Reach Community Church 2/177 Beavers Road Northcote VIC 3070
Tel: (03) 9481 6889 Email: info@reachcc.org
www.reachcc.org
Pastor: Victor Soo Church Administrator: Sharon Oen
CHURCH SERVICE Celebration Service REACH Kids
Chinese Service
Sunday Sunday
l 10am - 12pm l 11am - 12pm
Saturday l 7pm - 9pm
PRAYER MEETING
Monthly Ministry & Prayer Intercessory Prayer
1st Friday of the Month l 7.30pm - 9.30pm
Tuesday l 7.30pm - 9.30pm
BIBLE STUDY
Young Adults
University & Youth Groups
Family
Wednesday l 7.30pm - 9.30pm Friday l 7.30pm - 9.30pm Monday l 8pm - 10pm
Friday l 7.30pm - 9.30pm
OTHER ACTIVITIES Praise Dance
MOPS (Mothers of Pre-schoolers)
Ladies’ Meeting Men’s Breakfast
Thursday l 10am - 12pm Every 2nd & 4th Friday l 10am - 12pm Quarterly Quarterly
Welcome to the fourteenth issue of REACH. This issue is full of JOY and blessing, a testimony on how God makes all things beautiful in His time, a health education on anxiety in children, and a charge to go forth to fulfil the great commission. 4
Reach Message
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Reach Insight
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Reach Character
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Reach Song
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Reach Word Search
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Reach Book Review
Go fulfil the Great Commission The Joy of the Lord is Your Strength Practise Joyfulness Once it was the blessing
Joy
Desiring God 12
Reach Testimony
God makes all things beautiful in His time 16
Reach Health
Anxiety in children 19
Reach Recipe
Honey Joys
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welcome
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Reach Message
GO Fulfil the Great Commission! Reach / Autumn 2019
By Pastor Victor Soo
Therefore, when they had come together, they asked Him, saying, “Lord, will You at this time restore the kingdom to Israel?” And He said to them, “It is not for you to know times or seasons which the Father has put in His own authority. But you shall receive power when the Holy Spirit has come upon you; and you shall be witnesses to Me in Jerusalem, and in all Judea and Samaria, and to the end of the earth. (Acts 1:6-8) In the above passage, the disciples of Christ asked a very important question before His Ascension. They were seeking the restoration of the splendour of the kingdom of Israel as it was like in the days of King David. They desperately desired that kingdom for they were under the tyranny of Rome. They did not understand that Jesus had already delivered to them a spiritual Kingdom.
From that time Jesus began to preach and to say, “Repent, for the kingdom of heaven is at hand.” (Matthew 4:17) Jesus came to restore that which was lost by Adam. God’s Plan since Creation was to have mankind take dominion of earth. In any war, there need to be a combination of Objective, Strategy and Tactic. In our spiritual war, our Objective is The Kingdom of God, the Strategy is the use of The Great Commission with The Church being the Tactic. Jesus appeared by first proclaiming the Kingdom has come through repentance unto God. Our spiritual birth offers us the keys to this new spiritual Kingdom. Although we already have the title, we still need to evict Satan and his cohorts
who are squatting illegally. Hence, Jesus reiterated that at our salvation, we are to possess the Kingdom of God by driving out the kingdom of darkness. In order to achieve that, He gave us authority to accede and succeed our task as Ambassadors to represent our new Kingdom, and the power as Ministers of the Gospel to overcome any opposition.
And Jesus came and spoke to them, saying, “All authority has been given to Me in heaven and on earth. Go therefore and make disciples of all the nations, baptizing them in the name of the Father and of the Son and of the Holy Spirit, teaching them to observe all things that I have commanded you; and lo, I am with you always, even to the end of the age.” Amen. (Matthew 28:18-20) This passage is commonly known as The Great Commission, and we have adopted it as our Church Objective for 2019. We obtained salvation to live a life of great significance, and to promptly go share the Good News, make disciples and train others to reproduce the same outcomes! The cost is high but the value of discipleship is incalculable! All believers are commanded to accomplish this Call delivered by the Trinity of God. Note the “All” in the passage. It comprehensively covers everything for its fulfilment. It resonates with celestial authority and divine power to proclaim salvation is here. We are un-stoppable, for God is our partner in our restoration of The Kingdom using The Great Commission as the vehicle to fulfil it through the Church in the driving seat.
Happiness and joy are among the top 10 things “people want in life but can’t seem to get”, according to HuffPost1.There are many self-help books on happiness or joy, teaching people how to obtain them.
The Joy of the Lord
However, being joyful is not a matter of will power, nor following a set of rules. It is a transformation of our inner being, our heart and our mind:
In Genesis, it recounted the creation of God in six days. God created and delights in His creation:
Don’t copy the behaviour and customs of this world, but let God transform you into a new person by changing the way you think. Then you will learn to know God’s will for you, which is good and pleasing and perfect. (Romans 12:2, NLT) How do we live a joyful life? What does the Bible teach about joy?
In the book of Nehemiah in the Old Testament, led by Nehemiah the cupbearer of the Persian King, the Israelites returned to Jerusalem, after years of captivity, to rebuild the city wall. When the wall was completed, the Israelites gathered together and Ezra the priest read the Book of the Law of Moses in front of the assembly. “…all the people
wept, when they heard the words of the Law” (Nehemiah 8:9). Nehemiah told them not to be grieved.
Then he said to them, “Go your way, eat the fat, drink the sweet, and send portions to those for whom nothing is prepared; for this day is holy to our Lord. Do not sorrow, for the joy of the LORD is your strength.” (Nehemiah 8:10) What is the joy of the Lord? How does the joy of the Lord become our strength?
There are many bible verses about God’s joy or His delights. God delights in five major things.
God’s joy in His creation
Then God saw everything that He had made, and indeed it was very good. So the evening and the morning were the sixth day. (Genesis 1:31) God’s joy in His people
God created human in His image (Genesis 1:26) and He rejoices over His people:
The LORD your God in your midst, the Mighty One, will save; He will rejoice over you with gladness, He will quiet you with His love, He will rejoice over you with singing. (Zephaniah 3:17) For the LORD takes pleasure in His people; He will beautify the humble with salvation. (Psalm 149:4) It is important for us to be assured of God’s joy in us, but understand that it is not because of what we have achieved or how good we are, but because of who God is.
God’s joy over the repentance of sinners
In Luke 15, Jesus Christ told three parables – the parable of the lost sheep, the parable of the lost coin, and the parable of the lost son.
The Top 10 Things People Want In Life But Can’t Seem To Get, posted on 29/03/2016, updated on 06/12/2017, by Kathy Caprino.
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The Joy of the Lord is Your Strength
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Reach Insight
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Reach Insight When Jesus illustrated the same point with three different parables, we are sure to understand it is an issue dear to His heart.
I say to you that likewise there will be more joy in heaven over one sinner who repents than over ninety-nine just persons who need no repentance (Luke 15:7).
God’s joy in Christ and His works Behold! My Servant whom I uphold, My Elect One in whom My soul delights! I have put My Spirit upon Him; He will bring forth justice to the Gentiles. (Isaiah 42:1) And suddenly a voice came from heaven, saying, “This is My beloved Son, in whom I am well pleased.” (Matthew 3:17) God’s joy in righteousness and all that is good Dishonest scales are an abomination to the LORD, but a just weight is His delight. (Proverbs 11:1)
Those who are of a perverse heart are an abomination to the LORD, but the blameless in their ways are His delight. (Proverbs 11:20)
Lying lips are an abomination to the LORD, but those who deal truthfully are His delight. (Proverbs 12:22) The steps of a good man are ordered by the LORD, and He delights in his way. (Psalm 37:23)
The Joy of the Lord is your Strength Now that we understand God’s joy from the Scripture, how does the joy of the Lord become our strength? In the gospel of John, Jesus spoke of the fullness of joy:
I am the true vine, and My Father is the vinedresser. 2Every branch in Me
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that does not bear fruit He takes away; and every branch that bears fruit He prunes, that it may bear more fruit… 4Abide in Me, and I in you. As the branch cannot bear fruit of itself, unless it abides in the vine, neither can you, unless you abide in Me... 7If you abide in Me, and My words abide in you, you will ask what you desire, and it shall be done for you. 8By this My Father is glorified, that you bear much fruit; so you will be My disciples. 9As the Father loved Me, I also have loved you; abide in My love. 10If you keep My commandments, you will abide in My love, just as I have kept My Father’s commandments and abide in His love. 11These things I have spoken to you, that My joy may remain in you, and that your joy may be full. (John 15:1-11) Jesus told His disciples that their joy will be full when His joy remains in them, what does this mean? For Christ’s joy to remain in us, three important elements are necessary: 1. Disciplined by the Father God the Father prunes every branch that bears fruit (v2). Tree pruning is an important procedure to maintain the wellbeing of a tree. It removes the diseased or dead branches, keeps the tree healthy and strong, helps the new branches to grow, improves fruit production, and beautifies the tree. Similarly, when God disciplines us, be sure that the process will not be pleasant, but the end product will be pleasing to God:
For whom the LORD loves He chastens, and scourges every son whom He receives. 11Now no chastening seems to be joyful for the present, but painful; nevertheless, afterward it yields the peaceable fruit of righteousness to those who have been trained by it. (Hebrews 6
12:6, 11)
You have turned for me my mourning into dancing; you have put off my sackcloth and clothed me with gladness. (Psalm 30:11)
2. United with Christ Jesus told His disciples, “Abide in Me, abide in My love, abide in My words” (v4, 7, 9). What does this intimate relationship with Christ look like? Have you ever seen a couple in love? I’m often amazed by how they change and become more like each other - in their facial expression, in their speech, in their attitude etc. In the same way, when we are united with Christ, we imitate Him, not only what He would say and do in critical circumstances, but how He would live our life, on a daily basis.
Instead, we will speak the truth in love, growing in every way more and more like Christ, who is the head of his body, the church. (Ephesians 4:15, NLT)
When we are united with Christ, it does not mean that life will be easy, but we can rejoice in the midst of sufferings which is only temporary:
Beloved, do not think it strange concerning the fiery trial which is to try you, as though some strange thing happened to you; but rejoice to the extent that you partake of Christ’s sufferings, that when His glory is revealed, you may also be glad with exceeding joy. (1 Peter
4:12-13)
3. Indwelled by the Holy Spirit Jesus promised His disciples that after
He ascended into Heaven, He would send them a Helper, the Holy Spirit:
If you love Me, keep My commandments. And I will pray the Father, and He will give you another Helper, that He may abide with you forever – the Spirit of truth… He dwells with you and will be in you. (John 14:15-17)
This Holy Spirit will give us hope and strengthen us in times of our weaknesses:
Now may the God of hope fill you with all joy and peace in believing, that you may abound in hope by the power of the Holy Spirit. (Romans 15:13) I pray that from his glorious, unlimited resources he will empower you with inner strength through his Spirit. (Ephesians
3:16, NLT)
When we are disciplined by the Father, united with Christ, and indwelled by the Holy Spirit, no matter what we go through in life, we have the confidence that God’s grace is with us, we can respond with the right attitude as Christ, and be strengthened by the Holy Spirit. God’s will becomes our will. Obeying God’s command is no longer a matter of will power, but a manner of willing heart - no reservation nor resistance, only submission and surrender. When that happens, we can shout with joy, “The joy of the Lord is my strength.” This joy no one can take from us (John 16:22) for we are assured that all things work together for the good of those who love God and are called according to His purpose (Romans 8:28).
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Although not all hard times are due to discipline from God, when we go through trials in life, we can be sure that God is with us and He will turn our mourning into dancing:
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Reach Insight
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Reach Character
Practise Joyfulness
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Practise Joyfulness
In the article “The Joy of the Lord is Your Strength” (see page 5‐7), we learn that being joyful is not In the article “The Joy of the Lord is Your Strength” (see page 5-7), we learn that being following a set of rules but a transformation of our inner being. We need to be disciplined by the joyful is not following a set of rules but a transformation of our inner being. We need to be disciplined by the Father, united with Christ, and indwelled by the Holy Spirit, Father, united with Christ, and indwelled by the Holy Spirit, before we can practise joyfulness with a before we can practise joyfulness with a willing heart. willing heart.
Join God’s family.
Now when he had brought them into his house, he set food before them; and he rejoiced, having believed in God with all his household. (Acts 16:34)
Open our eyes to the wonderful truth
But God demonstrates His own love toward us, in that while we were still sinners, Christ died for us. (Romans 5:8)
of God’s love for us.
But let all those rejoice who put their trust in You; let them ever shout for joy, because You defend them; let those also who love Your name be joyful in You. (Psalm 5:11)
Yield our lives to God and His
Now no chastening seems to be joyful for the present, but painful; nevertheless, afterward it yields the peaceable fruit of righteousness to those who have been trained by it. (Hebrews 12:11)
Fill our hearts with gratitude.
Rejoice always, pray without ceasing, in everything give thanks; for this is the will of God in Christ Jesus for you. (1 Thessalonians 5:16‐18)
Understand the word of God by reading it diligently.
And all the people went their way to eat and drink, to send portions and rejoice greatly, because they understood the words that were declared to them. (Nehemiah 8:12)
Look for good in every situation1.
My brethren, count it all joy when you fall into various trials, knowing that the testing of your faith produces patience. (James 1:2‐3)
Not to focus on the faults of others,
After all, what gives us hope and joy, and what will be our proud reward and crown as we stand before our Lord Jesus when he returns? It is you! Yes, you are our pride and joy. (1 Thessalonians 2:19‐20)
Encourage one another.
Be joyful. Grow to maturity. Encourage each other. Live in harmony and peace. Then the God of love and peace will be with you. (2 Corinthians 13:11, NLT)
Set our eyes on the hope of salvation and heaven.
You love him even though you have never seen him. Though you do not see him now, you trust him; and you rejoice with a glorious, inexpressible joy. The reward for trusting him will be the salvation of your souls. (1 Peter 1:8‐9, NLT)
Serve God and His people wholeheartedly.
Yes, and if I am being poured out as a drink offering on the sacrifice and service of your faith, I am glad and rejoice with you all. (Philippians 2:17)
correction.
but their potential to grow spiritually as children of God.
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Taken from Achieving True Success How to Build Character as a Family, published by Character Training Institute, Inc.
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Once it was the blessing
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Reach Song
A beautiful hymn that has never failed to bring tears to my eyes. The transformation from “striving” to “thriving”, and from “I seek” to “I surrender” brings us to a complete union with Christ. What a joy and peace when our “hopes are anchored safe within the veil”. (Verse 1) Once it was the blessing, now it is the Lord; Once it was the feeling, now it is His Word; Once His gift I wanted, now, the Giver own; Once I sought for healing, now Himself alone. (Chorus) All in all forever, only Christ I’ll sing; Everything is in Christ, and Christ is everything. (Verse 2) Once ‘twas painful trying, now ‘tis perfect trust; Once a half salvation, now the uttermost; Once ‘twas ceaseless holding, now He holds me fast; Once ‘twas constant drifting, now my anchor’s cast. (Verse 3) Once ‘twas busy planning, now ‘tis trustful prayer; Once ‘twas anxious caring, now He has the care; Once ‘twas what I wanted, now what Jesus says; Once ‘twas constant asking, now ‘tis ceaseless praise. (Verse 4) Once it was my working, His it hence shall be; Once I tried to use Him, now He uses me; Once the pow’r I wanted, now the Mighty One; Once for self I laboured, now for Him alone. (Verse 5) Once I hoped in Jesus, now I know He’s mine; Once my lamps were dying, now they brightly shine; Once for death I waited, now His coming hail; And my hopes are anchored safe within the veil.
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Lyrics by Albert Benjamin Simpson (1843-1919)
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Joy
Each of the listed words can be found in the grid: across, down, and diagonally, including backwards. Mark the letters of each word as you find it. Letters may be used more than once. Every fourth letter of the unused letters will spell out the solution.
BLESSEDNESS DELIGHT EXULTATION SOLUTION: __ __ __ __ __ __
ENJOYMENT GAIETY GLADNESS __ __
__ __ __
HAPPINESS JOYFULNESS JUBILATIONS __ __ __ __
__ __
MERRINESS PLEASURES SATISFACTION __ __ __ __
__ __ __ __ __ __ __ __. Answer: The Joy of the LORD is your Strength.
Reach / Autumn 2019
Reach Word Search
Desiring God: Meditations of a Christian Hedonist1
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Reach Book Review Author: John Piper
Piper explained that a Christian Hedonist is one who makes delighting in God the aim of his life. The aim of this book is “to persuade you that the chief end of man is to glorify God by enjoying him forever.” He then went on to expound the ten principles of “Christian Hedonism”: 1. The happiness of God is the foundation of Christian Hedonism. Piper taught me, through many bible verses, that the foundation of my joy is God’s joy, His sovereignty and His glory. 2. To delight in God, we must turn from sin and turn to Jesus Christ as our Saviour. This “conversion” is a combination of supernatural act of God and our persevering faith. 3. Worship is the feast of a Christian Hedonist. Piper painted a beautiful picture of our worship to God, “The fuel of worship is a true vision of the greatness of God; the fire that makes the fuel burn white hot is the quickening of the Holy Spirit; the furnace made alive and warm by the flame of truth is our renewed spirit; and the resulting heat of our affections is powerful worship, pushing its way out in confessions, longings, acclamations, tears, songs, shouts, bowed heads, lifted hands and obedient lives.” 4. Love is the labour of a Christian Hedonist i.e. our joy in God becomes a motive for all our good deeds. “Love is the 1
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“A Christian hedonist? This sounds so sinful! Should I be reading this?” This was my initial reaction when I first picked up this book. What caught my eyes was on the first page of the Preface, where Piper wrote, “That God is most glorified in me when I am most satisfied in him continues to be a spectacular and precious truth in my mind and heart.” Wow, so I embarked on a joyful journey with Piper, and through the many biblical truths presented in the book, my soul was revived and my strength was renewed. overflow of joy in God which gladly meets the needs of others.” 5. The Word of God, which gives us hope and faith, preserves our joy. 6. The power of a Christian Hedonist is prayer - when we pray we have fellowship with Jesus Christ, and prayer empowers us to love. 7. Piper devoted a chapter on the correct way of using money, the currency of a Christian Hedonist. 8. Marriage patterns the relationship between Christ and the church, and so married couples should pursue joy in the holy joy of their spouses. 9. Missions are the duty of a Christian Hedonist. “Every believer should be a soulwinner.” We are to enlarge our joy in Christ by extending His love to others. 10. How a Christian Hedonist should react in suffering – when we choose joy amid suffering, we magnify and glorify the worth of God, who makes joy possible during suffering. Despite the criticisms I had read about this book - mainly around Piper’s emphasis on seeking pleasures, I don’t think what he wrote is unbiblical. Piper emphasised on seeking pleasures IN God, not FROM God, and the purpose of our joy is to glorify God, not to satisfy ourselves.
The review here is based on the 10th anniversary expanded edition, which includes expanded and additional chapters.
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Reach Testimony
God makes all things beautiful in His time By Sharon Khoo
Reach / Autumn 2019
An unexpected prophecy Growing up we all got asked, “What do you want to be when you grow up?� In 2008 it was my turn to decide what I wanted to do after finishing high school. Throughout my childhood I was tossing up between becoming a teacher or a paediatric nurse. Both appealed to me because both involved caring for children and NOT an office job. I ended up pursuing nursing because I thought being a teacher I would have to bring work home (which I was not prepared to do), but as a nurse I would not have to bring my patients home. During my nursing course, a prophet prophesied over me - he saw that I was surrounded by a lot of children and that I would go to Asia to be a missionary. I understood the first part of the prophecy as I had always loved children, had worked part time as a babysitter and was heavily involved in Sunday School ministry at the time. However, what caught me (and I was sure some people in the church) by surprise was me being a missionary in Asia. Being a missionary sounded scary, and in Asia? Well, those who know me know that Asia is not a place on my bucket list. Despite this, I chose to remember this prophecy and was keen to see it come to past one day.
For prophecy never came by the will of man, but holy men of God spoke as they were moved by the Holy Spirit. (2 Peter 1:21)
After completing my nursing course, it was time to apply for a job. I wanted to specialise in paediatrics and held strong onto the prophecy, thinking that was where God wanted me to be. I could not imagine being any other specialised nurse other than a paediatric nurse. When I didn’t get accepted into a graduate program at the Royal Children’s Hospital, I cried my eyes out. My dreams just shattered right in front of me. I pondered on where I had gone wrong and why God did not answer my prayer despite knowing my passion for children. I thought maybe God wanted me to be exposed to adult nursing first before specialising in paediatric nursing. I was reminded of the scripture in Jeremiah 29:11: “For I know the plans I have for you,” declares the LORD, “plans to prosper you
and not to harm you, plans to give you hope and a future.” I knew God had the best plan set out for me and decided to go with it. Everything for a reason I started my graduate year in adult nursing in 2012, at Western Health (WH). I gained a lot of knowledge in adult nursing that year. With the knowledge and skills I acquired, I was able to provide emergency medical assistance to three adults on three separate occasions in the community, including my mother’s customer. I realised the reason God put me through adult nursing even though it was not my desire at the time. Approaching the end of my graduate year I decided to apply for a paediatric program the following year at WH. I was told by many colleagues that the paediatric program at WH was extremely competitive and that my chance of getting in was close to impossible since I had no experience in paediatric nursing. Despite this I decided to apply, knowing if it was the will of God, nothing would be impossible! There were 30 applicants for the 3 positions in the paediatric program that year. Praise God I was one of the successful applicants! For with God nothing will be impossible (Luke 1:37). I commenced the paediatric program in 2013 and was rotated through paediatric ward, emergency department and Special Care Nursery. The paediatric program was amazing, I was exposed to a wide range of settings and patients. I gained a lot of paediatric knowledge and skills. After my paediatric year I found myself in a situation where a child needed emergency medical help in the community and praise God yet again I was able to assist.
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An unanswered prayer
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Reach Testimony
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Reach Testimony Knowing my paediatric program would come to an end by the end of that year, I thought about where I wanted to go next. Even though I loved paediatric nursing, I also thoroughly enjoyed adult nursing and did not want to lose skills in either area. I decided to work as a casual nurse which would allow me to work with both adult and paediatric patients. With the flexibility of my casual work, I started thinking about studying Early Childhood Teaching. How amazing it would be to do both nursing and teaching, a dream job for me. I applied for a post graduate diploma in early childhood teaching and commenced my studies in 2014. After graduating from early childhood teaching, I decided to work as a casual teacher to get exposure to different centres and kindergartens before settling in a place where I would find comfortable working long term. Working casual in both nursing and teaching was great, I was getting casual pay, I could choose which days I wanted to work, and take leave without having to wait for approval. However, the issues with casual work was that I had to wait for a call each day to see if I had work, and sometimes I was called as early as 5am for a morning nursing shift, having no paid leave and no sick leave.
Therefore I say to you, do not worry about your life, what you will eat or what you will drink; nor about your body, what you will put on. Is not life more than food and the body more than clothing? Look at the birds of the air, for they neither sow nor reap nor gather into barns; yet your heavenly Father feeds them. Are you not of more value than they? Which of you by worrying can add one cubit to his stature? (Matthew 6:25-27) Everything for His glory In 2016 Reach Community Church had its first mission trip to the Philippines. The Philippines was a country I was interested in, only because I had been told by many people that I look like a Filipino. My parents even joke with me to this very day that I was adopted. Must I say it is an honour to be mistaken as a Filipino as they have many beautiful features and have won many Miss Universe titles. There was nothing holding me back from going on this mission trip, so I packed my bags and told my parents that I was going to find my Filipino parents in the Philippines. I also wondered if this was God’s prophecy coming true. I did not know what to expect or what to do but trusted that God would use me to bless others, for His glory. During the mission trip I taught First Aid 2-3 times a day to different groups of people at different locations. I taught basic life support for adults, paediatrics and neonates, and practical basic first aid skill. I was exhausted from teaching in a hot and humid climate with only fans to keep me cool, but with the strength of God I pushed on as I knew I was doing this for His glory. I also organised a children’s program for over 100 children at a massive crusade event. I asked God for help and wisdom on how to engage the children and to direct them to Christ. I thank God I had help from others and an amazing translator who assisted me. The event was a success! And there I was, in Asia as a missionary surrounded by children. God’s prophecy had come true!
He has made everything beautiful in its time. Also He has put eternity in their hearts, except that no one can find out the work that God does from beginning to end. (Ecclesiastes 3:11) God is never early nor late, His timing is always perfect.
Reach / Autumn 2019
However, God has always provided me good health and work for most days I was available. Having two professions also helped with getting consistent work. When I made myself available for a morning nursing shift and was not offered a shift, I then made myself available for a teaching shift. If there was no teaching shift, I could put myself down for an afternoon or night nursing shift. It taught me to not worry, to rely and to have faith in God, as I did not know whether I would get work that day or the next.
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Reach Testimony
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Reach Health
Anxiety in children
Reach / Autumn 2019
According to the Australia National Mental Health Survey conducted1 in 2013-14, almost 14% of children and young people (4-17 years old) had mental health problems in the previous 12 months. This is equivalent to 560,000 children and adolescents. In the same survey, anxiety disorders were the second most common mental disorder, affecting around 278,000 children and adolescents. What is Anxiety? Anxiety is defined as “a multisystem response to perceived threat or danger”2 (emphasis added). Perceptions differ from one person to another, hence different objects or events elicit anxiety in different people. Feeling anxious is a normal human emotion. Appropriate level of anxiety can be beneficial; it alerts, warns and protects us from dangerous situations, and prevents us from taking unnecessary risks. It also motivates us to make extra effort to improve our present circumstances. However, anxiety becomes a problem anxiety disorder - when: • It is excessive, intense, severe and frequent. • It persists beyond common fears of certain age group, and lasts for weeks, months and years. • It interferes with daily activities, relationships, school or family life. In anxiety disorder, the level of anxiety is often out of proportion to the actual threat or danger. In this article, we will explore the risk factors and manifestations of anxiety in children and adolescents, common anxiety disorders, and their management. Significant anxiety could be a manifestation of Autism Spectrum Disorder, which is beyond the scope of 1
2 3
this article. Causes and Risk Factors of Anxiety The causes of anxiety are not well understood and are multi-factorial. The progression from feeling anxious to anxiety disorder is complex and contributed by many factors e.g. family history, biological factors (neurotransmitters in our brain), personality type, learned behaviour, previous experience or trauma, resilience, presence of persistent stress (e.g. poor physical health, emotional stress), and support network. The Australia National Mental Health Survey found that anxiety disorders were more prevalent in young people living in families with: • Lower household income. • Parents or carers having lower levels of education . • Parents or carers having higher levels of unemployment. • Non-traditional family type (step, blended and one parent or carer families). • Poorer level of family functioning, which covers issues such as communication and planning within the family, dealing with conflict, levels of emotional and practical support. Manifestations of Anxiety Young people with anxiety can present in various ways: • Physical problems, often pain (e.g. headache, tummy pain) or changes in the body (e.g. racing heartbeat, chest pain, sweating, unexplained tiredness). • Lack of appetite, weight loss and sleep disturbance. • Change of behaviour, cognition and mood e.g. lack of concentration and motivation in learning, irritability,
Conducted by the Telethon Kids Institute at The University of Western Australia in partnership with Roy Morgan Research Medical-dictionary.thefreedictionary.com Except in Obsessive-compulsive disorder, where no difference was noted.
Panic attack is an episode where a person experiences intense fear and anxiety, often accompanied by symptoms such as pounding heart, sweating, shaking, shortness of breath, dizziness, fear of losing control, tingling sensation. It is more common in teenagers than in young children. Common Types of Anxiety Disorders Separation Anxiety Disorder Separation anxiety disorder is the most common anxiety disorder in children 4-11 years old4. Children with separation anxiety are overly anxious of being separated from their primary carer. Although it is not uncommon for young children (babies and toddlers) to feel anxious and fearful when first leaving home e.g. going to childcare, kinder or school, it becomes problematic if the anxiety is excessive, persistent and affects the child’s ability to participate in activities. It is often manifested as school refusal or sleep problem. Social Anxiety Disorder (or Social Phobia) Young people with social phobia have intense fear and anxiety in social situations, where they have to interact with other people, or where they might draw attention. They worry about being perceived negatively. As a result, they refuse to join in classroom activities or discussions, going to parties or eating in public. School refusal and social withdrawal are common presentations of social phobia. Generalised Anxiety Disorder (GAD) Young people with GAD worry about many things in life e.g. health, school
performance, finance, appearance, death of parents or closed ones. Obsessive-Compulsive Disorder (OCD) As the name suggests, there are two components of OCD: obsessions and compulsions. Although under the new DSM-V5, OCD is no longer under the classification of Anxiety Disorders, anxiety is a main feature of OCD. Obsessions are “recurrent and persistent thought, urges, or impulses… that are intrusive and unwanted, and cause marked anxiety or distress”6. Compulsions are “repetitive behaviours (e.g. hand washing) or mental acts (e.g. counting)… in response to an obsession”6. Management of Anxiety Disorders Anxiety disorders can have significant impact on the life of young people. Management can be divided into: 1) prevention, 2) early intervention, and 3) treatment, which often overlaps. It is important to emphasise that the cause of anxiety disorder is complex and poorly understood. Parents should not be blamed if their child has anxiety problem. However, there are many things parents can do to decrease their child’s risk. If you are a parent, do not underestimate your ability to help your child to overcome fear and worries. Your coaching and relationship with your children might be the best protective factor for them. In addition, the more they trust you, the more they will allow you to help them, this is especially true for older children and teenagers. Prevention Prevention is what every parent can do at home to build resilience in their children, even before you identify any anxiety in your children. • Be a role model Model your willingness to try out new things.
Australia National Mental Health Survey. Diagnostic and Statistical Manual of Mental Disorders (5th Edition), a handbook and guide to the diagnosis of mental disorders. 6 DSM-V 4
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excessive worries over making things right (“perfectionist”) or trying new things, withdrawal from social situations, avoidant behaviour, overly sensitive to criticism, and needing constant reassurance.
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Reach Health When you are anxious or worried, verbalise it and tell your child how you intend to overcome it. If you have problem with anxiety, seek help early. Do not let your own anxiety trickle down to your child. • Do not threaten your child unnecessarily e.g. “if you don’t listen, I’m going to send you away.” • Talk to your children about their feelings. Do not dismiss their fear or concern, no matter how trivial you think they are. You cannot overcome worries by avoidant. Teach them to regulate their emotion.
• Teach your children to replace worries and negative thoughts with positive thoughts. • Teach them to break down big tasks into smaller steps. • Do not reinforce negative avoidant behaviour e.g. if they refuse to go to school, do not let them stay at home on their electronic devices. • If their concerns are real, help them to problem solve. • Help them to recognise when they are anxious, and move on to something positive or pleasant. • Encourage and praise their effort.
• Allow your children to take appropriate risk, do not over-protect them. • Teach your children to accept uncertainty e.g. it is OK to take a step even when they are not 100% sure that things will turn out the way they want. • Teach your children to take responsibility for their own decisions. • Build confidence. Children who lack confidence tend to worry more about how they perform, how others perceive them, or if they are doing the right thing. If the only feedback they get from you is criticism, it will only intensify their anxiety. Praise their effort, not their talent or success. Do not compare. • Spend quality time with your child. • Create a sense of belonging within the family, a family environment that is accepting. • Foster positive communication within the family. • Develop healthy lifestyle – a balanced diet, physical exercise which improves mood, and adequate sleep. • Teach your child social skill, problem solving skill and stress management.
Treatment Once your child’s anxiety interferes with daily life, professional help is highly recommended. School welfare officer, counsellor or psychologist is a good start. Local doctors, paediatricians, psychiatrists and allied health professionals (e.g. psychologists) are other resources. Treatment recommended by professionals might include: • Psychological therapies • Graded exposure. • Cognitive Behaviour Therapy - challenging the negative thoughts and changing the behaviour. • Coping with anxiety • Breathing and relaxation techniques. • Medication is sometimes used in older children and teenagers with significant anxiety affecting their daily functions. Often, the goal is not to “eliminate” anxiety completely, as it might be unrealistic, but to learn to cope and manage their anxiety.
Early intervention If your child expresses or shows signs of anxiety, do not dismiss them, acknowledge them and intervene early. Be patient, do not let your frustration intensify their anxiety. • Challenge the wrong thinking e.g. “everyone hates me”, “I’m so stupid”, “I’ll never get it right”. Help them to put things into perspective without excessive reassurance.
Anxiety disorders are the second most common mental disorder in children and adolescents in Australia. Although the cause and risk factors are complex, there are measures parents can take to prevent and to help their children. Mind and perception are powerful intrinsic factors, beware of what you put or allow others (including the media) to put into the mind of your children.
Since we have been talking about Joy in this issue, it is appropriate to add to your joy with this recipe of Honey Joys, taken from the website.
Ingredients: (Makes 24)
90g butter or margarine 1/3 cup sugar 1 tablespoon honey 6 cups cornflakes
Method: 1. 2. 3. 4. 5. 6. 7.
Preheat oven to 150 ° C. Line 24 hole patty pan with paper cases. Melt butter, sugar and honey together in a saucepan until frothy. Add cornflakes and mix well. Working quickly spoon into paper patty cases. Bake in the oven for 10 minutes. Cool and enjoy.
Tips: Add coloured sprinkles on top to brighten your Joy.
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Honey Joys
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