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What Is Therapy Homework?

Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness.

Dr. Sabrina Romanoff, PsyD, is a licensed clinical psychologist and a professor at Yeshiva University’s clinical psychology doctoral program.

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Types of Therapy That Involve Homework

If you’ve recently started going to therapy , you may find yourself being assigned therapy homework. You may wonder what exactly it entails and what purpose it serves. Therapy homework comprises tasks or assignments that your therapist asks you to complete between sessions, says Nicole Erkfitz , DSW, LCSW, a licensed clinical social worker and executive director at AMFM Healthcare, Virginia.

Homework can be given in any form of therapy, and it may come as a worksheet, a task to complete, or a thought/piece of knowledge you are requested to keep with you throughout the week, Dr. Erkfitz explains.

This article explores the role of homework in certain forms of therapy, the benefits therapy homework can offer, and some tips to help you comply with your homework assignments.

Therapy homework can be assigned as part of any type of therapy. However, some therapists and forms of therapy may utilize it more than others.

For instance, a 2019-study notes that therapy homework is an integral part of cognitive-behavioral therapy (CBT) . According to Dr. Erkfitz, therapy homework is built into the protocol and framework of CBT, as well as dialectical behavior therapy (DBT) , which is a sub-type of CBT.

Therefore, if you’re seeing a therapist who practices CBT or DBT, chances are you’ll regularly have homework to do.

On the other hand, an example of a type of therapy that doesn’t generally involve homework is eye movement desensitization and reprocessing (EMDR) therapy. EMDR is a type of therapy that generally relies on the relationship between the therapist and client during sessions and is a modality that specifically doesn’t rely on homework, says Dr. Erkfitz.

However, she explains that if the client is feeling rejuvenated and well after their processing session, for instance, their therapist may ask them to write down a list of times that their positive cognition came up for them over the next week.

"Regardless of the type of therapy, the best kind of homework is when you don’t even realize you were assigned homework," says Erkfitz.

Benefits of Therapy Homework

Below, Dr. Erkfitz explains the benefits of therapy homework.

It Helps Your Therapist Review Your Progress

The most important part of therapy homework is the follow-up discussion at the next session. The time you spend reviewing with your therapist how the past week went, if you completed your homework, or if you didn’t and why, gives your therapist valuable feedback on your progress and insight on how they can better support you.

It Gives Your Therapist More Insight

Therapy can be tricky because by the time you are committed to showing up and putting in the work, you are already bringing a better and stronger version of yourself than what you have been experiencing in your day-to-day life that led you to seek therapy.

Homework gives your therapist an inside look into your day-to-day life, which can sometimes be hard to recap in a session. Certain homework assignments keep you thinking throughout the week about what you want to share during your sessions, giving your therapist historical data to review and address.

It Helps Empower You

The sense of empowerment you can gain from utilizing your new skills, setting new boundaries , and redirecting your own cognitive distortions is something a therapist can’t give you in the therapy session. This is something you give yourself. Therapy homework is how you come to the realization that you got this and that you can do it.

"The main benefit of therapy homework is that it builds your skills as well as the understanding that you can do this on your own," says Erkfitz.

Tips for Your Therapy Homework

Below, Dr. Erkfitz shares some tips that can help with therapy homework:

• Set aside time for your homework: Create a designated time to complete your therapy homework. The aim of therapy homework is to keep you thinking and working on your goals between sessions. Use your designated time as a sacred space to invest in yourself and pour your thoughts and emotions into your homework, just as you would in a therapy session .
• Be honest: As therapists, we are not looking for you to write down what you think we want to read or what you think you should write down. It’s important to be honest with us, and yourself, about what you are truly feeling and thinking.
• Practice your skills: Completing the worksheet or log are important, but you also have to be willing to put your skills and learnings into practice. Allow yourself to be vulnerable and open to trying new things so that you can report back to your therapist about whether what you’re trying is working for you or not.
• Remember that it’s intended to help you: Therapy homework helps you maximize the benefits of therapy and get the most value out of the process. A 2013-study notes that better homework compliance is linked to better treatment outcomes.
• Talk to your therapist if you’re struggling: Therapy homework shouldn’t feel like work. If you find that you’re doing homework as a monotonous task, talk to your therapist and let them know that your heart isn’t in it and that you’re not finding it beneficial. They can explain the importance of the tasks to you, tailor your assignments to your preferences, or change their course of treatment if need be.

"When the therapy homework starts 'hitting home' for you, that’s when you know you’re on the right track and doing the work you need to be doing," says Erkfitz.

A Word From Verywell

Similar to how school involves classwork and homework, therapy can also involve in-person sessions and homework assignments.

If your therapist has assigned you homework, try to make time to do it. Completing it honestly can help you and your therapist gain insights into your emotional processes and overall progress. Most importantly, it can help you develop coping skills and practice them, which can boost your confidence, empower you, and make your therapeutic process more effective.

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We've tried, tested, and written unbiased reviews of the best online therapy programs including Talkspace, BetterHelp, and ReGain. Find out which option is the best for you.

Conklin LR, Strunk DR, Cooper AA. Therapist behaviors as predictors of immediate homework engagement in cognitive therapy for depression . Cognit Ther Res . 2018;42(1):16-23. doi:10.1007/s10608-017-9873-6

Lebeau RT, Davies CD, Culver NC, Craske MG. Homework compliance counts in cognitive-behavioral therapy . Cogn Behav Ther . 2013;42(3):171-179. doi:10.1080/16506073.2013.763286

By Sanjana Gupta Sanjana is a health writer and editor. Her work spans various health-related topics, including mental health, fitness, nutrition, and wellness.

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11 New Therapy Worksheets for Anxiety, PTSD, and More

Updated: Sep 5, 2023

Download worksheets on CBT, anxiety, PTSD, self-care and more

T herapy worksheets can make all the difference. While it’s great to talk through new concepts, having a physical tool to share or send home can reinforce all the work done in sessions.

Fortunately, PDF worksheets can work just as well for telehealth as in-person therapy. You can print them out, or share them electronically on-screen or via e-mail.

Here’s a little about how these worksheets were developed, along with descriptions of each.

Article Highlights Background

CBT Triangle

Anxiety Plan

Understanding PTSD

Strong Emotions

Challenging Thoughts

Reframing trauma thoughts, anxiety hierarchy.

Trauma Narrative Making Meaning

Grounding Stones

Using These Tools

I developed each of the worksheets below based on my CBT and PTSD training, as well as my real-life experience in the field.

I find many of the mental health worksheets online cover key concepts, but they aren’t always user-friendly.

For example, a “cognitive distortion,” really just refers to an unhelpful thought. “Exposure,” means facing a fear that’s making your life difficult.

(And sometimes all those charts in traditional worksheets just make me dizzy.)

My worksheets and tools generally try to avoid this kind of psychological jargon, especially in the prompts and descriptions for clients. (I do sometimes keep these tech terms in the titles, mainly so that therapists recognize them at a glance.)

While we teachers and counselors like terms like “evidence-based,” many clients simply want to know what these skills mean for their lives, and how they can feel a little better.

They don't necessarily need to know any of the psychology terms to overcome specific symptoms or problems.

With that in mind, here are the worksheets I’ve developed based on concepts like anxiety management, mindfulness, grounding, PTSD treatment, exposure , and self-care.

To get started, my CBT triangle worksheet is available here for free . You can get the rest of these in a bundle at a nominal price. (Use coupon code 1110 for 10% off any of the worksheet kits and downloads.)

If you’re struggling with cost, send me a message and I’ll keep you updated when I run deals or promotions in the future.

Now, let’s get into some therapy worksheets !

CBT Triangle Worksheet

The cognitive behavioral triangle, or CBT triangle , is a quick and easy tool to teach the idea of changing our thoughts.

While feelings are natural, and many thoughts are automatic, we can change negative patterns over time.

For example, if someone tends to beat themselves up anytime they struggle at work, there may be a pattern in place.

They may believe their colleagues or boss don’t like them. This could lead to them feeling anxious or discouraged.

This discouragement could then make it harder to work, repeating the cycle.

With the CBT triangle, you can chart these patterns. The thought, “I’m bad at this job,” connects to the feeling, “discouragement, fear,” which leads to the behavior (taking more time on projects).

This then reinforces the original thought of, “I’m bad at this job,” and the triangle goes round and round.

The most basic step in CBT is to practice changing that original thought.

In a therapy session, we might try changing it to, “I’m still learning this job, but I get a little better each day.”

This would lead to the feeling of hopefulness, and the behavior of asking for help when needed, or getting a project done a bit faster.

This then leads to more positive thoughts, feelings, and behaviors.

This worksheet walks through this process, gives examples, and prompts for your students or clients to practice. (Or you can use it for yourself! I do that plenty.)

Download the CBT triangle worksheet here for free , and get news and freebies in the future.

Anxiety Plan Worksheet

I most often work with problems like anxiety, post-traumatic stress disorder (PTSD), phobias, and panic disorders. These bring nasty symptoms that can lead to staying at home, missing work, and distancing from relationships.

While some anxiety is normal, there’s typically an underlying cause if it’s gotten this bad. While we work on dealing with that main issue, my clients need some relief in the moment .

While there are a handful of skills that work for many people, each of us are unique. That’s why I suggest clients try multiple options to see what works best for them. Simply having one to three tools can help someone get through a very difficult situation.

This worksheet covers the basics of anxiety, and walks the reader through developing a plan to use when things get bad.

You can get the anxiety plan worksheet here, as part of this bundle .

Understanding PTSD Worksheet

There are three main types of PTSD therapy I’ve used with clients. These included prolonged exposure (PE), cognitive processing therapy (CPT), and trauma-focused CBT (TF-CBT). In each of these, the first step is psychoeducation, or learning about the condition .

This worksheet is straightforward and includes the four categories of PTSD symptoms. It then walks you and your client through identifying their symptoms so they can better understand what’s going on.

This is a good tool to use at the beginning of trauma treatment. You can access it as part of the worksheet bundle. Check it out here.

Strong Emotions Worksheet

Feelings are normal. We’re all human, and we all have them in one way or another. Some of us struggle either temporarily or permanently with super-strong emotions.

Many therapies, like DBT (dialectical behavioral therapy) or TF-CBT have elements relating to emotion regulation. We want a balance of facing difficult feelings, accepting them, and decreasing them when they cause us problems.

This worksheet covers those concepts, including elements of exposure and regulation. It also includes tips to use when emotions connect to suicidal ideation or self-harm. This is a great tool to have on hand for yourself or your clients during times of overwhelm.

Get the strong emotions worksheet here as part of this set .

This worksheet builds on the idea of the CBT triangle, but takes it a step further. While the triangle is a place to start for everyday struggles, the process can be a bit harder for deeper issues.

One way to tackle these more difficult thoughts is through the socratic questioning process. This is a technique where a therapist guides the client in thinking through a belief, rather than simply telling them what to believe.

For example, if something thinks, “I’m a failure at everything I try,” it’s easy to answer, “No you’re not, and here’s why ...”

While that could be helpful, it can sometimes backfire. Many people hear that type of response all the time, but still don’t accept it. They may even try to defend the reasons they’re a failure, reinforcing the idea.

With questions, we can guide our own brains to come to new conclusions. This worksheet walks through a common process of challenging this type of thought.

Rather than jumping to the end, you or your client ask questions like, “Why do I believe this thought?” and “What is the evidence against this?”

Not only does this get us thinking differently about a particular belief, it can reprogram the way our brain responds to these thoughts in general.

This worksheet can be a great tool all on its own, or can be a starting place for you and your clients or students to begin to think differently.

Download it here as part of the anxiety set.

The previous worksheets build up to this more challenging one, which is why I developed them as a set.

When someone has PTSD, it means they have particular thoughts about the trauma that are holding them back. In CPT, they call these “stuck points.”

These thoughts usually include ones of self-blame for the trauma, and beliefs by the client that they can no longer be safe in the world.

This feeling of being unsafe is what leads the body to respond with other symptoms, such as hypervigilance, and intrusive memories. It’s trying to keep the person on alert, so they’ll be prepared for the next dangerous situation.

However, in most cases the individual is not in constant danger once the traumatic event has passed. However, their stuck points continue to convince them they are.

This worksheet covers common PTSD-related beliefs, often called “cognitive distortions,” relating to the trauma. It includes examples, and how one might challenge these thoughts.

This type of worksheet is likely to be used over several sessions in therapy. It fits particularly well with the processes of TF-CBT and CPT. It could also be used as an adjunct to PE and EMDR (eye movement desensitization reprocessing) therapy.

You can download the worksheet right away, and part of the anxiety and PTSD set here .

It’s harder to get around this particular technical term. The anxiety hierarchy is sometimes called gradual exposure. I like to call it mindful exposure, because adding the mindfulness element makes it work even better.

An anxiety hierarchy can be used when someone has a phobia, or a particular fear related to their anxiety or PTSD.

When someone continues to avoid the fear, it gets worse over time. Even if they are facing it, they may be powering through, or “white knuckling” it. This can also make the fear stronger, because the body stays on alert for danger.

Mindfully exposing to the fear will help decrease it. Sometimes this takes a while, and other times it only takes once.

For example, if someone has a fear of all dogs, they may start by simply walking near dogs. Over time, this could advance to walking with a friendly dog, all the way up to cuddling up with one.

At some point, the person is likely to replace their unrealistic fear of all dogs with a more balanced one. Rather than believing, “all dogs are dangerous,” they might come to believe, “many dogs are friendly and safe.”

This worksheet walks the reader through that process, and includes a homework sheet they can take with to fill out each time they practice.

Trauma Narrative

If you’re a mental health professional, you may be familiar with the term “trauma narrative, or “written account of the trauma.”

This simply means writing what happened during and after the trauma.

This is often used in therapies like CPT and TF-CBT. In PE, it’s typically done verbally, rather than in written form.

While it can be one of the most difficult parts of recovery, nearly all of my clients who do it say it was the most helpful part of their therapy.

Originally, the trauma narrative was always used in CPT. Over time, the therapists found that some people got better without it , although many clients still choose to do it.

The narrative is a type of mindful exposure in and of itself. Sometimes people struggle with facing their negative beliefs about themselves and the trauma. It may seem too scary to face them head on.

The trauma narrative helps people overcome this roadblock, so they can begin to get better. It also gives some power back. Rather than being controlled by having to avoid memories and fears all of the time, someone can take the reins of their life back.

The trauma narrative worksheet explains this process, and provides the space and structure to complete the narrative. This is generally done with the guidance of a therapist.

This is so that the therapist can help the client work through this challenging step. They can also provide some structure that encourages the survivor to actually do this, rather than always putting it off.

To get the worksheet as part of the set, click here .

Making Meaning

So many people hate the phrase, “everything happens for a reason.” I definitely get that. I’d like to rephrase it to, “We can make meaning of everything that happens.”

This can be a helpful part of recovery, and it seems to help people make peace with bad things. The alternative is to believe that all of life stinks, and will continue to until the end. This is a pretty tough way to live.

This worksheet keeps that step in mind. It’s meant to be used towards the end of working through PTSD symptoms. It looks at the big picture, and looking forward in life. It’s a great tool for those finishing up this portion of their therapy.

To get this worksheet along with the set, visit here .

Grounding Stone Worksheet and Kit

I recently developed this kit in response to our popular grounding stones article . This is a fun and tangible activity that helps teach the concept of mindfulness.

This worksheet includes education about grounding itself, and teaches the steps behind the process.

The steps of using a grounding stone are included in the worksheet. The kit also includes bonuses of posters, an audio meditation of the grounding stone exercise, and editable files to update the documents.

Check it out here , to see what’s included.

Self-Care Guide

It’s great to tackle problems and develop coping skills. Often we also need to look at the big picture as well.

Once we overcome problems like anxiety and PTSD, where do we go from there?

This worksheet takes a broader look at overall wellness. It includes prompts about one’s own strengths, as well as a brainstorming page on how to improve self-care.

This can be a great supplement to any other type of therapy group, class, or event. Download it as an individual worksheet here.

Making Use of Tools

When our lives are focused on helping clients, students, family, and others, things can get hectic. Therapy tools can help take a bit of that pressure off, while still offering evidence-based practices for real issues.

If you’re looking to make progress with your group or clients, stay on track, and use well-supported techniques, I’ve got you covered.

Our most popular product is our anxiety and PTSD bundle of worksheets, which you can download right here , and start using today.

Cohen, J. A., & Mannarino, A. P. (2015). Trauma-focused Cognitive Behavior Therapy for Traumatized Children and Families. Child and adolescent psychiatric clinics of North America , 24 (3), 557–570. https://doi.org/10.1016/j.chc.2015.02.005

Walter, K. H., Dickstein, B. D., Barnes, S. M., & Chard, K. M. (2014). Comparing effectiveness of CPT to CPT-C among U.S. Veterans in an interdisciplinary residential PTSD/TBI treatment program. Journal of traumatic stress , 27 (4), 438–445.

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Stress Therapy Treatment

What is stress, stress management therapy, tips to reduce stress, finding a therapist.

Stress therapy, also known as stress management or stress management therapy, can help people learn to manage stressful situations or feelings. The therapy includes a group of techniques, strategies, or programs that are used to address stressful situations and your stress response to them.

It is common to experience stress throughout life, and many people go through phases of high or increased levels of stress. While short periods of slightly increased stress levels may be considered normal, it is important to address high levels of stress and extended periods of increased stress.

This article will discuss stress, types of stress therapy, and how to know if you need stress therapy. It also covers ways you can benefit from it and tips for finding a therapist who suits your needs.

Charday Penn / Getty Images

Stress is a feeling of overwhelm or doubt related to situations or things that happen to us. It can be physical, mental, or emotional. For example, stress can feel like an upset stomach , lots of thoughts racing through the mind, or self-doubt.

Stress can be caused by a wide variety of life events and transitions, positive and negative, including relationship changes, work or employment changes, moving to a new place, illness or death, and other life challenges.

It is important to understand that stressful situations or events are not limited to negative experiences. Stress can come from positive changes, too. The Social Readjustment Rating Scale (also known as the Life Events Rating Scale) was developed by Thomas Holmes and Richard Rahe, two American psychiatrists . This tool includes life events that may lead to stress, some that people generally consider to be positive and those considered negative.

Possible Causes of Stress

Many situations or events can cause stress, such as:

• Addition of a new family member
• Changes in personal habits, education, career, or relationship dynamics
• Changes in eating or sleeping habits
• Changes experienced by a spouse or partner
• Conflict at work or school, or with family or friends
• Death, injury, or illness of a friend or family member
• Divorce, separation, breakup, or reconciliation of a partnership, marriage, or relationship
• Financial status change, new loan or mortgage, or mortgage or loan default
• High personal achievement
• Holidays or vacations
• Injury or recovery or physical, mental, or emotional health challenges
• Legal challenges
• Life transitions such as pregnancy or retirement
• Living condition changes or a household member moving in or out
• Recreational or social activity changes
• Responsibility changes
• Sexual challenges
• Social relationship conflict

Stress management therapy is the use of techniques, strategies, or programs specifically to reduce stress levels, prevent stress, or cope with situations or events that could lead to increased stress levels. Two examples include psychotherapy ( talk therapy ) for stress and relaxation training.

Stress therapy can be beneficial when someone is:

• Experiencing stress for a long period
• Experiencing high levels of stress
• Going through life changes or transitions
• Anticipating future changes or transitions

Stress Therapy Benefits

There are many benefits of stress therapy, including reducing the risks associated with stress. Negative effects of stress include physical, mental, emotional, and social challenges, and compromised quality of life. Some examples of the negative effects of stress include:

• Increased anger
• Negative interactions with family, friends, or others
• Trouble sleeping
• Increased chance of getting sick

Stress negatively impacts every body system, including digestion, reproduction, bones and muscles, breathing, the heart and circulation, nerves, tissues, organs, and hormones. For example, people who are stressed are likely to have high blood pressure .

Stress therapy can help to reduce stress levels, prevent and address these negative effects, boost mood, and increase your quality of life.

Benefits of stress therapy include:

• Better digestion
• Better mood
• Better sleep
• Chronic disease management
• Increased productivity
• Improved immune system function
• Improved mental and emotional health
• Improved physical health
• Improved relationship interactions
• Lower blood pressure
• Reduced pain

Stress Therapy Types

There are different types of stress management therapy. Cognitive behavioral therapy (CBT), mindfulness-based cognitive therapy (MBCT), and psychodynamic therapy are talk therapy methods that can focus specifically on stress.

Preventive stress management teaches how to recognize, prepare for, and respond to stressors, such as with coping strategies, and is provided before the stressful event takes place.

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy is a type of talk therapy commonly used for stress management. This method focuses on the connection between thoughts, feelings or emotions, and behaviors, and how making changes to one can change others, as well as their outcomes.

CBT focuses on identifying faulty thought patterns that impact emotions and behaviors. For example, it may include noticing how the thought of not being good at something can lead to a fear of trying.

There are CBT programs and treatments specifically for stress that can help people change their thoughts, feelings, and behaviors in ways that promote relaxation and reduce stress. CBT-based stress management has been found to reduce levels of stress and anxiety, improve psychological well-being, and increase confidence.

Mindfulness-Based Cognitive Therapy (MBCT)

Mindfulness focuses on awareness of internal thoughts and feelings, as well as external surroundings and environments. For example, it may include focusing on how the sun and breeze feel on your skin or noticing thoughts that pop into your mind.

Mindfulness-based cognitive therapy is a type of talk therapy that combines mindfulness practices such as meditation with cognitive behavioral therapy. This method can focus specifically on stress management.

Mindfulness-Based Stress Reduction (MBSR)

Mindfulness-based stress reduction combines mindfulness techniques with stress management techniques to prevent and address stress. It may include meditation, relaxation, yoga, body awareness, and other techniques. MBSR has been shown to reduce stress, anxiety, depression, and burnout, and to improve quality of life.

Psychodynamic Therapy

Psychodynamic therapy is a type of talk therapy that explores a person's past experiences, emotions, and beliefs and their connection to their current mindset. The goals of psychodynamic therapy are to increase a person's self-awareness and understanding of the influence of the past on present behavior.

This type of therapy may help people understand how their past is influencing their stress and the ways they cope with stress.

Who Needs Stress Therapy?

Stress therapy is not only for people with a diagnosis or mental health condition. It can be beneficial for anyone dealing with high levels of stress, experiencing any level of stress for a long period, or going through a challenging life event or transition.

Those who anticipate a future stressful life event or transition can benefit from preventive stress management therapy.

In addition to stress therapy, there are many things people can do to prevent and cope with stress. This can be anything that promotes relaxation, such as:

• Taking a walk
• Reading a book
• Enjoying a personal hobby
• Getting physical activity, such as bike riding, hiking, or swimming
• Volunteering
• Spending time in nature

Some other practices that can help you prevent and manage stress include the following:

• Avoid drugs and alcohol
• Create, communicate, and hold boundaries
• Connect with loved ones
• Eat a well-balanced diet
• Exercise regularly
• Follow a routine or keep a daily practice
• Help others and volunteer
• Manage your expectations for yourself
• Make time for hobbies
• Practice relaxation techniques
• Prioritize self-care

The relaxation response is the opposite of stress and happens by calming the mind and body using relaxation techniques. There are many relaxation techniques that can help to reduce—and even prevent—stress. These can be used alone, combined with other relaxation techniques, or along with stress therapy.

Examples of relaxation techniques include:

• Art therapy and music therapy
• Body awareness that focuses on breathing and muscle relaxation
• Mantras and prayer
• Meditation and visualization
• Tai chi or yoga

Breathing Techniques

Breathing techniques can promote relaxation and reduce stress. There are many different breathing techniques that work in different ways. For example, ujjayi breathing, or ocean breathing, is a yoga breathing technique that has been shown to have a relaxing effect and reduce stress.

Breathing techniques for relaxation and stress reduction include:

• Abdominal breathing (also called diaphragmatic breathing or belly breathing) : A breathing technique that involves breathing in through the nose and out through the mouth, and focusing on pulling the air into the diaphragm and expanding the abdomen
• Ujjayi breathing or ocean breathing : A yoga breathing technique that involves breathing in and out through the nose, with inhaling and exhaling of the same duration
• 4-4-4 breathing technique : A count-based breathing technique that involves inhaling for a count of four, holding the air in for a count of four, exhaling for a count of four, allowing the lungs to remain empty for a count of four, and then repeating the process

The first step to getting support with stress therapy is finding a therapist or other mental health professional who practices stress therapy. Primary care providers may be able to give recommendations. Insurance companies can often provide a list of professionals who are covered by the plan.

Psychologists and psychotherapists commonly help people with behavioral changes in response to stress, but other mental health professionals can also help address stress, including:

• Psychiatrist: A doctor who specializes in mental health and can also prescribe mental health medications.
• Group counselor: A licensed professional who specializes in working with a small group of people who have similar challenges.
• Play therapists: A professional trained to work with younger children using play as a form of therapy to help them express themselves.
• School counselors: A person trained to help students of all ages with personal challenges, including stress.

It is a good idea to make sure the provider works with people to address stress before scheduling an appointment. This information may be available on the provider's website if they have one, and you can ask when scheduling an appointment.

Mental Health Hotline

If you or a loved one is struggling with stress, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 800-662-4357 for information on support and treatment facilities in your area.

For more mental health resources, see our National Helpline Database .

Stress is the response of the mind and body to external events, situations, and pressures that can feel overwhelming. It can be caused by life changes and transitions, both positive and negative.

Stress therapy is a group of talk therapy methods, techniques, strategies, or programs to prevent and treat stress. The benefits of stress therapy go beyond stress prevention and reduction and include improved physical, mental, and emotional health and quality of life. Cognitive behavioral therapy, mindfulness-based cognitive therapy, mindfulness-based stress reduction, and psychodynamic therapy are examples of stress therapy methods.

American Psychological Association. Stress management .

Mental Health Foundation. Stress .

American Psychological Association. Life events rating scale.

American Psychological Association. Stress effects on the body .

Sarkar A, Roy D, Chauhan MM, et al. A lay epidemiological study on coexistent stress in hypertension: Its prevalence, risk factors, and implications in patients' lives . J Family Med Prim Care. 2019 Mar;8(3):966-971. doi: 10.4103/jfmpc.jfmpc_60_19

Office of Disease Prevention and Health Promotion. Manage stress . Health.gov.

American Psychological Association. Preventive stress management .

American Psychological Association. Cognitive therapy .

Jafar HM, Salabifard S, Mousavi SM, Sobhani Z. The effectiveness of group training of cbt-based stress management on anxiety, psychological hardiness and general self-efficacy among university students .  Glob J Health Sci . 2016;8(6):47-54. doi:10.5539/gjhs.v8n6p47

American Psychological Association. Mindfulness .

Brown School of Public Health. What is mindfulness based cognitive therapy? .

Khoury B, Sharma M, Rush SE, Fournier C. Mindfulness-based stress reduction for healthy individuals: A meta-analysis .  Journal of Psychosomatic Research . 2015;78(6):519-528. doi:10.1016/j.jpsychores.2015.03.009

National Health Service. 10 stress busters .

American Heart Association. Spending time in nature to reduce stress and anxiety .

Centers for Disease Control and Prevention. Coping with stress .

Harvard Medical School. Six relaxation techniques to reduce stress .

Epe J, Stark R, Ott U. Different effects of four yogic breathing techniques on mindfulness, stress, and well-being .  OBM Integrative and Complementary Medicine . 2021;6(3):1-1. doi:10.21926/obm.icm.2103031

American Psychological Association. How do I find a good therapist? .

By Ashley Olivine, Ph.D., MPH Dr. Olivine is a Texas-based psychologist with over a decade of experience serving clients in the clinical setting and private practice.

• Jan 30, 2023
• 26 min read

19 Tips to Motivate Clients With Therapy Homework- (Infographic)

Updated: Sep 14, 2023

Our team reached out to a group of therapists to find out what tips they had to offer on how to get clients to do their therapy homework. The infographic below is a collection summary of the quotes we received from 19 therapists.

While many of the interventions are known among professionals, each participant offers unique insight while answering the same question. The sessions that each therapist has with their clients are fantastic opportunities for discovery and figuring things out. The truth is that much of the learning and growth often come from the application of what has been discovered and figured out. In other words, you never get the full value of your in-person sessions without doing the homework!

Here are what our contributors recommended (you can find the full transcript and a link to the official article down below).

19 Therapists Weigh in On How to Motivate Clients Who Don’t Do Their Therapy Homework

Therapy sessions bring people to many new realizations. However, real learning takes place when a client attempts to apply these new ways of thinking and acting to their everyday life and to the goals they wish to accomplish. A big part of the process is the homework or exercises a therapist assigns to a client. If a client doesn’t do their homework, does this make the therapist's job much harder?

Below you will find the testimony of 19 different therapists that are weighing in on this very real and common occurrence. Each therapist gives their two cents on whether this issue is counter-productive, ways to get around, and more importantly ways to motivate their clients!

Tina Marie Del Rosario, LCSW, MSW, Adjunct Professor @ Pepperdine University

Owner of Healing Collective Therapy Group

https://healingcollectivetherapy.com

A common theme I see in people who lack motivation is the absence of self-compassion. Clients who show up faithfully are clearly displaying a form of motivation. But when it comes to doing the work, there are clients who meet resistance and acts of avoidance. .

What interventions have you found to be helpful in motivating clients?

I find that starting with a psychodynamic approach is necessary. Exploring what is coming up for the client when resistance and avoidance are present is often helpful. The thoughts, attitudes and emotions attached to these feelings have come from some past experience.

Identifying where it is coming from can help the client process said past experience(s) and recognize the lack of relevance it has to present day. More often than not, self-critical narratives are attached to the feelings of resistance.

These criticisms evoke both somatic symptoms and self-protection motivations that lead to avoidance. Becoming aware of what is coming up and how it is showing up is necessary to combat lack of motivation. Once identified, we can then work together to process it all and begin to change the narrative.

When clients realize their lack of motivation is not coming from “laziness” or “a character flaw,” they then can begin to remove the self-critical narratives and replace them with self-compassion.

With this new internal dynamic and the absence of self-criticism, clients find it easier to begin to motivate themselves to do the work.

Ellie Borden, BA, RP, PCC

Registered Psychotherapist, Clinical Director and Clinical Supervisor.

https://www.mindbydesign.ca

Resistance can be a common part of any change process. Some people struggling with different challenges may appear not to want to change. Even those clients who attend therapy loyally and recognize the need for change in their lives may fail to complete their homework or take the necessary steps outside therapy to modify their behavior.

This is a powerful moment in therapy and can give a therapist the insight necessary to recognize the deeper issues affecting someone's motivation to take the necessary steps toward the change they seek. Often, recognizing avoidant patterns or behavior is an opportunity to identify unresolved matters and the core elements that require healing.

Moreover, a therapist can help an individual reformat their why for change. It is important that someone's why is emotionally driven and leads to effortless motivation. The responsibility for change is the client's alone. However, a trained professional can give someone the objective perspective needed to get them moving in the right direction.

While a therapist can help a client become more motivated to change, ultimately, the onus is on the client to change. With that in mind, there are specific methods that therapists can use with clients to properly motivate them to make the needed changes in their lives.

One of the most widely used interventions for motivating clients is motivational interviewing. The goal of motivational interviewing is to help clients increase their intrinsic desire to change and achieve their goals in therapy. One of the techniques in motivational interviewing is bolstering the client's sense of self-efficacy by helping them recall examples of overcoming challenges in the past. This can allow the client to see that change is achievable and that the situation may not be as hopeless as they think. Developing discrepancies is another technique in motivational interviewing.

This involves a therapist helping the client voice their thoughts, feelings, and conflicts to call attention to the discrepancy between how the client is behaving and how they would like to behave. Motivational interviewing is a great way to help clients recognize their inner strengths and develop the desire to change.

There are many reasons why a client may resist taking the proper action discussed in therapy. One is fear of failure. Some clients, particularly those who are clinically depressed, do not have much faith in themselves or their ability to succeed. Even the slightest real or perceived setback can cause them to catastrophize or engage in negative self-talk such as I am so stupid or I am a failure who can never do anything right. With such a mindset, it is no wonder many clients are unwilling to attempt the steps required for positive change, even if they may truly desire to change. This is one reason why strengthening a client's self-efficacy is crucial.

Another cause of a client's resistance to change is a lack of clear goals. Some clients may struggle to articulate a vision of what desired change looks like, even if they sense that something has gone wrong. Helping the client develop a clear and realistic plan for change can give them additional motivation for following through with the often difficult and confusing work of pursuing meaningful changes in their lives.

Sarah F. O'Brien, LCSW, LLC

Thrive & Shine Counseling

https://www.sarahobrienlcsw.com

Without fail, as a therapist I will point out the discrepancy-mentioning to them how consistent they are with attending sessions, yet how inconsistent they are with completing homework. This usually sparks conversation and processing about why this may be happening for the client.

As a Clinical Social Worker, we are trained to assess a person fully within the context of their life circumstances, something we call BioPsychoSocialSpiritual assessment. With this, I may ask and find extenuating at-home circumstances that prevent clients from being able to complete homework i.e. too busy, not setting enough boundaries at work, ignoring self-care, over-committing to things that aren't beneficial to client's mental health.

What interventions have you found to be *helpful with motivating clients?

To increase client commitment to the change process, I use interventions such as:

*Psychoeducation* (explaining to them, with psychotherapy, most of 'the work' occurs outside of session to achieve desired change).

*Motivational Interviewing techniques* (to prompt and explore client reasons for lack of homework follow through and their awareness, if any, about this).

*Creative homework assignments* based on client's interests or talents (outside the box stuff that doesn't include worksheets or even writing anything down i.e. going for a walk and looking for different types of flowers or trees--this is a mindfulness practice. Or art/expressive assignments i.e. creating a playlist, making a collage or vision board, designing a room or space in their mind-- this is emotional processing, gaining new perspective, finding a safe 'place' to decompress).

*Encourage and suggest clients develop a reward system* for themselves for completing homework assignments (small gifts or tokens for completing that week's assignment, i.e. getting special coffee, taking an hour off work early, favorite dessert they rarely have etc. And larger tokens for consistent completion--every week for a month, for example, or tracking progress or having a breakthrough from the homework-- i.e. taking a weekend trip, taking a whole day off for self, purchasing non-practical or coveted item for self).

Although people willingly engage in therapy, the change process is often arduous and longer than we anticipate (or desire!). People lose motivation, it happens. Enjoyable assignments and rewards for completion are the external factors that motivate us until some positive change starts to occur. When noticeable, positive differences emerge from 'doing the work' outside of sessions, internal motivation often kicks in for clients and they WANT to keep doing homework BECAUSE it's producing the change they want to see in themselves.

Candace Kotkin-De Carvalho, LSW, LCADC, CCS, CCTP

Absolute Awakenings | Morris Plains, New Jersey

https://absoluteawakenings.com/

Therapy isn't a magic pill; clients need to work on their issues as part of the process. One strategy that may help is setting up firm boundaries. This can include scheduling regular appointments and requiring homework assignments between sessions. If a client repeatedly misses appointments or doesn't complete required tasks, it is helpful to schedule a check-in session to discuss this issue and help the client stay on track.

There may also be times when it's necessary to end therapy with a client who refuses to work on their issues. It can be challenging to make this decision, but it is important to do what's best for both the client and therapist to maintain a healthy professional relationship. If you are struggling with these issues, it may be helpful to seek out support from other mental health professionals or find a trusted mentor who can provide guidance.

Reflective listening and active listening can help clients feel heard and understood, which can ultimately motivate them to do the work. Reflective listening involves paraphrasing back to the client what you have heard them say. This way, empathy, and understanding are communicated, and the client feels more motivated to continue working on their issues. Active listening involves listening through nonverbal cues, such as eye contact, nodding, and facial expressions. This approach also encourages a client to articulate their own thoughts and feelings.

When it comes to doing their part in therapy, some clients may need additional support and guidance. This can include breaking down tasks into smaller parts, setting up time-bound goals, or providing positive reinforcement for progress made. If you give them homework assignments, check in with them at their next appointment to see how they are progressing and provide feedback or encouragement as needed.

For example, it may be overwhelming for some clients to make a major life change in one sitting, so you can help them develop a gradual plan to work toward their goals. Meanwhile, other clients may feel frustrated and unmotivated if they aren't making enough progress or meeting their goals quickly enough. In these cases, it can be helpful to provide positive reinforcement when they

make progress, such as offering verbal praise or tangible rewards.

Our behaviors are heavily affected by our thoughts, emotions, and environment. For clients who have been struggling with mental health issues for a long time, their thought patterns and coping mechanisms may be ingrained in their psyche. As a therapist, it is important to acknowledge that these behaviors may take time to change.

Often, this involves helping the client identify and understand unhealthy thought patterns and behaviors. This may involve identifying negative self-talk, challenging unhelpful beliefs, or learning coping strategies to better manage stress and anxiety. Accordingly, help the client focus on their strengths and build positive relationships with others. Acknowledging that they are working through a difficult time can provide support and motivation for them to keep going.

In addition, be mindful of your own thoughts and emotions as a therapist. For example, it is helpful to have regular supervision or check-ins with other mental health professionals so you can discuss any challenging client interactions. This will help ensure that your professional boundaries are maintained and that you provide the best support for your client.

Lauren Cook-McKay

Licensed Marriage, and Family Therapist and VP of Marketing at Divorce Answers

https://divorceanswers.com/

Although therapy is a two-way street in order to be successful, it's also a safe space for clients to be a mess. Dealing with incomplete homework usually involved capitalizing the inaction as a window to the realization of the issues they're dealing with in their lives.

Paradigm shifts were emphasized as a necessity, but the inaction itself is conceptualized as evidence of a barrier to wellness so it's leveraged for strategizing on better methods for management that are more suited to the client's capacities. We also make sure to leave room for these strategies to be adjusted until clients are ready to fully overcome their hindrances.

The most effective intervention that improves clients' motivations is the involvement of their support systems. Typically, the barriers they're facing and the reasons behind them being unpacked during the session bring forth the need to have sit-down talks with their loved ones. *Practicing that suggestion, they're able to verbally communicate the impact of the reactions and behaviors of the people around them which they've been repressing. *This frees them from their old self-concept and ultimately minimizes their hindrances.

After defining the specifics around the sequence of events that lead to the inaction of an assignment, analyses generally reveal that *clients feel unable due to complete them mostly due to the overwhelming pressure from expectations of accomplishing the assignment and/or apprehension of the mental labor being demanded by the task, as well as the potential impacts of the self-reflections that the task aims to bring to light. These reasons stop them from their tracks and/or deplete their mental energy to commit to the whole treatment.

Lawrence Barnier

Mental Health Officer

Women's Resources e-Information

https://www.wrei.org/

There are a few different ways to approach this situation. One way is to try to understand why the client is not doing the work. It could be that they do not understand what is expected of them, or they may feel overwhelmed and unsure of how to get started.

In these cases, it may be helpful to provide some guidance and support to help the client get started.

Another reason why a client may not be doing the work could be that they are not interested in changing their behavior. In these cases, the therapist may need to reassess the goals of therapy and decide if it is still appropriate to continue working with that client.

There are a number of interventions that can be helpful in motivating clients. One strategy is to set goals with the client and track their progress. This can help to provide feedback and encouragement and can help to show the client that they are making progress.

Another strategy is to provide positive reinforcement when the client demonstrates good behavior. This can help to encourage the client and can help to build a positive relationship with the therapist.

Finally, it is important to be understanding and supportive when the client does not meet their goals. This can help to provide motivation and can show the client that the therapist is there to help them.

Claudia Luiz

Psychoanalyst

http://www.claudialuiz.com

When clients “resist” in therapy, that resistance can yield more information than what the client can tell you consciously. If you focus on the resistances - why the homework isn’t getting done, why the client is stuck, why they can’t break negative patterns and integrate what they are learning - you are really getting into the zones that the client hasn’t been invited yet to explore.

We now know from neuroscience, the three areas of the brain that can hijack conscious effort. Fear, rage, and grief. When people are afraid of feeling things, they get stuck.

Neuroscience gives us a model for what the patient may be resisting. The other emotional zones, seeking, play, and love can be engaged in this exploration. The framework gives us a way of thinking of the clients' “stuckness” in a productive and creative way.

Joining the client in their “stuckness” with compassion and curiosity, while shifting the framework of what you are ultimately working on, avoids power struggles, or potentially shaming the client. It lets them know compassionately that we understand about resistances, and that talking more about feelings can hold the key to unlocking the mystery of what is standing in the way of progress.

Elisa Tidswell

Certified Coach and Therapist, Committed to Empowering Women, Breaking

Negative Generational Cycles, and Creating Economic Justice

https://elisatidswell.com

It's vital that therapists understand how to keep their clients accountable to their growth. Accountability is where therapists help their clients take action that will help them grow - and action is the only place where transformation takes place. Transformation is what clients pay their therapists for.

It's also really important that therapists get really good at accountability, otherwise, they can actually wind up demoralizing their clients. After all, if clients don't do their homework consistently they are likely to internalize it, believing that there is something wrong with them or that they are failing. This is the polar opposite of what therapists want for their clients.

So how can therapists help their clients do their homework? By cultivating an environment of curiosity and learning. Accountability is not about judgment or being 'told off', however, sadly this is exactly what many people believe it to be: they learned about accountability from their parents and school environments where not doing homework or handing in sub-par homework was met with shame. It's really important for therapists to dispel this mindset and ensure their clients know that accountability is about learning.

The best approach I have found after coaching hundreds of clients to stay accountable is to include three main parts to the accountability conversation. The first is for the client to share a win: something positive that's happened since they last met with their therapist. This could be an insight, a decision, a process (such as 'I felt my feelings!'), or something extrinsic, such as a pay rise. Sharing a win is important to put the client in a state of abundance and is commonly used by positive psychologists in their practice.

The second part is to consider a goal or homework that the client did do, and break it down to see why they did it. For example, what were they thinking, how were they feeling about it, how did the goal tie in with their values, what was their motivation to get it done, did they tell others about it, had they put it in their diary, and so on. The therapist and the client want to learn about what works for them so that they can double down on it.

The third part is to consider a goal or homework that the client didn't do and then see what they can learn from why they didn't do it. Was the goal too big and overwhelming, and actually needed to be broken down into smaller steps? Were they clear on how to get started with the homework or was their understanding fuzzy? Was the homework tied in with their vision or values? Had they put it in their diary? Did they have support from others? Was a limiting belief getting in the way? Once the therapist and client have learned more about why they didn't do it, they can create a new goal to support them in achieving the original one.

The best action a therapist can take in supporting their clients with their homework is to let go of judgement and to a growth mindset. They have to see accountability itself as a learning exercise where they can explore

what's going on for the client, and understand what works for them.

Trish Glynn, LMHC, CRC

Licensed mental health counselor

Owner and therapist at The Carey Center

https://careycenter.squarespace.com/

Therapy is all about meeting the client where they’re at. Of

course, therapy will work best when the client is actively engaged both in and outside the therapy room. Results tend to be better and come faster. But not everyone is doing the work when they leave the appointment. There can be many reasons as well as many ways to address this. As a therapist, you want to try to figure out the “why” as that will help you determine next best steps.

For example, maybe you’re assigning work that is “too much” or isn’t a good fit for them. Are you asking a client to journal every week when sitting down to write is a mismatch for them?

Part of therapy is figuring out why the client is stuck. That takes time and talking about it in order to understand what the individual reason and best response may be.

In some cases, we just need more details, and so we keep talking and exploring to figure it out.

The client has a reason for what they do or don’t do – and therapy is about finding that out. Progress can come from discussing things the client has maybe never talked about with anyone before.

Also, it can be helpful to seek out some emotionally compelling reasons for change. If you can come up with some really meaningful “why” that speaks to the client, that can create a shift. Logic is often useless. We often know why we should do things. Yet, we don’t. But emotion can get us moving. What interventions have you found to be helpful in motivating clients?

A lot depends on client preference. As a therapist, it’s important to build rapport and get to know who is in front of you. That’s the ideal way to figure out what will work best for them. Because something can be incredibly effective, but if it’s not a good fit for a particular person, it won’t matter. Often, an eclectic approach is best. We are all so very different. One of the most important elements in therapy is the relationship. That matters more than any particular intervention. That’s why people go to therapy to talk to someone – a self-help book, for example, can list out some

interventions, but nothing compares to the human relationship, the rapport, the empathy, and the positive regard, which occurs in the therapy room. You can’t buy that off a shelf. Elaborate on any details you find helpful for explaining the mindset of the client and how it changes.

Therapy involves understanding the current mindset of the client. We want to understand if it’s fixed, or more growth-oriented, for example. We want to consider how their mindset both helps and hinders them. It’s usually a fixed mindset that gets us into trouble. We think we can’t change and our circumstances, too, can’t change. We will give up more easily and ignore helpful feedback. With a growth mindset, we know we are a work in progress. We are more open to accepting challenges. We are more able to seek them out.

Changing from fixed to growth involves challenging current thoughts. For instance, you can get stuck making a lot of false assumptions. You can begin to question your thoughts. Is that true? How do I know? What else might be happening here? Am I being too black and white, and missing the grey areas?

We have to notice where our mindset is now. Then we begin questioning it. We begin really getting deliberate about looking at our thoughts. For most of us, we don’t really spend much time if any thinking about our thoughts. It can help to start pausing to consider what thoughts are in your mind. And then we can start examining them and challenging them. And that’s when we can begin to create a shift. We can’t change what we don’t look at and understand.

Janelle Marshall, LPC

Marshall Gray Counseling Services

https://www.marshallgraycounselling.com

How do you navigate clients who faithfully come to therapy, but don't do the work?

I check in with the client and help process any challenges that are interfering with their ability to do the work. Sometimes the perception of the client not “doing the work” is an indicator of emotional trauma or blockage that needs to be processed.

Journaling is one of my favorite interventions to share with clients. I find it helpful for clients to visualize their therapeutic goals and their thoughts behind how their lives will reflect the efforts attempted. Habit tracking is a tool that helps take motivation a step further with clients that are committed to the therapeutic process. I have a collection of reflective habit tracker journals that serve as a guide to help the user align their actions with their desired goals.

As a solution-focused therapist, I help prepare my clients to embrace the evolution of their mindset throughout our journey together. It’s also understood that the client’s anticipated mindset change is contingent upon their willingness to commit to the work assigned in and out of the session.

Miriam Manela

The Thrive Group

https://childrenbloom.com/

The best motivation for clients is first and foremost for the therapist to let go of having a NEED to change their client, to let go of convincing their client to change and to simply allow the client to do what they have been doing and nothing different.

I usually tell clients, without any judgment, but just to give them an awareness that typically when the follow-up program is kept then results are significantly faster. If there is no follow-up done, that is okay, I just like them to be aware that therapy can take quite a bit longer then.

The third technique I use in therapy to motivate clients to change from within themselves is to create intentions. Rather than giving the client something they need to do, I would make an intention with them, which they could say once a day to give themselves the awareness of their challenge. Or if not, they may only use their intention once a week when they come to me for a session.

An intention would sound something like, I noticed that when someone questions my authority, I get very agitated. or I noticed that when my child comes home from school, or my boss walks into my office I feel flustered, overwhelmed, frustrated or anxious, etc. So without needing to tell the client to do any specific exercise at home, we've instead created together an intention to repeat every day to give themselves awareness. I may have them create a reminder on their phone with it or post a sticky note in their bedroom or bathroom.

Just remembering their awareness helps them remember what to do to calm down, on their own.

Danielle Bagus, MSW, LSW

Relief Mental Health

https://www.reliefmh.com

When a client seeks out therapy, faithfully attends without fail but once in session we are going over the same issues over and over again and I have found they are not doing the work on themselves outside of the therapy sessions, I attempt to look for a support system that may help them.

This might be a significant other, a parent, sibling, friend, etc. I ask who is in their close circle who they trust to help hold them accountable. I will also hold them accountable but sometimes encouragement coming from a loved one or someone they don't want to let down will mean more.

I also have found that the homework might not necessarily match up with their skill set or what they are willing to put in at that time. Therefore, as their therapist, it's my responsibility to find a new method or way to connect with the client and help them be successful.

One size does not fit all when it comes to therapy. Therapists need to have lots of tools in their toolkit to meet the needs of the client and ultimately to meet the client where they are in the process of therapy.

I think this can really depend on the client and what they need out of therapy. I find that Cognitive Behavioral Therapy (CBT) works the best to motivate my clients to continue to do the work outside of therapy. CBT helps people with such a wide range of mental health issues and ultimately helps with really digging deep to find new ways of thinking, coping and behaving in certain situations.

Clients seek therapy for many different reasons. Some want to change their mindset, some wish to seek outside advice or help on a specific situation or topic (divorce, relationship, school based issues, family issues, etc.), some come because they have been diagnosed with a mental illness (bipolar, depression, schizophrenia, eating disorder, OCD) and need help maintaining a healthy mindset, some clients want an outside person to just listen, the list goes on. As a therapist, you are there to be an impartial, nonjudgmental resource for the client. You are there to help them realize different ways of doing things and different ways of thinking.

The client takes the first step in seeking out therapy but also needs to be the one doing the work and willing to change what they have always done with the guidance of their therapist. It's important for the therapist to always ask what the client wants out of therapy or a specific session. Sometimes the client doesn't know but I think our clients are more self-aware than they realize. If you can ask the right questions, they ultimately will tell you what they need, want or expect to get out of therapy in general or even a specific session.

Kellie Brown, LMHC, NCC, MCAP, (she, her)

Licensed Mental Health Counselor (LMHC)

Owner of Quiet Water Counseling in Florida

https://www.QuietWaterCounseling.com

Oftentimes when a client comes regularly to therapy but does not want to do work outside of sessions it comes down to the client being afraid of making changes in their lives. People get so use to doing things one way it is very hard to change directions and try something new.

So instead of setting clients up for failure by giving them a huge homework assignment that is very likely overwhelming and they probably won't do, I give them very small tasks to accomplish.

So instead of giving a client the homework assignment of going to an Alcoholics Anonymous meeting or joining a gym, I ask clients to research AA meetings, or research local gyms. The next week I might ask them to just drive to the location of the meeting, or drive to the gym location, but tell them they don't have to go in, I just want them to physically see where it is located.

Giving smaller homework assignments tends to help break down a huge change into something more manageable.

Elizabeth Mateer, MS, MA, LMHCA *(she/her/they)

Director, Divergent Wellbeing https://www.divergentwellbeing.com

Lead with curiosity. Asking why didn't you do X this week like we talked about automatically leads to defensiveness and shuts down motivation to discuss what happened. Something like After our conversation last week, you seemed excited to work on using that coping skill. I'm curious about what the barrier was when you thought about applying it this week. This framing allows the client to explore the *process* of doing the work, rather than the content of I didn't do it.

Don't let it go. As therapists, we tend to feel compassion and understanding toward our client's challenges. While this is an important skill in many aspects of therapy, it can sometimes be tempting to let it go when our clients are consistently not doing the work outside of therapy. This is not only avoidant ourselves, but it doesn't serve our clients by teaching them to take accountability for their well-being. We can still be compassionate while being direct.

Meet them where they are at. Clients know when they aren't doing what they said they would, and yet, they are still showing up. That says a lot about the relationship and trust you've already built with them. Highlighting any progress you see, regardless of how small, is an effective way to motivate clients to continue moving forward. Sometimes these clients just move at a slower pace than others we see coming into therapy ready to take action, and that's OK.

Self-reflect on what we are asking from them and if it is too much. Sometimes as therapists we see the potential a client has and give homework assignments that are beyond what is realistic in the present moment, especially if we have seen our clients for a long time and have an idea of what they are capable of. Is there a way to break down the work into smaller, more achievable pieces? For some clients, if a task seems too aspirational or unrealistic, they won't attempt it at all. Smaller steps towards progress are better than no progress at all.

Steve Carleton, LCSW, CACIII

Gallus Detox

https://www.gallusdetox.com/

Navigating clients who come to therapy but don't complete their homework can be difficult and often requires a tailored approach.

The first step is to create an honest dialogue with the client about why they are not completing the assigned tasks.It could be that the tasks are too challenging or time-consuming, or that they don't understand what is expected of them. It is important to understand the underlying reasons behind the lack of motivation, and build a plan together that works for both parties.

The next step is to offer alternative homework assignments that are tailored to each individual client's needs. This could include reading an article or book related to the problem being discussed in therapy, journaling about their thoughts and feelings, writing a letter to their future self, or attending a workshop or class related to the topic. It might even be more helpful to ask your client what they would like to work on or what they would find most helpful. This will help to make the homework assignments more meaningful and will give them a sense of ownership over their progress.

The last step is for the therapist to provide ongoing support and accountability for their client's progress. Check-ins at the end of each session are a great way to ensure that homework is being completed, and providing regular feedback can help the client stay motivated. Above all else, try to create an environment of understanding and acceptance that encourages your client to be open and honest about their progress. With patience and dedication, you can help your clients reach their goals.

Nirmala Bijraj, LMHC, NCC, She/Her/Hers*

Aligned Self, LLC

https://alignedself.co

I explore with them why they don't do the homework, what about getting it done, and doing it, makes it difficult.

I usually start with the least possibly intrusive change. We explore the change they want to make, identify the first step and then explore how to incorporate that change with the least amount of barriers and effort possible to start to build a new habit.

I've found if we start with something that feels like the least amount of effort, takes the least amount of time, and is the least intrusive on their life and schedule, then the client is most likely to do it.

For example: A client wants to work out in the mornings: *(this is a real scenario that I've worked with clients on with these steps). We start with building the habit of getting into gym clothes first thing in the morning when they wake up, the goal is to start the habit, we don't focus on how many times they work out or if they work out at all, just starting the first part of the process.

Then a week or two later or more depending on the client, we would add a 10-20 minute workout, something that they can actually make the time to do, 5 minutes if that's all the time they have to start with, again the least amount of effort that will help them start building the habit. And then continue to build on that habit until they're where they want to be with that goal.

Lindsey Ferris, MS, LMFTA

Individual & Couples Psychotherapist

https://www.talkhealthrive.com

If I notice that clients are coming regularly and sticking with therapy, but I'm not seeing progress or an effort to do out-of-session homework. I will bring this up directly to the client to ask them what they are seeing and how they are experiencing therapy. If they are seeing the changes and growth, they want to see, then I'll have them elaborate on this so I can understand from their perspective what growth and change looks like.

Oftentimes it takes checking in with my client to learn that they in fact are feeling the benefits and see growth in themselves in different ways than what I may be looking for, and it is a good idea to level set vs. assume that 'work' isn't being done or growth isn't happening.

If I find that clients are resistant to homework, or not making progress towards their therapeutic goals, I will address this directly and ask them what is getting in the way of doing homework and impacting their ability to engage fully in their therapy process. This can often lead to areas that need to be addressed first, before other priorities, so that any

therapy-interfering behavior can be resolved and progress can continue.

I find that oftentimes addressing directly with clients what I am observing in therapy interfering behavior or lack of compliance to homework can lead to thought-provoking insight and dialogue and instigate a change in how the client sees the way they show up for therapy. Once it is out on the table as a barrier to therapy compliance, the client and I can have an open dialogue about when either of us see it coming up in the room to work towards behaviors and changes that they want to see. When a client has insight into patterns that may be blocking them from growth, it can be a true aha moment that changes the engagement and adherence to therapeutic homework and growth.

William Schroeder

Licensed Counselor and Owner of Just Mind LLC

https://justmind.org/

Every therapist has clients like this and it's a helpful thing to not beat around the bush about. If you notice someone is saying they are motivated and then not doing the work, the meat of the therapy is digging into what's getting in the way.

Motivational interviewing could be one way to approach this. On a scale of 1-10, how motivated are you to see X change. If it's low, then that's helpful to know and you might need a new target. If it's high and there isn't follow through, then you need to see what ideas they have that might help them have success and assess their perception of those as well.

Sometimes trauma can get in the way and it can help to make sure this is properly assessed. There are a number of trauma screens but trauma can be a big barrier to change if it's not dealt with. Things like EMDR can be helpful in treating PTSD, for instance. 100% of single-trauma incidents and 77% of multiple-trauma survivors no longer met the diagnostic criteria for PTSD after 6 fifty-minute EMDR sessions.

It also can be helpful to assess ADHD to see if that's possibly a complicating factor. The World Health Organization has a simple test clinicians or clients can use to see if they might meet criteria.”

Alexandra Alex Cromer, LPC

Thrive Works

https://thriveworks.com/richmond-therapy/

A great tactic to navigate this is to have an honest conversation on their progress and introduce them to your theoretical framework/how you judge and measure client success.

The Transtheoretical Model of Change is my personal favorite, and it takes into account client motivation and any barriers that might be keeping them from making continued progress.

Another tactic is to discuss one of the main goals of therapy with a client; making the client more effective in their daily lives. Through this lens, we can invite the client into a bidirectional conversation in which we discuss progress and change as well as ways in which they believe your time together in therapy is effective.

I tend to favor a lot of motivational interviewing techniques as well as cognitive challenging skills to help motivate clients. If a client is faithfully attending session but is not doing the work, we could ask them a cognitive challenging question to get them to explore and identify their current patterns and routines and the efficacy of these.

Motivational interviewing techniques are similar in this way, in that they require work and active reflection on the part of the client in order to answer the questions. The most effective techniques to motivate clients are the ones which require the clients to do active work and are not closed-ended questions. The more you can allow a client to engage in self-reflection, research shows client motivation and propensity to change increases.

One of the biggest frustrations that therapists experience is a client who is seemingly not putting in the work or reportedly making progress and change. It's very common for a therapist to assume that a client is unwilling to change and is purposefully resistant to the process. Often, this is not the case and the client's stagnation can be better explained through a theoretical lens. For example, using the Transtheoretical Model of Change, we can identify that client barriers to progress come in the form of fear of failure, anxiety, and perceived low self-esteem, rather than willful ignorance.

Honest, direct conversations with clients allow them to see themselves through your perspective, and vice versa. Typically, research shows that clients who have a high sense of self-efficacy have a higher propensity to engage in change making behaviors. Therapists can increase client self-efficacy by continuing to engage clients in

Self-reflection.

Wrapping up…

The bottom line is that when clients do their homework things progress quicker, but when clients DON’T do their homework, we get new insights to resistances and what is actually going on inside. Thank you to all the fantastic therapists that contributed to this article! With great insight comes improved well-being.

You can find the original article published here: https://www.psychreg.org/therapists-weigh-how-motivate-clients-who-dont-do-their-therapy-homework/

Feel free to download the interactive PDF but don't forget to share the link to our page!!

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A therapy and mental health resource site

200+ Sites with Free Therapy Worksheets & Handouts

An extensive list of 200+ sites with free therapy worksheets and handouts on various topics, for clinical use or for self-help.

This post is archived; I will no longer be updating this page. For the newest edition of this guide, please see 250+ Sites with Free Therapy Worksheets .

(Updated 11/28/23) If you’re a counselor or therapist, you’re probably familiar with Therapist Aid , one of the most well-known sites for providing no-cost therapy worksheets. But Therapist Aid isn’t the only resource for free clinical tools! This is a list of over 200 sites with free therapy worksheets and handouts.

See below for links to websites with free therapy worksheets and handouts for clinical use and self-help.

Click here for therapy worksheets, handouts, and guides posted on this site. Access additional free printables by joining Mind Remake Project’s Facebook group, Resources for Mental Health Counselors & Social Workers. 🆕

Sites with Free Therapy Worksheets & Handouts

Therapy worksheets for mental health.

• 91 Free Counseling Handouts | Handouts on self-esteem, emotions, recovery, stress, and more (Source: Kevin Everett FitzMaurice)
• A Good Way to Think: Resources | Therapy worksheets and handouts on happiness, well-being, values, etc. (Source: A Good Way to Think by David)
• Articles by Dr. Paul David | Clinical handouts on depression, relationships, substance use disorders, family issues, etc. (Source: Dr. Paul David, PhD)
• Belmont Wellness: Psychoeducational Handouts, Quizzes, and Group Activities | Printable handouts on assertiveness, emotional wellness, stress management, and more (Source: Judith Belmont of Belmont Wellness)
• Black Dog Institute: Resources & Support | Downloadable fact sheets, handouts, mood trackers, and more on a variety of mental health topics (Source: Black Dog Institute Australia)
• Brené Brown Downloads and Guides | Resources for work, parenting, the classroom, and daily life (Source: Brené Brown, LLC)
• Bryan Konik: Free Therapy Worksheets | A collection of therapy worksheets on stress management, anxiety, relationships, goal setting, and trauma (Source: Bryan Konik, Therapist & Social Worker)
• Cairn Center: Resources | A modest collection of printable assessments, handouts, and worksheets on DBT, anxiety, depression, etc. (Source: Cairn Center)
• Coping.us | Printable tools for coping (Source: James J. Messina, PhD & Constance Messina, PhD) 
• Cornell Health: Fact Sheet Library | A variety of handouts and tracking sheet on various health topics; only a few relate to mental health and addiction (Source: Cornell University)
• Counseling Library Handouts | A collection of handouts on depression, trauma, personality, and more (Source: Morning Light Counseling, Carrie M. Wrigley, LCSW)
• Counselors Associated: Free PDFs | A small collection of PDF downloads (Source: Counselors Associated, Inc.)
• Downloads | A small collection of therapy worksheets/workbooks on boundaries, anger, anxiety/mindfulness, relationships, and more (Source: Christina Bell, Registered Psychologist)
• DOWNLOADS from Get Self Help | Free therapy worksheets and handouts on a variety of topics (Source: Getselfhelp.co.uk)
• Dr. D. Fox: Forms, Presentation Slides, & Worksheets | Topics include anger, emotions, borderline personality disorder, etc. (Source: Daniel J. Fox, PhD, Applied Psychological Services, PLLC)
• Dr. John Barletta: Tip Sheets | Downloadable tip sheets on a variety of topics (Source: Dr. John Barletta)
• EchoHawk Counseling: Materials and Resources | Articles, worksheets, and handouts on a variety of topics, including boundaries, emotions, grief, stress, trauma, etc. (Source: Lance Echo-Hawk)
• Eddins Counseling Group: Worksheets | A short list of free worksheets and handouts (Source: Eddins Counseling Group)
• Faith Harper: Worksheets and Printables | A small collection of therapy worksheets and handouts, including a gratitude journal (Source: Faith G. Harper, PhD, LPC-S, ACS, ACN)
• Free Social Work Tools and Resources | Worksheets, workbooks, assessments, and other resources for adults and children (Source: SocialWorkersToolbox.com)
• How Therapy Works: Free Downloads | A few free resources from Jeffery Smith, MD (Source: http://www.howtherapyworks.com )
• James Drew Psychotherapy: Forms | A small collection of worksheets/handouts on feelings, communication, values, goals, etc. (Source: James Drew, LPC)
• Jane Rekas: Downloads | A large collection of downloads (Source: Jane Rekas, MSW)
• Mark Purcell, PsyD: Professional Resources | Links to PowerPoint slides, DBT worksheets, assessments for suicide risk and compassion fatigue, and more
• Mark R. Young, LMSW, LCSW: Links & Forms | Links to factsheets, worksheets, assessments, etc. (Source: Mark R. Young, LMSW, LCSW)
• Mental Health America DIY Tools | A collection of free downloads from MHA
• Mental Health America Self-Help Tools | Links to assessments, worksheets, handouts, and more (Source: Mental Health America)
• Mental Health CE Course Articles | Course content handouts on a variety of mental health topics (Source: MentalHealthCE.com)
• Mind My Peelings: Worksheets & Infographics | A small collection of downloadable tools (Source: Mind My Peelings)
• My Group Guide: Therapy Resources | Source: My Group Guide
• Nancy L. Johnston: Downloads | A small collection of downloads on codependency, enabling, etc. (Source: Nancy L. Johnston, LPC, LSATP)
• Oxford Clinical Psychology: Forms and Worksheets | A large collection of therapy worksheets based on evidence-based practices (Source: Oxford Clinical Psychology)
• Patient Handouts | A large collection of handouts for mental health and addiction (Source: Redemption Psychiatry)
• Peggy L. Ferguson, Ph.D.: Addiction Recovery Worksheets | A modest collection of handouts/worksheets for addiction and recovery (Source: Peggy L. Ferguson, PhD)
• PsychPoint: Therapy Worksheets
• Self-Help Library | Multiple handouts on topics including communication, relationships, anxiety, ADHD, anger, depression, and more (Source: Present Centered Therapy)
• Self-Help Toolkits | Articles and handouts on worry, depression, assertiveness, etc. (Source: Dr. Danny Gagnon, PhD, Montreal Psychologist)
• Sleep and Depression Laboratory: Resources | A small collection of worksheets related to sleep, worry, and depression (Source: Dr. Colleen E. Carney, PhD, CPsych)
• Sober Eastbourne | A UK-based resource site with links to organizations that post free tools for mental health and recovery
• The Stages of Change | 7-page PDF packet (Source: Virginia Tech Continuing and Professional Education)
• St. Louis Counseling & Wellness Handouts | Downloadable tools on various topics including addiction, CBT, communication, stress, and positive psychology
• Talk, Trust and Feel Therapeutics | Articles/handouts on anger, abandonment, narcissism, and relationships (Source: Lynne Namka, EdD)
• Therapist Aid | Free therapy worksheets
• Therapy Worksheets | A resource blog with links to free therapy worksheets on various mental health topics (Source: Therapy Worksheets by Will Baum, LCSW)
• Tim’s Resource Notebook | A small collection of handouts on various topics such as relationships, emotions, and values (Source: Tim’s Resource Notebook)

Therapy Worksheets for Substance Use Disorders & Addiction

• 12-Step Worksheets | Source: 12step.org
• Addiction Recovery Worksheets | A modest collection of worksheets (Source: Bowen Center)
• ASI-MV Worksheets & Handouts | Addiction and recovery handouts (Source: IBH)
• Client Worksheets from Treatment for Stimulant Use Disorders (Treatment Improvement Protocols Services) | 44 therapy worksheets on addiction and recovery (Source: Treatment for Stimulant Use Disorders, SAMHSA/NIH)
• Integrity Counseling Handouts | A short list of client handouts on addiction (Source: Integrity Counseling, Inc.)
• InFocus Helpful Resources | Family handouts on addiction (Source: SHARC Australia)
• Motivational Interviewing Worksheets | Source: MINT
• Refuge Recovery | Download and print the truth inventory worksheets (Source: Refuge Recovery)
• Relapse Autopsy | 12-page PDF packet (Source: Willow Tree Counseling)
• Self-Help Exercises | Source: Gambling Therapy
• SMART Recovery Toolbox | Addiction and recovery resources (Source: SMART Recovery)
• Substance Abuse | 12-page PDF packet (Source: Carleton University, Criminal Justice Decision Making Laboratory & Ontario Ministry of Community Safety and Correctional Services)
• Taking the Escalator: Therapy Tools | Handouts on addiction and recovery (Source: Taking the Escalator)
• Worksheets | A small collection of addiction and recovery worksheets (Source: A Recovery Story)

Depression, Stress, & Anxiety

• Alphabet of Stress Management and Coping Skills | Coping skills for every letter of the alphabet (Source: Ramapo College of New Jersey)
• Anxiety Canada: Free Downloadable PDF Resources | Anxiety worksheets for parents and self-help (Source: Anxiety Canada)
• Behavioral Activation for Depression | 35-page packet (Source: Michigan Medicine)
• Counseling Library: Handouts on Depression | Source: Morning Light Counseling
• Creating Your Personal Stress Management Plan | 10-page packet (Source: Fostering Resilience)
• Downloads (Patient Resources) | Downloadable PDF resources for anxiety and depression (Source: Michigan Medicine)
• Dr. Chloe: Worksheets for Anxiety Management | A small collection of worksheets and handouts (Source: Dr. Chloe)
• Panic Attack Worksheets | 9-page PDF packet (Source: Inner Health Studio)
• Relaxation | 15-page packet on relaxation skills for anxiety (Source: Michigan Medicine)
• Stress Management | 5-page packet on stress management (Source: Inner Health Studio)
• Stress Management – Patient Handouts | A collection of handouts on stress management; some of the other sections, including “General Health and Wellness” and “Nutrition” have links to handouts as well (Source: UMASS Medical School Department of Psychiatry)
• Treatment for Mood Disorders Worksheet Packet | 7-page PDF packet (Source: Michael DiPaolo, PhD)

Trauma & Related Disorders

• Center for Sexual Assault & Traumatic Stress: Therapist Resources | Client handouts, assessments, info sheets, toolkits, training resources, links, etc. (UW Medicine Harborview Medical Center)
• Child and Family Studies: Sex in the Family | 8-page packet on shame and guilt in relation to child sexual abuse (Source: Carol Morgaine, PhD)
• Counseling Library: Handouts on Abuse/Trauma | Source: Morning Light Counseling
• Crisis and Trauma Resource Center (CTRC) Printable Handouts | Several handouts and worksheets to download for free (Source: CTRC)
• Detaching From Emotional Pain (Grounding) | 12-page PDF packet (Source: Sunspire Health)
• Disaster Mental Health Handouts | Source: David Baldwin’s Trauma Information Pages
• Grounding Exercises | 2-page PDF handout (Source: Truman State University)
• Grounding Techniques | 1-page PDF handout (Source: JMU Counseling Center)
• Healing Private Wounds Booklets | Religious handouts on healing from sexual abuse (Source: Healing Private Wounds)
• MN Trauma Project: Downloadable Resources to Use in Therapy | A short list of links to trauma worksheets
• Prince Edward Island Rape and Sexual Assault Centre Resources | PDF handouts (Source: PEIRSAC)
• Selected Handouts and Worksheets from Treatment of Postraumatic Stress Disorder in Special Populations: A Cognitive Restructuring Program | 13-page PDF packet (Source: Mueser, K. T., Rosenberg, S. D., & Rosenberg, H. J., 2009)
• Trauma Research and Treatment: Trauma Toolkit | A small collection of trauma handouts (Source: Trauma Research and Treatment)
• Wisconsin Hawthorn Project: Handouts & Worksheets | Handouts in English and Spanish (Source: Wisconsin Hawthorn Project)
• CBT for Psychosis & Trauma Handouts | Source: Recovery from Schizophrenia and other Psychotic Disorders
• Early Psychosis Intervention: Downloads | Source: EPI
• Goal-Setting Worksheet for Patients with Schizophrenia | 3-page PDF (Source: Med-IQ)
• List of 60 Coping Strategies for Hallucinations | 2-page PDF (Source: South Bay Project Resource)
• Treatment for Schizophrenia Worksheet Pack | 6-page PDF packet (Source: Dr. Michael DiPaolo, PhD)

Grief & Loss

• Activities for Grieving Children | 7-page PDF packet (Source: Youth Light)
• Bereavement Handouts | A small collection of handouts (Source: Hospice & Palliative Care)
• The Center for Complicated Grief: Handouts | Assessments, handouts, and guides (Source: The Center for Complicated Grief)
• A Child’s Understanding of Death | 11-page packet (Source: Pikes Peak Hospice)
• Grief Recovery Pyramid | 7-page PDF packet (Source: Arlene Taylor, PhD)
• Loss, Grief, Bereavement Supplemental Teaching Materials/Training Session Activities Contents | 35-page PDF packet (Source: Hospice Education Network)
• MyGriefAssist: Grief Factsheets | Source: MyGriefAssist
• OneLegacy: Handouts to Download and Print | Handouts on grief and loss (Source: OneLegacy)
• Printable Grief and Loss Resources | A fairly extensive collection of printable handouts on grief and loss (Source: Hamilton’s Funeral & After Life Services)
• Worksheets to Help Those Coping with Grief | A collection of handouts/worksheets for download (Source: Peacefully)
• Anger: Causes and Coping Strategies | 14-page PDF packet (Source: Indian Railway Psycho-Technical Directorate)
• Anger Management | 13-page PDF packet (Source: Carleton University, Criminal Justice Decision Making Laboratory & Ontario Ministry of Community Safety and Correctional Services)
• Anger Management Techniques | 4-page PDF (Source: Hellenic College Holy Cross)
• Anger Management Tools | A short list of downloadable resources (Source: Tim’s Resource Notebook)
• Anger Management Worksheets | A few free therapy worksheets/handouts for anger (Source: Anger Management Resource)
• Dealing with Anger | 7-page PDF packet (Source: Inner Health Studio)
• Free Anger Management Worksheets: Letting Go of Anger | A small collection of worksheets for anger management (Source: Gentle Stress Relief)
• Getting to Know Your Anger | 42-page PDF packet (Source: Wellness Reproductions)
• LoveToKnow: Free Anger Worksheets | 7 downloadable anger management worksheets (Source: LoveToKnow)
• Steps for Change: Anger Management Worksheets | Source: Steps for Change

Self-Esteem

• Free Self-Esteem Worksheets | Source: Self-Esteem 2 Go
• Growing Self-Esteem: Self-Esteem Worksheets | Source: Growing-Self-Esteem.com
• My 101 Accomplishments | 6-page PDF booklet (Source: Rec Therapy Today)
• Self-Esteem Activities | A modest collection of handouts/activities for self-esteem (Source: Doorways to Self-Esteem)
• Self-Esteem Experts: Self-Esteem Activities | Printable handouts on self-esteem (Source: Self-Esteem Experts)
• Spiritual Self-Schema Development Worksheets: Yale School of Medicine
• Strategies to Build Healthy Self-Esteem | 7-page PDF packet (Source: McGill)

Values & Goal-Setting

• 10 Free Printable Goal-Setting Worksheets | Source: Parade
• Core Values and Essential Intentions Worksheet | 2-page PDF worksheet (Source: Life Balance Institute)
• Core Values Clarification Exercise | 4-page PDF worksheet (Source: University of Wisconsin-Madison Division of Extension)
• Core Values Worksheet | 4-page PDF (Source: Mike Desjardins)
• Life Values Inventory | 5-page PDF (Source: Brown, Duane & R. Kelly Crace, 1996, Life Values Resources, [email protected])
• Personal Values Card Sort | 9-page PDF (Source: Miller, C’de Baca, Matthews, Wilbourne, 2001, University of New Mexico)
• Values | 2-page PDF worksheet (Source: Miller, C’de Baca, Matthews, 1994, Values Card Sort, University of New Mexico)
• Values and Goals Worksheet | 1-page PDF worksheet (Source: James Drew, LPC)
• Values Assessment Worksheet | 2-page PDF worksheet (Source: Carleton University)
• Values Exercise | 2-page PDF worksheet (Source: TapRooT)
• Values Identification Worksheet | 6-page PDF worksheet (Source: Synergy Institute Online)
• What Are My Values? | 4-page PDF worksheet (Source: stephaniefrank.com)

Wellness & Resiliency

• Assessing Your Life Balance | 3-page PDF (Source: UCI)
• The Blissful Mind: Wellness Wheel | A 5-page PDF packet
• Counseling Library: Handouts on Emotional Wellness | Source: Morning Light Counseling
• Dearborn County CASA: 8 Dimensions of Wellness | 4 wellness downloads
• Essential Life Skills: Self-Help Worksheets | A collection of free downloadable tools and therapy worksheets on topics related to wellness, balance, and resilience
• Experiential Group Exercises for Shame-Resilience | 4-page PDF packet with questions for discussion and group activities (Source: Haymarket Center)
• Free Printable Self-Improvement Worksheets | Source: Holistic Life by Kate
• Free Tools | Handouts, worksheets, and workbooks including mindful coloring sheets (Source: The Wellness Society)
• Handouts and Worksheets | 21-page PDF packet with handouts and worksheets on self-care topics (Source: Psychological First Aid for Schools Field Operations Guide)
• Hoffman Institute Tools | Downloadable tools for change (Source: Hoffman Institute)
• Homework and Handouts for Clients | Handouts and worksheets related to self-compassion (Source: ACT With Compassion)
• Managing Emotional Intelligence | 7-page PDF packet (Source: Moxie Consulting, Inc.)
• Personal Development | Handouts on resilience, communication, etc. (Source: Workplace Strategies for Mental Health)
• Relaxing Mindfulness Activities for Teens | Change to Chill | Printable worksheets, coloring sheets, and DIY activities (Source: Change to Chill) 🆕
• Self-Care and Wellness Resources | Printable handouts and tools (Source: irenegreene.com)
• Self-Care Starter Kit | Handouts on self-care topics (Source: UB School of Social Work)
• University of Utah Health: Wellness Educational Materials | Downloadable handouts on health topics
• U.S. Department of Veterans: The Healing Power of Hope and Optimism | A 5-page PDF
• UW Integrative Health: Clinician and Patient Education | Downloadable tools on health and wellness topics
• Wellness Toolkits | Printable toolkits (Source: NIH)
• Realize Your Meaning & Purpose
• Engage with Others
• Identify Possibilities
• Identify Strengths & Values
• Emotional Management
• Create a Resilient Mindset
• Expand Your Perspective

ACT, CBT, & DBT Therapy Worksheets

• ACT Mindfully: Worksheets, Book Chapters & ACT Made Simple | ACT worksheets and other free resources (Source: ACT Mindfully)
• Carolina Integrative Psychotherapy: Forms and Worksheets for Clients and Group Participants | A small collection of DBT therapy worksheets and handouts (Source: Carolina Integrative Psychotherapy)
• Carol Lozier, LCSW: Dialectical Behavior Therapy Printables: Worksheets and Handouts | A small collection of DBT handouts and worksheets (Source: Carol Lozier, LCSW)
• Cognitive Therapy Skills | 33-page packet (Source: Michigan Medicine)
• Counseling Library: Handouts on CBT Skills and Strategies | Source: Morning Light Counseling
• Clinician Worksheets and Handouts: Clinician Treatment Tools | A variety of CBT, DBT, etc. therapy worksheets (Source: Coping.us)
• DBT Peer Connections: DBT Handouts and Worksheets | DBT resources (Source: DBT Peer Connections)
• DBT Self-Help | Printable lessons and diary cards (Source: DBT Self-Help)
• DBT Work Sheets Index | Source: Dialectical Behavioral Skills Training
• Dr. Grant Blashki: CBT Worksheets | A small collection of downloadable therapy worksheets (Source: Dr. Grant Blashki)
• Dr. John Forsyth: Free Resources | Two free packets of worksheets (ACT and mindfulness) (Source: Dr. John Forsyth)
• Dr. Jonathan S. Abramowitz: Free Stuff for Consumers and Professionals
• Intro to DBT (Handouts & Worksheets) | 8-page PDF (Source: Peer-Guided DBT Lessons)
• Living CBT: Free Self-Help | 20+ CBT worksheets (Source: Living CBT)
• Online CBT Resources | Worksheets and questionnaires from Andrew Grimmer, a counselling psychologist and accredited cognitive behavioural psychotherapist in the UK (Source: Online CBT Resources)
• Printable Versions of CPT/CBT Worksheets | English and Spanish worksheets (Source: F.A.S.T. Lab at Stanford Medicine)
• Veronica Walsh’s CBT Blog: Free Downloadable Cognitive Behavioural Therapy Worksheets/Handouts | Print/use these therapy worksheets only with blog author’s permission (Source: Veronica Walsh’s CBT Blog Dublin, Ireland)

Therapy Worksheets for Children & Youth

• A Collection of Anger Management/Impulse Control Activities & Lesson Plans (PreK-3rd Grade) | 64-page PDF packet (Source: Childcare Consultation Staff)
• Activities for Grieving Children | 7-page PDF (Source: Youth Light)
• Cope-Cake: Coping Skills Worksheets and Game | 30-page packet for young children/students (Source: Closet Counselor)
• Crossroads Counseling Center: Resources | Handouts on depression, anxiety, ADHD, etc. in children (Source: Crossroads Counseling Center)
• Curriculum Materials from Pennsylvania Child Welfare Resource Center | Links to handouts (Source: University of Pittsburgh, School of Social Work)
• Emotional Intelligence Activities for Children Ages 5-7 | 34-page PDF packet (Source: Ohio National Guard Family Readiness and Warrior Support Program Youth Programs)
• Emotional Intelligence Activities for Children Ages 8-10 | 33-page PDF packet (Source: Ohio National Guard Family Readiness and Warrior Support Program Youth Programs)
• Mylemarks: Free Downloads | Therapy worksheets for children (Source: Mylemarks)
• Oklahoma TF-CBT Therapy Resources | Printable trauma-focused handouts and assessments for therapists to use with children and adolescents (Source: Oklahoma TF-CBT Therapy Resources)
• Prevention Dimensions: Lesson Plans | Downloadable PDF handouts for children from kindergarten to sixth grade (Source: Utah Education Network)
• Printable Worksheets | Worksheets for children on physical activity, substance abuse, nutrition, and more (Source: BJC School Outreach and Youth Development)
• Social Emotional Activities Workbook | 74-page PDF packet (Source: Los Angeles Unified School District)
• Social Skills Worksheets | A packet of therapy worksheets to use with children/youth (Source: Julie MacRae & Sara Noble, Minneapolis Public Schools)
• Stress Reduction Activities for Students | 20-page PDF packet (Source: Student, Family, and Community Support Department)
• Thriving at Home: Telehealth Play Therapy Activities for Licensed Therapists | 15-page PDF packet with activities for therapists to use with children and families (Source: MindPeace Cincinnati)

Therapy Worksheets for Adolescents & Young Adults

• 101 Wellness Tips for College Students | A 7-page PDF (Source: Stetson)
• Brescia University College: Resource Toolbox | Downloadable tools for students
• Emotional Intelligence Activities for Pre-Teens Ages 11-12 | 33-page PDF packet (Source: Ohio National Guard Family Readiness and Warrior Support Program Youth Programs)
• Emotional Intelligence Activities for Teens Ages 13-18 | 34-page PDF packet (Source: Ohio National Guard Family Readiness and Warrior Support Program Youth Programs)
• Eppler-Wolff Counseling Center Handouts | Handouts for college students (Source: Union College)
• Just for Teens: A Personal Plan for Managing Stress | 7-page PDF handout (Source: American Academy of Pediatrics from Reaching Teens: Strength-Based Communication Strategies to Build Resilience and Support Healthy Adolescent Development )
• Oregon State University: Learning Corner | Student worksheets on time management, wellness, organization skills, etc. (Source: Oregon State University Academic Success Center)
• The Relaxation Room | Self-care and stress management handouts for college students (Source: Andrews University)
• Resilience Toolkit | PDF handouts for college students on resiliency (Source: Winona State University)
• Self-Help Resources | Links to articles for college students on a variety of topics (not in PDF form) (Source: Metropolitan Community College Counseling Services)
• Step UP! Resource Library | Worksheets/handouts for students on prosocial behavior and bystander intervention (Source: Step UP!)
• Teens Finding Hope: Worksheets and Information to Download | Spanish and English PDFs available (Source: Teens Finding Hope)
• Tip Sheets | Student tip sheets on anger, body image, relationships, and other topics (Source: Meredith College Counseling Center)
• Tools & Checklists | Therapy worksheets and handouts for students (Source: Campus Mind Works, University of Michigan)
• UC Berkeley University Health Services Resources | Links to handouts, articles, and self-help tools for students (Source: UC Berkeley)
• UMatter | Tools for college students on wellness, communication, healthy relationships, and more (Source: Princeton University)
• Western Carolina University Counseling and Psychological Services: Self-Help | A modest collection of student wellness handouts along with a printable self-help workbook (Source: WCU)
• Your Life Your Voice: Tips and Tools | Links to articles and PDF printables on a variety of topics for teens and young adults (Source: Your Life Your Voice from Boys Town)

Therapy Worksheets for Marriage/Relationships & Family

• 12 Types of Intimacy | Source: Tim’s Resource Notebook
• 21 Couples Therapy Worksheets, Techniques, & Activities | Source: Positive Psychology
• Articles for Parenting | Links to various articles/handouts (not in PDF form) (Source: MomMD)
• Counseling Library: Handouts on Gender Differences | Source: Morning Light Counseling
• Dialogue Question Ideas | Source: Tim’s Resource Notebook
• Emotionally Focused Therapy: Forms for Couples | A list of forms to use in EFT couples counseling (Source: Training and Research Institute for Emotionally Focused Therapy Alliant)
• Exercises for Forgiveness | 7-page PDF for recovering from an emotional affair (Source: Emotional Affair Journey)
• Focus on Feelings | Source: Tim’s Resource Notebook
• Healthy Boundaries | 3-page PDF handout (Source: Larry L. Winckles)
• Healthy Boundaries Program | 15-page PDF packet (Source: The University of Toledo Police Department)
• Healthy Boundaries vs. Unhealthy Boundaries | 6-page PDF handout (Source: kimsaeed.com)
• Homework Page: Tools for Growth and Communication | Therapy worksheets, handouts, and assessments for couples and families (Source: Present Centered Therapy)
• How We Love: Freebies | A small collection of free downloads (Source: How We Love)
• Imago Work-Up Exercise | 2-page PDF (Source: The Mindful Ecotherapy Center)
• Joy2MeU | A collection of articles by Robert Burney on relationships, codependency, and related topics (not in PDF form) (Source: Joy2MeU.com)
• Learning to Forgive: The 5 Steps to Forgiveness | 6-page PDF handout (Source: Thriveworks)
• My Marriage/Relationship: Where Am I Now? | Source: Tim’s Resource Notebook
• New Beginnings Family Counseling: Handouts | Handouts on communication, attachment styles, emotions, etc. (Source: New Beginnings Family Counseling)
• Parenting Worksheets | 14-page PDF packet for parents (Source: Sheffield Safeguarding Children Board) 🆕
• Pasadena Marriage Counseling: Free Marriage Counseling Resources | A small collection of worksheets for couples therapy (Source: Pasadena Marriage Counseling)
• Radical Forgiveness: Free Tools | A small collection of therapy worksheets on forgiveness (Source: Radical Forgiveness)
• Relationship Communication | Source: Tim’s Resource Notebook
• Relationship Worksheet | Source: Tim’s Resource Notebook
• Resources & Information | A collection of articles, handouts, and assessments for marriage and relationships (Source: The Relationship Institute)
• Signs of Unhealthy Boundaries | 6-page PDF handout (Source: Healing Private Wounds)
• Thriving Couples Hierarchy | Source: Tim’s Resource Notebook
• Worksheets for Couples | Faith-based therapy worksheets/handouts (Source: Hope Couples)

Additional Therapy Worksheets & Handouts

• 8 Helpful “Letting Go of Resentment” Worksheets | Links to PDF therapy worksheets (Source: Invisible Lioness)
• Acorns to Oaktrees: Eating Disorder Worksheets/Eating Disorder Forms | A small collection of handouts for eating disorders (Source: Acorns to Oaktrees)
• Activity eBooks | A collection of downloadable workbooks on self-esteem, social skills, emotions, etc. (Source: Rec Therapy Today)
• ADHD ReWired: Therapy Worksheets | Thought records, behavior charts, and other tools (Source: ADHD ReWired)
• Alzheimer’s Association: Downloadable Resources | Handouts on Alzheimer’s (Source: Alzheimer’s Association)
• Attitudes and Behaviour | 9-page PDF packet on criminal thinking (Source: Carleton University, Criminal Justice Decision Making Laboratory & Ontario Ministry of Community Safety and Correctional Services)
• Commonly Prescribed Psychotropic Medications | 4-page PDF (Source: NAMI Minnesota)
• Conflict Resolution Skills | 6-page PDF packet (Source: Edmonds College)
• Coping Skills | 2-page PDF worksheet (Source: Temple University)
• Counseling Library: Handouts on Personality Differences | Source: Morning Light Counseling
• EDA Step Worksheets | 37-page packet (Source: Eating Disorders Anonymous)
• Free Mindfulness Worksheets | A large collection of mindfulness handouts (Source: Mindfulness Exercises)
• Free, Printable Coloring Pages for Adults | Source: The Spruce Crafts
• GoYourOwnWay Document Downloads | Downloads for veterans on various topics (Source: GoYourOwnWay)
• Guilt vs. Shame Infographic: National Institute for the Clinical Application of Behavioral Medicine | Printable infographic to illustrate the differences (Source: NICABM)
• Integrated Health and Mental Health Care Tools | Downloadable resources from UIC Center (Source: University of Illinois at Chicago)
• International OCD Foundation: Assessments & Worksheets | Handouts for use with individuals with OCD (Source: IOCDF)
• Managing Your OCD at Home | 7-page PDF packet (Source: Anxiety Canada)
• Motivation To Change | 16-page PDF packet on motivation to change criminal behavior (Source: Carleton University, Criminal Justice Decision Making Laboratory & Ontario Ministry of Community Safety and Correctional Services)
• Multicultural Psychology: Downloadable Worksheets & Documents
• Obsessive Compulsive Disorder: Identification and Self-Help Strategies | 10-page PDF packet (Source: University of Alberta)
• Peers & Relationships | 12-page PDF packet on how associates impact criminal behavior (Source: Carleton University, Criminal Justice Decision Making Laboratory & Ontario Ministry of Community Safety and Correctional Services)
• Prochaska and DiClemente’s Stages of Change Model | 4-page PDF handout (Source: Step UP!)
• Quick Reference to Psychotropic Medication | Downloadable PDF chart (Source: John Preston, PsyD)
• Reducing Self-Harm | 5-page PDF (Source: Students Against Depression)
• Self-Directed Recovery | Downloadable resources (Source: UIC Center)
• Shame Psychoeducation Handout | 5-page PDF handout (Source: Association for Contextual Behavioral Science)
• Stages of Change: Primary Tasks | 2-page PDF handout (Source: UCLA Integrated Substance Abuse Programs)
• Telehealth Therapy Resources | A collection of therapy worksheets and resources (Telehealth Therapy Resources)
• Understanding and Coping with Guilt and Shame | 4-page PDF handout (Source: Taking the Escalator)

Please contact me if a link isn’t working or if you’d like to recommend a site with free therapy worksheets!

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16 thoughts on “200+ Sites with Free Therapy Worksheets & Handouts”

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Any Richard Swartz Internal Family Systems or EMDR material?

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This is a wonderful collection of materials

Patricia Swick Ottawa Ontario

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this is woderful , this kind of writing and site will change the lives of millions of people thanks a lot from Program your Mind for ultimate Success

Thank you for providing these free resources to the public.

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PAID $29.95 (?) for “Adult Coloring Pages” after completing all of the free pages a few months ago. I’ve been getting one new page every day, paid for 1 yr. Subscription. Haven’t received a new page in at least 3 days. I have NO IDEA how to Contact them about this oversight and want service to be restored, or Refund my Payment. (Also, I’d like to let them know that some of the pages are Repeat Images from their free pages.) They are a variety of Categories: Mandelas, Plants, Animals, major Holidays, Food, People, Graphic Design Patterns, etc. — A good mix of Subject matters. 4 identical inline images each available to be Colored. These are just Coloring Pages, no Doctor or Psychological affiliations to these images.) How can I contact them to Continue my Subscription or Refund my Payment?? PLEASE HELP ME FIND THE SOURCE CO. Thank You SO Very Much!!

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The Truth About Homework Stress: What Parents & Students Need to Know

• Fact Checked

Written by:

published on:

• December 21, 2023

Updated on:

• January 9, 2024

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Homework is generally given out to ensure that students take time to review and remember the days lessons. It can help improve on a student’s general performance and enhance traits like self-discipline and independent problem solving.

Parents are able to see what their children are doing in school, while also helping teachers determine how well the lesson material is being learned. Homework is quite beneficial when used the right way and can improve student  performance.

This well intentioned practice can turn sour if it’s not handled the right way. Studies show that if a student is inundated with too much homework, not only do they get lower scores, but they are more likely to get stressed.

The age at which homework stress is affecting students is getting lower, some even as low as kindergarten. Makes you wonder what could a five year old possibly need to review as homework?

One of the speculated reasons for this stress is that the complexity of what a student is expected to learn is increasing, while the breaks for working out excess energy are reduced. Students are getting significantly more homework than recommended by the education leaders, some even nearly three times more.

To make matters worse, teachers may give homework that is both time consuming and will keep students busy while being totally non-productive.

Remedial work like telling students to copy notes word for word from their text books will  do nothing to improve their grades or help them progress. It just adds unnecessary stress.

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Effects of homework stress at home

Both parents and students tend to get stressed out at the beginning of a new school year due to the impending arrival of homework.

Nightly battles centered on finishing assignments are a household routine in houses with students.

Research has found that too much homework can negatively affect children. In creating a lack of balance between play time and time spent doing homework, a child can get headaches, sleep deprivation or even ulcers.

And homework stress doesn’t just impact grade schoolers. College students are also affected, and the stress is affecting their academic performance.

Even the parent’s confidence in their abilities to help their children with homework suffers due increasing stress levels in the household.

Fights and conflict over homework are more likely in families where parents do not have at least a college degree. When the child needs assistance, they have to turn to their older siblings who might already be bombarded with their own homework.

Parents who have a college degree feel more confident in approaching the school and discussing the appropriate amount of school work.

“It seems that homework being assigned discriminates against parents who don’t have college degree, parents who have English as their second language and against parents who are poor.” Said Stephanie Donaldson Pressman, the contributing editor of the study and clinical director of the New England Center for Pediatric Psychology.

With all the stress associated with homework, it’s not surprising that some parents have opted not to let their children do homework. Parents that have instituted a no-homework policy have stated that it has taken a lot of the stress out of their evenings.

The recommended amount homework

The standard endorsed by the National Education Association is called the “10 minute rule”; 10 minutes per grade level per night. This recommendation was made after a number of studies were done on the effects of too much homework on families.

The 10 minute rule basically means 10 minutes of homework in the first grade, 20 minute for the second grade all the way up to 120 minutes for senior year in high school. Note that no homework is endorsed in classes under the first grade.

Parents reported first graders were spending around half an hour on homework each night, and kindergarteners spent 25 minutes a night on assignments according to a study carried out by Brown University.

Making a five year old sit still for half an hour is very difficult as they are at the age where they just want to move around and play.

A child who is exposed to 4-5 hours of homework after school is less likely to find the time to go out and play with their friends, which leads to accumulation of stress energy in the body.

Their social life also suffers because between the time spent at school and doing homework, a child will hardly have the time to pursue hobbies. They may also develop a negative attitude towards learning.

The research highlighted that 56% of students consider homework a primary source of stress.

And if you’re curious how the U.S stacks up against other countries in regards to how much time children spend on homework, it’s pretty high on the list .

Signs to look out for on a student that has homework stress

Since not every student is affected by homework stress in the same way, it’s important to be aware of some of the signs your child might be mentally drained from too much homework.

Here are some common signs of homework stress:

• Sleep disturbances
• Frequent stomachaches and headaches
• Decreased appetite or changed eating habits
• New or recurring fears
• Not able to relax
• Regressing to behavior they had when younger
• Bursts of anger crying or whining
• Becoming withdrawn while others may become clingy
• Drastic changes in academic performance
• Having trouble concentrating or completing homework
• Constantly complains about their ability to do homework

If you’re a parent and notice any of these signs in your child, step in to find out what’s going on and if homework is the source of their stress.

If you’re a student, pay attention if you start experiencing any of these symptoms as a result of your homework load. Don’t be afraid to ask your teacher or parents for help if the stress of homework becomes too much for you.

What parents do wrong when it comes to homework stress

Most parents push their children to do more and be more, without considering the damage being done by this kind of pressure.

Some think that homework brought home is always something the children can deal with on their own. If the child cannot handle their homework then these parents get angry and make the child feel stupid.

This may lead to more arguing and increased dislike of homework in the household. Ultimately the child develops an even worse attitude towards homework.

Another common mistake parents make is never questioning the amount of homework their children get, or how much time they spend on it. It’s easy to just assume whatever the teacher assigned is adequate, but as we mentioned earlier, that’s not always the case.

Be proactive and involved with your child’s homework. If you notice they’re spending hours every night on homework, ask them about it. Just because they don’t complain doesn’t mean there isn’t a problem.

How can parents help?

• While every parent wants their child to become successful and achieve the very best, it’s important to pull back on the mounting pressure and remember that they’re still just kids. They need time out to release their stress and connect with other children.
• Many children may be afraid to admit that they’re overwhelmed by homework because they might be misconstrued as failures. The best thing a parent can do is make home a safe place for children to express themselves freely. You can do this by lending a listening ear and not judging your kids.
• Parents can also take the initiative to let the school know that they’re unhappy with the amount of homework being given. Even if you don’t feel comfortable complaining, you can approach the school through the parent-teacher association available and request your representative to plead your case.
• It may not be all the subjects that are causing your child to get stressed. Parents should find out if there is a specific subject of homework that is causing stress. You could also consult with other parents to see what they can do to fix the situation. It may be the amount or the content that causes stress, so the first step is identifying the problem.
• Work with your child to create a schedule for getting homework done on time. You can set a specific period of time for homework, and schedule time for other activities too. Strike a balance between work and play.
• Understanding that your child is stressed about homework doesn’t mean you have to allow them not to try. Let them sit down and work on it as much as they’re able to, and recruit help from the older siblings or a neighbor if possible.
• Check out these resources to help your child with their homework .

The main idea here is to not abolish homework completely, but to review the amount and quality of homework being given out. Stress, depression and lower grades are the last things parents want for their children.

The schools and parents need to work together to find a solution to this obvious problem.

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Starting Therapy Off Right

Therapy can be transformational. but the therapist you choose matters..

Posted May 30, 2024 | Reviewed by Gary Drevitch

• What Is Therapy?
• Find a therapist near me
• The therapist you choose can have a profound impact on how quickly you begin to feel better.
• Your therapist should be warm, empathetic, honest, and transparent with you.
• Therapists who offer evidence-based therapy are practicing treatments backed by research.

You’ve decided to go to therapy . Maybe you decided on your own to go, or maybe a healthcare professional recommended it. Maybe you’ve been in therapy before, or maybe it’s your first time. No matter your reasons, finding the right therapist is critical. The good news is that thanks to a large increase in therapists offering telehealth or web-based services, you probably have a much larger pool of therapists to choose from than you did five years ago. The bad news is that it can be difficult to know exactly what to look for in a mental health professional, understand their backgrounds and credentials, and find someone who will help you feel better and stay better, and achieve your goals as quickly as possible.

As you begin your search, you will want to have a basic understanding of the concept of “evidence-based therapy.” Evidence-based means that the treatment has been scientifically tested and found to be effective at improving mental health conditions. There are several types of therapy that are evidence-based. The most popular and most widely practiced is Cognitive Behavior Therapy, or CBT. There are variations and offshoots of CBT that are also evidence-based and have been adapted for specific problems and situations, like Mindfulness -Based Cognitive Therapy; CBT for Insomnia ; and Trauma -Focused CBT. Dialectical Behavior Therapy was originally developed to help chronically suicidal individuals but is also effective for the treatment of personality disorders and other issues. If you seek a therapist who practices evidence-based therapy, you will know that you are receiving a type of therapy that has been demonstrated by research to be beneficial.

Next, you will want to be sure that your therapist has adequate credentials and training. Anyone, literally anyone, can call themselves a therapist, a psychotherapist, or, for example, a cognitive behavior therapist, because these are not labels regulated by states. Therapists who are licensed by their state have different levels of education and specialty areas. Psychiatrists and psychiatric nurse practitioners can prescribe medication , and some also provide talk therapy. Clinical psychologists and master’s level counselors like clinical social workers, licensed professional counselors, and licensed marriage and family therapists can’t, in most states, prescribe medication but do provide talk therapy. No matter what credentials your therapist has, they should maintain a professional license to practice with their state licensing board.

You’ll also want to ask whether a mental health professional has expertise in the specific areas you’d like to address, and whether they have experience and training in adapting therapy to individuals with similar backgrounds and characteristics to yours. Some therapists specialize in working with older adults, religious minorities, the LGBTQ+ population, or with issues like grief , stress , insomnia, relationship problems, and others. Your therapist’s experience and expertise should be a good match with your goals for treatment and how you identify.

Just as important as the therapist’s credentials are their personal characteristics. Your therapist should demonstrate excellent basic counseling skills: They should be warm, approachable, a good listener, and they should convey realistic hope that they can help you. They should be straightforward and transparent about their credentials, experience, and training. They should also explain your diagnosis to you, work with you to create a treatment plan, and describe the process of treatment. They should answer your questions and welcome feedback, both positive and negative.

Finally, the process of treatment and your specific treatment plan should make sense to you and work within any limitations you may have relating to investment of time and cost. Does your therapist have a plan not only to address the problems and symptoms that may have prompted you to seek therapy, but also to help you achieve your goals and work toward your aspirations? Did the therapist take your strengths, resources, and values into account when creating the plan? Can the therapist give you a rough idea of how long you can expect to be in treatment? Therapy should not last indefinitely; your therapist should measure progress at each session and teach you interventions and skills that you can do on your own outside of therapy. Once you have achieved sustained measurable improvement with your symptoms, and made significant progress toward your goals, you and the therapist should collaboratively decide whether to start tapering sessions, and ultimately, to end treatment.

If you do decide to seek treatment, give yourself credit: I think it’s an act of courage for individuals to recognize that they need help and then to go to a mental health professional they don’t know. If you are seeking mental health treatment, you may have been struggling for quite a long time. In the U.S., the average person with a mental health disorder lives with it for over 10 years without receiving treatment. Some people face practical barriers, others fear judgment from friends and family, and still others have negative associations with therapy. They may picture themselves lying on a couch discussing painful events from their childhood with a detached stranger, as therapy is often portrayed on TV. (Luckily, therapy doesn’t have to look anything like that.) Be sure to acknowledge that what you are doing takes bravery.

To find a therapist, visit the Psychology Today Therapy Directory .

Judith S. Beck, Ph.D., is President of the nonprofit Beck Institute for Cognitive Behavior Therapy and Clinical Professor of Psychology in Psychiatry at the University of Pennsylvania.

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At any moment, someone’s aggravating behavior or our own bad luck can set us off on an emotional spiral that threatens to derail our entire day. Here’s how we can face our triggers with less reactivity so that we can get on with our lives.

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June 5, 2024

MDMA Therapy Is Rejected by FDA Panel

Scientific advisers vote overwhelmingly that the risks of MDMA treatment for post-traumatic stress disorder outweigh the benefits

By Sara Reardon & Nature magazine

MDMA has been tested as a treatment for post-traumatic stress disorder but has now garnered a vote of no confidence from FDA advisors.

Universal History Archive/Universal Images Group via Getty Images

In a decision that shocked some observers, key advisers to the US Food and Drug Administration (FDA) voted that the effectiveness of the party drug MDMA for treating post-traumatic stress disorder is unproven.

Members of an independent scientific advisory committee voted 9 to 2 that human trials of MDMA did not prove its efficacy. They also voted 10 to 1 that the risks of MDMA, also known as ecstasy, outweigh its benefits. The FDA does not have to follow its advisory committee’s recommendations when deciding whether to approve a drug, but often does.

The vote highlighted the difficulty of assessing psychedelic drugs and the FDA’s limited ability to evaluate psychiatric treatments. “It felt strange to vote no,” says committee member and statistician Satish Iyengar at the University of Pittsburgh in Pennsylvania, given that the drug’s effects seemed so strong . “There were just too many problems with it.”

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The meeting was held 4 June in Silver Spring, Maryland.

Long campaign

MDMA is a synthetic compound that can evoke euphoria and raise energy levels. It has already been approved for limited use in Australia to treat post-traumatic stress disorder (PTSD) and depression.

For decades, the nonprofit group Multidisciplinary Association for Psychedelic Studies (MAPS) in San Jose, California, has been running MDMA clinical trials and campaigning for drug legalization worldwide. The association’s commercial arm, Lykos Therapeutics in San Jose, has developed an MDMA treatment protocol involving a series of psychotherapy sessions, along with three sessions in which a team of two therapists administers MDMA. The idea, the company has said, is that MDMA is not a treatment in itself, but rather helps people open up to their therapists about traumatic events that might otherwise be difficult to confront.

In its application to the FDA, Lykos cited two clinical trials in which a total of around 200 people with PTSD received either MDMA or a placebo. More than 80% of those who received MDMA saw significant improvements in their symptoms. And the effect seemed to persist when investigators followed up with a portion of these participants between 6 and 24 months later.

Lingering concerns

But FDA scientists themselves had a number of concerns about Lykos’s studies, which they felt were lacking crucial psychological and physiological safety data. A major concern was the fact that participants — and their therapists — could almost always tell whether they had received MDMA or a placebo . An FDA report released ahead of the meeting called the data “challenging to interpret.”

“The fact is you just can’t blind these studies,” FDA psychiatry division director Tiffany Farchione said at the meeting. In 2016, MAPS and the FDA agreed on a protocol in which an independent assessor who had not taken part in the trial would evaluate each person’s psychiatric progress. But both FDA staff and the advisory committee remained worried that people’s expectations of receiving a drug would affect their response to it.

Other concerns included the fact that around 40% of the trial participants had taken illicit MDMA before the trial, potentially biasing the sample. And many sought other treatments — including psychedelic drugs — between the initial trial and the follow-up, suggesting that their symptoms might have continued and that their improvement might not have been due entirely to MDMA.

Many of the advisory committee members’ questions centered on the role of psychotherapy. Lykos has developed a therapy protocol that would be administered along with the drug. But the FDA does not regulate therapy. The most it can do is ensure that medical practitioners overseeing the drug’s administration provide some therapy.

Therapeutic wild card

Lykos’s protocol gives therapists substantial discretion in how they treat their clients, which left some committee members concerned that trial participants might have received different therapy experiences depending on whether they received a drug or placebo. They pointed out that a good therapist could make a useless drug seem effective, and there is no way to disentangle the two effects. Panel members also worried about how therapists would be trained, and called for strong regulations to protect people from abuse by clinicians when under the influence of the drug.

Farchione says she hoped the advisory committee would help the agency to address these issues, particularly given that many other companies are studying psychedelic therapies that the FDA will eventually need to evaluate. “I think we are charting new territory, and we want to set it up right,” she says.

Further raising concerns, a report from the Institute for Clinical and Economic Review, a nonprofit group in Boston, Massachusetts, that analyses medical procedures, reported allegations that people who’d had bad experiences in the initial trials had been discouraged from participating in the follow up study. Lykos denied this at the committee meeting, and the FDA is conducting an investigation that will conclude before it makes a decision on the drug.

“I was absolutely shocked” by the committee’s vote, says psychiatrist Rachel Yehuda at the Icahn School of Medicine at Mount Sinai in New York City, who was not on the committee. “It was very disappointing.” She says the experts brought up good points over the eight-hour hearing, particularly about safety of people receiving treatment. She hopes that the FDA will look for ways to address these concerns instead of simply denying the drug. “I want us to have learned from the committee’s wisdom.” The FDA is expected to issue a decision in August.

In a statement Lykos said, “While we are disappointed in the vote, we are committed to continuing to collaborate with the FDA with their ongoing review of our [new drug application] over the coming weeks.”

This article is reproduced with permission and was first published on June 5, 2024 .

20 Positive Psychotherapy Exercises, Sessions and Worksheets

The word “psychotherapy” often evokes images of nerve-wracked patients reclining on couches, a stern therapist with furrowed brows and a notepad, and a deep uneasiness linked to the identification and analysis of every childhood trauma you have suffered, whether you remembered it before the session or not.

Although this is an outdated and largely inaccurate idea of psychotherapy, it still may seem counterintuitive to combine positive psychology with psychotherapy.

Psychotherapy is typically reserved for those with moderate to severe behavioral, emotional, or personality issues—not people who are often happy and healthy, and also struggle with occasional stress.

How can this type of therapy, which deals with such serious and difficult subject matter, possibly be considered “positive?”

Fortunately, many respected psychologists have been working to develop a useful and evidence-based positive approach to psychotherapy over the last two decades.

These pioneering researchers have married the research of positive psychology and the science and practice of psychotherapy into a life-affirming alternative to traditional psychotherapy—one that focuses on your strengths instead of your weaknesses, and works towards improving what is good in life instead of mitigating that which is not (Seligman, Rashid, & Parks, 2006).

It does not replace traditional psychotherapy, but can act as an extremely effective supplement to help a person move from “just getting by” to flourishing and thriving! For more on this effective ‘supplement’, we share a variety of exercises, tools and a range of therapy sessions.

Before you continue, we thought you might like to download our three Positive Psychology Exercises for free . These science-based exercises will explore fundamental aspects of positive psychology including strengths, values, and self-compassion, and will give you the tools to enhance the wellbeing of your clients, students, or employees.

This Article Contains:

5 positive psychotherapy exercises and tools, 15 sessions – exercises and tools, a take-home message.

Here is an overview of some of the most effective exercises and tools in a positive psychotherapist’s toolbox.

1. Gratitude Journal

One of the simplest yet most effective exercises in positive psychology is a  gratitude journal . Evidence has shown that developing gratitude for the things in your life that you may otherwise take for granted, can have a big impact on your outlook and satisfaction with your life (Davis et al., 2016; Sheldon & Lyubomirsky, 2006).

The practice of keeping a gratitude journal is quite simple and easy to explain to a client who might need a boost in positive emotions.

As a therapist or other mental health professional, instruct your client to do the following:

• Get a notebook or journal that you can dedicate to this practice every day.
• Every night before bed, write down three things that you were grateful for that day.
• Alternatively, you can write down five things that you were grateful for on a weekly basis.
• Encourage them to think of particular details from the day or week, rather than something broad or non-specific (i.e., “the warm sunshine coming through the window this afternoon” rather than “the weather”).

If your client is having trouble thinking of things they are grateful for, tell them to try thinking about what their life would be like without certain aspects. This will help them to identify the things in their life they are most grateful (Marsh, 2011).

2. Design a Beautiful Day

Who doesn’t want to design a beautiful day for themselves?

This exercise is not only fun for most clients, but it also carries a double impact: the planning of the near-perfect day, and the actual experience of the near-perfect day.

As a counselor or therapist, encourage your client to think about what a beautiful day means to them.

What do they love to do? What do they enjoy that they haven’t had a chance to do recently? What have they always wanted to do but have never tried?

These questions can help guide your client to discover what constitutes a beautiful day to them. Direct your client to pick a day in the near future and design their day with the following tips in mind:

• Some alone time is fine, but try to involve others for at least part of the day.
• Include the small details that you are looking forward to in your plan, but don’t plan out your entire day. Leave some room for spontaneity!
• Break your usual routine and do something different, whether it’s big or small.
• Be aware that your beautiful day will almost certainly not go exactly as planned, but it can still be beautiful!
• Use mindfulness on your beautiful day to soak in the simple pleasures you will experience throughout the day.

3. Self-Esteem Journal

The self-esteem journal is another straightforward but effective exercise for clients suffering from feelings of low self-worth.

This Self-Esteem Journal For Adults provides a template for each day of the week and three prompts per day for your client to respond to, including prompts like:

• Something I did well today…
• Today I had fun when…
• I felt proud when…
• Today I accomplished…
• I had a positive experience with…
• Something I did for someone…

The simple act of noticing and identifying positive things from their day can help clients gradually build their self-esteem and enhance their wellbeing. Sometimes all we need is a little nudge to remember the positive things we do!

4. Mindfulness Meditation

Mindfulness meditation can be an excellent tool to fight anxiety, depression, and other negative emotions, making it a perfect tool for therapists and counselors to use with their clients.

To introduce your client to mindfulness meditation, you can try the “ mini-mindfulness exercise ,” a quick and easy lesson that only takes a few minutes to implement.

Follow these steps to guide your client through the process:

• Have your client sit in a comfortable position with a dignified but relaxed posture and their eyes closed. Encourage them to turn off “autopilot” and turn on their deeper awareness of where they are, what they are doing, and what they are thinking.
• Guide them through the process of becoming aware of their breath. Instruct them to take several breaths without trying to manipulate or change their breathing; instead encourage them to be aware of how it feels as they inhale air through the nostrils or mouth and into the lungs, as they hold the air for a brief moment, and as they exhale the air again. Direct their attention to how their chest feels as it rises and falls, how their belly feels as it expands and contracts, and how the rest of their body feels as they simply breathe.
• Direct your client to let their awareness expand. Now, they can extend their focus beyond their breath to the whole body. Have them pay attention to how their body feels, including any tightness or soreness that may be settled into their muscles. Let them be present with this awareness for a minute or two, and tell them to open their eyes and continue with the session or with their day when they are ready.

Once your client is introduced to mindfulness meditation, encourage them to try it out on their own. They may find, as so many others have, that mindfulness can be a great way to not only address difficult or negative emotions but maintain positive ones throughout the day as well.

5. Values in Action Inventory of Strengths (VIA-IS)

The VIA-IS is one of the most commonly used tools in positive psychology, and it has applications in positive psychotherapy as well. Completing this questionnaire will help your clients identify their dominant strengths— allowing them to focus their energy and attention on using their inherent strengths in their daily life, instead of getting distracted by the skills or traits they may feel they are lacking.

The VIA-IS is reliable, validated, and backed by tons of scientific research, and best of all – it’s free to use (Ruch, Proyer, Harzer, Park, Peterson, & Seligman, 2010).

Direct your clients to the VIA website to learn about the 24 character strengths and take the VIA-IS to discover their own top strengths.

These strengths are organized into six broad categories as follows:

Wisdom and Knowledge

• Creativity;
• Love of learning;
• Perspective.
• Perseverance;
• Social intelligence.
• Leadership.
• Forgiveness;
• Self-regulation .

Transcendence

• Appreciation of beauty and excellence;
• Gratitude ;
• Spirituality.

Once your client has taken the survey and identified their top 5 strengths , instruct them to bring in their results and have a discussion with them about how they can better apply these strengths to their work, relationships, recreation, and daily life.

The order of sessions outlined below is merely suggestive but there are some essential components that should be maintained to increase long term effectiveness and enhance learning.

While every session introduces new exercises and tools, it is also recommended that some form of restorative technique is used at the beginning and at the conclusion of every session.

For each session, we also suggest one homework assignment to facilitate maintenance in between sessions.

If you are a therapist who regularly assigns homework to your clients, we recommend checking out the platform Quenza to help digitize and scale this aspect of your therapy practice.

The platform incorporates a simple drag-and-drop builder that therapists can use to craft a range of digital activities for their clients to complete in between therapy sessions. These activities can include audio meditations, reflections, self-paced learning modules, and more.

Once done, the therapist can then share these activities directly to their clients’ devices, such as the Daily Reflection on the right, track their progress using Quenza’s dashboard, and send follow-up reminders to complete the activities via push notification.

Additionally, one size does not fit all when introducing any practice including mindfulness, so fit should be carefully considered and special attention should be paid to cultural considerations.

Session I – Positive Inception

Goal : Exploration of strengths and positive attributes is accomplished by inviting the client to share a personal story that shows them at their best as a form of introduction.

Tool : Positive Introduction prompt

Rationale : Initial session is intended to set a positive tone for the on-going practitioner-client interaction. Building rapport both at the outset and throughout the relationship are key factors to better outcomes from a therapeutic process.

One positive psychotherapy practice recommended for this session is a positive introduction. A positive introduction is based on principles of Appreciative Inquiry and involves asking a client to recall a positive event in his or her life that ended very well.

Positive memories can generate positive emotions and improve mood regulation. Positive narratives also help restore healthier self-concept and allow the client to build resources in terms of new ideas and perspectives (Denborough, 2014).

In-session Resources:

• Positive Introduction

Describe an event in your life where you handled a difficult situation in a positive way and things turn out well. It does not have to be a major event but try to think of something that brought out the best in you. Write about the situation in form of story with a beginning, middle and positive end: ____________

Discussion questions:

• Tell me how this event influenced how you see yourself?
• What about you specifically helped you deal with this situation?
• Are other people aware of this story in the way you described it?

Homework : As homework, clients can create anchors out of these positive memories by collecting pictures or artifacts that remind them of the pleasant memory. The practitioner can also provide the client with an option to seal this positive introduction in an envelope to be opened at a later date and kept by the practitioner for safekeeping.

Lastly, the client should be encouraged to write similar stories and keep them handy for a quick pick me up.

Practitioner can also suggest that client asks others to share their inspiring stories, that client share more stories like this one and pay attention to what they say about themselves, what themes keep recurring, how their stories change depending on audience, what role they play in their own stories and whether they are a victim or a survivor.

Clinician notes:

Pay careful attention and take notes as the narratives will tend to form sequences.

If a client has a difficulty recalling positive events, they can ask family or friends to recall for them or they can tell a story of someone they admire.

Session II – The Powers Within

Goal : To assess signature strengths and to cultivate engagement through daily activities by choosing tasks that speak to one’s strengths.

Tool : Signature Strengths Assessment

Rationale : Exercising specific strengths can facilitate goal progression and contribute to wellness and personal growth (Linley, Nielsen, Gillett, & Biswas-Diener, 2010). Psychology of motivation teaches us that there are keystone habits that spark positive changes in other areas related to the one being made, so can certain strengths support the healing and growth process. Strength assessment is given, and the concept of engagement is explained.

Preparation:

Prior to the session, the client should ask three people to report on their strengths.

In-session Worksheets:

• Your Core Values

Read carefully the descriptions of 24 character strengths below. They can be found in the VIA Institute on Character website .

Circle 5 of the strengths that you find yourself exercising most often and that you feel characterize you the most:

List your 5 signature strengths and then answer questions and prompts to determine the key markers of your signature strengths.

• Authenticity: Is this strength a part of who I am at the core?
• Enthusiasm: While using this strength I feel excited and joyous.
• Learning: Is it natural and effortless for me to use this strength?
• Persistence: I find it difficult to stop when I use this strength.
• Energy: When I use this strength, do I feel invigorated and full of zest?
• Creativity: Do I find new ways and design projects to use this strength?

Pick one or two and try to describe specific experiences or anecdotes associated with expression of that strength: _____________

Now consider the client’s peer feedback. The reports will probably not be identical, but some significant overlap is highly likely.

Circle any areas of considerable overlap and try to identify the following:

• Signature strengths – these have been mentioned several (3-4 times) by the client’s feedback providers
• Potential blind spots – strengths mentioned by others, but not the client themselves.
• How confident do you feel about knowing your signature strengths after completing the assessment?
• How well do your strengths reflect your personality?
• Which of the strengths you identified have always been there and which have you acquired at some point in your life?
• Which signature strengths stood out for you in terms of specific markers like authenticity, energy or learning?

Homework : Instruct clients to take VIA strengths survey assessment and ask that they observe if using signature strengths produces greater engagement.

Clinician notes :

Reminders are tangible cues in our environment that focus our attention on a particular commitment we made. Reminders help anchor a new habit of thought and behavior.

They can be simple or more complicated and creative like a screen saver on the clients’ phone, a bracelet or a keychain that reminds them of their signature strengths, a picture on the wall of the person who motivates them or an entry in their planner with times for a podcast that encourages them to practice and reflect.

Session III – Amplify Your Internal Assets

Goal : To gain a deeper understanding of optimal levels of usage of strengths. Use your signature strengths to be happier as well as to develop skills. Use your strengths to manage your negatives.

Tool : Optimizing Strengths exercise

Rationale : Biswas-Diener, Kashdan, and Minhas (2011) argue against just identifying one’s strengths as it represents a fixed mindset and decreases motivation. He suggests that we should treat strengths as “potentials for excellence” to foster belief in the possibility of improvement where therapy can lead us to develop them further.

Development of practical intelligence can be initiated through considering how client’s strengths can be translated into concrete purposeful actions that enhance commitment, engagement and problem-solving.

• Optimizing Strengths

Read the common scenarios below and reflect on the potential of under and overuse of strengths:

• Someone is feeling sad or appears disinterested and apathetic
• Someone obsesses over small details and worries too much about things you perceive as insignificant
• Someone is always volunteering and takes on too many commitments and projects
• Someone is often playful and humorous
• Some fail to confront another for inappropriate behavior

Discussion questions :

• What behaviors let you know you’re overusing or underusing your strengths?
• What specific circumstances trigger your overuse or underuse of strengths?
• What cultural or personal history factors could reinforce your over- or underuse of strengths?
• If you’re overusing one strength, what other strength could counterbalance that overuse?

For between sessions assignment, ask the client to describe a current challenge and then reflect on the following questions:

• Is it due to overuse or underuse of strengths?
• What aspects of this challenge would you like to change?
• What strengths can you use in this situation?
• What are the implications on others of using these strengths?
• In what way can you calibrate the use of these strengths to improve the situations?

In imparting practical wisdom strategies make sure clients perceive this as the development of a strength, not merely as use of a well-developed strength. Practical wisdom strategies are:

• Translate strengths into specific actions and observe the outcome
• Consider if strengths are relevant to the context
• Resolve conflicting strengths through reflecting on the possible outcomes of the use of these strengths
• Consider the impact of your strengths on others
• Calibrate according to changing circumstances

Session IV – You at Your Best

Goal : Visualize a better version of yourself.

Tool : You at Your Best Worksheet

Rationale : Our visions of who we wish to become in the future, be it our best selves, our ideal selves or simply our better selves, reflect our personal and professional goals and are created by imagining a better version of who we are today and then striving toward it.

Cultivating and sustaining desirable action can bring us closer to that future self and it may require that we refrain from behaviors that deter us and change old habits that don’t serve us.

Ideal selves reflect our hopes, dreams, and aspirations, and speak to our skills, abilities, achievements, and accomplishments that we wish to attain (Higgins, 1987; Markus & Nurius, 1986).

Research supports this phenomenon of movement toward ideal selves and shows that it predicts many positive outcomes: life satisfaction, emotional wellbeing, self-esteem, vitality, relational stability, relational satisfaction (Drigotas, 2002; Drigotas, Rusbult, Wieselquist, & Whitton, 1999; Kumashiro, Rusbult, Finkenauer, & Stocker, 2007; Rusbult, Kumashiro, Kubacka, & Finkel, 2009).

• You At Your Best

1. Find your story.

Recall a recent time or event when you were at your absolute best. You might have been overcoming a serious challenge, or perhaps you made someone else’s life better.

Think about what made you feel happier, more alive. Maybe you were:

• more relaxed,
• more grounded,
• more enthusiastic,
• more energized,
• more engaged,
• more creative,
• more connected,
• more reflective,

Describe your story as clearly as possible, allowing the details in your narrative to demonstrate your strengths and values.

What happened? What was your part in it? How did you feel?

3. Beginning, Middle, End

Craft your narrative with a start, middle, and powerful ending. It may help to replay the experience in your mind as it happened.

Highlight or circle any words that you feel might relate to your personal strengths.

5. Find your Strengths

List the strengths you’ve identified from the exercise.

• How can you move toward this better version of you?
• How can you use your signature strengths?
• What concrete action can you commit to?
• What barriers do you see and what and who can help?
• How different is your life once you’ve made the change?

Homework : Commit to specific actions for the week. Name someone who is willing to support you. Decide on how often this person will check in on your progress and how.

Clinician notes : Remind the client that less is more, and that a long list is bound to fail because cognitive overload is likely to lead them to do nothing. Modest aspirations translate into small wins that lead to gradual change. Reinforcing new behaviors takes time and failure is a normal part of the process. Remind the client that they are more likely to succeed on their fifth or sixth attempt.

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Session V – Positive Reappraisal

Goal : Open and closed memories are reappraised through four different methods.

Tools : Open and Closed Memories Questionnaire, Positive Reappraisal exercise

Rationale : Personal written disclosure is employed to explore resentment and painful memories and to encourage cognitive processing using your strengths in order to re-file them so that they don’t drain your energy.

The purpose of positive appraisal is not to change the event or the person involved in these negative memories but to refile then in a way that does not continue to drain us emotionally or psychologically.

• Open and Closed Memories Questionnaire

Please answer the following questions to determine if you have open memories:

• Does my past prevent me from moving forward?
• Does your open or negative memory involve someone who harmed you and you find yourself thinking about this person or the consequences of their actions?
• What are the advantages and disadvantages of engaging in this processing of painful memories?
• Have you sought another person’s perspective on this issue?

Now apply the following positive reappraisal strategies to one of your memories:

• Create some distance. One way to create a psychological space between you and your negative memory is to describe from this person’s perspective to allow yourself to revise the meaning and the feelings around it. Imagine yourself as a journalist or a fly on the wall and describe your open memory from a vantage point of a third person while keeping a neutral expression.
• Reinterpret by focusing on subtle aspects of the memory and deliberately recall any positive aspects you may have missed while keeping the negatives at bay. Think of your values in life and how those can be infused in how you remember.
• Step back and observe your memory unfold with a non-judgmental receptive mind and shift focus to internal and external experiences evoked by the memory. See if you can allow your memory to pass by.
• Divert your attention to a different task that is engaging.
• Which strategy was most beneficial?
• Which strategy was difficult to do?
• How has this experience put your life in perspective for you?
• How has this event benefited you as a person?
• What personal strengths grew out of this experience?
• How has this experience helped you see differently what and who is important in your life?

Homework : Apply one of the strategies to a new challenge and reflect on it in writing before the next session.

Clinician notes : A level of caution needs to be exercised when exploring painful memories. Encourage the client to explore a memory that is not too traumatic. Start the session with a mindfulness practice and ask the client to monitor their emotional state.

Session VI – Forgiveness is Divine

Goal : Model of forgiveness is introduced, and the letter of forgiveness is assigned to transform bitterness.

Tool : REACH Forgiveness worksheet and Forgiveness Letter.

Rationale : Forgiveness is a choice, although not an easy one. It is a gradual process that requires commitment. Decisional forgiveness is only the first step. Empathy is key and ultimately forgiveness is a gift you give to yourself.

Everett Worthington (n.d.), leading research in forgiveness, designed a model that outlines the necessary components of effective emotional forgiveness and the worksheet below is based on his REACH method. You can find an extensive discussion of the psychology of forgiveness in our blog.

One model of forgiveness therapy that places empathy at its center and stresses emotional forgiveness is Worthington’s REACH forgiveness model based on the stress and coping theory of forgiveness. Each step in REACH is applied to a target transgression that the client is trying to change.

R = Recall the Hurt E = Empathize with the Person Who Hurt You A = Give an Altruistic Gift of Forgiveness C = Commit to the Emotional Forgiveness That Was Experienced H = Hold on to Forgiveness When Doubts Arise (Worthington, 2006).

• REACH forgiveness

Follow the reach model in your written narrative of forgiveness:

• R = Recall the Hurt. Close your eyes and recall the transgression and the person involved. Take a deep breath and try not to allow self-pity to take over. Write briefly about what happened: ___________
• E = Empathize with the Person Who Hurt You. People often act in hurtful ways when they feel threatened, afraid or hurt. Do your best in trying to imagine what the transgressor was thinking and feeling and write a plausible explanation for their actions. This part is supposed to be difficult: ___________
• A = Give an Altruistic Gift of Forgiveness. Remember a time when you were forgiven by another person. Describe the event and its effect on you: ____________
• C = Commit to the Emotional Forgiveness That Was Experienced. Commit to a gesture of forgiveness, public or private, either by sharing with someone your decision to forgive or by writing a forgiveness letter that you never send.
• H = Hold on to Forgiveness When Doubts Arise. Recurrence of memories will be normal but the reminder you created above will be helpful in holding onto your decision to forgive. Brainstorm ways in which you can support your resolution as well as those that may deter you.

A key to helping a person develop empathy for the transgressor is to help the client take the perspective of the other person. To assist the client, write the five Ps on a sheet of paper as a cue to the client and ask them to answer the questions using the five prompts:

• Pressures: What were the situational pressures that made the person behave the way he or she did?
• Past: What were the background factors contributing to the person acting the way he or she did?
• Personality: What are the events in the person’s life that lead to the person having the personality that he or she does?
• Provocations: What were my own provocative behaviors? Alternatively, might the other person, from his or her point of view, perceive something I did as a provocation?
• Plans: What were the person’s good intentions? Did the person want to help me, correct me, or have in mind that he or she thought would be good for me, but his or her behavior did not have that effect? In fact, it had just the opposite effect.

Homework : Leslie Greenberg and Wanda Malcolm (2002) have demonstrated that people who can generate fantasies where they vividly imagine the offender apologizing and being deeply remorseful are ones who are most likely able to forgive successfully.

Ask the client to vividly imagine the offender apologizing and then write a letter of forgiveness to this person. The client does not need to do anything with the letter itself.

Clinician notes : Although relaxation techniques should be used at the outset and at the conclusion of every session, this one, in particular, is important.

If the client has a difficulty finding compassion for the transgressor, one of the most effective ways to help a client experience empathy is to use the empty-chair technique.

The client imagines sitting across from the offender, who is imagined to be in an empty chair. The client describes his or her complaint as if the offender were there. The client then moves to the empty chair and responds from the point of view of the offender. The conversation proceeds with the client moving back and forth between chairs.

The objective is to allow the person to express both sides of the conversation personally, and thus experience empathy. In doing so, the person might imagine an apology or at least an acknowledgment of the hurt that was inflicted.

Session VII – Good Enough

Goal : To establish realistic expectations of progress. Good enough mindset and concepts of satisficing versus maximizing are introduced, and an action plan to increase satisficing is devised.

Tool : Maximizer v. Satisficer Assessment, Strategies to Increase Satisficing

Rationale : According to psychologist Barry Schwartz (2004), maximizers always aim to make the best possible choice. They take their time and compare products both before and after making purchasing decisions.

Maximizers are more prone to depression due to overly high expectations and fear of regret. Maximizers, like perfectionists, seek to achieve the best, but perfectionists have high standards that they don’t expect to meet, whereas maximizers have very high standards that they do expect to meet, and, when they are unable to meet them, they become depressed (Chowdhury, Ratneshwar, & Mohanty, 2009; Schwartz et al., 2002).

The questionnaire below will help to assess if your client is a maximizer or a satisficer. There are several techniques for increasing satisficing and developing a “good enough” mindset.

• Maximizer v. Satisficer Assessment

Read the following statements and carefully rate to what degree they are true and descriptive of who you most often are. Rate them on a scale of one to seven, where one means  completely disagree and seven means strongly agree.

Now add the scores for your answers. The average score is 50, the high score is 75 and the low score is 25 or below. If your score is below 40, you are on the satisficing end of the scale. If you scored 65 and above, it is likely you have maximizing type behaviors that may impact your wellbeing. Consider some of the strategies to increase satisficing listed below.

Strategies to Increase Satisficing

To make choices versus simply have choices means to be able to reflect on what makes a decision important, what makes particular choice say about you, or even create new options if no good options are available. To practice these skills, try the following:

• Shorten or eliminate deliberation about decisions that are not important.
• Take the time that has just become available to you to ask yourself what you really want in the areas of life where making decisions really matters.

To generally do more satisficing, try the following:

• Recall the time when you settled for good enough.
• Reflect on how you chose in those areas.
• Apply the strategy to another area.

Reflect on what pursuing all the available opportunities costs you:

• Make a decision to stick with a decision to do something unless you’re truly dissatisfied.
• Resist the urge to go after the new and improved.
• Resolve to combat the fear of missing out.
• Adopt the attitude where you don’t fix what’s not broken.

Imagine there is no going back. Make your decision irreversible and final to limit the amount of time you waste processing the alternatives:

• Make a list of reversible decisions.
• Now pick some of those decisions to be made irreversible.

Practice attitude of gratitude and being grateful for what you have and the good aspects of the choices you have made and resolve not to ruminate what was bad about them:

• Pick a few decisions you’ve made to practice this attitude.

Having regrets can influence our ability to make a decision to a point of us avoiding to make them. Make an effort to minimize regret where appropriate:

• Reduce the number of options before making a decision.
• Focus on what is good about making the decision.
• Identify yourself as a satisficer versus maximizer.

Adaptation, also known as the hedonic treadmill, robs us of satisfaction we can get from a positive experience. Combat adaptation and develop realistic expectations about how experiences change over time:

• Next time you purchase something fully consider how long the thrill of owning it will last.
• Vow to spend less time looking for a perfect match.
• Create a reminder to yourself to appreciate how good things really are versus how they are less than what they originally were.

Lower your expectations. Our satisfaction with experiences is determined to a large extent by our expectations. To increase satisfaction with results, try the following:

• Reduce the number of options you will consider.
• Allow for serendipity.
• Ask yourself what a satisficer would do in this situation.

Beware of social comparisons. Practice not comparing yourself to others as quality of experience can be significantly reduced by comparing yourself to others:

• Focus on what makes you happy and what gives meaning to your life.
• Limit the use of social media when you feel the urge to compare your life to that of others.

Appreciate constrains. Our freedom of choice and ability to decide decreases as our options increase. Our society provides rules by which we are limited in forms of laws and norms of behavior.

• Create your own list of rules that you are willing to practice to increase your ability to make effective choices.
• What does your satisficer versus maximizer score say about you?
• If you scored high, what are the emotional or physical costs of maximizing?
• In what way knowing your tendencies can help you make meaningful changes in your life?

Homework : Ask the client to practice one or more techniques of satisficing throughout the week.

Clinician notes : Repetition just like regular reminders can aid the client in creating lasting change. Together repetitive action and repetition create ritual over time. Encourage clients to build new positive habits of thinking and behaving.

Session VIII – Count Your Blessings

Goal : The notion of counting one’s blessings and enduring thankfulness is discussed, gratitude exercise is introduced, and blessings journal is assigned.

Tool : Three Good Things and Gratitude Visit

Rationale : Extensive research shows that enduring thankfulness has many health benefits (Emmons, 2007). In one clinical study, the gratitude condition participants reported significantly better mental health than those in the expressive and control conditions.

This session introduces the client to the practice of gratitude by counting one’s blessings daily and planning a gratitude visit. Clients are also asked to keep a gratitude journal between sessions.

Three Good Things

Before going to bed, write about three good things that happened to you that day. Reflect on those good things by answering the following questions:

• Why did this good thing happen and what does it mean to you?
• What lessons have you learned from reflecting on this good thing?
• How did you or others contribute to this good thing happening?

Gratitude Visit

Gratitude is oriented toward others. Think of a person to whom you would like to express gratitude. Write a letter to them. Try to be specific in describing the way in which their actions have made an important difference in your life. When finished, arrange a visit with that person without explaining the purpose. Try to make it as casual as possible.

When you see them after you settle in, read your letter slowly, with expression and eye contact. And allow the other person to react unhurriedly. Reminisce about the times and specific events that made that person important to you.

• What feelings came up as you wrote your letter?
• What was the easiest part to write and what was the toughest part?
• Describe the other person’s reaction to your expression of gratitude?
• How were you affected by their reaction?
• How long did these feelings last after you presented your letter?
• How often did you recall the experience in the days following?

Homework : Blessings journal is assigned, and client is asked to write about three good things that happened that day before bedtime every night for a week in a way that was introduced during the session.

Suggest that clients socialize with more people who are grateful and observe if that improves their mood. People who are thankful have a language of future, abundance, gifts, and satisfaction.

You can also ask clients to find ways to express gratitude directly to another person. While doing so, ask them to avoid saying just thank you and express gratitude in concrete terms.

Clinician notes : Considerable effort and time to manage the logistics are required to write a letter and arrange a visit. Be sure to provide clients adequate time and support to complete this practice over the course of therapy. You can discuss the timeline, periodically remind them, and even encourage clients to read their Gratitude Letters so they can make changes and rehearse the experience of writing it and reading it out loud.

Be sure clients have the opportunity to share their experiences of the Gratitude Visit.

Session IX – Instilling Hope and Optimism

Goal : One Door Closes, One Door Opens exercise is introduced and the client is encouraged to reflect on three doors that closed and what opportunities for growth it offered.

Tools : One Door Closes, One Door Opens, and Learning Optimism prompts

Rationale : Essentially, hope is the perception that one can reach the desired goals (Snyder, 1994). Hopeful thinking comes down to cultivating the belief that one can find and use pathways to desired goals (Snyder, Rand, & Sigmond, 2002).

Optimism can be learned and can be cultivated by explaining setbacks in a way that steers clear of catastrophizing and helplessness. Optimistic people see bad events as temporary setbacks and explain good events in terms of permanent causes such as traits or abilities.

Optimists also tend to steer away from sweeping universal explanations for events in their lives and don’t allow helplessness to cut across other aspects of their lives (Seligman, 1991).

Painful experiences can be re-narrated as it is the client who gets to say what it all means. Like a writer, a sculptor or a painter the client can re-create his or her life story from a different perspective, allow it to take a different shape and incorporate light into the dark parts of their experience.

• One Door Closes, Another Door Opens

Think of times when you failed to get a job you wanted or when you were rejected by someone you loved. When one door closes, another one almost always opens. Reflect and write about three doors that closed and what opportunities for growth it offered. Use the following questions to help with your reflections:

• What was the impact of doors that closed?
• Did this impact bring something positive to you? What was it?
• What led to a door closing, and what or who helped you to open another door?
• How did you grow from doors that opened?
• If there is room for more growth, what might this growth look like?

Learning Optimism

Think of something that happened recently that negatively impacted your life. Explore your beliefs about the adversity to check for catastrophizing.

• What evidence do you have that your evaluation of the situation is correct?
• What were the contributing causes to the situation?
• What does this mean and what are the potential implications?
• How is the belief about the situation useful to you?
• When a door closes, how do you explain the causes of failure to yourself?
• Regarding your happiness and wellbeing, what were the negatives and positives of this adversity?
• Was the impact of this setback all-encompassing or long-lasting?
• Was it easy or hard for you to see if a door opened, even just a crack?
• What does the closed door represent for you now?
• How did the One Door Closes, Another Door Opens practice enhanced your flexibility and adaptability?
• Do you think that deliberate focus on the brighter side might encourage you to minimize or overlook tough realizations that you need to face?
• Would you still like the door that closed to be opened, or do you not care about it now?

Homework : As a weekly exercise explain and write down your broad outlook on life in one or two sentences and then monitor if daily stressors have an impact on your overall perspective. If so, brainstorm ways to help your perspective remain constant.

Alternatively, to practice hope, ask the client to reflect on one or two people who helped to open the doors or who held the opened doors for them to enter.

And to practice optimism, ask the client to help a friend with a problem by encouraging him or her to look for the positive aspects of the situation.

Clinician notes : The benefits of optimism are not unbounded, but they do free us to achieve the goals we set. Our sense of values or our judgment is not eroded by learning optimism , it is enhanced by it.

Suggest to your clients that if rumination keeps showing up, they consider positive distraction and volunteer the time they normally spend analyzing problems to endeavors that make an impact on the world. Not only will they distract themselves in a positive way but may also gain a much-needed perspective on their problems.

Session X – Resilience

Goal : Posttraumatic growth (PTG) is introduced and practiced through writing therapy.

Tool : Expressive Writing

Rationale : Many patients following trauma develop Posttraumatic Stress Disorder (PTSD), but many also experience Posttraumatic Growth (PTG). Without minimizing the pain and while respecting clients’ readiness, exploration of the possibility for growth from trauma can help them gain insight into the meaning of life and the importance of relationships.

Research shows that PTG can lead clients to:

• mitigate the feelings of loss or helplessness (Calhoun & Tedeschi, 2006)
• develop a renewed belief in their abilities to endure and prevail
• achieve improved relationships through discovering who they can really count on
• feel more comfortable with intimacy (Kinsella, Grace, Muldoon, & Fortune, 2015)
• have a greater sense of compassion for others who suffer
• develop greater appreciation for life (Jayawickreme & Blackie, 2014; Roepke, 2015)
• enhanced personal strength and spirituality (Fazio, Rashid, & Hayward, 2008)

Positive reinterpretation, problem-focused coping, and positive religious coping facilitate PTG. Although time itself doesn’t influence PTG as it remains stable over time, intervening events and processes do facilitate growth.

James Pennebaker’s strategy, known as the Writing Therapy, showed that writing about a traumatic or upsetting experience can improve people’s health and wellbeing (Pennebaker, & Evans, 2014).

While assuring complete confidentiality, clients are asked to write for 15 to 30 minutes for three to five consecutive days about one of their most distressing or traumatic life experiences in detail and to fully explore their personal reactions and deepest emotions.

• Expressive Writing

Using a note pad or journal, please write a detailed account of a trauma you experienced. In your writing, try to let go and explore your deepest thoughts and feelings about the traumatic experience in your life. You can tie this experience to other parts of your life, or keep it focused on one specific area.

Continue to write for at least 15 to 20 minutes a day for four consecutive days. Make sure you keep your writings in a safe, secure place that only you have access to. You can write about the same experience on all four days or you can write about different experiences.

At the end of four days, after describing the experience, please write if the experience has helped you with the following:

• understand what the experience means to you.
• understand your ability to handle similar situations.
• understand your relationships in a different light.
• What was the most difficult part of writing?
• Do you agree that even though it may have been difficult, it was still worth writing?

Some reactions to the trauma, adversity, or losses can be so strong that we deliberately avoid associated feelings.

• Did the writing process help you see this avoidance if any?
• Did writing help you to visualize growth in terms of your perspective on life?
• Did you experience healing or growth, despite having the lingering pain of the trauma or loss?

Homework : Ask the client to continue writing for three more consecutive days for 15 to 30 minutes each time. Remind the client to make sure to keep their writings in a safe, secure place that only he or she has access to. They can write about the same experience on all four days or they can write about different experiences.

Clinician notes : To better understand the context in which clients are living, the practitioner should continue discussing therapeutic changes with clients without necessarily asking about growth. It also helps to accept the fact that it may be difficult to pinpoint the start and end that marks when growth from trauma occurs.

Focusing on themes of change may help identify when additional support is needed to amplify PTG while keeping in mind that some clients for reasons outside of their control will not continue to experience long-term growth.

Session XI – Taste for Life

Goal : Tendencies toward busy behavior are assessed and savoring exercise is assigned based on the client’s preference and strategies to safeguard against adaptations are discussed.

Tool : Busy Behavior Assessment and Savoring Techniques

Rationale : According to Carl Honoré (2004), we live in a multitasking era where we have become addicted to speed. Evidence shows that people who are cognitively busy are also more likely to act selfishly, use sexist language, and make erroneous judgment in social situations.

On the other hand, research also shows that when people are in a relaxed state, the brain slips into a deeper, richer, more nuanced mode of thought (Kahneman, 2011). Psychologists actually call this “Slow Thinking,” and one method for achieving this cognitive state it to practice what is known as savoring .

Fred Bryant, a pioneer in savoring, defines it as a mindful process of attending to and appreciating the positive experiences in one’s life (2003). Bryant describes four types of savoring: basking, thanksgiving, marveling, and luxuriating. Research shows that savoring fosters:

• positive emotions
• increases wellbeing
• deepens a connection to the meaningful people in our lives.

Savoring requires effort that involves deliberately working against the pressures to multitask. Learning to savor requires time and becomes more natural the more we practice it.

Kinds of Savoring Experiences:

• Basking  is about taking great pleasure or satisfaction in one’s accomplishments, good fortune, and blessings
• Thanksgiving is about expressing gratitude and giving thanks
• Luxuriating is about taking great pleasure and showing no restraint in enjoying physical comforts and sensations
• Marveling is about becoming filled with wonder or astonishment: beauty often induces marveling and exercising virtue may also inspire it
• Mindfulness is a state of being aware, attentive, and observant of oneself, one’s surroundings and other people.
• Busy Behavior Assessment

Reflect on whether or not you find yourself constantly busy and how this manifest in your daily life by answering the following questions:

• Do you multitask or find yourself constantly short on time?
• What are some of the signs of being busy and living life in the fast track: information overload, time crunch, overstimulation, underperforming, anxiety, and multitasking?
• Which ones of these do you experience?
• Reflect on what drives your busy behavior.
• Do you believe that these drivers are internal, external, or a combination of both?

Savoring Techniques

Practice the following strategies to increase savoring. All of the strategies to slow down mentioned here require active engagement. Select one or two of the following Savoring Techniques:

• Sharing With Others: Seek out others to share an experience. Tell them how much you value the moment (this is the single strongest predictor of pleasure.)
• Memory Building: Take mental photographs or even a physical souvenir of an event and reminisce about it later with others.
• Self-praise: Share your achievements with others and be proud. Do so in a way that is authentic and honest in celebrating your persistence in maintaining focus in achieving something meaningful to you.
• Sharpening Perceptions: Focus deliberately on certain elements and block out others. For example, most people spend far more time thinking about how they can correct something that has gone wrong than they do basking in what has gone right.

Brainstorm specific actions you will take to practice one or more of these techniques and think about who will support you or what can inhibit your progress.

Discussion questions : When, where, and how frequently can you use it to increase positive emotions in your daily life?

Homework : Pick a favorite or a different savoring technique and practice it between sessions. Reflect and write your personal list of actions which can sustain and enhance savoring.

Clinician notes : Savoring requires practice and some clients may struggle with savoring practices because they overthink the experience which tends to interfere with their ability to notice and attend to their senses.

The focus of the Savoring practices is positive but if the clients are feeling distressed, see if they are able to put aside their negative thoughts and feelings by using the diversion strategy from Session Five: Open and Closed Memories to optimally benefit from this exercise.

Clients should attend mindfully to all aspects of a savoring experience, including its cognitive, affective, and behavioral aspects. However, tuning in too much to feelings or thoughts may backfire and could interfere, eventually dampening the savoring experience so encourage the client to monitor their experiences for adaptation.

Session XII – People Matter

Goal : Seeing best in others and developing strategies for cultivation of positive relationships

Tool : Strength Spotting Exercise

Rationale : Recognizing the strengths of one’s loved ones has been proven to have significant positive benefits on relationships and wellbeing of those who practice it actively.

Understanding one another’s strengths foster a greater appreciation for each person’s intentions and actions and promote empathy. Ultimately, positive relationships buffer us against stress. The central positive psychotherapy (PPT) practice covered in this session is learning to see strengths in others and creating a Tree of Positive Relationships.

• Strengths Spotting

Answer the following questions about people you have close relationships with:

• Who in your immediate or extended relationships always appears to be the most hopeful and optimistic person?
• Who in your relationship circles has the most humorous and playful disposition?
• Who in your relations is the most creative person?
• Who is always cheerful, bubbly, and smiley?
• Who is the most curious person?
• Who always treats others fairly and squarely?
• Who is the most loving person in your family or friends?
• Who among your loved ones loves to create new things?
• Who is a good leader?
• Who in your relations is the most forgiving person?
• Who among your loved ones shows balanced self-regulation?
• What behaviors, actions, or habits does your partner exhibit to denote the strengths you identified?
• Do you share strengths with each other?
• Discuss any you share as well as ones you don’t.
• In what ways do your strengths complement each other?
• Did you also look at your partner’s and your bottom strengths?
• What can you learn from those?

Homework : If practical, ask your family and friends to take the VIA strengths survey. Create a Tree of Positive Relationships to help you and people you are close to gain greater insight into each other’s strengths.

Encourage clients to have uninterrupted, quality conversations with their loved ones at least once per week.

Clinician notes : To maintain progress, suggest that clients brainstorm a way to celebrate each other’s strengths. Suggest they focus on bonding activities that establish communication patterns, routines, and traditions both through daily, casual ways of enjoying each other’s company as well as more elaborate planned celebrations and vacations.

Session XIII – Politics of Wellbeing

Goal : Positive communication is addressed through learning about Active Constructive Responding and client is encouraged to look for opportunities to practice.

Tool : Active Constructive Responding (ACR)

Rationale : Shelly Gable and her colleagues found that sharing and responding positively to good events in our lives increases relationship satisfaction and strengthens our bonds (2004). When we capitalize on positive events in our lives by allowing others to partake in the good news not only do we amplify it, but also increase feelings of being valued and validated.

• Active Constructive Responding (ACR)

Read carefully the following descriptions of different styles of responding to good news. Check off which type of responses you identify with most of the time.

• When I share good news, my partner responds enthusiastically.
• Sometimes my partner is more excited about my wins than I am.
• My partner shows a genuine interest and asks a lot of questions when I talk about good events.
• My partner is happy for me but does not make a big deal out of my sharing positive news.
• When good things happen to me, my partner is silently supportive.
• Although my partner says little, I know she is happy for me.
• Often when I share good news, my partner finds a problem with it.
• My partner often sees a downside to the good events.
• My partner is often quick to point out the downside of good things.
• I’m not sure my partner often cares much.
• I often feel my partner doesn’t pay attention to me.
• My partner often seems uninterested.

Now let us try ACR in session. We will take turns sharing good news and then allowing the other person to respond. Think of something positive and recent that happened to you and tell me about it.

• What can you learn about yourself from identifying your response style?
• Are there any barriers that hinder you in engaging in ACR? They can be subjective or objective such as your personality style, preferences, and family of origin, culture, beliefs, or interpersonal dynamics.
• Should you already engage in some sort of ACR, what can you do to take it to a higher level?
• If you find that ACR doesn’t come naturally to you, what small steps can you take to adopt some aspects of this practice that are consistent with your disposition?
• Identify individuals or situations that display all four responding styles.
• What effects do you notice of each style both on sharer and responder?

Homework : Ask the client to practice ACR beyond his intimate relationships and use it with family member and friends.

Clinician notes : If the client is proficient in ACR, consider expanding the practice of positive communication into positive affirmations where partners offer each other words and actions that confirm the partners’ beliefs about themselves and behave in ways that are congruent with their partner’s ideal self (Drigotas, 2002).

Ask the client to practice perceptual affirmations where partners’ general view of each other is aligned with their ideal self, where we perceive our partners as trying their best, where we are forgiving of shortcoming and sympathize with the pain of failure, and finally, where we shine the light on qualities.

Ask the client to also practice behavioral affirmations where partners elicit behaviors that are in congruence with the other person’s ideal selves as well as create opportunities for expression of those ideal selves while decreasing situations that can negate them and behaviors that conflict.

This paves the way toward movement in the direction of being the most valuable self through skill development and reflection on aspirations congruent with deeply help hopes and dreams.

Session XIV – Gift of Time

Goal : Therapeutic benefits of helping others are introduced and the client is encouraged to Give the Gift of Time in a way that employs their strengths.

Tool : Gift of Time

Rationale : Helping others and practicing altruistic behavior has been shown to significantly increase a sense of meaning and purpose in life. In addition to making a difference, we also benefit from shifting our focus away from ourselves and indulging in our own thoughts (Keltner, 2009).

Research shows that material gifts lose their charm and value over time, but positive experiences and interactions continue to pay dividends through increased confidence that you can, in fact, do good (Kasser & Kanner, 2004).

• Gift of Time

Think of ways in which you could give someone you care about a Gift of Time. Brainstorm ways of doing something that requires a fair amount of time and involves using your strengths. Using your strengths to deliver the gift will make the exercise more satisfying.

• If creativity is your strength, write an anniversary note or make a gift by hand.
• If kindness sets you apart, prepare a dinner or run errands for a sick friend.
• If your humor is your strength, find a way to cheer someone up.

Write about your experience, recalling the details of what was involved in planning and reflect on how it made you feel.

• What feeling came up as you were giving your gift?
• How did you feel after giving your gift?
• What was the reaction of the recipient of your gift?
• What were the positive or negative consequences resulting from giving your gift?
• Did you use one or more of your signature strengths? If so, which one?
• Have you undertaken such an activity in the past? What was it?
• Did you find that it was different this time around? If so, what differences did you notice?
• Have there been times in the past when you were asked to give the Gift of Time and you didn’t want to?
• Have you been a recipient of someone else’s Gift of Time? What was it?
• Are you willing to give the Gift of Time regularly for a particular cause? What cause might this be?
• Do you anticipate any adaptation, and do you think the Gift of Time might not provide as much satisfaction as it did the first time?
• If so, what steps can you take to address this?

Homework : To maintain progress, suggest that the client performs a few random acts of kindness or consider volunteering for a cause they care about in a way that would allow them to use their strengths.

Clinician Note : Exercise caution if the self-care of clients is already compromised and make sure that their altruistic endeavors don’t negatively impact their self-care needs. To help clients decide on the scale of their altruistic endeavors, explore carefully client’s level of distress and wellbeing as it may reveal their exposure to a potential vulnerability.

Session XV – A Life Worth Living

Goal : The concept of a full life is explained as an integration of enjoyment, engagement and meaning and ways of sustaining positive change in the future are devised.

Tools : From Your Past Toward Your Future and Positive Legacy

Rationale : Cultivation of meaning helps us articulate our life goals in a way that integrates our past, present, and future. It provides a sense of efficacy, helps create ways to justify our actions and connects us to other people through a shared sense of purpose.

Cultivating long term life-satisfaction is closely tied to meaningful pursuits and our lives provide opportunities for meaningful stretches if one is willing to look.

In this final session, we combine the positive introduction with a better version of the self, and the hope of leaving a positive legacy.

• From Your Past Toward Your Future

If available, please read your Positive Introduction from Session I. If not, simply recall your story of resilience from our first session. Answer the following questions:

• From the experience of resilience in your Positive Introduction story, what meaning do you derive today? ____
• Which character strengths are most prominent in your story now that you have explored them further? _____
• Do you still use these strengths in everyday life? If so, how? ______
• What does your story of resilience tell you about your life’s purpose? ____
• What creative or significant achievements would you like to pursue in the next 10 years? ____
• If you were to pick one, what makes it most important for you and why? ____
• In what way will this goal make a difference for others? ____
• What steps do you need to take over the next 10 years to accomplish it? Describe what you need to do year by year? ______
• Which of your signature strengths will you use in accomplishing this goal? ____

Positive Legacy

Envision your life as you would like it to be and how you would want to be remembered by others. What accomplishments and strengths would they mention? What would you like your legacy to be? Describe in concrete terms. _____

Now look back at what you wrote and ask yourself if you have a plan that is both realistic and within your ability to do so.

• What was like it to re-read your story of resilience again?
• Would you write it the same way today? If not, what would you change?
• How has your thinking about the purpose and meaning of life changed over the course of our sessions?
• What was the process like for you of reflecting on and then writing about your goals for the future?
• What will your life look like when you accomplish your goals?
• What might happen if you do not accomplish your goals?
• Think of ways you can use your signature strengths to do something that would enable you to leave a Positive Legacy.
• What specific actions would you take to accomplish your short and long-term goals? What is the timeline for completion of these actions?

Homework : Resolve to keep this in a safe place and read it again a year from now. At that point ask yourself if you made progress, if you need to revise your goals, or if new goals have emerged for you.

Clinician notes : Some client may struggle to find purpose and meaning in their life, especially if they are struggling with a significant loss, trauma or severe depression. Nevertheless, it is very important for the client to be asked about meaning. Irvin Yalom (2020), the author of Existential Psychotherapy states that every one of his clients expressed concerns about the lack of meaning in their lives.

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We hope that you found this overview of effective positive psychotherapy tools to be helpful.

What has your experience been using these positive psychotherapy exercises? Leave a comment below. We would love to hear and learn from you.

We hope you enjoyed reading this article. Don’t forget to download our three Positive Psychology Exercises for free .

• Biswas-Diener, R., Kashdan, T. B., & Minhas, G. (2011). A dynamic approach to psychological strength development and intervention.  The Journal of Positive Psychology ,  6 (2), 106-118.
• Bryant, F. (2003). Savoring Beliefs Inventory (SBI): A scale for measuring beliefs about savouring.  Journal of Mental Health ,  12 (2), 175-196.
• Calhoun, L. G., & Tedeschi, R. G. (2006). The foundations of posttraumatic growth: An expanded framework. In L. G. Calhoun & R. G. Tedeschi (Eds.), Handbook of posttraumatic growth (pp. 1-23). Mahwah, NJ: Lawrence Erlbaum Associates.
• Chowdhury, T. G., Ratneshwar, S., & Mohanty, P. (2009). The time-harried shopper: Exploring the differences between maximizers and satisficers.  Marketing Letters ,  20 (2), 155-167.
• Davis, D. E., Choe, E., Meyers, J., Wade, N., Varjas, K., Gifford, A., … & Worthington Jr, E. L. (2016). Thankful for the little things: A meta-analysis of gratitude interventions.  Journal of Counseling Psychology ,  63 (1), 20-31.
• Denborough, D. (2014).  Retelling the stories of our lives: Everyday narrative therapy to draw inspiration and transform experience . New York, NY: Norton.
• Drigotas, S. M. (2002). The Michelangelo phenomenon and personal well‐being.  Journal of Personality ,  70 (1), 59-77.
• Drigotas, S. M., Rusbult, C. E., Wieselquist, J., & Whitton, S. W. (1999). Close partner as sculptor of the ideal self: Behavioral affirmation and the Michelangelo phenomenon.  Journal of Personality and Social Psychology ,  77 (2), 293-323.
• Emmons, R. A. (2007).  Thanks! How the new science of gratitude can make you happier . New York, NY: Houghton Mifflin Harcourt.
• Fazio, R. J., Rashid, T., & Hayward, H. (2008). Growth through loss and adversity: A choice worth making. In S. J. Lopez (Ed.),  Positive psychology: Exploring the best in people, Vol. 3. Growing in the face of adversity (pp. 1–27). Westport, CT: Praeger Publishers/Greenwood Publishing Group.
• Greenberg, L. S., & Malcolm, W. (2002). Resolving unfinished business: Relating process to outcome.  Journal of Consulting and Clinical Psychology ,  70 (2), 406-416.
• Higgins, E. T. (1987). Self-discrepancy: A theory relating self and affect. Psychological Review ,  94 (3), 319-340.
• Honoré, C. (2004). In praise of slow: How a worldwide movement is challenging the cult of speed . London, UK: Orion.
• Jayawickreme, E., & Blackie, L. E. (2014). Post-traumatic growth as positive personality change: Evidence, controversies and future directions. European Journal of Personality ,  28 (4), 312-331.
• Kahneman, D. (2011).  Thinking, fast and slow . New York, NY: Macmillan.
• Kasser, T., & Kanner, A. D. (Eds.). (2004).  Psychology and consumer culture: The struggle for a good life in a materialistic world. Washington, DC: American Psychological Association.
• Keltner, D. (2009).  Born to be good: The science of a meaningful life . New York, NY: WW Norton & Company.
• Kinsella, E. L., Grace, J. J., Muldoon, O. T., & Fortune, D. G. (2015). Post-traumatic growth following acquired brain injury: a systematic review and meta-analysis.  Frontiers in Psychology ,  6.
• Kumashiro, M., Rusbult, C. E., Finkenauer, C., & Stocker, S. L. (2007). To think or to do: The impact of assessment and locomotion orientation on the Michelangelo phenomenon.  Journal of Social and Personal Relationships ,  24 (4), 591-611.
• Linley, P. A., Nielsen, K. M., Gillett, R., & Biswas-Diener, R. (2010). Using signature strengths in pursuit of goals: Effects on goal progress, need satisfaction, and well-being, and implications for coaching psychologists.  International Coaching Psychology Review ,  5 (1), 6-15.
• Markus, H., & Nurius, P. (1986). Possible selves.  American Psychologist, 41 (9), 954-969.
• Marsh, J. (2011, November 17). Tips for keeping a gratitude journal. Greater Good Magazine.  Retrieved from https://greatergood.berkeley.edu/article/item/tips_for_keeping_a_gratitude_journal
• Pennebaker, J. W., & Evans, J. F. (2014).  Expressive writing: Words that heal: Using expressive writing to overcome traumas and emotional upheavals, resolve issues, improve health, and build resilience . Enumclaw, WA: Idyll Arbor.
• Roepke, A. M. (2015). Psychosocial interventions and posttraumatic growth: A meta-analysis. Journal of Consulting and Clinical Psychology ,  83 (1), 129-142.
• Ruch, W., Proyer, R. T., Harzer, C., Park, N., Peterson, C., & Seligman, M. E. (2010). Values in action inventory of strengths (VIA-IS).  Journal of Individual Differences, 31 (3), 138-149.
• Rusbult, C. E., Kumashiro, M., Kubacka, K. E., & Finkel, E. J. (2009). “The part of me that you bring out”: Ideal similarity and the Michelangelo phenomenon. Journal of Personality and Social Psychology, 96 (1), 61-82.
• Schwartz, B. (2004). The paradox of choice: Why more is less. New York, NY: Harper‐Collins.
• Schwartz, B., Ward, A., Monterosso, J., Lyubomirsky, S., White, K., & Lehman, D. R. (2002). Maximizing versus satisficing: happiness is a matter of choice.  Journal of Personality and Social Psychology ,  83 (5), 1178-1197.
• Seligman, M. E. (1991). Learned optimism . New York, NY: AA Knopf.
• Seligman, M. E., Rashid, T., & Parks, A. C. (2006). Positive psychotherapy.  American Psychologist ,  61 (8), 774-788.
• Sheldon, K. M., & Lyubomirsky, S. (2006). How to increase and sustain positive emotion: The effects of expressing gratitude and visualizing best possible selves.  The Journal of Positive Psychology ,  1 (2), 73-82.
• Snyder, C. R. (1994).  The psychology of hope . New York, NY: Free Press.
• Snyder, C. R., Rand, K. L., & Sigmond, D. R. (2005). Hope theory: A member of the positive psychology family. In C. R. Snyder & S. J. Lopez (Eds.), Handbook of positive psychology (pp. 257-276). Oxford, UK: Oxford University Press.
• Worthington Jr, E. L. (2006). Just forgiving: How the psychology and theology of forgiveness and justice inter-relate. Journal of Psychology & Christianity ,  25 (2), 155-168.
• Worthington Jr, E. L. (n.d.). REACH forgiveness of others. Retrieved from http://www.evworthington-forgiveness.com/reach-forgiveness-of-others
• Yalom, I. D. (2020).  Existential psychotherapy . New York, NY: Hachette.

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This article is very informative and comprehensive. It has broadened my knowledge and perspective on Positive Psychotherapy. The exercises can benefit my clients as well as myself in the pursuit of happiness.

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you are a genius!!!!!!

Beautifully executed. Focused on the positive. Clients would feel enthused to pursue it. A positive psychology CBT.

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Revolutionize Your Sessions: Effective Homework for Therapy

The power of therapeutic homework.

In the realm of therapy,  therapeutic homework  is a powerful tool that can revolutionize the effectiveness of sessions. This practice involves assigning specific tasks or exercises for clients to complete outside of therapy sessions, with the aim of enhancing the therapeutic process and promoting progress towards their goals.

Introduction to Therapeutic Homework

Therapeutic homework is a collaborative effort between the therapist and the client. It provides an opportunity for clients to actively engage in their own healing and personal growth. By participating in homework assignments, clients can continue their therapeutic work beyond the confines of the therapy room, allowing for a more comprehensive and holistic approach to treatment. Therapeutic homework can take various forms, including worksheets, journaling, mindfulness exercises, and more.

Benefits of Incorporating Homework into Therapy

Incorporating homework into therapy offers numerous benefits for both clients and therapists. Some of the key advantages include:

• Reinforcing therapeutic concepts : Homework assignments provide an opportunity for clients to reinforce the concepts and skills learned in therapy. By practicing these skills outside of sessions, clients can solidify their understanding and apply them to real-life situations.
• Facilitating continuity and progress : Therapeutic homework ensures that the progress made in therapy extends beyond the limited time spent in sessions. It promotes continuity by allowing clients to work on their goals between sessions, fostering a consistent and ongoing therapeutic process.
• Empowering clients : Therapeutic homework empowers clients by giving them an active role in their own healing journey. It encourages self-reflection, self-awareness, and personal responsibility for their growth and well-being.
• Maximizing session time : By completing homework assignments, clients arrive at therapy sessions prepared and ready to delve deeper into their progress and challenges. This optimizes session time, allowing therapists to focus on addressing specific issues and providing guidance based on the work done outside of therapy.
• Promoting generalization of skills : Homework assignments help clients apply therapeutic techniques and insights to real-life situations. By practicing new skills in their everyday lives, clients can generalize what they have learned and experience positive changes in various aspects of their lives.
• Enhancing self-reflection : Homework assignments that involve journaling or reflective writing encourage clients to engage in self-reflection. This process allows clients to gain deeper insights into their thoughts, emotions, and behaviors, facilitating personal growth and self-discovery.

By incorporating therapeutic homework into the therapeutic process, clients can actively participate in their own healing journey, reinforce therapeutic concepts, and experience continued progress. Therapists, on the other hand, can leverage homework assignments to optimize session time, track client progress, and tailor treatment plans to suit individual needs.

In the following sections, we will explore different types of therapeutic homework and provide guidance on designing effective assignments that align with client goals and preferences. Stay tuned for insights on incorporating technology into therapeutic homework and maximizing the impact of these assignments in the therapeutic process.

Types of Therapeutic Homework

To enhance the effectiveness of therapy, incorporating  therapeutic homework  can be highly beneficial. Therapeutic homework refers to assignments and activities that clients engage in outside of therapy sessions. These assignments are designed to reinforce the therapeutic process, promote self-reflection, and facilitate personal growth. Here are three common types of therapeutic homework:

Cognitive-Behavioral Therapy (CBT) Worksheets

Cognitive-Behavioral Therapy (CBT) is a widely used therapeutic approach that focuses on identifying and modifying negative thoughts and behaviors. CBT worksheets are valuable tools in this process. These worksheets guide clients through various exercises and thought-provoking questions to challenge unhelpful thoughts and develop healthier cognitive patterns. Examples of CBT worksheets include thought records, behavior logs, and cognitive restructuring exercises. These worksheets encourage clients to actively engage in self-reflection and apply the strategies learned in therapy to their daily lives. For a comprehensive collection of CBT worksheets, you can refer to our article on  therapeutic homework resources .

Journaling and Reflective Writing

Journaling and reflective writing provide a powerful outlet for clients to express their thoughts, feelings, and experiences. Through journaling, clients can explore their emotions, gain insights into their behaviors, and track patterns over time. Therapists often encourage clients to write in their journals regularly, allowing them to delve deeper into their inner world and reflect on their progress. Journaling prompts and guided questions can be provided to stimulate self-reflection and facilitate therapeutic growth. Clients can also use their journals to record significant events, moments of gratitude, or positive affirmations. Journaling and reflective writing can be a highly personalized and effective form of therapeutic homework. For more ideas on incorporating journaling into therapy, check out our article on  therapy homework journal .

Mindfulness and Meditation Practices

Mindfulness and meditation practices have gained significant recognition in the field of therapy. These practices involve intentionally focusing one’s attention on the present moment, cultivating awareness, and accepting one’s experiences without judgment. Therapists often assign mindfulness exercises and meditation practices as therapeutic homework. These assignments may include guided meditations, body scans, breathing exercises, or mindful activities like mindful eating or walking. Engaging in regular mindfulness and meditation practices can help clients develop a greater sense of calm, reduce stress, improve emotional regulation , and enhance overall well-being. To explore various mindfulness and meditation exercises, you can refer to our article on  therapeutic homework activities .

By incorporating cognitive-behavioral therapy worksheets, journaling and reflective writing, and mindfulness and meditation practices into therapeutic homework, therapists can empower their clients to actively participate in their own healing and growth. These activities provide clients with opportunities for self-discovery, self-reflection, and the application of therapeutic strategies beyond the therapy room. Remember, when assigning therapeutic homework, it’s crucial to tailor the assignments to the client’s individual goals, set realistic expectations, and provide clear instructions and guidelines. This ensures that therapeutic homework becomes an integral part of the therapeutic journey.

Designing Effective Homework Assignments

Creating effective homework assignments is a crucial aspect of therapy. Well-designed assignments  tailored to client goals ,  setting realistic expectations , and  providing clear instructions and guidelines  can enhance the therapeutic process and enable clients to make meaningful progress.

Tailoring Homework to Client Goals

To ensure the effectiveness of therapeutic homework, it is important to tailor the assignments to the specific goals and needs of each client. By understanding the client’s challenges, strengths, and desired outcomes, therapists can create assignments that directly address their unique circumstances. This personalized approach increases client engagement and motivation, as they can see the relevance of the homework to their therapy journey. For inspiration and ideas on therapeutic assignments, therapists can explore resources such as  therapeutic homework ideas .

Setting Realistic Expectations

Setting realistic expectations is crucial in designing effective homework assignments. It is important to consider the client’s time, energy, and resources available for completing the assignments. Assignments that are too challenging or time-consuming can lead to frustration and reduced compliance. On the other hand, assignments that are too simplistic may not provide enough opportunity for growth. Striking a balance and discussing expectations with the client helps ensure they feel supported and motivated to complete the assignments.

Providing Clear Instructions and Guidelines

Clear instructions and guidelines are essential for clients to understand and execute their homework assignments effectively. Therapists should provide detailed explanations of the task, including step-by-step instructions, expected outcomes, and any specific guidelines to follow. Breaking down complex assignments into manageable steps can help clients feel more confident and capable of completing them. Additionally, therapists can provide examples or visual aids to further clarify the expectations. This clarity reduces confusion and increases the likelihood of successful completion.

By  tailoring homework to client goals ,  setting realistic expectations , and  providing clear instructions and guidelines , therapists can maximize the effectiveness of therapeutic homework. This approach promotes client engagement, motivation, and progress towards their therapeutic goals. For therapists seeking a comprehensive platform to manage and deliver therapeutic homework assignments, tools like a  therapeutic homework portal  can streamline the process and enhance the client experience.

Incorporating Technology into Therapeutic Homework

As technology continues to advance, it has become increasingly common to incorporate it into various aspects of life, including therapy. When it comes to therapeutic homework, technology offers a range of opportunities to enhance the effectiveness and convenience of assignments. Let’s explore some ways in which technology can be incorporated into therapeutic homework.

Online Platforms and Apps

Online platforms and apps provide a convenient and accessible way to assign and manage therapeutic homework. These platforms often offer features such as customizable  therapeutic assignments , progress tracking, and secure communication channels between clients and therapists. By utilizing a  therapeutic homework portal , therapists can easily assign and monitor homework, while clients can access their assignments and provide feedback. This digital approach streamlines the process, making it more efficient and engaging for both parties. For more information on digital therapeutic exercises and activities, visit our article on  digital therapeutic exercises .

Virtual Tools and Resources

Virtual tools and resources can greatly enhance the effectiveness and variety of therapeutic homework assignments. Therapists can take advantage of  virtual therapy assignments  that utilize interactive multimedia, such as videos, audios, and online worksheets. These tools can help clients engage with their therapeutic work in a dynamic and immersive way. Additionally, online platforms often offer a wealth of  therapy homework resources  that therapists can leverage to design customized assignments tailored to their clients’ needs. These resources can include therapeutic worksheets, journal prompts, and other interactive materials. To explore more therapeutic homework ideas, check out our article on  therapeutic homework ideas .

Ensuring Privacy and Security

When incorporating technology into therapeutic homework, it is crucial to prioritize  privacy and security . Therapists should ensure that the chosen platforms and apps adhere to strict privacy standards and comply with relevant regulations. This includes implementing measures to safeguard client data and protect confidential information. It is essential to choose reputable platforms that utilize encryption and secure communication protocols to maintain the privacy and confidentiality of both therapists and clients. For more information on how to securely manage therapeutic homework, refer to our article on  therapy homework privacy .

By incorporating technology into therapeutic homework, therapists can enhance the overall experience for their clients. Online platforms and apps, virtual tools and resources, and a focus on privacy and security can revolutionize the way therapeutic homework is assigned and completed. Taking advantage of these technological advancements can lead to more engaging and effective therapeutic outcomes.

Maximizing the Impact of Therapeutic Homework

To ensure the effectiveness of  therapeutic homework , it is important to focus on client engagement and motivation, tracking progress and evaluating results, as well as collaboration and feedback.

Client Engagement and Motivation

Engaging clients in the therapeutic homework process is essential for its success. Therapists can encourage client engagement by explaining the purpose and benefits of the assigned tasks, ensuring that they understand the relevance to their therapy goals. It is important to foster a sense of ownership and autonomy, allowing clients to actively participate in the selection and design of their homework assignments. By involving clients in this process, they are more likely to be motivated and committed to completing the tasks. Providing positive reinforcement and acknowledging their efforts and progress can also enhance motivation.

Tracking Progress and Evaluating Results

Tracking the progress of clients in completing their therapeutic homework and evaluating the results is crucial for both the therapist and the client. This allows therapists to assess the effectiveness of the assignments and make any necessary adjustments. It is important to establish a system for tracking homework completion, such as using a  therapy homework planner  or  therapy homework tracker . This way, both the therapist and the client can have a clear overview of the tasks completed, the challenges encountered, and the progress made. Regularly reviewing and discussing the homework during therapy sessions provides an opportunity for the therapist and client to reflect on the outcomes and adjust the treatment plan accordingly.

Collaboration and Feedback

Maintaining open lines of communication and fostering collaboration between the therapist and the client is essential for the success of therapeutic homework. Encouraging clients to provide feedback on their experiences with the assignments allows therapists to gain insights into their needs and preferences. This feedback can guide therapists in tailoring future assignments to better meet the client’s goals and preferences. Additionally, therapists should create a safe and non-judgmental space for clients to share their thoughts and concerns regarding the homework. Collaborative discussions about the homework assignments can enhance the therapeutic relationship and ensure that the tasks align with the client’s individual needs and therapy objectives.

By maximizing client engagement and motivation, tracking progress and evaluating results, as well as fostering collaboration and feedback, therapists can optimize the impact of therapeutic homework. This approach enhances the effectiveness of therapy by extending the therapeutic process beyond the therapy session and empowering clients to actively participate in their own healing and growth.

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The FDA is weighing whether to approve MDMA for PTSD. Here's what that could look like for patients.

By Alexander Tin

Edited By Allison Elyse Gualtieri

May 31, 2024 / 2:19 PM EDT / CBS News

Ahead of a key meeting Tuesday to weigh the potential approval of midomafetamine , or MDMA, for patients with post-traumatic stress disorder, the Food and Drug Administration is proposing a new set of restrictions on how eligible patients would be able to get the drug.

Details of the FDA's proposal were published Friday in a set of documents released by the agency ahead of an advisory committee meeting next week. 

After the panel votes, drugmaker Lykos Therapeutics says the FDA is expected to make a decision by Aug. 11 on whether to approve its approach for patients with PTSD: a four-month course of MDMA combined with psychotherapy.

Among the FDA's questions for the committee is whether the benefits of MDMA , combined with the FDA's proposed restrictions on prescriptions for the hallucinogenic drug, will be enough to outweigh its risks.

"Patient impairment is an expected effect from midomafetamine administration and there must be safeguards to mitigate serious harm from patient impairment, similar to the risk mitigation in the clinical trials, to support patient safety," the FDA's reviewers said in a briefing document ahead of the meeting.

Under the proposal, administering MDMA would be restricted to healthcare facilities that agree to ensure at least two providers are onsite to monitor patients while taking the drug.

Patients will need to be monitored for at least eight hours, until they are psychologically stable enough to be discharged to an adult after the session. During the trials, many ended up staying overnight at study sites, being monitored by therapists.

Providers will also need to prepare for some physical risks. In the trials, one participant was hospitalized after MDMA was suspected to have exacerbated a pre-existing heart problem.

Patients will also need to be enrolled in a registry tracking side effects and issues that come up from the sessions, as well as how they are faring following completion of the treatment.

"We are also concerned about worsening of psychological disorders that cause disability or that may lead to hospitalization or death, and suicidal behaviors and ideation," the FDA said.

The drugmaker has also been in talks with the FDA over other steps to curb risks of the drug, like providing the product in only single dose packages aimed at limiting the risk of "nonmedical use," Lykos said in their briefing document .

The FDA often turns to its authority to apply additional restrictions on prescription drugs, dubbed Risk Evaluation and Mitigation Strategies or REMS, to curb the pitfalls of drugs that it thinks would otherwise be too dangerous to approve.

Nasal sprays of hallucinogen esketamine to treat depression, branded as Spravato, were also approved in 2019 under these kinds of REMS restrictions.

Additional restrictions could be imposed by a different agency – the Drug Enforcement Administration – which will be responsible for "rescheduling" the drug. 

The DEA currently deems MDMA or "ecstasy" to be a Schedule I drug, alongside other substances like heroin which the DEA says have "no currently accepted medical use and a high potential for abuse."

Alexander Tin is a digital reporter for CBS News based in the Washington, D.C. bureau. He covers the Biden administration's public health agencies, including the federal response to infectious disease outbreaks like COVID-19.

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F.D.A. Panel Rejects MDMA-Aided Therapy for PTSD

An independent group of experts expressed concerns that the data from clinical trials did not outweigh risks for treatment of post-traumatic stress disorder.

By Andrew Jacobs

An independent advisory panel of the Food and Drug Administration rejected the use of MDMA-assisted therapy for post-traumatic stress disorder on Tuesday, highlighting the unparalleled regulatory challenges of a novel therapy using the drug commonly known as Ecstasy.

Before the vote, members of the panel raised concerns about the designs of the two studies submitted by the drug’s sponsor, Lykos Therapeutics. Many questions focused on the fact that study participants were by and large able to correctly guess whether they had been given MDMA, also known by the names of Ecstasy or molly.

The panel voted 9-2 on whether the MDMA-assisted therapy was effective, and voted 10-1 on whether the proposed treatment’s benefits outweighed its risks.

Other panelists expressed concerns over the drug’s potential cardiovascular effects, and possible bias among the therapists and facilitators who guided the sessions and may have positively influenced patient outcomes. A case of misconduct involving a patient and therapist in the study also weighed on some panelists’ minds.

Many of the committee members said they were especially worried about the failure of Lykos to collect detailed data from participants on the potential for abuse of a drug that generates feelings of bliss and well-being.

“I absolutely agree that we need new and better treatments for PTSD,” said Paul Holtzheimer, deputy director for research at the National Center for PTSD, a panelist who voted no on the question of whether the benefits of MDMA-therapy outweighed the risks.

“However, I also note that premature introduction of a treatment can actually stifle development, stifle implementation and lead to premature adoption of treatments that are either not completely known to be safe, not fully effective or not being used at their optimal efficacy,” he added.

While the vote is not binding on the F.D.A., the agency often follows the recommendations of its advisory panels. A final decision by the agency is expected in mid-August.

MDMA, or methylenedioxymethamphetamine, also sometimes referred to as midomafetamine is a synthetic psychoactive drug that fosters self-awareness, feelings of empathy and social connectedness.

The illegal drug is listed as a Schedule I substance, defined as having no accepted medical use and a high potential for abuse. Should it win F.D.A. approval, federal health authorities and Justice Department officials would have to follow certain steps to downgrade the drug’s listing, much like the process now underway with cannabis .

The D.E.A. might also set production quotas for the drug ingredients, as it does with stimulant medications used to treat ADHD.

With the panel’s focus on such topics as “euphoria,” “suicidal ideation” and “expectation bias,” the daylong session on Tuesday demonstrated the nuances and complexities facing regulators as they grapple with the terra incognita of a therapy that only recently entered mainstream psychiatry after the nation’s decades-long war on drugs.

An added wrinkle: the F.D.A. is a regulator of medications. It does not regulate psychotherapy and has not evaluated drugs whose efficacy is tied to talk therapy.

If approved, MDMA-assisted therapy would be the first new treatment for PTSD in nearly 25 years. The condition, which affects some 13 million Americans, has been implicated in the outsized suicide rates among military veterans, whose suffering has galvanized lawmakers from both parties and prompted a sea change in public attitudes about therapies reliant on psychedelic compounds.

According to the studies submitted by Lykos, patients who received MDMA plus psychotherapy reported significant improvements in their mental health. The most recent drug trial found that more than 86 percent of those who took MDMA achieved a measurable reduction in severity of their PTSD symptoms.

About 71 percent of participants improved enough that they no longer met the criteria for a diagnosis. Of those who took the placebo, 69 percent improved and nearly 48 percent no longer qualified for a PTSD diagnosis, according to the submitted data.

The questions, concerns and evident skepticism voiced by the 10-member panel echoed those raised by agency staff members, who last week issued a briefing document aimed at helping the panel evaluate the efficacy and potential adverse health effects of MDMA therapy.

In her opening remarks, Dr. Tiffany Farchione, director of the F.D.A.’s division of psychiatry, noted the regulatory challenges posed by MDMA, saying “we’ve been learning as we go along.” But in her testimony and in staff documents, she and other agency officials repeatedly noted that the overall study results were significant and lasting.

“Although the application presents a number of complex review issues, it does include two positive studies in which participants in the midomafetamine arm experienced statistically significant and clinically meaningful improvement in their PTSD symptoms,” she said. “And that improvement appears to be durable for at least several months after the end of the acute treatment period.”

Much of the criticism about Lykos’s study designs focused on so-called functional unblinding, a problem that affects many studies involving psychoactive compounds. Although the roughly 400 patients who took part in the studies were not told whether they had received MDMA or a placebo, to reduce the odds of bias in the results, the vast majority were acutely aware of any altered state of mind, leading them to correctly guess which study arm they were enrolled in.

The F.D.A., which worked with Lykos to design the trials, has acknowledged shortcomings in the study designs and recently issued new guidance to address the issues facing psychedelic researchers.

A number of other critical voices emerged in recent months. They include the Institute for Clinical and Economic Review, a nonprofit that examines the costs and effectiveness of medications, which issued a report calling the effects of the treatment “inconclusive” and questioning Lykos’s study results.

Other organizations, like the American Psychiatric Association, have not opposed approval outright, but have called on the F.D.A. to mitigate any potential negative consequences by crafting rigorous regulations, strict prescribing and dispensing controls, and close monitoring of patients.

The F.D.A. staff analysis recommended that approval should be contingent on restricted health care settings, monitoring of patients and diligent reporting of adverse events.

Just before they voted on Tuesday, the advisory panel heard from more than 30 speakers who offered starkly divergent views on the application.

Several critics focused on Rick Doblin, a veteran psychedelics advocate who in 1986 founded the Multidisciplinary Association for Psychedelic Studies, the nonprofit organization that filed the original application for MDMA-assisted therapy with the F.DA. The for-profit company, Lykos Therapeutics, formerly MAPS PBC, would market the drug if it were approved.

Brian Pace, a lecturer at Ohio State University, described the company applying for approval as a “therapy cult” and criticized Mr. Doblin’s public comments highlighting his zeal for psychedelics, including a belief that legalizing and regulating them would bring about world peace.

But the majority of those who spoke in favor of the application offered deeply personal accounts of how MDMA-therapy had largely quieted the symptoms of their PTSD.

Among them was Cristina Pearse, who said she suffered from PTSD after being sexually assaulted when she was 9. Over the years, she said she had been prescribed a litany of psychiatric medications and at one point she attempted suicide.

MDMA therapy, she said, changed her life. “What used to feel like a tsunami of overwhelming panic was now merely a puddle at my feet,” said Ms. Pearse, who started an organization that helps women recovering from trauma.

She ended her testimony by urging the F.D.A. to approve the application.

“How many more people need to die before we approve an effective therapy?” she asked. “As you weigh the risk, please keep in mind that this therapy can save many lives. I lost most of my life to this disease. I’m grateful to reclaim it now. But I wish this was an approved medication decades ago.”

Andrew Jacobs is a Times reporter focused on how healthcare policy, politics and corporate interests affect people’s lives. More about Andrew Jacobs

Advances in Psychedelic Therapy

Psychedelics — though mostly still illegal — have surged in popularity in recent years as alternative treatments for mental health..

After decades of demonization and criminalization, psychedelic drugs are on the cusp of entering mainstream psychiatry , with U.S. combat veterans leading the lobbying effort .

Psychoactive mushrooms, legal in Oregon  but still illegal under federal law, are gaining popularity as therapy tools .

As psychedelics move from the underground to mainstream medicine, clinicians aspiring to work in the field are inducing altered states with deep breathing .

MDMA-assisted therapy , which seems to be effective in reducing symptoms of post-traumatic stress disorder, is inching closer to approval in the United States .

Ketamine has become increasingly popular as a therapy for treatment-resistant depression . But the misuse of the anesthetic drug has spurred F.D.A. warnings .

Many drugs known for mind-altering trips are being studied to treat depression, substance use and other disorders. This is what researchers have learned so far .

While psychedelics are showing real promise for therapeutic use, they can be dangerous for some. Here’s what to know about who should be cautious .