Kid strategy of the week:

Calm/Safe Place- Kid version: Help your client imagine a place where they feel calm, safe, and/or peaceful. This can be an actual physical space (a corner of their room, a favorite couch in their house), a place where the client has traveled, or an imaginary place. Engage the client in an art activity to help make their calm/safe space more tangible. Some ideas include:

Drawing or painting a picture of their calm/safe space

Making a Word document collage together by copying/pasting pictures or drawings you find on the internet

Making a Pinterest board

Encourage your client to incorporate all their senses. What does their calm/safe space look like? What sounds do they hear there? What textures do they feel? What sounds and tastes are there?

Encourage your client to spend a few minutes imagining being in that place. How does their body feel? What emotions do they feel when they imagine being in that space?

Find a way for your client to bring a reminder (the drawing, a screenshot on their phone or a caregivers’ phone) with them, especially during stressful situations. Some clients find that just looking at a visual reminder can help them feel calm and safe; others may find that taking a break in another room to imagine themselves in that space can feel soothing and helpful.

Sample Progress Note: The focus of the session was to (tailor based on tx plan). The therapist engaged the client in an art therapy activity (Calm/Safe space) to help the Ct identify and create a safe space for Ct to use for self-soothing. The Ct was (engaged/not engaged) in the activity.

Couples strategy of the week:

Using Safe Words/Phrases and Taking Breaks in Arguments: In the heat of an argument or disagreement, it can sometimes feel challenging to express when we feel overwhelmed, shut down, or ungrounded. These may be times when creating a sense of safety, taking a break from the conversation, and returning to the conversation later could be helpful. When you and your partner are both feeling relaxed and calm, take some time to create a Safe Word or Phrase that you can say in the middle of a disagreement that will communicate that you need a break.

Tips:

Choose a Safe Word or Phrase that you can both remember. Some couples like to choose something that feels silly, which can break some of the tension in the moment.

If possible, figure out the details of the break beforehand. How long should it be? Will you be together or apart during the break? What are some things that could feel helpful, grounding, or calming during the break?

Respect the Safe Word or Phrase. This can build a sense of safety and trust in your relationship.

Sample Progress Note: The focus of this session was… The therapist helped the couple explore strategies to de-escalate disagreements, identify their needs, and communicate their needs by defining a safe word/phrase they can use during disagreements and how to take breaks during disagreements. The couple reported that exploring these strategies and topics was (helpful/unhelpful/interesting/unrealistic/etc), and they were able to define a safe word/phrase, as well as what kind of breaks would be helpful for them during disagreements.

Adult strategy of the week:

Creating a Safe Space At Home: Choose a space in your home to dedicate to safety and calmness. This could be a room, or even a closet, corner, or a spot outside. Fill the space with things that make you feel safe and calm, so that you can take breaks there and feel more grounded. When thinking about things to include, it can be helpful to think about what textures, smells, imagery, sounds, lighting, or tastes help you feel safe, calm, and grounded.

Sample Progress Note: The focus of this session was… The therapist helped the client create a calm safe place in their home to help them feel more grounded and regulated when their mental health symptoms increase in intensity. Client reported that creating a calm and safe place in their home (seems helpful/seems challenging/etc), and they explored (situations when a calm and safe place could be helpful/barriers to creating a calm and safe place/etc).

Meditation/Mindfulness strategy of the week:

Trauma-Informed Meditation: See the below link for additional information about how to adapt typical meditation scripts to make them more trauma-informed, which can allow survivors of trauma to access meditation and mindfulness in a way that emphasizes choice, power, and safety.

Source: http://www.drkateking.com/trauma-informed-guided-meditation/

Sample Progress Note: The focus of this session was… The therapist led a meditation activity (Trauma-Informed Meditation). Ct. (engaged/did not engage in the activity), and they reported that the activity was (helpful/difficult/not helpful).

For those who wish to do so, will now begin a guided meditation practice for about ten minutes. At the end of practice, I will ring this gong… << transparency, setting expectations >>

If you feel uncomfortable in this activity, you can exit the room at any time. You may also choose to sit with us but engage your mind in another manner for these ten minutes.

If you want a break from the activity at any time, you could bring your attention to the sounds or colors in the room, or another external object. << offering suitable alternatives, normalizing the fact that the activity might be challenging >>

This meditation is your time to practice, and we are creating this experience together. As I offer cues, please do what feels safe for you, and ignore the rest. << emphasizing collaboration, personal autonomy, and safety>>

We will now begin the meditation. << clarity of action >>

I invite you to bring your attention to your physical posture… << emphasizing personal choice >>

Find a seated position where you can rest comfortably for about ten minutes. << clear expectations >>

You may feel your weight balanced on the seat cushion beneath you. << cueing without commanding >>

You might experience an elongated, comfortable spine, and an uplifted feeling in your chest. << cueing without commanding >>

You might feel your shoulder blades relax down your back. << cueing without commanding >>

At any time during this practice, if you become uncomfortable or experience pain, you have a choice in how to respond. You may choose to wait out the discomfort to see if it subsides. You may also choose to adjust your physical posture to maintain a feeling of physical ease. << offering choices, emphasizing autonomy, making it clear that compliance is not required >>

We want your posture to be comfortable and sustainable, so please do what works for your body. << emphasizing autonomy/choice >>

You may feel the muscles of your face relax. << cueing without commanding >>

See how it feels to have your eyes open… to soften your gaze and let it rest about six feet ahead of you.

If you prefer, you may close your eyes. << offering alternatives >>

When you are ready, you might notice where you feel your breath in your body… << allowing individuals to move at their own pace >>

You might feel your abdomen rise and fall, or the air beneath your nostrils, or simply a soft rhythmic quality in your torso. << cueing without commanding >>

If your breath becomes difficult or unpleasant to focus on, bring your attention to an object in the room as your focal point.  << not assuming it is easy or pleasant for everyone, and offering alternative >>

See what it might feel like to rest quietly with your breath, or with your attention on this object… << encouraging curiosity, personal choice >>

When you notice that thoughts or feelings arise, you might experiment with bringing your attention back to your breath, or another consistent object of attention… << encouraging curiosity, moving at your own pace, personal choice >>

Remember that there is nothing wrong with thoughts and feelings arising… just gently remind yourself that they are not needed during this activity, and bring your attention back to your breath… << emphasizing acceptance of current experience, not setting up a ‘right’ and ‘wrong’ way that could elicit shame >>

This state of being may feel pleasant or relaxed, it may feel somewhat uncomfortable, or you may experience it as neutral… << not making assumptions, normalizing array of experiences >>

Respect whatever experience is arising for you, and take care of yourself during this time… << encouraging autonomy, personal choice, self-compassion >>

<< Longer space without talking >>

If you notice yourself thinking, you might gently bring your attention back to the experience of your body breathing, or your chosen object of attention… << could repeat something like this periodically; continues to emphasize personal choice and offer suitable alternative in case inner experience is distressing >>

<< Longer space without talking >>

If you need to take a break from this practice at any time, you are welcome to change your inner experience to something that feels more comfortable for the moment, and rejoin us at any time…

<< Longer space without talking >>

Take a moment to offer yourself gratitude and respect for whatever arose in this practice, to whatever degree you engaged… << cueing closure, decrease likelihood that gong will startle >>

<< Gong to close practice >>