Full Course Description
Rewire the Anxious Brain: Neuroscience-Informed Treatment of Anxiety, Panic and Worry
- Ascertain the underlying neurological processes that impact anxious symptoms for clients.
- Develop client engagement in treatment using personalized goals and attending to the therapeutic relationship.
- Evaluate the differences between amygdala-based and cortex-based anxiety symptoms and identify how these symptoms inform treatment interventions.
- Communicate strategies for calming and training the amygdala in order to alleviate symptoms of anxiety.
- Implement methods for teaching clients to retrain the cortex so that anxiety is resisted rather than exacerbated.
- Analyze how psychotropic medication impacts neuroplasticity in the brain; identify related treatment implications.
Use Neuroscience in the Treatment of Anxiety
Enhancing Engagement in Treatment
- We know more about anxiety-based disorders than any other disorders
- Science gives explanations, evidence, authority, destigmatizes difficulties
- It can be difficult to explain, answer questions
- Clients may feel a lack of responsibility
- Oversimplification is inevitable
- Don’t neglect the therapeutic relationship!
- Address the challenges of anxious clients
- Remember that strategies are effortful
- Guide the process using client’s goals
- Maintain motivation
Identify Two Neural Pathways to Anxiety
- Define Neuroplasticity in everyday language
- Therapy is about creating a new self
- ”Rewiring” as an accessible concept for change
- Re-consolidation: the modification of emotional memories
Client Friendly Explanations
- Amygdala – bottom-up triggering of emotion, physicality of anxiety
- Cortex – top-down emotion generation based in cognition
- Explain the two pathways to clients
- How anxiety is initiated in each pathway and how pathways influence each other
Neuroplasticity in the Amygdala (Essential for all Anxiety Disorders, PTSD, OCD, Depression)
- Use illustrations to create concrete understanding
- Fight/flight/freeze responses
- The “language of the amygdala”
- Anxiety and the cortex
- Help clients recognize the two pathways to anxiety
Neuroplasticity in the Cortex (Essential for GAD, SAD, OCD, PTSD, Depression)
- Sleep and the amygdala
- The influence of exercise
- Breathing techniques to reduce activation
- Relaxation, meditation, and yoga to modify responses
- Exposure as opportunities for the amygdala to learn
- Combatting avoidance
- When anxiety indicates that the amygdala can learn new responses
- Push through anxiety to change the amygdala
Neuroplasticity and Medications for Anxiety Disorders, OCD, PTSD, Depression
- ”Survival of the busiest” principle – strengthen or weaken specific circuitry
- The healthy (adaptive) use of worry in the cortex
- ”You can’t erase: You must replace”
- Recognize and modify the impact of uncertainty
- Training correct uses of distraction
- Left hemisphere techniques – cognitive defusion, coping thoughts, fighting anticipation
- Right hemisphere techniques – imagery, music
- Mindfulness and anxiety resistances
Moving Beyond Diagnostic Categories to Focus on Anxiety Pathways
- Medication’s effects in the rewiring process
- The myth of the chemical imbalance
- The danger of sedating the brain with benzodiazepines
- Promoting neuroplasticity with SSRIs, SNRIs
- The effectiveness of CBT and meds
Research, Risks and Limitations
- Anxiety is a component of many diagnoses (depression, substance abuse, etc.)
- Amygdala – and cortex-based techniques help in other disorders
- Targeting brain-based symptoms rather than disorders
- Worry, obsessions, rumination respond to similar cortex-based techniques
- Panic, phobic responses, and compulsions respond to amygdala-based techniques
- Empirical versus clinical and anecdotal evidence
- Clinical considerations for specific clients and settings
- Efficacy of particular interventions may vary
Ten Best-Ever Anxiety Treatment Techniques
Assessment and Differential Diagnosis
Techniques That Work to Modulate Physiology
- The causes of panic, generalized anxiety and social anxiety that help select treatment
- Differential diagnosis in children – ADD and ASD
- Treatment approaches that change brain function for long-lasting recovery
- The impact of insomnia in generalized anxiety
Techniques for Treating Cognitive Problems of Anxiety and Panic
- The right way to teach and use diaphragmatic breathing
- Develop the 4 competencies of stress management
- Utilize different types of relaxation and discuss their use in different types of anxiety disorders
- Four important lifestyle changes everyone can make to reduce anxiety
Techniques for Managing Social Anxiety
- The best thought-replacement methods for worry and rumination
- Clear the mind of ruminative and racing thoughts
- Know when anger triggers anxiety and how to work with it in worried clients
- How to stop worry before it happens
Limitations of the Research and Potential Risks
- Apply the “Three Deep Breaths and Good Preparation” model to construct treatment goals for social anxiety
- Structure cognitive change through planned “counter-cognitions”
- Apply ‘in vivo exposure’ techniques that optimize recovery from social anxiety
- Controlled studies on the human brain structure and function are limited by challenges of studying the brain in action
- New studies continually modify our understanding of how neurotransmitters interact and affect cognition, emotion and behavior
- There are no significant risks associated with Cognitive-Behavioral Therapy
- Assessment of an individual’s capacity to understand and utilize an intervention should always precede employment of the technique
- Determine the neurobiological causes of panic, generalized anxiety, and social anxiety and ascertain how this information impacts treatment decisions.
- Implement strategies for stress management to reduce symptoms of anxiety in clients, including lifestyle changes, cognitive interventions and time management tools.
- Perform effective use of diaphragmatic breathing techniques for physiological modulation in the treatment of anxiety.
- Demonstrate how the process of memory reconsolidation can be utilized to reduce reactivity to trauma cues, including shame trauma, that trigger social anxiety or panic attacks and sets up effective exposures to promote rapid recovery.
- Integrate specific clinical techniques to address persistent worry and understand how this changes the neurobiology of ruminative thought patterns in clients.
- Utilize cognitive therapy interventions with clients to manage perfectionism, procrastination and rigid approaches to problems.
2-Day Intensive Training: Mindfulness Certification Course
- Investigate the empirical support for mindfulness and connect this information to clinical implications for various conditions.
- Evaluate how understandable descriptions of neurological processes underlying disorders, in conjunction with understandable explanations of how mindfulness affects those processes, can motivate clients to engage in treatment.
- Assess for situations that may contraindicate the use of mindfulness with clients.
- Support how mindfulness training can enhance the cultivation of the therapeutic relationship.
- Employ mindfulness practices to impact the stress reaction and shift clients to a relaxation response.
- Evaluate how mindfulness interventions utilized in treatment plans for anxiety can help counter automatic patterns of thoughts.
- Assess how mindfulness can be taught in the clinical setting to help depressed clients manage negative self-talk.
- Support how mindfulness can enhance addiction treatment and help clients identify triggers that could lead to relapse.
- Investigate how mindfulness and breathing techniques that reduce the body’s anger response can be taught in-session to help clients manage their angered outbursts.
- Employ grounding techniques and breathing exercises that can be used to increase feelings of safety in traumatized clients.
- Assess how integrating mindfulness as an adjunctive therapy can help clinicians diversify available clinical techniques and individualize treatment.
- Distinguish between individual and group mindfulness practices and identify which types of clients would benefit from each.
- Differentiate between formal and informal mindfulness practices and characterize how they can be used in conjunction with one another to address the unique needs of clients.
Mindfulness and the Clinician:
“Know What You Teach” and “Teach What You Know”
Mindfulness Psychoeducation Approaches:
- Empirical support for improved symptomology and well-being
- The latest research on therapists who practice mindfulness
- Your mindfulness practice and how you can embody mindfulness
- Situations that may contraindicate applying mindfulness in session
- Research limitations
Easy to Use Strategies to Enhance Motivation in Therapy
Deepen the Therapeutic Relationship:
- Mindfulness vocabulary
- Visuals and metaphors to explain mindfulness
- Motivate clients with neuroplasticity
Build Presence, Trust and Empathetic Connection with Clients
Teach Mindfulness to Clients:
- Overcoming barriers
- Affect regulation techniques for therapist and client
- Strategies to create empathetic connection
- Exercises to build clients trust in themselves
Formal and Informal Mindfulness Practices
Group Therapy vs. Individual Sessions
- Tips for teaching clients about the senses and awareness
- Strategies to shift from “Automatic Pilot”
- Skill building interventions to increase responsiveness & reduce reactivity
- Strategies to cultivate attunement
- Approaches for deepened experience of mindfulness
- Brief and other informal practices
- How to adapt practices to special populations
Anxiety and Stress:
- Effectiveness of group vs. individual mindfulness
- How to set up and conduct a mindfulness group
- Screening for individual goodness of fit
- Encouraging client buy-in and commitment to practice
- Mindfulness interventions specifically designed for groups
Mindfulness Interventions to Relax the Body and Mind
Mindfulness for Trauma:
- Breathing practices that break the rumination cycle
- Guided visualizations to lower the stress response
- Movement strategies
- Multi-sensory regulation techniques
- Mindfully reduce the intensity of panic attacks
Disempower Intrusive Thoughts
Using Mindfulness in Depression Treatment
- Muscle tension releasing – exercises to counter fight or flight
- Guided meditations to disempower intrusive thoughts
- Grounding exercises and sample scripts
Mindfulness for Addictions: Break the Habit Loop
- Recognize self-criticism and respond with self-love
- Manage negative self-talk with awareness of thoughts
- Meditations to boost well-being
Mindful Anger: Breathing and Self-Soothing Techniques
- Awareness vs. autopilot -- relapse prevention
- Mindfulness for triggers
- Emotional regulation for cravings
Mindfulness, Diversity, & Cultural Humility
- Breathe through anger
- Distraction and grounding techniques
- Self-soothe with calming words and imagery
Mindfully Conquer Compassion Fatigue
- Adapt mindfulness experiences with cultural sensitivity
- Assess appropriateness of mindfulness interventions for individuals
- Negotiate the treatment plan
- Right here/right now – stay in the moment to reduce anxieties
- Effective and healthy ways to manage your emotions
- Change limiting stories about caring for yourself
- Release the negative – 3 steps to countering negativity bias