Welcome to the Open Sky Webinar

1. Welcome to the Open Sky Webinar • We will be starting at 6 pm – see you soon!

2. Anxiety in Adolescents and Young Adults: What It Looks Like and What Helps Joanna Bettmann Schaefer, Ph.D, LCSW Open Sky’s Research Director

3. Agenda • Clinical and Sub-clinical Anxiety • Anxiety Disorders in the DSM-IV TR • Treatments for Anxiety • How you can help

4. Clinical and Sub-clinical Anxiety • Everyone experiences anxiety: worry, concern, fear • Not everyone experiences clinical levels of anxiety: anxiety which cause “clinically significant impairment or distress” • Many people experience sub-clinical anxiety – occasionally or frequently • Common symptoms of anxiety: • Rapid heartbeat • Muscle tension • Queasiness • Dry mouth • Sweating • Apprehension and sense of unease • Repetitive thoughts

5. Anxiety Disorders in the Diagnostic and Statistical Manual of Mental Disorders-IV Text Revision (DSM-IV TR) • Panic Disorder with Agoraphobia • Panic Disorder without Agoraphobia • Agoraphobia without Panic • Specific Phobia (animal, environment, blood, situational, other) • Social Phobia • Obsessive-Compulsive Disorder • Posttraumatic Stress Disorder • Generalized Anxiety Disorder

6. Panic Disorder • Consists of recurrent panic attacks: sudden onset of panic symptoms • Palpitations, increased heart rate • Sweating • Trembling, shaking • Sensation of shortness of breath • Feeling of choking • Chest pain • Nausea or abdominal distress • Feeling dizzy or light-headed • Feeling detached from self • Fear of losing control or going crazy • Fear of dying • Numbness or tingling • Chills or hot flashes

7. Agoraphobia and Specific Phobias • Agoraphobia: Anxiety about being in places from which you cannot escape or where leaving might be embarrassing • Specific Phobia • Marked and persistent fear that is unreasonable • Can be animal, environment (storms, heights, water, etc.), blood (injection, doctors, etc.), situational (flying, bridges, elevators, tunnels, etc.), or other • Children may express phobias through crying, clinging, tantrums, or freezing behavior

8. Social Phobia (Social Anxiety Disorder) • Persistent fear of social or performance situations in which you are exposed to unfamiliar people or to possible scrutiny by others • Fearing that you will act in a way that will be humiliating or embarrassing • Exposure to the feared social situation provokes anxiety or panic (in children, can be expressed as crying, avoidance, tantrums) • Adults (but not children) with this disorder recognize their fears as unreasonable • These fears lead to avoidance

9. Obsessive Compulsive Disorder • Obsessions • Recurrent/persistent thoughts, impulses or images that are intrusive and cause anxiety or distress • These are more than excessive worries about real-life problems • The person attempts to ignore or suppress the thoughts • Compulsions • Repetitive behaviors (washing, ordering, checking) or mental acts (praying, counting, repeating words) that the person feels driven to perform • These behaviors are aimed at preventing or reducing distress, but are not realistically connected to what they are designed to neutralize • The adult person (not the child) recognizes their behaviors/thoughts are excessive or unreasonable

10. Post Traumatic Stress Disorder (PTSD) • The person experienced/witnessed events that involved actual or threatened death or serious injury or threat to the physical integrity of self or others • The person’s response involved intense fear, helplessness, horror • Symptoms last more than 1 month • Symptoms consist of • Re-experiencing symptoms • Avoidance symptoms • Increased arousal symptoms

11. Generalized Anxiety Disorder • Excessive anxiety/worry – for more days than not for at least 6 months • The person finds it difficult to control the worry • Symptoms include: • Restlessness, feeling keyed up or on edge • Being easily fatigued • Difficulty concentrating • Irritability • Muscle tension • Sleep disturbance

12. Anxiety in Adolescents and Young Adults • Looks similar to adult presentation of anxiety • Children often manifest anxious symptoms somatically: vague somatic complaints, bed-wetting, minor illnesses, situational avoidance • Consider developmental level of your child in considering how their anxiety presents

13. Treatments for Anxiety • Relaxation training • Mindfulness/meditation exercises • Social skills training • Exposure therapy • Cognitive/behavioral therapy • Relationally-oriented psychotherapy • Medication

14. How You Can Help • Don’t diagnose your child – leave that to trained professionals • Be supportive of their treatment by identifying your own anxieties and worries – you can help them by getting centered and supported yourself • Attend family therapy at home in order to identify which family issues might contribute to your child’s distress and how you can best support their recovery • If you know your child has an anxiety disorder, learn more about it. Ask your Open Sky therapist or home therapist for resources or check out The Anxiety and Phobia Workbook, by Edmund J. Bourne (2011: New Harbinger Publications)

15. Working with Anxiety in Wilderness • The nature of wilderness: environment, weather, future information, lack of control, group dynamics and how Open Sky supports students • Interventions designed to work with Anxiety and students

16. Thanks for Attending Our Webinar! Contact Information for the Presenter: Joanna Bettmann Schaefer, Ph.D, LCSW Research Director, Open Sky Wilderness Therapy joanna@openskywilderness.com Salt Lake office: 801-587-7600 Please keep this browser window open; when the webinar is over, it will take you to a short survey for today’s session.