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Using a Strengths-Based Biopsychosocial Approach to Addressing Anxiety
Instructor: Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC, NCC
Executive Director, AllCEUs

CEs available at: https://www.allceus.com/member/cart/index/product/id/504/c/

Objectives
– Define a strengths based approach
– Define a biopsychosocial approach

Why I Care/How It Impacts Recovery
– Anxiety can be debilitating
– Low-grade chronic stress/anxiety erodes your energy and ability to concentrate
– Anxiety is a major trigger for:
– Addiction relapse
– Increased physical pain
– Sleep problems
What Does Strengths Based Mean
– It is easier (and more effective) to build upon something that already works to some extent.
– Strengths-based approach helps people identify how they are already trying to cope and builds on that
– There are two types of strengths
– Prevention/Resilience Strengths
– What you do on a daily basis to stay healthy and happy
– Intervention/Coping Strengths
– In the past when you have felt this way, what helped-
– What made it worse-
What is a Biopsychosocial Approach
– Bio-logical
– Neurochemicals
– Nutrition
– Sleep
– Sunlight & Circadian Rhythms
– Psycho-logical
– Mindfulness
– Distress Tolerance
– Coping Skills
– Cognitive Restructuring
– Social
– Improving self-esteem and your relationship with self
– Improving relationships with healthy, supportive others
What is Anxiety
– Anxiety is half of the “Fight or Flight Response”
– It is an excitatory response
– It’s function is to protect you from danger
– It can become a problem when it is
– Overgeneralized
– Overly intense/uncontrollable
– Constant due to brain injury
– Like depression, it can be caused by excess serotonin  Serotonin: A Common Neurobiologic Substrate in Anxiety and Depression.  EISON, MICHAEL S. PhD

Symptoms of Generalized Anxiety
– Generalized anxiety disorder symptoms can vary. They may include:
– Persistent worrying or obsession about small or large concerns that's out of proportion to the impact of the event
– Inability to set aside or let go of a worry
– Inability to relax, restlessness, and feeling keyed up or on edge
– Difficulty concentrating, or the feeling that your mind “goes blank”
– Distress about making decisions for fear of making the wrong decision
– Carrying every option in a situation all the way out to its possible negative conclusion
– Difficulty handling uncertainty or indecisiveness

Symptoms of Generalized Anxiety
– Generalized anxiety disorder symptoms can vary. They may include:
– Physical signs and symptoms may include:
– Fatigue
– Irritability
– Muscle tension or muscle aches
– Trembling, feeling twitchy
– Being easily startled
– Trouble sleeping
– Sweating
– Nausea, diarrhea or irritable bowel syndrome
– Headaches

Symptoms of Generalized Anxiety (Kids)
– Excessive worry about:
– Performance at school or sporting events
– Being on time (punctuality)
– Earthquakes, nuclear war or other catastrophic events
– A child or teen with GAD may also:
– Feel overly anxious to fit in
– Be a perfectionist
– Lack confidence
– Strive for approval
– Require a lot of reassurance about performance

Biological Interventions
– Your body thinks there is a threat.  Figure out why
– Supportive Care
– Create a sleep routine
– Helps the brain and body rebalance
– Can help repair adrenal fatigue
– Improves energy level
– Nutrition
– Minimize caffeine and other stimulants
– Try to prevent spikes (and drops) in blood sugar
– Drink enough water
– Medication
– SSRIs/SNRIs
– Benzodiazepines
Biological Interventions
– Supportive Care cont…
– Sunlight
– Vitamin D deficiency has been implicated in some mood issues
– Sunlight prompts the skin to tell the brain to produce neurotransmitters
– Sunlight sets circadian rhythms which impact the release of serotonin, melatonin and GABA
– Exercise
– Studies have shown that exercise can have a relaxing effect.  Start slowly.
Psychological Interventions
– Basic Fears
– Failure
– Rejection/Isolation
– Loss of Control
– The Unknown
– Mindfulness & Acceptance
– Observation | Acceptance | Labeling and Letting Go
– Identify trigger thoughts
– Distress Tolerance:  It isn’t always about controlling your anxiety
– Distract don’t react
– Use distancing techniques
Psychological Interventions
– Relaxation Skills
– What is relaxation…
– Diaphragmatic breathing
– Combat breathing
– Meditation
– Cued Progressive Muscular Relaxation
– Self-Esteem
– Real vs. Ideal Self
– Compassionate self talk
– Spotlighting strengths & acceptance of imperfections

Psychological Interventions
– Cognitive Restructuring
– Address irrational thoughts and cognitive distortions
– Reframe challenges in terms of current strengths (not past weaknesses)
– Create an attitude of gratitude and optimism
– Acceptance and Commitment Therapy

Psychological Interventions
– Recreation and Relaxation
– There will always be stuff you could do…
– Make a list of fun things

Social Interventions
– Improve your relationship with yourself
– Identify your needs and wants
– Be your own best friend
– Internal vs. external validation
– Be compassionate
– Develop healthy, supportive relationships
– Learn about boundaries
– Develop assertiveness skills
– Describe the ideal healthy, supportive relationship
– Separate the ideals from the reals
– Identify who that is, or where that could be found
Resources from New Harbinger
Apply It
– Identify 3 ways you could have used this information in the past week.
– What was the situation-
– What did you do-
– How effective was that for you-
– Short term
– Long Term
– If you would have had this new information, what could you have done differently-
– How would that have changed the outcome-
– How can you start integrating this knowledge into your routine
Summary
– Anxiety is a natural emotion that serves a survival function
– Excessive anxiety can develop from
– Lack of sleep
– Nutritional problems
– Neurochemical imbalances
– Failure to develop adequate copings skills
– Cognitive distortions
– Low self-esteem/a need for external validation
– Recovery involves
– Improving health behaviors
– Identifying and building on current coping strategies
– Addressing cognitive distortions
– Developing a healthy, supportive relationship with self and others