Kid /Teen strategy of the week:
Emotion Body Scans: Learning to attend to emotions like sadness, anger, anxiety, and joy can be helpful in kids/teens feeling more aware of and able to regulate their moods. A body scan is one way of tuning into how emotions are experienced in the body and also supports kids/teens in learning about the mind-body connection. Overall, emotional body scans are effective for managing strong emotions and fostering a calmer mood.
- With kids/teens, coming up with a fun and relatable way to engage in a body scan makes it more likely they will use again! Here’s an idea…
- Start by inviting the client to envision a wand and think of a sound for when the wand comes across an emotion in their body (e.g., beep, blurp, humm, etc.)
- Then, start at the feet and slowly move the wand up towards the head, stopping each time the client finds an emotion in their body to explore, what does it feel, look, sound like or what is its shape, color, or event texture!
- You may find it helpful to begin by modeling the exercise and provide examples on how the body send signals of how we are feeling (e.g. in our eyes, ears, face, belly, shoulders, hands, feet) and what body feelings happen with different emotions (e.g. butterflies, warmth, muscles tightening, sweating, ringing, etc.)
Source: https://www.mindful.org/body-scan-kids/
Sample Progress Note: The focus of the session was (tailor based on treatment plan). The therapist engaged the client in an emotional body scan exercise to build understanding on the connection between emotions and the body and ways of attending to mood. The client responded to the activity by (fill in the blank).
Adult strategy of the week:
CBT Pleasant Activity Scheduling: When feeling lower in mood and fatigued, a natural response is to engage less in life. A while of doing fewer things in life that bring joy can contribute to feeling more negative emotions and less able to navigate these. The strategy of scheduling activities that are enjoyable helps clients to attend to their mood in a different way by experiencing moments of positive mood amid their fatigue.
In session, come up with one activity each day the client can do that may be enjoyable, such as:
- Monday: have a mindful moment
- Tuesday: talk to a friend or family member
- Wednesday: walk for 2-10min
- Thursday: tune into music
- Friday: watch a funny video, show, movie
- Saturday: savor a new food
- Sunday: re-read a favorite book
Then, have clients log/rate how they are feeling after engaging in the activity.
Source: Pleasant-Activity-Scheduling-Worksheet.pdf (positivepsychology.com)
Sample Progress Note: The focus of this session was… The therapist provided psychoeducation about CBT pleasant activity scheduling and engaged the Ct in a activity of identifying enjoyable activities to do each day in the next week. The client reported that was (helpful/not helpful/painful/etc) to identify things to look forward to in the future.
Depression strategy of the week:
DBT PLEASE Skill: Often when experiencing depression engaging in forms of self-care can be especially helpful for emotional regulation as well as important for building emotional resilience. The DBT PLEASE skill entails an acronym, in which each letter represents a strategy for attending to various aspects of the self that may be impacted by and/or contributing to a lower mood:
- Physical health (e.g., going the doctor as needed and following recommendations, taking medications as prescribed)
- List resources and strengths
- Eat healthy foods in a balanced way
- Avoid mood altering substances
- Sleep enough to feel good
- Exercise every day (or as much as you can)
- Daily practice makes the difference**
Source: https://dbt.tools/emotional_regulation/abc-please.php
Sample Progress Note: The focus of this session was… The therapist supported the client in learning and practicing the DBT PLEASE skill. The client reported that it was (helpful/not helpful/etc) to learn this skill and was able to identify (one/a couple/several) ways to practice outside of session.
Mindfulness/Meditation of the week:
Meditation for Depression: Meditation can be a space to attend to emotions and build one’s ability to name as well as navigate strong emotions. Use this mediation for attending, labeling, and accepting emotional experiences.
Source: https://www.mindful.org/a-guided-meditation-to-label-difficult-emotions/
Sample Progress Note: The focus of this session was… The therapist led Ct. in a mindfulness activity around labeling and sitting with emotions. Ct. (engaged/did not engage in the activity), and they reported that the meditation was (helpful/difficult/not helpful).
Script:
1. Find your seat. Start by finding a comfortable quiet place to sit in a dignified posture, which is relaxed but upright, tranquil, and alert. Close your eyes fully or partially. Take a few deep breaths to allow your body to relax.
2. Shift attention to sensations in the body. Bring your awareness to your body by noticing your posture. Feel the world of sensation occurring within your body at this very moment.
3. Notice your breathing. Now place your hand on your heart and begin to feel your breathing: the out-breath and the in-breath. If it’s easier, just focus on one, and rest, waiting for the next breath. Do this for another minute, and if along the way you’d like to let your hand slowly fall to your lap, feel free to do so.
4. When you get distracted, come back to the breath. When you notice your mind has wandered, as it always does, gently come back to your breath as a touchpoint again.
5. As you continue mindfulness of breathing, notice what emotions begin to surface. Shift your attention from your breath and ask yourself: What am I feeling? What emotions are my feeling, right here right now? If you sat down for this exercise without any strong emotions, perhaps you’re feeling contentment. Or perhaps you’re curious, or maybe there’s another emotion inside such as longing or yearning, or perhaps sadness or joy, worry, perhaps a sense of urgency. Maybe loneliness. Or maybe you’re bursting with pride or feeling lost or envy. Maybe you’re having a lot of feelings.
6. Label the most prominent emotion or emotions. Try to identify the strongest feeling that you’re having and give it a name quietly in the midst of your feelings and kind of using your body as an antenna, perhaps only picking up faint signals. Faint signals that first let yourself become aware of the emotions that are percolating in your body. And when you have an emotion and you have a name for it, have a label for it, then repeat that name three times in a kind, and gentle voice. For example, worry, worry, worry, joy, joy, joy. Return to your breath, feel your breath. And now go back and forth between your breath and your emotions in a relaxed way.
7. Continue to shift between the breath and the emotion you are holding. So, when you feel the emotion, label it and then return to your breath. If you feel overwhelmed by the emotion or it’s very disturbing, then just stay with your breath until you feel better.
8. Show yourself loving-kindness. Breathe, feel each breath, and keep your hand over your heart, feeling the warmth of your hand, and the loving-kindness, the good will that’s within you and has even inspired you to undertake this exercise. The wish to be happy and free from suffering. Feeling that innate good will and breathe through your heart. And when the emotion arises or sweeps away your attention just label it and then return to your breath.
9. Open your eyes. Slowly open your eyes if they have been closed.
10. As you go about your day, know that you can always find refuge in your breathing and most emotions can be made more workable by labeling them.
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