Soothing with the Senses Box: Prepare the parents ahead of the session and have them help the child find an old shoebox or Kleenex box. During the session (possibly with the parents’ help again), direct the child to go around the house and find things that help them feel calm or happy using their five senses. Help the child think about times when they could use the box to feel better.

Sight: Pictures of people that they love or pretty scenery, trinkets from a happy memory, a picture of their favorite superhero or cartoon character

Sound: a CD with their favorite songs or soothing music, a list of YouTube videos they can go to with their favorite songs or sounds on them, a sound machine (rain sounds, river sounds, etc), earplugs or headphones

Touch: A cozy blanket, favorite stuffed animal

Taste: A favorite piece of candy, gum, or mints, a preferred drink or snack

Smell: Yummy-smelling lotion, essential oils, a parent’s perfume or cologne on a cotton ball

Sample progress note:

The focus of the session was to (tailor based on tx plan). The therapist and Ct created a “Calm Box” (soothing with the senses) to develop coping skills. Ct identified (list situations) in which they could use the box to help themselves calm down or feel better.

ACCEPTS is an acronym to help us remember different ways to distract ourselves when there isn’t anything we can do about stressors at the moment. Create a list of things to do in each of the categories (see link for more details).

• A – Activities
• C – Contributing
• C – Comparisons
• E – Emotions
• P – Pushing Away
• T – Thoughts
• S – Sensations

https://www.dbtselfhelp.com/html/accepts.html

Sample progress note:

The focus of this session was to… The therapist used psycho-education about DBT skills (i.e., ACCEPTS) to help ct. identify ways to cope with difficult emotions. Ct. was able to identify different strategies to help them cope with difficult emotions, and they were (able/not able) to integrate the psycho-education into their narrative.

Container – https://www.resilientlifetherapy.net/new-blog/2018/8/16/the-container-exercise

Sample progress note: The focus of this session was… The therapist lead a mindfulness activity (i.e., Container) to help ct. practice mindfulness and containment. Ct. (engaged/did not engage in the activity), and they reported that the activity was (helpful/difficult/not helpful).

Ok, now, close your eyes and imagine a container.  It can be any container.  What does it look like?  How big is it?  What color is it?  Is it something special to you or something you’ve seen before?  Where is your container?  Pick something that has a lid or would have the ability to hold “stuff” securely.  Some people have imagined armoires, unique wooden containers with small and big drawers, tool boxes, mason jars, rubber-maids, cookie jars, etc.  There is no right or wrong.  This will be your very own container.  Now just take a moment to imagine it.

Now, do you have anything that is bothering you?  Identify something mildly to moderately nagging; something you can’t do anything about right now.  Perhaps you’re at work and keep getting a nagging thought and feeling about organizing a closet of yours that you just can’t seem to get around to lately.  Or perhaps you feel a little uncomfortable about a recent interaction you had with a friend and its not the right time to resolve it with them because they are out of town or unavailable.  Maybe you’re nervous about an upcoming event you need to attend or trip you need to take.  Something like that.  On a scale of zero to 10 (with 10 being the most distress you can imagine and zero being completely neutral) think of something that is a two or a three.

Notice how you feel when you think about it.  Notice what you see in your mind’s eye when you think about it.  Notice your thoughts.  Be with this for a moment.  Now imagine sending your feelings, the images, and thoughts to your container.  You can do this by imagining them (one at a time or as a single combined unit) flowing from your body into the container.  Or you can imagine walking up to your container and placing these items in, followed by placing the lid on it, and then walking away.  Whatever works for you.  Take a moment to try this.

Now, check in with yourself again.  What do you notice in your body… in your mind?  Has the distress reduced?  How would you rate it on a scale of zero to 10? If you noticed that your distress reduced, this may be a very useful tool for you to engage regularly to help manage emotions and mental difficulty.