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6.3 Program Overview

6.3.4 Contents

In addition, various materials are needed at specific sessions in the child group, including (1) a large blank body outline (e.g., Fig. 6 of the Parent Manual), approx- imately the size of a white board or flip chart (or a large body outline can be drawn on the flip chart) for use in child sessions (C-Sessions) 1 and 2; (2) small toys or stuffed animals for the children to use when learning Balloon Breathing at C-Session 2 and each subsequent session; (3) the Sneaky Fears puppets starting in C-Session 2 and the Missy Mistake puppet starting in C-Session 6; (4) a blank laminated Feeling Thermometer (Fig. 8 of the Parent Manual) the size of a white board or flip chart (or a Feeling Thermometer can be drawn on the flip chart at C-Session 5 and each sub- sequent session; (6) a large laminated Bravery Ladder (Fig. 28 of the Parent Manual) along with laminated stick-on illustrations of the ‘steps to being friendly’ with Velcro on the back of each illustration (as detailed in Sect.10.3.3.1.1); and (7) a graduation certificate for each child at C-Session 8 (e.g., Fig.11.1). Table6.3summarizes the various aforementioned details about setting and materials that are recommended in the implementation of the Taming Sneaky Fears group CBT program with children.

6.3.3.3 Snack

Snack could be provided either by the professionals running the group or by the parents attending the group program. If parents provide the snack, a list of which parent is responsible for bringing the snack at which session is established during the Introduction Session (Sect.7.2.4). Prior to the end of each parent session, the parent group therapists remind the parents of who is responsible for bringing the snack to the following session. Socioeconomic and other variables can help to determine whether snack is provided by the professionals running the program or by parents attending the group. Snack typically consists of healthy and nutritious foods such as cheese and crackers, cut-up fruit, or a granola bar along with a juice box or water.

Allergies, other food tolerances, and/or specific dietary requirements must be taken into consideration when determining the snack. The role of Snack Time is detailed in Sect.8.4.6.1.

Fig. 6.3 Overview of concepts and skills covered in the Taming Sneaky Fears program

frequently revisited during subsequent sessions. With the children, the concept and related skills are covered over multiple sessions because young children require practice and repetition to master how to do a Body Scan (child sessions (C-Sessions) 1, 2, and subsequent sessions), how to use the Feeling Thermometer (C-Session 5 and subsequent sessions), and how to correctly use the relaxation strategies (C-Session 1 and every subsequent session).

Table6.4provides a detailed outline of the topics covered during the Introduction Session and each of the subsequent eight sessions of the Taming Sneaky Fears pro- gram, including the suggested number of minutes devoted to each topic or activity in the parent and child groups.

As seen in Table6.4, the Introduction Session differs from all subsequent sessions.

Chapter7focuses on this Introduction Session and provides step-by-step guidelines to implement it successfully. Chapters8–11focus on subsequent sessions.

Table 6.4 The Taming Sneaky Fears group CBT program at a glance—Format and outline of topics covered at each session

Sessiona Parent groupb Child groupb

Minutes Minutes

Introduction 10–15 Welcome, introductions, and overview of the child component of program (all parents and therapists are present; led by one child group therapist, then the child group therapists leave) 30–35 Overview of the parent and

child programs (led by parent group therapists after the child group therapists depart) Psychoeducation

Anxiety Disorders

Overlap between CBT and the Taming Sneaky Fears program

What to Do to Help Brave moments and effective praise

1 5 Introduction of children 5 Introduction of children

5 Debrief around separation 10 Circle Time and Story Time—Storyc

Chapter 1—Meet Leo the Lion and discussion of story 10 Brave moments and effective

praise

5 Purpose, rules, and name of the group

30 How to Be a Feeling Catcher

Body Scan

Feeling Thermometer How to Be the Boss of My Body

Spaghetti Arms and Toes

Balloon Breathing

Imagery

15 How to Be a Feeling Catcher

Body Scans for happy and mad/angry

How to Be the Boss of My Body

Spaghetti Arms and Toes 10 Craft Time

5 Snack Time

<1 Wrap up—when child group therapist enters the parent group room, parent group session ends

<1 Wrap up—one child therapist goes to parent room to signal end of session

(continued)

Table 6.4 (continued)

Sessiona Parent groupb Child groupb

Minutes Minutes

2 5 Parents volunteer examples of

brave moments and effective praise

5 Circle Time—reintroduction of children, review of events that might have happened to the children since the previous session, and review of topics covered in the previous session

5 Review of other tasks 10 Story Time—StorycChapter 2 and discussion of story 30–40 How to Be a Trick Catcher

and catch the Tricks Sneaky Fears play

Not Telling the Truth

Exaggerating

Only Showing the Bad Things

How to Be the Boss of My Brain

Use the Stop sign

Use the Trick Stoppers:

– Ignore Sneaky Fears – Think Brave Thoughts – Talk to an Adult

15 How to Be the Boss of My Body Balloon Breathing

Imagery

How to Be a Feeling Catcher

Body Scans for nervous/scared and shy

10 Craft Time

5 Snack Time

<1 Wrap up <1 Wrap up

3 5–10 Parents volunteer examples of brave moments and effective praise

5–10 Circle Time—review of events that might have happened to the children since the previous session, topics covered at the previous session, and relaxation strategies 5–10 Review of other tasks 10 Story Time—Storyc

Chapter 3—Meet Sneaky Fears and discussion of story 30–40 How to Climb Bravery

Ladders (to overcome fears) How to manage excessive worries

15 How to Be a Trick Catcher

Trick #1: Not Telling the Truth

How to Be the Boss of My Brain:

Use the Stop sign

Use the Trick Stoppers – Ignore Sneaky Fears – Think Brave Thoughts 10 Craft Time

5 Snack Time

<1 Wrap up <1 Wrap up

(continued)

Table 6.4 (continued)

Sessiona Parent groupb Child groupb

Minutes Minutes

4 5 How to manage behavior 5–10 Circle Time—review of events that might have happened to the children since the previous session, topics covered at the previous session, and relaxation strategies

45 Watch the1-2-3 MagicDVD 10 Story Time—StorycChapter 4 and discussion of story 15 How to be a Trick Catcher

Trick #2: Exaggerating

Trick #3: Only Showing the Bad Things How to Be the Boss of My Brain:

Use the Trick Stopper – Talk to an Adult 10 Craft Time

5 Snack Time

<1 Wrap up <1 Wrap up

Child group therapists meet with each child’s parent(s) for five minutesat the end of Session 4and (as needed)immediately prior to the beginning of Session 5to provide and receive feedback on each child’s progress

5 Child group therapists meet with each child’s parent(s) for five minutesat the end of Session 4and (as needed)immediately prior to the beginning of Session 5to provide and receive feedback on each child’s progress 5–10 Parents volunteer examples of

brave moments and effective praise

5–10 Circle Time—review of events that might have happened to the children since the previous session, topics covered in the previous session, and relaxation strategies

5–10 Review of other tasks 10 Story Time—StorycChapter 5 and discussion of story 30–40 Common problem: Sleep

Importance of humor Bravery Ladders—Review

15 How to Be a Feeling Catcher

Feeling Thermometer 10 Craft Time

5 Snack Time

<1 Wrap up <1 Wrap up

(continued)

Table 6.4 (continued)

Sessiona Parent groupb Child groupb

Minutes Minutes

6 5–10 Parents volunteer examples of brave moments and effective praise

5–10 Circle Time—review of events that might have happened to the children since the previous session, topics covered at the previous sessions, and relaxation strategies

5–10 Review of other tasks 10 Story Time—StorycChapter 6 and discussion of story 30–40 Review of materials covered

to date

15 How to Climb Bravery Ladders

10 Craft Time

5 Snack Time

<1 Wrap up <1 Wrap up

7 5–10 Parents volunteer for brave moments and effective praise

5–10 Circle Time—review of events that might have happened to the children since the previous session, topics covered at the previous sessions, and relaxation strategies

5–10 Review other homework 10 Story Time—StorycChapter 7 and discussion of story

30–40 Review session 15 How to Climb Bravery

Ladders 10 Craft Time

5 Snack Time

<1 Wrap up <1 Wrap up

8d 20 Review session 5 Circle Time—review of events

that might have happened to the children since the previous session, topics covered at the previous sessions, and relaxation strategies

10 Story Time—storycChapter 8 and discussion of story 10 Review of all concepts 15 Children come in for

graduation

15 Children go to parent group room for graduation

a45- to 50-minutes sessions: children and parent groups run concurrently, but in separate rooms

bIdeally, the parent and child group rooms are in close proximity

cChildren’s story section ofTaming Sneaky Fears—Leo the Lion’s story of bravery & Inside Leo’s den: The workbook(Benoit & Monga,2018a,b)

dSession 8 lasts 40 minutes with the children coming to the parents’ room after 25 minutes for graduation

<:less than

References

American Psychiatric Association. (2013).Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.

Benoit, D., & Monga, S. (2018a).Apprivoiser les Peurs-pas-fines—L’histoire de bravoure de Léo le lionceau & Dans la tanière de Léo: Le cahier de travail. Victoria, British Columbia: FriesenPress.

Benoit, D., & Monga, S. (2018b).Taming Sneaky Fears—Leo the Lion’s story of bravery & inside Leo’s den: The workbook. Victoria, British Columbia: FriesenPress.

Huebner, D. (2006).What to do when you worry too much—A kid’s guide to overcoming anxiety.

Washington, DC: Magination Press.

World Health Organization (2016).The ICD-10 classification of mental and behavioural disorders:

Clinical descriptions and diagnostic guidelines. Geneva: World Health Organization.

The Taming Sneaky Fears Program:

Introduction Session