Accepting Differences: One way to work with kids and teens on fostering healthy relationships is by building skills around empathy. An aspect of practicing empathy is learning to accept and appreciate differences. When exploring friendships and relationships with kids/teens, here are some ways to start building empathy skills:
o Who is one of your favorite friends to be around and why (i.e. in activity below, how they appreciate them as human beings)
• What are your similarities?
• What are your differences? (i.e. seeing their world)
o When friends feel differently about the same thing, how can we use empathy to understand each other’s feelings?
• Talk about how there are different points of view and empathy is thinking outside one’s comfort zone (i.e. seeing their world)
• Such as: how might you feel AND how might they feel? (i.e. understand their feelings)
• How might you communicate your understanding of how they feel?
o As an activity in session, you can use the template below to have the client write in answers to the above.
Defusing from Thoughts: Sometimes we can become strongly connected to a certain way of thinking, believing, and being, that could lead to experiencing distress within the self and with others. Acceptance & Commitment Therapy (ACT) has developed a series of metaphors to support clients in building awareness on how they may be fused with thoughts and ways of being with themselves, another, and the world. The ‘Hands as Thoughts’ Metaphor helps to illustrate how to engage fully in our experience and facilitate effective action.
o Imagine for a moment that your hands are your thoughts. Hold your hands together side by side, palms open, as if they are the pages of an open book.
• Then slowly and steadily raise your hands towards your face. Keep going until they are covering your eyes.
• Take a few seconds to look at the world around you through the gaps between your fingers, and notice how this affects your view of the world.
o Now imagine what it would be like to go around all day with your hands covering your eyes in this manner.
• How much would it limit you? How much would you miss out on? How would it reduce your ability to respond to the world around you?
• This is approximately how restricted we are in cognitive fusion. We become so caught up in our thoughts that we lose contact with many aspects of our here-and-now experience, and our thoughts have such a huge influence over our behavior that our ability to act effectively is significantly reduced.
o Once again cover your eyes with your hands, but this time lower them from your face very, very slowly.
• As the distance between your hands and your face increases, notice how much easier it is to connect with the world around you.
o Notice how much easier it is to take effective action without your hands covering your eyes; how much more information you can take in; how much more connected you are with the world around you.
Sample Progress Note: The focus of this session was… The therapist engaged the client in an ACT cognitive defusion exercise to support them in building awareness on a fusion to thoughts that may be contributing to distress. The client reported that it was (helpful/not helpful/painful/etc) to engage in this activity and was able to identify ways to practice outside of session.
Community Strategy of the Week:
Inclusive Thinking: When we include others in our thinking, in a balanced way, it can help to improve our effectiveness of engaging with those around us. The DBT T.H.I.N.K. skill provides a framework for thinking with consideration for another’s perspective, thinking, way of being, which in turn supports one in approaching others with empathy and compassion.
o Think . . . about it from the other person’s perspective.
o Have empathy. . . What might he or she be feeling or thinking?
o Interpretations . . .Can you think of more than one possible interpretation or explanation for the other’s way of being/behavior? List other possible reasons for the behavior; come up with at least one benign reason
o Notice . . . ways the other person has been trying to make things better, to help, or to show he or she cares. Or, notice how the other person may be struggling with his or her own stress or problems.
o Kindness . . . Can you use kindness and be gentle when you approach the other person?
Source: Rathus, J. H., & Miller, A. L. (2014). DBT skills manual for adolescents. Guilford Publications.
Sample Progress Note: The focus of this session was… The therapist provided psychoeducation on the DBT THINK skill to build interpersonal effectiveness and supported the client in practicing this strategy. The client reported that it was (helpful/not helpful/etc) to learn about and use skill and was able to identify (one/a couple/several) ways to utilize outside of session.
Mindfulness/Meditation of the Week:
Compassion for Others: Compassion for the self and others can support one in building meaningful as well as neutral relationships. Below is a mindfulness activity for growing compassion with another; follow the source link for more meditations on compassion for the self and others.
• Compassion for a Neutral Person
o Visualize someone you neither like nor dislike—someone you may see in your everyday life, such as a classmate with whom you are not familiar, a bus driver, or a stranger you pass on the street. [5 seconds]
o Although you are not familiar with this person, think of how this person may suffer in their own life. This person may also have conflicts with loved ones, or struggled with an addiction, or been bullied, or may have suffered illness. Imagine a situation in which this person may have suffered. [30 seconds]
o Notice your heart center. Does it feel different? Do you feel more warmth, openness and tenderness? Are there other sensations, perhaps an aching sensation? How does your heart feel different from when you were envisioning your own or a loved one’s suffering? [10 seconds]
o Continue to visualize this person as you breathe. Imagine that you are extending the golden light from your heart to them, and that the golden light is easing their suffering. Extend this light out to them during your exhalation, with the strong heartfelt wish that they be free from suffering. See if this wish can be as strong as the wish for your own or a loved one’s suffering to be relieved. Silently recite to them: [2 minutes]
• May you be free from this suffering.
• May you have joy and happiness.
• May you be free from this suffering.
• May you have joy and happiness.
o Again, notice how this feels in your heart. Did the sensations change from when you were envisioning this person’s suffering? Did you continue to feel warmth, openness and tenderness? Were there other sensations? Did you have a wish to take away this person’s suffering? How were these feelings different from when you were wishing to take away your own or a loved one’s suffering? [30 seconds]
Sample Progress Note: The focus of this session was… The therapist led Ct. in a mindfulness activity around practicing compassion towards another. Ct. (engaged/did not engage in the activity), and they reported that the mindfulness activity was (helpful/difficult/not helpful).
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