2-Day: Anxiety Certification Course

CPD

Handouts

Faculty

Janene Donarski, PhD, LP, LMSW, CCATP Related seminars and products

---

Janene M. Donarski, PhD, LP, LMSW, CCATP, is a fully licensed clinical psychologist and licensed master social worker who works in counseling therapy as well as psychological testing for mental health issues. Dr. Donarski specializes in neuropsychological assessment of children, adolescents, adults and geriatric populations including head injury, organic issues, emotional and complex behavior disorders. Dr. Donarski works extensively with anxiety issues including panic, hypervigilance and PTSD. She trains others in techniques of relaxation, reduction of fear, and exposure therapies to reduce triggers and symptoms in daily life. She also assists in testing within the academic areas including ADHD, learning disabilities and autism for IEPs and/or 504 plans/behavior plans.

Dr. Donarski works with all population counseling/therapy, including individual, martial/couple, family, LGBTQ, and group counseling. She is a certified EMDR Level II counselor as well as a certified hypnotherapist and practitioner for Neuro-Linguistic Programming and Time Line Therapy®.

Dr. Donarski is also experienced in working with victims of violence, foster care/adoption issues, sexual issues, as well as those who are seeking sex offender treatment. She often works with attorneys as a forensic psychologist/expert witness for legal cases involving custody, guardianship, social security benefits, and criminal cases. Dr. Donarski has spoken on a variety of mental health issues, including somatic ailments, behavioral disorders and mental health concerns in the geriatric population.

Speaker Disclosures:
Financial: Dr. Janene Donarski maintains a private practice. She receives a speaking honorarium and recording royalties from PESI, Inc. She has no relevant financial relationships with ineligible organizations.
Non-financial: Dr. Janene Donarski is a member of the American Psychological Association, the Michigan Psychological Association, the National Association of Social Workers, the American Counseling Association, and others. For a complete list, please contact info@pesi.com.

Objectives

1. Analyze the underlying neurological processes that impact anxious symptoms for clients.
2. Evaluate the neurological processes underlying anxiety in a clearly understandable manner that enhances client motivation.
3. Develop client engagement in treatment using personalized goals and attending to the therapeutic relationship.
4. Prepare personalized goals to increase client engagement and focus client efforts on making lasting changes in the brain.
5. Evaluate the differences between amygdala-based and cortex-based anxiety symptoms and identify how these symptoms inform treatment interventions.
6. Apply strategies for calming and training the amygdala to alleviate symptoms of anxiety.
7. Develop methods for teaching clients to retrain the cortex so that anxiety is resisted rather than exacerbated.
8. Assess appropriate treatment interventions by determining whether the client is experiencing rebound anxiety or relapse symptoms.
9. Analyze how psychotropic medication impacts neuroplasticity in the brain; identify related treatment implications.
10. Use reframing exposure as an opportunity to teach the amygdala new responses to improve client engagement and treatment compliance.
11. Execute client education exercises that can be utilized in session to train clients in the use of mindfulness techniques.
12. Employ clinical strategies for managing comorbid depression that reduce worry, rumination, and common cognitive errors while promoting positive thinking and social interaction.

Outline

• Positives:
  • Causes and treatments known
  • Can explain the neurological symptoms
  • Science provides evidence, authority
  • De-stigmatizes disorders
• Clinician concerns:
  • You don’t have to be a neuroscientist
  • Oversimplification is inevitable
  • Finding the right level of explanation is essential

• Don’t neglect the therapeutic relationship
• Focus on personalized goals
• Address the challenges of anxious clients
• Remember that strategies are effortful
• Guide the process using client’s goals
• Maintain motivation

• Defined in everyday language
• Neurologically informed therapy goal
  • ”Change the brain” in desired ways
  • Make the brain more resistant to anxiety
  • Create a new self
• Re-consolidation: The modification of emotional memories

• Strategies can be used to effectively “rewire” the brain
• Long history of evidence supporting efficacy
• Skills-based approach
• Strong focus on the present
• Psychoeducation is essential

• Amygdala – bottom-up triggering of emotion, physicality of anxiety
• Cortex – top-down emotion generation based in cognition
• How to explain the pathways to clients
• How anxiety is initiated in each pathway
• The pathways influence each other

• Use illustrations to create concrete understanding
• Fight/flight/freeze responses
• The “language of the amygdala”
• Anxiety and the cortex
• Help clients recognize the two pathways

• Sleep and the amygdala
• The influence of exercise
• Breathing techniques to reduce activation
• Relaxation, meditation, and yoga to modify responses
• Exposure as opportunities for the amygdala to learn
• Combating avoidance
• Indications that the amygdala can learn new responses
• Push through anxiety to change the amygdala

• ”Survival of the busiest” principle
• Strengthen or weaken specific circuitry
• The healthy (adaptive) use of worry in the cortex
• ”You can’t erase: You must replace”
• Recognize and modify the impact of uncertainty
• Training correct uses of distraction
• Left hemisphere techniques
  • Cognitive defusion
  • Coping thoughts
  • Fighting anticipation
• Right hemisphere techniques
  • Imagery
  • Music
• Mindfulness and anxiety resistances

• Medication’s effects in the rewiring process
• The myth of the chemical imbalance
• The danger of sedating the brain with benzodiazepines
• Promote neuroplasticity with SSRIs, SNRIs
• The effectiveness of CBT and meds

• Address anxiety as a component of many diagnoses
  • Depression, substance abuse, etc.
• Amygdala and cortex-based techniques that can help in other disorders
• Target brain-based symptoms rather than disorders
• Worry, obsessions, rumination respond to similar cortex-based techniques
• Panic, phobic responses, compulsions respond to amygdala-based techniques

Target Audience

• Psychologists
• Social Workers
• Counselors
• Speech-Language Pathologists
• Physicians
• Addiction Counselors
• Marriage and Family Therapists
• Psychiatric Nurses
• Nurse Practitioners
• Occupational Therapists
• Occupational Therapy Assistants