Credit Valley Hosp Run Program

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Therapeutic Run Program offered through the Child & Family Clinic at The Credit Valley Hospital - Mississauga Ont.

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Credit Valley Hosp Run Program

  1. 1. The Teen Run Group Therapy A creative “health based” approach to treating adolescent depression/anxiety and low self esteem <ul><li>Dan McGann, Social Worker </li></ul><ul><li>Child & Family Services </li></ul><ul><li>The Credit Valley Hospital </li></ul>
  2. 2. MY RUNNING FRIEND (Unique bonding) “We talk about everything under the sun . . . and I don't even know her last name” By Michele Bender – Runner’s World Magazine, Aug 2007 &quot;When you run sometimes hundreds or thousands of miles together, you trust each other, bare your souls to each other, and help each other heal.&quot; Dr.&quot;Ozzie&quot; Gontang, Ph.D., Numerous studies have shown that exercise stimulates the neurotransmitters serotonin, dopamine, epinephrine, and beta-endorphin, all of which elevate mood and reduce depression and anxiety. “ What is said on the road, stays on the road.”
  3. 3. Run Dan Run!! <ul><li>My own depression </li></ul><ul><li>Started to run </li></ul><ul><li>Training for 10 years </li></ul><ul><li>Completing my first Marathon </li></ul><ul><li>- May 2006 </li></ul><ul><li>Created a Program </li></ul>
  4. 4. Adolescence & Depression <ul><li>Major Public Health Issue </li></ul><ul><li>10-20% Depressive Disorder </li></ul><ul><li>25-50% Associated Anxiety Disorder </li></ul><ul><li>20% Associated Substance Use Disorder </li></ul>
  5. 5. <ul><li>70% of depressed adolescents will have a 2 nd episode within 5 years </li></ul><ul><li>10-20% - ultimate diagnosis of Bipolar Disorder </li></ul><ul><li>80% of Suicidal Adolescents suffer with depression </li></ul><ul><li>Suicide is the 2 rd leading cause of death in Adolescents </li></ul>
  6. 6. <ul><li>Small minority of Adolescents receive treatment </li></ul><ul><li>Minority complete treatment </li></ul><ul><li>Traditional treatments such as medication and psychotherapy have limited efficacy. </li></ul>
  7. 7. Psychological Treatments <ul><li>Modest Benefit: </li></ul><ul><li>I.P.T. </li></ul><ul><li>C.B.T. </li></ul>
  8. 8. Biological <ul><li>TADS combination of Fluoxetine & therapy </li></ul><ul><li>Handful of drug trials demonstrating effectiveness </li></ul><ul><li>Many drug trials showing no benefit </li></ul><ul><li>High drop out from medication </li></ul>
  9. 9. Compliance Issues <ul><li>Side effects </li></ul><ul><li>Recent concerns regarding increase in suicidal ideation </li></ul>
  10. 10. Conventional Psychotherapy <ul><li>Requires “Face to face” communication of thoughts and feelings </li></ul><ul><li>Focus on painful and emotional issues </li></ul><ul><li>Office based sessions reinforce the “sick-role” </li></ul>
  11. 11. The Running Group <ul><li>Group support </li></ul><ul><li>Out of the “office” </li></ul><ul><li>Mastering a skill </li></ul><ul><li>Integration of mind & Body </li></ul><ul><li>Indirect learning (less threatening) </li></ul>
  12. 12. <ul><li>Control & Predictability </li></ul><ul><li>Structure & Routine </li></ul><ul><li>Audio, visual, kinesthetic learning </li></ul>
  13. 13. <ul><li>Action vs. Passivity </li></ul><ul><li>Mastery vs. Victimization </li></ul><ul><li>Changes the internal narrative </li></ul><ul><li>Endorphin release </li></ul><ul><li>“ Runner’s High” </li></ul>
  14. 14. Proposal <ul><li>Adolescent group 14 – 19 years </li></ul><ul><li>Depression/Anxiety </li></ul><ul><li>Pre-test for Baseline </li></ul><ul><li>Teach them to run 3X/wk/12 wks </li></ul><ul><li>Community Race 5K/10K </li></ul><ul><li>Post-test for comparison </li></ul><ul><li>All teens are medically cleared by their family Doc and waiver signed by parents </li></ul>
  15. 16. Our Sponsors Personal donations from: Dr. David Rosen Dr. Marino Battigelli Tina Triano Stan and Jessie Solarski Dan McGann *Youth Branch – CVH Volunteer Services
  16. 18. Volunteer Coaches Impact on coaching staff is amazing – the power of “giving back”
  17. 19. Program Format <ul><li>A gradual skill/endurance building </li></ul><ul><li>1:1 -----------------------  10:1 </li></ul><ul><li>30 minutes </li></ul><ul><li>12 Weeks </li></ul>
  18. 20. Frequency <ul><li>Tuesday evenings from 6:30 - 7:45 </li></ul><ul><li>Guest speaker and short run </li></ul><ul><li>Saturday at 8:30 - 9:30 am ~ longer runs </li></ul><ul><li>Each teen was also asked to run one more time through the week independently and record on their log sheet. </li></ul>
  19. 21. Our Speakers <ul><li>Jeff Stapleton, Running Coach </li></ul><ul><li>Dr. Ian MacIntyre – sports physician </li></ul><ul><li>Sandy Beckett, Physiotherapist </li></ul><ul><li>Heidi Nixdorf & Sandra Gabriel ~ Dieticians </li></ul><ul><li>Dan McGann, Psychology of Running </li></ul><ul><li>Detective Sean Sullivan (Capt Peel Police Run team) </li></ul><ul><li>John Knox – core training </li></ul><ul><li>Rick Ball - Paralympics -Team Canada </li></ul><ul><li>Tom Lettner, Senior Runner/Ironman </li></ul>
  20. 23. <ul><li>Pre and Post Testing </li></ul><ul><li>“ What I Think & Feel” (RCMAS) 49 items </li></ul><ul><li>Parent-Teen relationship scale </li></ul>
  21. 24. Group Characteristics <ul><li>Age range: 14 to 19 years </li></ul><ul><li>Gender: 22 males – 21 females – 11 are parents </li></ul><ul><li>Diagnosis: 2/3rds anxiety ~ 1/3 rd depression </li></ul><ul><li>43 participants in total </li></ul>
  22. 25. Teen Run Log <ul><li>Scale mood pre run?/10 </li></ul><ul><li>Scale mood post run ?/10 </li></ul><ul><li>Note conditions, distance and time </li></ul><ul><li>Space also provided for comments </li></ul>
  23. 26. What they Learn <ul><li>How to take a goal, break it down, and achieve through small steps. </li></ul><ul><li>Impact of mood on performance </li></ul><ul><li>Importance of structure & routine </li></ul><ul><li>Being supportive of others - being supported by others (looping) </li></ul><ul><li>Influence of diet on energy </li></ul><ul><li>Increased self awareness through use of your running log book </li></ul>
  24. 27. <ul><li>Learning skills in developing “ mental toughness ” “ the ability to keep going and stay positive and focused when faced with challenges” (long runs, hills) </li></ul><ul><li>Learn from their mistakes (lessons/opportunities for new learning) - not to over-react </li></ul><ul><li>Learn form others - from their mistakes </li></ul><ul><li>Learn to run softy and silently ( no drama ) </li></ul><ul><li>Learn how to talk and breathe as they run </li></ul><ul><li>Developing positive cognitive skills (positive thinking, focus, etc) </li></ul>
  25. 28. <ul><li>How to look at challenges and obstacles (hills) as good teachers and skill builders </li></ul>
  26. 29. <ul><li>Learn to pace themselves - when to hold back and when to push in order to complete a run well and in a good time. </li></ul><ul><li>That action (running) in the face of adversity is much better than standing still or retreating </li></ul><ul><li>Run towards your fears not away from them. </li></ul><ul><li>How to celebrate their achievements and meet their goals! ( end run cheer/ grad party with personalized certificates ) </li></ul>
  27. 30. Teen Comments <ul><li>“ I can’t believe I ran that far!” </li></ul><ul><li>“ Running for me is better than making out with boys I don’t know or cutting myself .” </li></ul><ul><li>“ Headache, legs hurt ~ never felt better!” </li></ul><ul><li>“ I liked running in the rain today.” </li></ul><ul><li>“ The run helped me to feel relaxed and de stressed  ” </li></ul>
  28. 32. Parent Comments <ul><li>“ My son seems more relaxed after each run ~ very satisfied with what he’s accomplished.” </li></ul><ul><li>“ I found that her confidence level increased as the time went on. I think that it has made such a difference to her to actually see tangible results.” </li></ul><ul><li>“ His mood and anxiety levels seem improved .” </li></ul><ul><li>“ She said that she could actually feel her spirits lift after each run .” </li></ul>
  29. 33. New Research <ul><li>MSW Thesis “Evaluation of Running Group Therapy with Youth” ~ qualitative </li></ul><ul><li>Family Run Program ; “ The value of running to improve the quality of the parent- teen relationship ” – pre and post scale </li></ul><ul><li>Continued pre and post test using the RCMAS </li></ul><ul><li>Revised Children’s Manifest Anxiety Scale </li></ul><ul><li>Collaborative Research with University of Toronto Department of Psychiatry </li></ul><ul><li>Pre and post run log recording </li></ul>
  30. 35. Lesleigh's Story
  31. 36. Lesleigh completes her 1 st Half Marathon

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