Republic of Uganda

Distress Management Strategies

Workshop 5: Monday 21st November

Elaine Hunter and Dave Baillie

Bridge from our last meeting

What were the key things discussed?

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Homework review

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 Agenda for today’s training

What do you think would be important to cover

today in terms of distress management
strategies?

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 Our ideas for today’s training
Strategies for reducing distress/arousal
◦ Elaine
 Imagery techniques
 Light stream
 Safe place (& experiential exercise)
 Self soothing strategies
◦ Dave
 Controlled breathing
 Guided relaxation (& experiential exercise)

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What types of clients might some
of these strategies be useful for?
 Useful for:
 Anxiety
 Depression
 Borderline PD
 Psychosis
 Low self esteem
 i.e. Just about every diagnosis and even those
without....
 Light stream
◦ From EMDR as de-arousal strategy
 Useful when people have physical symptoms of distress such
as tension in part of body
 Uses imagery to visualise the physical sensations and then
imagining light streaming into the body and changing the
physical sensations
 See handout for script
 Safe (or special) place imagery
◦ Comes from PTSD treatment (EMDR)
◦ Create and practice vivid imagery of a peaceful place
that client can use at any time when feeing distressed
Experiential exercise
How was that for you?
 Useful for clients who become very distressed
so they can be self sufficient in comforting
themselves
 Can generate strategies with the client in

various categories :
◦ Using different senses (sight, touch, sound, taste,
smell – see handout for ideas)
◦ Doing something active
◦ Creating opposite emotions
◦ ‘Setting aside’ thoughts or emotions
◦ Creating an ‘emergency self soothing kit’
 Anxiety states often associated with hyper-
ventilating or over-breathing
 Can look at correlation between client’s

symptoms and those created with 1 minute of

fast breathing in session
 Can give information about what happens

physiologically when take in too much

oxygen
 Can practice slow breathing with client

◦ Ratio of double count out to count in

◦ E.g. Breathe in for 3  breathe out for 6
 Can practice techniques such as progressive
muscular relaxation (PMR) with clients
 Useful to reduce general anxiety level
 Can practice regularly so that better able to use
strategy when more anxious
 Practice in session together
 Can record this and give client a copy to practice
for homework
 Also possible to get pre-recorded CD’s
 Can ask client to complete relaxation diary to see
how they improve with practice.
Experiential exercise
How was that for you?
 Homework setting
What would be useful for you to do between
now and the next time we meet?

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 Summary of today’s meeting
What were the key things discussed today?
What did you learn from our session today?

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 Feedback

How did you find the session today?

Is there anything you didn’t like that we need
to change?
What could we do differently?

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