Feel the fear and do it anyway…

51 Pages·2012·1.23 MB·English

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Feel the fear and do it anyway…
Susan Jeffers ®

A workbook for people with low mood and anxiety linked to stroke

Mike Scanlan
Sue Wood
Sara Gregory
and the Community Stroke Team

Northamptonshire Healthcare NHS Foundation Trust – Pathfinder Project – Revised 8/12
1. Welcome

Welcome to the group and the booklet we will be using to help us to help you feel less
anxious and in more control of your life following a stroke.

Dr. Mike Scanlan and Sue Wood work in The Wellbeing Team, part of the NHS in
Northamptonshire. We have received funding from the Department of Health to set up and
run courses for people who have had a stroke and feel worried, panicky, and low.

Together with colleagues in GP surgeries, the community and the local hospital we are
developing a course aimed at helping you to manage the effects of your stroke and
develop new strategies to help you to feel relaxed and enjoy life more.

Many of you have been referred by a healthcare professional who recognised that you
may benefit from learning some new skills and techniques to help you deal with feeling
sad, low, anxious, or panicky.

Having a stroke can affect how you see yourself, experiencing problems that may lead to a
hospital admission or feelings of panic, helplessness or low. You may have noticed that
remembering such times makes you feel scared or uncomfortable, if so share your
concerns – you are not alone with these thoughts.

The brains ‘normal’ response to fear is to prepare the body to behave vigorously.
However, this is unhelpful if you have had a stroke.

We are going to look at strategies that bring together topics to help you deal better when
the effects of your stroke start to affect how you, including relaxation, thinking differently,
re-engaging in pastimes that you used to enjoy and engaging in new pursuits.

We know there are a number of significant benefits gained from working as a group.

(cid:1) The other participants all know what life is like after having a stroke
(cid:1) You will all have your own helpful strategies to share
(cid:1) It may be that you will be able to support each other emotionally during and after
the group has finished
(cid:1) You can develop your social circle which is often restricted when you have a long-
term condition

Remember you are the expert in your personal experience of having a stroke, so we will
be using your expertise too!

We look forward to getting to know you and learn from you and the other participants
during this course

Kind regards,

Sue & Mike
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2. Index

1. Welcome page 2

2. Index page 3

3. Introduction page 4

4. Group participants

5. Group programme

Week 1 – The importance of breathing exercises and relaxation

Week 2 – Breathing mindfully

Week 3 – Becoming more compassionate with yourself

Week 4 – Making compassionate decisions

Week 5 – Reviewing breathing, relaxation and mindfulness

Week 6 – A shared understanding about living with a stroke and
breaking the vicious cycle

Week 7 – Doing more can help you feel better and less tired

Week 8 – Summary and review

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3. Introduction
Who we are
Mike Scanlan, PhD, is a Nurse Consultant in Changing Minds with a broad background in
mental health and combines clinical work with training, research and developing innovative
projects.
Mike played a key role in developing new services for people with common mental health
difficulties and developed a number of training packages for healthcare staff.
Mike delivers a wide range of therapies including Mindfulness, EMDR, Compassion
Focussed Therapy, and sleep groups.

Sue Wood works in The Wellbeing Team as a Psychological Wellbeing Practitioner (PWP)
with people who experience common mental distress such as depression, low mood,
anxiety, and panic.
Sue qualified as a General Nurse in 1987 and has experience of working with carers.
She has recently helped to deliver a module to qualified staff about working with people
who have a long-term condition and common mental distress at the University of
Nottingham.

Sara Gregory is based in the Community Stroke Team and has helped to develop and
deliver this group with Mike and Sue.

We are passionate about working with people who have a long-term health condition, such
as stroke, COPD and diabetes, and also feel anxious, low, or panicky, helping them to
make the most of their lives.
Contact details
Mike Scanlan, Clinical Lead [email protected]

Sue Wood, Project Lead [email protected]
01536 400 600
07827 277 171

Your Group
(cid:1) The group will run every Thursday starting at 11.30 am and lasting about 40 minutes
for eight weeks

(cid:1) In between the group sessions we will phone you to answer questions or discuss
anything you don’t want to talk about in the group

(cid:1) We will be referring to this booklet throughout the group

(cid:1) In this booklet you will see this picture symbol when there is an activity for
you to do, we will discuss the activity in the group session before you need
to start it

(cid:1) You will see this picture to tell you about your home practice
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Confidentiality
(cid:1) We suggest that you consider whether you want to be on your own and private during
the phone sessions or prefer to have a friend or family member with you

(cid:1) We will not pass on any information about you to anyone else unless you have
consented to this

(cid:1) If you wish to make contact with any other participants between group sessions or once
the course has finished please contact us and will check that others agree to sharing
their phone number

What we need you to do

(cid:1) Commit to joining every session, this may mean you will need to change appointments
or other commitments that occur at the same time

(cid:1) We encourage you to actively participate in the group sessions by talking about your
own experiences and sharing your concerns. The other participants will want to learn
from you too!

(cid:1) Complete the worksheets in your booklet, it will be helpful for you to refresh your
memory

(cid:1) Practice your ‘homework’ regularly between sessions

(cid:1) Complete a set of questionnaires before each group session

4. Group programme

Over the course of the next seven weeks, we will be talking about and practising the
following:

Week 1 – The importance of breathing and relaxation

Week 2 – Breathing mindfully

Week 3 – Becoming more compassionate with yourself

Week 4 – Making compassionate decisions

Week 5 – Review of weeks 1 - 4

Week 6 – A shared understanding about living with a stroke and
breaking the vicious cycle

Week 7 – Doing more can help you feel better and less tired

Week 8 – Summary and review
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5. Questionnaires

For us to be able to show the benefits of the group on your health and wellbeing we ask
you to complete some questionnaires; they will be familiar to you as they are the same
ones you completed during your assessment session.

You will find the questionnaires after each group session plan.

We will also ask you to complete a feedback questionnaire at the end of the course to tell
us what you have found helpful and what we can do to improve the group.

The questionnaires will provide some (anonymous) information to the NHS and
Department of Health including the outcome of this treatment.

If you have any questions or if you are unsure about completing them, please contact Sue,
you don’t need to wait for the next group session.

6. What Next?

You will have a visit from one of our practitioners once the group sessions have finished.
You will complete the set of questionnaires again and have the opportunity to share your
workbook – if you wish, discuss your experience of the course, how you are feeling and
options for additional psychological support should that be appropriate.

We will be developing some ‘Master Classes’ that you can join in with – these will be about
topics such as improving your sleep; Tai-Chi; adapting to living with long-term conditions
and mindfulness. Once dates are confirmed you will be invited to join, they will also be
delivered as a phone conference or with audio-visual equipment when we have the
equipment to do so.

We will contact you in six months to offer review appointments to see how you have used
the strategies you have learnt and how you are feeling.

We encourage group participants to maintain contact with other group members to
continue the friendships and support you have developed.
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Group Participants

You may wish to note down the names and something to remember each person by as a
reminder of the other group participants

First Name Reminder

Sue Wood Wellbeing Practitioner from Changing Minds

Sara Gregory Nurse from the Community Stroke Team

Feel the

fear and do

it anyway
group
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Week 1 – The importance of breathing and relaxation
We all know it is important to relax; it can help to reduce anxiety
and stress. While we are not always very good at taking time out
for ourselves, we usually feel better when we do.

When you have experienced a stroke, it is common to feel
anxious and worried but practising breathing and relaxation
exercises can help you to relax.

Over the next few pages, you will find some breathing and
relaxation exercises for you to try. Relaxation is a bit like exercise and you may need to try
a few different ways before you find what helps you most, and remember the benefits will
increase with practice!

Have a go at each of the techniques, not all will be beneficial to everyone, and some
people may experience more benefit than others, however most people will gain
something.

You can combine two or more relaxing exercises.

Make a note or the breathing/relaxation exercises you find most helpful or other
information that shows how you have benefitted from the breathing and relaxation
exercises in the table below.

1.

2.

3.

4.

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Breathing Exercise – 7-11 Breathing
You may notice you begin to breathe more quickly when you feel stressed; this exercise
can help you to regulate your breathing.

It can also help you to relax when you make your ‘out’ breaths longer than your ‘in’ breaths
by stimulating your sympathetic nervous system.

7-11 Breathing Exercise

(cid:1) Sit comfortably, close your eyes if you wish

(cid:1) To get an idea of how long to take when breathing in and out you can time
your breath.

Count to seven in your head over a period of about 4-5 seconds then count to
eleven in your head over a period of about 7-8 seconds

You do not need to be precise, this will just give you an idea of the length for
your “in” and “out” breaths

(cid:1) Take a slow breath in to the count of 7

(cid:1) Hold for a few seconds

(cid:1) Release your breath “out” in a controlled and slow manner to the count of 11

(cid:1) Hold for a few seconds

(cid:1) Repeat as necessary – you will usually notice the benefits after doing at least
5-6 times.

You may continue for as long as you feel comfortable

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