• Audience: Elementary students in a classroom, mock school supply shop where one student has to ask another student for craft supplies to color a picture of a blank superhero and have to “buy” the color markers they need and picture as well. Can have more supplies to buy and have a visual of school supplies to buy. Zones of Regulation - Yellow Zone Strategies when feeling anxious to try, deep breaths (5 finger breathing) or tracing the labyrinth, use a fidget, say a positive affirmation and socratic questioning (stop, rewind, rethink).

• Diagnosis(es)/Condition(s) & Age Range/Population: Selective mutism - age range 5-8

• Purpose: The purpose of this is to get the children to be more comfortable using their voice by having them talk to other children their age and rewarding them for doing it so they associate talking with positive effects.

• Instructions: 

  • Introduce store and activity to group

  • Demonstrate how to ask for craft supplies and provide compliments about what they chose 

  • If they are having difficulty speaking they can use the visuals for supplies to choose or choose a coping strategy like deep breaths, using a positive affirmation ( i can do this I am brave) or Socratic questioning (rethinking anxious thoughts)

  • Talk about their superhero drawing with a peer or adult

  • Give a lot of positive feedback for sharing and give a reward like preferred activity or snack time

• Rationale & Impact on Function: 

  • This may assist with elementary schoolers’ with selective mutism by allowing them to share their thoughts and talk to people in their age group. This is a good way to start because it is a less intimidating than having them talk to adults who are more “serious”.

Audience - client

Population - any age

Purpose - Support mindfulness, interoception, emotional regulation, and environmental registration and processing when a person is feeling overwhelmed during their occupations in their daily environment such as completing an assignment for school, going on a plane trip, or starting a new job.

Instructions - 

1. Prepare visual for 54321 Grounding Exercise for client and educate the purpose.

2. Discuss places or activities where the person feels overwhelmed and when to perform a grounding exercise.

3. Practice listing each in the order using a script such as "list 5 things you see, 4 things you can feel, 3 things you hear, 2 things you smell, and 1 thing you taste."

4. Discuss how the client feels after completing this exercise.

5. Discuss activities/places where the client can benefit from trialing this.

6. Practice using technique during the occupation.

Rationale - When a person with anxiety and OCD becomes overwhelmed by their surroundings such as when feeling overwhelmed at school or work along with their thought processes, it can be hard to self-regulate and process what is really happening around them. Grounding techniques can help support self-awareness, sensory processing, emotional regulation.

Halloran, J. (2019, May 9). Calm and connected - Episode 16: 5 4 3 2 1 grounding. https://www.janinehalloran.com/podcast/calm-and-connected-episode-16

Audience - client

Population - adult any age

Purpose - Use as a coping strategy for anxious thought patterns to question the reality of a thought process and support engagement in daily activities

Instructions - 

1. If the client discloses a problem that requires Socratic questioning provided them with a Socratic questions worksheet and work through the thought pattern

2. You can also provide a prompt, model, or cue how to use Socratic questions

Rationale - people with anxiety and OCD often have self-doubt and misinterpret social situations which can often lead to negative self-talk, social withdrawal, and avoidance of social situations and impact participation in work, leisure, education, and relationships with family, friends, and intimate relationships. Socratic questioning helps rethink the original thought process into a more realistic understanding of the situation.