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List of Resources

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UCSF Department of Psychiatry and Behavioral Sciences

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In this section:

Articles tell us what to do, but apps help lead us and remind us to practice self-care every day. Below are apps we recommend, and many have been shown to be effective in evidence-based research. These high quality apps have been made available to UCSF, with some also free to the general public.

The Stress Free UC Study found that Headspace, used daily for just 10 minutes, reduced stress in a meaningful way and the benefits lasted for two months after stopping use. Headspace can be done in the morning or evening, alone or with family, or anytime you need to take a break.

Please consider trying one of these apps.

Apps for everyone

Meditation and relaxation

Headspace: Two-week free trial for the general public. (Providers with a National Provider Identifier can sign up for free full access.)

Calm: Seven-day free trial. A meditation, sleep, and relaxation app that also provides resources specifically for coping with COVID-19 anxiety.

Stop, Breathe & Think: Always free, and for kids too.

Insight Timer: Always free. This is not a daily app, but rather a great library where you can search for various types of meditations and lengths by excellent teachers.

10% Happier: Free and paid options available. Health care providers can use redemption code HEALTHCARE to unlock all content.

UCLA Mindful App: Free and has meditation by Diana Winston.

Mindfulness Coach: Mindfulness Coach 2.0 was developed to help veterans, service members, and others learn how to practice mindfulness. The app provides a gradual, self-guided training program designed to help you understand and adopt a simple mindfulness practice.

Coping with stress and anxiety

Sanvello: Clinically validated techniques for reducing stress and treating anxiety and depression (free premium access during COVID-19 pandemic).

Happify: Some free content, including stress reduction and cognitive techniques to address anxiety.

MindShift CBT: Free content, including cognitive behavioral therapy strategies to address general worry, social anxiety, and panic.

PTSD Coach: Created by VA's National Center for PTSD and the Department of Defense's National Center for Telehealth & Technology. This app provides you with education about post-traumatic Stress Disorder (PTSD), information about professional care, a self-assessment for PTSD, opportunities to find support, and tools that can help you manage the stresses of daily life with PTSD.

PTSD Family Coach: In conjunction with PTSD Coach, the PTSD Family Coach app is for family members of those living with PTSD. The app provides extensive information about PTSD, how to take care of yourself, how to take care of your relationship with your loved one or with children, and how to help your loved one get the treatment they deserve.

Mothers and Babies Online Course: Available in both English and Spanish, this online course teaches skills to manage changes in how you feel. Designed for pregnant women, new mothers, and those who want to support them.

COVID Coach: Created for everyone, including veterans and service members, to support self-care and overall mental health during the coronavirus pandemic.

Insomnia

CBT-i Coach - Free cognitive behavioral therapy for insomnia, available for iOS and Android.

Additional apps

Interested in finding another high quality mental health app, but feeling overwhelmed by all the choices? PsyberGuide is a helpful non-profit site developed by UCSF alum and UC Irvine professor Stephen Schueller, PhD, that provides expert reviews on mental health apps (both credibility and user experience) and offers solid recommendations.

Apps for UCSF members only

The Daylight and Sleepio apps are usually only offered through paying employers, but are now accessible to UCSF employees for free when you sign up using the links below in the next 30 days. Your free account will last for a year from signup and includes access to 24/7 user support.

Anxiety

Insomnia

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In this section: Articles tell us what to do, but apps help lead us and remind us to practice self-care every day. Below are apps we recommend, and many have been shown to be effective in evidence-based research. These high quality apps have been made available to UCSF, with some also free to the general public.

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My Life App- Meditation

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Insight Timer App- Meditation

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Insight Timer - #1 Free Meditation App for Sleep, Relax & More

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The best meditation app with the world’s largest FREE library of more than 190k guided meditations, 17k teachers & the world’s most loved meditation Timer.

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Gratitude Journal Printable

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It's easy to focus on positivity with this gratitude journal printable! Featuring daily entries, this gratitude template is free to download.

Too often we are focused on what we want, what we don't have, or what everyone else has. All this focus on the negative and what's missing is sure to stir up a bad mood. One of the quickest and easiest ways to turn around a bad mood is to think positively and practice gratitude.

Maybe you had a rough day at work. Maybe your spouse didn't clean up the dishes (again). Maybe the kids are bickering non-stop. Instead of focusing on the negativity, think about what you are grateful for in each of these situations. Perhaps despite dealing with a difficult customer, you have a great co-worker that had your back. Maybe your spouse didn't clean up the dishes but they did get the kids to stop arguing.

Practicing gratitude is a great method of self-care and will improve your mental health. It will teach you to focus on the positive things in your life and appreciate even the little things!
RELATED: 10 EASY SELF-CARE IDEAS FOR BUSY MOMS
How to use the Gratitude Journal Printable

Each day, think of something positive about the day. Write a brief note about what you are grateful for. It could be something that happened, such as a co-worker helping with a difficult project. It could be something simple, such as great weather or a delicious dinner.

Even just jotting down a short list at the end of each day is a great way to focus on the positives!

Download the Gratitude Journal Template PDF

The gratitude journal template is a PDF file and Adobe Reader is required to access and open these files. It is free to download.
Click here to download the Gratitude Journal Printable. Please note: This printable is for your personal use only and not to be distributed, edited or copied.

Printed colors may vary from computer monitor colors. Want to save on color ink? Just print in black and white!

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Free Weekly Gratitude Journal Printable Template Page

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Too often we are focused on what we want, what we don't have, or what everyone else has. All this focus on the negative and what's missing is sure to stir up a bad mood. One of the quickest and easiest ways to turn around a bad mood is to think positively and practice gratitude.

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Coping Strategies

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Jim Kendall, LCSW, CEAP, Manager, Work/Life Connections-EAP

Pandemic fatigue is a sobering reality. We all hoped that COVID-19 would be under control by Independence Day but that was wishful thinking.

Emotionally, the increasing surge in COVID-19 positive cases locally and throughout the country has been anxiety provoking and discouraging. Continued uncertainty is hard to handle. We are running a marathon without knowing the total distance of race. It is hard to pace yourself when you don't know the end point.

Coping with this extended problem requires long-term strategies.

1. Self-care is not optional. Dr Edward Krall notes in his article "Ten Commandments for Physician Wellness" that we must take charge of our own well-being; we cannot expect even the most caring employer to be responsible to keep us comfortable. Part of our professional obligation is to strive for our own well-being (VUMC Credo).

2. Setting attainable well-being goals and implementing that plan is critical. Those goals might include exercise, meditation, nutrition, yoga, mindfulness, prayer, gardening, connections with others, music, reading, or other forms of restoration. Find the right match for you and do it regularly.

3. Plan and use your paid time off (PTO) to recharge. While in years past, we may have saved vacation days for travel or going to the beach, that may be less realistic for the foreseeable future. Enjoy experiences with your family, friends, and pets.

4. Take a vacation from news and social media. The bombardment of negative and sensational headlines can be overwhelming. There is little need to know the daily tally of coronavirus infections and deaths, unless your job is dependent upon those figures. Political discord will continue whether we follow it daily or not.

5. Seek diversions that are healing. Spend time intentionally and do things that give you meaning.

6. Create some predictable routines. Focus on managing the things you have control over.

Be kind to yourself as you are trying to adjust to this ever-changing challenge.

If you are finding yourself becoming depressed or struggling with how to cope, contact Work/Life Connections-EAP to set up a confidential appointment with one of our EAP Counselors by calling 615-936-1327.

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Six Coping Strategies to Combat Pandemic Fatigue

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Jim Kendall, LCSW, CEAP, Manager, Work/Life Connections-EAP Pandemic fatigue is a sobering reality. We all hoped that COVID-19 would be under control by Independence Day but that was wishful thinking. Emotionally, the increasing surge in COVID-19 positive cases locally and throughout the country has been anxiety provoking and discouraging.

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MindShift App- CBT

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CHILL ZONE

Listen to audio recordings of guided relaxation and mindfulness meditations to help you get, and stay, in a more relaxed and mindful headspace.

FACING FEARS

Overcome your fears by gradually facing them in small manageable steps.

CBT-BASED TOOLS

Interactive cognitive-based tools to help you reorient your thinking, and behavioural strategies to help you take action and make lasting positive change.

QUICK RELIEF

When you need anxiety help fast, use these quick and easy tools to help you take a breath, ground yourself, shift your thinking, and take steps to cope.

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Is anxiety getting in the way of your life? MindShift™ CBT uses scientifically proven strategies based on Cognitive Behavioural Therapy (CBT) to help you learn to relax and be mindful, develop more effective ways of thinking, and use active steps to take charge of your anxiety.

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The Tree illustrates some of the contemplative practices currently in use in secular organizational and academic settings. This is not intended to be a comprehensive list. Below the tree you will find links to descriptions of many of these practices as well as a more in-depth description of the tree and image files for downloading.

Some of the practices on the tree link to further information-either on our website, or on Wikipedia.
© CMind, the Center for Contemplative Mind in Society
Concept & design byMaia Duerr; illustration by Carrie Bergman
Suggested citation for this version:
CMind. (2014). The Tree of Contemplative Practices [Illustration]. The Center for Contemplative Mind in Society. http://www.contemplativemind.org/practices/tree

Understanding the Tree

On the Tree of Contemplative Practices, the roots symbolize the two intentions that are the foundation of all contemplative practices. The roots of the tree encompass and transcend differences in the religious traditions from which many of the practices originated, and allow room for the inclusion of new practices that are being created in secular contexts.

The branches represent different groupings of practices. For example, Stillness Practices focus on quieting the mind and body in order to develop calmness and focus. Generative Practices may come in many different forms but share the common intent of generating thoughts and feelings, such as thoughts of devotion and compassion, rather than calming and quieting the mind. (Please note that such classifications are not definitive, and many practices could be included in more than one category.)

Because this illustration cannot possibly include all contemplative practices, we offer a free download of a blank tree that you can customize to include your own practices. Activities not included on the tree (including those which may seem mundane, such as gardening or eating) may be understood to be contemplative practices when done with the intent of cultivating awareness and wisdom.

Where Did This Image Come From?

The original version of the tree was created to illustrate a 2004 report, " A Powerful Silence: The Role of Meditation and Other Contemplative Practices in American Life and Work" (Duerr, 2004), for a project that explored the ways contemplative practices were being used within organizations. The practices listed on the initial tree illustration were those reported by project participants. Over the years, as CMind's focus shifted to academia, we heard from educators about how particular practices were being used in their work, and so the current tree is representative of practices used in academic contexts. No version of the tree is intended to be definitive or fully representative of the varieties of contemplative practice.

Downloading and Reprinting the Tree

Yes, you may use the tree for personal, educational, and non-commercial purposes without permission. For example, please do feel free to use it to illustrate the academic paper you are writing, hand it out to your class or workshop, post it on your blog, or print it out to display it at your organization or institution. The Tree of Contemplative Practices is a copyrighted image. Only commercial use of the image (i.e., selling it), including derivative work, is not allowed without our permission.

You can contact Carrie Bergman at carrie@contemplativemind.org if you have questions regarding the use of the tree, if you require a signature for your publisher's permissions form, or just to share how you have used the tree in your work. We love hearing about how it has been useful to you! Thank you!

For low-resolution use: Download a 185 KB, 600 x 608 pixel .jpg image of the Tree of Contemplative Practices

A Blank Tree for Your Own Practices

Here's a version of the Tree with the practice and branch names removed, so you can fill it in however you wish.

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The Tree illustrates some of the contemplative practices currently in use in secular organizational and academic settings. This is not intended to be a comprehensive list. Below the tree you will find links to descriptions of many of these practices as well as a more in-depth description of the tree and image files for downloading.

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Spring has arrived. As I look out my window, I see four feet of snow everywhere, and yet underneath, asleep in the frozen ground are the green grass, flowers, perennials and vines that will burst out of the ground as soon as the sun makes its way to the soil. It always amazes me that so much life and color slumbers in the frozen ground all Winter to re-emerge with great energy and enthusiasm in the Spring. It is a reflection of the inner resources that lie dormant inside us until we need them, and of the resilience that is available to all of us if we know how to cultivate it.

Not only is Spring a season, but according to the dictionary it is "a resilient device....that can be pressed or pulled but returns to its former shape when released, used chiefly to exert constant tension or absorb movement." We need that kind of resilience in both our personal and professional lives, especially in leadership roles and times of change and stress when we're pressed and pulled by forces beyond our control. Whether they come from work, parenting, relationship, loss or world events, resilience is critical to health and well-being.

We all have a resilience zone where we live most of the time, and we have a range of emotion and experience within that zone. We can be angry, sad, or upset, but we are still able to stay calm and respond to whatever is challenging us. A stressful event can happen that bumps us out of our zone. When we get bumped out we can go out 'high' into anxiety, frustration and anger. When we get bumped out 'low', we can go into depression and withdrawal. The capacity of our resilience and what bumps us out is different for everyone. The toughest situation is when the stressor is consistent over a long period of time. That can strain our resilience the most and is when we need to be most attentive to our self care. The more we can cultivate our resilience the quicker we can recover back to our zone.

The above graphic of the zone is from the Community Resiliency Model developed by the Trauma Resource Institute. I became certified as a teacher of their model last year and have found the knowledge and tools to be really helpful to my clients - both individuals and groups.

Self care and engaging our five senses - taste, touch, hearing, vision and smell are keys to resilience. The following practices will cultivate resilience:

Meditation, yoga

Time in nature

Singing, Dancing, Laughing

Creative projects that make you lose track of time

Rest

Awe, wonder, beauty

Any physical activity you enjoy

Hugs

Water - swimming, bathing in and relaxing with a drink of water

Gratitude

If you find yourself bumped out of your zone over a period of time and unable to recover, reach out to a trusted professional -therapist, coach, spiritual guide, etc. for support.

And remember, resilience and well-being are always within reach even when your personal landscape feels stark and cold. It's there ready and waiting for you.

Sabrina Roblin, CPCC has been a professional coach, mentor, and trainer since 2004. She has worked successfully with individuals and for corporate clients that include Cargill, Medtronic and Stantec. Contact her for more information and a complimentary coaching session.

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Spring has arrived. As I look out my window, I see four feet of snow everywhere, and yet underneath, asleep in the frozen ground are the green grass, flowers, perennials and vines that will burst out of the ground as soon as the sun makes its way to the soil.

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Grounding exercises

Grounding is an important therapeutic approach for handling dissociation or flashbacks, and reducing the symptoms of anxiety and panic. It is important to practice the exercises again and again until the skill becomes automatic and can be called on even during moments of distress. The aim of grounding is to take the survivor out of whatever traumatic moment she is remembering.

1. Grounding the body. (10-15 minutes.)

This exercise can help a survivor to come down from hyperarousal and find a more balanced emotional state. It can also be used to focus survivors who are in 'freeze-mode'.

Sit on your chair. Feel your feet touching the ground. Stamp your left foot into the ground, then your right. Do it slowly: left, right, left. Do this several times. Feel your thighs and buttocks in contact with the seat of your chair (5 seconds). Notice if your legs and buttocks now feel more present or less present than when you started focusing on your legs.

Now move your focus to your spine. Feel your spine as your midline. Slowly lengthen your spine and notice if it affects your breath (10 seconds). Move your focus toward your hands and arms. Put your hands together. Do it in a way that feels comfortable for you. Push your hands together and feel your strength and temperature. Release and pause, then push your hands together again. Release and rest your arms.

Now move your focus to your eyes. Look around the room. Find something that tells you that you are here. Remind yourself that you are here, now, and that you are safe. Notice how this exercise affects your breathing, your presence, your mood, and your strength.

Source: Jacobson, Edmund. 1974. Progressive Relaxation. Chicago: The University of Chicago Press, Midway Reprint.

2. The Hug. (5-8 minutes.)

This exercise deepens and anchors positive feelings and messages. It is taken from EMDR (Eye movement desensitisation reprocessing), a trauma processing method. The method employs bilateral physical stimulation (in this case tapping), which, combined with positive spoken messages, is said to deepen and anchor positive feelings. The sentence can also be spoken silently.

Put your right hand palm down on your left shoulder. Put your left hand palm down on your right shoulder. Choose a sentence that will strengthen you. For example: "I'm a good enough helper". Say the sentence out loud first and pat your right hand on your left shoulder, then your left hand on your right shoulder.

Alternate the patting. Do ten pats altogether, five on each side, each time repeating your sentences aloud.

3. Progressive release of muscular tension. (15 minutes.)

This exercise calms a survivor who is agitated.

Whenever you become anxious, your body tenses. This can generate symptoms of pain in the shoulders, neck or back, or tension in the jaw, arms or legs. To train yourself to progressively release this tension, start by intentionally tensing specific groups of muscles, and relaxing them.

Focus on the difference of feeling between the tense and relaxed state of the muscles. Practise on different parts of the body: the head, face, neck, shoulder, back, stomach, buttocks, arms, hands, legs or feet. Increase tension and hold it for 5 seconds; then release and hold for 10 seconds. Find the tempo that suits you. Increase the tension and release the tension ten times in each muscle group, with a short pause in between.

Start by focusing on your hands. Make a fist, hold it for 5 seconds, release for 10. Notice the difference between the tense and released states. Do it once more.

Move the focus to your arms. Pull your forearms towards your shoulder. Feel the tension in your upper arms. Hold for 5 seconds, release for 10. Notice the difference, Do it once more.

Stretch your arm out, and lock the elbow. Feel the tension in the triceps. Hold for 5 seconds, release for 10. Notice the difference. Repeat. When your arms are relaxed, let them rest in your lap.

Focus on your face. Increase the tension in your forehead, lift your eyebrows. Notice the tension. Hold for 5 seconds, release for 10. Notice the difference. Repeat.

Increase the tension in your jaw. Hold. Release. Repeat.

Focus on the muscles in your neck. Bend your neck so that your chin touches your chest, turn your head slowly to the left, bring it back to the centre, bend it back, bring it back to the centre, turn it to the right, bring it back to the centre. Repeat slowly since there is often a lot of tension in this area.

Focus on your shoulders. Lift them. Hold and notice the tension. Release. Notice the difference. Repeat.

Focus on the shoulder blades. Pull them back. Increase the tension. Relax. Notice the difference and repeat.

Stretch your back by sitting in a very upright position. Hold the tension and relax, notice the difference and repeat.

Increase the tension in your buttocks. Hold for 5 seconds and release, notice the difference, repeat.

Hold your breath. Pull your stomach in, tighten it, and relax. Notice the difference, repeat.

Focus on your legs. Stretch them out, feel the tension in your thighs, hold and relax.

Straighten your legs again; this time make your toes point towards you. Notice the tension in the back of your legs, and the feeling of relaxation when you release. Repeat.

Focus on your toes, make them point downwards as far as you can. Feel the tension and release.

Scan your whole body. Does any part still feel tense? Repeat the exercise for this part.

Imagine that a relaxed feeling is spreading through your whole body. Your body feels warm, perhaps a little heavier, relaxed.

4. Creating a safe place. (10-12 minutes.)

This exercise helps survivors who are in "freeze-mode", feeling numbed and frozen. Make yourself comfortable, with your feet on the ground. Feel and relax your body, your head, your face, your arms, spine, stomach, buttocks, thighs, legs. Choose whether you want to close your eyes or keep them open during this exercise. Listen carefully to the Trainer's voice.

* Think of a place in which in the past you were calm and confident and safe. It may be outdoors, at home, or somewhere else. It can be a place to which you have been once or many times, which you saw in a film or heard about, or imagine. You can be there by yourself or with someone you know. It can be private, unknown to others, somewhere that no one can find without your permission. Or you can decide to share it with others.

This place must suit you and meet your needs. You can constantly recreate or adapt it. It is comfortable and richly equipped for all your wants. Everything you need to be comfortable is present. It is somewhere that fits you.

It shuts out every stimulus that might be overwhelming.

* Imagine this place. Imagine you are there. Take time to absorb it in detail: its colours, shapes, smells and sound. Imagine sunshine, feel the wind and the temperature. Notice how it feels to stand, sit or lie there, how your skin and your body feel in contact with it.

* How does your body feel when everyone is safe, and everything is fine? In your safe place you can see, hear, smell and feel exactly what you need to feel safe. Perhaps you take off your shoes and feel what it is like to walk barefoot in the grass or in the sand.

* You can go to this place whenever you want and as often as you want. Just thinking about it will cause you to feel calmer and more confident.

* Remain there for five more seconds. Then prepare to return to this room, open your eyes, stretch yourself, do what you need to return to the present.

5. Re-orienting to the present. (10 minutes.)

This exercise is of help to survivors in 'freeze-mode', who feel numbed and frozen.

Form pairs and sit together. One of the pair should play a helper and the other a survivor. The Helper should assist the Survivor to use her senses to put herself fully in the present and feel safe.

Take turns.

Look round you and name 3 things you see.

Look at something (an object, a colour, etc.)

Tell yourself what you are seeing.

Name 3 things you hear.

Listen to a sound (music, voices, other sounds).

Tell yourself what you are hearing.

Name 3 things you touch.

Touch something (different textures, different objects).

Tell yourself what you are touching.

Now, notice your state of mind.

Do you feel that you are more present in the room or less present after doing the exercise?

Do you feel calmer or more energised?

6. 'Squeeze-hug'. (5 minutes.)

This exercise calms survivors who are agitated. It can also help 'frozen' survivors to concentrate on the here-and-now.

Cross your arms in front of you and draw them towards your chest. With your right hand, hold your left upper arm. With your left hand, hold your right upper arm. Squeeze gently, and pull your arms inwards. Hold the squeeze for a little while. Find the right amount of squeeze for you right now. Hold the tension and release. Then squeeze for a little while again and release. Stay like that for a moment.

7. Feeling the weight of your body. (5 minutes.)

This exercise helps survivors who are 'frozen' or numb to focus on the present.

The exercise activates muscles in the torso and legs, which gives a feeling of physical structure. When we are overwhelmed, our muscles often change from extreme tension to collapse; they shift from a state of active defence (fight and flight) to submission and become more than ordinarily relaxed (hypotonic). When we are in touch with our strength and structure, it is easier to bear feelings. We can contain our experience and manage feelings of fragmentation (of being overwhelmed) better.

Feel your feet on the ground. Pause for five seconds.

Feel the weight of your legs. Hold for five seconds.

Try stamping your feet carefully and slowly from left to right, left, right, left, right. Feel your buttocks and thighs touching the seat of the chair. Hold that for five seconds.

Feel your back against the back of the chair.

Stay like that and notice if you feel any difference.

8. Straightening the back. (15 minutes.)

This exercise increases a survivor's awareness that the 'state of her body' depends on her 'state of mind'.

We carry ourselves with our spines. We can react to danger by collapsing the spine, and this affects our posture. By changing our posture, we give ourselves new strength and can more easily contain and manage our experiences. We give ourselves a stronger back and reconnect with our bodily resources.

* Collapse your chest and back. Notice how it feels. Pause. How does it affect your breathing? Pause again. Be aware of your feelings and mood. Pause. Be aware of your body. Pause. Be aware of your thoughts. Now say: "I am happy!" Say again: "I am happy!" Do you feel happy? Does it feel right to say you are happy?

* Now slowly lengthen your spine until you are comfortable. Adjust and experiment until your spine feels aligned and naturally lengthened. Be aware how you feel now. Be aware of your breathing. Pause for five seconds. Be aware of your feelings and mood. Pause. Be aware of your body. Pause. Be aware of your thoughts. Pause. Now say: "I am sad!" Say several times. "I am sad!" Do you feel sad? Does it feel right to say that you are sad?

9. Square-breathing. (4 minutes.)

Sit comfortably. Lower your shoulders.

* Look at a square form, or visualise one with your eyes closed.

* Breathe in while counting to 4. Let your eyes wander up the left side of the square.

* Hold your breath while counting to 4. Let your eyes run across the top of the square.

* Breathe out while counting to 4. Let your eyes run down the right side of the square.

* Hold your breath while counting to 4. Let your eyes run along the bottom of the square.

Repeat 4 times.

10. Breath counting. (4 minutes.)

Sit in a comfortable position with the spine straight and the head inclined slightly forward. Gently close your eyes and take a few deep breaths.

To begin the exercise, count "one" to yourself as you exhale.

The next time you exhale, count "two," and so on up to "five".

Then begin a new cycle, counting "one" on the next exhalation.

Repeat 5 times.

Never count higher than five, and count only when you exhale. You will know your attention has wandered when you find yourself counting up to eight, twelve, etc.

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Grounding is an important therapeutic approach for handling dissociation or flashbacks, and reducing the symptoms of anxiety and panic. It is important to practice the exercises again and again until the skill becomes automatic and can be called on even during moments of distress.

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"Coping in the Real World" section of resources

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ABCT Statement on COVID-19

Our understanding of coronavirus (COVID-19) is rapidly evolving. As news of the virus spreading globally and within our local communities continues, we at the Association for Behavioral and Cognitive Therapies want to reassure you that concern and worry are normal and adaptive during a pandemic. Many of us are concerned about our health and that of our loved ones, especially those of us with older and possibly vulnerable family and friends. It is understandable to be concerned about our jobs and financial situation, particularly if the current outbreak continues for weeks or months.

Knowing how the virus spreads and how to protect ourselves and our loved ones can help us feel empowered and prepared to deal with the situation. It is easy to quickly become overwhelmed by conflicting and, at times, frightening information. Consuming too much news, in whatever medium, can sometimes do more harm than good. Consider choosing one or two reliable sources of health information (see below for suggestions from the CDC), and limiting the time you spend reading news each day. Follow recommended public health strategies (e.g., hand washing, staying home if sick, social distancing), and employ healthy coping strategies, such as exercising, connecting with loved ones (even virtually), and engaging in positive, productive activities. Remember that cognitive-behavioral therapy (CBT) is the best known and most scientifically supported therapy for anxiety. If you need additional ideas for managing anxiety and stress during this challenging time, check out the links below.

For those of us with young children, it is important to address questions and concerns children may have in an age-appropriate way without increasing anxiety. Reassure children that worry is normal when news of a disease emerges. For very young children, a useful approach to facilitate discussion is play and drawing; with tweens and teens a conversation is best. Reassure children that COVID-19 appears to be mild in children. If you need guidance see our links below

There are also tips on dealing with anxiety in this anxiety-provoking time.

Health Information:

Centers for Disease Control (CDC)

Health Canada

World Health Organization (WHO)

California Association of Marriage and Family Therapists (CAMFT) on Telehealth and HIPAA

Medicaid COVID-19 Federal and State Waivers (CMS; Centers for Medicare and Medicaid)

World Confederation of Cognitive and Behavioural Therapies (WCCBT) Response to COVID-19: A CBT Perspective

COVID and addictions, double difficulty (NIDA): article is available at the Annals of Internal Medicine website here

Treating Insomnia During COVID 19 Pandemic (Behavioral Sleep Medicine; Simpson and Manber)

Self-Care Resources for Health Care Professionals (American Psychological Association)

Working With Front Line Service Providers (ADAA)

Fostering Psychological Resilience in the Wake of Adverse Events (McGinn; WCCBT; Yeshiva University; Cognitive and Behavioral Consultants)

How children and adolescents may be impacted; parents' stress, guilt, and coping. Topics include will children be impacted psychologically and developmentally, how to tell if your child needs help, communicating with your children about COVID-19, caregivers fears, guilt, and perfectionism, tolerance of uncertainty, plus self-help resources. (Friedberg; Sanity podcast)

How We Deliver Treatment Is Changing Worldwide in the Time of COVID-19 (WCCBT; World Confederation of Cognitive and Behavioural Therapies)

Resources for Anxiety:

Telehealth:

Coping in the Real World

All staff are working from home as mandated by the Governor of New York. You can still reach staff via email; a full directory is here

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ABCT | Association for Behavioral and Cognitive Therapies | Cognitive Behavioral Therapy

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ABCT Statement on COVID-19 Our understanding of coronavirus (COVID-19) is rapidly evolving. As news of the virus spreading globally and within our local communities continues, we at the Association for Behavioral and Cognitive Therapies want to reassure you that concern and worry are normal and adaptive during a pandemic.

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The COVID-19 pandemic has brought with it a great deal of uncertainty leaving many people feeling anxious and fearful of what's to come. Anxiety is often associated with symptoms like persistent worry, feeling "on edge", changes in sleep and appetite, and physical symptoms like headaches, muscle tension, and gastrointestinal distress. Chronic anxiety can take a toll on your health, both mentally and physically. It's understandable to be anxious in the face of so much uncertainty; however, it's important to be proactive in learning strategies to keep your anxiety in check to protect yourself against downstream health consequences.

Learning strategies for approaching negative thoughts can be an important component to protecting your mental health. "Cognitive restructuring" is a strategy used in Cognitive Behavioral Therapy, a popular treatment modality helpful for relieving symptoms of mental health problems like depression and anxiety. At the basis of cognitive restructuring is the acknowledgment that our thoughts are often biased by our own emotions, experiences, personality, and biology. Our brains are wired to alert us to potential threats, which is why we tend to overestimate the likelihood of negative outcomes and anticipate worst-case scenarios. In psychology, these biased negative thoughts are called "cognitive errors" or "cognitive distortions".

Cognitive errors left unchecked can leave us stuck in an "anxiety spiral". Our emotions are closely related to our thoughts, and when we are feeling anxious and fearful, these emotions will likely influence our thoughts to sway toward the negative. In turn, negative thoughts can perpetuate anxiety and fear, creating a feedback loop that can quickly spiral out of control, leaving us feeling helpless and running through an endless list of possible catastrophic outcomes.

Because our thoughts are so subjectively influenced, it's important to remember that they are not reflections of some indisputable, objective "truth". We often treat them as if they are, and this type of thinking contributes to the spiral. So what's the solution? We can check our thoughts for logic and objectivity to interrupt the feedback loop before it gets out of control.

Here are three questions to ask yourself to check your thoughts for cognitive errors:

1. Am I overestimating the likelihood of a negative outcome?

Negative predictions are a common cognitive error. Be aware of the thoughts you have, and remember that just because you think about something doesn't mean it's true or that an outcome you fear is likely to happen.

2. Even if I do encounter a negative outcome, am I jumping to conclusions that the outcome will be catastrophic?

This is a cognitive error called "catastrophizing". Consider the alternatives. Sure, the worst-case scenario is a possibility, but what are other possible outcomes? Imagine outcomes that are neutral, positive, or mildly negative instead of really negative.

3. And what if the worst-case scenario I'm envisioning does happen? Am I underestimating my ability to cope with it?

Imagining an experience to be completely intolerable is another common cognitive error. Take stock of your own resilience. Most likely, you're underestimating your own ability to cope through something distressing. Think about times in the past you've made it through something challenging. What helped you to cope?

Getting Help

Learning and implementing these skills can be an important component of managing your anxiety. However, there may be more to the story if you find your anxiety to be unmanageable. If you are suffering, know that help is available from the safety of your own home. Great Lakes Psychology Group values access to mental healthcare for all, and we believe that getting started with therapy should be simple. If you'd prefer to start online therapy in the wake of the pandemic but anticipate that you'd prefer to switch to in-office therapy at some point, you have the option of choosing a GLPG therapist located in your community.

Click here to learn more about the services we provide.

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3 Steps for Interrupting "Anxiety Spirals" During the COVID-19 Pandemic - Great Lakes Psychology Group

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The COVID-19 pandemic has brought with it a great deal of uncertainty leaving many people feeling anxious and fearful of what's to come. Anxiety is often associated with symptoms like persistent worry, feeling "on edge", changes in sleep and appetite, and physical symptoms like headaches, muscle tension, and gastrointestinal distress....

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Scientists now know COVID-19 spreads far more easily indoors than outdoors, according to the Centers for Disease Control and Prevention (CDC). As a result, many people moved their activities into the great wide open this summer. But as cold weather looms in some places, patio get-togethers, picnics and some outdoor sports may be more difficult, if not impossible.

That doesn't mean our social lives or fitness routines have to grind to a halt, however. You may need to swap out some options and make modifications to others. With a little outside-the-box thinking, you can conquer the cold and find new ways to connect and cope.

How many people will be present? The more contact you have with those outside your household, the greater the risk of COVID-19 spread.

How far apart they'll be. Staying at least 6 feet away from others reduces your risk of getting infected. The closer you are to someone who has the virus, the more likely you'll catch it.

How long the activity lasts. The more minutes and hours you spend with other people, the greater the risk of passing the virus between you and them.

Your underlying risk factors - and theirs.

Keeping all these elements in mind can help you decide which cold-weather pursuits are safe for your particular situation, and which you'll want to change up.

For instance, if your kids' baseball team used to provide both movement and camaraderie, you might need both a new exercise method and a way for them to connect with friends safely.

Dining al fresco may have offered both grown-up social time and a relaxing change of scenery - so you might have to schedule both a family-only adventure day and a bigger virtual get-together with friends.

Look for sidewalk cafes with portable, or consider investing in your own gas-fired patiowarmers. A fire pit or outdoor fireplace can also warm your yard or deck. Just be sure to follow local regulations in regard to fire safety and pollution levels. And remember that breathing in smoke can be risky for people with asthma, heart disease or other heaters conditions.

If you're in a northern climate, remember how you and your friends played in the snow for hours as a kid? You can recreate these adventures now, regardless of age. Get together with others to make snow angels, build snowmen or go sledding. Remember to keep space between people who aren't in your Have yourself a snow day. household

Adverse conditions can make physical activity more complicated than simply heading out the door for a walk or a run. But even if you don't have access to a gym or fitness center, you can still stay in shape this fall and winter.

Ice and snow can make running, cycling or other activities risky. But they represent prime conditions for a range of other activities. Consider downhill or cross-country, ice,or even playing broomball on the skiing skating snowshoeing ice. Just make sure, whatever you choose, that you include only those in your household - or keep your distance.

As the more carefree days of summer fade and the holiday season approaches, you may find yourself more tense than ever - with fewer ways to relax. If exercise and social time alone aren't calming your mind, work one or more of these methods into your routine.

Humor can feel hard to come by in challenging times, but know that it's OK to feel joy even when you're facing challenges. Find your smile by cuing up your favorite sitcom, playing a game with a child or calling a friend who always makes you giggle.

You might it helpful to block time for exercise, social events and stress relievers in your calendar, just the way you would a work meeting or a doctor's appointment. That way, you can ensure you make time for everything that matters to you - and your family.

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Creative Winter Coping Strategies for Body, Mind and Spirit

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Scientists now know COVID-19 spreads far more easily indoors than outdoors, according to the Centers for Disease Control and Prevention (CDC). As a result, many people moved their activities into the great wide open this summer. But as cold weather looms in some places, patio get-togethers, picnics and some outdoor sports may be more difficult, if not impossible.

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Winter Hiking

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Bundle up! It's time to take in the fresh air on these beautiful trails this winter. Here are some of my favorites that stay open, no matter how cold it gets outside.

We're aware that these uncertain times are limiting many aspects of life as we all practice social and physical distancing. While we're continuing to feature destinations that make our state wonderful, we don't expect or encourage you to go check them out immediately. We believe that supporting local attractions is important now more than ever and we hope our articles inspire your future adventures! And on that note, please nominate your favorite local business that could use some love right now: https://www.onlyinyourstate.com/nominate/

Wooded trails wind through this park that has both the St. Francis River and Big Creek running through.

Address:
Rt. 1 Patterson, MO 63956

Clifty Creek Natural Area was the first designated natural area in Missouri and features a beautiful natural bridge as well as dry glades and lush stream bottoms.

Where's your favorite winter hike in Missouri? Let us know in the comments.

Address: 307 Pinetum Loop Rd. Gray Summit, MO 63039

Address: 128 NW 150th Ln. Mindenmines, MO 64769

Address: 700 1st St. Rocheport, MO 65279

Address: 1401 Kiefer Creek Rd. Ballwin, MO 63021

Address: 76 MO-128 Trenton, MO 64683

Address: 801 Strodtman Rd. St. Louis, MO 63138

Address: 7556 Hwy H Leasburg, MO 65535

Address: 4600 S. Missouri 94 Augusta, MO 63332

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11 Picturesque Trails In Missouri That Are Perfect For Winter Hiking

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Bundle up! It's time to take in the fresh air on these beautiful trails this winter. Here are some of my favorites that stay open, no matter how cold it gets outside. We're aware that these uncertain times are limiting many aspects of life as we all practice social and physical distancing.

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Reflective Winter Hikes

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A new year means new beginnings, the chance to start over or to keep moving ahead on the path we're already on. It's also a time for reflection on what we've accomplished in the previous year and what we hope to experience in the year ahead. These seven winter hikes in Missouri promise an idyllic backdrop for breathing in the fresh air, for getting in tune with nature, and for reflecting on the year ahead.

We're aware that these uncertain times are limiting many aspects of life as we all practice social and physical distancing. While we're continuing to feature destinations that make our state wonderful, we don't expect or encourage you to go check them out immediately. We believe that supporting local attractions is important now more than ever and we hope our articles inspire your future adventures! And on that note, please nominate your favorite local business that could use some love right now: https://www.onlyinyourstate.com/nominate/

Bundle up - and bring plenty of water and snacks - for your trek along the 11.6-mile Bell Mountain Loop Trail. If you're up for a quiet hike where you'll have plenty of time to reflect, you'll probably like this trail that's not really that busy with hikers. Hike along the trail that's dotted with trees, particularly pretty in snow caps, and pass Shut-In Creek and Joe's Creek.

What are your favorite winter hikes in Missouri? Let us know in the comments! If you like staying active during the winter, how about heading to one of these five indoor ice skating rinks in Missouri?

Address: Bell Mountain, Kaolin Township, MO 63623, USA

Address: Greer Spring, Woodside Township, MO 65606, USA

Address: 26250 MO-64A, Lebanon, MO 65536, USA

Address: 1401 Kiefer Creek Rd, Ballwin, MO 63021, USA

Address: Taum Sauk Mountain, Arcadia Township, MO 63650, USA

Address: 307 Pinetum Loop Rd, Gray Summit, MO 63039, USA

Address: 12096 Park Dr #8121, Ste. Genevieve, MO 63670, USA

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7 Cool And Calming Hikes To Take In Missouri To Help You Reflect On The Year Ahead

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A new year means new beginnings, the chance to start over or to keep moving ahead on the path we're already on. It's also a time for reflection on what we've accomplished in the previous year and what we hope to experience in the year ahead.

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Spotify Mindfulness Playlist
Gift giving
Decorating
Communicating-text, social media