PANIC STATIONSPANICSTATIONS

Panic Stations
Module 12
Self Management
Introduction

2

Maintaining Gains

2

Healthy Me Worksheet
Setbacks

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Self Management Plan

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Module Summary

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About this Module

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The information provided in this document is for information purposes only. Please refer to the full
disclaimer and copyright statement available at http://www.cci.health.wa.gov.au regarding the informationon this website before making use of such information.
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Page 1PANIC STATIONSIntroduction
Congratulations on making it to the end of this information package! We’re glad you stayed on with us. If
you haven’t read all the modules, it might be good to go back to the ones you missed. However, the mostimportant thing for you now is to keep practising the strategies you have learned through reading themodules in this info-pack. This means continuing to apply all of the useful skills and insights about yourself
you might have gained. If you continue practising the concepts and skills you have learned, they will
become like habits that have been integrated into your lifestyle.
There are a few things to keep in mind now that you have learned some important skills in managing youranxiety. One area to think about is how to maintain the gains that you have made. Another area to think
about is how to minimise setbacks that might occur.

Maintaining Gains
It is important to recognise the progress that you've made, and when you are reaching your goals it isuseful to 'pat yourself on the back' and celebrate those milestones. This will hopefully encourage you tokeep going, to keep practising, to keep applying the new skills you have learnt. Maintaining the gains you
have made occurs by continuing to confront situations you may have felt anxious in and continuing topractise the skills. Developing new skills that are designed to challenge what may be years worth of old
habits takes time and persistence.
So there are some important things you will need to do in order to make the most of what you havelearned to stay well or gain that extra improvement. The easiest way to summarise this is by looking at
the “Healthy Me“ worksheet on the next page. It shows the main areas of your life that you should givesome attention to in order for you to continue maintaining your gains.
You will notice that on the “Healthy Me” Worksheet, each heading has spaces left blank for you to write inwhat you will need to attend to. For example, under Self-Care you might write: “ I will shop every week
and purchase fruit and vegetables, and avoid eating take-out. Under Social Activities you might write: “I willvisit friends at least once each week.” You may want to update this worksheet on a regular basis when you
need to extend your goals or modify them. We really encourage you to do this, as it will enable you tokeep track of things.

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Page 2PANIC STATIONSThinking

Social Activities

Pleasant Activities

Healthy

Self-Care/Exercise

Relaxation

ME
Other

Social Support

Goals

PANIC STATIONS

Setbacks or slip-ups in progress can happen at any time and are to beexpected. Try not to fall into the trap of believing that you are ‘back tosquare one’ as this will only make you feel worse. Change is not a steadyprocess, it's more like the old saying: “Two steps forward, one step back“
from time to time.

ChangeSetbacks

Time
Think about how you learnt to ride a bike. It probably took a few unsteadyattempts and a few falls before you gained your balance. Even when you getyour balance, you might still be unsteady when travelling over new ground, or on different surfaces. In thesame way, different situations may be more challenging, and may require extra effort and persistence, morethought disputation, or more stepladders. Even after much practice, there may be times when you thinkyou've slipped back and feel a little off balance. Developing new skills is never a smooth process, you'realways being faced with new challenges and different situations to apply those skills.

REASONS FOR SETBACKS

There are several reasons for setbacks occurring. There may be an increase in physical or mental stress.
Just like riding a bike over challenging terrain, physical and mental stress can be challenges to the new waysof thinking and acting that you have developed. Also, when we are physically unwell, we are less likely tohave the necessary mental and physical energy to do the detective work and dispute unhelpful thoughts.
It may help to remind yourself that most people have ‘down days’ or days where life’s hassles are harder todeal with – its part of being human! Use your skills of challenging your thinking to help when this situation
occurs. Also, you can use setbacks as a way of learning something new about yourself to help avoid similar
problems in the future.

PREVENTING MAJOR SETBACKS

As you are progressing through your goals, try not to focus too much on small setbacks. If you areexperiencing several small setbacks then there are some ways of preventing a major setback.
1. Identify early warning signs
The first step is to look at your own early warning signs. Some common examples are:•••Spending increased time worrying about what others think or having more unhelpful thoughts.
An increase in the amount of time avoiding particular situations or activites.
An increase in physical symptoms of anxiety when you are in previously feared situations.

2. Revise skills
Think about the skills you have learned and what has been helpful in reducing your anxiety (the calming
technique, relaxation, challenging unhelpful thoughts, situation step-ladders). Have you stopped practisingthese skills consistently? You may wish to revise the modules and the techniques you have learned andperhaps increase practising those skills.
3. Social Support
It is wise to find someone with whom you can sit down and have a good talk. This doesn’t mean a therapy
session where you pour out your heart but rather just a chance to talk through what’s going on in yourlife, what your goals are, and generally just to ventilate with someone you trust. Often, problems seembigger than they really are when a person tries to deal with them on their own. Hearing yourself talkthrough something can help to put it into perspective.
On the next page is a self-management plan for you to complete. Make a note of the early warning
signs that might signal a setback then write down the strategies and tools you have learnt about that
can help you to deal with a setback.
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Self-Management Plan
What are the early warning signs that tell that I might be heading for a setback and need to dosomething about it myself? eg. Spending more time worrying about what others think OR I am spending more time
avoiding situations OR I have more unhelpful thoughts than usual

What are some of my unhelpful thinking styles that I need to watch out for?

What situations are potential problems for me?

What are my future support options? eg Friends, family, GP, other…

What strategies/techniques have I found most helpful and need to continue to practise?

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Page 5PANIC STATIONSModule Summary••••

It is important that you keep applying and practising the strategies you
learned through reading the modules in this info-pack
Consistent and continuous practice will enable you to integrate thestrategies into your lifestyle
Setbacks are expected when we make changes to the way we think and act –challenge any unhelpful thoughts that might get in the way of your progressand repeat the modules to remind you of the skills you have learnt.
Find some friends with whom you can be with and talk to. A group offriends can be a source of social support and good company for social
activities

We hope that you have found thisinformation package to be of benefit to
you and that you will maintain the gains
you have made. If you have questions
about medication or psychotherapy for
depression, do go and see your doctor oran appropriate mental health practitioner.
For now, it’s goodbye from us at CCI.
Take care!

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About This Module
CONTRIBUTORSPaula Nathan (MPsych1)
Director, Centre for Clinical Interventions
Adjunct Senior Lecturer, School of Psychiatry and Clinical
Neuroscience, The University of Western Australia
1Masters of Psychology (Clinical Psychology)

Dr Louella Lim (DPsych2)
Centre for Clinical Interventions
Dr Helen Correia (MApp Psych1; PhD)
Centre for Clinical Interventions

2Doctor of Psychology (Clinical)

Some of the material in this module was taken fromNathan, P.R., Rees, C.S., Lim, L., & Smith, L.M. (2001). Mood Management – Anxiety: A Cognitive Behavioural
Treatment Programme for Individual Therapy. Perth: Rioby Publishing.

BACKGROUND
The concepts and strategies in this module have been developed from evidence based psychologicalpractice, primarily Cognitive-Behaviour Therapy (CBT). CBT for panic disorder is a type of psychotherapy
that is based on the theory that panic disorder is a result of problematic cognitions (thoughts) andbehaviours. There is strong scientific evidence to support that cognitions and behaviours can play animportant role in panic disorder, and that targeting cognitions and behaviours in therapy can help many
people to overcome panic disorder. Examples of this evidence have been reported in the following:
Royal Australian and New Zealand College of Psychiatrists Clinical Practice Guidelines Team for PanicDisorder and Agoraphobia. (2003). Australian and New Zealand clinical practice guidelines for thetreatment of panic disorder and agoraphobia. Aust N Z J Psychiatry, 37(6), 641-56.

FURTHER READING
There have been many other information resources written for people with panic attacks
Barlow, D. H., & Craske, M. G. (2000). Mastery of your anxiety and panic (3rd edition). San Antonio, TX: The
Psychological Corporation. (ISBN: 0127850783)
Royal Australian and New Zealand College of Psychiatrists. (2003). Panic Disorder and Agoraphobia:
Treatment Guide for Consumers and Carers. Available: http://www.ranzcp.org/publicarea/cpg.asp (clickon “Panic Disorder and Agoraphobia”). Accessed Feb. 2004.
Zuercher-White, E. (1998). An End To Panic: Breakthrough Techniques For Overcoming Panic Disorder (2ndEdition). Oakland, CA: New Harbinger Publications. . (ISBN: 1567313760)“PANIC STATIONS”
We would like to thank Uta Juniper for the title of the InfoPax that this module forms part of:Nathan, P., Correia, H., & Lim, L. (2004). Panic Stations! Coping with Panic Attacks. Perth: Centre for ClinicalInterventions.
ISBN: 0-9751985-8-0 Created: June, 2004.

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