Step 1 of 5 20% Anxiety/OCD Cycle: Overview Let’s start by understanding your anxiety and OCD in a way that helps us plan exposure therapy. To do this, we need to learn how kids can get stuck in a cycle of anxiety or OCD. Then, we learn how they can break that cycle by facing their fears. Anxiety/OCD Cycle: Sets Off Now that you understand how kids can get stuck in anxiety or OCD, let’s learn what sets off your symptoms. After you watch the video, answer a few short questions. You can choose as many items from as many categories as apply to you. However, downloading your personal Anxiety or OCD cycle works best if you just enter one or two items at a time. What gives you anxiety?Things and situations in the worldSocial situations Social situations Social Situations* Speaking in group settings (class, team meetings) Talking to kids (during lunch, recesses) Talking to adults (teachers, family friends) Performing (music, sports) Talking in public (stores, ordering food) Reports or presentations Going to social events Making plans (inviting a friend over, phone calls) Being places and doing things where people can see me (being observed) Other social (enter) Other social* Contamination (Germs, chemicals, or other) Contamination (Germs, chemicals, or other) Contamination (Germs, chemicals, or other)* Germs from other people Chemicals Spreading germs Other contamination (enter) Other contamination* OCD patterns, things being out of order or not just-right OCD patterns, things being out of order or not just-right OCD patterns, things being out of order or not just-right* Numbers: counting, "good"/"bad" numbers Touching, tapping things right Moving, arranging thinks right Evening things out, right/left Other patterns (enter) Other patterns* Things, places, or activities Things, places, or activities Things, places, or activities* Heights Storms Water Shots Blood Buses and Trains Bridges Crowds Elevators or small/tight spaces Doctors or dentists Driving Flying/Planes Other places phobia (enter) Other places phobia* Animals Animals Animals* Bugs or Bees Spiders Dogs Mice and Rats Snakes Birds Other animal (enter) Other animal* Separation from parents or other caregivers Separation from parents or other caregivers Separation from parents or other caregivers* Playing alone at home Going to sleep alone Separating to go to school or other places Separation in public Other separation (enter) Other separation* Something else out in the world Something else out in the world Something else out in the world*Other things/places in the world: Thoughts in my headWorries about things that might happen (Generalized Worry) Worries about things that might happen (Generalized Worry) Worries about things that might happen (Generalized Worry)* My own health and safety Health and safety of others Family stability and finances The future Making mistakes Changes in schedules or routines New or unfamiliar places or activities Doing well in school or activities Current events Other worry (enter) Other worry* Memories of things that have happened (Trauma) Memories of things that have happened (Trauma) Memories of things that have happened (Trauma)* Hurt by someone else Saw someone get hurt Touched or treated in a way that upset me Natural disaster Car accident Other trauma Other trauma* OCD thoughts of doing bad things, making bad things happen, or having bad things happen to me OCD thoughts of doing bad things, making bad things happen, or having bad things happen to me OCD thoughts of doing bad things, making bad things happen, or having bad things happen to me* Hurting someone Hurting myself Touching people the wrong way, etc Being hurt by someone Being touched by people the wrong way, etc Other intrusive Other intrusive* Other thoughts in my head Other thoughts in my head Other thoughts in my head*Other thoughts: Feelings in my bodyPanic Attacks Panic Attacks Panic Attacks* Heart pounding Sweating or shaking Shaking Can’t breathe Choking Chest pain Stomach ache Light headed or dizzy Hot or cold Tingly or numb Unreal Lose control (cry, scream) Die Looking silly Other panic Other panic* Feeling I might throw-up Feeling I might throw-up Feeling I might throw-up* Throw-up from eating Throw-up from getting sick Throw-up from anxiety attack Other throw-up Other throw-up* Feeling that I am choking Feeling that I am choking Feeling that I am choking* Choke from eating Choke from anxiety attack Other choke Other choke* Feeling that I have a disease (Health anxiety) Feeling that I have a disease (Health anxiety) Feeling that I have a disease (Health anxiety)* Blood pressure Heart rate Bumps, rashes on my skin Headaches Breathing problems Other disease Other disease* Other feelings in my body Other feelings in my body Other feelings in my body*Other bodily: Anxiety/OCD Cycle: Expectations Now that you have identified what sets off your anxiety or OCD, let’s figure out what you expect to happen that makes those safe situations seem scary. After you watch the video, answer a few short questions to understand the beliefs and feelings that go with each thing that sets off your anxiety. Expectations - Things and situations in the worldWhat do you expect to happen when you are faced with the social situations you selected?* People will laugh at me People will think I am dumb People will get mad at me People won’t like me I will say the wrong thing or make a mistake I need to get out of here to feel okay I need to stay home to feel okay I need to stop talking to feel okay I just can't handle it I can't handle it by myself Other thought Other thought* How do you feel at these times?* Scared Afraid Worried Nervous Anxious Grossed out Like things just aren't right Like something is wrong Other feeling Other feeling* What do you expect to happen when you are faced with germs, chemicals, or other contamination?* I will get sick I will die It will hurt me I will make other people sick It will change who I am or something about me I need to wash my hands to feel okay I just can't handle it I can't handle it by myself Other thought Other thought* How do you feel at these times?* Scared Afraid Worried Nervous Anxious Grossed out Like things just aren't right Like something is wrong Other feeling Other feeling* What do you expect to happen when you are faced with the OCD patterns, things being out of order or not just-right items you selected?* Someone will get hurt if it is not fixed Something bad will happen if it is not fixed It will bother me until it is fixed I need to fix this to feel okay I just can't handle it I can't handle it by myself Other thought Other thought* How do you feel at these times?* Scared Afraid Worried Nervous Anxious Grossed out Like things just aren't right Like something is wrong Other feeling Other feeling* What do you expect to happen when you are faced with the things, places, or activities you selected?* I will fall I will get stuck or trapped I won’t be able to leave I will pass out I will get lost I will get hurt I will get in an accident The house will get destroyed I need to get away to feel better I just can't handle it I can't handle it by myself Other feeling Other thought* How do you feel at these times?* Scared Afraid Worried Nervous Anxious Grossed out Like things just aren't right Like something is wrong Other feeling Other feeling* What do you expect to happen when you are faced with the animals you selected?* It will bite, sting or hurt me I need to get away to feel better I just can't handle it I can't handle it by myself Other thought Other thought* How do you feel at these times?* Scared Afraid Worried Nervous Anxious Grossed out Like things just aren't right Like something is wrong Other feeling Other feeling* What do you expect to happen when you are faced with separation from parents or other caregivers?* My parents won't come back Something bad will happen to my parents Something bad will happen to me I need to be with my parent(s) to feel okay I just can't handle it I can't handle it by myself Other thought Other thought* How do you feel at these times?* Scared Afraid Worried Nervous Anxious Grossed out Like things just aren't right Like something is wrong Other feeling Other feeling* What do you expect to happen when you are faced with the other thing out in the world you selected?* Something bad will happen to me Something bad will happen to someone else I need to get away to feel better I just can't handle it I can't handle it by myself Other thought Other thought* How do you feel at these times?* Scared Afraid Worried Nervous Anxious Grossed out Like things just aren't right Like something is wrong Other feeling Other feeling* Expectations - Thoughts in my headWhat do you expect to happen when you are faced with the worries that you selected?* The worries are likely to come true The worries won’t go away The worries will bother me until I make them stop The worries will bother me until someone (parents) tells me it will be okay I can’t handle these worries on my own I need to stop thinking about it to feel okay I just can't handle it I can't handle it by myself Other thought Other thought* How do you feel at these times?* Scared Afraid Worried Nervous Anxious Grossed out Like things just aren't right Like something is wrong Other feeling Other feeling* What do you expect to happen when you are faced with the memories of things that have happened?* It will happen again The memories won’t go away The memories will bother me until I make them stop The memories will bother me until someone (parents) tells me it will be okay I can’t handle these memories on my own I need to stop thinking about it to feel okay I just can't handle it I can't handle it by myself Other thought Other thought* How do you feel at these times?* Scared Afraid Worried Nervous Anxious Grossed out Like things just aren't right Like something is wrong Other feeling Other feeling* What do you expect to happen when you are faced with the OCD thoughts of doing bad things, making bad things happen, or having bad things happen to you?* The thoughts will come true if I think about them I am bad for having these thoughts The thoughts won’t go away The thoughts will bother me until I make them stop The thoughts will bother me until someone (parents) tells me it will be okay I can’t handle these thoughts on my own I need to stop thinking about it to feel okay I just can't handle it I can't handle it by myself Other thought Other thought* How do you feel at these times?* Scared Afraid Worried Nervous Anxious Grossed out Like things just aren't right Like something is wrong Other feeling Other feeling* What do you expect to happen when you are faced with the other thoughts you selected?* The thoughts are likely to come true The thoughts won’t go away The thoughts will bother me until I make them stop The thoughts will bother me until someone (parents) tells me it will be okay I can’t handle these thoughts on my own I need to stop thinking about it to feel okay I just can't handle it I can't handle it by myself Other thought Other thought* How do you feel at these times?* Scared Afraid Worried Nervous Anxious Grossed out Like things just aren't right Like something is wrong Other feeling Other feeling* Expectations - Feelings in my bodyWhat do you expect to happen when you are faced with panic attacks?* My anxiety will go out of control I will pass out or faint I will die I will embarrass myself I will start to cry I can't do anything when I feel like this This feeling needs to stop for me to be okay I just can't handle it I can't handle it by myself Other thought Other thought* How do you feel at these times?* Scared Afraid Worried Nervous Anxious Grossed out Like things just aren't right Like something is wrong Other feeling Other feeling* What do you expect to happen when you are faced with the feeling you might throw-up?* I am going to throw-up I can't handle throwing-up Throwing up will be very embarrassing I can't do anything when I feel like this This feeling needs to stop for me to be okay I just can't handle it I can't handle it by myself Other thought Other thought* How do you feel at these times?* Scared Afraid Worried Nervous Anxious Grossed out Like things just aren't right Like something is wrong Other feeling Other feeling* What do you expect to happen when you are faced with the feeling that you are choking?* I will choke and die I can't do anything when I feel like this This feeling needs to stop for me to be okay I just can't handle it I can't handle it by myself Other thought Other thought* How do you feel at these times?* Scared Afraid Worried Nervous Anxious Grossed out Like things just aren't right Like something is wrong Other feeling Other feeling* What do you expect to happen when you are faced with the feeling that you have a disease?* I will get a serious illness I will die if I don't get help I can't handle not knowing if I have a disease I just can't handle it I can't handle it by myself Other thought Other thought* How do you feel at these times?* Scared Afraid Worried Nervous Anxious Grossed out Like things just aren't right Like something is wrong Other feeling Other feeling* What do you expect to happen when you are faced with the other feelings in your body you selected?* I won't be able to handle it I can't do anything when I feel like this This feeling needs to stop for me to be okay I just can't handle it I can't handle it by myself Other thought Other thought* How do you feel at these times?* Scared Afraid Worried Nervous Anxious Grossed out Like things just aren't right Like something is wrong Other feeling Other feeling* Anxiety/OCD Cycle: Avoidance Great work figuring out what sets off your anxiety or OCD and why. Now, let’s learn how avoiding that fear stops you from learning that what you are afraid of isn’t so bad. Watch the video and then answer the questions to identify what you do to avoid. Avoidance - Things and situations in the worldWhat do you do to avoid the social situations you selected?* Don't go to activities (school, after-school activities, others' houses, etc.) Don't talk Keep my head down Don't make eye contact Speak very softly Don't join activities Have my parents talk for me Other avoidance Other avoidance* What do you do to avoid germs, chemicals, or other contamination?* Don't touch it Cover my hand before touching things Wash my hands Clean things Ask someone if I will be okay Other rituals to remove contamination Other avoidance Other avoidance* What do you do to avoid getting OCD patterns wrong, things being out of order or not just-right?* Erase and rewrite Re-read over and over Tap, touch, or rub things over and over Straighten or rearrange things over and over Do things the "right" number of times or until the "feel right" Count things Check the things (doors or lights) over and over Other avoidance Other avoidance* What do you do to avoid the things, places, or activities you selected?* I don't go to those places I only go there if someone is with me I go but distract myself or think happy thoughts Other avoidance Other avoidance* What do you do to avoid the animals you selected?* Don't go places where they might be Don't play outside Don't go swimming Hide behind my parents or other people Other avoidance Other avoidance* What do you do to avoid separation from parents or other caregivers?* Don't go to school or other places Cry and cling to my parents Make my parents stay home Refuse to stay with a sitter Have my parents stay with me until I fall asleep Ask my parents if they are okay Check in with my parents over and over Other avoidance Other avoidance* What do you do to avoid the other things out in the world you selected?* Stay away from those places Other avoidance Other avoidance* Avoidance - Thoughts in my headWhat do you do to avoid when you have worries about bad things that might happen?* Check my work over and over Ask someone (parents or teacher) if things are okay Ask people if they are okay Make sure my work is perfect Check for mistakes over and over Work or study harder or longer than I need to Think happy thoughts Keep busy Try to think of other things Other avoidance Other avoidance* What do you do to avoid the memories of things that have happened?* Think happy thoughts Keep busy Try to think of other things Ask someone (parents or teacher) if things are okay Check over and over that I am safe Other avoidance Other avoidance* What do you do to avoid the OCD thoughts of doing bad things, making bad things happen, or having bad things happen to you?* Have someone (parents or teacher) tell me the thoughts won't come true Have someone (parents or teacher) tell me I am okay Tap, touch, or rub things over and over to stop bad things from happening Do things again while thinking a good thought Think happy thoughts Keep busy Try to think of other things Erase and rewrite Re-read over and over Straighten or rearrange things over and over Do things the "right" number of times or until it feels okay Count things Check the things (doors or lights) over and over Other avoidance Other avoidance* What do you do to avoid the other thoughts in your head you selected?* Have someone (parents or teacher) tell me the thoughts won't come true Have someone (parents or teacher) tell me I am okay Tap, touch, or rub things over and over to stop bad things from happening Do things again while thinking a good thought Think happy thoughts Keep busy Try to think of other things Check the things (doors or lights) over and over Other avoidance Other avoidance* Avoidance - Feelings in my bodyWhat do you do to avoid panic attacks?* Don't go places where I had panic attacks Stay near my parents or other adults Don't be alone Have someone (parents or teacher) tell me I am okay Think happy thoughts Keep busy Try to think of other things Other avoidance Other avoidance* What do you do to avoid the feeling you might throw-up?* Don't eat Only eat "safe" foods Only eat at home or in "safe" places Have someone (parents or teacher) tell me I am okay Stay away from things that remind me of throwing-up Other avoidance Other avoidance* What do you do to avoid the feeling that you are choking?* Don't eat Only eat "safe" foods Only eat at home or in "safe" places Chew foods more than I need to Have someone (parents or teacher) tell me I am okay Stay away from things that remind me of choking Other avoidance Other avoidance* What do you do to avoid the feeling that you have a disease?* Have someone (parents or teacher) tell me I am okay Look up my symptoms online Go to the doctor or school nurse Check my body to make sure I'm okay Other avoidance Other avoidance* What do you do to avoid the other feelings in your body you selected?* Stay near my parents or other adults Don't be alone Have someone (parents or teacher) tell me I am okay Check my body to make sure I'm okay Other avoidance Other avoidance* Anxiety/OCD Cycle: Exposure Now that we understand how your anxiety or OCD works, the last step to creating your personal cycle is to decide what type of activities you will need to do to face your fears. Watch the video and then answer the questions to pick the exposures that match your anxiety or OCD symptoms. Exposure - Things and situations in the worldWhat do you need to do to face your fears of the social situations you selected?* Talk to people Start conversations Read in front of the class Say "Hi" to kids Ask questions Join activities Stumble over my words on purpose Other exposure Other exposure* What do you need to do to face your fears of germs, chemicals, or other contamination?* Touch places with "germs" or "contamination", without washing or doing something to feel okay Get "germs" or "contamination" all over me , without washing or doing something to feel okay Get "germs" or "contamination" on things I keep "clean" , without washing or doing something to feel okay Get "germs" or "contamination" on other people, without washing or doing something to feel okay Other exposure Other exposure* What do you need to do to face your fears of OCD patterns being wrong, things being out of order or not just-right?* Make things messy, without straightening Write sloppy, without correcting Misread words, without rereading Do the pattern wrong, and don't fix it Do things the "wrong" number of times, and don't fix it Leave things undone (light on), and don't check or have someone fix it Other exposure Other exposure* What do you need to do to face your fears of the things, places, or activities you selected?* Stand on a bridge Stand on a high place Stay in a crowded place Walk in a wide open place Drive Ride a bus, train, or plane Go the Doctor Get a shot Other exposure Other exposure* What do you need to do to face your fears of the animals you selected?* Look at pictures, read books, and watch videos about the animal Go to places the animal might be Sit near them Hold, pet or touch them Other exposure Other exposure* What do you need to do to face your fears of separation from parents or other caregivers?* Stay in a room by myself Stay home with a sitter Go to school or someplace else without a parent staying Stay home alone Go to bed alone Other exposure Other exposure* What do you need to do to face your fears of the other things out in the world you selected?* Go there and do it Other exposure Other exposure* Exposure - Thoughts in my headWhat do you need to do to face your worries about bad things that might happen?* Repeat the worries over and over until the get boring Purposely make mistakes Study less than I need to Don't check to make sure things are right Other exposure Other exposure* What do you need to do to face your memories of things that have happened?* Repeat the story over and over until it gets boring Read things that remind me of what happened Go safe places that remind me of what happened Look at things that remind me of what happened Other exposure Other exposure* What do you need to do to face your OCD thoughts of doing bad things, making bad things happen, or having bad things happen to you?* Repeat the thoughts over and over until the get boring, without doing rituals Do the ritual "wrong" to "make the bad thing happen", without fixing it Do things while having the bad thought to "make it happen", without fixing it Other exposure Other exposure* What do you need to do to face your fears of the other thoughts you selected?* Repeat the thoughts over and over until the get boring Other exposure Other exposure* Exposure - Feelings in my bodyWhat do you need to do to face your fears of panic attacks?* Make yourself have the feelings until they get boring Make your heart pound until it gets boring Make your breathing uncomfortable until it gets boring Make yourself panic until it gets boring Go alone to places where you are afraid you will panic Other exposure Other exposure* What do you need to do to face your fears of feeling you might throw-up?* Eat foods that you think will make you throw-up Eat in places you would be afraid to throw-up Eat and then do things you fear will make you throw-up Read stories, watch videos, or talk about throwing-up Repeat thoughts about throwing up until they get boring Other exposure Other exposure* What do you need to do to face your fears of feeling that you are choking?* Eat foods that you think will make you choke Eat in places you would be afraid to choke Eat food quickly without over chewing Other exposure Other exposure* What do you need to do to face your fears of feeling that you have a disease?* Repeat your worries about illness until the get boring, without doing something to feel better Repeat thoughts about something being wrong with your heart rate or breathing until the thoughts are boring, without doing something to feel better Read stories about people having illness without doing something to feel better Other exposure Other exposure* What do you need to do to face your fears of the other feelings in your body you selected?* Make yourself have the feelings until they get boring Other exposure Other exposure* Here is an example of an Anxiety Cycle for a boy who is afraid of dogs. 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