Weekly Intervention Ideas: August 10th Edition

Kid strategy of the week:

Parenting Intervention: Showing Empathy to our Children during the Pandemic. Talk through the image below with your client’s parent (use your clinical judgment about whether it would be helpful to include the client in this conversation or meet with the parent alone). Discuss that while this represents what different students are able to cope with at school, it also applies to most or all our kids right now. 

Children are dealing with a host of stressors: not getting to see their friends, learning how to tolerate wearing masks, feeling bored/antsy/cooped up at home, not getting to go to their favorite summer activities, learning to do school online, worrying about getting or passing on the virus, and being exposed to snippets of the news or adult anxiety about the state of our world. Even if they look like they’re handling it well (and many are!), their cup probably looks a lot more like “Student A” then “Student B.” This can help parents understand when their child seems to get upset more easily or has trouble with things that didn’t used to cause a problem. Help your client’s parent identify the ways their child may be coping with many unseen stressors (the water in their cup) and how this might be limiting their capacity for handling other difficulties.

Acknowledge that the parent’s glass is likely extra-full too during this time, and normalize/validate the parent’s emotions of anxiety, worry, irritation, and overwhelm.

Source: https://www.counselorchelsey.com/blog/showingempathytostudents

Sample Progress Note: The focus of this session was… The therapist engaged the Ct’s parent in a psychoeducational intervention and discussion to help them recognize unseen stressors that their child is coping with during the COVID-19 pandemic and increase their level of empathy for their child.


Couples strategy of the week:

Turn Towards – The Stress-Reducing Conversation: In this exercise, teach the couple how to have a conversation in which they take turns sharing what they feel stressed about in their lives outside of the relationship. The Speaker’s job is to share what is stressful for them (not something within the relationship), being as open as possible until they feel like their partner understands the problem. The Listener’s job is to show their partner that they care without trying to solve the problem for their partner. Skills the Listener can use include showing interest, expressing empathy, siding with their partner (not playing devil’s advocate), avoiding problem solving, and avoiding making it “our problem” unless their partner wants to. (Gottman Institute, 2016).

Sample Progress Note: The focus of this session was… The therapist helped the couple improve their communication skills and their feelings of connectedness through an activity (The Stress-Reducing Conversation). The couple (engaged/had difficulty engaging) in the activity, and they reported that the activity was (helpful/challenging/frustrating).

Adult strategy of the week:

Basic Tapping Sequence for Anxiety: Use the following activity to explore a strategy to manage feelings of anxiety by tapping on your body: (click on “Basic Tapping Sequence for Anxiety) https://www.thetappingsolution.com/tapping-101/  

Sample Progress Note: The focus of this session was… The therapist helped client learn a new way to manage their anxiety symptoms using Tapping. Client (engaged/did not engage) in the activity and reported that the activity was (helpful/interesting/boring). 

Mindfulness/Meditation of the week:

Sitting Meditation: https://palousemindfulness.com/docs/sittingmeditation_script.pdf

Sample progress note: The focus of this session was… The therapist led a meditation activity (i.e., Sitting Meditation). Ct. (engaged/did not engage in the activity), and they reported that the activity was (helpful/difficult/not helpful).

This segment guides you through a sitting meditation with breath as the primary object of awareness… Arranging to spend this time in a comfortable but attentive posture, preferably sitting up without leaning back for support, if that’s possible for you, and at a time and in a place where you won’t be disturbed. Sitting in a dignified posture, head balanced on shoulders, arms and hands resting in a comfortable position. 

This is a time for allowing ourselves to switch from our normal mode of doing and moving and reacting to one of simply being. Just being attentive to what’s happening within your own awareness, right here and right now. 

And as you sit, just noticing sensations of breath. 

Just noticing how your abdomen moves on each in-breath and out-breath, the movement of air through your nostrils, a slight movement of chest and shoulders. 

Just bringing your awareness to whichever part of your breath cycle and wherever it is the most vivid, whether it be your tummy, your chest or your shoulders, or the movement of air through your nostrils… 

Noticing the entire cycle of breath, from the movement of the air coming in, and filling the lungs, and extending the abdomen slightly, the movement of air going out, and being aware of the pause, the stopping point, in between the in-breath and the out-breath, and the outbreath and the next in-breath. It’s all one movement, even through the changing of direction; just notice where that pause is… seeing to what degree you can be aware of your whole entire cycle… recognizing that each part of the cycle is different from the other part… and this time through maybe different than the last time through, and each one is absolutely unique in its own way, if you pay attention. 

You’ll notice your attention from time to time shifting away from breath. The mind may wander into fantasies, or memories, thoughts of the day, worries that you might have, things you need to do… and without giving yourself a hard time when you notice that that’s happened, gently but firmly bring your awareness back to the sensations of breathing… the actual physical sensations of breath as it moves through your body. 

Being aware of where the mind goes… gently shifting your awareness to sensations of breath… 

And notice the tendency to want TO CONTROL your breathing… Letting the quality of attention be light and easy… one of simply observing and noticing… just as if you were on a float on a gently undulating sea… where you’re up with one wave and down with the next… you don’t control the duration of the wave, or the depth between the waves; you’re just riding… 

And just gently coming back to sensations of breathing… 

You may notice that there are SOUNDS in addition to the sounds that come from this recording… sounds of traffic or movement, or something else going on… and just noticing that your attention has moved to that perception of sound… just staying with it long enough to notice the quality of the sound… sound is vibration, tone, volume or intensity… being aware of the mind to label sound, as traffic, or as voices, or as music… coming closer to the actual experience of the sound as it hits your ear drums… qualities or pitch or rhythm or intensity… separating out the actual reception of sound from the labels we put on it… 

And if you’ve been paying attention to sound or noticing that you’ve gotten off to noticing the perception of sound, bring your attention once again back to breath… letting your breath be your anchor of awareness… so that each time your awareness goes somewhere else, just gently coming back to breath, without judgment or any upset if you can do that. If you see that my attention has gone somewhere else, just coming back to breath… 

And noticing the tendency TO HAVE AN OPINION about things… about liking the way things are going right now… not liking it, finding it uncomfortable; that too can be an object of awareness… just noticing that you have an opinion about things often. So, that’s my liking mind; it’s liking this. So that’s my critical mind that would rather have things be different than they are… and that too can be noticed… building the capacity to notice liking or disliking… and not to have to do anything about it… how freeing that is! 

And as you notice that happening, just bringing your awareness to the physical sensations of breath… wherever it’s most vivid for you… just riding the entire cycle, one cycle after another. 

You may notice your attention shifting to BODY SENSATIONS, of achiness or discomfort… of tension… and as you notice these sensations of discomfort that happen for you, there’s several things which can be done with just the sensation, and one is to, if it’s one that can be remedied by shifting a little bit, one way to deal with the sensation is to allow yourself to shift, but in doing that, first becoming aware of the sensation, noticing precisely where the tension or the achiness might be, and once you’re aware of where that is, developing an intention to move, and moving mindfully, and with full intent to make that motion. That’s one way to deal with strong sensation. A second way, and neither one is better than the other is, as long as full awareness is brought to all parts, is to notice that sensation… noticing it in its fullness… being curious about the extent of it… how your experience of it is at the moment… the actual physical sensations of tension or of throbbing, or of tightness, or of pulling, or tingling. And the second way of dealing with it is just to notice that it’s possible to stay for a moment longer with that sensation, experienced as pure sensation, without the labels of discomfort, or of tension, or of achiness; just noticing just where it is… noticing your experience of it… and staying with it, without having to react to it, just for the moment… 

And if your attention keeps getting called back to that area of intense sensation, knowing you have those 2 choices; of forming an intention to do something about it, and mindfully doing it, but forming intention first; or bringing your attention and intention right in to it. Be curious about it: How big is it? How long is it? What quality does it have? How is it changing over time? 

And wherever the mind goes, in terms of thoughts, to liking or disliking, perceptions or sensation, or hearing of sound, or feelings of peace or of sadness, or frustration, or of anticipation; just noticing these raw thought forms, and bringing awareness to sensations to the movement of breath… 

And being curious about breath… observing that no 2 breaths are exactly the same… 

And seeing if it is possible to have a FRIENDLY ATTITUDE toward whatever comes into your awareness… how if your mind has gone off on a fantasy or a thought, or a judgment, or a worry, or a sensation, or a sound, just in a friendly way notice that this is happening and coming back to breath. Recognizing that the entire cycle of awareness is important to this experience, including the movement from breath, and including the coming back… 

And nothing to do but ride the waves of breath… 

Seeing if it is possible in those moments when your awareness is gone somewhere else… noticing how that flicker of attention happens, that moment when you realize it is somewhere else, somewhere other than breath, and at that moment seeing if it is possible of having an attitude of CELEBRATION, of congratulation, of recognition that this is a moment of awareness. You acknowledge yourself for noticing you’ve gone somewhere else. And just easily bring your attention back to breath… in a friendly and a non-judgmental way.

 As this meditation comes to an end, recognizing that you spent this time intentionally aware of your moment to moment experience… nourishing and strengthening your ability to be with whatever comes your way… building the capacity for opening the senses… to the vividness, to the aliveness of the present moment… expanding your skill to be curious, and available, about whatever presents itself… without judgment.

 And when you’re ready, allowing the eyes to let some light in, if you’ve had them closed, and permitting yourself to shift or stretch in whatever way feels comfortable, as this sitting meditation ends. 

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