Overcoming

obstacles

ENRICH Activities

[Link]
 Content

Introduction and the 4I’s....................................................................3-4

Inspiration................................................................................................5-6
Problem statement, Goals & Values................................... 7-10
Robin’s story .............................................................................11-13
Information.............................................................................................. 14
Learning about Anxiety & Depression ................................. 15
ENRICH activities........................................................................... 16
Common thinking traps.............................................................17
Guide to using ENRICH activities......................................18-20
Implementation...............................................................................21-22
Robin’s ENRICH activity................................................................23
ENRICH worksheets ...............................................................24-29
Into the Future........................................................................................ 30
Relapse Prevention Plan.......................................................31-34

Version 1.0.
ISBN 978-0-6480216-1-2

Copyright © 2017 Behavioural Health, Flinders University

All images used were sourced and purchased, where appropriate, from two stock image
websites ([Link] and [Link]).

Behavioural Health - Flinders University

Margaret Tobin Centre
Flinders Drive, Bedford Park SA 5042 AUSTRALIA
Phone: +61 8 8404 2323
Web: [Link]

Authors: Dr Anthony Venning, Paula Redpath & Simone Orlowski

Acknowledgements: Professor Malcolm Battersby, Professor Sharon Lawn, Andrea Morello
& Tassia Oswald

2
Congratulations, you have committed to making
changes in your life by signing up to this program!
You have now met with your coach and received
this workbook. The hardest part is seeking help,
so you are already well on your way to making
changes. This guided self-help program is made
up of three major components: you, your coach
and this workbook.

The most important component of the program is

You. Your coach’s role is to guide and support you
to use the strategies in this workbook, to make the
most of this program.

This workbook contains information, worksheets

and resources to guide you through the program.
Making any change takes time and persistence.
Your willingness to give new challenges a go will
be an important factor in seeing the change you
want in your life.

Help yourself with

the right tools and
support....

Copyright © 2017 Behavioural Health, Flinders University 3

 4I’S
This workbook is made up of the four sections we call the 4I’s:
•• Inspiration - to help connect you with why you’re doing this.
•• Information - to let you know what this is all about.
•• Implementation - to direct you how to start.
•• Into the future - to show you how to maintain the changes that have been made.

4
3
2 INTO THE
FUTURE
1 IMPLEMENTATION
INFORMATION
INSPIRATION
What’s next?

How do I start? • What worked for you?

What is this all about? • Read through Robin’s • Think about the tools
worksheets to see how and resources that have
Why am I doing this? • Anxiety and depression she used ENRICH worked
activities in everyday life
• Take some time to • Information on ENRICH to explore, challenge and • Keep doing these
reflect on where you are activities: what they are, assess the impact of her
now, where you plan to why they are beneficial thoughts on her • Look out for signs of
be in the future and why and how they can be behaviour unhelpful thoughts and
you decided now is the used behaviours
time for change • Talk to your coach
• DEFINE, DO & DISCOVER
• Read through Robin’s guide • Make use of the tools
story to see how the and resources you need
program helped her to
make positive changes in • Talk with family and
her life friends about what you
are doing

4 Copyright © 2017 Behavioural Health, Flinders University

INSPIRATION

Copyright © 2017 Behavioural Health, Flinders University

 Inspiration

When you first met with your coach, you As you work through this program, you
identified the main problem you are will learn more about how anxiety and
currently experiencing. You also talked depression impact on your life. Sometimes
about how your behaviours, feelings, and it can be difficult to recognise the progress
thoughts contribute to, and maintain, you have made. You might like to come
the problem. Now that you have started, back to the pages in this section as sources
you and your coach will work together of inspiration and motivation to see how
to identify goals to work on. Fill out the far you’ve come since you started.
worksheets in this section of the book
based on what you discussed with your
coach.

6 Copyright © 2017 Behavioural Health, Flinders University

Problem statement

Impact of the problem

Copyright © 2017 Behavioural Health, Flinders University 7

 Setting goals

Working out at the beginning where you hope to be at the end is useful for identifying clear and
meaningful changes. Together with your coach, you will work out some goals so that you are able
to determine if what you are doing is making a difference.

Treatment goals should be S.M.A.R.T.

Specific
what are you going to do, when
are you going to do it, for how
long and how often?
S
Measurable
how will you measure progress
toward the goal?
M
Achievable
needs to be a realistic activity or
activities for you
A
Relevant
should be related to the problem
you are working on
R
Time Limited
be clear about how long the
goal will take to complete
T
8 Copyright © 2017 Behavioural Health, Flinders University
Goal 1
What will I do differently?

Where will I be doing it?

How regularly will I do it?

Currently, I can complete my goal

Goal 2
What will I do differently?

Where will I be doing it?

How regularly will I do it?

Currently, I can complete my goal

Copyright © 2017 Behavioural Health, Flinders University 9

 Values
Areas in my life that matter the most
and give me reason to change

e.g. getting another job (value

= gives me independence and
purpose).

Take some time to think about why What am I prepared to change so that my
making these changes is important to actions match what I care most about?
you.
e.g. go to courses and be prepared to learn
new skills.

10 Copyright © 2017 Behavioural Health, Flinders University

 Robin’s story

Robin is 45 years old and recently divorced. She

has also just lost her job that she has worked in
for the past 25 years. She is unsure if she has
the skills to find another job and is worried
about having to retrain again.

While Robin understands her new situation,

she is anxious about her job prospects, and
about attending training courses with much
younger people.

Robin’s training course began two weeks

ago and she has missed some classes. When
Robin starts to think about contributing
in class, and the possibility she will say
something stupid or get an answer wrong,
she starts to feel a tightness in her chest and
becomes overwhelmed. This causes her to feel
inadequate and she starts to doubt herself.
She has not called her children all week and
has been making excuses about why she can’t
go to her regular book club.

Robin found out about the program and made

a call. She met with a coach for an assessment
and learned that her feelings of inadequacy
were common for people in similar situations.

With the help of her coach, Robin was able

to put her problem into words and rate the
impact it was having on her life.

Copyright © 2017 Behavioural Health, Flinders University 11

 Robin’s problem statement
When I think about attending my training course

I become anxious and experience tightness in my chest, shortness of

breath and a sense of being overwhelmed

I am worried about what others will think of me and that I will say or do
something stupid

I avoid attending the course and am falling behind. This is affecting my

relationships with my friends, children and my job prospects – which will impact
on my finances

Impact of the problem


The coach then helped Robin to identify a clear goal to work towards and to rate the level of difficulty associated
with achieving it right now.

Goal 1
What I will do differently?
Attend classes weekly. Participate in conversation by offering at least two opinions
to the group each time.

Where I will be doing it?

In classes.

How regularly I will do it?

Weekly, for the next two months.

Currently, I can complete my goal


Following the assessment Robin met with her coach by phone each week for five weeks. Together with her coach,
she worked through the ENRICH activities Guided Self-Help Book.

12 Copyright © 2017 Behavioural Health, Flinders University

 Where is
Robin now?
Every week Robin and her coach would
review and re-rate her problem statement
and goals and agree on the activities she
would complete between her sessions.
Robin had a few hiccups along the way,
but regular reviews of her problem and
goals allowed her to recognise that she
was gradually improving. Robin is now
regularly attending and participating in
classes and has managed to secure part-
time employment to support herself as
she retrains. She was surprised to find
other classmates around her own age
and in a similar situation to her. Robin has
now developed a new circle of friends
who she regularly studies and socialises
with.

The Implementation section of this

workbook will show you some of the
activities Robin completed to get to
where she is now, and will be a space for
you to try your own!

Copyright © 2017 Behavioural Health, Flinders University 13

 INFORMATION

14 Copyright © 2017 Behavioural Health, Flinders University

 Anxiety and Depression

Anxiety is when you might feel Depression may be when you feel
overwhelmed, upset, or worried about consistently low for two or more weeks
things in your life. When this happens what and lose interest in the activities you used
you Do, what you Feel, and what you Think to enjoy. When this happens what you
impacts on how you go about your life. For Do, what you Feel, and what you Think
example, you may go out less, avoid seeing impacts on how you go about your life. For
friends, or continually take days off work. example, you may stay home more, stop
going to work and seeing friends, and stop
participating in activities.

When you are anxious; When you are depressed;

You might Do You might Do

Avoid the situation, keep to what’s safe.... Spend more time alone, enjoy things less....

You might Feel You might Feel

Tense, short of breath.... Flat, unmotivated, sad....

You might Think You might Think

I can’t escape, I can’t handle this.... It’s too much effort, I’m useless....
ith

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Copyright © 2017 Behavioural Health, Flinders University 15

 Experimenting with Negative Responses Initiates CHange
ENRICH

ENRICH activities (also known as behavioural experiments) are used to test the usefulness of
thoughts that may be unhelpful. They can help you to develop new ways of thinking. ENRICH
activities provide you with opportunities to identify your initial thoughts about a situation, and
challenge whether or not the outcome of the situation matched with what you thought it would be.

In carrying out ENRICH activities, the overall aim is to test out the negative or unhelpful thoughts
that lead to difficult feelings and changes in behaviour, and to create new evidence which supports
more balanced ways of thinking. Below is an example of an ENRICH activity:

Monday mornings start with a team meeting at Adam’s

workplace. During this meeting, work assignments are
distributed and workloads are reviewed. Adam struggles
with voicing his opinion at these meetings because he is
worried about offending or upsetting people. Adam believes
that if he does voice his opinion people will not like him, that
they will think his opinion is not valid and that he is not a
team player. As a result of him ‘keeping quiet’, he is regularly
assigned the leftover and most boring tasks to work on.

Adam would like to test whether these thoughts are true.

Along with his coach, they will plan an ENRICH activity using
the Define, Do and Discover guide outlined in this section.

It is important to remember that in working through this program you are beginning a process
of learning and change. The results of this process usually are not obvious overnight. Investing in
yourself and your mental health is worth it! Changing what you do, how you feel and what you think
requires persistence – it takes time, practice and courage. Some days you may feel confident and
that things are moving in the right direction, other days you may feel nothing has changed at all. Be
patient and remember why you have committed to this program.

16 Copyright © 2017 Behavioural Health, Flinders University

 Examples of common thinking traps

Unhelpful thoughts and predictions about how we think situations in our lives are going to turn out can
stop us from doing the things we want, or need to do, to manage our lives. Unhelpful thoughts and
predictions can lead us to avoid or escape situations which are linked to negative thoughts and feelings. As
a result, we choose safe behaviours and situations that provide short-term relief from unpleasant feelings.
Predicting how a situation may turn out, before we have experienced it, can prevent us from experiencing
a situation for what it is. Rather, we get stuck with ideas of what we assume will happen. ENRICH activities
can help us to develop more accurate and helpful predictions about how situations are likely to turn out
in reality.

All-or-nothing thinking:
Seeing things in black and white.

Over-generalisation:
Generalising the outcome of one event to all future events.

Mental filter:
Picking out a single negative detail and dwelling on it.

Jumping to conclusions:
Thinking you know how something will turn out, before actually experiencing it first.

Magnification (catastrophizing):
Exaggerating the importance of things (e.g., others achievements or your mistakes).

Emotional reasoning:
Believing that your unpleasant emotions reflect the way things really are:
“I feel it, therefore it must be true.”

Should statements:
Applying rigid rules and telling yourself what you should and shouldn’t think at certain times.

Copyright © 2017 Behavioural Health, Flinders University 17

 A guide for carrying out your own
ENRICH activities

1 2 3
DEFINE DO DISCOVER
Plan:
Develop a specific and time-limited
plan to test out your thought in
action. Discover what the
ENRICH activity did
Think through exactly how you will for you:
carry it out: What will I carry out? Reflect on the
Choose a thought When and where will it happen? outcome of the
you would like to activity. What
test. Decide on what evidence you will happened? Did you
use to verify the outcome of the correctly predict the
Provide a reason as activity (e.g., how will you know outcome?
to why you want to whether your prediction was
test this particular supported). On a scale of
thought. 0-100%, rate the
Think about any barriers that may
stop you from carrying out the strength of your
On a scale of 0-100%, original thought.
activity and list possible options
rate the strength of
for dealing with them.
this thought. Based on these initial
Predict: reflections, think about
Make a prediction about the what you have learnt
likely outcome of the activity. from conducting the
Using a scale of 0-100%, rate ENRICH activity.
the likelihood of this outcome.
Think about other ENRICH
Now develop an alternative activities you might like to
(more realistic) outcome and rate try.
the likelihood of this occurring
using a scale of 0-100%.

Do:
Carry out the ENRICH activity.

18 Copyright © 2017 Behavioural Health, Flinders University

 Take away

ENRICH activities provide a way to challenge the unhelpful thoughts that affect our lives.

Recognising what we think about a situation before we go into it can reveal to us that our initial
thoughts are not always correct.

The key is active participation –thinking about it less, and doing more.

Change takes time and isn’t always straight-forward. It is important to be realistic about how soon
you expect to see change - stick with it!

If you’re trying to achieve, there will be roadblocks. I’ve had

them; everybody has had them. But obstacles don’t have
to stop you. If you run into a wall, don’t turn around and
give up. Figure out how to climb it, go through it, or work
around it.
Michael Jordan

Copyright © 2017 Behavioural Health, Flinders University 19

 Food for thought
A space to reflect on what I have read
and what it means to me....

20 Copyright © 2017 Behavioural Health, Flinders University

IMPLEMENTATION

Copyright © 2017 Behavioural Health, Flinders University 21

21
 Making change

Now that you have identified sources of Inspiration to complete this program,
and have learnt valuable Information about how to make positive changes in
your life through ENRICH activities, it is time to Implement some strategies.

This section involves completing your ENRICH activities with the help of your
ENRICH Plans.

First, you will see how Robin completed an ENRICH activity during her program.
With the guidance of your coach, you will then have the opportunity to start
implementing them yourself!

22 Copyright © 2017 Behavioural Health, Flinders University

 Robin’s ENRICH plan
Define Date: 15/01/2017
Thought
to be tested: When I talk in tutorials I will say something stupid and people will
laugh at me because I am not tech savvy
reason I want to test this thought is: It is stopping me from attending the course
The

rate the current strength of this thought (e.g., belief that it is true) (0-100%): 85%
I

Plan
The ENRICH activity I plan to carry out is: Go to the local apple store and ask the same

salesperson (on separate occasions) how to operate phone apps that I don’t use.

It will be carried out

When? On Tuesday and Thursday mornings for two weeks
Where? Phone store/apple store
With whom? On my own
I will know whether my prediction(s) has been supported by: Observing the reaction of the

salesperson and also by noticing how I respond (my feelings and my behaviour)

Potential barriers to completing the activity may be: I can’t do the activity at all. I start

the activity but can’t go through with it and have to leave the shop. Misreading the
salesperson’s response to my questions

As a result I plan to: Ask a salesperson who appears to be close to my age and/or is female

Predict
activity: I think I will be embarrassed – I will go red and start
When I do this ENRICH
sweating. I will have to leave the shop.
I am (0-100%) 90% sure
this prediction will happen

Another (more realistic) outcome of this ENRICH activity is: That even if I do appear silly the salesperson
won’t laugh at me and will forget about it pretty quickly – they may even gladly help me
I 10%
am (0-100%) sure this prediction will happen

Learn
What happened during
the activity? It was hard but I did it. It wasn’t as unpleasant as I thought it
would be. The salesperson did look at me funny but I was able to stay and get help with the apps and I
felt good afterwards, despite some discomfort
I correctly predict the outcome of the activity? No

Did
now rate the strength of my original thought at (0-100%) 30%
I

Upon reflection, I have learnt that:
What I ‘think’, is often worse than the actual outcome
Re-assess
Other ENRICH activities I would like to try are:
1. Calling my tutor about the missed classes
2. Meeting my tutor and touring the campus
3. Going to class, listening to conversation and offering an opinion
Copyright © 2017 Behavioural Health, Flinders University
23
 ENRICH plan
Define Date:
Thought to be tested:

The reason I want to test this thought is:

I rate the current strength of this thought at (e.g., belief that it is true) (0-100%):

Plan
The ENRICH activity I plan to carry out is:

It will be carried out

When?
Where?
With whom?
I will know whether my prediction(s) has been supported by:

Potential barriers to completing the activity may be:

As a result I plan to:

Predict
When I do this ENRICH activity:

I am (0-100%) sure this prediction will happen

Another (more realistic) outcome of this ENRICH activity is:

I am (0-100%) sure this prediction will happen

Learn
What happened during the activity?

Did I correctly predict the outcome of the activity?

I now rate the strength of my original thought at (0-100%)
Upon reflection, I have learnt that:

Re-assess
Other ENRICH activities I would like to try are:

24 Copyright © 2017 Behavioural Health, Flinders University

 ENRICH plan
Define Date:
Thought to be tested:

The reason I want to test this thought is:

I rate the current strength of this thought at (e.g., belief that it is true) (0-100%):

Plan
The ENRICH activity I plan to carry out is:

It will be carried out

When?
Where?
With whom?
I will know whether my prediction(s) has been supported by:

Potential barriers to completing the activity may be:

As a result I plan to:

Predict
When I do this ENRICH activity:

I am (0-100%) sure this prediction will happen

Another (more realistic) outcome of this ENRICH activity is:

I am (0-100%) sure this prediction will happen

Learn
What happened during the activity?

Did I correctly predict the outcome of the activity?

I now rate the strength of my original thought at (0-100%)
Upon reflection, I have learnt that:

Re-assess
Other ENRICH activities I would like to try are:

Copyright © 2017 Behavioural Health, Flinders University

 ENRICH plan
Define Date:
Thought to be tested:

The reason I want to test this thought is:

I rate the current strength of this thought at (e.g., belief that it is true) (0-100%):

Plan
The ENRICH activity I plan to carry out is:

It will be carried out

When?
Where?
With whom?
I will know whether my prediction(s) has been supported by:

Potential barriers to completing the activity may be:

As a result I plan to:

Predict
When I do this ENRICH activity:

I am (0-100%) sure this prediction will happen

Another (more realistic) outcome of this ENRICH activity is:

I am (0-100%) sure this prediction will happen

Learn
What happened during the activity?

Did I correctly predict the outcome of the activity?

I now rate the strength of my original thought at (0-100%)
Upon reflection, I have learnt that:

Re-assess
Other ENRICH activities I would like to try are:

26 Copyright © 2017 Behavioural Health, Flinders University

 ENRICH plan
Define Date:
Thought to be tested:

The reason I want to test this thought is:

I rate the current strength of this thought at (e.g., belief that it is true) (0-100%):

Plan
The ENRICH activity I plan to carry out is:

It will be carried out

When?
Where?
With whom?
I will know whether my prediction(s) has been supported by:

Potential barriers to completing the activity may be:

As a result I plan to:

Predict
When I do this ENRICH activity:

I am (0-100%) sure this prediction will happen

Another (more realistic) outcome of this ENRICH activity is:

I am (0-100%) sure this prediction will happen

Learn
What happened during the activity?

Did I correctly predict the outcome of the activity?

I now rate the strength of my original thought at (0-100%)
Upon reflection, I have learnt that:

Re-assess
Other ENRICH activities I would like to try are:

Copyright © 2017 Behavioural Health, Flinders University 27

 ENRICH plan
Define Date:
Thought to be tested:

The reason I want to test this thought is:

I rate the current strength of this thought at (e.g., belief that it is true) (0-100%):

Plan
The ENRICH activity I plan to carry out is:

It will be carried out

When?
Where?
With whom?
I will know whether my prediction(s) has been supported by:

Potential barriers to completing the activity may be:

As a result I plan to:

Predict
When I do this ENRICH activity:

I am (0-100%) sure this prediction will happen

Another (more realistic) outcome of this ENRICH activity is:

I am (0-100%) sure this prediction will happen

Learn
What happened during the activity?

Did I correctly predict the outcome of the activity?

I now rate the strength of my original thought at (0-100%)
Upon reflection, I have learnt that:

Re-assess
Other ENRICH activities I would like to try are:

28 Copyright © 2017 Behavioural Health, Flinders University

 ENRICH plan
Define Date:
Thought to be tested:

The reason I want to test this thought is:

I rate the current strength of this thought at (e.g., belief that it is true) (0-100%):

Plan
The ENRICH activity I plan to carry out is:

It will be carried out

When?
Where?
With whom?
I will know whether my prediction(s) has been supported by:

Potential barriers to completing the activity may be:

As a result I plan to:

Predict
When I do this ENRICH activity:

I am (0-100%) sure this prediction will happen

Another (more realistic) outcome of this ENRICH activity is:

I am (0-100%) sure this prediction will happen

Learn
What happened during the activity?

Did I correctly predict the outcome of the activity?

I now rate the strength of my original thought at (0-100%)
Upon reflection, I have learnt that:

Re-assess
Other ENRICH activities I would like to try are:

Copyright © 2017 Behavioural Health, Flinders University 29

 Put worry in its place

Learning to act “as if” you are tolerant to uncertainty is a good place to start. Complete the 5-step put worry
in it’s place activity below, with the guidance of your coach. In order to cope, sometimes people over plan,
prepare, or avoid things, as a way of reducing uncertainty. This doesn’t always cause problems, but it can
lead to time-consuming behaviours and create a lot of stress. It feels like it helps in the short-term, but
usually becomes a problem in the long-term. While it is impossible to get rid of all anxiety, you can learn
to be more tolerant. The best way to start being more tolerant is to start acting as if you are. Changing the
way you respond to uncertainty will lead to changes in what you do, feel and think.

Step 1: Make a list of unhelpful behaviours

Write down all of the things you do to try and reduce feeling uncertain. For example, do you double-check
things often? Do you avoid situations? Do you prepare and plan a lot before doing a task?

•
•
•
•
•
Step 2: Make a list of behaviours to put worry in its place
While learning to act “as if” you are tolerant to uncertainty, start with small behaviours before trying
something more difficult. Below, list some behaviours you might try to change to help increase your
tolerance to uncertainty. For example, you may try going out with your partner and letting them plan the
evening, you may go to the shops without a planned list, or you may send an email without checking it over.
Rate how anxious you think these changes will be for you.

Behaviour to put worry in its place Level of anxiety (0 - 6)

Copyright © 2017 Behavioural Health, Flinders University 31

 Put worry in its place

Step 3: Practice putting worry in its place

Now that you have your list of behaviours that will help you to learn to tolerate uncertainty, it is time to
start practising. Start by choosing smaller behaviours that will cause you the least anxiety. Try to practice
3 behaviours a week.

Step 4: Keep a record

Each time you act “as if” you are tolerating uncertainty, write down the following about the experience:
What did you do?

How did you feel while you were doing it?

What happened?

If things did not go as planned, what did you do to manage?

What did you learn about your ability to cope with negative outcomes in the future?

Step 5: Keep it up!

Look for opportunities to tolerate uncertainty in your day-to-day life. The more you act “as if” you’re
comfortable with uncertainty, the easier it will become.

(Adapted from Dugas’ Basic Intolerance of Uncertainty Model)

32 Copyright © 2017 Behavioural Health, Flinders University

 Attentional Focus Technique

When you are caught up in your worries, your attention and focus is on past or future
worries, not on the here and now. Being able to bring your attention back to the here and
now can be an effective way for managing worries. One of the ways you can do this is by
learning and practicing the 3 steps of Attentional Focus, which can help you to attend to
what you are doing and what’s going on around you, despite your worries.

Shift your focus

Pick something in
1 your environment 3
that you can feel or
see. Give all of your
attention to this Apply your focus
Check your focus object for the next
Take a moment to pay minute. Describe the You’ve shifted your focus
attention to where you object to yourself in from your worry to
are and what you are detail. where you are and what
doing right now. you are doing - now
apply your attention to
the activity that the
worry interrupted.

Using Attentional Focus to disengage from your worries is a simple concept, but it takes
practice. At first, you’ll probably find that your mind is drawn back to your worries. Each
time you bring your focus back to the here and now, you reinforce a new way to stop the
worry.

Copyright © 2017 Behavioural Health, Flinders University 33

 6 Steps to Problem Solving

Step 1
Define your problem
Write down the problem to be solved:

Step 2 Step 3
Generate Advantages, disadvantages and resources for each possible solution
possible
solutions Advantages Disadvantages Resources

34 Copyright © 2017 Behavioural Health, Flinders University

 6 Steps to Problem Solving

Step 4
Based on the solution you have chosen, decide on a Plan
My plan:
When?

How?

Where?

With whom?

Potential barriers to completing my plan may be:

Possible options for dealing with these barriers:

Step 5
Implement your plan
Remember, planning is important, but doing is better! Make sure you carry out your plan.

Step 6
Evaluate the outcome
What happened? Write down what you did and what you noticed:

What have you learnt from using problem solving steps and implementing your chosen solution?

Based on what happened when you carried out your plan, what other solutions would you now
implement?

Alternatively, which other problem would you like to solve?

Copyright © 2017 Behavioural Health, Flinders University 35

 6 Steps to Problem Solving

Step 1
Define your problem
Write down the problem to be solved:

Step 2 Step 3
Generate Advantages, disadvantages and resources for each possible solution
possible
solutions Advantages Disadvantages Resources

36 Copyright © 2017 Behavioural Health, Flinders University

 6 Steps to Problem Solving

Step 4
Based on the solution you have chosen, decide on a Plan
My plan:
When?

How?

Where?

With whom?

Potential barriers to completing my plan may be:

Possible options for dealing with these barriers:

Step 5
Implement your plan
Remember, planning is important, but doing is better! Make sure you carry out your plan.

Step 6
Evaluate the outcome
What happened? Write down what you did and what you noticed:

What have you learnt from using problem solving steps and implementing your chosen solution?

Based on what happened when you carried out your plan, what other solutions would you now
implement?

Alternatively, which other problem would you like to solve?

Copyright © 2017 Behavioural Health, Flinders University 37

 6 Steps to Problem Solving

Step 1
Define your problem
Write down the problem to be solved:

Step 2 Step 3
Generate Advantages, disadvantages and resources for each possible solution
possible
solutions Advantages Disadvantages Resources

38 Copyright © 2017 Behavioural Health, Flinders University

 6 Steps to Problem Solving

Step 4
Based on the solution you have chosen, decide on a Plan
My plan:
When?

How?

Where?

With whom?

Potential barriers to completing my plan may be:

Possible options for dealing with these barriers:

Step 5
Implement your plan
Remember, planning is important, but doing is better! Make sure you carry out your plan.

Step 6
Evaluate the outcome
What happened? Write down what you did and what you noticed:

What have you learnt from using problem solving steps and implementing your chosen solution?

Based on what happened when you carried out your plan, what other solutions would you now
implement?

Alternatively, which other problem would you like to solve?

Copyright © 2017 Behavioural Health, Flinders University 39

 INTO THE
FUTURE

30 Copyright © 2017 Behavioural Health, Flinders University

 Relapse prevention

Throughout this program you have been If your mental health declines for longer than
provided with information and an opportunity that, then you may be experiencing a relapse.
to apply skills. You have been encouraged to Relapse is when you return to the previous
learn more about yourself, and in particular, behaviours, feelings and thoughts which caused
how the interactions between what you do, the anxiety or depression in the first place, and
feel and think, impacts on you. At this point, we are causing significant disruption to your life.
hope you have made some important changes
to your life. Relapse is not inevitable and does not happen
without warning signs. The techniques you
Having experienced anxiety or depression can have learnt throughout this program can help
increase the likelihood of experiencing them you avoid or reduce the severity of relapse.
again in the future. If you notice changes to Your confidence will grow as you continue to
what you are doing, how you are feeling, and apply the techniques that you have put into
what you are thinking, that last anywhere from practice. Supported by NETTS and your Relapse
a few days to a week, you may be experiencing Prevention Plan (see next pages) you will have
a setback – this is common. A setback is when a clear plan to respond to any setback and get
unhelpful behaviours, feelings or thoughts back on track.
become more frequent. Responding to a
setback by using the techniques you have
learnt throughout this program can get you
back on track.

Copyright © 2017 Behavioural Health, Flinders University 31

 NETTS:
New skills and knowledge, Exploring opportunities, Traps and Triggers, Solutions

New knowledge and Exploring how these Traps and Triggers Solutions for when
skills you have learnt skills and knowledge that can disrupt your you feel you may
can be applied to other recovery be experiencing a
areas/situations in your setback or relapse
life

UTIONS
SOL

Knowledge

NEW SKILLS Symptoms

& KNOWLEDGE (physical)
& Places

Strategies/
SOLU ONS

SOLUTIONS

NETTS
Skills TRAPS &
TRIGGERS
TI

Signs
New (thoughts &
Situations behaviours)

EXPLORE
OPPORTUNITIES New Goals

SO
LUTIONS

32 Copyright © 2017 Behavioural Health, Flinders University

 Relapse prevention plan

Refer to the worksheet below to develop your RPP with the help of NETTS

New knowledge and skills I have learnt

What I have learnt about the problem:

What I have learnt about what works:

Exploring opportunities
How can I use this further in other parts of my life:

1. ...............................................................................................................................................................................................................................................

2. ...............................................................................................................................................................................................................................................

3. ...............................................................................................................................................................................................................................................

4. ...............................................................................................................................................................................................................................................

5. ...............................................................................................................................................................................................................................................

Copyright © 2017 Behavioural Health, Flinders University 33

 Traps and Triggers
What early warning signs, thoughts, and feelings I need to be aware of:

People and places that can disrupt my recovery:

Solutions
What’s next?

People and/or services I will contact if I need some additional support:

When will I schedule my routine ‘Wellbeing Check-in’ day and time?

•• Developing your RPP is something that you will do together with your coach as part of this program.
•• We recommend that you keep this resource and refer to it as you need.
•• It may also be helpful for you to choose a routine ‘Wellbeing Check-in’ day and time every few weeks
to review your progress (e.g., by re-rating your initial problem statement and goals you recorded in the
INSPIRATION section of this workbook and adding in and rating any new goals that you have developed).

34 Copyright © 2017 Behavioural Health, Flinders University

This guided self-help workbook is designed as an essential resource in the delivery of Low Intensity
Cognitive Behaviour Therapy (LiCBT).

Copyright © 2017 Flinders Human Behaviour & Health Research Unit