternative solutions to a problem.PS: B1.4- Develop effective coping skills for dealing with problems.PS: B1.12- Develop an action plan to set and achieve realistic goals.PS: C1.10- Learn techniques for managing stress and conflict.RED.C.2.11- Identify situations from your daily life in terms of problems and solution strategies.Learning Objective(s):1. Student will understand the meaning of positive affirmations.2. Students will demonstrate the ability to replace negative self-talk with positive affirmations.3. Students will be able to identify a positive affirmation for one of their personal negative thoughts.Materials:Flip ChartMarkersPositive affirmations worksheets“The Power of Positivity” worksheetsPersonal Positivity worksheetsProcedure (50 minutes):Welcome back/ Worry Check (5 minutes)-I will open the session, by addressing the students’ personal worry webs. Similar to the last session, I will ask if anyone would like to share how they handled a worry, and cut any strands of our group worry web, if necessary. “Lets Talk Positive” ( 20 minutes):-We will begin this activity with a discussion about the definition of the phrase “positive affirmation.” Then, each student will receive a worksheet to keep with examples of positive affirmations. I will ask each student to read over their list of affirmations. Then, I will direct their attention to a flip chart, with pre-written, negative statements. Students will take turns crossing out a negative statement, and replacing it with an appropriate positive affirmation, from the list. After we finish the activity, I will hang the flip chart up, as a visual reminder to remain positive, throughout the remainder of our group sessions. (see appendix x for positive affirmations worksheet)Positive Partners Role Play (10 minutes):-Students will demonstrate their new knowledge of positive affirmations, in role-play scenarios. One student will role play the negative peer; the other will be the positive peer. For every negative statement made, the positive peer must use a positive affirmation to combat it. Then, they will switch roles. We will have a brief discussion about how students felt in their roles. I will explain that as Worry Warriors, we have to fight against negativity!Closing activities (15 minutes): -Finally, I will distribute a personal positivity worksheet, to each group member. They will be required to write one personal, anxious thought, a positive affirmation to combat it, and draw a picture that represents the positive outcome. I will allow them seven to eight minutes to complete the sheets. Then, I will allow student’s to share their thoughts and pictures, if they desire. I will collect these worksheets. Upon completion of the final activity, I will end by asking each student to express one thing they learned during the group session. I will end by reminding students to focus on combating their #5 worry from their “My Worries” log, until next session. (see appendix x for personal positivity worksheet).Plan for Evaluation: How will each of the following be collected? Process Data: -This group consists of 6-8 fifth grade students, who are battling anxiety. I will also take attendance, to take note of any absences.Perception Data: -In order to evaluate whether students have a thorough understanding of how to use positive affirmations and use them to replace negative self-talk, I will collect their personal positivity worksheets.Follow Up: -Students will work on their ongoing homework assignment, by focusing on coping with their #5 worry on their “My Worries” log, until next session. Lesson Plan TemplateSchool Counselor: Simone Diggs Date: 2014-2015Activity: Worry Warriors Lesson 5: Warrior Wind DownGrade(s): 5 ASCA and NCGES Student Standards (Domain/Standard/Competencies):? PS:B1.3 – Identify alternative solutions to a problem.? PS: B1.4 -Develop effective coping skills for dealing with problems.? PS:B1.12- Develop an action plan to set and achieve realistic goals.? PS: C1.10 – Learn techniques for managing stress and conflict.? RED.C.2.1- Identify situations from your daily life in terms of problems andsolution strategies.Learning Objective(s):1. Student will be able to mitigate anxiety, using breathing techniques.2. Student will be able to identify a personal “special place.” Materials:Deep breathing handoutsVisualizing your special place handout (for the counselor)White computer paperCrayonsMarkersColored PencilsComputer to play peaceful music Procedure (50 minutes):Worry Warrior Warm Up/Worry Check (10 minutes):-This group session will begin with a counselor led physical warm up. I will have the students do simple stretches, with light music in the background. This will be an attempt to relax any tension the students were experiencing prior to the session, in preparation for the breathing exercise. Following this, I will do a routine worry check, and allow students to share how they shortened a worry on their “My Worries” log. If necessary, I will cut the worry strands in our group worry web that need to be shortened.Inhale Happiness, Exhale Worry! (10 minutes):-I will ask students to find a comfortable space, in their chairs or on the floor. Once comfortable, I will lead them in a scripted, deep breathing exercise. When the exercise is over, I will allow the students a minute or two to process their state of being. Then, I will ask who feels more relaxed, as a result of the exercise. I will briefly explain the benefits of learning deep breathing, as a coping strategy. At the end of the discussion, I will give each student a handout titled, “How To Breathe Deeply.” (see appendix x for handout). This handout will be a resource they can take with them anywhere, and use when symptoms of anxiety begin to manifest.Our Special Places (20 minutes): -In this activity, students will learn a basic guided imagery strategy. Computer paper, markers, and crayons will be provided for the students. They will be directed to draw a picture of a special place that makes them calm and relaxed. I will provide them with examples of common, peaceful images. Next, they will be directed to make a mental picture of their special place. I will encourage them to imagine what they would smell, what sounds they would hear, what colors they would see, and what they would be doing. When we are finished practicing the guided imagery, we will discuss how they are feeling, after the exercise. Finally, I will encourage them to practice visualizing their special place, even when they are not anxious. When they are anxious, they can use their tangible or mental picture of their special place, to mitigate their anxiety. (see appendix x for “Visualizing Your Special Place” handout).Closing/Recall (10 minutes)-We will end the session by discussing whether or not the students thought the coping strategies they learned, were effective. We will have a brief discussion about what they have enjoyed about group thus far. Finally, I will remind them that they are responsible for addressing worry #5 on their “My Worries” log, before next session.Plan for Evaluation: How will each of the following be collected? Process Data:-This group should consist of six to eight, 5th grade students, battling anxiety. I will take attendance at the start of the session to account for any absences.Perception Data:-In order to evaluate if students felt more relaxed after the deep breathing exercise, I will simply ask them to raise their hands, to indicate their anxiety was lessened.-In order to evaluate whether students successfully identified a “special place”, I will observe what they draw during our “Our Special Places” activity.Follow Up: -Students will be assigned to focus on coping with worry #5 on their “My Worries” log. Lesson Plan TemplateSchool Counselor: Simone Diggs Date: 2014-2015Activity: Worry Warriors Lesson 6: “Tying Up Loose Ends”Grade: 5ASCA and NCGES Student Standards (Domain/Standard/Competencies): ? PS:B1.3 – Identify alternative solutions to a problem.? PS: B1.4 -Develop effective coping skills for dealing with problems.? PS:B1.12- Develop an action plan to set and achieve realistic goals.? PS: C1.10 – Learn techniques for managing stress and conflict.? RED.C.2.1- Identify situations from your daily life in terms of problems andsolution strategies.Learning Objective(s):1. Students will be able to create a personal worry plan.2. Students will be able to recall one helpful thing they learned about anxiety.Materials:Beach ballCoping caddies (bubble wrap, stress balls, poem)Certificates of completion“My Worry Plan” worksheetsBalloons (and ribbons)White strips of paperPost-testProcedure (50 minutes):Welcome Back/ Worry Check (5 minutes):-I will open the session by allowing students to share any worries that they were able to cope with from their personal worry webs, since the last time we met. In addition, I will shorten any of the worry strands on our group worry web, if applicable. Furthermore, I will acknowledge the progress we have made with making our group worry web smaller, throughout the weeks. I will encourage students to share how they think we were able to accomplish this.What I Learned About Worrying (5 minutes):-Students will form a circle and pass around a beach ball. As each student catches the ball, they will have to name something helpful they learned about worrying. Each student should get the ball once, and be able to recall one fact about worrying. If the students have more helpful facts they would like to share, we can play another round.“My Worry Plan” (10 minutes):-Every student will receive a copy of the “My Worry Plan” worksheet. On this worksheet, they will create a personal worry plan for themselves. This plan will include any coping strategies they think will be beneficial to their specific anxieties. I will briefly review the worry plans, but allow the students to keep them in their possession, as a reminder.Worry Release (15 minutes): -Prior to the group session, I will blow up one balloon, for each group member. I will also cut strips of white computer paper. Students will write their worries on the strips of paper. After that, they will tape the worries to the ribbon attached to the balloons. As a group, we will go outside and release our worries into the sky! Closing/Certificates/Coping Caddies (15 minutes):-Proceeding our worry release, we will return inside for the remaining 15 minutes. Students will take a post-test to assess what they have learned in the Worry Warrior group. During this time, I will award students with their Worry Warrior certificates of completion. In addition, each student will receive their coping caddies. Coping caddies will be small baskets that I prepared ahead of time, with materials that mitigate anxiety. These caddies will include bubble wrap, stress balls, bubbles, and a special poem about worrying. I will also encourage them to add their worry dolls and coping cards to the caddy. Plan for Evaluation: How will each of the following be collected? Process Data:-This group should consist of six to eight, fifth grade students. I will take attendance at the beginning of the session, to account for any absences. Perception Data:-In order to evaluate whether students were able to create a personal worry plan, I will check their “My Worry Plan” worksheets. In order to assess whether the students are able to name one helpful fact they learned about anxiety, I will observe them during the “What Have I Learned” ball toss game. Follow Up: -After the completion of the program, I will follow up with the teachers and students, concerning the progress of their ability to cope, once a month, for the remainder of the year.Worry Warriors: Anxiety Pre/Post-testDirections: Circle the number that best describes your feelings about each statement.12345Strongly AgreeAgreeNeither Agree nor DisagreeDisagreeStrongly DisagreeI feel anxious throughout most of the day. 12345I know the signs and symptoms of anxiety.12345I can measure my worries.12345I know the things that make me anxious.12345I have a plan for handling my anxiety.12345My anxiety is out of my control.12345I can handle my anxiety in a healthy way.123458. My anxiety makes it hard to focus.12345Worry Warriors: Coping Skills Pre/Post-testDirections: Circle the number that best describes how you feel about each statement.12345AlwaysAlmost AlwaysSometimesAlmost NeverNeverWhen I feel anxious, I do physical activities.12345When I feel anxious, I write down my worries.123453. When I feel anxious, I think of positive things.123454.When I feel anxious, I take deep breaths.123455. When I feel anxious, I think of a relaxing place.12345ReferencesAlegria M, Canino G, Ríos R, et al. (2002). Mental health care for Latinos: Inequalities in use of specialty mental health services among Latinos, African Americans, and Non-Latino Whites. Psychiatric Services, 53(12):1547–1555.Anticich, S. J., Barrett, P. M., Gillies, R., & Silverman, W. (2012). Recent Advances in Intervention for Early Childhood Anxiety. Australian Journal Of Guidance & Counselling, 22(2), 157-172. doi:10.1017/jgc.2012.24.Bledsoe SE. Barriers and promoters of mental health services utilization in a Latino context: A literature review and recommendations from an ecosystem perspective. Journal of Human Behavior in the Social Environment. 2008; 18(2):151–183.Bruce SE, Yonkers KA, Otto MW, et al. Influence of psychiatric comorbidity on recovery and recurrence in generalized anxiety disorder, social phobia, and panic disorder: a 12-year prospective study. Am J Psychiatry. 2005;162:1179–87.Cicchetti D, Toth SL. The development of depression in children and adolescents. Am Psychol. 1998;53:221–41.Ialongo, N., Edelsohn, G., Werthamer-Larsson, L., Crockett, L., & Kellam, S. (1995). The signi?cance of self-reported anxious symptoms in ?rst grade children: Predic- tion to anxious symptoms and adaptive functioning in ?fth grade. Journal of Child PsychologyandPsychiatry,36,427–437.doi:10.1111/j.1469-7610.1995.tb01300.xKataoka SH, Zhang L, Wells KB. Unmet need for mental health care among U.S. children: variation by ethnicity and insurance status. American Journal of Psychiatry. 2002; 159(9):1548– 1555. [PubMed: 12202276]Kendall, P.C., Settipani, C.A, & Cummings, C.M. (2012) No need to worry: The promising future of child anxiety research. Journal of Clinical Child & Adolescent Psychology, 41, 1, 103–115. doi:10.1080/15374416.2012.632352Kendall, S., Rodger, J., & Palmer, H. (2010). Redesigning provision for families with multiple problems – an assessment of the early impact of different local approaches. London: Department for Education.Kessler RC, Berglund P, Demler O, et al. Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62 (6):593–602.Knoff, H.M. (2006). The seven sure solutions to school-based mental health services success — the necessary collaboration between school and community providers. In S.W. Evans, M.D. Weist, & Z.N. Serpell (Eds.), Advancing school-based mental health interventions: Best practices and program models (pp. 6.1–6.21). New Jersey: Civic Research Institute.McLoone,J.,Hudson,J.L.,&Rapee,R.M(2006)Treatinganxietydisordersinaschool setting. Education and Treatment of Children, 29, 219–242.Prevalence of Social Anxiety among Elementary Grade Children. (2012, June 30). Bulletin of Education and Research, 34(1). Rapee RM, Spence SH. The etiology of social phobia: empirical evidence and an initial model. Clin Psychol Rev. 2004;24:737–67.Rapee RM, Kennedy S, Ingram M, et al. Prevention and early intervention of anxiety disorders in inhibited preschool children. J Consult Clin Psychol. 2005;73:488–97.Sieger K, Rojas-Vilches A, Mckinney C, et al. The effects and treatment of community violence in children and adolescents: What should be done? Trauma, Violence, & Abuse. 2004; 5(3):243–259.Thompson, E. H., Robertson, P., Curtis, R., & Frick, M. H. (2013, April). Students with anxiety: implications for professional school counselors. Professional School Counseling, 16(4), 222. Liam’s Worry Web Liam was a very talented spider. He loved to manipulate his silk string to create big, beautiful webs with all kinds of amazing patterns. Not only were his webs cool, but they were also very effective at catching his lunch. Liam needed his web to survive. The more focused and happy he was, the better his web worked for him. What makes you feel happy? How do you look when you are happy and calm? One day, something seemed different about Liam’s web. Instead of being a beautiful, stretched out pattern, it looked like a big mess. A new pattern began to form, and it wasn’t good. Liam overheard his parents arguing the night before and he couldn’t get his mind off of it. Now instead of spinning a big, beautiful web, he just spun in circles. His heart began to race and his hands got even stickier. Liam held it all in and spun. Why did his pattern change? What is happening to Liam? The next day Liam had a big test in Mrs. Spider’s class. Instead of studying, he spun in circles all night. Now he was not only worried about his parents, but he knew he wasn’t prepared for his big test. This made him spin even faster. Later that day, Liam’s buddy, Sam, didn’t visit Liam’s web for lunch. Liam worried that Sam might be angry with him. Liam began to spin out of control. His web no longer caught food, instead it caught Liam. Liam was stuck! “Will someone please help free me from my web?” cried Liam. Do you think Sam is mad at Liam? Why is Liam stuck? Liam’s best friend, Sam, overheard his cry for help. Sam, just like all the other spiders, could relate to Liam’s problem. Liam had spun a worry web. Sam was proud of Liam for taking the first step and asking for help. Sam offered to show Liam how to free himself from his web. Sam explained, “My tummy aches and my heart races when I start to feel anxious. These signs warn me that it is time to do something about my worry before I end up stuck in my own web. Do you ever feel like Liam and Sam? How do you know when you are worried? You did the right thing by asking for help. Sometimes we can’t get unstuck without a little support from a friend, parent, teacher, or counselor,” stated Sam. Instead of spinning all of my worries into a big ball of anxiety, I work on each worry one at a time. I follow five steps when I start to feel anxious so that I can stop myself from spinning out of control and fix my worries. Sam’s Steps: Step 1 Worry Signs: Recognize the signs that you have a worry. Step 2 Name Your Worry: Pull out one worry from your web and name it. Step 3 Measure Your Worry: How long is the worry? If it is a long worry; then it is a big worry. If it is a short worry; then it is a small worry. Step 4 Challenge Your Worry: What caused the worry? Does it make sense? What is the worst thing that can happen? What is the best thing that can happen? Is there anything you can do to change the situation? Step 5 Plan: Make a plan for the next time you experience the worry. With Sam’s help Liam began to remove each string of worry from his web. Liam now recognized his personal worry signs: racing heart, sticky hands, and trouble concentrating. Others can even tell something is wrong because the pattern in his web changes. Liam thought about what caused his pattern to change in his web. It all began when he heard his parent’s arguing. He removed this string from his web and put a name on it. This string was long, making it a big worry. The worst thing that could happen is that his parents might not make up. The best thing that could happen is that his parents would make up. Sam suggested that Liam ask his parents if they are alright. Next time this happens, Liam will write a letter to his parents explaining why their argument upset him. This will keep him from spinning out of control. What else can Liam do? Liam, now feeling pretty confident, tackled the next worry string. This string wasn’t quite as long as the first making it a slightly smaller worry. Liam didn’t study for his test because he was worried about his parents. This caused him to have anxiety about not doing well on his test. The worst thing that could happen is that he would fail the test. The best thing that could happen is that he would pass the test. He knew he had to talk to his teacher about why he did not study. Maybe she would give him another chance. The next time Liam is worried about a test he will recognize the worry signs, stop spinning, and find a quiet place to study. What else can Liam do? Now Liam was almost free! Only one more string to go before Liam would escape from his worry web. The final string was really short; making it a pretty small worry. This worry really didn’t make sense because Sam did not have a reason to be mad at Liam. The worst thing that could happen is that Sam was mad at Liam. The best thing that could happen is that Sam was not mad at Liam. He knew instead of getting worried, he could just ask Sam why he did not show up for lunch. And that is exactly what he did. Sam responded,” Since you are always such a good friend and share your lunch, I decided to wait for a yummy treat in my web to share with you. Unfortunately, it took longer than I thought to catch, so I missed lunch.” Liam promised Sam the next time he felt like Sam was mad he would talk to him about it before spinning out of control. Now Liam could go back to creating beautiful, functional patterns in his web. Instead of holding in a worry, he would do something about it next time. What else can Liam do? Are these things you can do next time you feel worried? My Worries How Did I Handle My Worries? My Worries How Did I Handle My Worries? ?Free Printable Behavior What Can Your Brain Focus On When You’re Feeling Anxious? Your brain can’t hold on to anxious thoughts when you’re using it for something else! Fill in the blank bubbles with your own ideas. Homework Word Puzzles Reading A Book Television Homework Word Puzzles Reading A Book Television ?Free Printable Behavior Challenge Your Worry What caused your worry? Does it make sense? What is the worst thing that can happen? What is the best thing that can happen? Can you do anything about it? If so, what can you do? Positive Affirmations I’m proud of what I’ve done Everything will work out just fine I’ll Be O.K. Movies aren’t real I’m in control of my mind I can control my anxiety Each time I face my anxiety it gets easier ?Free Printable Behavior How To Breathe DeeplyCalmly take a deep breath 1) 2) Hold your breath for a count of 3 1…..2…..3 3 )Let your breath out as slowly as you can. While letting your breath out, think about the word CALM. Try to feel CALM. Do this exercise 2 or 3 more times until you feel yourself calm down! How To Breathe DeeplyCalmly take a deep breath 1) 2) Hold your breath for a count of 3 1…..2…..3 3 )Let your breath out as slowly as you can. While letting your breath out, think about the word CALM. Try to feel CALM. Do this exercise 2 or 3 more times until you feel yourself calm down!?Free Printable Behavior My Worry Plan ................
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