I need help replying with this discussion post.

Hello Goutam... Nice to meet you. My name is Jason Tivade, and I am a psychiatric mental health nurse practitioner with Maryville University. I understand your mom brought you here to our clinic for therapy. Please tell me a little bit of what's going on with yourself [five to seven seconds of silence for Goutam to respond]? I am sorry to hear that you are dealing with crippling anxiety. Cognitive behavioral therapy or CBT can be an asset for you as it forces you to come to terms with your own thoughts, thought processes, feelings, emotions, and/or behaviors (Surmai & Duff, 2022). I understand you are a college student and life can be very stressful. What I am going to do for you in our session is teach you some behavioral techniques such as guided relaxation and meditation exercises to help you calm down whenever you are anxious and have overwhelming thoughts. The premise is to distract yourself from your own binding thoughts and for you to gain consciousness of your breathing and heart rate. Ultimately, you will be clearing your thoughts when conducting these guided relaxation and meditation techniques (Wheeler, 2020). According to Crosswell and Yun (2022), "Research shows meditation, in particular, effectively reduces stress, improves attention, and 'foster[s] the development of key self-regulation skills required for academic achievement and emotional well-being'..." (p. 864). So, again, these particular exercises will be beneficial for you as you progress through school and life.

Now let's get started on some breathing relaxation exercises. The first is to breathe in deeply for 5 seconds and exhale at the same pace. But when exhaling, repeat the words "relax... relax... relax" in a calm or soothing tone. Or, you could say the words "calm... calm... calm" instead; it is totally up to you. Now go ahead and follow me as we perform this exercise. Relax... relax... relax [repeat 3 times]. Continue practicing this at least 10 times each day and you're welcome to do more if needed. Do this exercise especially whenever you begin to feel your own anxious thoughts and heart rate elevate (Wheeler, 2020).

Another breathing exercise you can implement is diaphragmatic breathing or belly breathing. It is where your belly rises and falls when breathing. It is a great way to increase parasympathetic activity while decreasing your blood pressure (Zisopoulou, & Varvogli, 2023). Go ahead and gently place your hand on your belly and breathe in and out with me. Focus on your belly rising and falling with each inhalation and exhalation.

So, this will conclude our session, Goutam. Remember to use these techniques whenever you're overwhelmed with anxious thoughts. See you next time. Thank you.

Crosswell, L., & Yun, G. W. (2022). Examining virtual meditation as a stress management strategy on college campuses through longitudinal, quasi-experimental research.Behaviour & Information Technology,41(4), 864-878. https://doi-org.proxy.library.maryville.edu/10.1080/0144929X.2020.1838609

Surmai, M., & Duff, E. (2022). Cognitive behavioural therapy: A strategy to address pandemic-induced anxiety.The Journal for Nurse Practitioners,18(1), 36-39.

Wheeler, K. (2020).Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice(3rd ed.). Springer Publishing.

Zisopoulou, T., & Varvogli, L. (2023). Stress management methods in children and adolescents: Past, present, and future.Hormone Research in Paediatrics,96(1), 97-107. https://doi-org.proxy.library.maryville.edu/10.1159/000526946