DBT for Adolescents: notes

Orientation Module
DBT's Five Skills Sets

For each of the 5 problem areas, DBT offers specific skills to help teens develop healthier
behaviors:

1. Reduced Awareness & Confusion About Self:

o Mindfulness Skills 🧘: Teach awareness of emotions, thoughts, and urges to
improve focus and self-understanding.
2. Emotional Dysregulation:
o Emotion Regulation Skills 🌈: Help teens manage intense emotions and develop a
stable emotional state.
3. Impulsivity:
o Distress Tolerance Skills ⏳: Equip teens to cope with emotional urges without
acting impulsively.
4. Interpersonal Problems:
o Interpersonal Effectiveness Skills 💬: Teach teens how to communicate and
maintain relationships without conflict.
5. Teenager & Family Challenges:
o Walking the Middle Path Skills ⚖️: Focus on reducing extreme thinking and
improving family relationships.

Group Format & Session Breakdown 📅

 Total Program: 24 weeks with 5 modules, each focusing on one set of skills.
 Session Structure: 2-hour sessions.
o First Hour: Homework review & mindfulness practice 🧘
o Second Hour: New skill teachings 💡
o Mindfulness: Repeated throughout to help with self-awareness and managing
emotions 🌿

Biosocial Theory of DBT 🌱

 Bio (Biological): Refers to emotional sensitivity and brain wiring, explaining why some
teens feel emotions more intensely. 🧠
  Social (Environmental): Refers to how others (family, peers, etc.) react to these
emotions, which can either validate or invalidate them. 🌍

This interaction between biological sensitivity and an invalidating environment can lead to
emotional dysregulation, but DBT skills help regulate these emotions effectively. 🔄

Key Concepts:

 High Emotional Sensitivity & Reactivity: Teens with emotional dysregulation

experience intense emotions quickly.
 Slow Return to Baseline: Strong emotions may take longer to subside, causing stress. ⏳
 Strengths of High Sensitivity: Intense emotions can be powerful and motivating when
regulated properly. 💥

DBT provides the tools to manage these emotions and reduce problem behaviors. With practice,
teens can control their emotional "fires" and thrive in all aspects of life! 🔥

Invalidating Environments & DBT

What is Invalidation?

 Validation: Acknowledging, understanding, and respecting someone's feelings, thoughts,

or actions. 🌱
 Invalidation: Disrespecting or dismissing another person's emotional experience. It can
make someone feel like their emotions don’t make sense or are exaggerated. ❌

What Does an Invalidation Look Like?

 Parents or others may:

o Reject feelings: “You shouldn’t feel that way.”
o Ignore or dismiss emotions: “Don’t worry about it; it’s not a big deal.”
o Over-simplify solutions: “Just study harder next time.”
 How It Affects Teens:
o Leads to self-invalidation, where teens stop trusting their own feelings.
o Increases emotional dysregulation and makes future emotions harder to manage.
😞

3 Types of Invalidation

1. Type 1 – Complete Rejection of Feelings

o E.g., “Stop worrying, it’s just one test!”
 o Teens start to believe their feelings are wrong, leading to confusion and self-
doubt. 😔
2. Type 2 – Ignoring or Punishing Lower-Level Emotions
o E.g., “You’re overreacting!” followed by ignoring or reinforcing extreme
emotions.
o Escalates the teen’s emotional outbursts, creating a cycle of heightened reactions.
🔥
3. Type 3 – Over-Simplifying Solutions
o E.g., “Just say no to drugs, it’s easy.”
o Leads to unrealistic expectations and further disappointment. 🛑

How Invalidation Affects Relationships

 Ongoing Cycle: If invalidation continues, it increases emotional dysregulation in both

teens and family members, creating more conflict. 💔
 Breaking the Cycle: DBT teaches validation skills to break this cycle and improve
emotional connections. ✔️
o Teens and parents can validate each other’s feelings to promote understanding
and cooperation. 🤝

Why Validation Matters

 Validation reduces the intensity of emotions, fosters trust, and makes problem-solving
easier. ✅
 DBT's goal: To teach validation and help both teens and families regulate emotions for
healthier relationships and better communication. 💬

Next Steps

 Start using validation in everyday conversations (e.g., “I can see you’re upset, and I
understand why.”). 🌟
 Teens and families will learn DBT skills to manage emotions and validate each other,
improving the overall family dynamic.

DBT Treatment Assumptions 💭

What are Assumptions?

 Assumptions are unproven beliefs that guide DBT treatment. If you "buy into" these
assumptions, you’re more likely to experience success in DBT. They promote
acceptance and change in both teens and families. 🌱

Key DBT Assumptions:

 1. Everyone is doing the best they can 🌟
o No one is perfect, but at this moment, each person is doing their best with their
current knowledge and skills.
o Example: Even when behavior is frustrating, everyone involved (teens, parents,
therapists) is trying their best in that moment.
2. Everyone wants to improve 💪
o Everyone in DBT is here because they want to make their lives and relationships
better.
o Example: Even reluctant teens attending DBT are here for a reason – it’s a step
toward change.
3. Everyone needs to do better, try harder, and be more motivated 🔄
o While you're doing your best, there’s always room to improve and put more effort
into change.
o Example: You can always learn new skills to try harder, even when you're
already doing your best.
4. People may not have caused all their problems, but they still need to solve them 💡
o Life isn’t always fair, but solving problems is still necessary to move forward.
o Example: Even if problems are not your fault, you have the power to change how
you deal with them.
5. The lives of group members are painful as they are currently being lived 💔
o It’s important to acknowledge that life can feel painful for both teens and their
families, and they are likely going through a tough time.
o Example: Validating painful emotions makes it easier to support one another
through these struggles.
6. Group members must practice new behaviors in real life 🏡
o DBT isn't just about learning in the group; practicing these skills in everyday life
is essential for progress.
o Example: Practicing DBT skills at home or school strengthens emotional
regulation.
7. There is no absolute truth 🤔
o Both sides have valid points, and we aim to understand each other’s perspectives
to reach a middle ground.
o Example: Teens and parents can both be right in their own way, and DBT helps
them find common ground.
8. Teens and families cannot fail in DBT 🚫
o If things aren’t improving, the therapy or therapist might not be the right fit, not
the individual’s fault.
o Example: Just like with medical treatments, if DBT isn’t working, it’s the
treatment that needs adjustment, not the client’s effort.

Why These Assumptions Matter

 Acceptance + Change: These assumptions create a balance between accepting where

people are while encouraging growth and improvement.
  Reduce Blame: Helps create a non-judgmental, supportive environment where everyone
can thrive.

Engagement Tip: Encourage participants to reflect on and discuss these assumptions with each
other! 💬
Mindfulness Module
Mindfulness Skills Overview 🌟

Mindfulness is the core of DBT and helps people increase awareness of their thoughts, feelings,
and bodily sensations without judgment. It also improves attentional control, so individuals
can focus on the present moment and make more skillful decisions. This module is foundational
and is taught repeatedly to ensure it becomes a powerful tool for managing emotions. 🌱

Session 1: Introduction to Mindfulness 🧠

Key Concepts:

 Mindfulness means being fully aware of your thoughts, feelings, and environment
without judgment. 🌍
 Attentional Control means being able to focus on one thing at a time (instead of
multitasking). 🎯

Exercises:

1. Opened Mind 🧘‍♀️

o Practice focusing on your senses (smells, sounds, feelings) for 2 minutes.
o Purpose: To sharpen attention and stay present.
o Feedback: Participants share what they noticed.
2. Focused Mind 🎯
o Focus on one object (feet, a hand, an item in the room) for 2 minutes.
o Purpose: To help you focus your attention and bring your mind back when it
wanders.
o Feedback: Discuss how easy or hard it was to focus.

Why Mindfulness? 💡

1. More Control:
o Mindfulness helps you catch your emotions and urges early (before they reach
100%). This gives you a chance to choose a skillful response instead of reacting
impulsively. 💪
2. Reduces Suffering & Increases Pleasure:
o Being present allows you to fully enjoy life’s experiences—like eating a meal or
having a conversation—without distractions or worry. 😋
 3. Improves Decision-Making:
o Mindfulness helps you make better decisions, like when to pause and reflect
before reacting in a tough situation. 🤔
4. Increases Focus & Productivity:
o Staying focused helps you perform better at school, work, or in relationships. 📚
5. Enhances Compassion:
o Practicing mindfulness helps you be kind to yourself and others, reducing harsh
self-criticism. 💖
6. Reduces Stress & Improves Health:
o Mindfulness can lower physical pain, tension, and stress, promoting better
health. 🧘‍♂️

Session Structure

 Session 1: Introduction to mindfulness, brief practice, and homework on mindfulness

skills.
 Session 2: Review homework, deepen mindfulness practice, and introduce new
mindfulness techniques.

Homework 📋

 Practice mindfulness at home: focus on your breath, your senses, or a task (like eating
or walking) for a few minutes each day.

Mindfulness is key to being aware, reducing emotional reactions, and making thoughtful
decisions. It’s all about living with eyes wide open! 👀

Mindfulness Skills: Practice, Practice, Practice! 🧘‍♂️

Mindfulness skills take time to develop, just like building any skill (like running a marathon or
learning an instrument). It’s all about practice—the more you practice, the better you get. Don’t
get discouraged if you find it hard at first! Start small and gradually build your mindfulness
“muscles.” 💪

Three States of Mind 🧠

1. Emotional Mind 💥
  What is it?
When emotions take over and control your actions. You may act impulsively or without
thinking about consequences.
o Example: Getting road rage and wanting to chase someone who cut you off. 🚗
 Benefits: Sometimes, emotional mind can help express feelings (like crying when sad or
dancing at a party). 🎉
 Problems: It can lead to impulsive decisions that you regret later. 😔

2. Reasonable Mind 🔢

 What is it?
When you think logically, without emotions, focusing purely on facts.
o Example: Making a grocery list, balancing a checkbook, or solving math
problems. 🧮
 Benefits: It’s useful for planning and problem-solving.
 Problems: Only using Reasonable Mind can feel cold or disconnected from your
emotions (like choosing a career path based only on logic and not personal passion). 🧑‍💼

3. Wise Mind 🌿

 What is it?
A balanced state where you combine emotional and logical thinking. You make
decisions based on both your feelings and reason.
o Example: Deciding to break up with someone even though you love them,
because your logical side sees long-term incompatibility. 💔
 Benefits: It helps you make the best decisions by considering both emotions and logic.
 Problems: It requires practice to find the balance between emotion and logic. ⚖️

How to Use Wise Mind 🌟

1. Mindful Decision-Making:
When making decisions, tap into Wise Mind to use both emotions and logic.
o Example: Wanting to adopt more dogs, but realizing your Reasonable Mind says
it's impractical. Wise Mind helps you make the decision to help them find new
homes instead. 🐾
2. Reacting Mindfully:
When emotions arise, use Wise Mind to make thoughtful responses instead of reacting
impulsively.
o Example: Feeling upset but choosing to take deep breaths rather than lash out.

Practice 🧘
  Mindfulness helps you become more aware and focused on the present moment. It
reduces impulsive actions and increases calmness. 🌸
 Keep practicing mindfulness exercises to strengthen your Wise Mind!

Why Mindfulness is Important 💡

 Control your emotions: Stop emotional reactions before they escalate.

 Enhance well-being: Practice mindfulness to enjoy more moments of joy and pleasure.
 Improve decision-making: With Wise Mind, you’ll make better choices in tough
situations. 🎯

Mindfulness is the key to balancing emotions and reason, so keep practicing and watch the
positive changes unfold! 🌟

Homework Assignment: Observing Yourself in Each State of Mind 📚

Instructions:

 Task: Over the next week, observe yourself as you experience different situations and
identify which State of Mind you are in: Emotional Mind, Reasonable Mind, or Wise
Mind.
o Emotional Mind: When emotions take over and influence your thoughts and
actions. 💥
o Reasonable Mind: When you’re thinking logically, based only on facts. 🔢
o Wise Mind: The balanced state where both emotions and reason guide your
decisions. 🌿

What to Do:

1. Identify which state you are in during everyday situations.

2. Write down the following for each situation:
o Emotion (if any): What feelings were you experiencing? 😡💖😰
o Thought: What was going through your mind? 🧠
o Behavior: How did you act or respond? 🏃‍♂️
3. Reflect: Consider how the different states influenced your behavior and decision-making.

Questions to Consider:

 Do you notice patterns in when you go into Emotional Mind, Reasonable Mind, or Wise
Mind?
 How did each state affect your actions and feelings? 💭
Before You Start:

 Are you willing to try this practice for the week? ✅

 Any questions about the homework? 🤔

This practice helps you become more aware of your thinking and actions, and it’s a great way to
strengthen mindfulness and access Wise Mind. 🌟

Note:

This exercise will be part of your ongoing mindfulness practice, so remember to revisit this
handout each time we go over mindfulness skills. 💼

Session 2: Mindfulness Skills Practice & Introduction to "What" and "How"

Skills 🧘‍♀️

Brief Mindfulness Exercise 🌱

 Purpose: Start the session with a mindfulness practice to engage participants and
illustrate mindfulness in action.
 Example Story: A parent at a school meeting feeling unprepared and anxious, then using
mindfulness skills to ground themselves and access Reasonable Mind.
o Exercise: After the story, participants practice mindfulness for 3–5 minutes
(observe thoughts, feelings, and body sensations).

Homework Review & Check-In 📋

 Review mindfulness practices and experiences from last week’s homework.

Steps to Wise Mind ⚖️

Mindfulness skills help synthesize Emotional Mind and Reasonable Mind to reach Wise
Mind. There are three "what" skills and three "how" skills that guide you.

Mindfulness "What" Skills 🧠

1. Observe 👀
  What is it?
o Mindfully notice your experience without judgment or interpretation.
o Examples: Watch your thoughts as they come and go, observe your physical
sensations, or simply notice what’s happening in your environment.

Exercise: Practice Observing

 Focus on your thoughts and count them, or notice thoughts following certain word cues
(e.g., "water," "car"). 📋

2. Describe 📝

 What is it?
o Label your observations without interpretation or judgment.
o Example: Instead of saying, "I feel stupid," describe your physical feelings: "My
face feels hot, my hands are shaking."

Exercise: Observe & Describe

 A leader performs a non-judgmental action (e.g., furrowed brow, arms crossed). Ask
participants to describe what they see, not interpret. 🧐

3. Participate 🎉

 What is it?
o Fully engage in the present moment without distractions. Experience life without
self-consciousness or judgment.
o Example: Fully participating in an activity like dancing, talking, or playing sports
without worrying about how you look or feel. 🏀

Mindfulness "How" Skills ⚙️

1. Don’t Judge ✋

 What is it?
o Notice without labeling things as "good" or "bad." Stick to observable facts
instead of jumping to conclusions.
o Example: Instead of “That’s dumb,” try, “I feel frustrated when this happens.”

Exercise: Describing Without Judgment

 Describe a controversial event in the news but avoid judgmental language. Focus only
on observable facts. 📰
2. Stay Focused 🎯

 What is it?
o Stay present and focused on one thing at a time.
o Avoid multitasking or being distracted.

3. Do What Works ✅

 What is it?
o Focus on what will lead to positive outcomes and align with long-term goals,
even when emotions or thoughts suggest otherwise.
o Example: If angry, choose to calmly express your feelings instead of yelling.

Wrap-Up 🌟

 Discuss the importance of mindfulness in reducing impulsive behaviors and accessing

Wise Mind.
 Remind participants to practice mindfulness skills throughout the week to strengthen
their ability to engage with Wise Mind.

Homework 📚:

 Continue practicing mindfulness and observing thoughts/feelings.

 Focus on the "what" and "how" skills (observe, describe, participate) in daily life and
track their experience.

Session 2: Mindfulness Skills – "What" and "How" Skills Practice 🧘‍♂️

Brief Mindfulness Exercise 🧘‍♀️

 Purpose: Set the tone for the session with a brief mindfulness exercise to ground
participants.
 Example Story: A leader's personal example of being caught in Emotion Mind and
using mindfulness skills to transition into Wise Mind.

Homework Review & Check-In 📋

 Review mindfulness exercises from the previous session and discuss insights or
challenges.
Mindfulness "What" Skills 🔍

1. Observe 👀

 Definition: Notice your experience without judgment—just observe thoughts, feelings,

and physical sensations.
 Exercise: Observe your thoughts during a mindfulness bell practice and track new
thoughts with hash marks. 🧠

2. Describe 📝

 Definition: Put into words what you've observed, sticking to facts without interpreting or
labeling.
 Exercise: Observe and describe a leader's body language (e.g., arms crossed, furrowed
brow) without judgment.

3. Participate 🎉

 Definition: Fully engage in the present moment, letting go of distractions and self-
consciousness.
 Exercise: Participate in a mindfulness exercise and focus on one activity at a time. Avoid
multitasking. 🔄

Mindfulness "How" Skills 🧠

1. Don’t Judge ❌

 Definition: Notice your judgments but avoid labeling experiences as "good" or "bad."
 Exercise: Practice nonjudgmental descriptions of a controversial topic or a beloved/hated
figure. ⚖️

2. Stay Focused 🎯

 Definition: Focus on one thing at a time. Avoid multitasking and distractions.

 Exercise: Do one thing mindfully for 2–3 minutes (e.g., focusing on the feeling of
walking, a single object). 🚶‍♂️

3. Do What Works ✔️

 Definition: Act based on long-term goals rather than short-term emotional impulses.
 Example: Choosing to tolerate anger until the right time to address it, like the Elizabeth
example with her teacher. 🎯
Wrap-Up 🌟

 Key Takeaway: Mindfulness skills help us manage our emotions, make wise decisions,
and fully participate in life.
 Encourage consistent practice to strengthen mindfulness and reduce impulsivity.

Homework 📚

 Practice observing, describing, and participating in daily activities.

 Reflect on "what" and "how" skills through journaling and share next session.

Optional Exercises for Group Engagement:

 Practice nonjudgmentally describing controversial or beloved figures. 🌍

 Observe distractions and focus on one task at a time during the week. 💭

Session 3: Practicing Mindfulness in Daily Life 🌱

Introduction to Mindfulness Practice 🧘‍♂️

 Purpose: Encourage participants to integrate mindfulness into daily activities outside of

group sessions.
 Cheat Sheet: Refer to Mindfulness Handout 7, providing a quick reference guide to
mindfulness practices.
 Goal: Foster independence in using mindfulness skills to improve emotional regulation,
focus, and overall well-being.

Homework Assignment 📋

 Mindfulness Exercise Handout: Handout 8 – Practice Exercise: ‘What’ and ‘How’

Skills
 Instructions:
o Practice one "what" skill (Observe, Describe, Participate) and one "how" skill
(Don’t judge, Stay focused, Do what works).
o Reflect on when, where, and how you practiced these skills, and note their impact
on your thoughts, feelings, or behaviors.
o Bring your observations to the next session for group discussion.
Mindfulness Exercises for Adolescents 🧠

General Guidelines for Exercises:

 Ensure active participation from everyone, including family members.

 Turn off distractions (e.g., phones, pens).
 Exercises typically last 2–5 minutes.
 If attention drifts, gently redirect without judgment.
 Reflect on the exercise afterward to solidify mindfulness practice.

Mindfulness Exercises 🧘‍♀️

Exercise 1: What’s Different about Me? 🔍

 Goal: Observe and identify changes in appearance.

 Instructions: Pair up, observe each other, turn around, change three things, then see if
you can notice the differences.
 Mindfulness Skill Taught: Observing One-Mindfully.

Exercise 2: Sound Ball 🎶

 Goal: Focus on sounds and repetition.

 Instructions: "Throw" a sound to someone else, who repeats it and creates a new sound.
 Mindfulness Skill Taught: Observing and Participating One-Mindfully.

Exercise 3: Snap, Crackle, and Pop 🎤

 Goal: Focus on synchronized movements and sounds.

 Instructions: Each participant performs a gesture and makes a sound as part of a fast-
paced sequence. Those who make a mistake become distractors.
 Mindfulness Skill Taught: Observing and Participating One-Mindfully.

Exercise 4: Observation of Music 🎶

 Goal: Focus on the emotional and physical response to music.

  Instructions: Listen to a piece of music and observe your thoughts, emotions, and
physical sensations nonjudgmentally.
 Mindfulness Skill Taught: Observing, Describing, and Participating Without
Judgment.

Exercise 5: Egg Balancing 🥚

 Goal: Focus on balance and attention to small movements.

 Instructions: Balance an egg on a table for 2 minutes while observing the process.
 Mindfulness Skill Taught: Observing One-Mindfully and Nonjudgmentally.

Exercise 6: Hand Exercise ✋

 Goal: Practice mindful hand movements.

 Instructions: Follow a sequence of hand movements, with each hand lifting and placing
down, adjusting as needed.
 Mindfulness Skill Taught: Observing One-Mindfully and Nonjudgmentally.

Exercise 7: Mindfully Unwrapping a Hershey’s Kiss 🍬

 Goal: Mindfully engage in an everyday activity.

 Instructions: Slowly unwrap a Hershey's Kiss, focusing on the sensations and changes.
 Mindfulness Skill Taught: Observing and Describing One-Mindfully.

Exercise 8: Mindfulness PB&J 🍞🥒

 Goal: Fully engage in a seemingly mundane activity.

 Instructions: Make a peanut butter and jelly sandwich, paying full attention to every
step.
 Mindfulness Skill Taught: Observing, Describing, and Participating One-Mindfully
and Nonjudgmentally.

Exercise 9: Repeating an Activity 🔄

 Goal: Focus on a repeated motion with fresh awareness each time.

  Instructions: Slowly pick up and set down a pen, noticing each movement and the
sensations involved.
 Mindfulness Skill Taught: Observing and Describing One-Mindfully.

Exercise 10: Focusing on Scent 🌸

 Goal: Focus on the sensory experience of a scent.

 Instructions: Focus on the scent of a candle, noticing your physical and emotional
responses.
 Mindfulness Skill Taught: Observing One-Mindfully and Nonjudgmentally.

Exercise 11: Mindfully Eating a Raisin 🍇

 Goal: Mindfully engage in eating.

 Instructions: Observe all sensory details (texture, taste, smell) of a raisin as you eat it
slowly.
 Mindfulness Skill Taught: Observing and Describing One-Mindfully and
Nonjudgmentally.

Exercise 12: Switched-Candy Exercise 🍬

 Goal: Experience mindfulness by switching candies and focusing on sensations.

 Instructions: After switching candies with someone else, eat the candy mindfully and
observe all sensory aspects.
 Mindfulness Skill Taught: Radical Acceptance and Observing One-Mindfully.

Exercise 13: Ice Cube Exercise 🧊

 Goal: Notice sensations of cold.

 Instructions: Hold an ice cube, noticing how it melts and the physical sensations
associated with it.
 Mindfulness Skill Taught: Observing and Describing One-Mindfully and
Nonjudgmentally.

Closing Notes 🌟
  Key Goal: Encourage ongoing mindfulness practice outside of the group setting.
 Reminder: Use Mindfulness Cheat Sheet and Handouts for guidance and consistency.

Next Steps:

1. Continue practicing mindfulness skills daily.

2. Reflect on "what" and "how" skills and their impact on your daily life. 🧠
Distress Tolerance Skills
Distress Tolerance Module: Key Notes
Overview 🧠💪

Distress tolerance skills are designed to help you handle emotional pain and difficult situations
when problems can’t be solved right away. These skills offer short-term relief to survive
distress without worsening the situation through impulsive actions like substance use,
disordered eating, or self-harm.

Module Breakdown:
Crisis Survival Skills (Sessions 1-3) 🚨🛑

Goal: Change how you experience distress in the moment and survive the crisis without
escalating it.

 Skills Taught:
1. Distraction 🔄: Shift your focus away from the distress.
 Example: Try puzzles, drawing, watching funny videos to distract
yourself from overwhelming emotions. 📺
 Metaphor: Think of it like switching channels on the TV when the show
gets too intense. 📡
2. Self-Soothing 🌸: Comfort yourself by engaging the senses.
 Example: Light a scented candle, drink some herbal tea, or hold a soft
stuffed animal. 🐻
 Metaphor: Wrap yourself in a cozy blanket to calm the storm inside.
3. Improving the Moment ✨: Make the situation more bearable.
 Example: Listen to soothing music or look at peaceful photos.
 Metaphor: Paint the difficult moment with colors of calm. 🎨
4. TIPP (Temperature, Intense Exercise, Paced Breathing, Progressive
Relaxation) 🏃‍♂️❄️💨
 Temperature: Use cold water or ice packs to quickly reset your body. 🧊
 Intense Exercise: Get active to release pent-up tension. 🏃‍♀️
 Paced Breathing: Slow your breathing to calm your body.
 Progressive Relaxation: Tense and release muscles to ease physical
tension. 💪
 Example: If you’re anxious, splashing cold water on your face or doing jumping jacks
can cool down your emotions quickly—like hitting a reset button. 🔄
Reality Acceptance Skills (Session 4 onwards) 🌍🤝

Goal: Accept painful situations that cannot be changed. Move forward by embracing reality
instead of fighting it.

 Skills taught:
1. Radical Acceptance 🙌: Fully accept reality as it is. No fighting it, just embracing
it.
 Example: After a breakup, instead of avoiding the pain, acknowledge it
and let yourself feel it. 💔
 Metaphor: Hold a hot stone—don’t try to throw it away, just hold it
gently and let it pass. 🔥
 Exercise: Start with a half-smile 😊 to shift your mindset towards acceptance and ease.

Teaching Materials 📦

 For Distraction & Self-Soothing:

o Distracting materials: Word search puzzles, magazines, funny videos 📺
o Soothing materials: Herbal teas, candles, stuffed animals 🧸
 For TIPP: Bring in cold packs or ice water to teach body chemistry tips. 🧊

Homework Assignment 📝

1. Create Your Personalized Crisis Survival Kit 💼: Collect soothing and distracting
materials that work best for you.
2. Mini Kit 🎒: Prepare a smaller version for on-the-go (e.g., at school or work).
3. Practice: Use these skills throughout the week in real situations!

Session 1: Introduction to Distress Tolerance Skills 🌊💡

Goal of the Module 🎯

This module is all about distress tolerance skills that help us manage emotional pain and
difficult situations when they can’t be solved immediately. These skills help you survive tough
times without making things worse by acting impulsively. 🚫

 Crisis Survival Skills (Sessions 1–3): Short-term strategies to help cope with distress.
  Reality Acceptance Skills: Learning to accept painful situations that can’t be changed
right now.

Session Structure

1. Brief Mindfulness Exercise 🧘‍♀️: Start each session with a quick mindfulness practice.
2. Homework Review 📚: Discuss last week’s practice and experiences.
3. Break 🛑: Take a moment to relax and refocus.
4. Introduction to Distress Tolerance Skills: Learn how to survive pain without making it
worse. 💪

What Does Distress Mean? 😖 What Does Tolerance Mean? 💪

 Distress = Emotional pain, frustration, or feeling overwhelmed. 💥

 Tolerance = Being able to put up with the distress without making it worse. 🚷

Personal Example 📖

Imagine you're on a cruise ship 🚢, and you fall off into the ocean 🌊. The ship is far away, and
you can't swim to it. What do you do? 🏊‍♀️

 Emotion: Panic 😱
 Urge: Swim, scream, act impulsively! 🏃‍♀️
 Wise Mind Solution: Survival float! 🌊

Lesson: Distress tolerance is not about making you feel better right away, it’s about surviving
the distress without acting impulsively! 🧠

Why Tolerate Painful Feelings? 🤔

 Life is full of pain 😔, and trying to avoid it may create more problems in the long run. ❌
 Avoiding pain often leads to impulsive actions that make things worse. ⚡

Discussion 💬

 Why do we keep avoiding distress?

 What are the problems that arise from avoiding pain or acting impulsively? 🤔
Crisis Survival Skills 💥

1. Distraction 🧠

 Purpose: Take your mind off the distress to survive the moment. ✋
 Examples:
o Word puzzles 🧩
o Funny YouTube videos 🎥
o Art or coloring 🎨

2. Self-Soothing 💆‍♂️

 Purpose: Calm yourself with sensory experiences.

 Examples:
o Scented candles
o Listening to relaxing music 🎶
o Holding a soft stuffed animal 🧸

3. IMPROVE the Moment ✨

 Purpose: Change the internal experience to feel better. 🧘‍♀️

 Examples:
o Positive affirmations ✨
o Visualizing a calm place 🌅
o Breathing deeply

4. Pros and Cons ⚖️

 Purpose: Weigh the consequences of acting impulsively vs. acting skillfully. 💡

 Think about:
o Impulse: Acting quickly based on emotion
o Skillful action: Taking time to choose wisely 🤔

5. TIPP: Temperature, Intense Exercise, Paced Breathing, Paired Muscle Relaxation 🧊💪

 Purpose: Rapidly reduce extreme arousal in your body. 🏃‍♂️

 Examples:
o Splash cold water on your face ❄️
o Do some intense physical activity 🏃‍♀️
o Slow your breathing

Mindfulness Skills Are Essential 🧘

  Mindfulness helps you notice distress and decide to use your distress tolerance skills.
🧠💪

Discussion :

 Why is it important to survive a crisis? Can temporary solutions help in certain

situations? 💡

Harmful “Coping” Strategies 🚫

 Examples:
o Substance use (drinking, drugs) 🍻💊
o Self-harm 🔪
o Overeating or undereating 🍕🍎
o Avoidance (skipping school, hiding away) 🏠

Discussion:

 Raise your hand if you’ve ever used any of these strategies when distressed. 🙋‍♀️

Wrap-Up and Next Steps 🌱

 In the next sessions, we will teach crisis survival strategies to help you cope with
distress effectively. 🌟
 Homework:
o Practice using distraction, self-soothing, or TIPP when you feel distressed. 📖
o Create a personalized crisis survival kit to use during tough times. 🧳

Reflection ✨

 Mindfulness practice is essential to recognize when you need distress tolerance skills. 🌿
 The goal is to survive distress, not to solve the entire problem in one go. 💪

Homework Assignment 📝: Distress Tolerance Handout 4 – “Practice Exercise:

Distract with ‘Wise Mind ACCEPTS.’”

Objective:
  Commit to using two specific distraction skills from the Wise Mind ACCEPTS list
when faced with even mild distress during the week.
 Write down your selected skills and practice them throughout the week. 📚

Steps to Complete Your Homework :

1. Select two specific distraction skills from the ACCEPTS list that resonate with you.
For example:
o A - Activities: Play a game, read a book, or do a puzzle. 🧩
o P - Pushing Away: Put the situation temporarily out of your mind.
2. Write them down in Handout 4.
3. When faced with distress during the week, use these skills to distract yourself.
4. Reflect on how they worked:
o Did your distress level decrease? 📉
o Did the activity help you feel less bad, even if it didn’t solve the problem? 💭

Anticipated Challenges and Responses 💡:

1. Challenge 1: "Distress tolerance skills didn’t work for me."

Response: "Try varying the skills until you find the ones that work best for you.
Different situations require different approaches." 🔄
2. Challenge 2: "When my friends ditch me, listening to music just doesn’t help."
Response: "Sometimes, it’s about distraction rather than solving the problem right
away. Let’s try something else that you can do in that moment—maybe writing, drawing,
or moving your body!" 🎶✍️💃
3. Challenge 3: "These skills didn’t make me feel better."
Response: "These skills aren’t about making you feel better right away. They are
designed to help you survive the distress without making things worse. If you avoid
harmful behavior when upset, the skill worked!" 🙌
4. Challenge 4: "It didn’t last long enough."
Response: "Sometimes, you need to use multiple skills in sequence to help you ride out
intense distress. You might need to alternate skills until your distress lessens." 🌊

Reflection 🧐:

 How did your chosen skills work in reducing distress?

 Did you experience any positive outcomes by not acting impulsively? 🛑
 What skills did you find effective, and which ones didn’t work for you?
 Write your thoughts and bring them to the next session for discussion. ✨
Remember: These skills are not meant to solve the problem but to help survive the distress
without making the situation worse. Keep practicing and experimenting with what works for
you! 💪

Good luck, and keep moving forward! You’ve got this! 🌟

Homework Assignment 📝: Distress Tolerance Skills

1. Self-Soothing Skills

Objective:

 Commit to using two self-soothing activities when faced with even mild distress
during the week.
 Write down your chosen activities on Handout 6.
 Engage all five senses (vision, hearing, smell, taste, touch) and even movement for self-
soothing.

How to Do It:

1. Choose Two Self-Soothing Activities:

From the materials provided (e.g., music, tea, lotions, photos, stuffed animals,
movement), select two activities that soothe you. You can also use movement like
stretching or gentle walking.
2. Use the Activities During Distress:
Whenever you feel stressed or distressed, engage in one or both of your selected
activities. The goal is not to make yourself feel better right away but to stop yourself
from making the situation worse.
3. Track Your Distress Levels:
Before and after practicing the soothing activity, rate your distress from 0 (none) to 100
(maximum). Notice how your distress changes, if at all.
4. Reflection:
Write down any thoughts or feelings about using your self-soothing skills and how they
helped you tolerate the distress. Share this in the next session. 💭

2. IMPROVE the Moment Skills

Objective:
  Commit to using two IMPROVE activities when faced with distress.
 Write down your selections on Handout 8.
 IMPROVE the Moment is about managing how you think and feel about your situation.

How to Do It:

1. Choose Two IMPROVE Activities:

These can involve using imagery, creating meaning, relaxation, focusing on one thing at a
time, or taking a brief "vacation" from the distress. 🧘‍♂️🧘‍♀️
2. Use Them When You Feel Distressed:
If you’re feeling upset, practice one or both of your IMPROVE strategies to shift your
perspective or your emotional state.
3. Track Your Distress Levels:
Rate your distress again from 0 to 100 before and after using the IMPROVE activities.
How did it help? 🧠
4. Reflection:
Write down your experience with the IMPROVE skills. How did they affect your
thoughts, feelings, or behaviors?

Anticipated Challenges and Responses 💡:

1. “These skills didn’t make me feel better.”

Response: These skills are about reducing distress enough to prevent harmful behavior.
They aren’t about solving the problem, but about helping you survive the moment
without making things worse. 💪
2. “It didn’t last long enough.”
Response: It’s okay! Sometimes multiple skills need to be used together, or over time.
Practice helps you get better at managing your emotions. ⏳
3. “This doesn’t work for me.”
Response: If one activity doesn’t work, try another! Some skills work for some people at
some times, but you’ll find the ones that help you with practice. 🔄

Reflection 🧐:

 Which two self-soothing activities did you select, and how did they work for you?
 Which two IMPROVE activities did you choose, and how did they help change your
perspective?
 Did your distress decrease? How did it feel to practice these skills?
Reminder:
Self-soothing and IMPROVE skills are not meant to make you feel better instantly. Their
purpose is to survive distressing moments without making your situation worse. Keep
practicing! 😊

Session 3: Distress Tolerance and Skills Overview

Brief Mindfulness Exercise 🧘‍♂️🧘‍♀️

Quick grounding to center yourself before diving into today’s content.

Review Homework 📚

 Reflect on the Distress Tolerance Skills you practiced in the previous session.
 Share your thoughts, experiences, and any challenges faced.

Break 🍎☕

Take a short break to stretch and refresh before diving into today's exercises.

Pros and Cons: Understanding the Skill 📝

Why Bother with Pros and Cons? 🤔

The skill of considering pros and cons helps people recognize the impact of impulsive behavior
vs. skillful, mindful behavior.

It’s a tool for:

 Gaining perspective on impulsive vs. skillful actions.

 Shifting behaviors when dealing with distress.

For example: Choosing whether to engage in impulsive behavior like binge drinking after an
argument vs. tolerating the distress skillfully.
How to Do the Pros and Cons Exercise: 📝

1. Step 1: Write down a maladaptive behavior that causes distress (e.g., binge drinking
after an argument).
2. Step 2: Create two columns: Pros of the maladaptive behavior vs. Cons of the
maladaptive behavior.
3. Step 3: Discuss Pros of tolerating distress vs. Cons of tolerating distress.
4. Step 4: Label the effects as either short-term (ST) or long-term (LT).
For example:
o Binge drinking (impulsive behavior):
 Pros: Temporary relief, fun, escape (ST)
 Cons: Guilt, health consequences, worsening problems (ST/LT)
o Tolerating distress (mindful response):
 Pros: Less long-term damage, sense of empowerment (LT)
 Cons: Short-term discomfort, more effort (ST)

Exercise 🧠

 Think of a recent distressing event where you engaged in a maladaptive behavior.

 Fill out the Pros and Cons handout (Distress Tolerance Handout 9).
o Rate each pro and con with whether it has short-term (ST) or long-term (LT)
effects.
 Optional: Share a few examples with the group. Discuss how reflecting on pros and cons
can lead to healthier choices.

When to Use Pros and Cons 🕑

 In the moment of distress: Quickly think of the pros and cons to remind yourself of your
long-term goals and healthy coping strategies.
 “Cope-ahead practice”: Use the pros and cons as a guide to prepare for potentially
triggering situations.

Reduce Extreme Emotional Arousal Quickly with TIPP Skills ❄️

Why TIPP Skills Matter ⚡

When you’re overwhelmed and emotionally dysregulated (e.g., panic, anger, anxiety), TIPP
(Temperature, Intense Exercise, Paced Breathing, Progressive Muscle Relaxation) helps you
quickly lower your emotional intensity, making it easier to think clearly and use other skills.
How TIPP Skills Work 💨

TIPP skills engage the parasympathetic nervous system (PNS) to calm down your body after
activating the sympathetic nervous system (SNS) in distress.

TIPP Skills:

1. T: Temperature
o Cool down your face (ice packs, cold water) to trigger the body's calming reflex.
o Ex: Splashing cold water on your face for a few seconds can lower emotional
arousal.
2. I: Intense Aerobic Exercise
o 10-20 minutes of intense exercise (e.g., running, dancing) to quickly regulate
emotions and shift focus.
o Example: Run in place, do jumping jacks, or push-ups to use up that emotional
energy.
3. P: Paced Breathing
o Slow your breath to 5–6 breaths per minute by inhaling for 4 seconds, exhaling
for 6-8 seconds.
o Ex: Breathe in for 4 sec, out for 6 sec, calming the body and mind.
4. P: Progressive Muscle Relaxation
o Tense and relax muscle groups to relieve tension and ground yourself
emotionally.
o Ex: Tense your fists, hold, then release to relax.

Exercise ❄️

1. Temperature: Try using an ice pack or cold water (be cautious about medical
conditions).
o Focus on the changes in body sensations and how the emotion shifts.
2. Intense Exercise: Do a quick set of jumping jacks or running in place for 3 minutes.
o Track how your emotions and physical feelings change.

Reflection and Practice 📝

 Pros and Cons Practice: Reflect on how considering the long-term vs short-term effects
of behaviors can help guide better decisions in crisis moments.
 TIPP Practice: Try using TIPP skills when feeling overwhelmed or stressed. Track how
each one helps reduce your emotional intensity.
Reminder: These skills are not about feeling better immediately; they help prevent making
situations worse and give you time to think of more effective coping strategies. 💡

Homework Assignment 📚

For the next week, we will focus on continuing the development of distress tolerance skills,
especially in moments of distress. Here are the assignments:

1. Distress Tolerance Handout 10: “Practice Exercise: Pros and Cons” 📝

 Objective: Complete the Pros and Cons exercise whenever you feel at least mildly
distressed.
 Task: Reflect on a recent situation where you had the urge to act impulsively. Write out
the pros and cons of engaging in that behavior vs. using a healthier alternative.
 Tip: This will help you recognize the long-term benefits of making skillful choices
during difficult moments.

2. Distress Tolerance Handout 12: “Practice Exercise: TIPP Skills” ❄️💨

 Objective: Practice TIPP skills (Temperature, Intense Exercise, Paced Breathing,

Progressive Muscle Relaxation) at least once this week.
 Task: Try each skill, and track how you feel before and after practicing it. You’ll learn
how these skills reduce emotional intensity and help you regain control.
 Tip: If you practiced temperature, paced breathing, and progressive muscle
relaxation in-group, try intense exercise as your TIPP practice for the week.

3. Distress Tolerance Handout 13: “Crisis Survival Kit for Home, School, or Work” 🧳

 Objective: Create a personalized Crisis Survival Kit for home to help you manage
distress in moments of high emotional intensity.
 Task: Choose 5–10 items from the following categories to include:
o Distract with Wise Mind ACCEPTS (e.g., a favorite puzzle, cards, or a book)
o Self-Sooth with Six Senses (e.g., soothing music, scented candles, body lotion,
etc.)
o IMPROVE the Moment (e.g., a list of encouraging words, favorite motivational
quotes)
o Pros and Cons (e.g., list of your pros and cons for engaging in harmful
behaviors)
 o TIPP (e.g., a mini ice pack, a workout schedule, or a list of breathing exercises)
 Tip: Keep your kit accessible—store it in a bag, shoebox, or basket. When feeling
distressed, use your kit to immediately engage in helpful activities without having to
think about it.

Portable Survival Kit for School or Work (Optional) 🏫💼

 If you find distressing situations arise frequently at school or work, create a smaller,
portable crisis survival kit.
 Ideas for school/work kit:
o Multicolored rubber bands to manipulate.
o Paper and pens for doodling.
o Mini-playdough or squeeze ball for tactile soothing.
o Extra snacks for self-soothing.
o List of friends, teachers, or counselors to approach for support.
 Tip: This portable kit can also be handy when traveling or in public spaces like a bus,
gym, or during meetings.

Show and Tell Next Week 🎤

 **Bring your Crisis Survival Kit to share with the group. Let’s talk about what works
for you and any challenges you faced during the week while using your kit.
 Reminder: The purpose of these kits is to give you immediate tools for emotional
regulation during moments of distress so that you can reduce impulsive behaviors and
choose healthier coping strategies.

Goal: By the end of the week, you should feel more prepared to handle
distressing moments with greater resilience. The skills you practice now can help
you build long-term emotional stability.

Session 4: Distress Tolerance & Reality Acceptance

Mindfulness Exercise: The Half-Smile 😊

Objective: This exercise introduces reality acceptance through physical expression.

 Instructions:
 o Sit in a comfortable position.
o Step 1: Rate your distress level on a scale of 0 to 100 for the next 5 seconds.
o Step 2: Relax your facial muscles, starting from your forehead to your jaw.
o Step 3: Gently and subtly upturn the corners of your mouth into a half-smile (just
enough for you to feel it, not for others to notice). This subtle smile can influence
your emotional state and promote calm.
o Step 4: Stay with the half-smile for 1 minute, allowing your face to relax fully.
 After 1 minute:
o Step 5: Rate your distress level again from 0 to 100 and notice if there's any
difference.
o Discussion:
 Why it works: The half-smile helps your brain interpret greater calm and
acceptance. Your facial muscles communicate directly with the emotional
center of your brain. This skill helps you accept situations that can’t be
changed in the short term without resistance.
 Discussion Point:
o Ask participants if they felt any difference in their distress levels before and after
the exercise.
o Common reactions: "Does this just mean putting on a happy face?"
 Leader's Response: It's different from faking a smile. The half-smile is a
natural, subtle way to create acceptance, not force positivity. It’s about
soothing your emotional state rather than masking it.

Homework Review & Show and Tell 📦

 Objective: Share and discuss your personal crisis survival kits.

o Each member should bring their Crisis Survival Kit to the session.
o Instructions:
 Choose 5 favorite items from your kit.
 For each item, briefly explain how it represents a specific skill (e.g., self-
soothe, distract with "Wise Mind ACCEPTS", etc.).
 Examples:
 Lavender soap → Represents the self-soothe skill (smell).
 Favorite book → Serves as a distraction activity.
 Playing with a pet → Works as both a distraction and a self-
soothing activity.
 Time for Sharing: Each group member shares their kit’s contents and explains how the
items are useful for managing distress. This allows for creativity and inspiration as
everyone discusses their strategies.

Key Takeaways 📌:
  The half-smile can be a powerful tool for calming emotional distress, even if it feels a
little strange at first.
 Crisis survival kits are a tangible and personalized way to manage distress in moments
of high emotional arousal.
 Sharing your kit with others helps normalize the experience and may offer new ideas to
improve your toolkit.

Session 4: Radical Acceptance and Willingness

Reality Acceptance Skills 🌱

 Goal: Learning to accept reality as it is, even when it’s painful, instead of avoiding,
denying, or fighting it.
o Key Concept: Acceptance is not approval. It’s seeing the reality for what it is and
choosing to move forward without resistance.
o Why Bother with Acceptance?
 Avoiding or fighting painful situations often makes the situation worse.
 Radical acceptance reduces unnecessary suffering and allows for more
effective coping strategies.

Radical Acceptance 🌀

 Leaders' Example:
o Story: "Many years ago, I had an unexpected medical condition that I initially
couldn’t accept. It took time for me to radically accept my condition and, by
doing so, I found that I was able to take steps toward managing my health and my
emotions. Acceptance helped me reduce my suffering, even though I couldn’t
change the reality of my illness."
 Discussion:
o Leaders share personal examples of struggles they’ve had with accepting reality.
o Discussion Points:
 What does radical acceptance look like?
 How does accepting reality change the emotional experience?
o Alternative Responses to Painful Situations:

1. Solve the problem

2. Change how you feel about it 💭
3. Accept it ✅
4. Stay miserable 😞
5. Make it worse 😤
  Activity:
o Discuss how different responses can look in everyday scenarios.
o Examples:
 Situation: A family argument. What would each response look like?

Turning the Mind 🔄

 What is Turning the Mind?

o Turning the mind refers to making the choice to accept reality, especially
when it’s tough.
o Acceptance is a process, not a one-time decision.
o We may need to repeatedly turn our minds toward acceptance when we find
ourselves struggling.
 Challenges to Acceptance:
o Beliefs: "If I accept this, I’ll be weak or give up."
o Emotions: Anger, guilt, sadness, etc.
 Practice Turning the Mind:
o Discussion Point: When has denial kept you stuck? How did acceptance shift
your experience?
o Leaders’ Example: A story about a family situation where acceptance helped
bring more peace to an individual despite a painful reality.

Willingness vs. Willfulness 🔄 vs 🚫

 What is Willingness?
o Willingness is doing what the situation calls for, even when it’s difficult. It’s
about being effective, not stubborn.
o Willfulness is not facing reality and refusing to do what’s necessary.

Example:

o A teenager who is frustrated about missing study time and reacts impulsively with
anger versus one who accepts the situation, takes a break, and uses the time
effectively.
 Discussion Point:
o Willingness vs. Willfulness:
 Willingness: Doing what the situation requires, even if it’s not ideal.
 Willfulness: Stubbornly refusing to accept the situation, which worsens
things.
Ways to Practice Accepting Reality ✨

 Handout Overview:
o 1-6 Ways to Accept Reality:
 Examples of strategies to help practice accepting difficult situations:
 Radical Acceptance
 Turning the Mind
 Willingness vs. Willfulness
 Homework:
o Handout 18: “Practice Exercise: Accepting Reality”
 Write about a distressing situation from the week that you couldn’t change
right away.
 Reflect on whether you tried to radically accept it.
 If you struggled with acceptance, think about how you could use the skills
shared today.

Key Takeaways 💡

 Acceptance is a choice, and practicing it reduces suffering by allowing you to move

forward.
 Willingness leads to better outcomes than willfulness because it involves adapting to the
situation and making the best of it.
 Turning the mind towards acceptance is a powerful tool when dealing with difficult
emotions or situations.

Next Week:

 Share reflections on practicing acceptance and discuss any struggles faced.

 Continue building and refining crisis survival kits.
Walking the Middle Path Module 🌟
Overview of the Module 🌱

This module is designed for teens and families, focusing on the dialectical approach to address
common challenges in emotionally dysregulated adolescents. The core principles include:

 Nondialectical thinking and behavioral patterns in families.

 Polarized thinking often seen in teens and how it impacts relationships.
 Validation of emotions and behaviors to improve family communication.
 Applying learning principles to promote behavior change in both teens and parents.

The Middle Path approach is rooted in dialectical thinking, which allows for the acceptance of
opposing ideas and finding balance between change and acceptance.

Key Components:

 Dialectical Thinking:
o Opposites can both be true. This principle allows teens and families to address
challenges while simultaneously accepting the current situation as it is.
 Middle Path in Parenting:
o This approach combines the structure of authoritative parenting (clear rules and
follow-through) with flexibility (openness to discussion and negotiation). It
fosters healthy adjustment in children by balancing discipline and autonomy.

Focus on Validation 🌼

 Validation is a critical aspect of the module, as it helps validate emotions in a

potentially invalidating family context.
o Teens are taught to validate parents as well as themselves, which fosters
empathy and better communication.
o Validation reduces relationship conflict and improves overall communication
within families.
 Bio-Social Theory:
o The module aims to help families understand emotional dysregulation in the
context of the bio-social theory, which suggests that both biological factors (e.g.,
genetics, brain function) and social factors (e.g., family environment) contribute
to emotional dysregulation in adolescents.

Dialectical Dilemmas 🔄

 The module focuses on dialectical dilemmas—situations where opposite ideas can both
hold truth.
 o For example, how can parents be firm in their discipline while also flexible
enough to understand their teen’s perspective?
o The approach encourages acceptance of the teen’s perspective and balanced
rules and limits that help guide the teen’s development.
 Family Tableau Exercise:
o Teens and parents create a family tableau, where the teen stands against one
corner of the wall representing one side of the dilemma (e.g., “I need more
freedom”) and the parent stands at the opposite corner (e.g., “I need to set
boundaries”).
o This exercise encourages dialogue and understanding of each other’s viewpoints,
helping both parties see where they stand and where they need to compromise.

Teaching Strategies

 Multiple Examples:
Leaders should provide plenty of real-life scenarios and examples to help families
understand and apply dialectical thinking. Always ask teens how they relate to these
examples.
 Succinct Lectures & Interactive Discussions:
Keep lessons concise and ask group members for their thoughts and examples.
Encourage teens to actively participate.

Challenges in the Module ⚖️

 Families may find it difficult to balance validation with boundaries.

 Teens may struggle with understanding the importance of validation when their
emotions feel invalidated.
 Parents may find it difficult to practice flexibility when they feel strongly about
discipline and structure.

Next Steps:

1. Homework:
o Teens and parents are encouraged to practice validation in everyday situations
and apply dialectical thinking when faced with a dilemma. Each family member
should try to validate the other’s emotional responses, particularly in moments of
conflict.
2. Continued Focus on Validation:
o Focus on self-validation and parent validation as part of ongoing practice.
Handout 10 can be used to further explore self-validation for teens.
3. Family Sessions:
o Use family sessions to dive deeper into these concepts, especially when there’s
difficulty accepting or balancing different perspectives.

Takeaways 💡
  Dialectical thinking allows you to see that both sides of a situation can have truth.
 Validation helps reduce conflict and improves communication within families.
 Practicing the Middle Path in parenting provides a balanced approach between structure
and flexibility.

Next Week:

 Review homework on validation and family dilemmas.

 Dive deeper into behavioral change and continue applying dialectical principles in
daily family interactions.

Session 1: Walking the Middle Path

Goals 🌱

 Resolve family conflicts with a middle path: balancing acceptance & change.
 Focus on Dialectics (seeing multiple truths) and Validation (accepting feelings).
 Work on behavior change for healthier relationships.

Dialectics: The Key Concept 🔄

What’s Dialectics?

 Both/And thinking: Accepting that multiple truths can coexist.

 Example: A teen wants to stay out late 🌙, but a parent is worried about safety 🚗. Both
perspectives have value!

Mnemonic: BOTH SIDES – Balance One Truth, Honor the other Side, and Find a Middle path.

Exercise: Seeing Both Sides 🧠

1. Extreme Thinking

 Teens might say: “I should be home by 2 AM!”

 Parents might say: “No way! 10 PM is the limit.”
 Dialectics: Recognize the truth in both sides.

Example: Teen wants more freedom; Parent wants more safety.

  Middle Path Solution: Meet halfway, and create a compromise: “How about midnight
and check-ins every 30 minutes?”

Dialectical Wisdom 💡

1. Multiple Truths: There’s always more than one way to see things. 🧐
2. Acceptance of Differences: People’s views are valid, even if they’re different. 🤝
3. Change is Constant: Things will change over time. ⏳
4. Opposites Can Be True: "You are doing the best you can AND you need to try harder."
🎯

How to Think Dialectically 🧩

1. Both/And Thinking
o Avoid “always” or “never.” Example: “Sometimes I feel heard, but sometimes I
don’t.”
2. Look at All Sides
o Find the truth in each view. Ask yourself: “What am I missing?” 🔍
3. Use "I feel" Statements
o Example: “I feel frustrated when you don’t listen” instead of “You never listen!”
😤
4. Accept Different Opinions
o Acknowledge other perspectives: “I see your point, even if I don’t agree.” 💬

Activity: Family Conflict Roleplay 🎭

 Roleplay a family conflict (like curfew, phone use, etc.)

 Practice validating both perspectives.
 Find a middle path solution.

Homework 📚

1. Dialectics Handout 1
o Reflect on a conflict where both sides are true. How can you find the middle path?
✨
2. Dialectics Handout 2: How-to Guide
o Practice Both/And thinking this week. Avoid extreme thinking! ⚖️
3. Family Practice
 o In a real conflict, honor the truth in both sides and try to find a compromise.

Key Takeaways 💡

 Dialectics: Two truths can exist at the same time.

 Validation: Respecting each other’s views builds stronger connections. 💪
 Find the middle path for healthier conflict resolution.

Next Week:

 Review Dialectical thinking in real situations.

 Focus on Validation as a strategy for effective communication. 💬

Session 1: Walking the Middle Path 🌱

Exercise: Practice Dialectics 🔄

 Task: Read the “Practice Examples” in the Dialectics 'How-to' Guide and circle the
statements that reflect a dialectical viewpoint.
 Example Statements:
o "I am working to accept my situation and change it." ✅
o "You’re doing the best you can and you need to do better." 💪
o "The teacher is really strict and really nice." 📚
o "I can be rational and emotional." 💡

Why Dialectical Thinking? 🤔

 Multiple Truths: Seeing both sides of a situation helps reduce conflict and promotes
growth.
 Key Insight: Dialectics isn’t about choosing one side—both truths can coexist!

How We Can Get Stuck 😓

 Extreme Responses: Emotional reactions can push us to flip from one extreme to
another.
o Example: “I let my kid do whatever, but then I suddenly overreact and ground
them for months!” 🚨
 Polarized Thinking Examples:
 o “It’s all my parent’s fault!”
o “I’m either ignoring my kid’s room or throwing everything out!” 🛑

Scenarios for Discussion 💬

Scenario 1: Curfew Conflict

 Teen: "I want my friends over for the night."

 Dad: "No, they are too loud, I don’t want a mess."
 Dialectical Approach:
o Teen’s truth: More autonomy and fun with friends 🎉
o Dad’s truth: Safety and order at home 🏡
o Middle Path: Agree on a compromise, like a smaller group and curfew
extensions with check-ins 📱

Scenario 2: Father-Son Time 💖

 Dad: "I bought a car and detailed it just for you."

 Son: "I wanted to spend time with you, not just get a gift!"
 Dialectical Approach:
o Dad’s truth: Love through action (car) 🚗
o Son’s truth: Time together is important 🤗
o Middle Path: Acknowledge the gift and make time for joint activities next time.

Scenario 3: Late Movie 🍿

 Daughter: "I called at 11 PM as promised, but mom was still upset."

 Dialectical Approach:
o Daughter’s truth: Kept her promise ✅
o Mom’s truth: Concern for safety 🛑
o Middle Path: Agree to call when the movie ends, then communicate clearly
about unexpected delays.

Thinking Mistakes ⚠️

 All-or-Nothing Thinking: "If I don’t get a perfect grade, I’m a failure!" 🚫

 Jumping to Conclusions: "I didn’t hear back from my friend; they must hate me!" 😣
 Labeling: "I’m terrible at everything."
 “Shoulds”: "I should always be happy and perfect." 🎯

Goal: Recognize these thinking mistakes to avoid polarization and extreme reactions.
Adolescent–Family Dialectical Dilemmas 💔

 Too Loose vs. Too Strict

o Loose: No curfew, no supervision, too permissive 🚫
o Strict: Too many rules, overpunishing, too rigid 📏
o Middle Path: Balance autonomy with healthy boundaries!
 Making Light vs. Overreacting to Normal Behaviors
o Loose: Ignoring behaviors that need attention
o Strict: Overreacting to minor teenage mistakes 🔥
o Middle Path: Address the issue calmly without escalating unnecessarily.
 Fostering Independence vs. Dependence
o Loose: Letting teens be too independent too early 🔓
o Strict: Over-managing every aspect of their lives 🔒
o Middle Path: Support independence while providing guidance and safety.

Activity: Recognizing Dialectical Dilemmas

 Example 1:
o Teen: Wants to stay out past midnight 🕑
o Parent: Wants them home by 10 PM 🕙
o Middle Path: Understand both truths and negotiate a curfew extension with
safety measures ✅
 Example 2:
o Teen: Wants freedom with minimal rules 📱
o Parent: Wants more control for safety 🚨
o Middle Path: Develop trust and compromise with shared responsibility 👥

Homework 📝

1. Practice Dialectics:
o Reflect on a conflict and write about the both/and truths involved.
2. Thinking Mistakes Handout:
o Identify examples of thinking mistakes and how to correct them.

Key Takeaways 💡

 Dialectical Thinking: There’s always more than one truth.

 Validation: Understand both sides to create healthier, more balanced solutions.
  Middle Path: Balance between extremes helps resolve conflict and promotes growth.

Next Week:

 Focus on Validation and how it improves communication and reduces conflict. ✨

Session: Forcing Independence vs. Fostering Dependence

Overview: Understanding the Dilemma ⚖️

The dilemma of Forcing Independence vs. Fostering Dependence is a common challenge in

family dynamics. Here's what it looks like:

 Forcing Independence: Cutting ties too soon, over-accelerating the process of self-
sufficiency.
 Fostering Dependence: Hovering over your teen, doing everything for them, restricting
their independence.

Examples:

Forcing Independence

 Parenting Example: Parents of a 17-year-old girl who had been overprotective suddenly
demand she leave home when she becomes pregnant, after having "rescued" her from
many situations in the past.
 Teen Example: The same 17-year-old daughter packs up, saying, “Fine—I don’t need
you! I’ll handle it on my own!” 🚪

Fostering Dependence

 Parenting Example: Parents who micromanage their teen’s life—doing everything from
organizing their room to solving social conflicts for them. 💼
 Teen Example: Teen repeatedly seeks help for daily decisions or tasks, unable to do
them independently. 📱

Exercise: Does the Dilemma Apply to You? ✨

Task:

 Look at Handout 5, “Dialectical Dilemmas: How Does the Dilemma Apply to You?”
  Mark an X for where you fall on the Forcing Independence vs. Fostering Dependence
continuum. Mark a Y for where your family member is.
 Share your thoughts on where you fall!

Example Activity:

 Physical Placement: Each family member places themselves on the continuum (from
"Too Loose" to "Too Strict") using a wall as a guide.
 Group Discussion: Discuss where your family members are placed and explore how
both views can have their validity.

Middle Path: Holding On While Letting Go 🔄

 What is the Middle Path?

It's about balancing guidance, support, and rules with granting more freedom and
autonomy.
 Middle Path Examples:
o Pregnant 17-Year-Old: Instead of cutting off all support, the parents can
gradually reduce their involvement, allowing the teen to take on more
responsibility while offering guidance and emotional support. 🌱
o College Application: Letting your teen apply to a college across the country, but
ensuring frequent communication through technology. 📱

Discussion Points 💬

1. Pushing Away Too Soon:

o What happens if we push our teens too fast into independence before they are
ready? 😟
o Problem: It can overwhelm them, causing stress and emotional burnout.
o Middle Path: Gradually foster independence while providing a safety net.
2. Fostering Dependence:
o What are the risks of being overprotective or micromanaging? ⛔
o Problem: The teen doesn’t develop the necessary life skills, leading to frustration
and resentment.
o Middle Path: Offer guidance and boundaries while encouraging self-sufficiency.
🌟

Examples for Discussion:

 1. Parenting:
A teen gets an F in school. Mom wants to call the school and fix it.
o Middle Path: Encourage the teen to take responsibility for their grades while
offering support in the form of resources (study help, time management). 📚
2. Teen-Parent:
A teen with low grades wants more independence, but the parents are constantly
intervening.
o Middle Path: Encourage autonomy but help them with planning and prioritizing.
Help them find their own solutions without micromanaging. 💡
3. Parenting:
A teen is afraid of taking the train. Mom accompanies her for three months.
o Middle Path: Start with support and slowly reduce it as the teen gains
confidence, allowing her to do it independently over time. 🚉

Key Takeaways 💡

1. Balance: Let your teens become independent, but provide a safety net.
2. Middle Path: Acknowledge both the need for freedom and the need for guidance.
3. Effective Parenting: Give your teen space to grow while still offering support when
necessary.

Next Week:

 We will focus on Validation and Behavior Change as essential skills for managing
family dynamics.

Homework Assignment 📚

Walking the Middle Path Handout 7: “Practice Exercise: Thinking and Acting
Dialectically”

Instructions:

1. Non-Dialectical Example: Think of a time when you got stuck at one extreme of a
dialectical dilemma (e.g., being too loose or too strict, fostering dependence or forcing
independence, etc.). Write down a personal example of how you didn't consider both
sides of a situation and instead acted from an extreme position. 💭
2. Dialectical Example: Now, think of a time when you used dialectical thinking
(acknowledging both sides of a situation and finding a balanced middle path). Record
how you handled the situation by considering and validating both perspectives. ⚖️
Reflection Questions:

 What made it hard to consider both sides in the non-dialectical example?

 How did considering both sides help in the dialectical example?
 How can you apply this way of thinking to future situations?

Submit the Homework:

 Complete Handout 7 with your examples.

 Reflect on how dialectical thinking can help you avoid extremes in difficult situations.

Reminder 📅:

 Next Session: We will discuss validation and behavior change, helping you integrate
dialectical thinking into daily life.

Homework Assignment 📚

Walking the Middle Path Handout 11: “Practice Exercise: Validation of Self and Others”

Instructions:

1. Invalidating Statement for Self: Write down one example of a time when you
invalidated yourself. This could be when you judged or criticized your own feelings or
actions (e.g., "I shouldn't feel sad about this").
2. Validating Statements for Self: Write two validating statements for yourself. These
should acknowledge your emotions or actions in a non-judgmental way (e.g., "It's okay to
feel sad about this. It's a tough situation, and my feelings make sense").
3. Invalidating Statement for Others: Write one example of a time when you may have
invalidated someone else (e.g., "Stop overreacting, it's not a big deal").
4. Validating Statements for Others: Write two validating statements you can use with
others. These should recognize and understand their emotions or behavior (e.g., "I can
see why you're upset. It sounds really frustrating").

Self-Monitoring:
  Track Invalidating Thoughts/Statements: Throughout the week, try to catch any
invalidating thoughts or statements about yourself or others. When you notice them,
replace them with validating statements.

Goal:

 Practice Validation: Make sure to practice validating yourself or someone else at least
once during the week. Record your experiences and use them as learning points for the
next session.

Reminder 📅:

 Next Session: We'll focus on interpersonal effectiveness skills, building on what we've
learned in this session.

Session 3: Behavior Change Skills

Orientation of Clients to Behavior Change Skills 🧠

What Is Behavior Change?

Behavior change skills are strategies to help increase behaviors you want to see and reduce
behaviors that aren’t helpful, either in yourself or others. In simpler terms: it’s about learning to
reinforce good habits and reduce the bad ones.

For example, think about rewarding positive behavior right after it happens – like giving a treat
when a dog follows a command! The same works for humans. You reinforce a desired behavior
immediately to make it more likely to happen again.

What Behaviors Would You Like to Change? 🔄

Discussion Point:
Ask yourself: What behavior would I like to change? Is it my own behavior or someone else's?
Could it be quitting procrastination? Or maybe reducing yelling or spending more time with
family?

For behavior change to work, it needs to be specific and measurable! Example: instead of "I
want to be happier", say, "I want to exercise more or spend time with friends". 🎯
Positive Parenting Strategies 👫

Tip:
A great way to increase positive behaviors in your teen is through positive reinforcement! 🏅
Notice what they’re doing right, give praise, and offer support. For instance, if your teen gets a
good grade or helps out at home, reward them with attention, privileges, or praise.

It’s More Than Just Discipline:

Rather than focusing on what they do wrong, emphasize what they do right. It’s all about
building a positive cycle! 🌟

Ways to Increase Behaviors: Reinforcement 🎁

Reinforcing behaviors that you want to see more of is key! Reinforcers are rewards for
behaviors we want to increase. They can be anything that motivates the person, like praise,
money, or special time. 🏆

Types of Reinforcement:

 Positive Reinforcement: Adding something pleasant to increase a behavior (e.g., giving

a treat when a dog obeys).
 Negative Reinforcement: Removing something unpleasant to increase a behavior (e.g.,
turning off a loud noise when the desired action is done).

How to Use Positive Reinforcement 💥

 Immediate Reward: Give the reward immediately after the desired behavior so it’s
clearly connected! For example, don’t wait too long to praise your teen for doing their
chores. 🏅
 Motivating Reinforcers: Make sure the reward is something the person really values.
What’s motivating for one person might not be for another, like how coffee’s only
reinforcing for some at certain times! ☕️

Tip: Ask your family members what kind of reinforcers motivate them. 🍀

What to Reinforce 🔨
For Teens:
You could reinforce:

 Helping with chores 🧹

 Expressing anger calmly 😌
 Sticking to curfew 🕙

For Parents:
You could reinforce:

 Staying calm during a stressful situation 🌼

 Listening attentively 👂

When to Withhold Positive Reinforcement 🚫

Don’t Reinforce Negative Behavior:

Sometimes, withholding reinforcement is necessary. For example, if someone’s engaging in
harmful behavior, such as self-harm, don’t reward it. Monitor the behavior closely and take
appropriate actions, but don’t offer extra attention or rewards. 🛑

Shaping: Small Steps Toward Big Changes 🪜

What Is Shaping?
Shaping involves reinforcing small steps toward the final goal. It’s like climbing a staircase —
one step at a time until you reach the top!

Example:
If you want to help your teen improve their study habits, reward them for each step, like
starting their homework, finishing the first part, and so on. Each small step gets
reinforcement! 🏅

Self-Reinforcement 💪

Don’t forget to reward yourself too! 🏆 After making progress on your goals, treat yourself!
Maybe it’s taking a break, watching TV, or doing something fun! 🥳

Homework Assignment 📋
 1. Positive Reinforcement Exercise:
Write down something positive about a family member’s behavior that you can report in
the group next week. Say at least one positive thing to each other every day. 🎉
2. Specific Behavior to Reinforce:
Identify a behavior you want to increase in yourself and a behavior you want to increase
in someone else. Think about what reinforcers would motivate you and the other person
to achieve this goal. 🏅

Session 4: Ways to Decrease or Stop Behaviors

Introduction to Decreasing or Stopping Behaviors 🔽

In today’s session, we’ll dive into extinction and punishment strategies for reducing or stopping
unwanted behaviors in ourselves and others. These two skills will help you manage behaviors
that don’t align with your goals, whether it’s with your teen, partner, or even yourself! 🚦

Extinction: Stopping Behaviors by Withholding Reinforcement 🚫

What is Extinction?
When we reinforce a behavior, we increase its likelihood of happening again. But did you know
that ignoring unwanted behaviors can actually reduce them? This is what we call extinction. ✋

Example:
Imagine your child throws a tantrum in the supermarket for a candy bar. If you give in and buy
the candy, you're reinforcing the tantrum. But, if you ignore the tantrum and withhold the candy,
the behavior will eventually fade! 🎯

Key Steps in Extinction:

1. Reinforce an Alternative Behavior: Instead of giving attention to the tantrum, reward

positive behaviors like being calm. 💪
2. Expect a Behavioral Burst: When you start ignoring the undesired behavior, it may get
worse before it gets better. This is called the behavioral burst. Ride it out! 🌊
3. Don’t Reinforce with Intermittent Attention: If you give in sometimes, the behavior
will become harder to stop. It's like a slot machine—random reinforcement makes the
behavior more persistent. 🎰

Tips for Effective Use of Extinction 💡

 1. Be Neutral: Stay calm and unaffected by the undesired behavior. Don’t escalate with
anger or frustration. 😌
2. Consistency Is Key: Keep reinforcing the positive behavior and ignore the misbehavior
consistently.
3. Tell the Person Why You’re Using Extinction: Be upfront, so it doesn’t feel arbitrary.
Example: “I’m not responding to you when you speak like that.” 🎤
4. Don’t Forget to Reinforce Good Behavior: If the person does something right, reward
it immediately! 🏅

Punishment: Adding or Removing Consequences to Decrease Behavior ⚖️

What is Punishment?
Punishment is a consequence used to decrease unwanted behavior. It can either involve adding
something negative (e.g., extra chores) or removing something positive (e.g., privileges). ⚡

Caution with Punishment:

Overusing or misapplying punishment can backfire. It can lead to increased resentment, hiding
behaviors, or even worsen emotional dysregulation in teens. 😞

Effective Use of Punishment:

1. Reinforce Positive Behaviors First: Prevention is better than cure! Reward desired
behaviors so that they are more likely to continue. 🌱
2. Clear Expectations: Make sure everyone knows the rules and what happens when they
are broken. 📝
3. Use Measured Consequences: Choose consequences that fit the behavior. Don’t be too
extreme. A minor infraction shouldn’t result in a major punishment. 🚦
4. Immediate Application: Apply consequences immediately after the misbehavior.
Timing matters! ⏰
5. Natural Consequences: Sometimes the natural consequence of an action is punishment
enough. For example, if a teen skips studying and fails an exam, don’t add extra
punishment. The failure itself is already a consequence! 📉

Discussion Point: When to Use Extinction vs. Punishment 🤔

What Behaviors to Extinguish vs. Punish?

 Extinguish: Small annoying behaviors like minor interruptions or giggles during

homework.
 Punish: More serious behaviors like lying, stealing, or breaking curfew. 🔒
Shaping: Reinforcing Small Steps Toward Big Goals 🏁

What Is Shaping?
Shaping is when you reward small steps toward a bigger goal. It’s like building a house brick
by brick—each small step gets a reward! 🏠

Example:
If your teen needs to improve in school, don’t wait until the final exam to give praise. Start by
reinforcing small wins like finishing an assignment or getting a decent grade on a quiz. Each
small success deserves reinforcement! 🏅

Self-Reinforcement 🎉

Don’t Forget Yourself!

Reward yourself for your efforts too! Whether it's treating yourself to a movie after a productive
day or enjoying a cup of your favorite coffee. ☕️Self-reinforcement keeps you motivated to
continue the good work.

Homework Assignment 📋

1. Extinction Practice:
Identify annoying behaviors in others that you can ignore (such as interrupting) and
practice putting them on extinction. Observe the results over time! 📉
2. Punishment Practice:
Think of appropriate consequences for behaviors in your teens or yourself that require
punishment. Prepare a menu of consequences for when necessary, keeping them
measured and related to the offense. ⚖️

Key Takeaways 💡

1. Extinction works by withholding reinforcement for unwanted behaviors.

2. Punishment should be measured and immediate, and paired with reinforcing positive
behavior.
3. Shaping is about rewarding small steps to reach larger goals.
4. Self-reinforcement is just as important as reinforcing others! 🎯
Emotion Regulation Skills

Introduction to Emotion Regulation 🧭

In this module, we're teaching you how to take charge of your emotions. Instead of letting them
control you, you'll learn how to become the captain of your ship 🌊. Think of it like becoming
the king/queen of your emotional kingdom 👑, where you have control over your emotional
reactions!

Why Bother Taking Charge of Your Emotions? 🎯

Why is emotion regulation important?

1. Intense Emotions: Emotionally dysregulated individuals often experience overwhelming

emotions, like anger, frustration, or anxiety. 😠😟
2. Unhealthy Responses: These intense emotions can lead to impulsive behaviors (e.g.,
yelling, avoiding responsibilities, self-harm). 🚨
3. More Effective Solutions: This module teaches you how to replace those problem
behaviors with effective coping strategies that help you handle intense emotions better.
🌱

Goals of Emotion Regulation Skills Training 🎯

1. Understand Your Emotions 🧠

To change your emotions, you must first understand them. You'll learn to identify
emotions by practicing mindfulness and labeling your feelings. Once you know what
you’re feeling, you can choose the right response.
2. Reduce Emotional Vulnerability 🚫
You will learn how to reduce emotional reactivity and avoid being easily triggered.
This will help you manage your emotions in a healthier way and avoid negative
emotional spirals.
3. Increase Positive Emotions 🌞
By focusing on things that bring you joy and fulfillment, you’ll increase positive
emotions. This can make you feel more in control and connected to life.
4. Decrease Unwanted Emotions 💔
You will gain strategies for reducing negative emotions (e.g., anxiety, anger, sadness)
and stop them from affecting your daily life. One of the most powerful tools you'll learn
is opposite action—doing the opposite of what your emotion tells you to do! 🚶‍♀️
 5. Decrease Emotional Suffering 💡
You will learn techniques to stop emotional suffering before it overwhelms you.
Through mindfulness and acceptance skills, you can observe and release painful
emotions instead of letting them control you. ✨

The Functions of Emotions: What Good Are Emotions? 🌟

1. Emotions Give Us Information 📊

Emotions signal important things happening around us. Anxiety can tell us to be
cautious, anger can signal a boundary violation, and sadness can guide us to heal. 🧠

Metaphor: Think of emotions as the warning lights on a car dashboard—each one gives
you useful information to respond to the situation. 🚗

2. Emotions Influence Others 🌍

Emotions, expressed through body language and facial expressions, communicate how
we feel to others. They can motivate others to help, avoid, or connect with us. 😊

Example: If you're looking sad and withdrawn, others may feel compelled to ask if
you're OK. 😞

3. Emotions Motivate Action ⚡

Emotions trigger automatic action urges—they tell us when to act quickly, like when we
hear a loud horn honking. 🚨

Example: If you’re walking with a friend and hear a loud honk, your immediate response
is to move quickly, without thinking. Your fear urges you to take immediate action! ⚡

Mindfulness Exercise 🧘‍♀️

Take 2 minutes to reflect on the short list of emotions (Handout 3).

 Check off every emotion you’ve experienced this week.

 How many different emotions did you experience?
 Were any of them positive emotions? 😊

Labeling and Understanding Emotions

To regulate your emotions, you must first label them. 🌈

Study Tip: Practice mindfully labeling your emotions during the day. For example, when you
feel angry, pause and say, “I’m feeling angry right now,” instead of just reacting. This step alone
can start to shift your emotional state. 🧠

What to Do with Emotions: Using Them for Positive Change 🔧

Emotions can serve us or harm us. The key is deciding if your emotion is helping you or
hurting you. 🌱

1. When emotions work for you:

o Example: Feeling anxious in a dangerous situation (like a dark alley) helps you
stay alert and safe. 🦸‍♂️
2. When emotions work against you:
o Example: Feeling irritable and yelling at a family member can escalate the
situation. Instead, you might choose to practice mindfulness and self-soothe. ✋

Study Tip: Practice opposite action—when feeling an intense emotion, choose to act in the
opposite direction of what the emotion urges you to do. If you feel angry, try being calm and
engaging in a soothing activity. 💆‍♀️

Exercise: How Many Emotions Have You Felt This Week? 📝

1. Check the list of emotions from Handout 3.

2. Reflect on how different emotions arise in different situations.
3. Share with the group—how many emotions did you feel last week? Did you notice
patterns or intense emotional bursts?

Key Takeaways 💡

1. Emotions are informational—they guide us to make better decisions.

2. Mindfulness and labeling help you identify emotions so you can change them.
3. Opposite action is a powerful tool to decrease negative emotions.
4. Emotions influence others—learn to manage them to build better relationships.

Session 1: A Model of Emotions

Introduction to the Model of Emotions 🎨

In this session, we are going to explore the emotion regulation process using a model of
emotions that helps break down all the components involved in our emotional experience. 🧠💖
We will go through how emotions develop, and more importantly, how we can intervene to
manage and regulate them.

To make it easier, we will visualize this model as a chain of reactions, much like an electrical
circuit. If we break the circuit at any point, we can change the outcome of the emotion, making
it less intense or more manageable.

The Emotion Cycle: Breaking Down the Process 🔄

1. Prompting Event 🛑
The first stage in any emotion is the triggering event. This could be something external
(e.g., losing track of your child in a store) or internal (e.g., a memory, a thought, or even
a sensation like feeling hungry). It is the event that sparks the emotion.

Example: "When my daughter wandered away from me in the store, I couldn't find her,
and panic began to rise."

2. Vulnerability Factors 🧠
Some people are more sensitive to emotional triggers due to vulnerability factors, such
as being tired, hungry, or having a history of stress. These factors can intensify your
emotional reaction.

Example: "I was already tired and hungry, so my reaction to not finding her was much
stronger."

3. Thoughts 💭
Our thoughts about the event play a key role in how we experience emotions. Thoughts
like “She’s lost!” or “I’m a terrible parent!” amplify our emotional response.

Example: "My initial thought was, ‘She’s lost! I can’t find her!’"

4. Internal Reactions 💓
Emotions are not just in the mind—they affect our body too. You may feel adrenaline,
increased heart rate, or experience shaky hands when emotions are triggered.

Example: "My heart raced, my face went hot, and I felt a lump in my throat."

Tip: Keep track of your body sensations when emotions rise; this can help you
recognize early signs of distress.

5. Urges to Act ⚡
Strong emotions create urges to do something—often impulsive actions like shouting,
 running, or crying. These urges are natural but can be problematic if acted on without
thinking.

Example: "I had the urge to shout her name and run around the store."

6. External Reactions 👀
Our face and body language express our emotions. Body posture, gestures, and words
all give others clues about our emotional state.

Example: "I started shouting, and I could feel my fists clenching."

The Aftereffects

Emotions don’t just end when the situation does. There are secondary emotions and
aftereffects. These can include shame, regret, or guilt, and often arise from the first emotion
you feel. It’s important to recognize these secondary emotions and decide how to handle them.

Example: "After finding my daughter, I felt relief, but also guilt for losing track of her."

The Bidirectional Nature of Emotions 🔁

 Emotions don’t just follow one path. They are bidirectional, meaning your actions and
thoughts can also affect your internal experience.

Example: When I started to calm down after finding my daughter, my thoughts shifted from
panic to relief.

 Action ↔ Emotion: Your actions (like a deep breath or calming gesture) can reduce
your emotional intensity.
 Emotion ↔ Thoughts: After calming down, I shifted my thinking to: "Thank goodness,
she's safe."

Where Can You Intervene? ⚙️

The good news is that you have multiple places where you can intervene to regulate emotions.
Think of the emotion process as an electrical circuit—if you break the circuit at any point, the
emotion's intensity can be reduced. 🔌

 Mindfulness (observing your emotions without acting on them) allows you to cut the
circuit before the emotional intensity escalates. 🧘‍♂️
  Opposite Action helps by doing the opposite of what the emotion urges you to do. For
example, calming yourself down instead of acting out of anger. 😌

Homework 📋

 Emotion Mapping:
Complete Handout 7 by mapping out your emotions this week. Identify each
component of the emotion (prompting event, thoughts, body reactions, etc.) in a real-life
example. 🌟
 Reflect on Interventions:
Reflect on where in the emotion cycle you could have intervened to reduce emotional
intensity.

Study Tips 📖

 Track Your Emotions: Start a daily emotional log to help you map out your emotions
and notice patterns.
 Use the Model: The next time you feel an intense emotion, pause and mentally walk
through the model of emotions. This will help you gain control over your responses.
 Practice Opposite Action: Try to intentionally counter an emotional urge with an
opposite action to practice emotion regulation.

Session 2: Increasing Positives with ABC PLEASE Skills

Introduction: Balancing the Scale ⚖️

In this session, we focus on increasing positives and reducing negatives in our lives using the
ABC PLEASE skills.

The Scale of Positives vs. Negatives ⚖️

Picture your life as a scale. On one side, you have negatives (e.g., depression, stress, conflicts).
On the other side, there are positives (e.g., hobbies, good relationships). Our goal is to add more
positives and reduce the negatives. 🌟

Discussion:
Think about the negatives in your life (e.g., sadness, anxiety). Now, think about the positives
(e.g., hobbies, time with family). Our goal is to increase positives to balance the scale. 💪✨
Accumulating Positive Experiences (Short-Term) 🌞

We need to actively engage in pleasant activities to boost our emotions.

1. Why Bother? 🤔
Research shows that pleasant activities can reduce depression. They also help reduce
emotional vulnerability. On a good week, small setbacks feel less overwhelming than on
a tough week.
2. How to Do It 🔑
Schedule your activities. Treat them like appointments.
o Example: 1:00 PM: Play the piano.
o Use calendars or smartphones to remind you to stick to these activities. 🌈
3. Be Mindful of Positive Experiences 🧘‍♀️
Be present. Don’t let your mind drift. Focus on the enjoyment of the activity. 🧠✨

Example:

o “I was on a beach vacation, but I spent hours worrying about weather back
home. It ruined the fun.”
Tip: Focus on the present moment and enjoy what’s around you.

Pleasant Activities List 📋

Exercise:
Review the Pleasant Activities List (Handout 10). Check the activities you enjoy. Star the ones
you haven’t done recently but would like to try. Write down new ideas too! 📝

High-Energy Activity:

 Interview a partner about their favorite activities. Ask:

o What do you currently like to do? 🎮🎨
o What have you done before that you’d like to try again? 🎸
o What new activity do you want to try? 🌍

Lower-Energy Activity:

 Go through the list silently. Share one activity from each category with the group.

Parent-Teen Shared Pleasant Activities 👨‍👩‍👧

Family time can often be stressful. Positive shared activities can help strengthen relationships
and reduce emotional tension. 💖

Activity:

 Review the Parent-Teen Shared Pleasant Activities List (Handout 11). Choose
activities to enjoy together. It can reduce conflicts and create lasting memories.

Key Takeaways 📚

 Be mindful during pleasant activities to maximize enjoyment.

 Schedule enjoyable activities like appointments.
 Engage in activities even when you don’t feel like it.
 Increase positives by spending quality time with family or alone.

Homework 📋

1. Pleasant Activities Log:

o Track one activity per day for the next week. 📝
2. Parent-Teen Pleasant Time:
o Plan and schedule shared activities using the list. 🌟
3. Reflection:
o Reflect on how these activities impact your emotions and mood.

Study Tip 🧠

 Be Consistent: The more you engage in these activities, the easier it will become. Make
them non-negotiable.

Session 3: Accumulating Positive Experiences (Long-Term) 🌟

Why Focus on Long-Term Goals? 🏆

Focusing only on short-term positive emotions can be fun, but it doesn't help us build a
meaningful life. To experience more positive emotions, we need to build a life worth living.
This requires long-term goals that align with our values. 💫
Wise Mind Values and Priorities 🧠❤️

To create long-term goals, we need to understand our values. Values are the principles that
matter most to us in life. For example, you might value family, health, honesty, or education. 🌱

Exercise:

 Look at the Wise Mind Values and Priorities List. ✅

 Check off the values that resonate with you.
 Add any personal values that aren't listed.
 Discussion: Which values are most important to you? Are they your values, or influenced
by others?

Taking Small Steps Towards Long-Term Goals 🏃‍♂️

Long-term goals are achieved by taking small, manageable steps. For example, if your value is
health, a goal might be to get in better shape. The first step could be researching local gyms or
buying workout shoes. The goal is to start small and make progress. 🎯

Exercise:

 Identify a value that’s important to you.

 Write down a couple of long-term goals related to that value.
 Choose one goal to focus on.
 Brainstorm the first steps toward that goal.
 Choose a first step and break it down if necessary.

The Effects of Moving Towards Your Goals 🌈

Taking small steps towards your long-term goals can improve your mood and emotional state.
Even if the goal isn’t immediately fun or satisfying, the process of working towards it creates
long-term positive emotions. 🌻

Pay Attention to Relationships 🤝

Relationships deeply impact our happiness. When relationships are strained, our emotional well-
being often suffers. Strengthening connections with family and friends is key to emotional
health. 👫

Exercise:
  Reflect on your relationships.
 Rate them on a scale of 1–10 (1 = not close, 10 = excellent).
 Identify one relationship you’d like to improve.
 Share one action you can take to strengthen that relationship this week. 💖

Avoid Avoiding and Avoid Giving Up 🛑

Avoiding problems or giving up might offer short-term relief, but it makes us more vulnerable
emotionally. We need to face challenges and take action rather than avoid them. 🚀

Exercise:

 Think about something you’ve been avoiding.

 Share how it’s impacted your emotions.
 Can you commit to facing it this week? If not, discuss it with your therapist. 🌱

Homework 📚

1. Short-Term:
o Commit to one pleasant activity each day.
o Be mindful during the activity and focus on the experience. 🧘‍♀️
o Families can pick shared activities from the list and try them out together. 👨‍👩‍👧
2. Long-Term:
o Identify a long-term goal and take one small step towards it this week. 🎯

Study Tip 📖

 Start Small: Break down long-term goals into bite-sized steps. Small wins lead to big
changes! 🌟

Challenges in Teaching Accumulating Positives 💡

Overcoming Negative Thoughts About Pleasant Activities

When clients feel depressed or overwhelmed, they often believe they won't enjoy activities,
thinking, "I don't think I'll enjoy this." This is understandable, but it may be Emotion Mind
talking. 🧠
Response:

 Remind them that they can still try the activity, even if their emotions aren’t fully
aligned.
 Once they participate, they may feel better and experience enjoyment, even if it’s not
fully enjoyable right away. 🌈
 Behavior impacts mood: Just like mood affects behavior, the reverse is true. Taking
action can lift their mood over time. 💪

Breaking Down Long-Term Goals into Baby Steps 🐾

People often get overwhelmed when thinking about long-term goals and avoid taking the first
step. The key is to break goals down into smaller, manageable actions. 🌱

Tip:

 Help them identify the first small step, even if it's tiny. 🚶‍♀️
 If it still feels too hard, break it down further. For example, if the goal is getting in
shape, the first step could be as simple as googling local gyms or buying sneakers. 👟

Modeling and Coaching Small Steps 🚀

Leaders should model and coach participants through these small steps. Demonstrating how to
take baby steps will make the process feel more manageable and less overwhelming. 👏

Study Tip 📖

 Small Wins Matter: Celebrate even small achievements! The more they succeed in tiny
steps, the more they will feel motivated to tackle larger goals.

Building Mastery, Cope Ahead, and PLEASE Skills

Building Mastery: Feeling In Control 💪

What is Building Mastery?

Building mastery means increasing your sense of control over your life. Even small
accomplishments can make you feel more effective. For example, crossing off a task on your to-
do list brings a sense of achievement. ✅
  Mastery Examples:
o Going back to school after a break.
o Learning a new skill (e.g., playing a song on the violin).
o Rebuilding a relationship with someone.

Why it’s Important:

Mastery can boost your mood and prevent avoidance. It doesn't always have to be fun, but the
results are worthwhile. For example, you might not enjoy practicing the piano, but mastery of a
song is fulfilling.

Building Mastery Steps:

1. Do something small every day to feel competent and in control.

2. Gradually increase difficulty over time (step-by-step approach).
3. If a task feels too hard, break it down into smaller, achievable steps. 🔑

Cope Ahead: Preparing for Stressful Situations ⏳

What is Coping Ahead?

Coping ahead means preparing in advance for a potentially stressful or negative situation. By
visualizing the situation and planning how to use coping skills, you increase the chances of
successfully handling the situation.

Example Situations:

 Attending a party where an ex-friend is present.

 Giving a class presentation.
 Going to a family event with a difficult relative.

Coping Ahead Steps:

1. Describe the upcoming situation that triggers negative emotions.

2. Choose specific skills to manage the situation (e.g., deep breathing, distraction).
3. Visualize the situation vividly in your mind. Imagine yourself using the skills.
4. Rehearse the situation mentally to make sure you're prepared. 🎯

PLEASE Skills: Taking Care of Your Body 🧠

Why Physical Health Matters:

Taking care of your body is essential for your emotional well-being. Healthy physical habits
like eating well, exercising, sleeping enough, and avoiding harmful substances can greatly
improve your mood and mental health.
The Five PLEASE Skills:

1. P - Treat Physical Illness

2. L - Balance Eating
3. E - Avoid Mood-Altering Drugs
4. A - Balance Sleep
5. S - Get Exercise

Why it’s Important:

How we treat our bodies impacts our emotional regulation. Unhealthy lifestyle choices can
make emotional struggles worse, but taking care of your body can help reduce emotional
vulnerability.

Exercise and Homework 📝

Exercise:

 Identify one thing you will do this week to build mastery.

 Plan to cope ahead with a challenging situation.
 Practice two of the PLEASE skills this week to improve your physical and emotional
health.

Homework:

 Practice daily mastery tasks, even small ones.

 Use the Coping Ahead skill for a stressful upcoming event.
 Track progress on the PLEASE skills for a healthier mind and body.

Session 4: Mindfulness and Emotion Regulation Skills 🧘‍♂️💡

Mindfulness Exercise: The Wave Skill 🌊

Purpose: This exercise helps you recognize that emotions come and go, and teaches you how to
handle them skillfully without avoiding them. You are not your emotion, and you don’t need to
act on it.

Steps:

1. Experience your emotion like a wave, coming and going 🌊.

2. Step back and just notice.
3. Don’t try to get rid of it.
4. Don’t hold on to it.
 5. Mindfully notice where you feel the emotion in your body (e.g., tight chest, clenched
jaw).
6. Allow the sensations to be as they are. 🌸
7. Observe how long the emotion lasts.
8. Remember: You are not your emotion.
9. Remember moments when you felt differently.
10. Practice accepting the emotion with kindness (or at least tolerance).
11. Invite the emotion in, instead of pushing it away.
12. Radically accept it.

Homework Review 📝

 Check in on any previous exercises or commitments related to mindfulness and emotion

regulation.

Break 🛑

Check the Facts and Problem Solving 🧠

Why It’s Important: Sometimes our emotions can fuel our thoughts and make problems seem
bigger than they are. Checking the facts helps us evaluate whether our emotions are justified,
and problem-solving helps us find effective solutions.

Steps:

1. Check the facts: Is your emotional response accurate?

2. If needed, use problem-solving: Brainstorm possible solutions, test them out, and
evaluate them.

Example:

 Situation: A teen wants to join the school play but fears they’re not good enough.
 Solution: Check the facts (Are they actually bad at acting? Do they have the skills? Are
others supportive?). Then, problem-solve by researching tips or practicing with friends.

Opposite Action: Changing Emotion Through Behavior 🔄

What is Opposite Action?
Opposite action is when you act against the urge of your emotion to change it. For example, if
you're feeling angry and want to shout, try acting opposite by staying calm and breathing
deeply instead.

Why It Works:

 Every emotion comes with an action urge (e.g., fear makes you want to avoid, but
anger makes you want to attack).
 When the emotion isn’t fitting the facts or it’s too intense, acting opposite can help you
return to baseline mood.

When to Use Opposite Action

1. Emotion doesn’t fit the facts: e.g., fear of speaking in public, but no actual threat.
2. Emotion is too intense or has lasted too long: e.g., prolonged sadness after a loss.

Examples of Opposite Action

1. Opposite Action to Fear:

 Urge: Avoid the situation (e.g., public speaking).

 Opposite: Confront the fear by speaking in front of others, even if it feels
uncomfortable.

2. Opposite Action to Anger:

 Urge: Attack or lash out.

 Opposite: Breathe deeply, take a step back, and approach with kindness or empathy.

3. Opposite Action to Sadness:

 Urge: Stay isolated or be passive.

 Opposite: Engage in activities, socialize, and move—even when you don't feel like it.

4. Opposite Action to Shame:

 Urge: Hide or withdraw.

 Opposite: Stand tall, maintain eye contact, and be honest if your shame is unjustified.
How to Do Opposite Action

1. Identify the emotion using mindfulness.

2. Recognize the action urge tied to that emotion.
3. Check if the emotion fits the facts.
4. Determine if acting on the urge is effective.
5. If you want to change the emotion, figure out the opposite action.
6. Do the opposite action fully (including posture, tone, and words).
7. Repeat the opposite action until the emotion diminishes.

Role-Playing Activity 🎭

1. Scenario 1: You feel angry because your parents are ignoring you at home.
o Act on the urge: Yell at them.
o Act opposite: Approach them calmly and ask how their day was.
2. Scenario 2: You feel jealous because your friend has a new car, but you can’t afford one.
o Act on the urge: Accuse them of showing off.
o Act opposite: Appreciate their new car and show interest in their experiences.
3. Scenario 3: You feel sad after a breakup.
o Act on the urge: Isolate yourself.
o Act opposite: Engage in social activities or exercise to boost mood.

Homework 📝

1. Practice Opposite Action:

o Choose an emotion you want to change this week.
o Identify the action urge and do the opposite action (all the way: words, posture,
and tone).
o Report how you feel after trying it out.
2. Use the "Check the Facts" and "Problem-Solving" skills:
o Apply them to any situation this week where you feel emotionally triggered.
Interpersonal Effectiveness Skills

Purpose of the Module

This module focuses on building and maintaining positive relationships through specific
interpersonal skills. While other DBT skills (such as emotional regulation and distress
tolerance) certainly improve relationships, this module directly targets enhancing relationship
quality by teaching key relationship skills. Developing solid relationships can:

1. Help tolerate distress (strong support network).

2. Reduce conflict escalation.
3. Boost positive emotions and buffer against negative ones.

The skills in this module focus on three primary interpersonal goals:

1. Building positive relationships and reducing conflict (GIVE skills).

2. Effectively asking for what you want or saying no (DEAR MAN skills).
3. Maintaining self-respect (FAST skills).

Key Skills in This Module

1. GIVE Skills – Building positive relationships and preventing conflict escalation.

Learn how to interact in a way that promotes closeness and trust.
2. DEAR MAN Skills – Asking for what you need or saying no to others’ requests.
Learn how to assert your needs while respecting others.
3. FAST Skills – Maintaining self-respect while interacting with others.
Learn to maintain your values and dignity even when under pressure.

Additional Key Concepts

 THINK Skills: Optional skills that focus on challenging negative assumptions we may
have about others. These help to correct faulty interpretations and reduce
misunderstandings that lead to conflict.

The THINK skills are based on the social information-processing model (Crick &
Dodge, 1994), which explains how negative assumptions about others' behavior can
escalate conflict and emotions.
In-Session Practice & Role-Playing

Role-playing is critical in mastering these interpersonal effectiveness skills. Participants will

have hands-on opportunities to practice the GIVE, DEAR MAN, and FAST skills with
feedback, which is essential for generalizing these skills into real-life situations.

Summary of Skills

1. GIVE – Focus on building relationships and preventing escalation:

o G: Be gentle.
o I: Act with interest.
o V: Be validate.
o E: Use easy manner.
2. DEAR MAN – Assertively ask for what you want or say no:
o D: Describe the situation.
o E: Express your feelings.
o A: Assert your request.
o R: Reinforce the benefits of your request.
o M: Mindful of your goals.
o A: Appear confident.
o N: Negotiate if needed.
3. FAST – Maintain self-respect:
o F: Be fair to yourself and others.
o A: Stay assertive.
o S: Be stick to your values.
o T: Truthful in your communication.

Importance of Perspective-Taking (THINK Skills)

The THINK skills focus on understanding the thoughts and intentions of others to avoid
misinterpretation and negative bias. These skills help teens and families identify unwarranted
assumptions and respond in a way that promotes healthy interaction.

Conclusion

This module teaches direct, practical skills to foster positive relationships and reduce conflict.
It also emphasizes the importance of self-respect and perspective-taking to enhance
interpersonal effectiveness in various social settings.
Session 1: Interpersonal Effectiveness Skills

Overview of Interpersonal Effectiveness

We all face relationship challenges, whether with friends, family, or at work. When things go
wrong, emotions can skyrocket. In this module, we focus on building and maintaining healthy
relationships, asking for what we need, and keeping our self-respect. Practicing these skills
can improve relationships and prevent conflicts. 🌟💪

Goals of Interpersonal Effectiveness 🎯

This module has 3 main goals:

1. GIVE Skills: Keep & maintain healthy relationships.

2. DEAR MAN Skills: Get what you want or say "no."
3. FAST Skills: Maintain your self-respect.

Think of these as 3 juggling balls:

🎾 GIVE (healthy relationships)
DEAR MAN (getting needs met)
🏀 FAST (self-respect)

Key Points in Maintaining Healthy Relationships 🤝

 Sacrificing Needs Doesn’t Work

Many think that if they give up their own needs, relationships will improve. But it leads
to frustration, anger, or resignation. You might feel:
❌ "I’m just going to give in."
💥 Outcome: Relationship either blows up or feels miserable.
 Assert Without Hurting
You can ask for what you want without damaging the relationship. The DEAR MAN
skills help you ask effectively and say “no” while keeping harmony.
 Self-Respect is Key
It’s not just about getting what you want—how you feel about yourself matters. The
FAST skills ensure you maintain dignity while asking or saying “no.”

Clarifying Your Priorities 🧠

Before an interaction, prioritize which goal matters most. If you can’t get everything, decide
what’s crucial:

 Example: A college student vs. a landlord:

o Priority 1: Get the deposit back.
o Priority 2: Maintain self-respect (without losing control).
o Priority 3: Relationship with the landlord isn’t a top concern, but avoid
alienating him.

Factors That Interfere with Interpersonal Effectiveness 🛑

Things that stop you from achieving goals in relationships:

1. Lack of Skill: You don’t know what to say.

2. Worry Thoughts: Fear of negative outcomes.
3. Emotions: Anxiety, anger, etc., can cloud judgment.
4. Indecision: Not sure whether to act.
5. Environmental Factors: External barriers like time or situation.

Introduction to GIVE Skills ✨

GIVE skills help you keep relationships healthy and reduce conflict:

 G: Be Gentle – Communicate kindly, no judgment.

 I: Act Interested – Show genuine interest in the other person.
 V: Validate – Acknowledge the other person’s feelings.
 E: Use an Easy Manner – Keep the tone light, not too serious. 😌

Exercise 1: Leader Role-plays the Opposite 🎭

The leader exaggerates the opposite of each GIVE skill to show how bad it feels:

 Be Gentle: Leader attacks and yells, “Hurry up!”

 Act Interested: Leader yawns or ignores.
 Validate: Leader dismisses feelings, “Get over it!”
 Easy Manner: Leader stands stiffly and scowls.

Outcome: People feel disrespected and unheard. This shows why GIVE skills matter! ✅
Exercise 2: Leaders Role-plays Using GIVE 🎬

Next, the leaders role-play using GIVE skills. For example, a teen and parent have a
disagreement about joining the soccer team. The parent uses GIVE to express understanding
and calmly explain. The conversation doesn’t escalate, even though they don’t agree. 🌱

Exercise 3: Mindfulness Exercise 🧘‍♀️

Pair up! One person speaks, the other ignores them. Then switch—one listens with full
attention. After 2 minutes, switch again.

Result: Speakers feel hurt when ignored and supported when listened to. Validate by showing
you care. 💛

Challenges in Teaching GIVE Skills 🤔

 Validating vs Complimenting: Validation means acknowledging feelings (e.g., “That

must’ve been frustrating!”) while compliments may feel dismissive.
 Validating an Overreaction: Even if the emotion feels overblown, validate the
person’s feelings instead of minimizing them. (e.g., “It’s tough to miss the train!”).
 Validating vs Teaching Responsibility: You can validate feelings and still address the
behavior. (“I get why you’re upset about the grade. Let’s figure out what you can do
about it.”)

Homework Assignment 📋

Practice GIVE skills in 2 situations over the next week. Record how it went and how the
relationship felt. Did it improve? How did you feel afterward? 💬

Closing Discussion

Discuss with the group:

 How did GIVE skills improve relationships?

 Which skill was the hardest?
 Share one thing you learned and will practice.
Session 2: Getting Someone to Do What You Want: DEAR MAN Skills

Overview of DEAR MAN Skills

DEAR MAN is a powerful tool for asking for what you want or saying “no” effectively
without damaging relationships. It's about asserting your needs while being mindful and
respectful. 💬🔑

The DEAR MAN Story

Let’s start with a real-life example:

Imagine you’re in a stressful situation—your newborn needs urgent surgery. The doctor in
charge isn’t the one you expected, and you’re feeling anxious. By using DEAR MAN, you
calmly assert your desire for the expert surgeon to handle the surgery. ✨

In the example:

 Describe the situation: “Dr. B says she’ll do the surgery, but I wanted Dr. W.”
 Express feelings: “I’m anxious and worried about this.”
 Assert your need: “I want Dr. W to do the surgery.”
 Reinforce: “Dr. W has the expertise, and I’d feel reassured if he performed it.”
 Mindful: Stay focused on your goal despite Dr. B’s anger.
 Appear Confident: Speak firmly, with eye contact.
 Negotiate: “Can Dr. W do the surgery today?”

The outcome: Dr. W listens and agrees to take the surgery. 🎉

DEAR MAN Skills Breakdown 🔍

Let’s dive into each component of DEAR MAN:

 D: Describe the situation clearly (no judgments).

o Example: "I need help with the project. It's due tomorrow."
 E: Express your feelings or opinions with “I feel” or “I prefer,” not “you should.”
o Example: "I feel overwhelmed by the deadline and need your help."
 A: Assert by asking for what you want or saying “no”.
o Example: “Can you help me finish the project tonight?”
 R: Reinforce by showing how it benefits both of you.
o Example: “If you help, we can both finish it faster and avoid stress.”
 M: Be Mindful—stay focused on your goals.
 o Example: If they get distracted or defensive, return to the main point.
 A: Appear Confident—strong voice, eye contact, posture.
o Example: Don’t slouch. Keep your voice steady, and look them in the eye.
 N: Negotiate—be willing to give something to get what you want.
o Example: “I can help with your task after mine is done.”

Role-Play Examples 🎭

1. Scenario 1: You want to borrow money, but your friend says no. Using DEAR MAN:
o D: Describe: "I’m in a tough spot financially."
o E: Express: "I feel stressed because I can’t pay the rent."
o A: Assert: "Can you lend me $50?"
o R: Reinforce: "It would help me avoid late fees."
o M: Be Mindful: Stay on track, even if they hesitate.
o A: Appear Confident: Stand tall, steady voice.
o N: Negotiate: “I can pay you back in a week.”
2. Scenario 2: A parent says you can’t go out, and you want to extend curfew. Use DEAR
MAN to ask for more time:
o D: “You said I need to be home by 10.”
o E: “I feel disappointed because my friends will still be hanging out.”
o A: “Can I stay out until 11?”
o R: “It’s important for me to spend time with my friends tonight.”
o M: “I’ll check in with you at 10.”
o A: “I’ll be responsible and safe.”
o N: “I can help out at home tomorrow to make up for it.”

Challenges with DEAR MAN 😟

1. What if the other person isn’t effective?

o Stay mindful. Use broken record technique—repeat your point calmly.
o Example: If your boss is dismissive, calmly restate your request.
2. What if they “DEAR MAN” you back?
o If they say “no,” negotiate.
o Example: “I understand, but can we find a compromise?”
3. Isn’t using DEAR MAN too much?
o It’s not “groveling”—it’s about being respectful and clear.
o Example: A parent using DEAR MAN teaches mutual respect for both parties.

Homework Assignment 📚
Practice DEAR MAN skills in one situation over the next week. Record:

1. The situation
2. Your goal
3. How you used each component
4. The outcome

Example: Asking a friend for a favor: "I asked to borrow their notes, and they agreed."

Closing Thoughts 💭

 DEAR MAN can help you ask effectively while keeping the relationship intact.
 Keep practicing these skills until they feel natural in real situations! 💪

Session 3: Maintaining Your Self-Respect: FAST Skills 💪✨

Introduction to FAST Skills

Self-respect is about not compromising your values and feeling good about who you are. The
FAST skills help you:

 Not get exploited 🚫

 Stay true to yourself 🧘‍♀️
 Respect others while maintaining your self-respect 🌟

FAST Breakdown

Use FAST as a reminder for maintaining your self-respect:

 F: Fair – Be fair to yourself and the other person. 🤝

o Example: If your friend is asking too much of you, be fair by setting boundaries.
 A: Apologies – Don’t over-apologize. You don’t have to apologize for your principles.
🚫🙏
o Example: “I’m not sorry for needing time for myself. It’s important.”
 S: Stick to your values – Do what’s right for you based on your values. 🎯
o Example: Refuse to do something that violates your beliefs, like lying for a friend.
 T: Truthful – Be honest. Don’t lie or exaggerate.
o Example: Be straightforward when declining a favor: "I can’t help right now
because I have other plans."
Leader Role-Play Example 🎭

 Scenario: Your uncle offers you a job in the family business, but you have other dreams.
o Without FAST: You hesitate and say yes, feeling guilty and unsure. 😟
o With FAST:
 F: Be fair to both yourself and your uncle.
 A: Don’t over-apologize for not wanting the job.
 S: Stick to your own values of following your dreams.
 T: Be truthful: “I’m flattered, but I have other plans I need to focus on.”

Reflection: Was she fair to herself? Did she apologize too much? Did she stick to her values and
stay truthful? ✅

Group Practice with FAST Skills 💬

Let’s practice FAST skills with different situations.

 Scenario 1: You can’t afford to go out for your friend’s birthday at an expensive
restaurant. 🎂💸
o F: Be fair—consider your financial situation and communicate kindly.
o A: Don’t apologize excessively for not being able to afford it.
o S: Stick to your values of managing money wisely.
o T: Be truthful: “I’m unable to afford this, but I’d love to hang out another time.”
 Scenario 2: Your friend asks you to help with her homework, but you're already
swamped. 📚⏳
o F: Be fair to yourself by setting limits.
o A: Don't apologize for having your own priorities.
o S: Stick to your value of balancing your workload.
o T: Be truthful: “I really can’t help today, but maybe we can study together later.”

Challenging Worry Thoughts that Interfere with Interpersonal Effectiveness 🤔💭

Worry thoughts can stop us from being interpersonally effective. Challenge them with Wise
Mind statements! 🧠

 Example Worry: “What if they get mad at me for saying no?”

o Wise Mind Challenge: “I can handle someone being upset. I’ve said no before,
and it’s okay.”
Common Worry Thoughts & Wise Mind Self-Statements 🔄

 Worry: “What if they think I’m being rude for saying no?”
o Wise Mind: “Saying no is part of healthy boundaries, and I can still be
respectful.”
 Worry: “What if I fail? What if I look dumb?”
o Wise Mind: “It’s okay to make mistakes. I learn and grow from them.”
 Worry: “What if my parents think I’m not being responsible?”
o Wise Mind: “I’m being responsible by staying true to my priorities and not
overcommitting.”

Homework Assignment 📋

Practice FAST skills in two situations this week:

1. Situation 1: Describe how you used FAST skills (e.g., sticking to your values in a
conversation).
2. Situation 2: Describe how the situation turned out and the outcome.

Closing Thoughts 💬

 FAST skills are about staying true to yourself and protecting your self-respect while
interacting with others.
 Keep practicing these skills until they become second nature! 🌟💪

Session 4: Factors to Consider When Deciding How Intensely to Ask or Say “No”
🤔❌

Introduction to Factors to Consider in Asking or Saying "No"

When deciding whether to ask for something or say “no,” it’s crucial to consider several factors
to ensure that your approach is effective and respectful of the situation. Here's a quick guide:

Key Factors to Consider

 1. Priorities 🎯
o What’s most important in this situation?
o Is it maintaining the relationship, getting what you want, or keeping your self-
respect?
o Example: If you're asking for time off from work, prioritize whether maintaining
your relationship with your boss or completing a personal goal is more important
at that moment.
2. Capability 💪
o Does the other person have the ability to fulfill your request? Can you provide
what they’re asking for?
o Example: Don't ask your friend to lend you money if you know they’re struggling
financially. Know the person's capacity to meet your needs.
3. Timeliness 🕒
o Is now the right time?
o Consider whether it’s an appropriate moment for both of you to engage in the
conversation.
o Example: Don’t ask a parent for money when they’re stressed or during a busy
moment. Timing is key!
4. Preparation 📝
o Have you prepared the facts, details, or reasoning?
o Example: If you’re asking for a raise, do your research on salary trends, your
performance, and the timing of your request.
5. Relationship ❤️
o Is your request appropriate given the relationship you have with this person?
o Example: Asking a close friend to keep a secret is different from asking a
colleague the same request. Know the boundaries of your relationship.
6. Give and Take ⚖️
o How have you been balancing give-and-take with the other person?
o Example: If you’ve been asking a friend for favors regularly, it may be time to ask
yourself if the relationship feels balanced.

Sample Practice Scenarios 🎭

Let’s put these factors to the test with some real-life scenarios:

1. Scenario 1:
Relative smoking in the house – You want to ask them to stop.
o Factors to consider:
 Priorities: Is maintaining a positive relationship with this relative more
important than asking them to stop smoking?
 Timeliness: Is it a good time to bring it up?
2. Scenario 2:
Acquaintance asking for help – You don’t want to help paint their room.
o Factors to consider:
  Relationship: How well do you know this person? Is it reasonable to say
“no” without hurting the relationship?
3. Scenario 3:
Asking your sister to stop seeing your ex.
o Factors to consider:
 Priorities: Is keeping the relationship with your sister more important than
letting her know how you feel?

THINK Skills (Optional) 🧠💬

Sometimes, we make negative assumptions about others’ behavior, which can lead to conflict.
The THINK skills help you take a step back, consider other perspectives, and respond more
kindly.

1. Think 🤔:
o What’s the other person feeling? Are they worried, sad, or frustrated?
o Example: If a friend snaps at you, consider if they're stressed about something
else rather than assuming they’re angry at you.
2. Interpretations 📝:
o Could there be a positive interpretation?
o Example: Maybe your boss didn’t respond to your email because they were
swamped, not because they don’t like you.
3. Notice 👀:
o What has the other person done to show care?
o Example: They may have been distant, but maybe they’ve been busy with
personal struggles. Consider this before jumping to conclusions.
4. Kindness 🤝:
o Assume positive reasons for the other person’s behavior.
o Example: Instead of thinking someone is ignoring you, consider they might be
distracted or overwhelmed.

Role-Play Scenarios Using Multiple Skills 🎭

Now, let’s practice combining multiple interpersonal effectiveness skills!

 Scenario 1: You need to ask your boss for an extension on a report.

o Skills to use: DEAR MAN for the request, GIVE to maintain relationship, FAST
to stay true to your values.
 Scenario 2: You’re at a sleepover where people are pressuring you to do something
uncomfortable.
 o Skills to use: Use FAST to stay true to yourself, DEAR MAN to say no
assertively, and THINK to challenge negative assumptions about how others will
view you.

Homework Assignment 📋

Practice:

1. Interpersonal Effectiveness Handout 11: Focus on the factors to consider when asking
or saying “no.”
2. Interpersonal Effectiveness Handout 12: Use multiple skills at the same time in your
real-life interactions.
3. (Optional) Interpersonal Effectiveness Handout 14: Review THINK skills to challenge
negative assumptions.

Closing Thoughts 💡

Remember, the key to interpersonal effectiveness is balancing your needs with respect for others.
Use the right skill at the right time and keep practicing to become more effective in your
relationships! 🌟
Schedules to follow:
Orientation

Module Session Topic Details

Mindfulness Session 1 Orientation to Introduction to mindfulness skills and
Mindfulness how they help with managing emotions
and stress.
Distress Session 1 Orientation to Understanding distress tolerance and
Tolerance Distress Tolerance how it helps cope with emotional
overwhelm.
Emotion Session 1 Orientation to Introduction to emotion regulation,
Regulation Emotion focusing on how to manage emotions in
Regulation different situations.

Mindfulness

Session Topic Details

Session 1 Orientation to Mindfulness Introduction to the concept of mindfulness, its
purpose, and benefits. Basic skills for observing the
present moment.
Session 2 Mindfulness of Current Learn to observe and describe emotions without
Emotion (The Wave Skill) judgment, recognizing their temporary nature.
Session 3 Mindfulness of Thoughts Focus on observing and describing thoughts and
& Urges urges, without acting on them impulsively.
Session 4 Mindful Breathing and Techniques to anchor awareness in the present
Sensory Awareness moment through focused breathing and sensory
experiences.
Session 5 Integrating Mindfulness Practical tips for integrating mindfulness into daily
into Daily Life routines and handling everyday challenges.

Distress Tolerance

Session Topic Details

Session 1 Orientation to Distress Tolerance Introduction to distress tolerance and the
importance of managing overwhelming
emotions.
Session 2 TIPP Skills (Temperature, Intense Learn how to use TIPP skills to manage
Exercise, Paced Breathing, extreme emotions.
Progressive Relaxation)
Session 3 Self-Soothing Techniques Focus on using the five senses to self-
soothe during distressing situations.
 Session 4 Improving the Moment Techniques for improving the emotional
experience in difficult situations (e.g.,
visualization, distraction).
Session 5 Radical Acceptance Learn how to accept reality as it is
without judgment, even in painful or
difficult situations.

Walking the middle path

Session Focus Details

Session 1 Balancing Acceptance & Goal: Teach the concept of dialectics: accepting
Change: Understanding things as they are, while simultaneously working
Dialectics toward change. Example: "Two opposite truths can
coexist – I can accept where I am, and still work to
change my habits."
Session 2 Embracing Opposites: Goal: Help clients learn to use dialectical thinking in
Integrating Acceptance & real-life situations, balancing acceptance and change
Change into Daily Life in relationships and behaviors. Example: Accepting a
loved one’s behavior without letting it negatively
affect your own behavior.
Session 3 Practicing Flexibility in Goal: Focus on balancing personal needs with the
Relationships & Coping needs of others, particularly within family and
with Family Challenges intimate relationships. Metaphor: "Walking the
middle path" between your needs and the needs of
others.
Session 4 Deepening Connection: Goal: Teach clients to maintain individuality while
Balancing Individual and being in relationships. Discuss boundaries and
Relationship Needs compromise. Example: "I am my own person, but I
also care about my partner’s needs and work together
to balance both."

Emotion Regulation

Session Topic Details

Session 1 Orientation to Introduction to emotion regulation and its importance for
Emotion Regulation mental well-being.
Session 2 Identifying and Learn to identify and label emotions accurately as a first
Labeling Emotions step in managing them.
Session 3 Changing Your Techniques for changing emotional responses through
Emotional Responses behaviors, thoughts, and physiological states.
Session 4 Building Mastery & Learn how to increase feelings of effectiveness (mastery)
Coping Ahead Skills and how to cope ahead with difficult situations.
Session 5 Opposite Action Learn to act opposite to your emotional urges when your
emotions are not serving you well (e.g., acting opposite
to anger, sadness, etc.).
Interpersonal Effectiveness

Session Topic Details

Session 1 Overview & Introduction to the importance of healthy
Introduction to relationships and basic interpersonal skills.
Interpersonal
Effectiveness
Session 2 DEAR MAN Skills Learn how to assertively ask for what you want or
say "no" in a healthy way (Describe, Express,
Assert, Reinforce, Mindful, Appear Confident,
Negotiate).
Session 3 FAST Skills Focus on maintaining your self-respect, sticking to
your values, and being truthful.
Session 4 Factors to Consider in Explore factors like priorities, timeliness,
Asking or Saying "No" capability, and relationship dynamics when
making requests or saying "no."
Session 4 THINK Skills (Optional) Learn to reduce negative assumptions
(Optional) about others by considering their perspective and
motivations.
Session 5 Using Multiple Skills at Role-play scenarios that require integrating GIVE,
the Same Time DEAR MAN, and FAST skills. Discuss obstacles
and skill application in real-life situations.

Key Integration:

Module Session 1 Session 2 Session 3 Session 4

Mindfulness Observing & Participating One- Mindfulness in
Describing: Mindfully: Fully Mindfully: Daily Life:
Learn to notice engage in present Focus on one Integrate
emotions, moments without activity at a mindfulness into
thoughts, and distractions. time to maintain everyday tasks like
body sensations clarity and eating, walking,
without control. etc.
judgment.
Distress Crisis Survival TIPP Skills: Crisis Survival Reality
Tolerance Skills: Use Techniques like Kit: Create a Acceptance: Use
distraction and cold packs, personal toolkit radical acceptance
self-soothing to breathing for managing to cope with
handle distress. exercises to crises on-the- painful,
reduce intense go. unchangeable
emotions. situations.
Walking the Dialectical Balancing Embracing Connection &
Middle Path Thinking: Acceptance & Opposites: Boundaries: Learn
Balancing Change: Find the middle how to maintain
acceptance of Integrate the ground between boundaries while
reality with the need to accept conflicting fostering close
 need for change. reality while emotions and relationships.
striving for needs.
improvement.
Emotion Identifying Managing Increasing Sustaining
Regulation Emotions: Extreme Positive Emotional
Recognize and Emotions: Skills Emotions: Use Stability: Prevent
label emotions to calm down activities that emotional relapse
accurately to intense emotions promote and manage
understand their using self- positive setbacks with
impact. soothing and emotions like proactive skills.
mindfulness. exercise or
hobbies.
Interpersonal GIVE Skills: DEAR MAN FAST Skills: Integrating
Effectiveness Build positive Skills: Maintain self- Multiple Skills:
relationships Assertively ask respect by Use GIVE, DEAR
with respect and for what you staying true to MAN, and FAST
empathy need or say "no" values and skills in complex
(gentleness, effectively being truthful in interactions for
interest, without interactions. balanced outcomes.
validation). damaging
relationships.
Cross-Module Mindfulness Balance Emotion Radical
Integration for Distress: Acceptance & Regulation & Acceptance &
Apply Action: Use GIVE: Use Boundaries: Use
mindfulness to emotion emotion Walking the
recognize regulation to regulation to Middle Path for
distress early keep your mind stay centered acceptance, along
and use TIPP balanced while while applying with Interpersonal
for coping. acting mindfully. GIVE skills in Boundaries for
interactions. healthier
relationships.

Key Integration Summary:

1. Mindfulness & Distress Tolerance:

o Mindfulness teaches how to observe and become aware of emotional states,
which aids in implementing distress tolerance skills like distraction or self-
soothing.
o Example: Mindfulness helps identify when distress arises, allowing you to apply
TIPP or use soothing techniques before emotional responses escalate.
2. Distress Tolerance & Emotion Regulation:
o Crisis survival skills (like distraction) are short-term techniques, while emotion
regulation offers longer-term strategies for managing intense emotions.
o Example: After using TIPP to cool down, you can apply emotion regulation
skills to increase positive emotions or regulate your emotional baseline.
3. Walking the Middle Path & Interpersonal Effectiveness:
 o Dialectical thinking in walking the middle path supports balancing GIVE and
DEAR MAN skills, helping you maintain relationships while asserting your
needs or saying "no".
o Example: In a challenging conversation, using GIVE skills helps maintain
connection, while DEAR MAN helps assert what you want in a non-
confrontational way, balancing acceptance and change.
4. Emotion Regulation & Mindfulness:
o Mindfulness enables better recognition of emotions, while emotion regulation
teaches how to adjust them.
o Example: Practicing mindfulness helps you recognize emotional distress early,
allowing you to use emotion regulation techniques like rethinking the situation
or engaging in pleasant activities.
5. Distress Tolerance & Walking the Middle Path:
o Using distress tolerance skills in crises (such as TIPP) helps you stay focused
and calm, supporting walking the middle path by promoting acceptance of
situations you cannot change.
o Example: When facing a difficult family situation, use radical acceptance to
accept things as they are, while using TIPP to manage your emotional state.
6. Cross-Module Integration:
o Each skill from different modules complements and reinforces the others.
Mindfulness and emotion regulation go hand-in-hand to help you respond to
emotions with awareness and control. Interpersonal skills (like DEAR MAN
and GIVE) are enhanced by mindfulness and emotional regulation, ensuring
interactions are skillful and respectful.
o Example: When faced with a conflict, use GIVE skills to stay gentle and
validating while applying DEAR MAN to assert your needs clearly. If emotions
arise, use emotion regulation to stay balanced and apply mindfulness to
maintain focus.

Distress Tolerance, Mindfulness, and Emotion Regulation Modules Breakdown

Module Session 1 Session 2 Session 3 Session 4

Mindfulness Observing & Participating One- Mindfulness in
Describing: Mindfully: Fully Mindfully: Daily Life:
Learn to notice engage in present Focus on one Integrate
emotions, moments without activity at a mindfulness into
thoughts, and distractions. time to maintain everyday tasks like
body sensations clarity and eating, walking,
without control. etc.
judgment.
Distress Crisis Survival TIPP Skills: Crisis Survival Reality
Tolerance Skills: Use Techniques like Kit: Create a Acceptance: Use
distraction and cold packs, personal toolkit radical acceptance
self-soothing to breathing for managing to cope with
handle distress. exercises to crises on-the- painful,
 reduce intense go. unchangeable
emotions. situations.
Walking the Dialectical Balancing Embracing Connection &
Middle Path Thinking: Acceptance & Opposites: Boundaries: Learn
Balancing Change: Find the middle how to maintain
acceptance of Integrate the ground between boundaries while
reality with the need to accept conflicting fostering close
need for change. reality while emotions and relationships.
striving for needs.
improvement.
Emotion Identifying Managing Increasing Sustaining
Regulation Emotions: Extreme Positive Emotional
Recognize and Emotions: Skills Emotions: Use Stability: Prevent
label emotions to calm down activities that emotional relapse
accurately to intense emotions promote and manage
understand their using self- positive setbacks with
impact. soothing and emotions like proactive skills.
mindfulness. exercise or
hobbies.
Interpersonal GIVE Skills: DEAR MAN FAST Skills: Integrating
Effectiveness Build positive Skills: Maintain self- Multiple Skills:
relationships Assertively ask respect by Use GIVE, DEAR
with respect and for what you staying true to MAN, and FAST
empathy need or say "no" values and skills in complex
(gentleness, effectively being truthful in interactions for
interest, without interactions. balanced outcomes.
validation). damaging
relationships.
Cross-Module Mindfulness Balance Emotion Radical
Integration for Distress: Acceptance & Regulation & Acceptance &
Apply Action: Use GIVE: Use Boundaries: Use
mindfulness to emotion emotion Walking the
recognize regulation to regulation to Middle Path for
distress early keep your mind stay centered acceptance, along
and use TIPP balanced while while applying with Interpersonal
for coping. acting mindfully. GIVE skills in Boundaries for
interactions. healthier
relationships.

Cross-Module Connections

1. Mindfulness & Distress Tolerance:

o Mindfulness helps to observe emotional distress early, so you can apply Distress
Tolerance strategies like TIPP or self-soothing to manage it effectively.
o Example: Mindfulness helps identify rising tension or anxiety, allowing you to
use TIPP (like cold packs) to manage the emotional spike.
2. Emotion Regulation & Mindfulness:
o Mindfulness teaches awareness of emotions, which is foundational to Emotion
Regulation skills. When you’re mindful of how you’re feeling, you can apply
emotion regulation techniques like self-soothing or increasing positive
emotions.
o Example: You practice mindfulness by acknowledging frustration, then use
emotion regulation to calm down and stay balanced.
3. Walking the Middle Path & Emotion Regulation:
o Walking the Middle Path teaches balance, which complements Emotion
Regulation skills by encouraging dialectical thinking and the ability to accept
difficult emotions while taking effective actions.
o Example: Radical acceptance of emotions can help calm you down, allowing
you to apply emotion regulation to decrease negative feelings.
4. Interpersonal Effectiveness & Mindfulness:
o Mindfulness enhances your ability to communicate effectively by focusing on the
present moment, which supports the GIVE, DEAR MAN, and FAST skills in
interactions.
o Example: Being mindful during a conversation allows you to GIVE respectful
responses, DEAR MAN assertively, and maintain FAST skills for self-respect.