Therapeutic communication for anxiety

Specialties School

Published

I work at the high school level and there are a lot of students with mental health disruptions.  I will be called to a bathroom where a student is having a full-blown panic attack. 

My question is, what do you guys say to students who are having these panic attacks?  I don't know why, but all I can manage to say to them is "it's okay, you're okay, it'll be okay," which I know isn't therapeutic.  I've tried the "name 5 things you can see, 4 things you can hear, 3 things you can touch..." exercise but it has never worked.  Usually they just blank out and ignore me anyway when I do try to say anything meaningful to try and calm them down.  

Anyone have any tips on what I can say/do to help these students?

Specializes in Community health.

Another thing: Often, they feel like they aren’t getting enough oxygen. If you tell them to breathe deeply or slowly, they will say “I can’t.”  So I tell people to blow out as long as they can. Purse their lips just like blowing out a candle, or a whistle, and blow. Then quick breath in and blow out again, long breath. Sometimes that slows down their breathing enough to regulate it. 

On 5/25/2021 at 10:08 AM, KeeperOfTheIceRN said:

I ask them if they want to go outside for a little while. Mental health is not my strong suit by any means, but I'm a huge fan of getting them outside when they reach this point. Especially with the older ones. I've noticed the fresh air, change of scenery, and sun light (even on cloudy days) does wonders for them. If they want to walk, we walk. If they want to sit, we sit. If they want to talk, we talk. But I let them do what they feel they need to, within reason/safety parameters, and I just meet them there. 

I also have this jar that I made with glitter glue, sequins, and water. I'll have them shake it and then watch the glitter and sequins swirl around. I'll ask them to tell me some of the shapes they see (there's unicorns, stars, geometric shapes etc. etc. in the jar). This works best with my middle schoolers though. 

Change of scenery, 100%. Bathroom floor doesn’t make anybody feel great!

1 Votes
Specializes in Hospice.

Lots of great suggestions on this thread!

One trick I've found is to ask the child (or adult) what they do to calm themselves down when they get anxious. Many times, it's not the first time this has happened and they may know what helps them. 

1 Votes
Specializes in Vents, Telemetry, Home Care, Home infusion.

Does anyone use a piece of paper to fan child -helps to feel air movement or cold cloth on back of neck to calm them?

Going to camp in 1 week --getting prepared as our temps this week in mid 90's, bunks not air conditioned (infirmary is), covid --bing prepared.

0 Votes
Specializes in School nursing.

I will also get anyone else out and just sit or stand with them. I bring some tools with, but sometimes student won't let me really assess in a more meaningful way. But I remind them they are able to breathe because they are able to talk with me and if that changes, I'm here and ready. I also let them know I'm hanging with them, but also able to give them some space and a moment.

I also have small squishes in my office that I bring with and can place in a student's hand. The texture can help a lot to get them to a more calm place to try further techniques. (Link: https://www.amazon.com/Kizcity-Squishies-Squishy-Birthday-Classroom/dp/B087JJLH6M)

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