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Concrete Experience: I would feel a sense of responsibility to ensure this girl gets the best kind of support, but also apprehensive that a questionnaire would not be a sufficient enough tool to understand her anxiety and treat it the most effectively.

Observing and Reflecting: I would feel responsible to help her because of the knowledge that the earlier you can treat anxiety, the higher the chance of it becoming a problem later in life. Also, I would want to ensure a high level of trust and rapport with her, before her completing the questionnaires. Whilst apprehensive about this, I would still feel positive about the possibility of helping her.

Conceptualisation: I would want to build a good relationship with her first, so she feels she can be honest with me. She might not know what is fuelling her anxiety, so building this relationship would be really important, to allow her to be open and honest.

Doing: Before assessing any sort of anxiety levels, I would engage in light conversations and 'fun' therapeutic techniques so that she feels comfortable with me. I would later then try and include questionnaires amongst a range of other active techniques.

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Concrete Experience-

I would initially feel a huge amount of empathy for her, as she is at a very vulnerable age and struggling so much already. I would feel quite scared in case she revealed anything in the questionnaires, of which meant she was a harm to herself, or the people around her were hurting her and fuelling her anxiety.

Observing and Reflecting-

I would be concerned that the questionnaire use would not be suitable for her, and she may struggle to understand some of the deeper meaning behind the questions, and that possibly activities would be better to determine the source and the intensity of her anxiety. She might also think that I would ‘tell her mum/dad/guardians’ about the content of these and be concerned she would not feel able to disclose things until she had trust established with me.

Conceptualisation-

I would feel like this as I have not had the relevant training to help this girl and guidance on how to build a rapport with her. I would also feel like this, as having had personal experience with questionnaires like these at a younger age, it felt very cold and clinical.

Doing-

I would be able to listen and understand her as best as I could. But until I had enough training, I would not know what activities, or how to make the experience a little less daunting for her, so she would have to be placed in good care, by qualified CAMHS therapists.

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1) I would feel hopeful that the girl is going to begin therapy which will potentially reduce/manage her anxiety. I would also feel responsible for reassuring her that the questionnaires will help us work together to find the best ways to help her, and that if at any point recounting her experiences becomes too difficult she can stop.

2) I had concerns that thinking about past difficulties may exacerbate her anxiety, I also had concerns/felt pressure that if the therapy was not effective the anxiety could become more severe and disrupt her life as she gets older.

3) Conceptualisation- that early effective treatment can help an issue such as anxiety before it becomes worse, whereas lack of effective treatment can lead to individual developing unhelpful coping habits, so would want to get it right

4) Try to make her feel as comfortable and reassured as possible, whilst being positive about the questionnaires and giving her support if necessary, making sure I am aware of my own concerns but not communicating them or letting them effect my conduct .

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1) Concrete Experience
- I would feel pleased that this young girl is seeking help for her anxiety. However, I would feel concerned that she may feel pressured to talk about her experiences through the questionnaires. I would worry this would cause discomfort for the girl as she may not be comfortable opening up to me so early in the therapeutic process.
2) Reflection
- I am most anxious about ensuring that the girl is comfortable with me. I feel pressured to make the girl feel at ease as I know this experience may cause her greater anxiety initially.
3) Conceptualisation
- My thinking is informed by knowledge that therapy is extremely important for addressing anxiety, and also that especially targeting children is key. However, my reservations are led by knowledge that children may not speak out if they are feeling uncomfortable and therefore I am hesitant to create a negative experience for the girl.
4) Doing
- I would attempt to be engaging and positive about therapy and realistic about the help that I can provide the girl in terms that she could understand in order to make her most comfortable.
I would do my best to reduce anxiety regarding starting the therapeutic process.

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1.    Concrete Experience – I would feel happy that the girl is receiving therapy to try to help her anxiety, and that I may be able to offer her some help and support. I would also however feel apprehensive as she is only young and I would want to ensure I approached the situation in an appropriate way so as not to make her feel uncomfortable or worsen her anxiety.

2.    Observing and reflecting – I felt worried that I would not be able to give her sufficient help or support, as effective treatment could have a hugely positive impact on this girls life. I also had concerns that the therapy sessions themselves would be a source of anxiety for the girl therefore I would want to make the sessions as relaxed as possible and ensure that I came across as friendly and approachable and as someone she could trust. I thought that the nature of this session in which she would have to fill out questionnaires about her difficulties may also cause anxiety or be a source of stress for her, as she has to think about her problems, so again would want to try to make her feel as comfortable as possible in this session.

3.    Conceptualisation – Knowing the importance that therapy can have on someone’s life, especially someone this young who is already suffering from high anxiety, which is clearly creating difficulties in her life. Also believing that if she feels comfortable with me as the therapist and feels like she can trust me and talk to me it could make her experience with therapy much more positive.

4.    Doing – I would do my best to ensure that she feels comfortable in the sessions in terms of being comfortable with me as her therapist and comfortable with whatever is discussed in therapy. I would also try to make the questionnaires seem less overwhelming and intimidating by assuring her there is no right answer and they are only for me to be able to understand the difficulties she is having so I can give her the best support I can.

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Concrete experience: I would feel appreciative that she has decided to receive treatment and I would hope I would be able to treat her as effectively as possible.

Observing and reflecting: I would find it challenging asking her to do a series of questionnaires as she is only young and that can be very daunting for a young person. I would also be apprehensive if I was the right person suited to helping her.

Conceptualisation: Having had past experience working with young people I know they don’t like filling out questionnaires and can find it quite challenging. And knowing there are other professionals out there who could be more suited to the task.

Doing: I would start by talking to her to try and build a rapport before giving her the questionnaires. I may also try breaking up the time between each questionnaire with additional practical exercises, so it doesn’t feel so daunting.  I would offer her therapy and have confidence in myself that I will do my best to help her.

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1. I would be feeling conscious of her age, and how my perceptions of anxiety may differ as I am coming from an older perspective. However, I feel like I would feel confident in helping her if I had had experience working with children her age, and was trained in such interactions.

2. The biggest reservation I felt is that I may not be able to fully understand with her situation because of her age. I think this reservation comes from a place of wanting to get her the best help possible, particularly as her anxiety is severe.

3. I think my concerns come from thinking about how different I am now to when I was 11. Knowing that how I process things it very different makes me feel like it is possible I won't be able to fully consider why she is feeling as she is.

4. I think regardless of reservations I will listen openly and intently, and provide a safe and positive space for her to discuss her feelings.

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1) I would feel grateful that I was given the opportunity to help her tackle the issues before she gets older, rather than treating someone who has endured anxiety up until adulthood without help (not to minimise an 11 year old's struggles with anxiety of course)

2) I would feel pressure because with her being so young, I would feel an obligation to 'get it right' and help her so that her condition doesn't worsen. Like others have said, I would question whether I was the right person for the job

3) My doubt about how useful I would be comes from my personal beliefs about therapy- that the earlier you intervene, the greater the chance of success. So the pressure comes from knowledge of how important it is to get it right, along with the knowledge that I am not equipped with all the tools to help

4) The most I could do would be to try my best to provide a calm environment in which she could express her thoughts through the questionnaire without fear of judgement

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1. Concrete experience: I would feel positive that a girl of 11 was being offered treatment but very aware of my responsibility and slightly nervous of what she might write in response to the questions.
2. Observing and Reflecting: I am very aware of being a parent to girls and hope I have managed to maintain a professional but approachable attitude.
3. Conceptualisation: Past experience of supporting young people informs my thinking.
4. Doing: I would make every attempt to create a safe environment both practically and emotionally and if I felt it necessary seek guidance.

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1. I would feel encouraged that the girl has been given the opportunity to receive therapy and I will attempt to be as positive as possible when giving therapy to the girl. However, I would still be a little worried about the girls’ mental health.

2. My biggest reservation from this scenario would be from the standpoint that I don’t know whether I am the right person to help the girl. There might be someone else that would have a better connection and understanding with the girl to help her and maybe she needs help in another aspect of her life that leads to her anxiety (that I cannot help her with).

3. I have come to think like this based of my knowledge that others are more qualified than I am to help people with anxiety, as well as understanding that others may be able to better communicate with the girl.

4. I would give the girl therapy and during this, I will try to appear positive and understanding. I will also pay close attention to the girl’s responses and behaviours during the therapy.

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1. Initially, I would feel anxious, due to the pressure I would feel seeing that this girl has a high level of anxiety, and that I would be the therapist being paid to provide an effective treatment.
2. Firstly, I would remind myself that I have received adequate training to be in the position of a therapist, in addition to having a passion for supporting others and promoting positive well-being.
I would be concerned that the questionnaire process itself might make the girl anxious herself, and in fact this may not be helpful initially.
3. Knowing that there are many effective treatments that are successful, and many people and places I could access resources.
4. I would seek relevant support from other therapists and information to support my delivery of treatment. I would also really focus on my verbalisations and physicality, as I feel that her anxiety might be provoked by particular interactions.

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1. Concrete experience- I would feel pleased that the girl had reached out and sought help for her anxiety. In terms of the questionnaires, I might feel apprehensive about if they may increase the girls anxiety regarding pressure to get them 'right'

2. Observing and reflecting- I would feel reserved about the first meeting with this girl as I would want to make her feel that she has made a good choice in seeking help, and try and make her feel as at ease as possible. I would be nervous about making the experience scary or intimidating, and thus discouraging further contact. I would also explain to her that there is no right answer to the questionnaires and that they are for my own use only- it doesn't matter how she answers, only that she should be honest.

3. Conceptualisation- my reservation about ensuring the girl feels comfortable and at ease comes from thoughts that the situation may be overwhelming to an 11 year old, due to the somewhat formal nature of an appointment and opening up to an adult she does not know. Apprehension about the questionnaires is based on the worry that her anxiety may spike due to the 'pressure' of completing them

4. Doing- I would approach the meeting in a personable and friendly way, making sure that I appear approachable. This would include asking the girl about non-anxiety related aspects of herself, for example her interests and hobbies. I would then reassure her that I am only there to help and am not going to be judging her symptoms or answers to the questionnaires.

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1. Concrete experience - I would be conscious of the fact that this girl has high anxiety and may not want to be there at all. If I had already been trained in giving therapy to young people with anxiety, I would feel confident that this is something I could offer.

2. Observing and reflecting - I would be conscious of the fact that this girl has high anxiety, is young and may not want to complete any questionnaires about her experiences/difficulties, making her less likely to answer accurately. I would also feel apprehensive at the effectiveness of the questionnaires in helping me gain an understanding of her difficulties and experiences, as there are a number of issues with using these self-report measures alone for diagnostic purposes (Hodges, 1990). It may also be the case, however, that answering questions on paper in the form of a questionnaire may be easier for someone with high anxiety and communication apprehension than speaking to someone about difficult issues face-to-face.

3. Conceptualisation - At 11 years old, I know that I would have been unlikely to want to open up to a new person, particularly if I didn’t want to be there or was feeling anxious about the situation. Given that this person suffers from high anxiety, I would imagine that this is even worse for her.

4. Doing - I would offer the girl the questionnaires to complete, but also ensure she knows that anything she does answer on there will be dealt with with sensitivity and with respect for her privacy. If I was a trained therapist, I would go on to help her in the best way I can according to evidence-based interventions for anxiety in young people.

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1. I would feel uncomfortable handing questionnaires to her because I'm not sure if she will be able to fully understand her emotions and answer questions that are based on them.

2. I notice that I immediately felt a lot of pressure after knowing that I have to offer therapy to an 11 year old. I also noticed that I was immediately concerned with whether or not questionnaires would be the best approach for her.

3. I think my thinking is informed by my own personal experiences. Having completed a lot of questionnaires about emotions like anxiety or anger, I found that it is not always easy to answer them. It is really hard to be objective about your own emotions so I am not sure if is suitable for a child

4. I would try my best to make her comfortable so that her experience with therapy would not feel too cold and clinical. I would reassure her that the questionnaires are are not tests because they are only for me to better understand her. I would then make sure she is willing to fill out this questionnaires before proceeding.

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1. Concrete experience. I would feel hopeful that beginning therapy will be beneficial for the girl, but also concerned for her well-being in response to the questionnaire.
2. Observing and reflecting. I would be concerned about the questionnaires causing any anxiety, or her being cautious to answer them honestly.
3. Conceptualisation. This concern is perhaps informed by my own expectation to be nervous if answering similarly vulnerable questions.
4. I would offer encouragement and reassurance of her safety to answer the questionnaires honestly, and in her own time.

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1. I would be apprehensive if I would be useful, in terms of knowing how best to deal with the situation, but glad that she is asking for help at such a young age.
2. I think the questionnaire process may be a little overwhelming for her, as it seems very formal and impersonal. I think forming a relationship with her in terms of her feeling safe and like she can trust me to help her, would be important.
3. May be more likely to be open about their anxiety with someone they trust and feel comfortable with, where they are allowed to talk freely.
4. I would offer her therapy, and seek support from those who would be more knowledgable. I would also be attentive to any difficulties she is having with the style of therapy and alter it to make sure she feels comfortable and supported.

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1.     I would feel concerned as I may struggle to understand some of the anxieties she is experiencing, however if I had received training I would hope that this wouldn’t be too much of an issue and would feel that I am able to offer support.

2.     I would think about why I am concerned as I have been trained to deliver therapy effectively and tell myself that I can be confident in my ability, although I would acknowledge that others may be better at the task.

3.     I would consider that I have been asked to complete the task and wouldn’t have been if I was not capable. However, I would also have an awareness that just because I have received the same training as others doesn’t mean we will all be equally as capable at delivering treatment to all types of person, and even though I would still be capable of delivering the therapy I may not be the most suitable.

4.     I would use the knowledge I have gained from my training and experience (e.g. my experience with other patients who have used the questionnaires and what parts of the questionnaires previous patients found confusing/ambiguous) with other patients in order to deliver the therapy. I would assure myself that I will be able to deliver the therapy and seek advice from other practitioners if necessary.

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1) Due to the girl having high anxiety, I would make a conscious effort to explain that the questionnaires cannot be filled 'correctly' or 'incorrectly' to make sure I don't indirectly add to her anxiety
2) I feel my initial thought towards an issue is to ensure I don't make the situation worse, I feel a large amount of responsibility and therefore partial stress
3) my thinking is informed by the knowledge that I haven't personally experienced high anxiety and therefore need to be cautious if asked to deal with something I personally don't know much about
4) I would give her therapy, but perhaps wait until I have built an initial dialogue with the girl so I can be sure the questionnaires do not add to her anxiety

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1)As she is suffering with high anxiety, I would feel apprehensive about giving this poor girl too many questionnaires to fill out too soon in the therapy sessions. I would feel empathic towards her and hopeful that with therapy, she may feel less anxious.

2) My reservations would be that the young girl may be overwhelmed with the questionnaire process and therefore may not benefit as much as she needs from therapy. I feel like i would rather just give her time and a safe space to talk or to participate in other age-related play or art interventions.

3) As a mum, i know that an anxious 11-year old may disengage in a situation which they feel unsafe.

4)I would listen to her and continue with the therapy. But i also would pay close attention to her behaviour, looking for any cues which suggest she is overwhelmed or disengaging. I would alter the therapy to meet her needs.

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1.Concrete experience-  I would be slightly apprehensive in helping the girl but would be encouraged by her attempt to access treatment
2. Observing and reflecting- I would be nervous that the treatment is important and that I do not have the knowledge and skills to administer it effectively
3. Conceptualisation -  knowing the importance of therapy for those with high anxiety and also that there are others more qualified than myself in treating it
4. Doing- offer the girl my help, trying to build a good relationship and seeking additional guidance when needed

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1. concrete experience- I would feel a responsibility to help this girl because of her age and the severity of her symptoms, but I would feel pleased that she was accessing treatment

2. observing and reflecting- I would be concerned that the amount of help I can offer wouldn't be enough as I don't have relevant experience or knowledge

3. conceptualisation- knowing that the best thing for this girl would be effective, positive treatment that a trained therapist would be better at providing

4. doing- I would seek support from trained therapists but offer my help to the girl and guide her through the questionnaires

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1. I would feel pleased that the girl has access to treatment and I'd feel happy to try and treat her as it is important that she receives therapy for her anxiety.

2. I'd be nervous that I may not be the best person to help her/provide this treatment due to my lack of knowledge and experience.

3. lots of people have more knowledge and experience than I do in this area so may provide more effective help

4. I would try my best to give her the questionnaires and provide the therapy while building a positive therapeutic relationship in order to make the therapy as effective as I could.

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1. Concrete experience - I feel encouraged that this girl is being offered therapy to treat her anxiety and I would want to provide her with an effective treatment

2. Observing and reflecting - I feel a sense of pressure in my thoughts to help this girl due to her severe symptoms and ultimately want to form a positive therapeutic relationship with her

3. Conceptualisation - knowing that a positive therapeutic relationship would increase willingness to engage with treatment

4. Doing - I would give her therapy, and alongside the questionnaires I would try to be as open and engaging as possible

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1. concrete experience - I would feel like I might be able to offer the girl some help with her anxiety and also someone has asked me to do the task

2. observing and reflecting - I was reserved as i was unsure if I was the best suited person to the job.

3. Conceptualisation- knowing that their are other qualified people around and someone might be better at the job

4. Doing- I would offer therapy to the girl and try to go in confident so that my reservations don't effect the girl

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Kolb cycle

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Imagine you are asked to offer therapy to an 11 year old girl with high anxiety and have been asked to give her some questionnaires about her experiences/difficulties.

Thinking about the Kolb cycle:
1. Concrete experience-  how would you feel about that?

2. Observing and reflecting: Stepping back and looking at this, what do you notice about your thoughts and behaviours? Did you have any reservations or concerns?

3. Conceptualisation  - What informs your thinking here?

4. Doing - What do you think you would do?

Post your reactions to these questions on to this padlet by double clicking on the grass or clicking the red(ish) circle with the cross in it.