Positive Affirmations: Download the list below of positive affirmations. Share your screen with the client and have them tell you the affirmations that mean the most to them. You can tailor this to a certain challenging situation (i.e. worrying about returning to school, or getting frustrated with a sibling), or in general. Have the child write these affirmations on index cards or cut up construction paper and talk about situations when they can read the cards to themselves or ask a caregiver to read the cards aloud to them.
Sample Progress Note: The focus of this session was… The therapist engaged the Ct in a positive affirmation activity to increase their self-esteem and coping skills. Ct reported that the activity was (interesting/helpful/boring).
Couples strategy of the week:
Compromise and Problem-Solving: The couple should choose a disagreement that feels unresolved. Then, each partner should take turns identifying their core need in the resolution (e.g., financial security, protecting someone else’s feelings, acknowledgement of hurt feelings) and help the other partner understand the importance of the core need. After both partners feel like their core needs are understood, they should work together to find areas of flexibility in which they can compromise to find a resolution (Gottman Institute, 2016).
Sample Progress Note: The focus of this session was… The therapist helped the couple practice conflict resolution skills through compromise, problem-solving, and identification of needs. The couple (engaged/did not engage) in the conflict resolution, and they reported that it was (helpful/not helpful/frustrating).
Adult strategy of the week:
Distress Tolerance Skills (Improve the Moment): The following strategies from Dialectical Behavior Therapy (DBT) can help clients get through moments of distress by improving the moment:
Imagery: Imagine yourself in a calm, safe place, focusing on all the sensory details that make the place feel tangible (e.g., sights, smells, sounds). You can also imagine yourself doing well or succeeding at something.
Create meaning: Take some time to think about ways that the current situation could be meaningful, even though it’s distressing or unpleasant.
Prayer: Take some time to connect with a higher power or your own wise mind. Focus on accepting the present moment, as opposed to ruminating on thoughts such as, “why me?” Remember that accepting something does not mean that you need to agree with it or like it.
Relaxation: Do things that help you feel relaxed (e.g., a hot bath, breathing deeply, drinking a hot beverage, massaging your hands).
One Thing in the Moment: Be mindful about something in the moment. For example, you could try being completely mindful of washing your hands, your breathing, or sounds around you.
Sample progress note: The focus of this session was… The therapist provided psycho-education about distress tolerance skills (i.e, Improve the Moment from DBT) to help client manage their mental health symptoms. Client was (able to/unable to) identify ways to engage in each of the distress tolerance skills, and they reported that the psycho-education was (helpful/boring/interesting/etc).
Sample progress note: The focus of this session was… The therapist led a meditation activity (i.e., Forest Visualization). Ct. (engaged/did not engage in the activity), and they reported that the activity was (helpful/difficult/not helpful).
Begin by finding a comfortable position sitting or lying down. Allow your body to begin to relax as you start to create a picture in your mind. Let the forest visualization begin.
Imagine yourself walking on a path through a forest. The path is soft beneath your shoes, a mixture of soil, fallen leaves, pine needles, and moss. As you walk, your body relaxes and your mind clears, more and more with each step you take.
Breathe in the fresh mountain air, filling your lungs completely. Now exhale. Breathe out all the air. Feeling refreshed.
Take another deep breath in…revitalizing…. and breathe out completely, letting your body relax further.
Continue to breathe slowly and deeply as you walk through the forest and continue the forest visualization.
The air is cool, but comfortable. Sun filters through the trees, making a moving dappled pattern on the ground before you.
Listen to the sounds of the forest…. Birds singing. A gentle breeze blowing. The leaves on the trees shift and sway in the soft wind.
Your body relaxes more and more as you walk. Count your steps and breathe in unison with your strides. Breathe in 2, 3, 4… hold 2, 3…exhale 2, 3, 4, 5.
Breathe in 2, 3, 4… hold 2, 3…exhale 2, 3, 4, 5.
Breathe in 2, 3, 4… hold 2, 3…exhale 2, 3, 4, 5.
Continue to breathe like this, slowly and deeply, as you become more and more relaxed.
As you walk through the forest visualization, feel your muscles relaxing and lengthening. As your arms swing in rhythm with your walking, they become loose, relaxed, and limp.
Feel your back relaxing as your spine lengthens and the muscles relax. Feel the tension leaving your body as you admire the scenery around you.
Your legs and lower body relax as well, feeling free and relaxed.
As you continue to walk through the forest visualization, you begin to climb up a slight incline. You easily tread along smooth rocks on the path. Feeling at one with nature.
The breeze continues to blow through the treetops, but you are sheltered on the path, and the air around you is calm.
Small saplings grow at the sides of the path.
Around you is an immense array of greens. Some of the leaves on the trees are a delicate, light green. Some leaves are deep, dark, true forest green.
Many trees have needles that look very soft and very green. The forest floor is thick, green moss.
Tall trees grow on either side of the path. Picture the variety of trees around you. Some have smooth, white bark. Others are darker, with coarse, heavy bark, deeply grooved. Enjoy the colors of the bark on the trees – white, tan, brown, red, black… many combinations of color. You admire the rough, brown bark of pine trees and enjoy the fresh pine scent.
Smell the forest around you. The air is fresh, and filled with the scent of trees, soil, and mountain streams.
Continue the forest visualization…
You can hear the sound of water faintly in the distance. The gentle burbling sound of a creek.
As you continue to walk through the forest, you are gaining elevation and getting closer to the sound of a running stream.
Continue to enjoy the forest around you. Enjoy the forest visualization.
As you near the top of the mountain, you hear the stream, very close now. The path curves up ahead. You can see sunlight streaming onto the path.
As you round the corner, you hear the water, and see a clearing in the trees up ahead. A beautiful look out point awaits.
You are growing tired from your journey. Your body feels pleasantly tired and heavy.
Imagine yourself walking toward the clearing and the stream. Stepping stones make an easy path across the stream and toward the edge of the mountain. Step on each large flat stone to easily cross the small, shallow stream.
Up ahead is a large, smooth rock… like a chair waiting for you to rest. The rock is placed perfectly, high up on this beautiful vantage point.
Sit or lie down on the rock if you wish. It is very comfortable. You feel very comfortable and at ease. The sun shines down on you.
Looking around, you see mountains in the distance. Faint and blue.
You can look down from your vantage point into a valley with trees and a brilliant blue lake. Across from you is another mountain.
The clearing around you is made up of rocks, soil, pine needles, moss, and grass. The grass and mountain wildflowers around you blow gently in the breeze. A deer quietly emerges from the edge of the forest to graze in the clearing. As the deer raises its head to look at you, you can see its nostrils moving to catch your scent. The deer cautiously walks to the stream to drink before disappearing back into the forest.
Squirrels dart in and out of sight as they romp through the trees, and race across the clearing.
Feel the sun warming your body as you relax on the rock. Enjoy the majestic landscape around you and feel your body relaxing even more.
Your body becomes very warm, and very heavy.
Continue to breathe the clean, fresh air.
You feel so relaxed.
In unity with nature around you.
Enjoy the sights….sounds….and smells of the forest around you.
Feel the sun, warm on your skin.
Feel the gentle breeze blow across your cheek.
Listen to the birds singing.
Hear the stream flowing. The leaves rustling in the breeze. Squirrels chattering.
See the flowers, trees, valley, and mountains around you.
Lay back on the comfortable rock, and you can look up to see the blue sky. Small white clouds float gently across the sky. Watch them drift slowly by. Shapes ever changing.
Enjoy this peaceful place.
When you are ready to leave this peaceful place, slowly begin to reawaken your body.
Know that you can return to this forest visualization in your imagination whenever you like.
As you reawaken, keep with you the feeling of calm, peace, and relaxation.
Wiggle your fingers and toes to wake up your muscles.
Shrug your shoulders. Stretch if you want to.
When you are ready, open your eyes and return to full wakefulness, feeling alert and refreshed.
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