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Worry Management (HOW (Worry diary - used to notice worries in the moment,…
Worry Management
HOW
Worry diary - used to notice worries in the moment, identifying and separating practical and hypothetical worries and refocusing on the present
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Solutions :!?:
Normalise - we all worry and some worry is beneficial, not trying to eliminate just managing more in a helpful way
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Reframe the concept of worry, not trying to distract from worry
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Evidence base
:check:Maunder et al, 2009
LI GSH effective for anxiety, CBT most effective treatment in comparison to other methods
:warning:Van Der Heiden, 2012
Research regarding potentially useful techniques is limited
Covin et al, 2008 :check:
Classifying, PS and "worry exposure" is highly effective in reducing pathological worry, especially in younger adults
Although is provides success for most of the intervention, it does not use Worry Time as a strategy
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Worrying can stimulate search for important goal or solutions which can lead to a safety behaviour (Hallovell, 1997) :warning:
WHAT
A set of tools to notice, classify and manage worries
Aims to identify ways in which to help clients address worry by recording, classifying and dealing with them in the appropriate ways
WHEN
When clients present with excessive, uncontrollable worries about multiple topics
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Classification
Incorrect classification leads to treatment being ineffective (Papworth et al, 2013)
Practical Worries
Worries that the client can do something about now.
Worries that are affecting the client now and has a practical solution to
PROBLEM SOLVING
Is used because those who worry do not have a deficit in PS, but more in problem orientation, they know what to do but struggle to initiate/attend to problem solve (Dugas et al, 1995)
Is used because people with GAD have difficulty tolerating uncertainty and emotional arousal (Covin et al, 2008)
Problem solving helps by creating a strategy and provides a sense of achievement with evidence that the problem can be solved
Hypothetical Worries
Worries that are out of the clients control.
Worries that are often about the future and may not have a solution
WORRY TIME
Worry time can be difficult as people perceive worrying as useful in preparing for a situation, which can lead to client feeling reluctant to stop (Prados, 2011)
Therefore you can highlight the time lost to worry and the effect on the body #
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Worry time always clients to refocus on the present, knowing they will come back to the worry at a later time. Not distracting themselves from the worry, but the worry is distracting them from being in the present
Protocol :!:
Worry Time
- Plan the worry time
- Write down hypothetical worries
- Refocus on the present (use sensory refocusing techniques)
- Your scheduled worry time - now worry!
Problem Solving
- Explain rationale
- Identify problem
- Identify solutions
- Weigh up pros and cons for each solution
- Pick solution most likely to work based on pros and cons
- Plan implementation step by step
- Implement
- Review
WHY
Based on Wegner 1994 Ironic Process Theory
The more we attempt to suppress a thought/image, the more likely it is to appear in out mind. Many attempts to suppress worry, but this theory would suggest this is ineffective