Kid strategy of the week:

Worry monster: Explain to the child that some of us have “worry monsters” that tell us things that make us worried or scared. Perhaps their worry monster says things like “You’re going to get sick,” “You are not good at this,” or “What if something bad happens?” 

Spend some time drawing your worry monsters and have the client give theirs a name.

Around the picture of the worry monster, have the client write the specific things that their worry monster tells them.

Explain to the child that we can feed or starve our worry monster. Talk about what “feeds” the childs worry monster (listening to the worry monster, watching scary videos, not talking with someone about their worries), and what “starves” the worry monster (talking back to the worry monster, talking with a trusted adult, using coping and self-soothing skills, etc).

Sample Progress Note: The focus of the session was to (tailor based on tx plan). The therapist provided psychoeducation about and externalization of worry symptoms using the Worry Monster art therapy activity. The dyad processed coping skills to reduce worry and anxiety. The Ct (did/did not) identify several self-soothing skills to reduce their anxiety and worry.

Couples strategy of the week:

Couples Strength Exercise: During difficult times, it is easy to overlook your partner’s strengths or feel unacknowledged yourself. In this exercise, couples spend time noticing each other’s strengths and acknowledging them.

Sample progress note: The focus of this session was… The therapist used a couples strength exercise to increase the couple’s protective factors, by assisting them in recognizing and acknowledging their partner’s strengths.The couple (was engaged/not engaged/resistant), and they reported that it was (helpful/not helpful/challenging).

Adult strategy of the week:

DEARMAN is an acronym to help us  effectively advocate for ourselves and improve our interpersonal communication. Use this acronym to broach a difficult conversation with a family member, friend, or at work. See the link for more details.

D – Describe

E – Express

A – Assert

R – Reinforce

M – (Stay) Mindful

A – Appear confident

N – Negotiate

Sample progress note: The focus of this session was to… The therapist used psycho-education about DBT skills (i.e., DEARMAN) to help ct. identify ways to improve their interpersonal effectiveness. Ct. was able to identify different strategies to help them communicate more effectively with others, and they were (able/not able) to identify a situation in which they could use this skill.

Mindfulness/meditation of the week:

Self-compassion break: Use the following script for clients who are experiencing shame or self-criticism. You can also send the link below (which includes an audio clip) to clients who may want to use this on their own between sessions.


Sample progress note: The focus of this session was… The therapist led a mindfulness activity (i.e., Self-Compassion Break). Ct. (engaged/did not engage in the activity), and they reported that the activity was (helpful/difficult/not helpful).

Think of a situation in your life that is difficult and is causing you stress.

Call the situation to mind and see if you can actually feel the stress and emotional discomfort in your body.

Now say to yourself, “This is a moment of suffering.” This acknowledgment is a form of mindfulness—of simply noticing what is going on for you emotionally in the present moment, without judging that experience as good or bad. You can also say to yourself, “This hurts” or “This is stress.” Use whatever statement feels most natural to you.

Next, say to yourself, “Suffering is a part of life.” This is a recognition of your common humanity with others—that all people have trying experiences, and these experiences give you something in common with the rest of humanity rather than mark you as abnormal or deficient. Other options for this statement include “Other people feel this way,” “I’m not alone,” or “We all struggle in our lives.”

Now, put your hands over your heart, feel the warmth of your hands and the gentle touch on your chest, and say, “May I be kind to myself.” This is a way to express self-kindness. You can also consider whether there is another specific phrase that would speak to you in that particular situation. Some examples: “May I give myself the compassion that I need,” “May I accept myself as I am,” “May I learn to accept myself as I am,” “May I forgive myself,” “May I be strong,” and “May I be patient.”