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INTRODUCTION TO

MENTAL/EMOTIONAL

HEALTH

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LESSON #1: MAKING SENSE OF MENTAL/EMOTIONAL HEALTH ISSUES

DIRECTIONS for TREE OF MENTAL HEALTH: On the following page is the list of Mental/Emotional Health Topics we will discuss during this unit. On the two pages that follow

are two “empty” trees… a “healthy” or “preventative” tree and a “sickly” or “harmful” tree. Your job is to add the topics so that they create the described tree. You may find that not all of the items “fit” into your tree’s theme.

To create the “healthy” tree or tree of prevention, begin by first deciding which items belong

at the “root” of the tree – that is, the things that would serve to make you strong mentally & emotionally, therefore making your tree one that is resistant to other topics on the list. Next, select things that relate to the roots that help your tree to grow strong enough to produce

leaves and place those things on the trunk and lower branches. Finally, produce the topics that would be produced on your “leaves”.

To create the “sickly” tree or tree of harm, do the reverse of what you did for the “healthy” tree. What would be the root causes of a mentally/emotionally unhealthy person? How would

it grow from the roots so that the leaves are replaced by the unhealthy topics on the list?

MENTAL ILLNESS WORD CLOUD: Create a word cloud that depicts the more prominent issues that trigger the consequential issues in this cloud. Remember that in a word cloud, the

prominent issues should appear larger. The farther away you go from the initial causes, the smaller the words will become.

TEACHER OPTION 1: MENTAL HEALTH WORD CLOUD HOMEWORK: If given to you as homework, you are to create your cloud at home on your own device, print a hard copy and

bring it in to your classroom teacher. TEACHER OPTION 2: MENTAL HEALTH WORD CLOUD CLASSWORK: Your classroom

teacher may opt to do this assignment using the CHS iPad Cart. The library will download the FREE APP Wordsalad onto the iPads. Click on that app on the iPad. After it loads, begin making

your word cloud. When you have the finished product, Press the home button and the top button simultaneously to take a picture of your final product and turn it in electronically as explained by your classroom teacher.

NEED HELP finding a website to use to make your Word Cloud? Check out this link for

options! Note, there are plenty of free sites, so subscribing to a paid one isn’t necessary! http://www.edudemic.com/9-word-cloud-generators-that-arent-wordle/

Example:

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ISSUES IN MENTAL/EMOTIONAL HEALTH

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Version 1: Tree of Mental/Emotional Health – Healthy Tree

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Version 1: Tree of Mental/Emotional Health – Unhealthy Tree

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CLASSROOM DISCUSSION & REFLECTION

Mental/Emotional Health Tree

Classroom Discussion

1 Identify all of the issues on the topic list you believe are unhealthy.

2 What did you feel were the 3 root issues of each of the trees and why?

Healthy:

Unhealthy:

3 What issues do you feel are the farthest reaching from the root issues? That is, which

topics have the least to do with a person becoming mentally healthy or unhealthy?

4 What was difficult about this assignment?

5 Are there any Mental/Emotional Health issues that are not on the list that you feel should

be on the list? If so, identify as many as you are able.

Reflection:

1 The primary roots of my personal tree are:

2 What would be the three issues that branch from your roots that you struggle the most

with?

3 How could you add positive leaves or prevent more negative leaves from being added to

your tree?

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Lesson 2: Who Am I and Who Will I Be? Name

Period

Stop… think… Who Are You? What hats do you wear? What do you believe? What are your strengths?

What are your weaknesses? What are your passions? What do you dislike? What are your pet peeves?

What do you believe in so much that no one could ever change your mind about it?

If you CAN answer those questions and others, then you have a good idea of who you are. If you cannot, it’s

time to work on YOU. Teens spend a lot of time taking care of their responsibilities to school, family and

friends. When they are alone and have free time, they tend to flock to electronic devices, social media, or fill

every spare minute with other activities leaving very little time to spend by themselves thinking about the

answers to the above questions.

If you don’t know who you are, how will you know what you believe? What you like? What you love? If you

don’t know those things, how will you choose a career? A partner? A hobby? The bottom line is… it takes

times to learn these things about yourself.

You have four years… let’s take some time to start to get to know YOU. Answer the questions that follow as

OPENLY and HONESTLY as you are able. Don’t panic or stress if you don’t know the answer… just write

and let your mind follow your instincts to put the words on the page. You’ve spent more than fourteen years

with yourself… the answer is there… just think about it.

Finding ourselves is where we begin to find Mental & Emotional Health for a lifetime. It’s the first stop in

Total Health… let’s get started…

--- --- --- --- --- --- --- --- --- --- --- --- --- ---

Reflection: Who Am I and Who Do I Want to Become?

1. Who is the single most influential person in your life? What is it that they contribute to your

beliefs and behaviors?

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2. Think of the person in #1… which of their traits/qualities would you hope to develop in yourself.

Why?

3. If you could spend TWO HOURS with any person in the world who is NOT a relative – living or

dead – who would it be and why would you want to spend that hour with them?

4. What are your passions? What do you absolutely LOVE to do? What do you care most about at

this time in your life? Why?

5. Fear can be our greatest enemy (of course, it can also keep us from doing things could be

harmful to us!) Fears that prevent us from achieving in life can be debilitating. What is the fear(s)

that have prevented you from doing things you truly wanted/hoped to do or accomplish? Explain.

6. What could you be happy doing day in, day out until you were 65 years old? We’ll tell you a

secret… a happy job is the job that allows you to follow your passion all day long. Why? Well,

first… you get PAID to do something you love… what’s not to be happy about! And remember,

you spend 8-14 hours a day at your job, so you’ve gotta love what you’re doing to be able to do it

daily for that long, right? … So, if you could get paid to follow your passion, what would you do?

If you combine all of the information from all of your answers above, it should give you an idea of

what your career path should be! For example, if you LOVE building things and you LOVE

studying the human body and you LOVE helping others… you don’t have to be a doctor… you

could be a biomedical engineer! So… what is your passion and how could you it your career?

7. What is your perception of Aging and Retirement? What kind of aged person will you be?

Who will you be when you retire? Will you be an asset to society or a burden? Will you

be grumpy or kind? Will you be active or sedentary? Will you join Senior Citizen Groups

or hang out with friends and family? How will you have made yourself the best YOU, to

be the best FUTURE YOU that you can be? Ponder… then, write!

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8. ANALYZE the diagram below. When you consider the information from the previous lessons,

what does the graphic below say about the thoughts and behaviors of teens in relation to the risk

for mental/emotional health issues?

r

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Extra Space for Who Am I, Who Will I Be Reflection NAME

Note: Please put the number of the question you are continuing on this page before you begin.

Thank you for helping us navigate your reflection!

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LESSON 3: MENTAL HEALTH SERVICES FOR ADOLESCENT YOUTH AT CONESTOGA

IDENTIFYNG RISK FACTORS: Throughout Middle School, you learned a great deal about various risk

factors that help us to identify mental/emotional health concerns in adolescence. If you had a friend who you

felt was showing signs of such risk factors, what would you do? Where would you seek help? Here are

places on our campus where you can go. You do not have to suffer in silence. Pick one of the groups below,

then get up and seek someone from the group out so you can get on your way to feeling better about your

days.

Peer Mediators – the peer mediators have specialized training to mentor all new incoming students. There

are five branches to the team: Mediation, Links, FROGS, STAR, and PALs. Their mission is to provide

activities that support school unity and positive school climate while providing education and support to

students in conflict whether personal or interpersonal. They are not counselors, but they are trained to

recognize when a student may need additional support. They are part of our school’s crisis intervention

team in that they are a primary resource for referring students in need. Nervous about seeing one of the

other groups listed? A mediator will help you transition to them. They want you to get the help you need

when your life is not going as well as you would like.

Which branches of the team are primarily responsible for serving Freshmen students with transition

to high school life as well as providing support for personal & interpersonal conflicts?

Guidance Counselors – Guidance Counselors possess a Bachelor’s and/or Master’s Degree in

Educational School Counseling. Some of our counselors were teachers before they became counselors.

They provide mental/emotional support for students in need, serve as the intermediary between mediators

and their links if there is something they feel the mediator can help their link with, serve as a communication

link between staff and student in the case of special situations that arise with their students, and serve to

refer students for additional counseling services by more highly trained and specialized personnel if they

think it is needed.

What is your Guidance Counselor’s Name?

CARE Team – The Conestoga Assistance and Referral Effort is a team of teachers, counselors, nurses,

outside service counselors and an administrator who determine if intervention is needed with regard to a

student’s social, mental/emotional, physical or academic health. They are a group who will visit each area of

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student performance and if they determine support should be offered, they refer the student to our school

Mental Health Specialist (mental/emotional/social concerns), our School Psychologist (academic testing,

physical health concerns), the IIT Team (Instructional Intervention Team – a team of teachers who provide

tutoring services to students), or COAD (Chester County Council on Addictive Diseases) – our outside

counselor who comes to CHS to provide services for students who are referred for substance abuse, grief,

peer group counseling, educational program due to violation of school policy, re-entry to CHS after

completing a rehabilitation program and others. There are many trained CARE Team members in the

building. We rotate onto the team on a yearly basis.

Can you name one teacher or counselor who is currently serving on the CARE Team?

Mental Health Specialists – Our Mental Health Specialists provide counseling services to students

through their Individual Educational Placement services and/or as recommended by the CARE Team and

Guidance Counselors. When you are referred to them for support, they will meet with you for an initial

interview to determine appropriate services. They will then call your parent or guardian to discuss the

recommendations. When you think about the different facets of your life, you will likely think of home,

school, community, team, organization and clubs. The Mental Health Specialists will have a conversation

with anyone they deem instrumental in helping to provide the support a student’s needs whether short or

long term.

Can you name the two Mental Health Specialists on staff at CHS?

School Psychologists – Our two School Psychologists are full time licensed psychologists with a doctoral

degree in School Psychology. Their primary responsibility at CHS is performing psychological testing with

referred students to determine appropriate support for students to reach their full potential academically,

mentally, emotionally, socially and physically. They receive referred students from CARE Team,

Administrators, Counselors and the Mental Health Specialists. They are employed by the TESD through

COAD.

Can you name our two School Psychologists?

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Recognizing At-Risk Behaviors Name

Period

Directions: Read “Kyle’s Story” silently on the pages that follow. (Note – your teacher may choose

to “popcorn” this around the room as a method of reading this story aloud.) As you read, highlight

the character’s lines of speech or actions that you think may be a sign of a negative affect or

choice that is impacting the mental health of any characters in the story. When the story ends,

answer the questions that follow and be prepared for a classroom discussion.

1. List the comments or behaviors that concern you about Kyle.

2. List the narrator’s comments or behaviors that you believe provide support to Kyle.

3. Was it just by chance or by conscious awareness that the author provided necessary

support to Kyle?

4. Did bullying play a factor in Kyle’s life? Explain your answer whether yes or no.

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Kyle’s Story (based on a true story)

One day, when I was a freshman in high school, I saw a kid from my class was walking home from school. His name was Kyle. It looked like he was carrying all of his books. I thought to myself, "Why would anyone bring home all his books on a Friday? He must really be a nerd." I had quite a weekend planned with my friends (parties tonight and a football game tomorrow), so I shrugged my shoulders and went on. As I was walking, I saw a bunch of kids running toward him. They ran at him, knocking all his books out of his arms and tripping him so he landed in the dirt. His glasses went flying, and I saw them land in the grass about ten feet from him. He looked up and I saw this terrible sadness in his eyes. My heart went out to him. So, I jogged over to him and as he crawled around looking for his glasses, I saw a tear in his eye.

As I handed him his glasses, I said, "Those guys are jerks. They really should get lives. He looked at me and said, "Hey thanks!" There was a big smile on his face. It was one of those smiles that showed real gratitude. I helped him pick up his books, and asked him where he lived. As it turned out, he lived near me, so I asked him why I had never seen him before. He said he had gone to private school before now. I would have never hung out with a private school kid before. We talked all the way home, and I carried some of his books. He turned out to be a pretty cool kid. I asked him if he wanted to play a little football with my friends. He said yes. We hung out all weekend and the more I got to know Kyle, the more I liked him, and my friends thought the same of him. Monday morning came, and there was Kyle with the huge stack of books again. I stopped him and said, "Boy, you are gonna really build some serious muscles with this pile of books everyday!” He just laughed and handed me half the books. Over the next four years, Kyle and I became best friends. When we were seniors, we began to think about college. Kyle decided on Georgetown, and I was going to Duke. I knew that we would always be friends, that the miles would never be a problem. He was going to be a doctor, and I was going for business on a football scholarship. Kyle was valedictorian of our class. I teased him all the time about being a nerd. He had to prepare a speech for graduation. I was so glad it wasn't me having to get up there and speak. Graduation day, I saw Kyle. He looked great. He was one of those guys that had really found himself during high school. He filled out and actually looked good in glasses. He had more dates than I did and all the girls loved him. To tell the truth, sometimes I was jealous. Today was one of those days. I could see that he was nervous about his speech. So, I smacked him on the back and said, "Hey, big guy, you'll be great!" He looked at me with one of those looks (the really grateful one) and smiled. "Thanks," he said. As he started his speech, he cleared his throat, and began… "Graduation is a time to thank those who helped you make it through those tough years. Your parents, your teachers, your siblings, maybe a coach...but mostly your friends... I am here to tell all of you that being a friend to someone is the best gift you can give them. I am going to tell you a story."

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I just looked at my friend with disbelief as he told the story of the first day we met. He had planned to kill himself over the weekend. He talked of how he had cleaned out his locker so his Mom wouldn't have to do it later and was carrying all of his stuff home. He looked hard at me and gave me a little smile. "Thankfully, I was saved. My friend saved me from doing the unspeakable." I heard the gasp go through the crowd as this handsome, popular boy told us all about his weakest moment. I saw his Mom and Dad looking at me and smiling that same grateful smile. Not until that moment did I realize its’ depth. Never underestimate the power of your actions. With one small gesture you can change a person's life - for better or for worse. We all impact one another in some way. Look for good in others – there’s more there than you think and life is so much bigger than our petty little judgments of each other. --- --- --- --- --- --- --- --- --- --- --- --- --- ---

always remember…

we all go through stages in our lives…

there are many high points

and there are some low points…

when you think there is no hope,

reach out and hold on…

sometimes things are not what they appear…

suicide is never the answer…

suicide is a permanent solution to just one

of the temporary problems in life…

always choose life…

surround yourself with a few good people,

then learn to reach out when you must.

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Mental/Emotional Health Unit

Part 2

S.O.S. Prevention Program

Acknowledge

Care

Tell

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Mental Health Inc’s S.O.S. Program® Day One

Your Classroom Teacher will read the following information aloud to help you understand our lesson for today:

Today, our school is participating in the SOS Signs of Suicide Prevention Program, which is taking place throughout the country. Our goal today is to help you recognize the symptoms of depression and/or suicide in yourselves, your friends or your loved

ones. The purpose of this program is not to tell whether or not you are suffering from depression, but rather to tell you if you or someone you know may have symptoms that

indicate a need for further evaluation.

Today’s program will include the following:

1 A DVD about the signs of suicide and the steps to take if you feel a friend or loved

one is at risk. The students who participate in the video are students from the Main Line who have lived in a similar school and community environment as you.

2 Classroom worksheet & discussion

3 Completion of the Response Card by every student in the classroom. We ask that you respect the privacy of the person sitting next to you and keep your eyes to

yourself. The cards will be collected by the Guidance Counselor present in our classroom.

4 Ladies and Gentlemen, may I introduce (Counselor’s Name) . They will be here for the duration of the lesson today to distribute and collect the response cards

as part of the team that will provide support to students who may request it after the program.

5 Distribution of ACT® wallet cards at the end of the class period. We ask that you put

it somewhere you could access it any time you may need a refresher about ACT or the support numbers on the reverse side. Valley Creek Crisis number 610-918-2100

Teacher: Pre-DVD Introduction

Being in high school can be exciting, but it can also feel overwhelming as everything changes

at a fast rate and in a big way. With all that is going on, it’s normal for students to feel down or discouraged at times. This DVD is meant to help you to know when a situation has gone

beyond normal adjustment issues to something potentially more serious. This DVD will also show you how to respond by demonstrating the ‘red flags’ you should watch for. It will also show you what to do when your friend seems down for weeks, or when their own sadness or

lack of energy is seriously affecting their life.

Please watch the DVD at this time. There is no need to take notes – the notes are included in this section of the notebook as well as a newsletter you will receive at the conclusion of the program. Time permitting, we will hold a discussion at the conclusion of the DVD today or at

the start of Lesson Two tomorrow.

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Day One (cont’d)

Post-DVD Discussion Guide

1 Response Cards: Counselors will collect these throughout the discussion. Just hold it up when you’re finished and they will come and get it from you. Please note that

writing legibly will enable counselors to contact you in a more timely manner.

2 Purpose of the DVD: This DVD was intended to teach you to ACT®: Acknowledge, Care, Tell…

a. Acknowledge: Admit that you are seeing the signs of depression or suicide in a friend and that is serious.

b. Care: Let your friend know that you care about him or her and that you are concerned that he or she needs help you cannot provide.

c. Tell: Inform a trusted adult, either with your friend or on his or her behalf. In

watching the video, you should have noticed that despite he reluctance of actors to tell their parents, it is important to emphasize that parents should be

considered trusted adults who will help.

3 Worksheet: Complete the objective question worksheet on the next page while the guidance counselor collects the response cards. Again, please respect everyone’s

right to privacy. Work quietly on your own. If time permits, your teacher will review the correct answers. If not, the answers will be reviewed in tomorrow’s lesson.

4 ACT Cards & Student Newletter: to be distributed after discussion. Please add the

contact information for Valley Creek Crisis 610-918-2100 to the back of your card and to

your cellular phone if you have it with you. Please put the newsletter in your notebook. We

will be referring to it in future lessons during this unit.

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DVD Worksheet: Lesson 1 Name: Period:

Directions: Choose the BEST possible answer to each question based on knowledge gained from the DVR.

1 A risk factor is

a. Something that causes a person to commit suicide

b. The thing a person does to harm themselves.

c. Any personal trait or environmental quality that is associated with suicide

d. None of the above

2 A warning sign

a. Is usually something a person says just to get attention

b. Has to be something violent

c. Isn’t really something you can see until it’s too late

d. An indication that an individual may be experiencing depression or thoughts of suicide

3 A protective factor

a. Something my peers will use to hide the fact that they want to harm themselves

b. A personal trait or environmental quality that can reduce the risk of suicidal behavior

c. A person who takes away another person’s power

d. None of the above

4 A precipitating Event

a. A recent life event that serves as a trigger, moving an individual from thinking about suicide to

attempting to take his or her own life.

b. Snow, rain, sleet, etc.

c. The thing that stops a person from attempting to take his or her own life.

d. None of the above

5 ACT Stands for

a. Acceptance, Care, Tolerance

b. Acknowledge, Care, Tell

c. Acknowledge, Care, Tolerance

d. Acceptance, Care, Tell

6 Susan is a freshman at Conestoga and has played soccer and been a musician all of her life. While doing

course selection for their sophomore year, Susan tells her friend Karen that she is not trying out for soccer

next year because she wants to concentrate on her interest in music. When Karen asks her why, Susan

replies that it’s because she wants to make a career out of music. Karen’s primary concern for her friend

should be…

a. Susan is withdrawing from activities she loves and may be contemplating suicide

b. Susan is beginning to prioritize her life and future, so wants to be supportive. She should continue the

conversation by asking her friend questions about what she wants to do with music in the future.

c. Not having Susan on the soccer team may hurt their chances of qualifying for states next year

d. She should get Susan to Student Services right away because she is clearly suicidal.

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7 Jonathan’s friends have noticed that for the past few weeks, every time they ask him to do something, he

always says he doesn’t feel like it. They rarely see him except for in classes and at lunch where he is

unusually quiet. His friends wouldn’t think anything of it normally, but his sister told them he just sits in his

room all the time since his girlfriend broke up with him. She asks her brother’s friend Cam to talk to him.

What two risk factors would already be very apparent to Cam as he goes to meet with his friend?

a. Jonathan is showing a drop in grades and feelings of hopeless

b. Jonathan is showing a loss of interest in usual activities and has suffered a recent breakup

c. Jonathan is suffering from weight loss and family problems

d. Jonathan has not shown any risk factors or precipitating events for suicide, so Cam doesn’t need to

worry

8 Clinical Depression is…

a. More than the blues or the blahs

b. More than the normal everyday ups and downs

c. When the “down” mood and other symptoms last more than a couple of weeks

d. All of the above

9 The biological and emotional factors associated with depressive disorders may include (circle all that

apply),

a. A genetic link

b. Difficult life experiences

c. Difficulty handling stress

d. Low self-esteem and/or extreme pessimism about the future

10 Why is depression considered serious? (circle all that apply)

a. Poor school performance

b. Truancy/Running Away

c. Alcohol and Drug Abuse

d. Feelings of worthlessness and hopelessness

11 The rate of suicide among teens in the United States has in the past 25 years.

a. Decreased

b. Increased

c. Remained the same

d. No one knows

12 All forms of depressive disorders are alike

a. True

b. False

13 Which of the following statistics about depression do you believe are true (circle all that are true)

a. Around 19 million Americans will be affected by depression this year

b. 1/4 of all women will suffer at least one episode or occurrence of depression during their life

c. 1/8 of all men will suffer at least one episode or occurrence of depression during their life

d. Depression is less common in teens than adults but of 25 friends, 1 could be clinically depressed.

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14 *It is normal for teenagers to be moody; teens don’t suffer from ‘real’ depression

a. MYTH

b. FACT

15 *Teens who claim to be depressed are weak and just need to pull themselves together. There is nothing

anyone else can do to help

a. MYTH

b. FACT

16 *People who talk about suicide won’t really do it.

a. MYTH

b. FACT

17 *If a person is determined to kill themselves, nothing is going to stop them.

a. MYTH

b. FACT

18 *People who complete suicide are people who were unwilling to seek help.

a. MYTH

b. FACT

19 *Talking about suicide may give someone the idea to commit suicide

a. MYTH

b. FACT

20 The most important step towards overcoming depression is

a. Getting over it

b. Ignoring it

c. Just dealing with it

d. Asking for help

Myth/Fact question taken from Implementation Guide p. 49

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Mental Health Inc’s S.O.S. Program ® Day Two

Welcome back! Let’s get started…

1 Review

a. What is the SOS Program’s Purpose?

b. What does the acronym A.C.T. stand for?

c. DVD Worksheet Questions

2 DVD Discussion Questions

a. Boys discussing SAT Scores

i. What resonated with you about this clip?

ii. Why might a student who thinks he/she has to be “perfect” be at risk for suicide?

iii. Do you see indications of risk in the student’s words or behaviors?

iv. How did his friend react to these signs?

v. How did his friend use the ACT technique?

b. Girl (Lily) and her brother discussing break-up

i. Is it normal for people to have these kinds of feelings after a breakup with a

girlfriend or a boyfriend?

ii. Then what makes this girl’s reaction so concerning?

iii. What if Lily is gay and Alex was her girlfriend rather than her boyfriend? Do you

think this might increase the suicide risk?

iv. When you think about Lily being gay, do you understand better why when her

brother suggested that she talk to their parents she said, “Are you kidding? Mom

and dad wouldn’t understand.”

v. How did Lily’s brother support her, knowing that she needed to speak with

someone about her wishing she was dead and that it was also important that the

trusted adult they talk to be accepting of Lily being gay?

vi. How did this girl’s brother use the ACT technique?

c. Boy (Jason) who is always being picked on; potential for violent reaction

i. What are some things that tell you Jason may be at risk to do harm?

ii. Based on how he acts, would you think Jason might be depressed?

iii. Do you think that this dramatization has anything to do with suicide?

iv. How did the girls use the ACT technique in this dramatization?

d. Boy (Michael) in bedroom who has stopped interacting with friends

i. What has been happening to make Michael’s friend concerned and worried about

him?

ii. Can you find anything in this dramatization that may have caused Michaels’

depression?

iii. What if Michael had said or implied he was suicidal?

iv. In this dramatization, how did Michael’s friend use the ACT technique?

e. Jordan’s Story*

f. Elyssa’s Story* *Teacher notes on p. 40 and 42 of Implementation Manual

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Mental Health Inc’s S.O.S. Program ® Activity

3 HOTLINE ACTIVITY: Warning Signs of Suicide

a. Many suicidal individuals talk about their suicidal feelings or plans before they attempt

suicide. It is important to listen to these “cries for help” by practicing the ACT

(Acknowledge, Care, Tell) technique discussed in this unit.

b. An individual working at a suicide hotline has been given information about suicide

myths. One myth is that if you talk about suicide, you are more likely to attempt suicide.

These hotline volunteers use the “Warning Signs of Suicide” lists to help them determine

the risk level of the caller for attempting suicide.

c. Your task is to work in pairs as you listen to a script that will be enacted by your teacher

and the peer mediator in your room. The hotline staff is trying to communicate with the

person calling and helping to address the problems. You and your partner are to use the

“Warning Signs of Suicide” list to determine how many warning signs are in the script. A

discussion of the number of warning signs will follow.

d. Please turn to the “Warning Signs of Suicide” list at this time. Decide which one of you is

going to place the check marks. Remember… everyone needs to hear the call, so whisper

or point to the page if you need to communicate with your partner. You will have a few

minutes after the skit to make changes and/or review your answers.

WATCH & LISTEN TO HOTLINE CALL SKIT…

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ACTIVITY: HOTLINE SKIT WARNING SIGNS OF SUICIDE LIST

My Name: Partner’s Name:

FEELINGS In script

Hopeless: “Things will never get better”; “There’s no point in trying”

Worthless: “Everyone would be better off without me.”

Helpless: “There’s nothing I can do about it”; “I can’t do anything right”

Guilt, shame, self-hatred: “What I did was unforgivable”; “I’m useless”

Pervasive sadness

Persistent anxiety

Persistent agitation

Confusion: Can’t think straight, make decisions

ACTIONS In script

Uncharacteristic aggression

Risk taking

Withdrawing from friends/activities

Becoming accident prone

Recent losses: death, divorce, relationship, job, status, self-esteem

Getting into trouble, discipline problems

Drug or alcohol abuse

Themes of death or destruction in talk, writing or websites

CHANGE in script

Personality: more withdrawn, low energy, “don’t care attitude”, more boisterous, talkative, outgoing

Can’t concentrate on school, work, routine tasks

Loss of interest in hobbies or work

Marked decrease in school or work performance

Sleep, appetite increase/decrease

Sudden improvement after being down or withdrawn

THREATS in script

Statements talking about suicide directly/indirectly, written themes of death; preoccupation with death

Threats: “I won’t be around much longer”; writing suicide notes; making a direct threat

Plans: Giving away prized possessions; making arrangements for funeral; studying drug effects; obtaining a weapon

Attempts to kill themselves, such as through an overdose

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MENTAL HEALTH UNIT – PART 3

Unit Topics:

Resiliency

Learning

Sleep

Stress

Conestoga High School Wellness/Fitness Department

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RESILIENCY LESSON NAME INDIVIDUAL WORKSHEET PERIOD Directions: Read and complete the activities from the two authors on resiliency that are provided on the pages that follow. When finished, come back to this page and answer the questions below.

1. What is resiliency?

2. Why is it important that you develop the ability to be resilient?

3. Summarize three concepts/ideas presented by Author #1, Nan Henderson, N.S.W., that you should remember about resiliency. a. b. c.

4. Summarize three concepts/ideas presented by Author #2, Kenneth Ginsburg, M.D., MS Ed, FAAP, that you should remember about resiliency.

a. b. c.

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AUTHOR #1: Resiliency According to: Nan Henderson, N.S.W. PART 1: MEET THE AUTHOR: Resiliency Lesson Bibliography

Resiliency In Action, Inc. is a pioneering publishing and training company founded in 1996 by Nan Henderson, Bonnie Benard, and Nancy Sharp-Light. The mission of the company— developed before the word “resiliency” was commonly used—is to share the growing body of social science research that documents how people of all ages bounce back from life challenges of all kinds. In addition, these founders wanted to make the strategies recommended by this research accessible to everyone. They stated their goal in the first book published by Resiliency In Action:

“Our goal is a simple one: Share the results of numerous scientific studies that have emerged in the past decades showing specifically how people of all ages, families, and even organizations and communities overcome risk, trauma, and adversity to go on to live successful lives, and to do this in a practical, reader-friendly format.” – from the Preface to Resiliency In Action: Practical Ideas for Overcoming Risks and Building Strengths in Youth, Families, and Communities

Nan Henderson, M.S.W., is President of Resiliency In Action. Her publications on resiliency and wellness, positive youth development, and school and organizational change are used in more than 25 countries and have been translated into Spanish, French, and Russian. She has provided hundreds of presentations and trainings in 45 U.S. states and several foreign countries over the past two decades for a wide variety of audiences and organizations. These groups include Big Brothers/Big Sisters, Upward Bound, Americorps, State Departments of Education in CA, VT, CO, PA, ME, TX, and NH, the Ministry of Education in New Zealand, several Canadian school districts and organizations, and the U.S. Military.

The Pennsylvania Dept. of Education is advocating the adoption of Ms. Henderson’s model in every school in that state, and she has been involved in major resiliency initiatives in New York City Schools and Los Angeles Public Schools.

She has served on the faculty of five colleges/universities; worked as a clinical therapist with youth, adults, and families; and directed citywide and statewide prevention and resiliency programs. She is the author/editor of five books on resiliency, numerous articles, and an on-line newsletter distributed worldwide. She has also been featured as a “resiliency expert” on N.P.R’.s Talk of the Nation.

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PART 2: ANALYZE THE DIAGRAM

PART 3: THE RESILIENCY QUIZ by Nan Henderson, N.S.W. Nan developed this quiz for anyone—teens, adults, elders—to assess and strengthen the resiliency building conditions in their lives. Nan wants you to use it for yourself or use it as a tool to help others you care about build their resiliency.

QUIZ: Part 1 Do you have the conditions in your life that research shows help people to be resilient? People bounce back from tragedy, trauma, risks and stress by having the following “protective” conditions in their lives. The more times you answer yes (below), the greater the chances you can bounce back from your life’s problems “with more power and more smarts”. Doing that is a sure way to increase self-esteem.

For each “protective condition” below, circle “yes”, “no”, or “sometimes” for each statement as it applies to you. Celebrate your “YES” answers and decide how you can make changes in your life so that you are

able to circle the letters that corresponded to statements that were a “NO”. You can place an “S” over letters that correspond to statements that are “sometimes”.

Go to the next page and begin the Resiliency Quiz Part 1…

WHAT DOES IT MEAN?

WHAT IS YOUR INTERPRETATION OF NAN HENDERSON MEANS BY THE WHEEL AT THE LEFT?

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RESILIENCY QUIZ PART 1

CARING AND SUPPORT

Yes No Sometimes I have several people in my life who give me unconditional love, nonjudgmental listening and who I know are “there for me”.

Yes No Sometimes I am involved in a school, work, faith, or other group where I feel cared for and valued.

Yes No Sometimes I treat myself with kindness and compassion. I take time to nurture myself – including eating right and getting enough sleep and exercise.

HIGH EXPECTATION FOR SUCCESS

Yes No Sometimes I have several people in my life who let me know they believe in my ability to succeed.

Yes No Sometimes I get the message “you can succeed”, at my work or school.

Yes No Sometimes I believe in myself most of the time and generally give myself positive messages about my ability to accomplish my goals – even when I encounter difficulties.

OPPORTUNITIES FOR MEANINGFUL PARTICIPATION

Yes No Sometimes My voice (opinion) and choice (what I want) is heard and valued in my close personal relationships.

Yes No Sometimes My opinions and ideas are listened to and respected at my work or school.

Yes No Sometimes I volunteer to help others or a cause in my community, faith organization or school.

POSITIVE BONDS

Yes No Sometimes I am involved in one or more positive after-school hobbies or activities.

Yes No Sometimes I participate in one or more groups (such as a club, faith community, or sports team) outside of work or school.

Yes No Sometimes I feel “close to” most people at my work or school.

CLEAR AND CONSISTENT BOUNDARIES

Yes No Sometimes Most of my relationships with friends and family members have clear, healthy boundaries (which include mutual respect, personal autonomy, and each person in the relationship both giving and receiving).

Yes No Sometimes I experience clear, consistent expectations and rules at my work or in my school.

Yes No Sometimes I set and maintain healthy boundaries for myself by standing up for myself, not letting others take advantage of me and saying “no” when I need to.

LIFE SKILLS

Yes No Sometimes I have and use good listening, honest communication and healthy conflict resolution skills.

Yes No Sometimes I have the training and skills I need to do my job well, or all the skills I need to do well in school.

Yes No Sometimes I know how to set a goal and take the steps to achieve it.

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QUIZ: Part 2

People also successfully overcome life difficulties by drawing upon internal qualities that research has shown are particularly helpful when encountering a crisis, major stressor, or trauma.

The following list can be thought of as a “personal resiliency builder” menu. No one has everything on this list. When “the going gets tough” you probably have three or four of these qualities that you use most naturally and most often. It is helpful to know which are your primary resiliency builders; how have you used them in the past; and how can you use them to overcome the present challenges in your life.

You can also decide to add one or two of these to your “resiliency-builder” menu, if you think they would be useful for you.

PERSONAL RESILIENCY BUILDERS: Individual Qualities that Facilitate Resiliency

Put a + by the top three or four resiliency builders you use most often. Ask yourself how you have used these in the past or currently use them. Think of how you can best apply these resiliency builders to

current life problems, crises, or stressors. Next, put a by one or two resiliency builders you think you should add to your personal repertoire.

Relationships — Sociability/ability to be a friend/ability to form positive relationships Service – Giving of yourself to help other people; animals; organizations; and/or social causes Humor — Having and using a good sense of humor Inner Direction — Basing choices/decisions on internal evaluation (internal locus of control) Perceptiveness — Insightful understanding of people and situations Independence — “Adaptive” distancing from unhealthy people and situations/autonomy Positive View of Personal Future – Optimism; expecting a positive future Flexibility — Can adjust to change; can bend as necessary to positively cope with situations Love of Learning — Capacity for and connection to learning Self-motivation — Internal initiative and positive motivation from within Competence — Being “good at something”/personal competence Self-Worth — Feelings of self-worth and self-confidence Spirituality — Personal faith in something greater Perseverance — Keeping on despite difficulty; doesn’t give up Creativity — Expressing yourself through artistic endeavor, or through other means of creativity

You Can Best Help Yourself or Someone Else Be More Resilient by…

Communicating the Resiliency Attitude… say: “What is right with you is more powerful than anything wrong with you.”

Focusing on the person’s strengths more than problems and weaknesses… ask: “How can these strengths be used to overcome problems?” One way to do this is to help yourself or another person identify and best utilize the top personal resiliency builders listed in The Resiliency Quiz Part Two

Providing for yourself or another person the conditions listed in The Resiliency Quiz Part One.

Having patience…successfully bouncing back from a significant trauma or crisis takes time.

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AUTHOR #2: Resiliency According to: Kenneth Ginsburg, M.D., MS Ed, FAAP Kenneth Ginsburg, M.D., MS Ed, FAAP, is a pediatrician specializing in adolescent medicine at The Children’s Hospital of Philadelphia (CHOP). He has joined forces with the American Academy of Pediatrics (AAP) to author a guide to building resiliency in children. Dr. Ginsburg has identified seven “C”s of resilience, recognizing that “resilience isn’t a simple, one-part entity.” Using these guidelines can help children recognize their abilities and inner resources.

Competence Competence describes the feeling of knowing that you can handle a situation effectively.

1. Focus on your individual strengths 2. Focusing any identified mistakes on specific incidents 3. Gain empowerment from making good decisions 4. If adults in your life are so protective that you feel they believe you are incompetent, discuss this with

them, expressing what you need from them to feel competent. 5. Do not allow adults to compare you to your siblings. You are an individual who has individual interests and

talents.

Confidence Your belief in your own abilities is derived from competence. Build confidence by:

1. Focusing on your strengths 2. Be aware of the presence of the best qualities in you such as fairness, integrity, persistence, and kindness 3. Recognizing when you have done well 4. Graciously accept honest praise about specific achievements. You’ve earned it! 5. Do not take on more than you can realistically handle.

Connection

Developing close ties to family and community creates a solid sense of security that helps lead to strong values and prevents alternative destructive paths to love and attention. You can connect with others by:

1. Having a sense of physical safety and emotional security within your home 2. Develop ties with people who allow you to openly express all of your emotions. You want to feel comfortable

reaching out to these people when times are difficult. 3. Addressing conflict openly in your family to resolve problems 4. Create a common area where you can share time with your family – not necessarily TV time. 5. Foster healthy relationships that will reinforce positive messages, habits and choices.

Character

We all need a solid set of morals and values to determine right from wrong and to demonstrate a caring attitude toward others. To strengthen your character, start by:

1. Develop relationships with adults that demonstrate how behaviors affect others 2. Develop relationships with adults who can help you recognize yourself as a caring person. 3. Develop relationships with adults who demonstrate the importance of community. Encouraging the

development of spirituality 4. Avoiding associating with those who make racist or hateful statements or use such stereotypes

Contribution

The world is a better place because you are in it. Understanding the importance of your personal contribution can serve as a source of purpose and motivation. Contribute by:

1. Recognize that many children do not have what you have. 2. Serving others is important, so being around generous people will motivate you to do so. 3. Look for ways to contribute to your local and/or global community.

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Coping Learning to cope effectively with stress will help you be better prepared to overcome life’s challenges. You should:

1. Watch for adults who model positive coping strategies on a consistent basis. 2. Develop the positive and effective coping strategies you observe. 3. Just trying to stop negative behaviors will likely not work unless you use utilize strategies to break the

habits you’ve formed 4. Many risky behaviors are attempts to alleviate the stress and pain in your daily life. Stop and think before

you act. Ask yourself… why am I doing this. 5. You should not allow yourself to feel a sense of shame when you use negative coping behaviors. You are

young. Work harder or try new strategies to eliminate them. You may need to ask an adult for help in doing so. There is no shame in that either!

Control

You can control the outcomes of your decisions with practice. The more you gain control over the choices you are making in your life, the greater your ability to bounce back from stress and disappointment. You can empower yourself by:

1. Understand that life’s events are not purely random and that most things that happen are the result of another individual’s choices and actions

2. Understand that discipline is about teaching, not an adult trying to punish or control you. Disciplinary action conditions us to understand that our actions have consequences.

Dr. Ginsburg summarizes what your parents can do to help you become resilient as follows:

1. Children need to know that there is an adult in their life who believes in them and loves them unconditionally.

2. Kids will live “up” or “down” to our expectations.

Share this information with the adults and peers in your life so they can help you build resiliency. Self-Evaluation: Provide and honest rating of your resiliency skills for each of Ginsburg’s 3 C’s described above using the following scale… 1=needs improvement; 2=adequate; 3=proficient. Give your rationale for each in the space to the right. Competence Confidence Connection Character Contribution Coping Control

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The Brain: Understanding How You Learn Name Per

Which of the following best describes how you learn?

o Auditory Learner: You learn by listening to verbal communication or through reading… you learn best through reading (listening to your own voice in your head or reading aloud and/or teacher lecture.)

o Example – If you read a chapter in a textbook, take notes on key points and study those by reading them, you are ready for a test.

o Visual Learner: You learn by seeing… you learn best when a demonstration accompanies an explanation. o Example – Your math teacher gives you an explanation of how to solve a problem while you are looking at the

equation in your textbook. When your teacher visually solves the problem on the board before you, your comprehension of the formula becomes understood.

o Kinesthetic Tactual: You learn by doing… you learn best when you actually get your hands on what you’re trying to learn. o Example – Your math teacher has given you an explanation of how to use a formula. You watch as they explain it

on the board, but your comprehension of its use doesn’t fully take until you do a few problems on your own.

Can I improve my ability to study? YES… and it will be a tremendous help in managing your stress.

Need Study Advice? http://www.studygs.net This website provides detailed folders on the following topics about how you can best achieve your academic goals. Remember, you may currently be able to study very little but even the most talented students will be challenged at the college level. It is best to learn how to learn NOW!

Losing the Time Management Battle? Learn why, here: http://www.studygs.net/schedule/ OR… complete the chart below…

Complete the chart below, and then fill in the blank to the right with the amount of time remaining in your day of 24 hours.

Daily Activities Hours spent Daily Activities Hours spent

Sleeping Exercise/sports

Personal care/grooming Transportation (school, work, etc.)

Meal preparation/eating/clean-up Work/internship

Family commitments Classes

Socializing/entertainment (with friends) Studying

Relaxing/TV/video games, etc. (alone) Other

*Highly recommended for students with learning differences

Writing

Memorizing/Testing

Teaching/Curriculum

*Learning/Studying

Time/Project

Management

Reading/Research

Workplace

Math Bibliographies

Exercises/Games

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Making Your School Day “Stick”… Are you learning for a test or learning for your future? It is important to note that our educational system is set up by grade levels to create a progression where – in theory – what you need for each consecutive grade is taught in the previous grade. For example, what you learn in Math this year will be necessary in your next math course. That is the purpose behind the noted “prerequisites” listed in the Course Selection Book you will soon receive. SO… how do we make that information “stick”? In other words, how do we learn information for our future and not just for the test we have to take this week? For example, when information “sticks” we don’t have to waste time studying it over again when we study for midterms. What’s the difference between memorizing and learning? Why is it important to make short term memories (new information learned today) into long term memories (information that is always with you and applicable to daily life)?

https://www.youtube.com/watch?v=XB65VBuepfc (1:21) What is the Link between memory and sleep?

https://www.youtube.com/watch?v=ObuaXhtKbVY (2:32)

Let’s summarize…

1. How would you describe how you learn? (Auditory, Visual, Kinesthetic/Tactual)

2. What bad study habits have you developed that you need to break? (studying while on Facebook, etc.)

3. How do you plan to break those habits? (set alarms for myself, ask someone in my home for help, etc.)

4. Based on how you learn, what study techniques would work best for you? (flashcards, listening to notes…)

5. What parts of the studygs.net website are you recommending to yourself?

6. The next segment of the unit focuses on SLEEP… how many hours of sleep do you currently get each night? OPTIONAL TEACHER VIDEOS FOR CLASS USE… https://www.youtube.com/watch?v=zAwwJ-gng4w http://channel.nationalgeographic.com/channel/sleepless-in-america/videos/sleepless-in-america1/

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NOTES ON OPTIONAL TEACHER VIDEOS:

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Adapted from article by Mayo Clinic Staff, “Teen Sleep, Why is Your Teen So Tired”.

Teens are notorious for wanting to stay up late and for not wanting to get up early. If you are no exception, find out

what's behind this behavior and how you can get better sleep — starting tonight.

Everyone has an internal clock that influences body temperature, sleep cycles, appetite and hormonal changes. The

biological and psychological processes that follow the cycle of this 24-hour internal clock are called circadian rhythms.

Puberty changes a teen's internal clock, delaying the time he or she starts feeling sleepy and awakens.

Most teens need about nine hours of sleep a night — and sometimes more — to maintain optimal daytime alertness.

But few teens actually get that much sleep regularly, thanks to factors such as part-time jobs, early-morning classes,

homework, extracurricular activities, social demands, and use of computers and other electronic gadgets.

Sleep deprivation might not seem like a big deal, but it can have serious consequences. Tired teens can find it difficult

to concentrate and learn, or even stay awake in class. Too little sleep also might contribute to mood swings and

behavioral problems. Drowsy driving can lead to serious — even deadly — accidents.

If you aren’t getting enough sleep, there are a few things that you can try to help. For example:

Stick to a schedule. Tough as it might be, keep weekday and weekend bedtimes and wake times within two

hours of each other. Prioritize extracurricular activities and curb late-night social time as needed. If you have a job,

limit working hours to no more than 16 to 20 hours a week.

Nix long naps. If you are drowsy during the day, a 30-minute nap after school might be refreshing. Be cautious,

though. Too much daytime shut-eye might only make it harder to fall asleep at night.

Curb the caffeine. A jolt of caffeine might help you stay awake during class, but the effects are fleeting — and too

much caffeine can interfere with a good night's sleep.

Keep it calm. Wind down at night with a warm shower, a book or other relaxing activities.

Know when to unplug. Take the TV out of your room. Minimize use of electronics in the hour before bedtime.

Adjust the lighting. If you do use a phone or tablet near bedtime, turn down the brightness and hold the device at

least 14 inches (36 centimeters) away to reduce the risk of sleep disruption. In the morning, expose yourself to

bright light. These simple cues can help signal when it's time to sleep and when it's time to wake up.

Sleeping pills and other medications generally aren't recommended. For many teens, lifestyle changes can effectively

improve sleep. In some cases, excessive daytime sleepiness can be a sign of a problem, including:

Medication side effects. Many medications — including over-the-counter cold and allergy medications and

prescription medications to treat depression and attention-deficit/hyperactivity disorder — can disrupt sleep. For

more information, go to mayoclinic.org

Insomnia or biological clock disturbance. If you have trouble falling asleep or staying asleep, you are likely to

struggle with daytime sleepiness.

Depression. Sleeping too much or too little is a common sign of depression.

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Obstructive sleep apnea. When throat muscles fall slack during sleep, they stop air from moving freely through

the nose and windpipe. This can interfere with breathing and disrupt sleep. You might notice loud snoring or

intermittent pauses in breathing, often followed by snorting and more snoring.

Restless legs syndrome. This condition causes a "creepy" sensation in the legs and an irresistible urge to move

the legs, usually shortly after going to bed. The discomfort and movement can interrupt sleep.

Narcolepsy. Sudden daytime sleep, usually for only short periods of time, can be a sign of narcolepsy. Narcoleptic

episodes can occur at any time — even in the middle of a conversation. Sudden attacks of muscle weakness in

response to emotions such as laughter, anger or surprise are possible, too.

If you're concerned about your daytime sleepiness or sleep habits, contact your doctor. If you are depressed or have a

sleep disorder, proper treatment can be the key to a good night's sleep.

References 1. Moore M, et al. The sleepy adolescent: Causes and consequences of sleepiness in teens. Paediatric Respiratory Reviews. 2008;9:114. 2. Millman R. Excessive sleepiness in adolescents and young adults: Causes, consequences, and treatment strategies. Pediatrics. 2005;115:1774. 3. Crowley SJ, et al. Sleep, circadian rhythms, and delayed phase in adolescence. Sleep Medicine. 2007;8:602. 4. Noland H, et al. Adolescents' sleep behaviors and perceptions of sleep. Journal of School Health. 2009;79:224. 5. Findlay SM. The tired teen: A review of the assessment and management of the adolescent with sleepiness and fatigue. Paediatrics and Child Health.

2008;13:37. 6. Calamaro CJ, et al. Adolescents living the 24/7 lifestyle: Effects of caffeine and technology on sleep duration and daytime functioning. Pediatrics.

2009;123:e1005. 7. Bonin L. Unipolar depression in children and adolescents: Epidemiology, clinical features, assessment, and diagnosis. http://www.uptodate.com/home.

Accessed Aug. 1, 2014. 8. Danner F, et al. Adolescent sleep, school start times, and teen motor vehicle crashes. Journal of Clinical Sleep Medicine. 2008;4:533. 9. Wahlstrom K. School start time and sleepy teens. Archives of Pediatric and Adolescent Medicine. 2010;164:676. 10. Kliegman RM, et al. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa.: Saunders Elsevier; 2011. http://www.clinicalkey.com. Accessed July 31, 2014. 11. Are smartphones disrupting your sleep? Mayo Clinic study examines the question. Mayo Clinic. http://www.mayoclinic.org/news2013-rst/7505.html. Accessed

Aug. 4, 2014. Sep. 20, 2014 Original article: http://www.mayoclinic.org/healthy-living/tween-and-teen-health/in-depth/teens-health/art-20046157

.

© 1998-2014 Mayo Foundation for Medical Education and Research. All rights reserved.

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Name: Period:

AN INTRODUCTION TO STRESS There are three names associated with early stress research – Dr. Hans Selye, Dr. Thomas Holmes and Dr. Richard Rahe. Their research has proven to be the basis for all we know about stress and its effects on the body and mind today. Anything that causes stress is known as a STRESSOR. There are many stressors in our lives and they can be either positive (EUSTRESS) or negative (DISTRESS). Stressors may also start out as one form of stress and become the other. For example, if I win the lottery it would be Eustress… but when taxes are due and strangers I’ve never met start knocking on my door asking for money it can be a daunting task to make decisions as to how to disperse that newly found wealth. Eustress can serve to motivate us and trigger the release of “happy hormones” that make us feel moments of happiness, joy, excitement and euphoria. Distress, when prolonged can serve to wear us down both physically and psychologically or even cause illness or disease. Regardless of which form it takes, stress is a necessary part of our lives since too much of either can lead to a non-productive life. Take a moment and list some examples of both forms below:

EUSTRESS: DISTRESS: 1. 1.

2. 2.

3. 3.

4. 4.

5. 5.

The Science of Stress http://video.nationalgeographic.com/video/player/science/health-human-body-sci/human-body/science-stress-sci.html

VIDEO NOTES:

VIDEO QUESTIONS: Explain each of the following using the information provided in the video:

Define Cortisol:

Define Adrenaline:

Physical Stress vs. Psychological Stress

1. What is the difference in the way the body PRODUCES Cortisol & Adrenaline while under physical vs. psychological stress?

2. What is the difference in the way the body BURNS Cortisol & Adrenaline while under physical vs. psychological stress?

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MEASURING STRESS – HOW MUCH IS TOO MUCH?

Two scales have been created to determine the impact of stress on our daily lives as adults. One has been created to determine the impact of stress for youth such as yourselves. The information that follows will help you to understand the two – both are widely used, both serve a purpose depending on what we wish to learn about the impact of stress on an individual’s life. We will use only the youth scale in class, but the adult versions are provided as well. In 1967, Holmes & Rahe Social Re-Adjustment Rating Scale (SRRS) for identifying major stressful life events. According to this scale, one of the 43 stressful life events was awarded a “life change unit” depending on how traumatic it was felt to be by a large sample of participants. So, a total value for the sum of all stressful life events in one year of a person’s life can be calculated. The total value was summed up in their research as follows:

150 life change units = 30% chance of suffering from stress 150-299 life change units = a 50% chance of suffering from stress

300+ life change units = an 80% chance of developing a stress-related illness The scale is still used today for ADULTS with the understanding that it is a general tool to measure stress-related illness risk. The study is based on the responses of the participants and not all stressors will affect all people in the same way. An individual persons coping skills and resiliency cannot be factored into the scale. In addition, the 43 life changes aren’t every day events. Holmes & Rahe created a scale for youth in the 1980’s. That scale is the one we will work with in class today.

The Hassles & Uplifts Scale developed by Kanner, Coyne, Schaefer & Lazarus in 1981 takes into account things such as losing things, traffic jams, arguments, disappointments, weight & physical appearance, etc. As with the SSRS, individuals will respond differently to each of the items on the list. The sample scale below was created specifically for College-Age Students.

KANNER, COYNE, SCHAEFER & LAZARUS and the HASSLES AND UPLIFTS SCALE OF 1981

HOLMES & RAHE and the SOCIAL READJUSTMENT RATING SCALE OF 1967

Scrap Section for totaling

points:

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Holmes-Rahe Stress Scale for Youth Check the items below that you have had to cope with in the last 12 months. At the end, you will be able to put your past year in perspective to your total health.

Holmes & Rahe Social Re-Adjustment Rating Scale (SSRS) for Youth SCORING: Each event should be considered if it has taken place in the last 12 months. Add values to the right of each item to obtain the total score. Your susceptibility to illness and mental health problems is as follows:

Low < 149 – You are relatively stress free. Your risk of having any health problems due to stress is low Mild = 150-200 – You have a 33% chance of developing stress related illness. Moderate = 200-299 – You are having a kind of tough time right now. You have a 50% chance of developing stress conditions Major >300 – You are having a major life crisis right now. You have an 80% chance of having a major stress illness within the next two years.

Stress-Related Illnesses/Conditions may include: headache, diabetes, fatigue, hypertension, chest/back pain, ulcers, others

Scrap Section for Calculating Score:

EVENT VALUE EVENT VALUE

Death of spouse, parent, boyfriend/girlfriend 100 Gain of new family member (new baby born or parent remarries)

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Divorce (of yourself or your parents) 65 Change in work responsibilities 35

Puberty 65 Change in financial state 30

Pregnancy (or causing pregnancy) 65 Death of a close friend (not a family member)

30

Marital separation or breakup with boyfriend/ girlfriend

60 Change to a different kind of work 30

Jail term or probation 60 Change in number or arguments with mate, family or friends

30

Death of other family member (other than spouse, parent or boyfriend/girlfriend)

60 Sleep less than 8 hours per night 25

Broken engagement 55 Trouble with in-laws or boyfriend's or girlfriend's family

25

Engagement 50 Outstanding personal achievement (awards, grades, etc.)

25

Serious personal injury or illness 45 Mate or parents start or stop working 20

Marriage 45 Begin or end school 20

Entering college or beginning next level of school (starting junior high or high school)

45 Change in living conditions (visitors in the home, remodeling house, change in roommates)

20

Change in independence or responsibility 45 Change in personal habits (start or stop a habit like smoking or dieting)

20

Any drug and/or alcoholic use 45 Chronic allergies 20

Fired at work or expelled from school 45 Trouble with the boss 20

Change in alcohol or drug use 45 Change in work hours 15

Reconciliation with mate, family or boyfriend/girlfriend (getting back together)

40 Change in residence 15

Trouble at school 40 Change to a new school (other than graduation)

10

Serious health problem of a family member 40 Presently in pre-menstrual period 15

Working while attending school 35 Change in religious activity 15

Working more than 40 hours per week 35 Going in debt (you or your family) 10

Changing course of study 35 Change in frequency of family gatherings 10

Change in frequency of dating 35 Vacation 10

Sexual adjustment problems (confusion of sexual identify)

35 Presently in winter holiday season 10

Minor violation of the law 5

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UNDERSTANDING HOW STRESS IMPACTS THE PHYSIOLOGY OF YOUR BODY

THE ANATOMY OF THE STRESS RESPONSE

STRESSOR

PERCEIVED “DANGER”

BRAIN

ENDOCRINE SYSTEM

HYPOTHALAMUS

PITUITARY GLAND ADRENAL GLANDS Release “Adrenaline” which is actually two chemicals:

“Ephinephrine” & “Norephinephrine”

RELEASE OF ACTH to BLOODSTREAM

ADRENAL GLANDS PRODUCE: Corticosteroids or Cortisol

AUTONOMIC NERVOUS SYSTEM (SYMPATHETIC DIVISION)

TRIGGERS THE “FIGHT OR FLIGHT” RESPONSE

… And the symptoms of the “ALARM STAGE” of “The G.A.S. Principle”

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GENERAL ADAPTATION SYNDROME (The G.A.S. Principle)

Developed by Dr. Hans Selye “The Father of Modern Stress Research”

Three Stages of the Stress Response STAGE #1: THE ALARM STAGE – the body prepares itself for fight or flight. Symptoms include: pupils dilate throat muscles contract heart rate & stroke volume increase breathing rate increases; dry mouth adrenal glands secrete adrenaline liver and kidneys constrict digestion slows perspiration increases flushing muscles tense and tighten endorphins are released (the body’s natural painkillers)

STAGE #2: RESISTANCE – the body tries to cope and adjust to the stressor(s)

STAGE #3: EXHAUSTION – the body gives in when the stressors are not removed; symptoms of the alarm stage return; if this stage is prolonged, illness or death may result.

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NOTES ON THE G.A.S. PRINCIPLE:

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STRESS REDUCTION TECHNIQUES

PHYSICAL TENSION/STRESS:

PROGRESSIVE MUSCULAR RELAXATION 1: Female Voice https://www.youtube.com/watch?v=KRUdkxQOqWM

PROGRESSIVE MUSCULAR RELAXATION 2: Male Voice https://www.youtube.com/watch?v=TwCITgdBzI4

MENTAL TENSION/STRESS:

USING MUSIC TO RELAX: This attached YouTube link below is a sample of music that can be used with the 2nd PMR Exercise above OR you can use it while studying, reading, stretching, doing yoga, etc. If this music isn’t your “thing”, begin searching for music that has a SLOW to MODERATE tempo, no lyrics (that’s REALLY important), no loud, low bass and a soft, smooth rhythm. For some people, environmental sounds work well. REMEMBER… you want to relax and de-stress, not necessarily sleep! https://www.youtube.com/watch?v=Hl1P0f_z9P8

TAKE A BREAK TO DO SOMETHING FUN

TAKE A 10-20 MINUTE NAP

TIME MANAGEMENT - USE THE STUDYGS.NET WEBSITE AND WORK ON MANAGING YOUR TIME MORE EFFICIENTLY EMOTIONAL TENSION/STRESS:

SOME SUGGESTIONS: JOURNAL WRITING, PHYSICAL EXERCISE, LISTEN TO MUSIC WITH POSITIVE/OPTIMISTIC LYRICS, TALK TO SOMEONE WITH WHOM YOU FEEL COMFORTABLE SHARING YOUR FEELINGS, DRAW, WRITE, PLAY MUSIC – USE A CREATIVE OUTLET.

Practical Stress & Time Management Notes

1) Know who you are. When you know who you are, you are most likely to make choices that will not lead to compromising your values and your conscience… better known as the proverbial “guilty conscience” effect”.

Your Beliefs – compromising your belief system will take its toll on your mental health and prevent you from managing your time effectively.

Your Path – both short and long term goals for your future – don’t do anything that will take you from your path! Surround yourself with people who are aware of your goals and support the steps you need to take to attain them.

Your Commitment – Are you resilient? Can you persevere? Are you aware?

Your Awareness – are you aware of the things you are doing that are counterproductive to time management?

Your Perspective – remember – there are many ways to look at things! Is your glass half empty or half full? 2) Time Management - Homework: Your work as a student is one of your top priorities in life for the next four years. Use the Study GS website to analyze your current schedule to see how you currently spend your time. Be Honest! For example, if you think it takes you 15 minutes to get to school by car, does that include the time it takes for you to walk outside, enter a vehicle, pull out, drive (with traffic, stop signs and traffic lights), enter the school area traffic, deal with the parking lot/traffic and walk into the building to your classroom??

3) Use what you learned in #2 above to PLAN for your top priorities every day… most will find they fall in this order…

FAMILY RESPONSIBILITIES

SCHOOL – ACADEMICS

SCHOOL – EXTRACURRICULAR

PERSONAL HEALTH – EXERCISE, DIET, “ME TIME”, SLEEP

SOCIAL HEALTH – FRIENDS WHO ARE BEST SUITED TO YOUR GOALS/PLANS COME FIRST!

4) If it’s not getting you to your goal/plan, CHANGE IT!

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WE MUST REMEMBER… WE CAN RE-INVENT OURSELVES EVERY MINUTE OF THE DAY – JUST MAKE THE CHOICE TO BE WHO YOU CHOOSE TO BE AND ACT

ON IT… NO ONE HAS MORE CONTROL OVER YOUR FUTURE THAN YOU DO! ONCE CHOICE CAN MAKE THE DIFFERENCE…

MAKE CHOICES THAT ALLOW YOU TO MAKE CHOICES! What?! What does that mean??? It means if you are not of sound mind, you cannot consciously make the choice you would have made if you were. Does a drunk make a “choice” to drink and drive? If not, when does the “choosing” occur? EXPLAIN BELOW…

COPING & TIME MANAGEMENT SKILLS 1. Effective coping and time management skills can decrease the chance of stress ailments such as:

a. Muscle tension/tension headaches b. Immune system suppression c. Inability to concentrate/multitask/problem solve d. Decrease emotional outbursts and increase patience e. Increased blood flow, oxygen uptake and cardiac output with decreased blood pressure and respirations –

especially when coupled with regular exercise 2. Seeking and maintain your ‘comfort zone’ for stress – too much or too little is not good! 3. Completing unfinished business whenever possible 4. Maintaining control over the events in our lives which we can control 5. Release the burden of those events out of our control 6. Increasing our awareness of ourselves and releasing control of those we cannot control 7. Admitting and dealing constructively with our emotions 8. Maintaining honest communication with family, friends, co-workers, and others 9. Dealing with the here and now 10. Enjoying little things every day 11. Maintaining a positive self-concept by believing in ourselves 12. Not becoming absorbed in ourselves (self-pity), but doing things for others instead 13. Not depending on drugs and alcohol 14. Actively pursuing personal growth experiences 15. Seeking information and advice when we need to… remember that asking for help when we need it is healthy, even

though society may believe in “rugged individualism” and self-sufficiency 16. Managing time efficiently – doing the most important things first, taking time to meet personal needs, and discarding

nonessential tasks. Stop trying to do everything in a limited amount of time! 17. Have the following in place for a good social support system:

a. Listening b. an active listener c. does not judge you d. will give advice when you ask e. share successes, failures, or just let off

steam f. technical appreciation g. someone who is expert in your area h. someone whose honesty and integrity we

trust i. technical challenge j. challenges us – challenge produces

growth and excitement in our lives

k. emotional support l. willing to be on our side no matter what,

through thick or thin m. unconditional acceptance within reason n. emotional challenge o. people who are willing to question our

excuses, our goals, our choices p. help you cut through the emotions to

more constructive decisions q. share social reality r. reality checks s. asks the questions that give validity to the

world as you see it

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PRACTICAL STRESS REDUCTION TECHNIQUES Written version of previous exercise for use on your own

Note: It is recommended that you consult your physician before starting a program for lifestyle change. If you need assistance with these or other relaxation techniques, contact a health professional. RELAXATION – DEEP BREATHING: One of the body’s automatic reactions to stress is rapid, shallow breathing. Breathing slowly and deeply is one of the ways you can “turn off” your stress reaction and “turn on” your relaxation response. The Basic Technique: Deep breathing is a simple technique that is basic to most other relaxation skills. By inhaling deeply and allowing your lungs to breathe in as much oxygen as possible, you can begin to relieve the tension that can lead to negative stress. And, best of all, deep breathing can be done anywhere and at any time. Try to practice deep breathing for a few minutes three or four times a day, or whenever you begin to feel tense.

Sit or stand (using good posture) and place your hands firmly and comfortably on your stomach. Inhale slowly and deeply through your nose, letting your stomach expand as much as possible. Many people are “backward breathers” – they tend to tighten their stomachs when breathing in. By placing your hands on your stomach, you can actually feel when you are breathing properly. When you’ve breathed in as much as possible, hold your breath for a few seconds before exhaling.

With your hands on your stomach, exhale slowly through your mouth, pursing your lips as if you were going to whistle. By pursing your lips, you can control how fast you exhale and keep your airways open as long as possible. As you exhale, your stomach deflates, while the large muscle under your lungs (the diaphragm) expands. When your lungs feel “empty”, begin the inhale-exhale cycle again. Try to repeat this cycle three or four times at each session.

VISUALIZATION: This is a sort of “Mental Vacation”! A license to daydream! You can produce feelings of relaxation simply by using your imagination. Unlike clearing your mind where you try to focus on one single image, visualization allows your imagination to run free. Visualize how you feel – warm, relaxed, calm, etc. and/or where you are – smell the beach, hear the waves, see the sand, feel the sun! PROGRESSIVE MUSCULAR RELAXATION: The techniques described up until now are most helpful for people who know what relaxation feels like, but who may not know who to concentrate on relaxing. But what if you are so “geared-up” that you’re not even sure how it feels to relax? Progressive muscular relaxation is a technique that can help you actually feel the difference between tension and relaxation. The Basic Technique: Progressive muscular relaxation is a three-step technique. First, you tense a muscle and notice how it feels; then, you release the tension and pay attention to that feeling; and finally, you concentrate on the difference between the two sensations. This exercise can be done while sitting or lying down, and only takes about fifteen minutes. It helps if you can practice the technique in a quiet, relaxing atmosphere.

Tighten your hand muscle and make a fist; then notice how it feels. Your muscles are taut and strained, and your hand may even be trembling slightly. You may feel tension in your hand, wrist, and lower arm. Hold the tension for a few seconds before relaxing.

Release your hand, relax your fist, and let the tension slip away. You may notice that your hand feels lighter than it did while your muscle was tensed, and that your wrist and forearm also feel relieved of pressure.

Notice the difference between how your hand felt when tensed and how it felt when you released the tension. Does your hand tingle or feel warm when relaxed? Did the throbbing you felt when tense, disappear when you relaxed?

Progression of the Technique: It is most helpful to try this exercise on each of the major muscle groups of your body. The basic technique remains the same for each group: tighten the muscle, release the tension, then notice the difference. You can start with your hands, then progress to other muscles, or you can begin the exercise moving from “head-to-toe” tightening and relaxing the muscles in your face, shoulders, arms, hands, chest, back, stomach, legs and feet.

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RELAXATION – CLEARING YOUR MIND: Another relaxation technique that can help reduce stress is “clearing your mind”. Since your stress response is a physical and emotional interaction, giving yourself a mental “break” can help relax your body as well. When you clear your mind, you try to concentrate on one pleasant thought, word, or image and let the rest of your worries slip away. The Basic Technique: Clearing your mind forms the basis for other relaxation techniques such as meditation. The principle of clearing your mind is really quite simple – by allowing yourself to mentally focus on a single, peaceful word, thought, or image, you can create a feeling of deep relaxation. Clearing your mind helps you take a mental and physical retreat from the “outside world”, and helps you balance the stress of everyday life. RELAXATION - AUTOGENICS: Yet another relaxation technique is autogenic training. If you’ve ever heard the expression “mind over matter”, then you may already have a basic idea of what autogenic training is all about. By giving yourself mental “cues”, you can literally tell your body how to feel, and produce the relaxation response whenever you feel tense or under stress. The Basic Technique: Autogenics is a progressive technique. You begin by concentrating on a mental suggestion such as, “My left arm feels heavy and warm.” As you concentrate on this “command”, try to actually feel your arm getting heavier and warmer. Then repeat the same command, focusing on your right arm, left leg, right leg, and so on. Try to practice this exercise for about ten minutes, twice a day, or whenever you feel stressed.

Sit comfortably, loosen any tight clothes, close your eyes, and try to clear your mind. You may wish to breathe deeply for a few moments and repeat a peaceful suggestion such as, “I feel quiet”, “My mind is at rest”, or something similar.

Mentally focus, on your left arm and repeat to yourself “My left arm feels warm and heavy”, until it begins to feel warmer and heavier. Then try the same command, focusing on your right arm, left leg, right leg, and so on, until you feel completely relaxed.

Breathe deeply and stretch as you finish the exercise. Open your eyes, exhale slowly, and notice how you feel. As you become better and better at this technique, you’ll be able to help your body relax anywhere, at any time.

Progression of Autogenics: Autogenics is a technique that requires practice, time, and commitment – but the benefits you gain are well worth the investment. Start by practicing autogenics twice a day for about ten minutes each session. Within four to eight weeks, you may be able to produce this relaxation response with as little as five minutes of concentrated effort. And, as you progress, you’ll find that it’s easier and easier to help your body relax when you “put your mind to it”.

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NOTES ON PRACTICAL STRESS MANAGEMENT

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